Muscle strain or muscle pull is a condition, which is characterized by damage to the muscles or its adjoining tendons. Undue pressure can be exerted on the muscle when you are carrying out routine activities such as sudden lifting of heavy things or playing contact sports. The damage to the muscle is usually in the form of partial or complete tearing of the tendons and fibres attached to the muscles. The small blood vessels in the muscles can also be damaged by the tearing of the muscles, leading to local bleeding and bruising.

The symptoms of muscle pain are:
1. You will experience pain even while resting
2. There will be bruising, swelling and redness around the affected area
3. You will experience weakness of the muscles and tendons
4. The movement and mobility of the muscle will be impaired
5. You will experience pain when you use the affected muscles

The causes of a muscle strain are:
1. Playing contact sports can lead to injuries
2. Lifting heavy things
3. Exercising without a proper warm up routine
4. Lifting extremely heavy weights during exercise without proper acclimatization
5. Sleeping on one side only for a long period of time
6. Not stretching properly
7. Falling from a height

The treatments for muscle strains are:
1. Pain medications: You can opt for pain relieving medications such as non-steroidal anti-inflammatory medications to help combat the associated pain of a muscle strain.
2. Rice: Rice stands for rest, ice, compression and elevation. This treatment is usually the first step after suffering a strain, before opting for medications. This treatment prevents further aggravation of the problem.
3. Compress: You can alternate between hot and cold compress to reduce the swelling and pain.
4. Stretches: Once the affected area has healed, it is important for you stretch the muscles to improve their mobility and strength.

Not Stretching Properly? It May Cause You Muscle Strain

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

Fibromyalgia is a disorder that causes widespread body pain along with sleep deficits, memory loss, mood problems and fatigue. Symptoms may be triggered after a surgery, physical trauma, infection, or stress. Women are much more vulnerable to this disease than men. Many people affected with fibromyalgia may have suffered from headaches, backaches, depression, anxiety, tension, temporomandibular joint 
disorders and irritable bowel syndrome. Most of these patients have undergone multiple consultation with various doctors and undergone many tests, but no diagnosis could be made. These patients are often ignored by doctors and family members as always "complaining of pain".

Symptoms of Fibromyalgia:
1.Extensive Pain- Pain related to fibromyalgia is often depicted as a dull pain that lasts for at least three months. Pain can involve any body part like back,neck, chest, arms, legs. Patients have pain in multiple areas of body and painful areas change over time.

2.Fatigue- Patients afflicted with this disorder feel tired even after sleep. Such people are reported to sleep for longer hours than normal people, but their sleep often gets disrupted due to sleep apnoea and restless leg syndrome.

3.Cognitive Difficulties- These patients find it difficult to concentrate at work and also suffer from memory deficits in daily activities.

4.Other Symptoms: These patients may also have symptoms like burning urination, urgency of urination, numbness,loss of appetite, tingling sensation,diarrhoea, constipation, tinnitus, depression etc

Diagnosis of fibromyalgia:
There are no specific test to diagnose fibromyalgia. Diagnosis is made by a doctor specialised in Pain Medicine using clinical methods based on symptoms and examination. Blood tests like Haemogram, Thyroid function test, RA Factor, ESR are done to rule out other diseases which can cause similar symptoms. 

Treatment of Fibromyalgia
1.First step in treating these patients is to accept their problem and discuss with patient and family members regarding the presence of such disease entity.

2.Lifestyle changes like active involvement in cardiovascular exercises, swimming, yoga, meditation are important to control symptoms.

3.Conventional painkillers do not work in these patients. They requires special medications prescribed by a Pain Specialist for control of symptoms.

4. Counselling of patient is beneficial for associated depression.

Are You Suffering From Body Pains ? It Could Be Fibromyalgia!!

A fall or an injury is among the most common causes of a fracture. For a fracture to heal; the bones must be set in the correct position and a cast may need to be worn so as to hold them in place. This allows the bones to grow new tissue and bridge the break. The food you eat can help you speed up this process. Some of the best foods to build strong bones and help a fracture heal are:

