Tennis elbow is a type of tendinitis. It is usually the swelling of certain ligaments. It causes pain in the elbow as well as the arm. These ligaments are bands of strong and stretchable tissues that connect the muscles of your lower arm to your elbow. In spite of its name, you can in any case get tennis elbow regardless of the possibility that you have never been close to a tennis court. This is merely a name for the condition and has little to do with the sport. It can affect anyone who indulges in a swinging motion.

Any repetitive exercises that require a tight grip, particularly in cases where the thumb and the initial two fingers are used frequently, may cause tennis elbow. Tennis elbow is the most common reason for patients to see their doctors for elbow torment. It can occur in individuals of all ages; however, it is most common and normal at about the age of forty.

This condition is usually caused when there are repeated contractions of the lower arm muscles that you use to raise your hand and wrist as well as to straighten it. The repetitive movements and pressure to the tissue may bring about a series of little tears in the ligaments that connect the lower arm muscles to the hard surface on the outside of the elbow.

Tennis elbow ordinarily occurs after some time. Dull movements such as holding a racket during a swing can strain the muscles and put a lot of weight on the ligaments. That consistent pulling can cause a small amount of tears in the tissue. Tennis elbow may be caused because of the following reasons:

Playing tennis
Playing racquetball
Playing squash
Fencing
Weight lifting or any other stressful exercises involving the muscles
In tennis, the following moves can lead to tennis elbow:

One-handed backstroke with a poor stance or lose hand
A late forehand swing bringing a bend in the wrist altogether
Snapping and turning the wrist while hitting with full power
As the name suggests, playing tennis, particularly repeated use of the backhand stroke with poor strategy, is a conceivable reason for tennis elbow.
However, a number of other basic arm movements can also cause tennis elbow. It can also affect individuals with particular occupations or while performing leisure activities that require heavy arm movements or gripping, for example, the following:

Carpentry
Excessive writing
Painting
Raking
Weaving or knitting
Utilising plumbing devices
Driving screws
Chopping cooking ingredients or vegetables, especially meat
Repetitive computer mouse utilisation
Lifting heavy materials or even grocery bags
There are a number of ways to treat a tennis elbow. These include certain over-the-counter (OTC) medicines. If those do not work, seek the help of a specialist or physiotherapist. He or she can recommend you the right kind of medicines as well as exercises needed for the recovery.

Tennis Elbow - Common Causes Behind It!

Meniscus refers to the soft ligament in your knee joint, which cushions your bones and protects it from wear and tear. It is vital for the fulfilment of regular activities and the health of your bones. Thus, a damage to the meniscus can be extremely painful. Meniscuses are exposed to injuries and shocks in case of rigorous activities and this is a fairly common syndrome faced by athletes and sports person. It can cause a substantial amount of hurt and generally impairs movement to a large extent. It potentially gets worse as the inflammation sets in and the swelling grows. The risk of a meniscus tear increases with age. The treatment for a torn meniscus depends upon the degree of tear. While minor tears repair on their own, for graver injuries, the following therapies may prove effective.

Symptoms of a torn meniscus
1. You might be able to experience a popping sensation in your knee joint
2. Stiffness and swelling
3. You will experience pain, especially while you are trying to twist your knee
4. You might not be able to straighten your knee completely

The treatment for a torn meniscus depends upon the degree of tear. While minor tears repair on their own, for graver injuries, the following therapies may prove effective:
1. Light exercises: For slightly serious meniscus tears, there are certain knee exercises which are recommended to abort any further damage as well as to repair the wound. Limiting the activities which might exert pressure on the knees, getting adequate rest, using ice packs and wearing neoprene sleeves always aid in recovery.
2. Anti-inflammatory medications: Often, meniscus tears are cured with the help of anti-inflammatory drugs like Ibuprofen. They not only reduce pain but also enable the mending of the injured tissue. However, one needs to be aware of a few side effects which often become natural repercussions of such drugs. Possibility of ulcers and bleeding get increased by leaps and bounds on the intake of such drugs.
3. Surgery: For all other forms of meniscus tears, if healing is not obtained through non-surgical methods, the only option available is that of surgery. Such a situation arises when the pain becomes unbearable and the meniscus tear does not respond favorably to superficial treatments. These surgeries are less complicated than replacement surgeries. They usually do not involve any life threatening hazard and cautious and efficiently conducted surgeries release all pains and handicaps.

