Back pain is something that affects many people all over the world. Persistent and chronic pain seems to be one of the most common complaints. Middle back pain is back pain that is felt in the thoracic vertebrae region, which is located between the base of the neck and top of the lumbar spine. The ribs attach to a long, flat bone in the middle of the chest called the sternum and wrap around the back. In case, there is a nerve around there is squeezed, disturbed, or injured, you are likely to feel pain in different spots where the nerve goes through, for example, your arms, legs, chest and the stomach.

Some of the most common causes of middle back pain are as follows:

Middle back pain can happen as a consequence of injury or sudden damage or it can happen through strain or poor stance after some time.
The most widely recognized reason for middle back pain seems to begin from soft tissue problems or muscular irritation. These can emerge from poor stance, lack of strength, prolonged sitting in front of a computer, utilizing a heavy backpack, overuse injuries, (for example, repetitive movement), or injury, (like a whiplash damage brought about by an auto crash or as a consequence of a sports injuries).
The middle back is a moderately normal site for inflammatory, degenerative, metabolic, infective and neoplastic conditions.
Middle back pain and its dysfunctions are connected with various conditions, for example, essential and optional osteoporosis (particularly vertebral cracks and hyperkyphosis emerging from vertebral bone loss), ankylosing spondylitis, osteoarthritis and Scheuermann's infection.
Muscle strain, overuse or damage to the muscles, tendons, and discs that are backing your spine can also cause middle back pain.
Weight on the spinal nerves from specific issues, for example, a herniated disc.
A fracture in one of the vertebrae can also cause pain in this region.
Osteoarthritis created by the breakdown of ligament or cartilage that cushions the little joints in the spine.
Myofascial pain that influences the connective tissue of a muscle or gathering of muscles.
In uncommon cases, pain might be brought about by different issues, for example, gall bladder disease, cancer or an infection.
Getting hit hard in the back can also cause chronic pain.
Lift something too heavy may cause pain and a sudden pressure in this area.
A compression fracture of the vertebra can also bring about intense or chronic pain in the middle back. The injury may bring about a fracture, however in ladies over age 50 without critical injury or somebody known to have osteoporosis, an unconstrained vertebral fracture is possible.
Other contributing factors to injury include lack of strength which can be treated by a Pain Management Specialist using non-surgical methods.

Common Causes of Middle Back Pain

Paralysis means the loss of normal muscle function in a part of the body. It can occur to any part of the body such as just the legs, just the arms, or complete lower or upper body paralysis. The signals from the brain to that part of the body will stop, as a result of which, the person will not be able to move that part of the body. There will be a complete loss of sensation in that body part, the person will not be able to feel any pain or anything else.

Types of Paralysis:
Based on which part of the body is affected by paralysis, you can classify paralysis into four types:

When just one limb is paralyzed, it is called MONOPLEGIA.
When one side of the body is paralyzed, such as a leg and an arm, then it is called HEMIPLEGIA.
When the lower part of the body is paralyzed, then it is called PARAPLEGIA.
When both your legs and arms are paralyzed, it is called QUADRIPLEGIA.
How is Paralysis caused?
Our sensation and movement are controlled by the peripheral nervous system and the central nervous system. So, when there is any disruption in the communication between the brain and the muscles, muscle movement and control will be affected. In the long term, this will cause weakness in the muscles and finally, end with paralysis.

How does physiotherapy help with paralysis?
Basically, there is one important thing that you need to know about paralysis and that is there is no treatment available for paralysis. But physiotherapy offers a ray of hope. It may not help in treating this problem totally, but the person with paralysis will be able to get independent and more mobile.

The first thing you need to do is, you should start the physiotherapy treatment as soon as a person is affected with paralysis. You should not waste a lot of time. Early treatment can offer better results.
The main objective of physiotherapy for any patient is to make them as mobile as possible.
When you are undergoing physiotherapy treatment for paralysis, it will stop the progress of the paralysis.
If the paralysis is due to an external injury to your brain, then you will be highly benefited by physiotherapy. The physiotherapist will start working on the external swelling and also on the muscles that are not affected by the trauma. This will result in making a paralyzed person more mobile.
Physiotherapy is always considered as one of the best treatments for many health conditions. Many experts recommend physiotherapy for paralysis.

How Does Physiotherapy Help In Paralysis?

Our bones and joints make us functional on a day to day basis. It is, therefore, imperative that we should take good care of them at all times. There are many conditions that can affect our skeletal system and one of them is, Gout. While the link between the two may not be that obvious, gout happens to be a condition, which is sometimes related to arthritis. Therefore, it is sometimes known by the name 'gouty arthritis'.

While the issue may be severely painful, it does not mean that it cannot be reduced. And of course, when a person has the option and cutting the pain caused by gout drastically, his or her natural response is likely to be 'why not?'

Why Does It Happen?

The main reason for the occurrence of gout is too much uric acid being present in the body. The limbs of the body swell up, especially the extremities and this is known to be very painful. In many cases of gout, the swelling is especially evident in the big toe. Flare ups can last hours on end and may even get longer.