Milk: Milk is one of the richest sources of calcium and vitamin D. It is also rich in proteins. These three elements are crucial to building strong bones. Proteins help the body release amino acids which in turn come together and create new tissue for the bones. Calcium is, of course, the building block of our bones. However, it is vitamin D that enables the body to absorb this calcium and utilize it. If you do not like the taste of milk, you could substitute it with yogurt. This dairy product is considered equally rich in proteins, calcium and vitamin D. In addition, it also contains amino acids such as glutamine and lysine that helps the bones absorb calcium.
Kale: Kale is known as a superfood. One of the reasons for this is the amount of calcium it contains. Kale is one of the few vegetables that are rich in this mineral. Thus, lactose intolerant people can get their required calcium from this vegetable. Kale can be eaten raw or cooked. Kale can also be juiced. However, to benefit fully from the vitamins and minerals in this vegetable, it is best to eat it raw.
Spinach: Spinach is another green leafy vegetable that is rich in calcium. It also contains zinc. Zinc helps stimulate the chemical reactions needed to bind calcium and other minerals together to create new bones. In addition, spinach is also a rich source of vitamin K. While this vitamin does not play a direct role in healing bones, it helps speed up the healing process.
Broccoli: Broccoli is a cruciferous vegetable that is rich in vitamin K1. This is very beneficial to your overall health and bone health. Vitamin K1 aids in the mineralization process of fusing broken bones together and building new bone tissue. Thus, it helps the bones set correctly.
Citrus Fruits: Fruits such as oranges are chock-full of vitamin C. This nutrient helps build a strong immune system and aids in the fracture healing process. Vitamin C also helps the body create collagen that surrounds the broken bones and allows it to heal faster.

Food Items That Help You Recover From Fractures!

Extramedullary intradural tumours are a rarity. Of all the tumours of the nervous system, fewer than 15% are of the spine. And around 45% of them are intradural. And 40% of intradural tumours are extramedullary.

What are some common Intradural Extramedullary Spinal Tumours? 

Some forms of intradural extramedullary spinal tumours are-

Schwannomas

Meningiomas

Gliomas

Neurofibromas

What are the Symptoms of Intradural Extramedullary Spinal Tumours?

Some symptoms of this condition are-

Back pain

Cramps

Loss of feeling along the back

Loss of spinal flexibility

Weakness of the limbs

Slight degrees of paralysis

Hunched-over spine

If treatment is not sought immediately, the effect of the tumours would penetrate all levels of the spine and may lead to complete paralysis.

How are Intradural Extramedullary Spinal Tumours diagnosed?

A basic physical examination will reveal that there are tumours on the spine. Before treatment commences, the person will have to opt for these tests-

An MRI scan

A CT scan

X-rays

biopsy

Treatment of Intradural Extramedullary Spinal Tumours diagnosed?

Doctors do not usually suggest surgery right away. They will first try to vanquish the tumours with chemotherapy and radiation therapy. Sometimes a combination of both might be required.

If therapy does not work, surgery will be suggested. During the surgery, resection is done with the aim to assuage pain and stabilize the spine. Preoperative embolization is performed. A catheter is inserted into a vessel of the groin and directed to the tumour. Then a glue-like agent is administered to the vessels that carry blood to the tumour. When this supply is cut off, the tumour will shrink.

After the surgery, a person will be required to stay on in the hospital for a couple of weeks after which rehabilitation may be required to help the patient get back to a normal lifestyle.

Spinal tumours can be fatal. That is why it is important to pay heed to the symptoms and consult a doctor right away.

Intradural Extramedullary Spinal Tumour - In Depth!

Natural Ways To Manage Arthritis

You might be aware that there is no way that you can prevent arthritis to happen except for being car. But what you can do is delay and reduce the risk of its potential onset. If your joints are healthy now, there is no guarantee that they will always be, unless, you take good care. 

Do you know a few kinds of arthritis can be modified. They are:

1. Gout - Have a healthy, balanced diet which is low in cholesterol, alcohol and sugar. This will help you fight against the onset of gout.

2. Osteoarthritis - To modify the risk factor of osteoarthritis, it is important to maintain a healthy weight.

How to defeat arthritis?

1. Keep a check on your weight: If you are obese, you are putting more pressure on your joints and as a result, they wear out soon. By losing weight, you can make a lot of difference in your joint health.

2. Ensure good water intake: Our body is 70% water. And water is one of those things which is the most important for us. Staying hydrated is very important, even for your joints. Because when the body is dehydrated, and the body needs water, it uses the water stored in our bodies, incl the water in the cartilage.

3. Try to avoid any injury: No one really wants to get injured but it is important to be careful and cautious against injuries of any kind. The more injured your joints are, the more susceptible they are to wear and tear now, and arthritis later in life.

4. Don’t stress with physical tasks: There is a way and correct posture to do them, but many people ignore those and perform the tasks clumsily. This puts additional pressure on your joints.

5. Get Your share of Vitamin D: Vitamin D is very important for us. If your body has adequate amount of vitamin D, then you are less susceptible to arthritis. It is wise to get the levels tested and if low, a doctor consulted for proper medication.

If you would like to consult with me privately, please click on 'Consult'.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Pain- free Arthritis? Here’s How To Make It Happen!

Don't wait any longer, manage your Shoulder Specialist online with a Lybrate doctor today

Consult for Shoulder Specialist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES