If you are experiencing joint stiffness in your hip along with pain and tenderness, you could be suffering from hip arthritis or osteoarthritis. Osteoarthritis accounts for being the most common form of arthritis. It is referred to as degenerative joint disease and old-age arthritis and usually, occurs because of age-related issues. The condition occurs when injury and inflammation of a joint lead to the breakdown of the cartilage tissue, causing pain, swelling, and deformity.

How hip arthritis affects the hip joint?
People who are affected by osteoarthritis of the hip may have difficulty in walking properly. Diagnosis in the early stage is difficult as pain may occur in various locations such as the thigh, groin, knee or buttocks.

The underlying causes
The factors responsible for osteoarthritis include increasing age, joint injury and excess body weight. Some other factors may also be responsible. They are as follows:

When the joints have formed improperly.
In case of inherited defects in the cartilage.
When a person puts excess stress on the hip joint because of being overweight or due to certain activities and motions.
How it can be detected?
The different symptoms of hip arthritis or osteoarthritis are as follows:

Joint stiffness, especially after waking up in the morning.
Joint stiffness after sitting for a long period.
Swelling, pain, and tenderness in the hip joint.
A crunching feeling or sound of bones rubbing against one another.
The inability to move the hip for carrying out daily activities.
Treatment
The aim of osteoarthritis treatment is to improve the patient s ability to move about so that his regular life is less affected. The function of the hip and pain management are other targets of treatment for this condition. The different treatment plans are as follows:

Proper joint care and rest
Using a cane while walking for taking weight off your hip
Losing excessive weight
Non-drug pain relief measures for controlling pain
Regular exercise
Several medicines, including NSAIDS and other prescribed pain medication
Surgery
Alternative therapies
Hip replacement surgery
This is a surgical procedure used for osteoarthritis treatment when all other treatment plans fail. The damaged ball of the hip joint is replaced with a metal ball in this surgical procedure. The hip socket is resurfaced by using a plastic liner and metal shell. Apart from the mentioned treatment procedures, hip resurfacing is another surgical option for osteoarthritis treatment, which helps in giving relief when a hip replacement surgery is delayed. In this procedure, the affected hip joint surfaces are surgically removed and are replaced with metal.

Arthritis - How it Impacts Your Hip Bone?

While it may be obvious that no form of pain is welcome, it can be said that pain which is felt on account of being affected by sciatica is especially unwelcome. Taking that into due account, the good news is that physiotherapy can go a long way in helping by improving this sort of pain.

The longest nerve in the whole human body is the sciatic nerve, so it can be expected that when there is trouble with this nerve, the pain would be pretty significant. The leg pain which is caused to a person when this nerve happens to be getting pinched is known as sciatica.

There is a range of treatments when it comes to how something as painful as sciatica is to be solved. Now, while it is true that a solution such as making sure there is an amount of bed rest which is sufficient is very important, to say the very least, it is often the case that the person with sciatica would like his or her recovery to be hastened.

In order to make sure that this is the case, physiotherapy is quite useful. There are various forms of physiotherapy which can be made use of, and the decision as to which sort of physiotherapy a person would be best suited to would obviously be part of the subjective assessment of the person by a practitioner who is well qualified and experienced.

Some of the solutions when it comes to physiotherapy being used in order to treat sciatica are quite innovative, to say the very least. For example, there is physiotherapy instrument mobilisation, which is also known as PIM. What this entails is that a mechanical spring-loaded instrument is used in the process which serves the purpose of mobilising the spinal cord of a person along with his or her peripheral joints.

One form of physiotherapy oriented treatment which is used to address the issue of sciatica is real-time ultrasound physiotherapy. It can be said that this is not close to as cutting edge as physiotherapy instrument mobilisation is but it does serve as a rather dependable and useful way to battle sciatic pain. This form of physiotherapy makes use of ultrasound technology to analyse how the muscles function and then using that as a basis to create a list of physiotherapy exercises to be done by the person who is having sciatica. Rather than medicines, physiotherapy improves sciatica by getting a person to use oneself!

How Can Physiotherapy Help With Sciatica Pain?

At some point in life most people experience acute pain in their lower back which is extremely painful. Pain in the spine causes a lot of discomfort and disruption in the life of an individual and hence, it is always better to get it checked on time. There are patients who even wonder when they should consult a neurosurgeon or a spine surgeon for their back pain. It is advisable that a physical examination is done by a primary care physician for low back pain before consulting a spine surgeon.

