It is important for you to know about degenerative disc disease (DDD) and spondylosis. Spondylosis is an umbrella term for spine pain, which occurs because of degenerative conditions. Spondylosis refers to several conditions. They include spinal stenosis, which is the abnormal narrowing of the spinal canal, leading to leg pain, degeneration due to DDD and degenerative arthritis or osteoarthritis involving the spine. It may also include cervical osteoarthritis or neck arthritis.


About spondylosis
Spondylosis is a common condition, which is age related. The joints and discs present in the neck are specifically affected as a result of this condition. It commonly develops on account of the wear and tear of the cartilage and bones present in the neck. This condition, in spite of being common, worsens with age. In many patients, symptoms are not observed externally, but pain and muscle spasms are experienced. 


Many people with spondylosis do not undertake treatment in spite of suffering from the symptoms and pain. In case the symptoms are prevalent over a long time and tend to worsen, you have several modes of treatment to choose from. They may include medicines, corticosteroid injections, physical therapy and even surgery in some extreme cases. 


How does DDD or spondylosis occur? 
DDD is a spinal condition. It is caused due to the breakdown of the intervertebral discs. With ageing, the spine starts to show signs of wearing and tearing. This happens on account of the discs drying out and shrinking. All these age-related changes are responsible for arthritis, spinal stenosis and disc herniation. Because of these factors, pressure is likely to fall on your nerves and spinal cords, which may further cause back pain. DDD or spondylosis also develops on account of these factors.


Treatment for DDD and spondylosis
There are various modes of treatment, which are available for you to choose from in order to get relief from the symptoms and pain associated with DDD or spondylosis. You may be prescribed typical painkiller medications, such as non- steroidal anti-inflammatory drugs or NSAIDS, muscle relaxants, epidural injections, ultrasound and massage, oral steroids, transcutaneous electrical nerve stimulation (TENS) and many more. Every mode of treatment has got its own benefits, but has its limitations as well.


If you experience any symptoms of DDD or spondylosis, you must consult a doctor immediately. Your pain management physician or doctor will be able to diagnose your condition properly and will determine the mode of treatment which will suit you best.

Degenerative Disc Disease (DDD) and Spondylosis - How You Can Get it Treated?

Osteoporosis is a bone disease that happens when bone density decreases and the body stops producing as much bone as it did before. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps. It can affect both males and females but it is most likely to occur in women after menopause, because of a sudden decrease in estrogen, the hormone that usually protects against osteoporosis.

Symptoms of Osteoporosis-

The early stages of osteoporosis do not cause any symptoms or warning signs. In most cases, people with osteoporosis do not know that they have the condition until they have a fracture. If symptoms do appear, some of the earliest ones may include receding gums, weakened grip strength, weak and brittle nails, back pain, loss of height over time, a stooped posture, and a bone fracture that occurs much more easily than expected.

Causes of Osteoporosis-
Some of the leading reasons behind osteoporosis include the following:

Age: The biggest cause of osteoporosis is age. It mostly affects people aged above 50.
Menopause: Another primary cause of osteoporosis in women, which occurs around the age of 45 to 55 years. Due to the changes in hormone levels associated with it, menopause can cause a woman s body to lose bone even more quickly.
Reduced sex hormones: Lower estrogen levels appear to make it harder for the bone to reproduce.
Ethnicity: White people and Asians are more susceptible than other ethnic groups.
Bone structure: Being tall or slim increases the risk of osteoporosis.
Vitamin D deficiency: In case of vitamin D deficiency, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis.
Risk Factors for Osteoporosis-
A number of factors can increase the likelihood of osteoporosis, these may include your age, race, lifestyle choices, and medical condition and its associated treatment. Some of the risk factors for osteoporosis are out of your control, including sex, age, race, family history, and body frame size. Osteoporosis is more common in people who have too much or little of certain hormones in their bodies. Examples include sex hormones, thyroid hormones, and hormones released by the adrenal glands. Osteoporosis is more likely to occur in people who have low calcium intake, eating disorder, and gastrointestinal surgery. Osteoporosis has also been associated with medications used to combat or prevent seizures, gastric reflux, cancer, and transplant rejection. Even lifestyle choices such as sedentary lifestyle, excessive alcohol consumption, and tobacco use can increase your risk of osteoporosis.

Prevention of Osteoporosis-
There are many risk factors for osteoporosis that you cannot control. These include being female, getting older, and having a family history of osteoporosis. There are some of the factors, however, that does fall within your control. Some of these ways to control osteoporosis include getting plenty of vitamin D and calcium, doing weight-bearing exercises, abstinence from smoking and for women, weighing the pros and cons of hormone therapy. If you are at an increased risk of osteoporosis, talk to your doctor about the best way to prevent it and do that as early as possible.

Osteoporosis - Symptoms You Must Not Ignore!

The backbone (spine) has smooth movement with smooth intervertebral disks. However, this fluid movement can be limited due to arthritis, which can happen due to many reasons   genetic to age to injury to infection to tumors. The lower back has two sets of spinal disks   sacral and iliac. This sacroiliac region has an elastic vertebral tissue. This could be gradually replaced with hard bone, which can cause fusion between the disks. Such a condition is known as ankylosing spondylitis (fusing disk spaces), which is a type of arthritis.

The typical symptoms of ankylosing spondylitis (AS) are morning pain and stiffness in the low back and upper buttocks, which gradually decrease as the day goes by. The symptoms usually start and continue to gradually worsen over a period of 3 to 6 months. In severe cases, there could be spinal fractures, but in most cases, pain, stiffness and reduced movement are the main complaints.

