Bursitis is a disorder that is characterized by inflammation of a fluid filled sac called the bursa. Bursa is present in between various tissues such as muscles, tendons and bones where friction may occur. This sac cushions the tissues and prevents friction. The usual areas that are affected by this condition are hip, shoulder and the elbows.

The symptoms of bursitis are:
1. You will experience pain in the affected area
2. Tightness and stiffness in the area
3. Local swelling of the muscle
4. Redness of the area
5. Any physical contact with the area causes pain

Bursitis may also occur due to the following reasons:
1. Ageing results in loss of elasticity of the tendons, thus impairing their ability to tolerate any stressful activity
2. Sports such as baseball where you are required to throw the ball with force may lead to bursitis
3. If you do tasks that require kneeling down on a regular basis
4. Sitting on hard surfaces for extended periods of time
5. Abnormalities such as improperly placed joints
6. Inflammation from other conditions such as gout, thyroid disorders and rheumatoid arthritis may lead to bursitis

Treatment
The condition is treated by using a variety of methods such as exercise and medication. Antibiotics are used to treat any underlying infection causing bursitis. Injections may be administered to reduce inflammation in the affected area along with exercises to strengthen the affected muscle. In severe cases, the doctor may resort to surgery to treat this condition.

Prevention
You may use certain preventive measures to stay clear of bursitis. Some of them are
1. Lift with proper form: If you are lifting something heavy, then make sure you keep the spine straight and bend your knees slightly.
2. Take breaks: Don t remain in the same position for long duration, take small breaks and walk around to release the stress from your legs.
3. Exercise: Do strength building workouts to build strength in the joints. Include mobility and flexibility stretches in your routine to keep your joints healthy, thus increasing the range of motion.
4. Maintain optimal weight levels: If you are obese, then take steps to reduce your weight. Maintain a proper diet to check your waistline.

Bursitis - 4 Ways You Can Prevent it

Oh my aching Heel!! The combination of foot and ankle consists of 26 bones, 33 joints and an excess of 100 tendons. The longest bone present in the foot is the heel. Over usage or injury to the heel would lead you to experience pain in the heels. The severity of the heal pain can range from mild to excruciating. 

The cause behind heel pain is typically associated with excess usage of the heel bone. Straining of your heel occurs if you excessively pound your feet on surfaces that are hard, or you are overweight or even if you wear shoes that do not fit your feet properly. These strains cause irritation in the muscles, bones or tendons that are present in the heels. Some of the other common causes include: 

Heel Spurs: Development of heel spurs occurs due to the continuous stretching of the lining, which covers the heel. Upon continuous stretching, pieces of the lining tend to break off. Development of heel spurs is common in athletes who frequently jog or run. People who are obese also tend to experience pain due to heel spurs. 
Plantar Fasciitis: Development of Plantar Fasciitis occurs due to the inflammation of the tendinous tissue that connects the heel to the ball of the foot. Development of Plantar Fasciitis is common in athletes who frequently jog or run as well as people who wear shoes that don?t fit the feet properly. It may occasionally be associated with Vitamin B12 deficiency and raised uric acid in blood 
Achilles Tendinitis: This is the inflammation of the Achilles tendon. Achilles Tendinitis occurs commonly in people who have active lifestyles, such as people who are joggers, runners or even dancers. 
Treatment-

Physical therapy, medication or alternative treatments can be used to treat this form of pain. Medications for heel pain can only be in the form of anti-inflammatory drugs. Although these oral medications cannot significantly relieve heel pain, some injections containing substances such as corticosteroids, as well as Arthrocentesis (removal of fluid present in joints using hollow needles) might be able to provide relief. Recently PRP (Platelet Rich Plasma) injection have been found very useful in treating recalcitrant Plantar fasciitis and heel pains. 

Common practices that can be used to relieve discomfort include: 

Application of ice to the heel for a duration of 15 minutes daily. 
Utilize over-the-counter pain medications .
Have adequate amounts of rest .
Wear shoes that fit properly .
Walking on tip toes to stretch the plantar fascia helps to relieve heel pain.

Heel Pain: Know its Causes and Treatments

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

The human spine has 33 vertebrae. However, some conditions can fuse these vertebrae. Ankylosing Spondylitis is one such condition. This disease may also be known as AS or Bechterew's disease. It is an inflammatory disease that can make the spine less flexible by fusing the vertebrae of the lower back together. In some cases, it can also affect the rib cage and make it difficult to breathe. This disease typically affects more men as compared to women. Most patients begin showing symptoms in early adulthood.

Ankylosing Spondylitis affects the sacroiliac joints. These joints are located just above the tailbone. It causes inflammation of the spinal bones that in turn cause pain and stiffness. With time, this inflammation spreads to the entire spine and the vertebrae begin fusing together. This can make movement difficult and painful. In severe cases, it can also lead to the development of a hunchback. This disease also affects the other tissues of the body. For example, it can affect other joints and aggravate arthritis or affect organs such as the kidney, heart, lungs, and eyes.

A specific cause has not yet been identified for Ankylosing Spondylitis. However, studies show that genetic factors can be a trigger. In particular, the presence of the HLA-B27 gene increases a person s risk of developing symptoms pertaining to this condition. However, it is important to note that merely the presence of this gene does not make Ankylosing Spondylitis inevitable. Other genes that are associated with this disease are ARTS1 and IL23R. These genes influence the functioning of the immune system. While it can affect people of all ages, adults are at a higher risk of suffering from this condition.

