The backbone is made up of multiple small bones which are connected together by a softer bone. The spine is what allows important body movements including bending and walking. The issue is, with age, the backbone also loses its elasticity and becomes rigid. Though this is a natural process with ageing, lack of exercise and sedentary lifestyle makes it worse.

Lumbar spondylosis is the medical term for this chronic, degenerative condition of the lumbar and the sacral spines (the lower portion of the backbone). This leads to chronic stiffening of the spine, affecting movement. This joint is very crucial in all bending movements and spinal movements.

Causes of Lumbar Spondylosis:

Ageing: As the condition progresses, the nerves that run through the spines can get exposed and there could be pain and irritation
Genetic abnormalities that produce a weak bone
Spinal trauma like accident or falls
Sedentary lifestyle: Sitting in front of the computer for prolonged hours also causes lumbar spondylosis
Overuse: People who are weightlifters tend to put excessive pressure on the spine, causing lumbar spondylosis
Symptoms:

Stiffness and pain in the low back
Pain with continued sitting
Numbness and tingling if nerves are getting affected
Loss of balance, leading to frequent falls
Losing control over bowel and bladder movement
Pain radiating to the lower legs
Ayurvedic remedies: This includes a combination of external applications, yoga, and food preparations including kashayas and tailas.

This condition is caused by increased Vata and Kapha. Maharasnadi kashayam, Astavarga kashayam, and Dashamoola kashayam reduce these elements.
Pain and inflammation is relieved by the use of various Guggulu including Mahayogaraja Guggulu, Simhanada Guggulu, Trayodashang Guggulu, and Dhanvantara Vati  
The affected joints can be hydrated with the use of gandha taila and dhanwantharam.
Kukkutandatvak bhasma is known to strengthen the bone.
Ashwagandha is known to lubricate the vertebral disks and joints
External treatments like Abhyanga are useful in improving joint movement. They improve circulation and help in removal of toxins so that pure blood can flow and reduce inflammation.
Vasti: This helps in improving nutrition to the joints and bones, thereby helping them repair themselves and heal.
Yogas for lumbar spondylosis: The five most effective asanas are:

Ardhakati chakrasana
Pada hastasana
Matsyasana
Ardha chakrasana
Vakrasana (sitting in a chair)
Additional measures:

Sit in a comfortable position with adequate back support
Take short breaks to avoid continued sitting
Sleep comfortably, by resting the back adequately
Strengthen the back muscles by regular exercises.
Eat healthy, avoid junk, and drink plenty of water.

Lumbar Spondylosis & Ayurveda - What To Expect

If you suffer from rheumatoid arthritis, you may be at a high risk of developing Carpal tunnel syndrome. This is a very painful condition in which the hands and wrists are affected. The Carpal tunnel refers to a structure which is formed by the bones present in the wrist and the surrounding connective tissues, through which the nerves and tendons controlling the thumb movement pass. Carpal tunnel syndrome occurs when the connective tissues get swollen because of inflammation and the nerves passing through the tunnel are crowded and squeezed.

Ways to get relief from Carpal tunnel syndrome:

Here are some common ways by which a patient with Rheumatoid arthritis can get relief from any discomfort caused due to Carpal tunnel syndrome:

Get your Rheumatoid arthritis treated. Carpal tunnel syndrome is commonly caused because of an underlying sickness such as rheumatoid arthritis. Medicines such as disease modifying anti-rheumatic drugs are used to manage the condition and for reducing inflammation which causes carpal tunnel syndrome.
Getting enough rest is also very important. You must avoid using that hand or wrist, which has been affected for some weeks. This will allow the inflamed tissue to heal. 
You may wear a wrist splinter. A splint is suggested for resting your wrist therefore, it is kept in a neutral position. It can be worn during the day or when you are sleeping.
You can take prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. These also help in reducing the swelling of tissues within the carpal tunnel.
A Cortisone shot may also be effective for easing the carpal tunnel syndrome. These steroid injections are given directly into the carpal tunnel. You will be able to get temporary relief from pain.
A set of Carpal tunnel exercises have been developed by doctors. These are designed for stretching the wrists and for keeping them limber. You must perform these exercises on a regular basis for best results. Yoga is also effective for easing carpal tunnel syndrome. Performing regular yoga will help you to improve your wrist pain. The upper joints of the body are strengthened. 
Take breaks at work on a regular basis. By changing your position and taking short breaks, your Carpal tunnel symptoms are bound to improve. This is more essential for people who do a job where great stress is placed on the wrists. If you are into typing, you need to take breaks and stretch your wrists.
There are several alternative therapies for easing carpal tunnel syndrome, which  are being studied and researched on. They include the likes of acupuncture, chiropractic care, magnets, botox treatments and vitamin B6 supplements. 

