If you suffer from persistent backaches and neck pain, you may be diagnosed with spondylitis. Spondylitis refers to degenerative changes of the spine, such as the formation of bone spurs and degeneration of spinal discs. This condition can affect the neck, upper or mid back and lower back. Of these, spondylitis of the neck- cervical spondylitis and lower back- lumbar spondylitis are most common.

Spondylitis is considered to be triggered by age. As a person grows older, the wear and tear of the bones and ligaments of the spinal column can lead to the development of bone spurs and osteoarthritis. Age can also cause the discs between vertebrae to weaken and degenerate leading to bulging discs and herniating spinal discs. Most people experience the first symptoms of spondylitis between the age of 20 and 50. A family history of spondylitis and being prone to injuries also increases a person s risk of suffering from spondylitis.

Since spondylitis is a degenerative disease, there is no cure for this condition. However, the pain associated with it can be managed. Thus, treatment for spondylitis is very similar to treatment for neck or back pain. This treatment can be in the form of pain medication, exercise, physical therapy and minimally invasive surgery. Depending on the extent of spinal damage the doctor may prescribe steroids that need to be injected directly into the intervertebral spaces. This is also known as epidural injections.

Spondylitis patients are often advised to follow their normal schedule and refrain from bed rest as this can prolong recovery. However, at the same time, you should not undertake any activity that puts additional pressure or stress on the spinal column. Alternating between warm and cold compresses can help relieve the pain associated with spondylitis. Additionally, try sleeping with a pillow between your legs to relieve low back pain. 

Special pillows that offer cervical support can help relieve spondylitis of the neck.

Surgery may be considered in cases where this condition causes or worsens nerve damage. Spinal decompression surgery involves relieving pressure on the nerves in the spinal column that may be caused by a herniated disc, spinal stenosis or foraminal stenosis. This surgery can be performed through a laminectomy, discectomy or foraminotomy. Bone spurs in the spinal column or a vertebral disc can also be removed surgically. However, these surgeries are rarely performed as most patients respond well to non-surgical treatments.

Causes of Spondylitis - How Can it Be Treated?

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

When the median nerve that runs through the palm and forearm is twisted or squeezed, a condition called the Carpal tunnel syndrome (CTS) occurs. This carpal tunnel is a passage that is narrow and is present in the ligaments and tendons. This nerve is responsible for offering a feeling sensation to the palm, index finger, thumb, and the middle finger. A part of the ring finger too shares the same. The median nerve is compressed when the tendons are irritated. This leads to pain in the forearm and arm, palm, and wrist. Additionally, this condition can cause numbness and weakness.

How it begins? 

This condition does not occur suddenly but gradually. In the initial stage, the sufferer experiences burning, itching, and numbness in the palm. The thumb, index and the middle finger feel these symptoms. The affected individuals may notice that the hands are swollen and rendered useless. You may feel pain and numbness in one or both the hands during sleep. Slowly, the numbness and pain keeps increasing and can be felt during the day. This is why you may want to shake off hands multiple times.

Factors responsible for this condition: 

Various factors can trigger Carpal tunnel syndrome. If you have had any injury to the wrist in the past that caused swelling, you may suffer from this syndrome. For instance, a sprain or fracture can trigger a Carpal tunnel syndrome. A thyroid gland that is overactive or underactive, arthritis, and overactive pituitary gland, too, can cause this condition. If your occupation involves an excessive movement of the wrists or if your lifestyle involves excessive work stress and the use of vibrating tools, then also this syndrome may affect you. Compression of the median nerve or narrowing of the space for the median nerve are the two other reasons. Fluid retention during menopause or pregnancy can also result in Carpal tunnel syndrome.

Will you be at risk?

Women are more likely to suffer from this condition as compared to men because the carpal tunnel is smaller in the former group. The symptoms are first seen in the dominant hand. The high-risk group includes diabetics and people who suffer from other metabolic disorders. People who are working with industries that deal with manufacturing, cleaning, assembly, sewing, or poultry or fish packing mostly face this disorder.

What can you do?

Surgical and non-surgical treatment methods are available for Carpal tunnel syndrome. When you are diagnosed with Carpal tunnel syndrome, undergo the treatment as advised by the doctor. Wear a splint at nights. During days, when you see swelling or redness of the palm, apply cooling packs. Take breaks from work, if it involves pressurizing the median nerve or if there is any narrowing of the space. Chiropractic therapies, acupuncture, and yoga are known to offer relief as well.

Prevention techniques: 

To prevent Carpal tunnel syndrome, always ensure you stay in the right posture. Use a fingerless glove as this keeps the wrist and palm warm. Take frequent breaks from the task that you are performing, especially the ones that require too much of the wrist movement. Job demands should be considered, however, rotating tasks with colleagues can provide an excellent relief. If your doctor feels that surgery is the only option left to provide relief, then you need to go for the same. With the two options of open release surgery or endoscopic surgery, you can expect symptoms to be relieved as soon as the procedure is conducted. 

Things You Need To Know About Carpal Tunnel Syndrome! 

You must have had an ankle sprain or at least heard of it   it is an injury to the ligaments surrounding and connecting the bones of the leg to the foot. The injury occurs when you accidentally turn or twist the ankle in an awkward way. This can tear or stretch the ligaments that hold together the joint and bones of your ankle.

What Could Possible Lead to a Sprained Ankle? 
A sprain occurs when the ankle joint is forced out of its normal position as a result of the following  

  Awkwardly placing the foot while stepping up and down, jumping or running
  Stepping on an irregular surface
  During a sport or any sort of rigorous physical activity
  An injury while exercising
  Wearing inappropriate footwear

Symptoms of a Sprained Ankle-
A sprained ankle causes pain, swelling, and limited range of motion. You are likely to experience the following symptoms you sprain your ankle  

  Tenderness
  Bruising
  Stiffness
  Discolouration of skin
  Instability in the ankle
  Limping
  A popping sound or sensation at the time of the injury
  Inability to put pressure on the injured ankle

The symptoms of an ankle sprain are usually self-diagnosable and treatable at home. Nevertheless, you never know how severe the sprain could be. Therefore, consider seeing a doctor when you are having problems with your foot or ankle. A specialist can determine whether the injury is just a sprain or something more serious, with the help of X-ray and MRI.

What is the Treatment for Ankle Sprain?
The line of treatment depends on the type of sprain your ankle sustains. Treatment options include  

  RICE   Many people resort to simple home remedies such as RICE and cold compress to treat a sprained ankle. RICE refers to Rest, Ice, Compression, and Elevation. It is a first-aid cure for strains and sprains.
  Cold Compress    Helps reduce inflammation and dulls pain sensation
  Medications   If you visit an orthopaedic, he/she will prescribe the NSAIDs to ease pain and reduce inflammation and fever
  Braces and Splints   These are applied to aid in stabilizing and protecting the injured joint and its movement
  Elastic Bandage   Stretchy bandages are used to wrap strains and sprains. These provide compression and support during recovery.

Apart from medications and devices, the doctor may also recommend stretching, physiotherapy, and massage. Mild physical movement and exercise will help relax your muscles and restore flexibility and muscle strength.

An ankle sprain cannot be prevented; it can happen anytime. What you can do is consult a specialist and seek treatment to get back to your daily activities.

Know More About Ankle Sprain!

Are you suffering with pins and needles in your hand? You may be suffering with carpal tunnel syndrome. Carpal tunnel is a tunnel made of bones in the wrist. Roof of the the tunnel is made of a ligament. This tunnel contains a nerve and some tendons which help in bending of fingers.

This nerve is called median nerve and it acts as a electrical wire carrying sensation from certain parts of hand. It also functions as a wire carrying power signals from brain to hand. Increased pressure of the tunnel causes compression of the nerve and this condition is called as carpal tunnel syndrome. This syndrome gives symptoms of pins and needles in part of hand and weakness in grip. (Pins and needles in Hindi is commonly known as झुनझुनाहट or झुनझुनी or सुन्न पन). Often patient will wake up in night because of pins and needles and shake their hand to relieve the symptoms. It can also manifest as burning sensation or pain in hand.

Carpal tunnel can be caused due to multiple factors. It is commonly seen in pregnant females. Repeated use of hand in certain postures can also lead to carpal tunnel syndrome. Other causes are thyroid problems, diabetes, rheumatoid arthritis and injury to wrist.

Diagnosis of carpal tunnel is mainly clinical and nerve conduction study is a useful tool in confirming the diagnosis. Special (Neuropathic ) pain killers can help with the symptoms. Physiotherapy and posture training can also reduce pins and needles. Night splints are often helpful. If symptoms fail to improve with non operating measures, surgical decompression of carpal tunnel is indicated. Carpal tunnel surgery is performed as a day case procedure under local anaesthetic. It has very satisfying results and a quick recovery.

This article is for information purpose only and not a substitute for proper medical advise.

Pins & Needles In Hand - Carpal Tunnel Syndrome!

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!

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