The people who wish to get the gout that is putting him or her through so much pain treated, there are quite a few options at their disposal. There are pain relievers that can be consumed under the advice of a medically qualified professional. While these pain relievers do not treat gout, but can reduces the intensity of the symptoms. Daily doses can be recommended as per the requirement and severity of the situation.

How to Get Rid of Gout?

While some anti-inflammatory drugs may have their effect, but no matter how bad the pain, aspirin is a drug that needs to be avoided. Intake of aspirin can make the problem even worse, which is the last thing a person would want!

The severe problems of gout can be dealt with the chemicals known as corticosteroids. Now, while these can provide some very effective pain relief, using them can be tricky due to certain side effects. One of these side effects is that since these chemicals are injected into the joints, they can significantly weaken them. The other side effect is that they slow the healing process of the wound. Both of these side effects are highly undesirable for any patients. These chemicals are usually prescribed by the doctors after a thorough analysis of patient's condition and history.

A person who drinks alcohol and suffers from severe condition of gout should look to scale back the amount which is consumed by him or her. This is because alcohol increases the amount of uric acid which is present in the blood.

Gout and Its Treatments

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?

Endoscopy refers to inserting microscopic cameras into the body through tiny incisions which throw up pictures of the inside of the body onto a screen. Endoscopy has been used for diagnostic purposes since the 1970s. Endoscopy for surgery has become popular from the 1990s.

Endoscopic spine surgery is a state-of-the-art surgery technique which involves micro incisions and minute tubes that cause almost no damage to surrounding tissues and muscles. It is a minimally invasive surgery and it is also called a pinhole surgery.

What are the advantages of endoscopic pinhole spine surgery?

There are a lot of reasons why doctors opt for an endoscopic surgery-

  It is also called Minimally Invasive Spine Surgery (MISS) because it causes little blood loss
  Recovery is almost immediate. A person can resume everyday activities within a week
  Very little pain around the surgery region so minimum pain medication is needed.
  No muscle or bone is removed.
  Since screws and rods are not used, full mobility of the spine can be restored
  The wounds are minute and do not usually require stitches and thus no ugly scars are left after the wounds heal.

What are the characteristics of an endoscopic spine surgery?

  The surgery is performed under local anaesthesia
  The person is discharged within 24 hours of the surgery
  The incisions that are made are microscopic

What are the different types of endoscopic surgery?

Endoscopic discectomy:
It is the least invasive of all spinal surgeries. It is used for treating herniated discs. Endoscopy reveals images of the spine. Through the same tunnel, surgery tools are inserted and the bulging or herniated disc is pulled out with a grasper. The wound does not always require stitches to close it.

Endoscopic Laminotomy:
This a substitute for open laminotomy. The camera helps locate exactly where the target area is. Then an incision is made below and above the lamina to relieve the pressure compressing the nerve.

Endoscopic facet rhizotomy:
With microscopic cameras, the nerves causing pain are identified and then the laser is used to numb these nerves which relieve pain. This type of surgery can also remedy a previously botched spinal surgery, facet joint arthritis or facet joint pain

Endoscopic foraminotomy:
This type of surgery again uses microscopic surgical tools guided by a tiny camera to enlarge a narrowed neuro of spinal nerve root canal to give it more room to move about without being compressed.

Endoscopic Spine Surgery & Pinhole Technique!

Exercises for Sciatica
Sciatica is often distinguished not as a medical condition but as a set of symptoms that underlie a more serious medical concern such as a slipped disc, degeneration of the spine or the lumbar region etc.
It is important to note the symptoms of Sciatica, as these are quite distinct -
1.Constant pain in one of the buttocks or leg (rarely are both legs affected)
2.The pain worsens on sitting
3.The pain is often described as a sharp & searing pain similar to a burning sensation
4.The pain is often accompanied by a heaviness or numbness that makes movement difficult
5.Shifting of postures (sitting to standing and back to sitting) becomes painful and laborious
An alternative to surgery would be to supplement the oral medication with certain specific exercises.
Reflexology, Acupuncture and Chiropractic manipulation are all considered effective to alleviate the pain to a large extent.
Patients are often encouraged to partake in daily exercise routine, incorporating strengthening and stretching exercises.
The strengthening exercises target the core or abdominal muscles along with the back muscles to provide more support to the back.
The stretching exercises will help to “loosen up” the surrounding muscle groups such as the hamstrings, which then allow for more blood and oxygen circulation alleviating the pain and giving the immune system a much needed boost.
When patients engage in a regular programme of gentle stretching and strengthening exercises, they can recover quickly (in comparison to those who do not exercise) from the flare ups and over time the painful episodes are known to reduce significantly, both in frequency as well as intensity.
Ancient holistic practices such Yoga and Tai-chi are often considered the best form of exercises for the afflicted because of the balanced and slow but controlled movements that complement the ‘breath’ rather than causing further exertion to the already fragile bone density.
It is recommended that expert advice be sought and the exercises should be undertaken only under trained supervision. Please do not attempt to “experiment” with Yoga or Tai-Chi on your own, as improper or wrong posture could lead to irreparable damage to the spine. 


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 Exercises for Sciatica To Keep It Under Check

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