Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot. This can be a painful condition. Let us look at the ways in which it may be cured.

Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.

Flat Foot Pain - Ways It Can Be Treated!

A sprain refers to a break or a tear in any of the ligaments of your body. A ligament is a band consisting of tissues that connect the bones at any given joint in our body.

A strain on the other hand refers to a tear or a break in the entire muscle itself or a tendon (the band of tissues that connect the muscle to the bones).

Occurrence
Sprains usually take place due to unforeseen incidents like falls, accidents, and such other things that forces the body part to go out of its normal position. The most common types of sprains that people suffer from are ankle sprains which affect about 25,000 people every day on a worldwide basis.

Strains usually happen when you twist a whole muscle or a tendon. This condition most commonly occurs in cases of sportspersons who are engaged in contact sports like hockey, football, rugby, and such others.

Symptoms
The identification signs of sprains and strains are mostly very similar, which are listed below:
1. Pain and discomfort in the joints
2. Visible swelling or inflammation seen on the joints
3. Bruising of the affected area
4. Tenderness and softness of the affected joint

The overall intensity of the above mentioned symptoms might differ basis on the severity of the condition that is directly proportional to the nature of injury that you have faced. Some pains are so light that it may not affect your daily routine at all, whereas some pains are so intense, that you might not be able to move your affected joint at all.

Treatment
Some of the common methods to cure a sprain or a strain are listed below:
1. Rest the area which is affected
2. Apply ice bags or cold compress to soothe the pain
3. Compress the affected joint using a compression tape
4. Place the affected joint on an elevated area to speed up the healing process

Sprain Versus Strain

The human body is so amazing yet sometimes, it is delicate. The condition of cervical spondylitis is one of the examples of this being the case. It is also known as cervical disc disease and is reputed to cause a pretty large amount of pain! That being said, it is not as if this pain cannot be reduced. After all, physiotherapy can make almost any situation better and this is pretty much the case with cervical spondylitis, as well!


Neck traction happens to be one of the popular methods prescribed by physiotherapy to help people who are suffering from cervical spondylitis pain. What is done in this process is that the neck is extended but at a very slow rate. While this may not seem like much itself, why this helps is that it goes a pretty long way in taking a lot of pressure off the discs of the spine. While it is true that neck traction is a thing which can be performed at home, it is very important to check with a professional physiotherapist to make sure that the technique that one is practicing is faultless so as to make sure that any painful accidents are not allowed to take place and make the situation worse than it already is!


Physiotherapy is all about engaging in activities which help make the condition better. So, when a person has cervical spondylitis pain, the therapist will spend some time with him or her so that the neck can be slowly adjusted and this will help the range of motion of the person s neck improve by quite a large margin.


There are quite a few other ways to go about relieving the pain caused by cervical spondylitis by making use of physiotherapy. For example, deep tissue massage does have a large number of fans who swear by it. This is also the case when it comes to electrical stimulation. As a matter of fact, both of these are quite popular as a means to get the patient in the right condition for healing exercises to have their full effect.


After all the effort which is put in by the person by the way of exercise, it can be said to be important that he or she makes use of a cervical pillow, which is more commonly known as a neck pillow and a cervical collar, which can help the process of realignment. With correct physiotherapy, cervical spondylitis pain will soon be history!


How Can Physiotherapy Help Alleviate Cervical Spondylitis Pain?

A broken bone or a crack in the commonly known as a fracture. Any bone in the arm can be broken, but common areas for fractures in the arm is wrist, specifically the distal radius, forearm bones (radius and ulna), elbow, humerus and shoulder. 

What causes fracture in bones?

Fall: Falling an outstretched hand or elbow is the most common cause of a broken arm.
Sports injuries: Direct blows and injuries on the field or court are a common cause of all types of arm fractures.
Significant trauma: Any of your arm bones can break during a car accident, bike accident or other direct trauma.
Abuse: In children, a broken arm may be the result of child abuse.
How to identify?

An audible snap or cracking sound may be your first indication you've broken an arm.

Signs and symptoms include:

Severe pain, which may increase with movement
Swelling
Bruising
Deformity, such as a bent arm or wrist
Inability to turn your arm from palm up to palm down or vice versa
When to see a doctor?

If you have enough pain in your arm that you can't use it normally, see a doctor right away and do the same for your child. Delay in diagnosis and treatment of a broken arm, especially for children who heal faster than adults do, can lead to poor healing and deformity.

Fracture In Upper Limb Bones - 4 Things That Can Cause It

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

The joints and bones of the body are connected by fibrous band of tissue called as a ligament. When these ligaments are over stretched or are subjected to any injury that could cause tearing of the ligament and a sprain of the ligament happens. Sprains usually occur at the ankle joint, knee joint or the shoulder, since these areas have a connection of bones at a joint. 

During movement, the ligament functions to stretch or expand and move back to its original position. However, sometimes due to an over-stretch of the ligament, it gets pushed or expands beyond its usual position. A sudden twisting movement of the ligament can also cause a sprain. 

While walking, any abnormal movement of the leg can cause a sprain, hence, the ankle joint is the most common location affected by a sprain. Sports injuries are a common causative factor of sprains. In accordance to the body part involved frequently in playing sports, a wrist sprain or an ankle sprain is a common finding. 

Dancers are also prone to frequently sprain their ligaments. If a sprain occurs at the wrist joint, it can also lead to cause the Carpal tunnel syndrome, which leads to the numbness of the wrist joint. Moderate to severe pain around the affected joint, presence of bruising in cases of an injury, swelling around the affected joint and difficulty in movement are the common symptoms of a sprain.



There can be a popping sound heard during an injury to the joint, which indicates a sprain. Sprain of the joint can cause other complications too. If there is an involvement of the nerve in the injury, there can be an associated numbness and tingling sensation at the affected area. A physician performs physical inspection of the area while looking for the symptoms of sprain. If the injury involves a larger surface area and is causing severe pain, an MRI or X-ray can be ordered to detect for the ligament or bone involvement, respectively. 

Classification of sprain can be enlisted as follows: 

Grade 1 sprain (mild): Slight stretching and little damage to the fibers of the ligament. 
Grade 2 sprain (moderate): Includes partial tearing of the ligament.  
Grade 3 sprain (severe): Includes complete tearing of the ligament.  Prevention of a sprain can be achieved with certain measures. Specific exercises that can be targeted for sprain prevention can be learnt from the physical therapist.
Stretching exercises and muscle training are important in prevention of a sprain. Sprain preventing measures are as follows: 

1. Before beginning an exercise routine, it is essential to do warm up exercises. Slight jogging can be done to activate muscle movement. 

2. Stretching before and after an exercise routine is necessary. It ensures that the muscles around the joint are in a relaxed position. It helps in minimizing the risk of an injury. 

3. Some specific exercises that help to strengthen the muscles around ankles should be done. Heel raise exercise is beneficial in strengthening the ankle muscles. 

4. Exercises that target the improvement of overall body s balance should be done on a regular basis. These exercises help in preventing twisting of ankles during walking or moving down the stairs. 

5. In case of a previous ankle injury, it is recommended to wear an ankle brace to prevent any twisting caused by a dis-balance. 

Treatment of the sprain is done by following the RICE procedure. This procedure includes the protocol of rest, ice, compression and elevation. Analgesics can be taken for pain relief. Ice pack application helps in reducing the swelling. Using a compression bandage helps in immobilizing the injury.

Sprain - Effective Tips To Prevent It!

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