Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot. This can be a painful condition. Let us look at the ways in which it may be cured.

Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.

Flat Foot Pain - Ways It Can Be Treated!

Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.
Since prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips.
Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.
Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.
Lift objects correctly and maintain proper posture:While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed.
While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.
Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.
Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pinpoint the diagnosis and appropriate management.

3 Essential Tips to Prevent Back Pain

Why Does Your Back Hurt?

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis

The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles

A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries

Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

- Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.

- Consult the right physician instead of doing exercise that can aggravate your pain.

- Take a break from work and go for short walks, every couple of hours.

If you would like to consult with me privately, please click on 'consult'.

Why Does Your Back Hurt? + What To Do About It

Whether you're old or young, male or female, having a backache can be a real pain! A number of factors ranging from osteoarthritis to muscle strains can be attributed to back pains. No matter what the cause of a backache, a combination of core strengthening exercises, activity, and physical therapy can help lessen the pain.

A backache can be caused by something as simple as bending the wrong way. Hence, the first step towards dealing with a backache is to pay attention to daily movements. If you have to lift something heavy off the floor, bend your knees and let the weight of your load fall on your legs instead of it falling on your back. Here is more on how you can fight back pain with a bit of effort:

Light exercises
Simple, light exercises are the most effective ways of dealing with back pain. The key to exercising your back is moderation and knowing your limits.

Brisk walk and yoga
Regular brisk walks and yoga exercises that strengthen and stretch back muscles are effective ways to reduce and prevent back pain.

Right posture
Exercise can also help reduce excess weight that in turn helps reduce back aches. Slouching not only causes a hunch back but also aggravates back aches. Hence, maintain a right posture to take the pressure off nerves and lower back pain.

Proper posture while sleeping
A good night's sleep can also help soothe inflamed back joints and repair strained muscles. Pay attention to your mattress and ensure that your back is flat when you lie on it. Sleeping on your side can also help deal with the back pain. Consider resting your neck on a pillow, to keep your spine aligned while you sleep.

Hot & cold therapy
Experiment with hot and cold therapy before picking one of them to deal with your back pain. While applying ice packs on your back can help reduce inflammations, hot packs work better to reduce cramps and muscle spasms. Whether you use a hot pack or a cold pack, do not leave it on for more than 20 minutes.

Natural supplements
Natural supplements such as flaxseed oil, calcium, magnesium and vitamin c are helpful when dealing with back pains.

For short-term relief, you could also try over the counter pain relievers. However, do not let this become a long-term habit, as your body could get dependent on it. Other potential side effects could include stomach and liver problems. Hence, if your back ache does not subside on its own, it is best to consult a doctor before treating it yourself.

How to Deal with Back Pain

Hemorrhoids or piles are diagnosed by swelling of veins in the lower part of anus and rectum. Due to swelling, the walls of rectum and anus are stretched and thus become irritated. Hemorrhoids are of two types: Internal and External hemorrhoids.

Internal Haemorrhoids: As the name suggests, the piles are not visible from outside. These are present deep inside the rectum, located above the pectinate line and these are covered with the cells that are present through the rest of intestines. Internal hemorrhoids are normally painless. The first sign of internal hemorrhoids is rectal bleeding. However, straining can push internalhemorrhoid and it protrudes through the anus and this can be painful.

Causes of Haemorrhoids
The swelling of hemorrhoid occurs only when the pressure in the small vessels of rectum and anus is increased and is engorged with blood. The size of the hemorrhoids is also increased. The increased pressure may be due to various factors:

Consuming low fiber diet and pushing or straining while passing stools, thus blood vessel pressure is increased.
Pregnancy also is a cause of swelling as there is the increased pressure of the uterus on rectum and anus.
Sitting for long on toilet also increases pressure.
Obesity is also a cause of hemorrhoids.
People suffering from diarrhea, both acute and chronic.
A person having colon cancer might have hemorrhoids.
Signs and Symptoms of Haemorrhoids:

The most common symptoms of hemorrhoids are painless bleeding, itching in anal, swelling and feeling of the presence of lump at the anus.
All these symptoms are associated with inflamed hemorrhoid.
Inflamed internal hemorrhoid can cause swelling, but is painless as there are no fibers attached to veins above the pectinate line that cause pain. However, passing hard stools can scrape off the thin lining of hemorrhoid, which can cause the painless bleeding.
Spasms of the rectum and anal muscles caused by these swollen hemorrhoidscause pain, especially when they are protruded through the anus.
Internal hemorrhoids can form a clot or thrombose resulting in severe pain.
The presence of has inflammation, stool,and constant moisture and these can lead to itching and burning sensation in the anus among patient of internal hemorrhoid.
Treatment of Haemorrhoids

Diet: Haemorrhoids can be treated when individuals consume a fiber-rich diet in order to soften the stools and ease their bowel movements. Fiber-rich foods include fresh fruits, dry fruits, grains, vegetables, and cereals. About 20 to 30 grams per day of fibrous foods is recommended. Dietary fiber will help create bulk in the intestines which will help in softening of stools and ease bowel movement. Supplemental fiber available in the marketincludes psyllium husk, methylcellulose, and calcium polycarbophil. Other recommendations include increased intake of liquids and having stool softeners. Drinking enough water and liquids will prevent stool from hardening.
Over-the-counter topical treatment: There are various products available to treat hemorrhoids, such as gels, hydrocortisone creams, ointments, foams, pads, and suppositories.
Home remedies: Soaking anus in a warm sitz bath might also help in hemorrhoids for about 10 to 15 minutes per day. One should practice good hygiene and clean anus with warm water while showering. Avoid using soap and dry toilet paper. One can also use a cold compress on the anus.
Minimally Invasive Procedure for Hemorrhoids (MIPH)

Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.

MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised, proximal to the piles and disrupted mucosa is fixed by  stapled end to end mucosal anastomosis.

This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30 45 minutes.

Internal Haemorrhoids - Best Ways They Can Be Treated!

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