Paralysis is a chronic medical disease characterized by a loss of muscle function in the body accompanied by sensory loss. The patient is unable to control the paralysed muscle consciously. Most common causes of injury are stroke, multiple sclerosis, spinal cord injury and head injury.  There are 4 types of paralysis and the effect may be complete or partial. The effect may be confined to only one space or multiple areas; and it may affect one or both sides of the body. Paralysis, on one hand, can be brief and may last for a short time; if not, it can be long term or permanent too. 

Physiotherapy is a health care profession wherein diseases are assessed, diagnosed and treated via exercise. It is also used to prevent a particular disability or disease. Science has yet to discover a cure for paralysis but the aim of physiotherapy is to make the patient as independent as possible. Depending on the affected area and the extent of paralysis, physiotherapy is started. Doctors recommend physiotherapy for paralysis for the following reasons

Physiotherapy should be started immediately because it improves blood circulation and relaxes the affected muscles. It can also inhibit the advancement of paralysis and develop muscle tone and the general well-being of the patient.
If the brain has suffered a severe external injury, physiotherapy assists in reducing the swelling and fastens the recovery process.
It aims at making the patient mobile and fully functioning.
Physiotherapy focuses on the maintenance of respiratory function.
Prevents pressure sores and contracture.
The physiotherapist sometimes works on unaffected muscles to compensate for the paralysed ones. Physiotherapy maintains and builds muscular strength in the affected areas. This action prevents deformation of limbs.
Physiotherapy training helps in managing paralyzed bladder and bowel movements.
Physiotherapy helps in building the morale of the patient and motivates the patient to be independent.
A side effect of Paralysis is post-traumatic depression that includes anxiety, denial hostility. The patient is often angry which may worsen his condition. Physiotherapy helps in controlling these feelings and gives the patient hope.
A physiotherapist suggests adaptive and modern equipment such as a splint, orthosis, braces as well as a cane for the disabled person depending on severity of the condition.

Paralysis - How Physiotherapy Can Be Helpful?

The body s reacts to anything suspicious by developing an allergic reaction. Some of the common substances inducing this reaction include certain food substances, pollen, insect bites and certain metals. This body recognises these suspicious substances as antigens and produces what is known as antibodies. These produce various allergic reactions in the body ranging from something as minor as a skin rash to something drastically fatal as respiratory distress and even death.

Features:

Angioedema is one of the most severe forms of allergic reactions.
Translated literally as swelling of the blood vessels, angioedema causes swelling of the blood vessels in the underlying layers and this can lead to the formation of giant hives.
The hives or rashes are extremely itchy, reddish, and can vary in shape (oval or circular). The hives also are warm and painful when touched.
Angioedema usually affects the skin but can have more severe effects like blocking the airway and leading to respiratory distress
Causes: Angioedema is usually caused by one of the following:

Insect bites or stings
People with allergies to foods like peanuts, eggs, milk, shellfish, chocolates, tree nuts, etc.
Pollen, animal dander, latex, poison ivy, and other common allergens
Medicines like penicillin, aspirin, ibuprofen, and some anti-hypertensives
Autoimmune skin disorders like lupus
Reaction to incompatible blood transfusions
Weather conditions like extremes of cold, heat, or pressure
Infections like hepatitis, cytomegalovirus infections, Epstein-Barr infections, etc.
Conditions like leukaemia and thyroid disorders
Extreme emotional stress
Genetic angioedema, inherited from parents by children, which can last forever
Risk factors: Though hives usually develop without any warning signs, the following are some risk factors for developing angioedema.

Previous history of allergies
Predisposition to develop allergic reactions (overactive immune system)
Genetic history of allergies, especially of angioedema
Diagnosis:

In first-time patients, a detailed history with deep dive into similar instances in the past will be done
A physical exam to check for missed hives (like the back) is then done
Allergy testing may also be required to test if a person has a high predisposition to allergies
Blood testing to check for eosinophils, which is usually high in patients with allergies, is done.
Allergy testing to identify the trigger agent may be done if trigger is not known. This will help in preventing further attacks.
If genetic angioedema is suspected, C1 esterase inhibitor test and complement particles are also checked.
Treatment:
Non-medical treatment including loose clothing, cool compresses, and copiously moisturizing to reduce dryness and itching. This is usually sufficient in majority of the cases.
Medical: Antihistamines like cetirizine and loratadine are the next line of treatment. Very severe cases may require steroids like prednisone.


Angioedema - 11 Reasons Why It Can Happen!

Arthritis refers to extreme joint pain. It could either manifest in one of the joints in the body or more than one. At times, it occurs because of a vitamin deficiency. However, it can also advance with age. This is how arthritis can be easily diagnosed:

To diagnose arthritis, your specialist will consider the side effects and symptoms. They will then take a physical exam to check for swollen joints or loss of movement.

They will then use blood tests and X-ray to affirm the conclusion. X-ray and blood tests help in identifying the sort of arthritis you have. For instance, a great many people with rheumatoid arthritis have antibodies called rheumatoid components (RF) in their blood. X-rays are used to analyse osteoarthritis, normally uncovering lost ligament, bone deformities and in many extreme cases, a bone rubbing against another bone.

Sometimes, a needle is used to draw a little specimen of liquid from the joint for testing. This is done to eliminate different sorts of arthritis. In case your specialist speculates irresistible arthritis as a confusion of some other sickness, taking a sample of liquid from the influenced joint will typically affirm the finding and decide how it will be dealt with.

Depending on what kind of arthritis you have, your doctor will recommend you different therapies. However, some of the most common treatments for arthritis are as follows: 
Occupational Therapy

Certain therapies involve long-term treatment to treat the affected joint. With the assistance of an occupational therapist, you can learn simpler approaches to do your typical exercises. A therapist can show you how to do the following:
Maintain a strategic distance from positions that strain your joints.
Utilise your most healthy joints and muscles while saving weaker ones.
Use props to support certain joints.
Medication
Joint pain treatment will rely upon the nature and level of the condition. The principle objectives are to diminish aggravation and enhance the capacity of the influenced joints before the condition worsens. Your specialist will most likely recommend acetaminophen or a non-steroidal mitigating drug (NSAID), for example, Aleve.

Surgery
Different types of surgeries might be expected to lessen the inconvenience of joint inflammation or to recover the joint capacity. Synovectomy is the expulsion of a harmed connective tissue coating a joint depression. In case that ligament pain and irritation turn out to be genuinely chronic, or ligament joints turn out to be badly damaged, the answer may lie in surgical substitution.

Non-medical management of arthritis pain:
Besides medicine-based treatment for arthritis, there are many psychotherapeutic techniques to manage the same. Enhancing patients  mental state by showing them how to unwind and perform their every day exercises at a sensible pace will also help in finding a way to defeat mental anxiety and nervousness.

Arthritis - How Can It Be Diagnosed And Cured?

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!

Arthritis is a disease that affects the joints, muscles and soft tissues, which cause stiffness, disability and pain. It is one of the complex conditions and has also been discovered in the remains of people living more than 500,000 years ago.

Although it is usually found in people above 50 years, in rare cases, it can affect younger generations as well. The three most common forms are osteoarthritis, fibromyalgia and rheumatoid arthritis. The symptoms of some arthritis, such as rheumatoid arthritis, include the following:

Joints turning red, warm, swollen
Painful joints
Unexplained fever
Fatigue
Weight loss
Swollen lymph glands
These symptoms typically last more than two weeks.

Few facts about arthritis
Most people, even though diagnosed with arthritis, are unaware of the following facts:

Snakes, bees, and ants: After years of treatment, some people have turned to specific natural therapies that come from snakes, bees and ants. As per a study by researchers in Brazil, bee sting venom helps reduce the symptoms of arthritis.
Gout is a form of arthritis: Repeated flare-ups, pain and swelling are the result of uric acid, built around the joints. This can be due to genetic predisposition, some diseases and consumption of excess meat, seafood, fructose-sweetened drinks or alcohol. The bunion joint that connects the big toe to the foot is often affected first in people who have gout.
Children get arthritis too: Juvenile rheumatoid arthritis is the most common amongst children and affects kids between the ages of 1 - 3 or 8 - 12 years. It strikes girls about twice as often as boys. As per a recent survey, 1 in every 250 children globally suffers from arthritis.
Injuries increase the risk of arthritis: Injured joints are prone to develop osteoarthritis (OA). People with knee injuries have six times the chance, while those with hip injuries are three times more likely to develop OA.
Climate cannot cure: People have a misconception that wet, cold climates cause arthritis rather than a warmer climate. Unfortunately, that's not the case. Orthopaedics confirmed the same frequency for both warm and cold climates. However, sore joints find warm atmosphere more soothing.
Obesity increases the risk: Excess weight is one of the primary causes of osteoarthritis, especially for weight-bearing joints like knees, and to less extended hips. But there is also a higher risk to joints like ankles, back, big toes and hands.
Animals can also develop: Not only humans but animals like dogs, cats and others can also develop osteoarthritis. The symptoms are almost the same as the ones faced by a human. It can also lead to a loss of appetite, which can cause weight loss.
Race counts: Both whites and African Americans experience arthritis at similar rates. However, blacks have higher chances of severe joint pain and limitations in activity as compared to whites.
Women are prone to arthritis: Statistics show that women have a significantly higher risk for all types of arthritis except gout. As per the Arthritis Community, Research & Evaluation Unit, women are twofold more prone to arthritis than men.

9 Amazing Facts About Arthritis!

If you are an avid runner, then you might also be well aware of the type of running injuries one is prone to. It might be foolish to say that running injuries can be prevented. It is because these injuries do happen quite often. Though these cannot be prevented, these can definitely be treated. Furthermore, precautions from your side can always be taken to make sure that these injuries do not cause a major impact on your health and can be cured without much of a hassle. Here are some important points that you need to remember to avoid running injuries or to lessen their adverse impact on your body.


Flexible Body: Flexibility is an important part of a runner s body. You not only need to have the stamina to run, but also must possess flexible features to get you out swiftly from any serious damage. Flexibility is attained when you do regular exercises and stretching in particular. It makes your muscles resilient towards many injuries and provides your body a better shape and long lasting stamina as well.
Strengthen Your Body: Body strength is required if you want to avoid any sports injuries. Special strength training sessions are organised with the coaches of sportspersons. These sessions help in building up muscle strength. This would, in turn, lessen muscle fatigue and make you able enough to perform better.
Balanced Diet: It does not matter whether you are an athletic or not, a balanced diet is needed for everyone. Balanced diet does not mean picking and choosing of food. It means a proper diet chart, mapping everything that your body needs to stay fit. Furthermore, it should contain ample amount of water to keep you hydrated.
Take Rest When Required: It is often said by the elders that too much of work would ruin your health and body. Thus, even for the athletes, it is important to take rest in between periods of heavy training sessions. This would give you a chance to relax your body and relieve you of all the stress. Furthermore, if you are injured or hurt, it would give you ample time to recover from your injuries.
Wear Proper Shoes: As a runner, you need to take care of all parts of your body. This would also include your legs. To prevent any sprains or muscle injury in the leg and to practice for long hours, proper running shoes are needed.  


How To Avoid Running Injuries?

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