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?

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!

Slip disk is a condition of the spinal column which consists of a stack of vertebras from the cervical, thoracic and the lumbar spine.The bones of the spine are cushioned by disks that are present to absorb shocks. Trauma to the spine may cause the disk to bulge or be ruptured. This may lead to pain in the neck and the back. 

Causes of slip disk

Slip disk is caused when the jelly like substance present in the disks bulges out. The damaged disk thus puts pressure on the adjacent nerve causing excruciating pain. The various causes of a slipped disk are:

1. Incorrect form during exercise: If you are into weight lifting, it is important that you use proper form during exercising. Moves like barbell squat and deadlifts can put pressure on the spine and lead to disk problems, if not done correctly. Make sure you work on your core strength and keep your lower back straight while exercising. 

2. Smoking: Smoking causes the disks to lose their flexibility and thus, increases the risk of slipped disk.

3. Ageing: Ageing decreases the content of water in the spine, thus leading to inflexibility.

The symptoms of slip disk are:
1. Pain on one side of the body that tends to aggravate over time
2. Activities such as sitting and coughing may lead to pressure on the spine causing pain
3. Your range of motion on certain movements may be restricted
4. Pain in the neck while moving it
5. Numbness in the shoulder and the neck region
6. You may experience tingling sensations in the genitals, hips and the legs
7. You may have muscles spasms which lead to sudden contraction of the muscles
8. It may also lead to partial paralysis of the lower body

Prevention
1. If you are overweight, try to reduce weight and then focus on maintaining healthy weight levels
2. Maintain proper posture while sitting or standing
3. Exercise on a regular basis to build strength and keep your joints healthy
4. Don't remain in seated position for an extended period of time. Take small breaks in between to stretch

Slip Disk Problems

Most of the arthritic conditions don t have any cures. Ankylosing Spondylitis is also a type of arthritis that does not have a cure. It is a kind of arthritis of the spine; it affects the vertebrae. It primarily affects the spine, but it may also affect other areas such as shoulders, hills, hips, ribs, small joints of the feet and hands etc. In very advanced stages, it may also affect eyes, lungs and heart. 

However, what really makes it scary is Ankylosis. When Ankylosis takes place, there is formation of new bony structures in the spine. These structures cause some sections of the spine to fuse and make the spine immobile. 

Symptoms of Ankylosing Spondylitis 

  Pain and Stiffness 

One may feel a constant pain coupled with stiffness in areas like buttocks, lower back, hips etc. These symptoms may go on for months. It often starts at the sacroiliac joint. 

  Bony Fusion 

The formation of bony structures in the spine in advanced stages may affect movement of the back, neck, hips etc., and may also impair the ability to perform daily activities. The formation of bony structures may go to the extent of fusing the ribs in the rib cage to the breastbone or spine. This may limit the ability to expand the chest while taking deep breaths. 

  Pain in Ligaments and Tendons 

Ankylosing Spondylitis may also affect the tendons and ligaments that attach the muscles to the bones. This may precipitate pain and stiffness beneath or behind the heels. 

Cause of Ankylosing Spondylitis 

The cause of this disorder is not yet known, yet a genetic link cannot be ruled out. It has been observed that most of the people affected with Ankylosing Spondylitis carry a specific gene in them. People carrying this gene are susceptible to spondylitis. However, there are about 10% people who carry this gene, but don t have any sign of Ankylosing Spondylitis. So, a sure determinant of cause of this disease is not completely known. 

Diagnosis of Ankylosing Spondylitis 

To diagnosis Ankylosing Spondylitis, the physician has to look at several factors. 

These include: 

  Symptoms exhibited by the patient 

  Physical Findings 

  X-Rays of pelvis and back regions 

  Taking chest measurements while taking deep breaths 

  Laboratory tests Based upon the complete diagnosis, physician can positively determine if the condition is indeed Ankylosing Spondylitis. 

Treatment 

While a cure for Ankylosing Spondylitis is still not on the horizon, there are some treatments which can reduce pain and discomfort and thereby improve daily activities. Goals of treatment Since the disease can t be cured, the goal is to reduce pain and stiffness, prevent deformity, maintain a good posture, and help perform daily activities. In fact, if treatment is proper, the patient may lead to a semblance of a normal life. However, it calls for a team approach. The team must include a physical therapist and an occupational therapist, apart from a rheumatologist. If the patient is suffering from bony growth, the doctor may go for an osteotomy.

Ankylosing Spondylitis - How To Handle It?

Spinal stenosis is a condition where a part of the spinal column becomes narrow. There are generally two types of spinal stenosis- lumbar stenosis and cervical stenosis. Lumbar stenosis is the form of the condition that affects the lower back. It is also the most common type of spinal stenosis.

Common Causes of Lumbar Spinal Stenosis
Some people may be born with a narrow spinal canal, but in most cases the condition is caused post birth. Here is a look at some of the most common causes for the spinal stenosis.

Overgrowth of bone- Osteoarthritis can sometimes cause bone spur formation, which in turn can lead to the stenosis at the lumbar region of the spine. This usually occurs in adults, as osteoarthritis is common after a certain age.
Herniated discs- A soft cartilage exists between the vertebrae, which cushions any impact on them. However, this cartilage dries up over time, and with age may lead to formation of crack on the exterior, which in turn causes suppression of the inner soft material and nerves of the spine.
Stiffened ligaments- The ligaments in the spine may become thick and stiffened over time and age. Due to the thickness of the ligaments, a bulge may occur in the spinal column and lead to lumbar spinal stenosis.
Injuries to the spine- Lumbar spinal stenosis may often be brought on by an injury to the spine. A spinal fracture resulting from an accident may narrow down the spine, which can cause the issue.
Tumours- A tumour may affect anyone at any point of time. These tumours may occur between the spinal cord and the vertebrae or between two bones in the vertebrae.
Symptoms of Lumbar Spinal Stenosis
Often the spinal stenosis may lie dormant and not produce any noticeable symptoms. However, it can still be diagnosed using an MRI or CT scan. However, all forms of the condition gradually progress and produce severe symptoms. This is why the treatment should be started as soon as the lumbar spinal stenosis is diagnosed, for the best result.

Here are common symptoms associated with the disorder

Numbness and tingling in the leg and foot.
Pain in the back
Leg cramps after long spells of standing or walking.
Weakness in the legs and feet.
If you observe any of the symptoms mentioned above, make sure that you visit an orthopaedist, so that the condition can be diagnosed and treatment can be initiated at soon as possible.

Lumbar Canal Stenosis - What Causes It?

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

Don't wait any longer, manage your Pediatric Orthopedist online with a Lybrate doctor today

Consult for Pediatric Orthopedist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES