Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

There are various neurodegenerative disorders and Huntington Disease is one of them. It is characterized by loss of thinking ability, chorea or uncontrolled writhing and jerking movements, and psychiatric difficulties. 

Nerve cells in the brain are impaired in this disease. This leads to loss of coordination and involuntary movements. As the disease progresses, patients slowly fail to control their throat and mouth muscles and simple tasks like eating, swallowing, and speaking becomes challenging.

Huntington's Disease may also affect the reasoning and thinking abilities of an individual and makes communication and conversations more challenging. The problem of swallowing food can lead to choking as food can go down the wrong way or a lung infection in more severe cases. 

Speech-Language Pathologist or Speech Therapist helps the patients with speaking and swallowing problems with the help of various therapies.

Visiting a Speech-Language Pathologist in the initial stage of Huntington's Disease is advised. This helps in planning in advance about the ways to handle changes as the disease progresses. The therapist can help the patients when they begin showing an inability to speak or understand and swallowing problems. The symptoms showing swallowing difficulties may include choking, coughing and altered eating habits of the patient and loss of weight.

Symptoms

Dysarthria, in which the ability to remember words, understanding and forming a sentence is not lost but clear speech becomes difficult.

Stammering.

Slow or imprecise speech.

Aphasia, inability to understand what is being said and inability to remember grammar and vocabulary, and the pattern of losing a word in between the sentences.

Weak voice or low volume because of respiration issues.

Scanned Speech or unusual lengthy pauses between words.

Problem with pitch control and resonance.

Treatment

The progression of Huntington s disease varies from patient to patient and the therapy also varies as per the needs and challenges of the patients. The therapy usually starts with the discussion of problems and symptoms faced by the patients. 

For swallowing difficulties, patients may be recommended to maintain a journal of swallowing problems and fixing a time for meal intake every day. He/she may be recommended to eat soft food items, and eat slowly and chew the food properly.

As for speech therapy, one may be recommended breathing exercises. The therapist may demonstrate the patients how to overemphasize certain mouth movements to make the words easier to understand. The family of the patient is advised to reduce distraction while communicating with the patient. 

Assistive devices can also help with communication such as computers, smartphones or tablets. Other low-tech objects from everyday life, such as calendars, picture boards with a depiction of daily life activities, and object images and notebooks can also be helpful.

Take Away
Huntington Disease is a brain disorder where it becomes difficult for a person to control mouth muscles. In this, speaking, swallowing, and eating becomes a task for them. There are speech therapies that can help the patients to gather control over their words and communication problems.

 Huntington's Disease - How Effective Is Speech Therapy In It?

Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

Cranial nerve palsy is one of the common culprits of causing double vision. This is all the more true for people above the age of 60. A person is more prone to cranial nerve palsy if he is suffering from high blood pressure and diabetes. This is the reason why this disease is more commonly known as diabetes palsy. Eventually, though they get better and the problem of double vision disappears.

Symptoms:

One weak cranial nerve leads to the weakness of other cranial nerves as well. In case the eyes fail to move together, chances are that the patient will have double or blurred vision. In case the sixth nerve gets affected, side to side double vision is encountered. For the 3rd and 4th nerve disturbance, there could be a vertical double vision. The lack of blood flow causes pain to the eye.

Possible Causes of Cranial Nerve Palsy?

Cranial nerve palsy can result from traumatic or congenital factors. They can also result from vascular diseases such as strokes, hypertension, diabetes, and aneurysms. It can also arise out of infections, increased intracranial pressure, migraines, and tumours. A patient's age and clinical findings help a doctor decide the right course of treatment.

Treatment:

There are no particular treatments which can speed up the recovery of cranial nerve palsy. In a case of pupil pain, doctors may prescribe anti-inflammatory drugs such as Motrin and Advil. They key to natural recovery is to ensure that the blood sugar and the blood pressure is diligently controlled. By patching the eyes, the problem of double vision can be resolved. They are typically worn over both the eyes. They are however known to slow down the process of recovery and strain the eye. There is no known exercise to fix this condition. Botulinum injections are sometimes used by doctors to straighten the eyes but the result of such a treatment greatly varies from person to person. Doctors mostly rely on watchful waiting until the phase passes within 6-8 weeks. Pain medications are recommended on a case to case basis.

Lifestyle Changes:

Managing cranial nerve palsy can be difficult for a working person. It involves many lifestyle changes till the condition fully cares. Some of the suggestions given by an ophthalmologist include resting the eye as long as one can. Reading or working on a computer should be eschewed since it puts great pressure on the eyes. The eye should not be contacted with forehands in case there is too much pain. Other basic hygiene issues include taking the medicine time to time, cleaning the eye with fresh water two to three times a day, putting the eye drops on time as prescribed by the doctor.