Carpal Tunnel Syndrome - 7 Ways to Ease the Pain

It is quite likely for you to mistake fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS) as the same condition because of the frequent overlap and similar symptoms. As a result, people with both conditions are diagnosed with only one and are treated for that. The major difference between PMS and FMS is that they need different treatment. The trigger points can be eliminated, and while MPS pain may exacerbate FMS, treating MPS can improve FMS.

About FMS and MPS

FMS is a disorder featured by musculoskeletal pain along with sleep, fatigue and mood swings. It affects the way in which your brain processes pain signals.
MPS is another chronic pain disorder in which the pain is caused in the body because of pressure on sensitive points in the muscles. It is known as referred pain.
Symptoms:
There are several symptoms of MPS which are similar to that of FMS, while there are some different symptoms as well. The common symptoms are as follows:

Soft tissue pain
Headaches or migraines
Disturbance in sleep
Problems with balance
Tinnitus or ear pain
Memory problems
Excessive sweating
Here are the symptoms which are associated with MPS only and not with FMS:

Extreme numbness
Clicking or popping joints
Reduced range of motion in the joints
Blurry and double vision
Unusual nausea
Here are some symptoms which are observed in FMS but not in the case of MPS:

Fatigue
Panic attacks
Developing allergies and sensitivities
Feeling overwhelmed because of high sensory input levels
Confusion and disorientation
Diagnosis
MPS is difficult to diagnose and treat because of referred pain. The symptoms have to be recognised and the trigger points need to be identified for detecting MPS. The trigger points are found on the basis of the symptoms. Several tests like magnetic resonance elastography (MRE) and tissue biopsy are used for MPS diagnosis. On the other hand, there are no tests or scans which can detect FMS in patients.

Treatment
There are several overlaps as well as major differences when it comes to the treatment procedures of MPS and FMS. The treatment methods which are used for both MPS and FMS are as follows:

Acupuncture
Physical therapy which may be in different forms
Tricyclic antidepressant medicine
According to studies, trigger point injections are not too effective in giving relief to fibromyalgia tender points, while non-steroidal anti-inflammatory drugs (NSAIDS) are not useful for the treatment of FMS pain as they are meant for inflammation. It is very important for you to visit a doctor if you experience any symptoms of FMS or PMS. You require proper diagnosis so that the right treatment can be undertaken.

Fibromyalgia Syndrome (FMS) & Myofascial Pain Syndrome (MPS) - Signs That Indicate It!

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

As you age, many parts of the body start to wear down. Your spine is no different in this regard. When age affects the condition of the cervical section of the spine, it is known as cervical spondylosis. Other names for the disorder are neck arthritis or cervical osteoarthritis.

Even though age causes most cervical spondylosis, other factors may also be responsible for the onset of the disorder. Here is a look at some common causes for the same.

Causes for cervical spondylosis:

  Bone spurs - Your body may try to strengthen the joints by growing additional bone tissues. These are known as bone spurs. These spurs can pinch down on the nerves and the spinal cord, leading to pain and other symptoms.

  Dehydrated discs - The spine houses shock-absorbing pad-like structures between the vertebrae, called discs. These discs contain a gel-like substance that gives them its unique shock absorbing properties. Over time, the gel dries out, causing greater friction between bones during movement.

  Injury - A neck injury can lead to cervical spondylosis. The disorder may not appear as soon as you suffer from the injury but may take years to develop.

  Excessive physical strain - Some profession may require people to lift heavy weights or overexert themselves physically. These people may develop cervical spondylosis later on because of this work.

Symptoms of cervical spondylosis:

Here are some symptoms that are commonly associated with cervical spondylosis.

  Shoulder pain - Patients suffering from cervical spondylosis often complain about pain in the shoulder blade. This pain increases while the person is standing, sitting, coughing, sneezing and tilting their head backwards.

  Weakness - People with cervical spondylosis also suffer from muscle weakness. For instance, you may not be able to grab things tightly in your hands, if you suffer from the spinal disorder. Furthermore, lifting the arms may be difficult.

Other minor symptoms of cervical spondylosis include stiffness in the neck that grows worse with time and headache that affects the back part of the head.

Treatment for cervical spondylosis:

Treatment is not necessary in many cases due to the absence of any distinguishing symptoms. However, if the spondylosis interferes with normal life, medical intervention is required. Treatment for the disease includes-

  Physical therapy - Physical therapy sessions often help deal with the pain and stiffness resulting from the cervical spondylosis. Your doctor will prescribe weekly sessions, which will aid to reduce the symptoms of the condition after some time.

  Medications - Pain medications help manage the discomfort related to the condition. However, these drugs do not have any long-term effect on the body. They only provide temporary relief from the pain.

  Surgery - Surgery for cervical spondylosis is uncommon. However, if the condition does not respond to other forms of treatment, the operation may be required to remove bone spurs, herniated discs and rectify parts of the spinal column.

You can also ask your doctor about home remedies to follow to manage the symptoms of the disease.

Cervical Spondylosis - How Can It Be Treated?

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