Why consult a Physical care Physician First?
The main reason to consult a primary care physician at first is that he would prescribe medications for severe lower back pain. The medications could include non-narcotic pain medications such as Ultram or non-steroidal anti-inflammatory drugs such as Motrin. The physician can even refer you to a chiropractor or for physical therapy to get relief from the back pain. Mechanical means are made use of by a chiropractor mainly to alleviate the back pain of the patient.

If the patient feels better with the physical therapy or the medications prescribed by the family doctor and is able to resume normal activities, then there is no need to see a spine surgeon. It is often recommended to take good care of the back and to exercise. A combination of ergonomics, regular stretching and improved everyday posture is beneficial as it reduces the chance of causing pain in the lower back. Exercise plays a very important role and it provides the possibility of reducing the pain.

Conservative Care for Treating Lower back Pain
It is best for patients to consult a conservative care specialist if after consulting a chiropractor they do not find any reduction in their pain and they do not want to undergo spine surgery. The conservative care specialists are well-trained in rehabilitation of musculoskeletal disorders and specialize in spine care. The role of the conservative care specialist is similar to a cardiologist who specializes in treating neurological disorders.

The specialist for spine care works along with the surgeon in a spine center to treat the lower back pain. The specialist is trained in diagnostic techniques and is capable of making use of a combination of diagnostic tests as well as injection techniques such as epidural steroid injections to diagnose the source of the lower back pain in a patient. They can even advise patients whether it is appropriate to consult a spine surgeon for surgery. Surgery is done to correct the anatomical conditions and it is performed only when non-surgical treatments are not successful in alleviating the pain of the patient.

When Is The Right Time To See A Spine Surgeon?

The bones and joints orchestrate very well with each other for smooth movements of various joints and the spine. However, due to various reasons, some identified and others unknown, there could be inflammation of the areas where the bones join the muscles leading to impaired movement. The range of motion could be reduced or it could be painful, thereby, limiting movement. Spondyloarthritis includes a group of inflammatory diseases that involves the bones and joints and enthuses which are areas where the ligaments and tendons attach to the bones. This causes conditions like plantar fasciitis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. The term spondyloarthritis is a blanket term to describe any of the above-mentioned conditions.

Read on to know a little more in detail about it:

Causes: While the exact etiology is not identified for sure, most patients with spondyloarthritis have an autosomal dominant gene (HLA-B27). Chronic infections could trigger the onset of the disease too.

Symptoms:

1. In all forms of spondyloarthritis, there is always inflammation of the spine, joints and entheses. If the fingers or toes are involved, there could be swelling leading to what are typically known as 'sausage digits'.

2. There is sacroiliitis which is inflammation of the joint between the pelvis and the spine, and spondylitis which is inflammation of the joints between the spines. 3. Family history and autosomal dominant gene.

Diagnosis:

A detailed medical history and physical examination form the cornerstone of a confirmed diagnosis. In addition, radiographic examination and diagnostic blood tests also could be done to confirm the diagnosis. Radiographs, especially, of the spine and the low back show typical changes including sacroilitis in suspected cases of spondyloarthritis. If the spine does not show these changes, but there is a high likelihood of spondyloarthritis, then MRI (magnetic resonance imaging) can be used to confirm the diagnosis.

As a final step, a blood test for the HLA-B27 gene can also be confirmatory. However, it is not true that a person with the gene will definitely develop the disease.

Treatment:

The most important aspect of treatment is the use of pain medications and anti-inflammatory drugs (NSAIDs) which help manage pain and inflammation.
Corticosteroid injections may sometimes be given directly into the joint spaces or the membranes to provide quick relief of these symptoms.
ESWT / RSWT has a definite role to cure enthesopathy. Plantar fasciitis, and achillodynia can be cured with ESWT. Even small joints of hand and feet are amenable to treatment with RSWT. It is nonoperative and noninvasive treatment and has no side effects.
Very rarely, stronger drugs such as methotrexate or sulfasalazine may be used.
Another set of drugs known as TNF-blockers (tumor necrotizing factor blockers) are also shown to be highly effective in controlling the pain of the spine and joints.
In very severe cases, surgery may be required to correct joint damages or correct severe degenerative changes.
Exercise plays a very vital role in controlling the issue and improving range of motion.

What You Should Know About Spondyloarthritis?

Why osteoporosis and osteopenia are fast turning into diseases of the young

Did you know that osteoporosis causes more than 8.9 million fractures worldwide every year? what is frightening is many of these fractures are now taking place among the youth due to deficit diet and poor lifestyle coupled with genetic predisposition. Both osteoporosis and osteopenia are two forms of bone loss conditions, with the latter being a precursor to the former. To distinguish between the two a bone mineral density test is usually performed.

What is the difference between osteoporosis and osteopenia?

