Plantar fasciitis is the inflammation of fascial ligament (the plantar fascia) at the base of the heel bone. It is a commonly experienced heel pain condition which is caused due to injury or even wear and tear as well as excess weight gain, in some cases. The plantar fascia is the name given to a flat band of connective tissue that holds the foot and the rest of the leg in place with the heel in between. This also supports the foot s arch and helps in connecting the heel bones to the toes. When there is inflammation as well as weakness in this tissue band, then pain may occur and is known as plantar fasciitis.

It may occur in one foot or both feet and may also be caused due to old age, for many individuals. Also, those who are heavily into athletics can also face this kind of wear and tear of the plantar fascia. As with many pain-related conditions, this one can also be treated with regular and moderate exercises that can be practiced to build flexibility and strength. 

Let us find out more about the three exercises that are most suited for treating this condition.

Stretching: Stretching is an exercise that can help in repairing most joint and tissue pain as it helps in pulling the damaged parts back into the right place, especially if any kind of misalignment has occurred. This kind of action can also have a soothing effect when the pain increases. You can stretch your calves in order to help the pain that is caused by plantar fasciitis. You can start by facing the wall and placing your right foot over the left one. Then, place your palms on the wall and remain at a distance of one arm. You will then need to bend you left leg in a forward motion as your right leg and heel press against the ground. Hold for 30 seconds and release. Then, repeat with the other leg.
Chair stretch: Another way of doing stretch exercises is with the help of a chair. You will need to sit on a chair and remain in an upright position for this exercise. Keep a frozen water bottle or cylinder under your foot and roll it back and forth as you maintain a firm grip using your foot and heel.
Big toe stretch: While you are still seated on the chair, you can do a big toe stretch by crossing your leg over the knee and pushing and pulling your big toe. This will help in stretching the tissue that is causing the pain. You will need to pull and hold for at least 15 to 30 seconds for each toe. Practice on both feet.

Plantar Fasciitis - 3 Exercises That Can Help Relieve Pain!

Sciatica pain can be mild to intense. Many with lumbar herniated disc and sciatica often wonder whether or not they require a surgery. Needless to say, it is never an easy decision. But the good news is that micro discectomy surgery has a higher rate of success when it comes to relieving sciatica pain. When compared to many other options, this one is relatively minimally invasive. It doesn t alter the structure of the spine permanently since it works by removing a small portion of the disc, which has herniated or extruded out of the disc.

When your sciatica pain stems from lumbar disc herniation, a small open surgery with the help of magnification is the prevalently opted surgical approach. On the other hand, a laminectomy is done when the bone or disc pinching the nerve root is required to be removed.

When should you consider undergoing surgery for sciatica?
Typically, neurosurgeons recommend considering surgery for sciatica in a host of situations which include the following:

Severe pain in the leg lingering for more than six weeks, which mainly affects one side of the leg or buttock
Intense pain in the low back and buttock, which continues through the course of the sciatic nerve andextends to the lower leg and even foot. This pain can be described as sharp and searing rather than a dull thud.
When pain has not alleviated even after non-surgical treatments that may include non-steroidal anti-inflammatory drugs (NSAIDs),oral steroids, injections, manual manipulations, and physical therapy
When the patient is not able to take part in the day to day activities due to intense lower back pain and the symptoms tend to become severe during movements like sneeze and cough.
When the symptoms are continuing to worsen, thereby indicating nerve damage, particularly when the progressive signs have their root in neurological issues
It is important to note here that surgical intervention may only be needed when the patient experiences progressive weakness in the lower portion of the body or sudden loss of bladder or bowel movement, which may stem from cauda equina syndrome. Two surgeries, namely lumbar laminectomy and microdiscectomy are performed on the basis of the cause as well as the duration of the sciatica pain.
In some cases, the symptoms are unique on the basis of the underlying causes of sciatica. For instance, trying to bend the body backward or walking a longer distance than normal may trigger unbearable symptoms. On the other hand, when the affected individual tries to bend the body forward, it can lead to symptoms stemming from the lumbar herniated disc.
In case sciatica occurs after an accident, injury or trauma, or if it happens in tandem with other symptoms, then it requires an immediate medical attention.
Thus, choosing to go for a surgery depends on several factors that only your doctor can assess and decide upon.

Sciatica - When Do You Have To Go For Surgery?

Arthritis is a painful joint condition that leads to pain and stiffness as well as lack of proper mobility due to inflammation and swelling. Usually, an orthopaedic specialist will prescribe anti-inflammatory and pain relieving medication for this condition, but there are various things that you can do to ensure that this condition does not become a debilitating one in the long run. One of the best ways of doing this is by limiting your diet in certain ways when it comes to inflammation producing food. 

Here are a few types of food to avoid if you are suffering from arthritis.

Fried food: Fried and processed food is packed with too much of salt in order to better preserve it so that it has longer shelf life. Also, the use of oil in order to deep fry can have a detrimental effect on the inflammation that is already causing problems for your joints. Therefore, it is best to avoid fried, fatty and processed or packaged food that has been frozen for too long.
AGEs: When we speak of AGEs, we are not talking about the number of birthdays that you have celebrated. AGEs are actually Advanced Glycation End products that are a toxin released by food when it is heated, grilled, fried or pasteurised. These toxins can render damage to the proteins in your body. Once this process starts, the body retaliates by sending forth cytokines which are basically inflammatory messengers. This can lead to inflammation and arthritis.
Sugar: Sugar and other refined carbs also have a large amount of AGEs as discussed above. These types of food should also be avoided by patients suffering from arthritis. Also, artificially sweetened drinks and too many baked goodies should be avoided by these patients.
Dairy products: Owing to a certain kind of protein that most dairy products contain, these kinds of food are considered harmful for patients of arthritis. These proteins can encourage inflammation and irritation of the tissue that surrounds your joints. Switching to a vegan diet is considered helpful for arthritis patients.
Alcohol: Excessive drinking is a major problem that can aggravate your arthritis situation. Smoking and drug abuse also leads to such problems. Drinking excessively can lead to the development of gout.
Corn oil: This kind of oil is a part of most packaged, processed and fried food. It also leads to inflammation. Arthritis patients should switch to omega fatty three oils which can be found in fish.
Taking care of your body is a matter of maintaining a good diet with lots of activity that will be congenial for your condition. This will also help in keeping the painful symptoms of arthritis away.

Arthritis - 6 Foods You Must Avoid!

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

Neck pain is a common medical condition, which can be easily treated if proper care and medications are taken. It usually occurs due to strained neck muscles, often caused bad posture, though there might be other causes as well. Rarely, neck pain can be a symptom of a more serious problem as the condition is relatively mild in nature. The symptoms of a neck pain are very obvious which refers to any kind of discomfort in moving your neck on a daily basis. Along with this you might also have headache, stiffness of the head and muscle tightness. Some of the most common causative factors of neck pain are listed below.

Muscle strains
A muscle strain generally happens when you exert too much pressure on your neck continuously for long periods. It also happens when you have your neck fixed in the same position for long hours of the day. Muscle strains in the neck may occur when you keep your neck bent in the wrong way while doing activities like reading a book, looking at your mobile phone or working over your laptop for extended hours.

Worn joints
Just like all the other bodily joints, the neck joint also tends to wither and degrade with age. This phenomena is known as the wear and tear of the joints. The bones of the neck joint tend to wither with time, thereby making your joint frail and exposing it to various pains and medical conditions.

Nerve compression
Nerve compression is a medical symptom whereby, there is excessive pressure put on one particular nerve in the body. Herniated discs or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord, hence causing a long lasting neck pain. Damage caused from a nerve compression may be minor or severe depending on the pressure applied. It may cause temporary or long lasting problems depending on the degree of damage caused. The earlier you get a diagnosis and treatment for nerve compression, more quickly you will find relief.

Whiplash
Neck related injuries are common phases of pain and discomfort caused due to an external damage to the neck as a result of a tragic sports related or vehicular accident. A neck injury is also known as a whiplash and it refers to an injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip. Whiplash mostly occurs during accidents, physical abuse or other trauma.

4 Common Causes of Neck Pain

Debilitating inflammation in the joints and its surrounding tissue usually characterize arthritis. This ailment can greatly weaken the body. At the point when joints are seriously influenced by joint pain, there are a number of treatment methods that may be available for the patient. Pain relievers, physiotherapy and other forms of treatment can help in offering relief. Yet, when these methods fail, one can go in for replacement surgery of the affected joint. This may not just lessen or eliminate the pain experienced but it can also it can reestablish better strength in the joint. Hip, knee, and shoulder joint substitutions are a portion of the more normal surgeries suggested when managing joint pain.

Joint Replacement Surgery for Various Joints: Arthritis can affect a variety of joints in various ways. In the shoulder, this can be found in the humerus (the upper arm bone) and a bit of the scapula (the shoulder bone). In the knee, it includes the finishes of the femur and tibia (the thigh bone and shin bone, separately) and the patella (the knee top). In the hip, the influenced zones are the femur and the attachment in the pelvic bones in which it rests (the hip bone socket). In simple words, an aggregate joint trade or replacement for joint pain includes replacing the harmed joint surfaces with simulated segments artificially.

Ideal Candidate: In the event that your joint pain is progressed yet you are generally healthy, joint substitution might be a choice. Notwithstanding, you should take the advice of an accomplished orthopedic pro who can give you moderate treatment choices and other negligibly intrusive ways to deal with the condition before resorting surgery.

As a rule, you may not be a decent candidate of the replacement if:

-You have inadequately controlled diabetes

-You are a chain smoker

-You are extremely chubby

-You have encountered contaminations in the influenced ligament joint before

The best contender for a ligament joint replacement surgery includes patients who:

-Have joint pain that is extreme

-Are encountering a debilitating effect in their personal life due to the painful symptoms

-Have discovered moderate medicines, for example, mitigating drugs and non-intrusive treatment to be ineffectual

-Are willing to effectively and regularly participate in a recovery program after surgery

The accomplishment of a joint substitution surgery relies on upon the stability of the remaining parts of the joint. In the event that the joint has endured a few diseases, or in the event that it has experienced a few surgeries, it may not be sufficiently solid to withstand a joint replacement procedure. What's more, if you there are immune system disorders or long ailments like diabetes at play, then there may be little chance of aligning with the new joint.

Should You Undergo a Total Joint Replacement for Arthritis?

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