Physiotherapy can greatly help a patient of paralysis by making him/her independent to the maximum extent. Physiotherapy also plays an important role in negating potential complications after a paralysis. Although the process of rehabilitation can take time, it produces significantly encouraging result for a patient to continue with it until full recovery. The recovery depends on the type of paralysis a person has undergone. Notably, there are four types of paralysis:

Hemiplegia

Quadriplegia

Paraplegia

Monoplegia

Role of Physiotherapy-

The process of physiotherapy should resume as soon as the patient is stabilized. It not only helps in relaxing muscles, but also helps in smooth blood circulation. Long-term therapy can ensure muscle tone and overall well-being of an individual.

In the case of an external injury related to the brain, physiotherapy can speed up the recovery and reduce swelling to a significant extent. Some of the benefits are-

Physiotherapy can help a person regain the highest possible mobility.

Physiotherapy can increase the respiratory function of a person.

It helps the person in bringing down blood pressure and contracture.

A physiotherapist also focuses on unaffected area and works on them to ensure that the unaffected part of the body, in no way, loses mobility and retains the natural strength.

Physiotherapy also helps to manage a paralyzed bladder.

A physiotherapist suggests proper wheelchair, splint, braces, orthosis etc. These help a person to reintegrate quickly after the paralysis.

Physiotherapy lifts the morale and motivation of a patient by addressing post-traumatic experiences such as denial, anxiety, hostility, depression and anger.

It also serves as a perfect guide for the family of the patient.

Exercises that a Physiotherapist Suggests-

Aerobic Exercise: This is a set of physical exercises that lets the muscle tissues exchange oxygen at a rapid rate. The goal is to enhance the function of the motor neuron and the aerobic capacity of a patient. Support straps and gain belts might be required for a patient to stand on feet. A handrail helps to walk during this phase.

Physical Conditioning: Balance, stability, and coordination is the motive of any physical program for a paralyzed individual. Passive or active motion exercises help an individual to regain function of the limbs. Passive exercise also helps to regain strength. A physiotherapist rotates the thumb of a patient in such a way that the back of his hand faces forward.

Leg Rotations: One common exercise that is tried by a physiotherapist is to make the patient lie down on a mat with his/her legs straightened. Supporting the knee joint and the ankle, the right leg is moved outward and pulled backward. This is again repeated with the other leg.

Physiotherapy For Paralysis

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.

Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. There are 2 types of arthritis the knee joint in the human body can get afflicted with. They are:

Osteoarthritis: The form of arthritis which, with increasing pain, slowly wears down the joint cartilages is called osteoarthritis. This form of arthritis usually affects people after the age 40. The symptoms of osteoarthritis include:

severe pain in the knee joints

pain after walking up the stairs and it subsiding once you are on rest

severe pain after the movement of joints for a long time

pain that becomes worse in rainy days

joints becoming stiff after waking up in the morning but they improve in the latter part of the day

pain which also occurs in the thighs and the genital regions coupled with joints swelling and joints getting stiff after rest.

Rheumatoid Arthritis: Rheumatoid arthritis is a chronic form of arthritis caused because of the knee joint inflammations. This form of arthritis can occur at any age. Being an auto-immune disease, its symptoms include, but are not limited to:

severe pain in the morning

mild fever accompanying the pain

joints suddenly becoming swollen, red and warm causing, immense pain

sudden stiffness of the joints

pain that increases in cold weather

mild fever, extreme tiredness and weakening of the muscles

Doctors are still doubtful about what exactly causes the disease; but the deformation of the immune system might cause the damage of the joints, causing people who are already suffering from obesity, smokers, and women, in general, more prone to this disease.

When the knee pain is diagnosed as a form of arthritis, the following treatments are suggested:

If you are overweight or obese, losing some of those extra pounds can go a long way in reducing the pain.

Muscle-stretching exercises are effective in keeping the knee joints flexible.

Acupuncture and devices such as knee braces and knee caps can relieve the pain.

Prescribed dosage of anti-inflammatory drugs such as Tylenol, Motrin, and Advil or injections of hyaluronic acid might relieve your pain.

If regular treatments do not work, you might opt for knee-replacement surgery and osteotomy (the process of cutting a bone with the help of surgery) which might better the alignment of the knee by transforming the bone shapes.
Physiotherapy For Knee Arthritis-

Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions.

The main goals of physiotherapy for your knee arthritis are:

Reduce your knee pain and inflammation.
Normalise your knee joint range of motion.
Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
Strengthen your lower limb: calves, hip and pelvis muscles.
Improve your patellofemoral (knee cap) alignment and function.
Normalise your muscle lengths.
Improve your proprioception, agility and balance.
Improve your technique and function eg walking, squatting.

Arthritis - How Physiotherapy is Beneficial for it?

Gout is a disease of the joints. It is a kind of arthritis, which is caused by the deposition of uric acid in the joints. The deposited uric acid causes inflammation of the joints. The disease occurs when our body fails to eliminate the excess uric acid in blood by excretion or the production of the acid is increased.

The level of uric acid in our bodies goes up when the amount of purines in our meals is increased. Purines are responsible for the production of uric acid. They are found in meats, alcohol, sea food and other food items. When digestion of these foods takes place inside the body, purine is released into the blood stream. Uric acid level is also increased by a sedentary lifestyle. Sometimes other factors like intake of insufficient water, consumption of medicines and obesity can also affect the uric acid level in the blood.

Symptoms of Gout

One will notice a redness and swelling around the affected joint. Gout commonly affects the big toe, ankles, hands and wrists. The patient has to deal with intense shooting pain in the joint. The patient also feels some itching in the affected region. Some patients develop nodules called tophi in the joints.