A BMD (bone mineral density) t-score between -1 sd and -2.5 sd indicates osteopenia with a high chance of osteoporosis. On the other hand, a t-score of -2.5 sd and below stands for osteoporosis. A higher bone density (above -1sd) is usually indicative of stronger bones. Fragility index is more accurate way to assess the risk of fractures.

In osteoporosis the bone loss or weakening of bones take place over a long period of time, and results in unexpected fractures and severe bone problems. Disfigurement, fractures in the spine, loss of mobility and independence are usual characteristics of this bone disease once it progresses further.

Prevention is better than cure, always!

To keep bones strong and healthy, calcium and phosphate is continuously absorbed by the body. But after 30, the body?s ability to absorb calcium slows down and there?s a decrease in the production of new bones. In contrast, bone desorption (the process of transferring calcium from the bone to the blood) continues unabated.

When the body starts absorbing the store of calcium in the bones to meets its needs, it leads to calcium depletion and is one of the causes of the weakening of the bone.

At present, the age limit (50-60 years) for osteoporosis has seen a drop with many younger people increasingly suffering from the ailment. Factors like unhealthy lifestyle, late-night shifts, smoking and alcohol consumption have been found to be the culprits behind the rise in osteoporosis cases among the young. Recent studies have identified vitamin d deficiency as a major factor for poor bone health and bone mass density in the young.

How to keep your bones strong and healthy? and manage osteo - penia/porosis complications:

Bone loss can be prevented by adopting these very simple but effective ways:

- exercising can help in building strong bones and muscles, while preventing bone loss.

- maintaining a calcium intake of 1000 mg for pre-menopausal women and 1200 mg for women post menopause.

- staying out in the sun for 20 minutes to produce requisite amount of vitamin d for calcium absorption and using supplements of vitamin d.

- there are many safe medicines available to prevent and treat osteoporosis like alendronates, calcitonin, parathyroid, teriparatide preparation etc.

- in osteoporosis induced /associated fractures we have to to modify implants to negate weak purchase of implants in bone and improve mobility. We have been using these modifications in established osteopenia/porosis case in fractures treatment/joint replacement/ arthroscopic fixations and MIS spine fracture management.


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Are Osteoporosis and Osteopenia fast turning into diseases of the young?

When other treatments fail to provide relief, the last resort to treat spine problems is the spine surgery. Spine surgery is conventionally referred to as open surgery which indicates that the area that needs to be operated is opened with a long incision so that the surgeon is able to view and have access to the anatomy.

In the recent times, advances in the field of medical science have made it possible to treat back and neck conditions through minimally invasive surgical techniques that don t involve an elaborate incision. Let us understand more about it.

How is minimally invasive spine surgery carried out?
Minimally invasive spine surgery fusions and decompression processes are performed by exploiting different approaches. The most commonly utilized technique involves the use of the tubular retractor. In this process, the surgeon makes a small incision and then inserts the retractor through the skin right into the spinal column. It leads to a tunnel to the accurate area where the problem persists in the spine. The functionality of tubular retractor lies in the fact that it helps in holding the muscle open throughout the procedure.

A number of particular processes have been designated for the minimally invasive spine surgery. Some of the most common options include spinal decompression, discectomy, and transforaminal lumbar interbody fusion. Each of these processes is different and only an expert in this arena can determine what s suitable for you.

Minimally invasive spine surgery is also called less invasive spine surgery where surgeons make use of special instruments. One of the most compelling drawbacks of open surgery is that the pulling of the muscle can lead to damage to both the muscle and the tissues in close vicinity. On the other hand, minimally invasive spine surgery allows the surgeon to see the precise location of the affected area. Besides, it also leads to smaller incisions, reduced bleeding and short stay in the healthcare facility.

Consulting an expert about the surgery:
It is very important on part of the patients to discuss the suitability of minimally invasive spine surgery with their doctors since it is not a good option for all patients. It is generally suggested for patients having spinal tumours, spinal instability, spinal infections, vertebral compression fractures, lumbar spinal stenosis and spinal deformities like scoliosis.

When you know that you will have to undergo the surgery, it pays to gather information about the surgery and what you may expect from the recovery process. The most commendable benefits of minimally invasive spine surgery include better cosmetic results owing to lesser skin incisions and reduced dependence on the medications. Moreover, it is performed as an outpatient procedure and it makes use of local anaesthesia only. Thus, there is also a reduced chance of suffering from an adverse reaction to general anaesthesia.

So, depending on the pros and cons and depending on the individual condition, your doctor will decide on the course of action.

Everything You Need To Know About Minimally Invasive Spine Surgery!

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