Cervical spondylosis is an age related disorder affecting the discs and joints in your neck. The overuse of the bone and cartilage in the cervical spine of your neck leads to cervical spondylosis. While it is mostly caused by age, it can also be caused by other factors. Stiffness and severe, chronic pain are the most common problems with patients afflicted with cervical spondylosis. While in others, it might not cause problems and they can go about their daily activities.

Physiotherapy for Cervical Spondylosis
There is no cure for cervical spondylosis, but its symptoms can be treated with physiotherapy. If you have chronic pain in your neck, shoulder blades or arms, a physiotherapist can provide effective pain relief by strengthening your vertebrae and neck. This will improve your posture and prevent any relapse of the pain.

Firstly, the physiotherapist will evaluate your condition; check your reflexes and strength. Then, the physiotherapist will move on to the following treatments:

Stretching, strengthening and straightening exercises: Before beginning these exercises, your physiotherapist will first apply cold or heat to the affected area and then proceed with a deep tissue massage or electric stimulation. When your muscles are relaxed, the exercises will begin only then. These exercises are performed to strengthen the muscles in your neck. Through these, you will learn how to improve your range of movement and posture.
Neck traction: Pulling your head to stretch out your spine is called neck traction. This technique is used to improve movement and ease the pain. Traction is used to open the spaces between the vertebras gently in order to ease pressure on the distressed discs. Traction is done continuously or sporadically, with short periods of rest in between. If you cannot find the right physiotherapist to do this for you, there are devices to help you stretch your spine.
Cervical collars and pillows: Neck pillows or cervical pillows, are made to keep your neck steady while you sleep. Cervical collars are also called neck braces which are used to support the neck. While cervical collars have been proven to be quite beneficial, there isn t much evidence to support cervical pillows in treating cervical spondylosis. You can always consult your physiotherapist before purchasing a cervical pillow.

Cervical Spondylosis - How Physiotherapy Can Help Treat it?

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

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.


What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 


What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder
Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.


Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks.

Heel Bone Spurs - Causes and Risks Associated with it?

Bursitis is a disorder that is characterized by inflammation of a fluid filled sac called the bursa. Bursa is present in between various tissues such as muscles, tendons and bones where friction may occur. This sac cushions the tissues and prevents friction. The usual areas that are affected by this condition are hip, shoulder and the elbows.

The symptoms of bursitis are:
1. You will experience pain in the affected area
2. Tightness and stiffness in the area
3. Local swelling of the muscle
4. Redness of the area
5. Any physical contact with the area causes pain

Bursitis may also occur due to the following reasons:
1. Ageing results in loss of elasticity of the tendons, thus impairing their ability to tolerate any stressful activity
2. Sports such as baseball where you are required to throw the ball with force may lead to bursitis
3. If you do tasks that require kneeling down on a regular basis
4. Sitting on hard surfaces for extended periods of time
5. Abnormalities such as improperly placed joints
6. Inflammation from other conditions such as gout, thyroid disorders and rheumatoid arthritis may lead to bursitis

Treatment
The condition is treated by using a variety of methods such as exercise and medication. Antibiotics are used to treat any underlying infection causing bursitis. Injections may be administered to reduce inflammation in the affected area along with exercises to strengthen the affected muscle. In severe cases, the doctor may resort to surgery to treat this condition.

Prevention
You may use certain preventive measures to stay clear of bursitis. Some of them are
1. Lift with proper form: If you are lifting something heavy, then make sure you keep the spine straight and bend your knees slightly.
2. Take breaks: Don t remain in the same position for long duration, take small breaks and walk around to release the stress from your legs.
3. Exercise: Do strength building workouts to build strength in the joints. Include mobility and flexibility stretches in your routine to keep your joints healthy, thus increasing the range of motion.
4. Maintain optimal weight levels: If you are obese, then take steps to reduce your weight. Maintain a proper diet to check your waistline.

Bursitis - 4 Ways You Can Prevent it

In Ayuveda, muscle cramp is known as  khalli vaata . Vyaana vaata it is a biological force that is responsible for regulating the functioning of your voluntary muscles. In case of a muscle cramp, the vyaana vaata gets impaired. Metabolic wastes are harmful toxins that tend to get accumulated in your system if not flushed out of your body and deposited between your muscle tissues and nerve-endings. This toxic waste is known as 'aama' in Ayurveda and it is known be a prominent cause of cramps. Besides aama, vata dosha is also responsible for muscles cramps.

Ayurveda provides a number of remedies to treat the problem of muscle cramps. The following are some of the most effective remedies to relief the discomfort of muscle cramps:
1. Drink warm milk to get instant relief from abdominal cramps. The alkaline properties of milk help to pacify the acidic condition in stomach that results in cramps. It is also a rich source of calcium which is known to aid in the relaxation of troubled muscles.
2. Physical activity including stretching exercise is effective in reducing the acute pain of leg cramps.
3. Garlic compound which is also called as 'Lagsunadivati' is helpful in relaxing muscles and it is also known to calm the  vata dosha  that aids in relieving muscle cramps.
4. Do warm up exercises and stretching exercises to lessen the risk of developing a muscle cramp during your workout session
5. Increase the intake of foods that are rich in minerals, calcium, potassium and magnesium as it is known to reduce the chances of muscle cramps.
6. Massage the painful region with 'prasarini taila' or 'mahanarayana taila' to relax the strained muscle.
7. Apply ice pack on the strained muscle to reduce the swelling and pain of the muscle.
8. Sinhanaada guggulu is well known to provide instant relief from muscle cramp. It has medicinal properties which have a mild laxative effect. It eases the problem of abdominal cramps and lessens the discomfort associated with it.
9. In case of extreme pain, 'Lakshmivilaas rasa',  Prataapa lankeswara rasa , are among the most effective Ayurvedic medications which are known to provide relief in case of chronic muscle cramps.

Muscle Cramps - How to Treat them Effectively through Ayurveda

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.

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