The movement between bones and muscles is possible due to the fluid filled sacs that enable smooth gliding of the bones. When there is an inflammation of these sacs, condition known as bursitis results, leading to friction, reduced movement, painful movement, discomfort, and irritation.

Some of the common causes of bursitis include age, which brings along reduced elasticity of the tendons and ligaments.  Additionally, sudden injury to the bursa area, repetitive stress, overuse of the ligaments or tendons, incorrect posture, and improper exercise can all lead to bursitis.

The most commonly affected parts are the elbows, shoulders, hips, knees, and ankles. The dull, aching pain that ensues is accompanied by stiffness. Movement can worsen this pain.  The area can be red, hot, and swollen indicating infection. Whatever the area affected, some of the common ways to manage bursitis pain are listed below.

1. Rest - As soon as bursitis is identified, the area must be rested. As noted, in most cases, repetitive stress and injury is the most common cause, and resting the area really helps.

2. Ice only - If bursitis is happening for the first time, then an ice pack alone should help reduce the pain in 1 to 2 days.

3. Ice and moist heat - If it is happening repeatedly, then alternating moist heat and ice for 15 minutes each will help.  This can be done two to three times a day. 

4. Anti-inflammatories: In most cases, if rest and topical therapy are not working, then the regular anti-inflammatory agents may be given. 

5. Physical Therapy - In some cases, mild exercises can help reduce inflammation and pain. 

6. DMSO (dimethyl sulfoxide) - This clear, colorless, oily liquid is made from wood pulp and helps in reducing the inflammation caused by bursitis. A 70% DMSO mixture can be applied with cotton on the affected area 3 times a day for 3 days, then 2 times a day for the next 3 days, and then 1 time a day for the next 3 days.  If there is no improvement in the first 3 days, it needs to be discontinued.

7. Foods to remove calcium deposits - In a number of cases, bursitis that is present for months or years is worsened due to the calcium deposits. Foods like apple cider vinegar can help dissolve the calcium deposits that could have formed in the bursa.

8. Steroids: Local injections of corticosteroids may be necessary in some cases. Though inflammation can be curtailed with this, there is always the fear of hampered immunity and altered sugar levels.

9. Surgical drainage - In very rare cases, the bursa may need to be surgically drained.
Bursitis is a very common issue and can be managed easily as well. Consult your doctor and avoid medicating on your own.

Ways to Treat Bursitis

The shoulders are the most mobile joints in your body. Shoulder joints undergo wear and a tear over time and hence become unstable. Shoulder arthritis is one of the painful conditions affecting the shoulder joints. Arthritis not only takes a toll on the tendons and muscles, but also affects the ligaments and joints too. They usually cause symptoms such as joint pain, resulting in limited mobility.

Treatment:

Nonsurgical or Lifestyle treatments:

Take rest or avoid the activities that provoke pain or change the way of your arm movements.
Physical therapy boosts shoulder mobility.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin alleviate pain and inflammation.
Corticosteroid injections in the shoulders can also help to ease the pain and inflammation, although temporarily.
Applying moist heat or ice packs over the shoulders for about half an hour at least thrice a day brings relief.
Drugs such as methotrexate can be administered in case one is suffering from rheumatoid arthritis (a chronic disease attacking multiple joints of the body).
Dietary supplements such as chondroitin and glucosamine may help reduce pain.
Surgical treatments (if your pain results in disability and does not lessen with nonsurgical options)

Join replacement surgery or arthroplasty involves replacing the damaged parts of the shoulder with a prosthetic (artificial) joint.
Few mild forms of arthritis may be treated using the Arthroscopic procedure (minimally invasive surgery). It requires a surgeon to ease the joint pain by making small incisions to  clean out  the joint. A tiny camera fitted into the joint guides the surgeon through the surgery.
Resection arthroplasty is a method that involves the surgical removal of the bone from the collar bone and substituting it with a scar tissue to treat arthritis of particular joints.

Everything You Need To Know About Shoulder Arthritis Treatment

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

Spinal fractures occur as a result of an injury or dislocation of the bony vertebra. This causes the bone fragments to pinch and damage the spinal cord. Fractures can occur anywhere along the spine but the most common site of fracture is the lower back.

