Are you suffering with pins and needles in your hand? You may be suffering with carpal tunnel syndrome. Carpal tunnel is a tunnel made of bones in the wrist. Roof of the the tunnel is made of a ligament. This tunnel contains a nerve and some tendons which help in bending of fingers.

This nerve is called median nerve and it acts as a electrical wire carrying sensation from certain parts of hand. It also functions as a wire carrying power signals from brain to hand. Increased pressure of the tunnel causes compression of the nerve and this condition is called as carpal tunnel syndrome. This syndrome gives symptoms of pins and needles in part of hand and weakness in grip. (Pins and needles in Hindi is commonly known as झुनझुनाहट or झुनझुनी or सुन्न पन). Often patient will wake up in night because of pins and needles and shake their hand to relieve the symptoms. It can also manifest as burning sensation or pain in hand.

Carpal tunnel can be caused due to multiple factors. It is commonly seen in pregnant females. Repeated use of hand in certain postures can also lead to carpal tunnel syndrome. Other causes are thyroid problems, diabetes, rheumatoid arthritis and injury to wrist.

Diagnosis of carpal tunnel is mainly clinical and nerve conduction study is a useful tool in confirming the diagnosis. Special (Neuropathic ) pain killers can help with the symptoms. Physiotherapy and posture training can also reduce pins and needles. Night splints are often helpful. If symptoms fail to improve with non operating measures, surgical decompression of carpal tunnel is indicated. Carpal tunnel surgery is performed as a day case procedure under local anaesthetic. It has very satisfying results and a quick recovery.

This article is for information purpose only and not a substitute for proper medical advise.

Pins & Needles In Hand - Carpal Tunnel Syndrome!

A Guide to Dealing with Fibromyalgia

Fibromyalgia is a chronic condition marked by constant flu-like symptoms such as fatigue, headaches, insomnia and joint pains. However, the disease has no visible symptoms. There are also no known causes for the disease. While some believe stress to be a trigger for fibromyalgia, other theories suggest that physical and emotional factors such as a prior illness lead to the onset of this disease. This leads to fibromyalgia patients being often misunderstood and misdiagnosed. Almost 80% of fibromyalgia patients are women. While the disease is not lethal, it can make daily life difficult.

The criteria for fibromyalgia were established only in the late 1900s. In addition, the symptoms of this disease present themselves differently in each patient. This makes diagnosis very difficult.

Constant pain all over the body is the most common symptom of fibromyalgia.
You may also feel constantly tired, and unable to get a restful sleep.
Some fibromyalgia patients also suffer from depression or anxiety and an irritable bowel syndrome.
Fibromyalgia patients may also feel hyper sensitive to cold or heat, and feel numbness in fingers and toes.

Fibromyalgia has no known cure, and like arthritis, treatment for this disease addresses its symptoms. Most treatment programs include a combination of drugs, physical therapy, and behavioral techniques.

Pain relievers or anti-inflammatory medication and antidepressants are the two types of drugs administered to fibromyalgia patients. However, these should not be counted on as a long-term solution, as the side effects of these medicines can cause additional problems. Therapeutic massages and chiropractic manipulations can also help ease the pain. Along with this, it is also important to rest and relax. This helps reduce stress which often triggers fibromyalgia symptoms.

To get a better night's sleep, try going to bed and getting up at the same time every day. A warm glass of milk or chamomile tea just before bedtime can also help induce sleep. As far as possible, avoid taking sleeping tablets, as the body can soon become dependent on these.

Though you may constantly feel tired, increasing the day to day activity levels can have a positive effect on your health. Consider adding low-intensity activities such as walking, cycling, yoga or dancing to your daily routine. Complement these with a well-balanced, nutritious diet that includes lots of fruits and vegetables. If you or a loved one has fibromyalgia, bad days may not be prevented. But with treatment, they can be controlled.

A Guide to Dealing with Fibromyalgia

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!

Hemorrhoids or piles are diagnosed by swelling of veins in the lower part of anus and rectum. Due to swelling, the walls of rectum and anus are stretched and thus become irritated. Hemorrhoids are of two types: Internal and External hemorrhoids.

Internal Haemorrhoids: As the name suggests, the piles are not visible from outside. These are present deep inside the rectum, located above the pectinate line and these are covered with the cells that are present through the rest of intestines. Internal hemorrhoids are normally painless. The first sign of internal hemorrhoids is rectal bleeding. However, straining can push internalhemorrhoid and it protrudes through the anus and this can be painful.

Causes of Haemorrhoids
The swelling of hemorrhoid occurs only when the pressure in the small vessels of rectum and anus is increased and is engorged with blood. The size of the hemorrhoids is also increased. The increased pressure may be due to various factors:

Consuming low fiber diet and pushing or straining while passing stools, thus blood vessel pressure is increased.
Pregnancy also is a cause of swelling as there is the increased pressure of the uterus on rectum and anus.
Sitting for long on toilet also increases pressure.
Obesity is also a cause of hemorrhoids.
People suffering from diarrhea, both acute and chronic.
A person having colon cancer might have hemorrhoids.
Signs and Symptoms of Haemorrhoids:

The most common symptoms of hemorrhoids are painless bleeding, itching in anal, swelling and feeling of the presence of lump at the anus.
All these symptoms are associated with inflamed hemorrhoid.
Inflamed internal hemorrhoid can cause swelling, but is painless as there are no fibers attached to veins above the pectinate line that cause pain. However, passing hard stools can scrape off the thin lining of hemorrhoid, which can cause the painless bleeding.
Spasms of the rectum and anal muscles caused by these swollen hemorrhoidscause pain, especially when they are protruded through the anus.
Internal hemorrhoids can form a clot or thrombose resulting in severe pain.
The presence of has inflammation, stool,and constant moisture and these can lead to itching and burning sensation in the anus among patient of internal hemorrhoid.
Treatment of Haemorrhoids

Diet: Haemorrhoids can be treated when individuals consume a fiber-rich diet in order to soften the stools and ease their bowel movements. Fiber-rich foods include fresh fruits, dry fruits, grains, vegetables, and cereals. About 20 to 30 grams per day of fibrous foods is recommended. Dietary fiber will help create bulk in the intestines which will help in softening of stools and ease bowel movement. Supplemental fiber available in the marketincludes psyllium husk, methylcellulose, and calcium polycarbophil. Other recommendations include increased intake of liquids and having stool softeners. Drinking enough water and liquids will prevent stool from hardening.
Over-the-counter topical treatment: There are various products available to treat hemorrhoids, such as gels, hydrocortisone creams, ointments, foams, pads, and suppositories.
Home remedies: Soaking anus in a warm sitz bath might also help in hemorrhoids for about 10 to 15 minutes per day. One should practice good hygiene and clean anus with warm water while showering. Avoid using soap and dry toilet paper. One can also use a cold compress on the anus.
Minimally Invasive Procedure for Hemorrhoids (MIPH)

Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.

MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised, proximal to the piles and disrupted mucosa is fixed by  stapled end to end mucosal anastomosis.

This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30 45 minutes.

Internal Haemorrhoids - Best Ways They Can Be Treated!

The Anterior cruciate ligament (ACL) is an important ligament that gives stability to the knees. An injury to this ligament can result in a host of complications and discomfort. Children or adults who are into sports such as gymnastics, volleyball, tennis, basketball, soccer, football, often injure this ligament. As per various studies and surveys, ACL injury is more likely to affect female athletes as compared to their male counterparts.

Depending on the severity and extent of the damage, an Anterior Cruciate Ligament Injury may be ranked on a grade of 3.

Grade 1 sprains indicate a mild injury or stretching of the ligament, seldom affecting the stability of the knees.
Grade 2 sprains are indicative of a partial ligament tear (the ligament loosen up). The damage is still under control.
Grade 3 sprains are extensive and severe, indicating a complete ligament tear (the ligament often breaks in two pieces). With a complete ligament tear, the stability of the knee is also affected (the knee becomes highly unstable).
What causes Anterior Cruciate Ligament (ACL) Injury?
While a host of sports activities mentioned above increases the risk of the injury, a person may also suffer a partial or a complete anterior cruciate ligament tear under the following situations.

A jump down a ladder, a tree, or a wall. An incorrect jump or a landing may be equally responsible for the ligament tear.
A collision or a hit, especially on the knee (while playing football).
Slowing down suddenly while still in running motion. A person suddenly stopping or missing a step can also injure the ligament.
Symptoms associated with ACL injury

An excruciating pain (especially in the back and outside of the knee) is often seen in people with a complete ligament tear (the movement is yet not affected). However, within a few hours, there may a swelling around the knee, indicating the severity of the injury with internal bleeding within the knee joints.
There may be restricted knee movement. The knee also feels unstable, further limiting the movement.
Sometimes a pop in the knee can be heard just at the time of the ACL injury.
Prolonged ACL injury left unattended can result in a painful complication such as knee osteoarthritis.
Diagnosis
To diagnose the extent of the damage, the doctor may suggest

Physical examination, including a quick brief about the case history.
Imaging tests such as X-rays and MRI can go a long way to analyze the ligament injury.
In the case of extensive swelling of the knees, the doctor may carry out an arthroscopy to have a closer look inside of the knee.
An accurate and timely diagnosis is important to avoid the aggravation of the injury. In the case of swelling and knee pain, consult a doctor, and get yourself thoroughly examined.

Anterior Cruciate Ligament Injury- Causes, Symptoms, and Diagnosis

Primary Total Hip Replacement Surgery is generally a successful procedure, allowing people to restore their active and painless lifestyle. It involves the replacement of a hip joint with a prosthesis or an implant made of different materials. But, over a period of time, this procedure might fail for a number of reasons. When such a failure happens, revision surgery is employed. The Revision Total Hip Replacement Surgery is hence the second operation that removes parts of the first prosthesis to replace them with a new set.

The ultimate goal of both the procedures, namely Total Hip Replacement Surgery and Revision Total Hip Replacement Surgery is the same that is to improve the quality of life by bettering the functionality and relieving pain. However, these two surgeries are different in their procedure and complexity. Revision Total Hip Replacement Surgery is more complex and takes much longer time. It requires good planning and use of specialized tools and implants for achieving good results. Use of specialized implants compensates for the damage to soft tissue and bone that makes it difficult for the surgeon to use standard Primary Hip Implants.

Revision Total Hip Replacement Surgery can manifest itself into two forms:

There might be the need to remove the entire prosthesis and its replacement. It might also involve rebuilding the bone around the hips with augments or bone graft.

In another case, there is a possibility that only some parts or components of the prosthesis need to be removed and replaced.

When to go for Revision Total Hip Replacement Surgery:

When there is wearing and loosening of Implant, it does not function properly. For proper functioning, the implants can be cemented into place or press- fit allowing the bone to grow onto them. If this does not happen, the components get loose leading to pain. Loosening of implants might be caused by excessive body weight, rigorous physical activity, and wearing of the plastic liner inserted between metal cup and ball. Also, younger patients might also have to go through a Revision Surgery when the implant completes its life expectancy.

If there is a bacterial infection in the Total Hip Replacement, Revision Surgery is employed. This is so because antibiotics cannot alone eliminate bacteria from joints. In such cases, two stages of the operations are required. But sometimes, a single stage operation is also employed. However, it has limited application.

When there is a recurrent hip location in the ball and socket joint, Revision Surgery is opted to properly align the joint and to insert the implant.

In case of a periprosthetic fracture (when bone around the implant breaks), Revision Surgery is required.

When metal used in implant breaks or degrades, it may cause damage to soft surrounding tissue and bone. This would require a corrective Revision Surgery.

Preparation for the Surgery:

The patient undergoes a thorough physical examination. It is to ensure that undergoing surgery would not be harmful in any possible way. X-Rays, MRIs, and CT scans are employed to fully understand the structure of the joint. Laboratory tests are conducted to ascertain the fitness of the patient to undergo the procedure. It should be noted that post- surgery, the patient is not able to function at all and requires help even to perform petty tasks for himself. Thus, suitable arrangements should be made accordingly in advance for the same.

Post-Operative Care:

Post-operative care involves pain management, preventing infection, physical therapy, wound care, and prevention of blood clot. It ensures a healthy recovery.

Primary & Revision Total Hip Replacement Surgeries!

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