Why homeopathy for AS (Ankylosing spondylitis)?

Major benefits of homeopathy could be summarized as under:

It addresses altered immune system, treating the roots of this autoimmune disease.

It helps in pain control without side effects.

It aims at disease control.

It is absolutely safe even if used for a long time.

Homeopathic medicines are prescribed on the basis of individual case evaluation by taking into account patient s genetic, immunological and psychological parameters. It is safe and effective as a long-term therapy. It reduces pain, improves mobility and most importantly, controls the disease. It has no adverse effects.

Homeopathy helps AS patients by acting on the immune system, which is usually overactive in these people. Depending on the presenting symptoms, the doctor will prescribe a customized regimen for the patient.

Rhus Tox: This is the first medicine of choice when the patient experiences sacral/lumbar area pain that is worse at rest, with sitting, or after a period of inactivity. The pain radiates down the legs to the foot. Walking or any other activity/motion provides relief from the pain.

Aesculus: This is indicated in patients who have extremely painful and stiff low back and hips. The pain is a constant ache and there is discomfort with trying to rise from a seat, stooping, and walking, where greater effort is required. There is a feeling that the legs would give way, adding to resistance while walking.

Kalmia: This is used in patients where the back pain and stiffness are accompanied by a warm, numb, and prickly sensation. Low back pain and neck pain is associated with a burning sensation. The pain appears in sudden bursts in the early parts of the night and travels down the arm or up into the scapula.

Kali Carb: This is indicated where there is extreme weakness along with AS symptoms of pain and stiffness in the lumbosacral back area. The patient feels like he is going through a paralytic attack and must lie down to rest. This is a feeling similar to a broken back, and can extend up into the neck or down to the legs. The symptoms are more severe in the early morning hours. Changing positions in the bed worsens the pain.

If you or someone else is suffering from AS symptoms, give homeopathy a try.

Homeopathy Treatment For Ankylosing Spondylitis

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!

Disc prolapse   or what is popularly known as a herniated disc   occurs when the soft, rubbery tissues of the spinal discs push through a crack in the tougher exterior casing. It usually results from wear and tear of the spinal discs over time.

Risk Factors-
The following factors may put you at risk of a disc prolapse  
  Genetics   You may have a tendency towards developing a disc prolapse
  Occupation   People who are engaged in physically demanding jobs are more likely to develop back pain
  Weight   Excessive body weight puts pressure on the discs in the lower back

Signs to Watch Out for-
Signs and symptoms of disc prolapsed may include the following  
  Pain in the legs, particularly in the calf, thigh, and buttocks
  Pain in the arms and shoulder that intensify when you sneeze, cough, or even move your spine into certain positions
  Tingling or numbness in the affected areas
  Muscle weakness
  Inability to hold an object

If the pain deteriorates i.e. if the pain shoots down from your back or neck to the extremities, consult a doctor immediately.

Acupuncture for Disc Prolapse-
Although there are certain non-surgical and surgical treatment methods, many healthcare professionals and doctors nowadays recommend acupuncture as an alternative cure.

Acupuncture is an ancient Chinese practice that believes that people possess  Chi  or an energy force. When the force is unbalanced or blocked, your body becomes susceptible to illness and pain. Traditional acupuncturists strive to free up these energy channels (known as meridians) by inserting needles into specific points in your body. It activates the release of endorphins in your blood, which acts as natural pain relievers and reduces pain.
The process involves inserting multiple needles, depending on your diagnosis. Most people do not feel pain when the needles are inserted. In fact, they feel relaxed or energized. The acupuncturist will leave the needles in for about 20-40 minutes   this may cause temporary soreness but do not pose serious complications.
Acupuncture can help relieve pain associated with bulging, herniated disc. If you are considering this option, you should visit a complementary and alternative medicine practitioner.

Disc Prolapse - Know How Acupunture Can Help!

Torn cartilages are quite a common form of injury occurring in the human body. While one can t always be too cautious of injuries, one can still try to be conscious of their muscles and do not move about in an abrupt manner to cause injury to themselves. Further, even though torn cartilages are very common, they are quite painful and most often they occur in the knee. Here are some tips to ensure that your torn cartilage heals well and you are exposed to less pain during the healing period:

Rest: You must take rest. While it is advised to take bed rest, humanly it is impossible to spend all day in bed. Thus one can move about a little but avoid walking and straining their legs and knee too much. At times crutches can be taken while taking a few steps in the room.

Ice Therapy: Putting ice bags in the affected area helps in relaxing the muscles and reducing the pain quite a lot. Though previously people adhered to putting hot water bags, the scenario is slowly changing to ice therapy.

Compress: When you are suffering from a torn cartilage, the doctor often puts a bandage on the knee to compress the area. This is done so that the muscles are brought together and they can heal on their own with time and rest.

Elevate the Knee: Often it is seen that during such cases, the knee or the hands are rested in an elevated platform. This platform is created with the help of a pillow mostly. This lets the cartilage get time to rest and heal on its own.

Avoid Strenuous Activities: This includes jumping, running, jogging, kicking etc, when it comes to the legs and writing, lifting weight etc. when it comes to the hands. These activities require a lot of strength and power and most of all the use of the cartilages. Since the cartilages are torn and in their healing mode, it is best to avoid such activities for a certain amount of time to not put pressure on the cartilages and damage them further.

Painkillers: It has been already mentioned that the healing period can be painful. Thus, the doctor may prescribe some painkillers to ease the pain during this time.

Thus, these are some of the easiest ways to deal with a torn cartilage. The recovery period may be painful, but it happens to many people and is completely healable in nature.

How To Deal With Torn Cartilages?

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