The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

As children, you have probably learnt that paralysis is complete inability to move, sense, touch or control other bodily sensations. But little did we know that paralysis comes in many forms depending on the extent to which a person is immobilized. So, what is the difference between partial and total paralysis?

What is Total Paralysis?
Whether temporary or permanent, paralysis is the inability to move part of the body due to nerve damage. However it does not mean that people with total paralysis cannot move any parts of the body   they can still use their faces and necks. The extensive form of paralysis is typically referred to as quadriplegia, which involves diminished or absence of movement in the trunk, arms, legs, hands and feet. Some common symptoms of total paralysis are as follows:

Difficulty swallowing
Unable to control bowels and bladder
Pain anywhere in the body
No sensation below the site of injury
Difficulty breathing
What is partial paralysis?
A smaller portion of the body is affected by partial paralysis. One of the most common types of partial paralysis is Paraplegia that occurs below the waist. If affects both the legs, hips and other functions. Other forms of partial paralysis can be Monoplegia where a single area like one limb gets affected and Hemiplegia where parts of the body on the same side get affected. Some common symptoms of partial paralysis are as follows:

Inability to walk
Difficulty with sexual functioning
Pain below the site of injury
Unable to feel or move your legs or arms
How to Predict the type of paralysis?
The location of the injury or site of nerve damage will usually determine the type of paralysis. Damages in the cervical spinal cord almost inevitably lead to total paralysis associated with quadriplegia. The higher the injury is located, the more extensive the paralysis will be. Lower injuries commonly lead to partial paralysis. The prognosis is generally much better with this type of paralysis. With proper care and therapy, individuals may experience intermittent difficulties with movement and can regain.

Can paralysis be treated?
Whether it is total paralysis or partial paralysis, the positive prognosis is certainly possible, given the condition of the patient and other factors. Physical therapy involves teaching the brain and spinal cord to work around the damage and also aid neuron healing over time. Paralysis can be classified under a number of ways and the most basic classification is that of partial or complete paralysis. Talk to your doctor to understand what type of paralysis you have and adopt a positive outlook to help you towards recovery.

Partial Vs Complete Paralysis - Know The Difference!

The bones and joints orchestrate very well with each other for smooth movements of various joints and the spine. However, due to various reasons, some identified and others unknown, there could be inflammation of the areas where the bones join the muscles leading to impaired movement. The range of motion could be reduced or it could be painful, thereby, limiting movement. Spondyloarthritis includes a group of inflammatory diseases that involves the bones and joints and enthuses which are areas where the ligaments and tendons attach to the bones. This causes conditions like plantar fasciitis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. The term spondyloarthritis is a blanket term to describe any of the above-mentioned conditions.

Read on to know a little more in detail about it:

Causes: While the exact etiology is not identified for sure, most patients with spondyloarthritis have an autosomal dominant gene (HLA-B27). Chronic infections could trigger the onset of the disease too.

Symptoms:

1. In all forms of spondyloarthritis, there is always inflammation of the spine, joints and entheses. If the fingers or toes are involved, there could be swelling leading to what are typically known as 'sausage digits'.

2. There is sacroiliitis which is inflammation of the joint between the pelvis and the spine, and spondylitis which is inflammation of the joints between the spines. 3. Family history and autosomal dominant gene.

Diagnosis:

A detailed medical history and physical examination form the cornerstone of a confirmed diagnosis. In addition, radiographic examination and diagnostic blood tests also could be done to confirm the diagnosis. Radiographs, especially, of the spine and the low back show typical changes including sacroilitis in suspected cases of spondyloarthritis. If the spine does not show these changes, but there is a high likelihood of spondyloarthritis, then MRI (magnetic resonance imaging) can be used to confirm the diagnosis.

As a final step, a blood test for the HLA-B27 gene can also be confirmatory. However, it is not true that a person with the gene will definitely develop the disease.

Treatment:

The most important aspect of treatment is the use of pain medications and anti-inflammatory drugs (NSAIDs) which help manage pain and inflammation.
Corticosteroid injections may sometimes be given directly into the joint spaces or the membranes to provide quick relief of these symptoms.
ESWT / RSWT has a definite role to cure enthesopathy. Plantar fasciitis, and achillodynia can be cured with ESWT. Even small joints of hand and feet are amenable to treatment with RSWT. It is nonoperative and noninvasive treatment and has no side effects.
Very rarely, stronger drugs such as methotrexate or sulfasalazine may be used.
Another set of drugs known as TNF-blockers (tumor necrotizing factor blockers) are also shown to be highly effective in controlling the pain of the spine and joints.
In very severe cases, surgery may be required to correct joint damages or correct severe degenerative changes.
Exercise plays a very vital role in controlling the issue and improving range of motion.

What You Should Know About Spondyloarthritis?

Rotator Cuff Tear is one of the most common disabilities observed amongst adults above 40 years of age. Rotator Cuff is a group of four muscles that keep the Humerus (arm bone) attached to the socket of the Shoulder. The Rotator Cuff keeps the Shoulder Blade attached to the arm, and when there s a damage (tear) in one of these muscles, excruciating pain is felt by the patient.

Kinds of Rotator Cuff Tear-

  Partial Tear: This happens when one of the Tendons amongst the four Tendons is damaged or torn.
  Full Tear: This occurs when all the Tendons are torn; this is also called Complete Tear. Severe pain is experienced in this type of tear and surgery might be required.

Symptoms-

  A person may experience excruciating pain while performing daily tasks like Combing hair, Picking up Laundry, etc.
  Muscle weakness and stiffness on Shoulder.

