Cubital Tunnel Syndrome is also known as Ulnar Neuropathy, a nerve compression syndrome where the Ulnar nerve, also known as the funny bone nerve, gets compressed due to heightened pressure or stretching. It can lead to numbness or a tingling sensation in little and ring fingers, sometimes pain in forearm and an overall weakness in the hand. Ulnar nerve is one of the three main nerves in the arm. It runs in a groove on the inner side of the elbow. Since it travels through a narrow space and has very little protective tissue, the nerve is quite vulnerable to compression.

Symptoms
The symptoms of this condition may range from mild to severe. Some of the mild symptoms include:

Numbness in little and ring finger as the fingers fall asleep
A tingling sensation, usually like the pinch of pins and needles in ring and little finger
Pain in forearm
Weakness in the hand
Some of the severe symptoms include:
Reduction in overall hand grip
A claw like deformity in hand
Wasting of muscles of the hand
Bending elbow over a long period of time like while using cell phone or during sleep can cause ulnar nerve compression. Resting the elbow for a long period over a hard surface can also cause an irritation of the nerve, leading to such symptoms. In some cases, the nerve snaps back and forth over a bony bump, resulting in an irritated nerve. People who undertake intense physical activity, especially using their arms, are more likely to develop this problem. Eg. baseball pitchers. Apart from this, people who have suffered from a dislocated elbow or have arthritis are also at risk.

Generally, doctors diagnose this condition through the symptoms. However, nerve tests are also conducted to check the level of nerve compression. Electromyography is a procedure in which electrodes are placed on the skin and muscles to measure muscle health. Determining muscle health and level of compression helps decide the mode of treatment. Generally, the symptoms of cubital tunnel syndrome are managed through a conservative treatment. However, in cases of severe compression, surgery can be considered as an option to relieve pressure, moving nerve to the front of the elbow or removing a part of the bone.

For mild cases, a towel or a protective cover for elbow is recommended. The towel should be wrapped around the elbow loosely. An elbow splint can be worn at night to protect the elbow from being bent for long time.

How can a physical therapist help?
A physiotherapist has an essential role to play in treatment of this syndrome. A therapist can help the patient to learn ways of avoiding pressure to the nerve. After surgery, with restrictions of movement, a therapist can help achieve smooth recovery and movement of the elbow. Your physical therapist will determine the activities that bring on your symptoms. The recommendations at this point will be to avoid those activities for a time. Remember, the nerve is irritated and at times swollen. If the irritation and swelling are reduced, the symptoms should resolve.

Cubital Tunnel Syndrome  - How Physiotherapy Can Help You?

Rotator cuff is the name given to four muscles and their tendons, which keep your arms in your shoulder sockets, allowing you to lift your arms and do day-to-day stuff like combing your hair, cutting vegetables etc.

The shoulder joint is a very important joint of the body and this is why any tear that happens in the rotator cuff can be devastating.

Causes

Tears can happen in rotator cuff due to a number of factors like injury and degeneration due to age. Tears that happen due to an injury to the shoulder are called acute. Degenerative tears are tears that happen due to degeneration of the tendon over time.

Common causes of degeneration are lack of proper blood circulation, which impedes the rotator cuff s ability to repair itself. Repetitive stress is another cause where we stress the tendon by repeating the same shoulder motions again and again while playing games like tennis, cricket etc. and doing jobs that require us to extend our arms upwards a lot. Lifting heavy objects can also lead to tears.

Symptoms

Chronic shoulder and arm pain are good reasons for you to see your doctor. If you suffer from pain in your shoulder at rest, while sleeping on the affected shoulder or pain while lifting and lowering your arm, then there is no time to wait.

The doctor will do a physical examination by moving your arm in different directions. He may follow it up with X-rays and MRI to check how big the tear is in your rotator cuff.

Treatment

Once confirmed that you indeed have a rotator cuff tear, your doctor will start the treatment. The goal of any treatment is to reduce pain and make your shoulder joint work properly again.

Nonsurgical Treatments: 

Nonsurgical treatments include rest, using of a sling to protect the shoulder and modifying your daily activities. This means you may not be able to do activities that cause shoulder pain. Your doctor can also prescribe pain and anti-inflammatory medicines. Strengthening and physical therapy bring up the rear of this type of treatment.

What you must remember is that nonsurgical treatment relieves pain and improves function in the shoulder, but does not improve shoulder strength. The size of your tear may also increase over time.

Surgery: 

Surgery, which attaches the rotator cuff to your bone, is done if you suffer from continuous pain and symptoms over a year or so. If you have a large tear, conservative treatments will not work and surgery will have to be resorted to. 

If you have been suffering from chronic shoulder or arm pain, waiting and watching is definitely not an option. You must visit an orthopedic surgeon at the earliest. Remember, if treatment is not started soon enough, your rotator cuff tear will get larger and will require only surgery.

Rotator Cuff Tears: What Are My Options?

A broken bone is medically termed as a fracture.Fractures are linked with age as bones tend to become weak as one ages, so, the chances of a fracture occurring also increases. Fractures are usually classified into four types-
1. Closed fracture - In this type of fracture, the breaking of the bone does not result in an open wound
2. Open fracture- The opposite of closed fracture, the bone breaks through the skin. This may result in infections
3. Non-displaced fracture - in this type of fracture, the bone cracks but is not shifted out of its regular position.
4. Displaced fracture - A displaced fracture occurs when the affected bone is shifted out of its natural position.