In many cases, the initial inflammation of the spine is due to a bacterial infection of microbial infection. Though the infection itself may be treated and cured, it may cause the immune system to react and trigger inflammation. Once activated, if the immune system cannot be turned off, this inflammation will continue and can trigger Ankylosing Spondylitis. In each case, the disease presents a unique pattern of progression.

There is presently no cure for this condition, but with an early diagnosis and treatment, the symptoms can be managed and progression can be slowed. This treatment usually takes the form of medication to relieve pain, inflammation and discomfort and physical therapy. Surgery cannot be used to treat Ankylosing Spondylitis but in cases where it has caused severe joint damage, surgery may be advised to replace the damaged joint.

Ankylosing Spondylitis - What Are The Causes?

Total Hip Replacement is also known as Total Hip Arthroplasty, in which the damaged cartilage and bones in the hip area are removed and replaced with prosthetic components. On the other hand, Total Knee Replacement, also known as Total Knee Arthroplasty or resurfacing, involves replacing the bone surface of the knee area. 

Causes of Hip and Knee Pain 

Arthritis is the most common cause of chronic hip and knee pain or disability. Other causes include: 

  Avascular necrosis or Osteonecrosis is a condition where there is an inadequate supply of blood to the femoral head due to a hip injury. The inadequate supply of blood may cause the bone surface to collapse and this can result in arthritis. 

  Rheumatoid Arthritis is the most common inflammatory Arthritis. In this condition, the synovial membrane surrounding the joint begins to thicken and become inflamed. This results in cartilage loss, stiffness, and pain. 

  Osteoarthritis is the type of arthritis, usually related to old age but can occur among young people too. The cartilage cushioning the hip and knee bones becomes soft and gradually wears off. The bones eventually start rubbing against each other which causes stiffness and pain in the knee and hip area. 

  Post-Traumatic Arthritis can follow a severe hip and knee fracture or injury. 

  Some children with hip disease or problem, even after treatment, can develop into arthritis later. This may be caused by uneven or unusual growth of hip which affects the joint surfaces. 

Knee Replacement Procedure 

  Bone Preparation: The surface of impaired cartilage at the end of the tibia and femur are separated besides a small extent of the underlying bone. 

  Locating the Metal Implants: The removed bone and cartilage are substituted by metal implants creating the joint surface. These metal pieces may either be press-fit or cemented into the bone. 

  Resurfacing the Patella: The undersurface of the kneecap or Patella is cropped and reformed with a plastic button. This process is variable depending upon the condition. 

  Inserting a Spacer: To form a smooth gliding surface, a plastic spacer of medical-grade is positioned between the metal components. 

Hip Replacement Procedure 

  Metal stem replaces the damaged femoral head and positioned into the femur s hollow center. 

  On the upper portion of the stem, a ceramic or metal ball is planted. This ball acts as a substitute for the damaged/detached femoral head. 

  The damaged Acetabulum or cartilage surface of the socket is discarded and supplanted by a metal socket. Cement or screws are used to sustain the socket in place. 

  A spacer, either metallic, plastic or ceramic is placed between the socket and the new ball for a smooth gliding surface. 

Take Away 

Knee and Hip Replacement are taken as the last option for the patient. The surgery and its outcome vary depending upon various factors. One should consult the doctor before undergoing for the Hip and Knee Replacement Surgery.

Primary Knee & Hip Replacement - Know More About Them!

Repairing shoulder tendons through a telescope! When doctors talk about shoulder tendon repair, often they may be refering to rotator cuff surgery. The rotator cuff is a set of tendons and muscles that together form the cuff above the shoulder joint. The rotator cuff is responsible for stabilizing & keeping the arm within the joint, at the same time enabling the joint to move freely without any hindrance.

Thus it is responsible for maintaining strength of the shoulder. The tendons can become damaged due to injury or even overuse. When this occurs, the rotator cuff can be repaired with the help of surgery. Generally, a rotator cuff surgery makes use of an incision.

A shoulder arthroscopy, on the other hand, makes use of smaller incisions and repair is done with the help of a telescope.

Here are some of the commonly used techniques to repair a rotator cuff tear:

  When going for an open repair, the surgical incision is made and the deltoid gently moves out of the way making room to perform the surgery. Rarely an open repair method may prescribed for complex and larger tears or if any associated procedures are to be performed.

  In the case of the arthroscopy procedure, the small camera referred to as an arthroscope is put inside the small key hole incision that has already been made. The arthroscope, which connects to a video monitor, enables the surgeon to view the complete interior region of the shoulder. Further, few more incisions are made in order to allow insertion of various other instruments. During this surgical procedure, the damaged tissues are removed, or they are repaired depending on the damage levels. All of this is done with the help of an arthroscope.

Repairing the rotator cuff:

  In order to do so, the tendons need to be re-affixed to the bone.

  Small rivets referred to as suture anchors help to refasten the tendon and the bone. The suture is usually made of a special strong material that holds the repair for a long duration.

  The sutures are responsible for tying the tendon to the bone.

Why is this surgery recommended?

The physician recommends a rotator cuff tear or tendon surgery when the patient experiences pain while sleeping at night or faces difficulty carrying out daily physical activities, or when it has shown little improvement over the months in spite of exercising. This procedure is also recommended for people who lift heavy weights or are involved in sports activities. Moreover, the risks associated with this procedure are few and common to all surgical procedures.

A rotator cuff surgery performed arthroscopically has a very high success rate as it is performed under magnification. The procedure is far more precise than an open surgical procedure. Any associated injuries within the shoulder can be tackled simutaneously thus leaving very little room for errors. The recovery is therefore complete and faster due its minimally invasive nature.

Repairing Shoulder Tendons Through Surgery!

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