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?

If you suffer from chronic pain of any kind, it is important for you to know that it is associated and linked with your emotions. Other than your physical activities and personal relationships getting hampered, unwanted feelings like resentment, stress and frustration are also common. These emotions and feelings are capable of making your chronic pain condition more worse. 

The Relationship between your mind and body: Your mind and body work together and cannot be separated. Your mind controls all your thoughts and also affects the way in which pain is controlled or perceived by the body. Pain and the fear of pain may lead you to avoid activities. This may reduce your physical strength and cause disruption in the functioning of your body.

Stress: Stress affects your body both physically and emotionally. It may lead to an increase in your blood pressure, breathing rate, heart rate and muscle tension may also occur. These may lead to fatigue, appetite changes and sleep disruption. Stress also causes depression, anxiety, make you dependent on drugs and make you dependent on other people.

Depression: Depression is common among chronic pain patients. Chronic pain can make cases of existing depression much more worse and the existing pain is also worsened. There are chances of developing depression from chronic pain if depression runs in your family or genes. 

Symptoms of Depression are as follows:

Feeling sad, angry, worthless and hopeless frequently
Lack of energy
Lack of interest in regular activities
Difficulty in sleeping
An increase or decrease in appetite, which may lead to major weight gain or weight loss
Difficulty with concentration
Having suicidal thoughts and thoughts about dying or harming oneself
How to Handle your Emotions during Chronic Pain: A common therapy, which people with chronic pain undertake is called Cognitive Behavioural therapy. You should seek the help of a therapist. In this therapy, you will learn about thinking in a positive way instead of drowning in negative thoughts. Your fear of pain will be reduced and you will learn how to strengthen important relationships. You will be able to develop a sense of freedom from chronic pain. 

If your chronic pain occurs due to an accident or emotional trauma, you may be assessed for post-traumatic stress disorder (PTSD) by your healthcare provider. Many patients suffering from PTSD cannot deal with their pain until the emotional stress is dealt with. If you feel depressed and cannot control your emotions, you need to consult a doctor.

Chronic Pain - Is it Linked to Our Emotions?

Stitches or sutures act as a closure for either surface wounds or deep wounds. Procedure to close a deep wound comprises of sewing the two edges and applying stitches under the skin surface.

Catagories of sutures

    Non-absorbable stitches: Such stitches are applied in case of skin wounds or internal wounds. Such stitches get healed quickly and are easy to remove. Non-absorbable stitches are made of natural fibers or synthetic threads like nylon polypropylene. As the name suggests, these stitches are either permanent or persist for a long time.
    Absorbable stitches: Such stitches are applied on layers, which have the property of healing quickly. They are very firm during the initial days. Then they start getting dissolved in the body.

Precautions taken by medical team before applying stitches to prevent infection

    Careful checking of nose for occurrence of germs before the start of operation.
    Skin must be cleansed prior to surgery.
    Sanitizing hands prior conducting the surgery.
    Usage of germ free gloves and sterile clothes while applying sutures.
    Prescribing antibiotics to the patients who may fear high risk of infection.

Precautions to be taken by patient to prevent infection

    Take a bath prior to surgery.
    Avoid using razor at the surgical site. The same can be carried out by using clippers by the surgery team itself.
    Keep all your jewellery aside before the operation starts. Do not apply nail polish.
    It is advised to cover up the wound. Try to keep the adjacent areas germ free. This is a crucial step in avoiding infection.
    Visit your doctor at once on finding redness around the wound.

When to see the doctor
Pain up to a certain threshold is normal. In case pain gets unbearable, the scene can be alarming. It may be an indication of infection. Taking immediate remedial steps is necessary to avoid infection or any other side effects post the surgery. On meeting with any of the following signs, it is better to consult doctor at once.

    If the skin around the wound gets swollen.
    If you detect redness around the wound.
    If the pain becomes unbearable.
    If the wound starts developing pus.
    If your body temperature increases abnormally or if you have fever.
    If you observe red streaks around the wound.
    If in case a stitch gets opened up and the edges of the suture start widening. This is the most alarming sign. In case a suture gets opened, you must immediately seek a remedy.