Torn Meniscus Knee Treatment - Exercise, Anti Inflammatory & Surgery

Hip arthroscopy is a minimally invasive surgical procedure in which doctors view the joint problem without making any cuts through the skin and other soft tissues. Hip Arthroscopy is performed to treat several hip problems.

In Hip Arthroscopy, the doctors insert an arthroscope (a small camera) into the hip joint. The pictures are displayed on a video monitor with the help of an arthroscope. The surgeons will use these images to guide the surgical instrument.

As the surgical instrument and arthroscope are very thin, the surgeons make a very small incision compared to the one that is done in open surgery. As a result, patients feel less pain and stiffness in joints. This type of surgery also takes less time to recover and one can return to their normal life within a short period of time.

Hip Anatomy:

The hip is a socket and ball joint. The socket is formed by a part of a large pelvis bone called acetabulum. The ball joint is on the upper end of the femur (thighbone). Articular cartilage is a slippery tissue that covers the surface of the socket and ball. It creates a frictionless and smooth surface that helps the bones to glide across each other easily. Strong fibrocartilage is ringed on the acetabulum called labrum. It creates a gasket around the socket.

The joint is surrounded by a ligament, which creates a capsule to hold the joint together. The inner surface of the capsule is lined by a membrane called synovium. It produces a synovial fluid that helps in lubricating the joints.

When to Recommend Hip Arthroscopy?

If a person is suffering from chronic pain and does not respond to any other nonsurgical treatment, including physical therapy and medication, doctors may recommend a person opt for hip arthroscopy.

Hip arthroscopy helps a person to get relief from many problems that cause painful symptoms including damaged articular cartilage, labrum, or other soft tissues. The damage can be the result of any form of injury. However, there are other orthopedic conditions that can also lead to damage. The orthopedic conditions include:

Femoroacetabular Impingement (FAI):

In this type of disorder, an extra bone is developed on the femoral head (cam impingement) or along the acetabulum (pincer impingement). The overgrowth of the bone is known as spurs that damage the soft tissues surrounding the hip joint. In most cases, the bone spurs develop in either part. However, there are cases in which the bone spurs develop in both femoral head and acetabulum.

Dysplasia:

In this condition, the hip socket is abnormally shallow. Due to this problem, more stress is put on the labrum in order to keep the femoral head within the socket. This may raise the condition of the labral tear.

Snapping Hip Syndrome:

In this condition, the tendon rubs across the hip joint repeatedly. This type of popping or snapping is generally harmless and can be repaired without any treatment. However, the tendon may be fully damaged due to continuous rubbing in some cases.

Other conditions where hip arthroscopy is recommended include synovitis, hip joint infection, and labral tear.

Arthroscopic Femoroacetabular Surgery:

If the diagnosis results show that damage is caused by femoroacetabular impingement and a patient is not getting relieved from pain by any nonsurgical method, doctors recommend going for Arthroscopic Femoroacetabular Surgery.

In this type of surgery, the doctor repair and clear out the damage of the articular cartilage and labrum. He may also trim the rim of the acetabulum bone and shave the bump of the femoral head.

Arthroscopic Labral Repair:

If patients are not getting relief from conservative treatment, doctors recommend Arthroscopic Labral Repair. In this type of surgery, surgeons cut out and remove the damaged or torn part of the labrum. He further repairs the torn part by sewing it.

Take Away:

Both treatment methods are minimal incision processes and require fewer hospital stays. However, it is always advisable to consult a doctor before opting for any treatment.

Know More About Hip Arthroscopic Surgery!

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!

In the recent years, with the building work pressure and the increasing stress in our everyday activities, our regular lives have become choc-a-bloc with all sorts of engagements. This often renders our bodies prone to fatigue and listlessness. This phenomenon can often be observed in an intensified form by way of a disorder called Fibromyalgia or as it is deemed in common parlance, "rheumatism". 

Fibromyalgia is an ailment, which causes pain in the body tissues. The tender and fibrous tissues like muscles, ligaments and tendons are often affected by this disease. As a consequence of Fibromyalgia, one feels incapacitated to work or perform any physical activity. Sometimes Fibromyalgia is accompanied by extreme headaches, sleep disturbances, muscle pain and consistent dizziness. 