What causes spinal fractures?

Spinal fractures are often a result of the following-

  A sudden traumatic injury
  A high-velocity accident
  Falling from a height
  Sports injuries
  Spinal instability
  A whiplash

Types of spinal fractures:

Spinal fractures are classified into three categories, such as the following-

  Compression fracture - If you exert excessive pressure on the vertebra, it will break. This type of fracture occurs when the bones in the spine become fragile or weak to the extent that they easily crumble. People living with osteoporosis, certain types of cancer or tumours are prone to a compression fracture.

  Dislocation - When the discs and/or ligaments linking the vertebrae is torn or stretched, the bones may dislocate or come out of alignment.

  Fracture-dislocation - Torn ligament and broken bone lead to this condition. A fracture-dislocation is a debilitating condition and often requires surgical intervention.

Symptoms of spine fractures:

Following an accident or an injury, you can tell if you have ended up fracturing your spinal column by identifying these symptoms-

  Excruciating pain
  Tingling sensation
  Numbness
  Muscle spasm
  Swelling of the muscle
  Sudden onset of back pain
  Restricted spinal mobility
  The pain worsens if you walk or stand for long
  Deformity or disability of the spine

How are spinal fractures treated?

Spinal fracture treatment begins with administering pain-management drugs and medications to ease the symptoms, and stabilization methods to prevent injury. Depending on the nature of the fracture, your doctor may follow these lines of treatment-

  Fusion and instrumentation - These are surgical procedures to cure unstable fractures. Fusion refers to the joining of the vertebrae using a bone graft along with hardware such as hooks, rods, plates, or pedicle screws. The bone graft joins the vertebrae below and above to form a solid piece of bone.

  Kyphoplasty and vertebroplasty - These are minimally invasive procedures, wherein the surgeon injects bone cement into the fractured body through a needle. During kyphoplasty, the surgeon first inserts and inflates a balloon to expand the compressed vertebrae and then fills it with bone cement.

Spinal fractures are an extremely uncomfortable and painful condition to live with. It can hinder your day-to-day activities and affect your quality of life. It is imperative that you seek immediate treatment if you end up with fractures or dislocation of the spine.

Spine Fracture - How Can You Get It Fixed?

A bone fracture occurs when a strong external force is applied on the bones causing it to break. It is an extremely painful condition that results in days of immobility and rest. There are several reasons which can result in bone fracture, some of them being:

1. Injuries caused in sports
Any sport requires and demands extreme physical exertion and participation. Being involved in any sport therefore automatically increases your risk of incurring injuries. Bone fractures therefore are mostly reported during sports.

2. Osteoporosis
Due to the deficiency of calcium, the bones of both men and women tend to get weak and more susceptible to fracture and breakage. It is one of the primary causes that lead to bone fracture.

3. Osteomalacia
This also refers to a condition wherein the bones become weak and brittle. Much like osteoporosis, osteomalacia too significantly contributes to instances of bone fractures.

4. Osteosarcoma
This is a rare form of bone cancer that most often develops either near the femur or near the shinbone. An instance of this form of bone cancer is most often found in children and weakens the bone, consequently leading to fractures.

Though there may be different causes of broken fractures, its symptoms remain similar. Some of them are-

1. Swelling
One of the most common symptoms of bone fracture is perceptible swelling. If any of your bone is fractured, that particular part will be visibly swollen.

2. Deformity
Bones give your body the shape it has, thereby, any fracture anywhere would inevitably manifest itself as a clear deformity of that particular part.

3. Extreme pain
It goes without saying that a bone fracture would entail excruciating and extreme pain. This pain sharply increases with mobility thereby necessitating complete rest.

4. Temporary loss of function
The part of the body where the bone is broken temporarily becomes dysfunctional. For instance, if the bone in your hand is broken, you will find it extremely difficult to move and do any work with it.

Causes and Symptoms of Bone Fracture

The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.
Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

Carpal Tunnel - How Endoscopic Surgery is Beneficial?

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