How To Treat And Manage Cranial Nerve Palsy?

Do you know that Huntington s disease is an inherited disease? This condition leads to the progressive degeneration of the nerve cells present in your brain. Huntington's disease has severe impact on several functional abilities of an affected person and results in psychiatric, thinking and movement disorders.

Causes
Huntington s disease occurs from an inherited defect present in a single gene. It is a form of autosomal dominant disorder, which indicates that a person requires just one copy of the defective gene for developing the disorder. Except the genes on the chromosomes, two copies of every gene are inherited by a person. The affected parent may pass along the defective gene copy or the healthy copy.

Symptoms
Commonly, the symptoms of Huntington s disease start appearing during midlife. It may also affect a person during childhood. The symptoms of this disease vary from person to person. Abnormal movement and weight loss are common symptoms, which occur in all stages.

Early stage

The usual early stage symptoms include the following:

Slight coordination changes, which affect balance and make you clumsy
Uncontrollable fidgety movement
Stiffness and slowing
Irritability and depression
Problems with thinking in difficult situations
Middle stage
With passing time, the symptoms start interfering more with the patient s daily life and activities. You may start dropping things, face trouble with swallowing, and talking. Staying organized may get tough. Certain emotional changes are indicated.

Later stage
In the later stage of Huntington s disease, a patient becomes dependent on others for taking care of them. A patient cannot walk or speak, and fidgety movements are likely to become more severe or may subside.

Treatment
Huntington s disease has no fixed cure. Several measures are followed for managing the symptoms. They are as follows:

Medications are used to manage fidgety movements. Other medicines are also used for controlling any other side effect experienced.
Speech or language therapy may be beneficial in case of speech and swallowing problems.
Physical therapy may help you in improving your control movements. Assistive devices like handrails can be used for managing your changing physical abilities.
Nutritional support is used in which special utensils are used to focus on a nutrient-rich diet.
Exercise is also important for patients with Huntington s disease as it enables them to stay active and fit.
In case you experience any symptom of Huntington s disease, it is important for you to consult a doctor immediately. This is a severe disease and early diagnosis and treatment will prevent the condition from worsening.

Huntington's Disease - Understanding the Stages of Symptoms!

When is your pain chronic?

Your pain is chronic if it last for more than a period of six months. Chronic pain is a long-term pain whose nature can vary from mild to excruciating, and it may trouble you either continuously or at short and regular intervals. Chronic pain is so dangerous that it does not only cause discomfort and inconvenience but also robs you entirely of your capacity to work for a long time.

Chronic pain can occur in a number of organs of the human body like head, joints, back, shoulders, neck etc. In fact, pain in any part of your body can turn into chronic pain. Here are a few symptoms that can help you identify if what you are going through is, in fact, chronic pain:

- persistent and severe body pain

- burning sensation accompanied by the body pain

- fatigue and sleeplessness

- weak immune system

- stiff and sore joints

The 4 types of chronic pain disorders that you should be aware of are:

1. Nociceptive pain

The pain that affects the soft tissues of the body such as the skin and the muscles or the organs that have sensory nerves present in them is called nociceptive pain. The sensory nerves, known as nociceptors can detect the stimuli of pain and send information to the brain and the spinal cord for interpretation. The pain could be either somatic (originating in the outer body) or visceral (originating in the internal organs).

2. Neuropathic pain

This pain is caused when the nerves stop functioning normally. It is caused due to nerve disturbances that result in pain stimuli being spontaneously transmitted to the brain and spinal cord. If you are suffering from this type of chronic pain disorder, you will feel a sharp, shooting and stabbing pain. Neuropathic pain can also be caused due to the formation of neuroma (abnormal growth of the nerve tissue).

3. Psychogenic pain

The pain that is caused by psychological disorders like depression and anxiety is known as psychogenic pain. Sometimes this pain can be accompanied by physical complications like fatigue, body pain and muscle weakness.

4. Idiopathic pain

The pain that exists even though there is no physical or psychological cause for it is known as idiopathic pain. This pain is more common in people who have suffered from a pre-existing painful disorder. Some common examples of idiopathic pain are fibromyalgia (intense pain all over the body) and tmj disorders (pain in the jaw area).

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Why does PAIN occur? Understand the Mechanism of Pain

Your Pain is Chronic if it Falls Under These 4 Types of Chronic Pain Disorders!

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