The degree of chronicity of the disease may vary but the underlying cause remains the same. Given the high incidence of the disease, the treatment for the same is also widely available. However, for a more effective and lasting cure, many resort to homeopathy. Homeopathy offers several remedies to Fibromyalgia, classified on the basis of the discrete symptoms of the disease. 

1. Rhus Tox: Rhus Tox is an excellent antidote for rheumatism induced stillness and muscle pain. When paired with suitable exercises, it can afford a lot of relief. 

2. Ruta Grav: Ruta Grav aids in relieving tendon pains and sustained usage helps in restoring muscle strength in case of Fibromyalgia.

3. Rhododendron: Often the Fibromyalgia pain gets aggravated with a marked change in the season. Rhododendron mitigates the intensity of the pain. 

4. Arnica: For any injury induced body ache, Arnica is an extremely effective cure. It also functions as the foremost option, when the precise causes or the symptoms are unknown. 

5. Causticum: Certain forms of Fibromyalgia are accompanied with soreness, weakness and a feeling of stillness. Causticum soothes such ailments.

6. Bryonia: Bryonia alleviates chronic pain in the soft tissues of the body. Exposure to heat needs to be avoided mandatorily in order to optimize the effect of Bryonia. 

7. Kalmia Latifolia: When besides the obverse symptoms of Fibromyalgia, the pain in the muscle is accompanied with a feeling of cold and numbness, one of the best homeopathic cures is Kalmia Latifolia. 

Fibryomalgia is an ailment, which not only manifests physical troubles but also affects one's emotional status adversely. Therefore, to mete out the best remedy, homeopathy carefully assess both the physical and the psychosocial bearing of the patient before recommending a particular cure.

Homeopathy and Fibromyalgia

Not all people who suffer from Tennis Elbow have swung their racquets, and those who have never been affected by the problem will not be able to understand how severe the pain and discomfort can be. It is a debilitating condition that affects one s normal lifestyle in both minor and major ways.

Platelet-rich plasma therapy is nowadays considered a promising treatment for consistent and chronic tendon problems including Tennis Elbow and Golfer s Elbow. It is often conjugated with autologous blood injection which is a quick and minimally invasive process using the cells of the patients without any use of any drugs.

What is Tennis Elbow?
The human elbow is a joint comprising of three bones: humerus in the upper arm, ulna, and radius in the lower arm. Each part of the bone is covered with cartilage that facilitates free movements of the bones. Tennis elbow occurs at times when the epicondyle layer on the elbow joint become inflamed or torn.

Understanding platelet-rich plasma therapy
PRP is a non-surgical, in-office treatment which starts withdrawing a little amount of blood. The blood is then spun in a centrifuge for concentrating the platelets in the place. This process also segregates the red and white blood cells. Then the platelets together with some amount of plasma are injected into the body in the affected region which has some injury and is not able to heal properly.

When a person is affected with Tennis Elbow, the platelet-rich plasma is injected into the Flexor Origin present on the medial side of the wrist extensor tendon origin at the lateral epicondyle. The doctor may need to jab the needle in different places.

Why is PRP suitable for Tennis Elbow?
The primary objective of using platelet-rich plasma therapy is utilizing the cells and protein of the body along with specific healing factors that can stimulate and jumpstart the process of healing in the tendons. To begin the healing process that has either stalled or could not be completed or has never started, the PRP is the best means. The first step of beginning the healing process is dealing with the inflammation. Experts are fascinated at the way in which the platelet rich plasma can replace the conventional anti-inflammatory medical treatments of Tennis Elbow.

The arrival of platelet-rich plasma has caused the corticosteroid shots to lose their popularity. Because, though they can relieve acute pain for a short span of time, they do not promote healing and may also cause further breakdown of the affected area.

PRP therapy is known for improving the natural healing process of the body. It has ignorable side effects, and the best part is that it is minimally invasive. Since Tennis Elbow is becoming more common these days, it needs to be treated in ways that would be able to complement one's situation and restore normal functionality. 

Consider Platelet- Rich Plasma Treatment For Effective Treatment Of Tennis Elbow

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