Diagnosis of Rotator Cuff Tear-

  Ultrasound is used to check the internal structure of the shoulder and the damaged muscle pattern. The waves directed into the shoulder create images of the Tendons and ligaments of the shoulder. This allows the doctor to access the severity of the damage on the shoulder.
  MRI: When the doctor needs a better look at the Tendon damage, radio waves provide a better imagery than Ultrasound.

Treatment of Rotator Cuff Tear-

  RICE (Rest Ice Compression Elevation): In Case of partial rotator cuff injuries with very little damage, RICE is a good treatment option to treat temporary partial damage in the shoulder. Applying cold water and moving the hands slowly helps the muscles to get into shape.

  Injections: Non-inflammatory drugs are prescribed to the patient suffering from Full Rotator Cuff injury to deal with the pain. A Tendon tear can cause extreme pain, which might give the patient some sleepless nights. Non-inflammatory painkillers temporarily numb the shoulder, allowing the patient to sleep.

  Physical Therapies: Physical therapy is one of the most sought out treatment option. Physical therapy allows a person to recover from a rotator cuff injury through exercises and mild movements of the arms and shoulders.

  Surgery: When the injury is too severe for conventional treatment and medication, a patient might have to go through some complex surgeries.

A) Arthroscopic Tendon Repair: In this surgery, the doctor makes a small incision on the shoulders and then inserts a Laparoscope type instrument (Arthroscope) into the muscles, with a camera attached on the top. This instrument allows the surgeon to see the muscle structure and also helps in re-joining the tendons.

B) Open Tendon Repair: Arthroscopic Tendon Repair can be a bit complex, that s why an open tendon repair is preferred by most doctors. In this surgery, the surgeon makes a bigger incision and attaches the Tendons surgically. 

Conclusion-
Rotator Cuff Tears is a severe problem for the locomotion of body, but it is treatable, as long as one doesn t delay going to an experienced doctor.

Rotator Cuff Tear - Know The Treatment Options!

When we speak of bone health, calcium is usually the hero of the story. However, by itself, calcium is not enough for healthy bones. Vitamin D is equally important for healthy bones and the prevention of orthopedic conditions.

What does Vitamin D do?
Vitamin D helps the body absorb calcium from the food being eaten. It also controls the calcium and phosphate levels in the body. This is critical for the growth and development of new bones. Vitamin D also controls how much calcium and phosphates are being expelled by the body. In this way, vitamin D helps strengthen the bones and improve overall bone health.

Vitamin D Deficiency
Vitamin D is not commonly found in food. It is present only in certain types of oily fishes, egg yolks and mushrooms. Most of the vitamin D we eat comes from fortified cereals, breads and dairy products. The sun is an important source of vitamin D but exposing yourself to too much sunlight could cause various skin problems. Thus, vitamin D deficiency is very common. When it comes to bone health, vitamin D deficiency can cause low-density bones. This, in turn, can cause rickets and osteoporosis. People with vitamin D deficiency are likely to suffer frequent fractures. Vitamin D deficiency can also cause skeletal deformities such as bow legs and a stooped spine.

Vitamin D and Osteoporosis
Osteoporosis is a musculoskeletal condition that is marked by low bone density. Studies have shown that people with osteoporosis have lower levels of vitamin D as compared to others. Some studies also suggest that fractures are more common in winter as compared to summer. The winter sun is often hazy and many days can go by without strong sunlight. Thus it can be inferred that people do not get their required quota of vitamin D from the sunlight in winters leading to a deficiency and aggravated osteoporosis-related fractures.

Who is most susceptible to bone conditions caused by vitamin D deficiency?
Vitamin D deficiency is a very common condition across the globe. Some surveys have claimed that approximately 30% of the global population suffers from vitamin D deficiency. People with dark skin, women and elderly people are most susceptible to this deficiency. People suffering from kidney diseases may also be affected by vitamin D deficiency. Vitamin D supplements are usually very helpful in combatting this deficiency. These can be taken by young children as well as adults.

Relation Between Vitamin D Deficiency And Bone Problems!

It is very challenging to find operative treatments for chronic pain that offer improved daily functioning. Spinal Cord Stimulation is an excellent pain management method that can be used for patients when their neck or back pain cannot be treated by surgery or other options.

Each year more than 14,000 patients undergo the spinal cord stimulator transplant. The procedure comprises of mild electrical stimulations to the spinal cord. This modifies the nerve activity reducing the pain sensation or sensitivity that reaches the brain.

Neurostimulation therapy recommended by doctors is very effective, especially for chronic pain sufferers. The benefit of this proven therapy is that the pain experienced by the brain is minimized to a great extent. The therapy was designed only after observing how pain is managed by the brain. The therapy approved by the FDA is used to treat the pain caused due to nerve damage in the legs, arms and in the trunk. Spinal cord stimulation for chronic back and neck pain is provided to patients in pain management centers. The staff taking care of patients in these centers are specialized and trained in pain relief -how it occurs and best ways to treat it. Injections are also used to ease the pain.

How to treat back Pain?
Probably the worst pain an individual can experience is back pain, in some cases so severe that it hampers daily life. The treatment options that are used for treating back pain include electrical stimulation to the back and medication to the spine. The most common reason for spinal cord stimulation is failed back surgery. The pain related to the following conditions can also be alleviated through this therapy, scarring of the protective layers of the spinal nerves, painful inflammation and arachnoiditis.

Devices Used for Spinal Cord Stimulation
The devices used for spinal cord stimulation are available in several types but they comprise mainly of three parts. The pulse generator with a battery, a lead wire with 8-32 electrodes and a hand-held remote control that is useful in adjusting the settings of the device, and to switch it on and off. Electrical pulses are delivered to the spinal cord through the electrodes. It is very important that the procedure is carried out by doctors who specialize in pain management or by neurosurgeons.


Spinal Cord Stimulation For Chronic Back And Neck Pain!

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