Homeopathy Treatment for Gout

In most cases, patients seeking allopathic treatment for gout take frequent pain killers to get rid of the pain. The pain killers will provide temporary relief. But the main problem persists. However, homeopathy treats the root cause of the problem and aims at eradicating the disease completely. In this article, three commonly used homeopathic medicines used for treating gout have been listed. However, these medicines may not suit all individuals with gout. The effectiveness of the medicines largely depends on the patient s lifestyle. These medicines are listed below:

    Colchicum: It is the primary medicine given to patients suffering from gout. It is good for the treatment of the chronic cases. It is given to patients who suffer from pain in the big toe. The pain is unbearable, when the affected area is touched. The region turns hot, red and swollen. In these patients, the pain starts from the left side usually. The patient feels feverish. Their problem will intensify in warm weather. Their joints get stiffer.

    Ledum Pal: It is for patients who suffer from gout pain travelling upwards. The pain is likely to start from the patient s feet and travel towards the knees. The patient will not be able to bear external warmth. The patient feels better with cold application.

    Benzoic Acid: This medicine is for patients who suffer from gout along with offensive urine. The odour of the urine is intolerable. The colour of the urine is unusual brown in colour sometimes. There is a cracking sound in the joints.

Homoeopathic medicines can be a big boon for all those who suffer from high uric acid. These medicines work by reducing the uric acids overproduction by the body and accelerating the removal of this waste product from through the kidneys.

Homoeopathy is known to control the uric acid diathesis and is also useful in acute attacks. Homeopathy helps in controlling the pain during the acute attack of gout as well as helps in preventing the recurrence of such episodes. It helps in reducing stiffness and improves the mobility of the joints.

One big advantage that homoeopathy offers in the treatment of high uric acid is that once treated the chances of relapse are very less, this is also subjected to the condition that diet and Alcohol and weight are well controlled.

With continued treatment from a specialised homeopath, the patient notices reduction in the frequency of attacks and intensity of pains with gradually leading to complete cure.

Suffering from Gout - Can Homeopathy Help in Treating 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!

Arthritis is an inflammatory condition that affects the joints and bones of the patient and creates general problems when it comes to mobility and other such postures, which require some amount of physical stamina and strain. This kind of condition can be of many types. Furthermore, it can affect many different parts of the body right from the knees to the shoulders and the wrists. There are many forms of treatment for this condition, which may be carried out by orthopedic specialists as well as other practitioners of alternative medicine. 

Read on to find out why Ayurveda is one of the best ways to deal with this condition.

Ancient science: Ayurveda is an ancient science that is steeped in the logic of ages, and it has been allowed to evolve over numerous centuries, which makes it all the more authentic when it comes to various forms of treatment.
Combination of measures: Ayurveda is not just a field of medicine, but it is primarily known as a life science because it combines a variety of measures that have to do with inside out cleansing of the system. From massages to herbal medicines, yoga postures to lifestyle changes, this form of treatment can help the patient get rid of the condition rather than just treat the symptoms.
Massages: When we use a particular oil or herb to massage our bodies, we are actually imbibing the goodness and richness of those elements, which are ideal for the condition that we are suffering from. This oil that may be derived from cloves or various other elements that are naturally found, can actually seep right into the bones and joints to repair the condition. Mustard oil and camphor are also well known oils for arthritis.
Doshas: Ayurveda depends on the various doshas for a proper form of diagnosis, and arthritis comes under the Data dosha. This typically affects the energy, surrounding the proper functioning of the joints and therefore, one can safely say that this is a well-researched body of science, which is being put to use so as to prescribe medicines and other forms of treatment for that particular dosha.
Exercise: The yogic postures are known to have helped many people and the various asanas that are specifically required for an arthritis patient will help in doing away with the root cause of the disease. These asanas include the less rigorous ones that can build strength and stamina so that the patient is able to lead a more normal and healthy life.
Lifestyle changes: The diet changes that will be prescribed for arthritis-affected patients along with the changes in one s routine, will help in reaching the root cause of the condition so that he or she may get a better chance at normalcy in the long run.

Arthritis - Is Ayurveda The Best Treatment?

Stress fractures are small cracks that may appear in a bone. It occurs due to repetitive application of force in the same area. It is very common among various sports such as running, tennis and football. It may also occur due to osteoporosis as this disorder weakens the bones and allows stress fractures to occur easily.


The majority of stress fractures occur due to overuse of a specific muscle. The bones and the muscles used in a specific movement do not get time to recover, thus leading to stress fracture.


Causes
The major cause of stress fracture is change in physical activity, such as a sudden increase in exercise. The other factors that may lead to stress fracture are -


1. Poor conditioning: if you are starting an exercise regimen without proper preparation, then it may cause stress on the muscles. It is important that you condition your body before doing any intense activity to prevent injuries.


2. Bone insufficiency: various disorders such as osteoporosis reduces bone strength and increases the likelihood of a stress fracture. If you have low bone density then you are at a higher risk of having stress fractures.


3. Change in surface: change in surface like shifting from running on grass to road tends to cause more stress on the legs, thus increasing the likelihood of a fracture.


4. Improper form: performing any exercise with improper form may lead to a number of injuries. It is recommended to learn the correct technique before exercising, so you may use a spotter or a trainer to guide you.


Symptoms
The symptoms of a stress fracture are: 


1. Pain: you may experience dull to severe pain if you have stress fractures. The severity of pain will depend on the severity of the fracture.


2. Swelling: pain may be accompanied by swelling on the sides and the top of the foot.


3. Tenderness: stress fractures may cause tenderness in the muscles around the affected area.

Causes and Symptoms of Stress Fracture

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