Causes
Fractures can be caused by a number of factors, they are
1. Road accidents
2. When someone falls from a height
3. When the bone is directly exposed to a strong blow
4. When the bone is exposed to a repetitive force from activities such as sprinting
5. Osteoporosis, which is a condition where the bones become weak
6. The bones in the body tends to weaken with age, so at this time they become highly susceptible to fractures

Symptoms
1. Swelling in the area accompanied by pain
2. Limited movement of the affected joint
3. Muscle spasms
4. The affected area may also become numb

Diagnosis
The first step to diagnose a fracture is the knowing about the medical history of the patient and conducting a physical exam. The diagnosis is further confirmed by using imaging tests such as -
1. Magnetic resonance imaging (MRI) - In this procedure, images of internal body parts are taken with the help of a magnetic field and pulses of radio energy. MRIs can pick up signs of fractures very quickly, that is within the first week of injury. It is also easier to distinguish fractures from other related injuries in case of MRI.
2. X-rays -X-rays are a procedure that involves sending x-ray particles through an area to detect a fracture. Signs of a fracture may take several weeks to show up in x-rays.
3. Bone scan - In bone scans, some radioactive material is put inside the body through intravenous methods. These material tend to accumulate in the fractured area which then shows up in the images as a bright spot. If you wish to discuss about any specific problem, you can consult an Orthopedist.

How Is A Fracture Diagnosed?

Sciatica pain arises from the sciatic nerve which is the single largest nerve in our body. It consists of individual nerve roots, which branching out from the lower back of the spine to the back of each leg and combining together forms the sciatic nerve. The origination of the sciatic pain lies in the lower back of the body and radiates down the buttock to the sciatic nerve.

Causes of the sciatica pain

Arthritis: If an individual is diagnosed with arthritis, then he or she can expect a throbbing pain or numbness down till the leg.
Herniated disc: Another cause could be a herniated disc in the lower back of the body.
Spondylosis: Spondylosis in the lower back would also be a reason for the development of the sciatica pain.
PIVD/DISC bulge
Other causes are a spinal injury, diseased degenerative disc, infection on and around the lower back. The pain would worsen, if an individual is in an occupation where he or she has to stand or sit for hours at length. The lifting of heavy things would strain the sciatic nerves as well.

How to identify sciatica pain?
Sciatica pain varies from infrequent to a constant throbbing down the lower back. So initially it is difficult to detect whether it is sciatic pain or not. But when the constant pain in the lower back leads right down till the toes and foot, it is really time for an individual to get in touch with a doctor. The pain can give a burning sensation almost searing making it difficult for the person to stand up or walk properly. Along with the pain, one can feel fatigued. An involvement of the spinal cord is rare in the sciatic pain but is possible.

Treatment for sciatica pain
Sciatica can be treated in both surgical and non-surgical way. Surgical treatment is rare as sciatica tends to respond well with non-surgical treatments. If the pain continues for over a month despite treatment, surgical treatment will be considered. The non-surgical pain treatment would include physical exercises and oral medications along with natural treatment.

Medications: Painkiller medications prescribed by the doctor can be used to reduce sciatica. Medicines like aspirin, non-steroidal or oral steroids can help reduce the pain.
Steroid injection: Epidural steroid injection acts faster as it is injected in the affected area, thus providing relief from the pain quickly.
Exercise: Early morning exercises can be quite helpful.
Percutaneous Endoscopic Discectomy: The surgical treatment of Percutaneous endoscopic disc dissectomy constitutes a large part of interventional pain physicians and it has evolved considerably in terms of surgical technique and instrumentation. Percutaneous endoscopic discectomy is a relatively new technique for removing lumbar disc herniation. It involves using an endoscope to visualize the disc removal. The discectomy is performed through a posterolateral approach using specially developed instruments. The advantage of percutaneous endoscopic discectomy is that the disc is approached posterolaterally through the triangle of Kambin without the need for bone or facet resection thus preserving spinal stability. The procedure is day care and is done under local anaesthesia.

Sciatica Pain - 5 Ways You Can Treat It!

The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

Knee pain is one of the most common and painful ailments that can limit mobility. Injuries can result in cartilage or meniscal tears or sprains too. Obesity is another reason because of which knee pain is on the rise. Also, regular wear and tear of ligaments and tendons around the knees due to old age is another cause. These days, with reduced physical activities and sedentary lifestyles, the rate at which knees are wearing out has also become accelerated. Whatever the reason, a correct diagnosis followed by prompt treatment can help. Over the years, physiotherapy has been playing an important role in treating knee injuries. Whether to supplement the various drugs to reduce pain and inflammation or to avoid surgery, physiotherapy has helped many and its popularity is growing every day. Here are some ways that physiotherapy can help reduce pain.

Improve flexibility of tendons: The knee cap is an area where there are lot of tendons and ligaments, coordinating to enable movement. Careful exercising can ensure that the flexibility of tendons and ligaments is improved, thereby making your knee movement easier and less painful.
Improves blood supply: As we all know, proper movement requires good blood supply. Exercising with special focus on the knee ensures that blood supply is improved, and thereby the supporting ligaments and tendons function optimally.
Enhances the knee cap function: The knee cap is that portion which joins your thigh bone to your calf bones. This is prone to slip out of place, especially with arthritis and injuries. This can be painful and limit movement to a great degree. Focused exercises aimed at improving knee cap function will ensure that the knee cap has a wider range of function, and does not slip out of its socket easily.
Reduce rigidity: Once you start physiotherapy, you will feel your knees getting more flexible. The rigidity that had set in as a result of injuries and/or old age will also reduce over a period of time.
Slow down the wear and tear: When you start physiotherapy after knee damage, continuing the exercise routine, of course with expert guidance, can reduce the pace at which further damage might happen. A word of caution though. Be sure to consult an experienced physiotherapist before you begin. Exercising in a bad manner can do equal or more harm than the original injury or old age itself.

Knee Pain and Physiotherapy

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