Ask your doctor for the precautions you can take to avoid experiencing any of the above signs. If you come across such alarming symptoms, rush to the nearest hospital and get the appropriate treatment.

Pain in Stiches - When You Should See Your Doctor?

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

Lower back pain can be one of the most physically debilitating things that can affect you and limit your mobility. Even if the pain isn t that acute, it could still signal something deteriorating in your lower back. While oral medications, topical creams or sprays can help in reducing pain, there are other effective remedies you can try on your own. These will be handy when you have no medications at hand. One of these is the hot and cold therapy.

Heat therapy for lower back pain

Heat works well with lower back pain as it can dilate blood vessels and improve circulation within the tissue. This will help in circulation and also result in lowering the pain. Heat therapy will also loosen up other muscles in the area and help soothe sore areas which have been taking the burden along with the lower back muscles. Some of the techniques that can be applied are:

1. All day heat wraps: These are specially manufactured belts or wraps which wrap around your abdomen and keep tightness and pressure on your lower back as well as supplying heat.

2. Electric heating pads: These are mechanized heating pads which generate heat with electricity. You can place them under you back and then either sit or sleep with it positioned behind you. However, ensure that you don t keep these for too long as they could burn your skin.

3. Hot Compress with towels or hot water bags: Use a clean towel and heat it over a conductive surface and apply it on your lower back. You can also use hot water bags for the same purpose.

Cold therapy for lower back pain

Cold therapy uses the principle of constriction of blood vessels as well as slowing circulation. This will help numb the area and thus help relieve the pain. Some of the ways these can be administered are mentioned below.

1. Ice towel: In this method, soak a towel in ice cold water, wring it to dry it and then apply on your lower back. This will numb the pain without transferring the sting of the cold or damaging your skin.

2. Ice packs: Put about half a kg of ice in a plastic Ziploc bag and pour water over the ice to just about cover it. Push out the air out of the bag and then lock it. Use this ice pack with a towel to ensure that you back doesn't get wet.

3. Ice gel packs: These are ready made packs, which can be bought from medical stores and kept frozen to be used whenever you need it in order to relieve lower back pain.

Treating Lower Back Pain Using Hot and Cold Therapy

A pain in the neck, both in the metaphorical and the literal sense of the term can be quite discomforting. If we look at it from a medical point of view, the pain in the neck could be a serious sign of something being amiss and so, keeping in mind the causes of such a pain is just so important!

Recognizing the Type of Neck Pain

A pain in the neck can manifest itself in a variety of ways. Also, it need not also follow the textbook definition of the term. As a matter of fact, tingling, tenderness or numbness can also be significant symptoms of neck pain. Another major symptom can be having difficulty while swallowing. This could be much more crucial than just a problem with the digestive system.

Many cases that doctors come across when a patient comes to consult about a pain in the neck are regarding an issue with the spinal cord. At in certain cases, it could be related to an issue with the muscles which are located in the area.

When a person has neck pain, he or she should think back and try to remember if he or she was in an incident where the neck could have possibly been the recipient of some sort of impact. This could be a possible explanation of the pain. Also, if there is a pain in the neck after an incident, it is better not to delay a visit to the doctor as the person is likely to be uncomfortable. The neglect is this condition can also lead to the problem getting progressively worse.

In some cases, a pain in the neck can even be congenital. A very good example of this is wry neck, or torticollis. When a pain in the neck is diagnosed by the doctor, figuring out what the likely cause is quite an important thing to do and should be the first thing which is done by him or her as the various ways to treat a pain in the neck vary according to the cause of it.

The problem of neck pain is very common as two third of the population suffers from it at some point in their lives. This does not mean that it needs to affect a person's quality of life. The right precautions and proper medication can make sure that his or her neck is not on the line!

Causes of Neck Pain and Diagnosis

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