Spinal fractures are extremely painful and usually happen when an external force applied to the spine exceeds the vertebral column s ability to bear the load. Many times, the bone fragments pinch and damage the spinal cord, which leads to an injury or dislocation of the bony vertebra. Although spinal fractures can develop anywhere along the spine, the most common site is the lower back.

What causes spinal fractures?

Spinal fractures can occur due to both minor trauma/falls and major accidents. The following are the probable causes of such fractures-

  Injuries sustained while playing a sport
  A traumatic injury
  Spinal instability
  Injuries sustained after falling from a height
  A whiplash
  Injuries sustained in an accident
  An underlying condition such as Osteoporosis, which causes the spinal bones to weaken

Symptoms observed:

Spinal fractures are characterized by the following symptoms-

  Muscle spasm and swelling
  Numbness
  Acute pain that worsens when you walk or stand for a long time
  A tingling sensation
  Restricted mobility of the spinal column
  Spinal deformity/disability
  Sudden onset of pain in the lower back region

What are the various types of spinal fractures?

Spinal fractures primarily fall into four categories, namely the following-

  Compression - Compression fractures are quite common in people with osteoporosis or bone cancer. The bones become fragile and brittle. If sudden force is applied with extreme pressure, the vertebra may not be able to support the load and that may result in a fracture.

  Burst - Severe trauma, such as a car accident can cause burst fractures. The external pressure is so much that the vertebra gets crushed. As a result, the bony fragments spread out and cause spinal cord injury. Unlike a compression fracture, where only a part of the vertebra is damaged, a burst fracture leads to multiple fractures in the vertebra.

  Flexion-distraction - This type of fracture is likely to happen if you are involved in a car accident. Normally, the spine is made to flex forward. However, a sudden jerk that pushes your body forward can put a lot of pressure on the spine and cause the vertebrae to break.

  Fracture-dislocation - This debilitating condition results from a torn ligament and broken bone.

What is the treatment for spinal fractures?

Treatment options for spinal fractures include both non-surgical and surgical methods.

  Non-surgical treatment - Most cases of spinal fractures can be treated with immobilization in a corset or brace for up to 10-12 weeks. Bracing will help prevent deformity and reduce pain.

  Surgical treatment - The doctor may recommend surgery in severe cases. The two standard surgical procedures are-

Vertebroplasty - The surgeon will insert a tube, known as a catheter, into the compressed vertebra. Through the catheter, he/she will inject bone cement into the fracture site. This will harden and stabilize the vertebral column. Vertebroplasty has proved to be an effective procedure to reduce pain. The surgery restores mobility and prevents loss of bone due to bed rest.

Kyphoplasty - During this procedure, the surgeon inserts a catheter into the spinal column under the guidance of an X-ray. Next, he/she makes small incisions along the back and inserts an inflatable bone stamp. The tamp, once inflated, bring back the vertebral body to its original height. It also creates a cavity to be filled with bone cement, which seals the cracks. The bone cement stops the vertebra from collapsing again. After the whole procedure, the surgeon will remove the catheter and stitch the incisions.

Following surgery, you will need to wear a brace for about 6-12 weeks. Physical therapy is strongly recommended initially to help you get back to your daily activities in a week or two.

Spinal Fractures - All You Should Know!

Sleep is the normal physiological process of our body which is as important as respiration and digestion. Sleep is vital for maintaining our physical and mental health. Normal adults require 8 hours of sleep every day, whereas it 14 to 15 hours of sleep is recommended for for infants and toddlers.

What are the different stages of Sleep

Every human has a natural circadian clock in their body, which is responsible for maintaining our sleep - wake homeostasis. The different stages of sleep include REM and NREM that is rapid eye movement sleep and non rapid eye movement sleep respectively. REM is the deep sleep stage in which it is very difficult to wake up the person as this stage includes the sensory inhibition and all voluntary muscles along with almost all interactions with the surroundings are inhibited. Therefore, a person s physical stress and tiredness also gets relieved during this stage of sleep. NREM sleep is the stage between REM and awakening and here the person may have sensory connection with his or her surroundings, but may not respond.

Sleep and its benefits
Sleep and stress have a very strong connection with each other. The best way to relieve stress and any other mental disturbance is sleep. It is essential to have knowledge about sleep psychiatry for almost all physicians as they face many sleep deprived patients in their day to day practice.

    Sleep is not only responsible for relieving mental stress and depression, but has other benefits as well
    Sleep is also essential for the normal physiological growth in early infancy and it is vital for development of normal alertness, attention and knowledge
    It also relaxes our voluntary muscles and thereby, relieves us from physical stress
    Sleep disturbance may also aggravate diseases in our body. Sleep is also the state of recovery and healing.

Sleep psychiatry also insist on meditation and ensures that people have normal pattern of sleep, in order to maintain the mental health of the person in a normal state.

Sleep Pyschiatry: Its Stages and Benefits

The world celebrates World Pneumonia Day on 12 November. As we all know, pneumonia, the world's greatest killer of children under five, is a respiratory illness. Pneumonia is a type of lung infection that may affect one or both lungs. In this condition, the air sacs, also known as alveoli, fill with pus or fluid, which makes it difficult to breathe. Moreover, pneumonia is known to cause inflammation in the air sacs. This disease may range from mild to life-threatening and the severity depends on the cause of inflammation, the organism fostering your infection, your age and general health. 

Symptoms:

Most common symptoms associated with the condition are:

Chest pain
Difficulty in breathing
Shaking chills
Rapid heartbeat
Fever
Rapid breathing
Dry cough
Vomiting
Wheezing
Nausea 
Muscle aches
Bluish skin tone due to oxygen deficiency 
Blood in sputum that is coughed up mucus
Labored breathing
Confusion 
High fever
Causes: 

Bacteria: One of the most common causes of pneumonia is the bacteria named as Streptococcus pneumoniae. This type of pneumonia may occur after you have had flu or a cold or maybe even on its own. Moreover, it may affect only one part of the lung i.e. the lobe and is also known as lobar pneumonia. 
Viruses: Viruses are one of the main reasons why children below 5 years of age suffer from pneumonia. Viruses that cause pneumonia may also cause cold or flu. Viral pneumonia is usually mild and may be treated at home itself. However, in some cases, it may be very severe and life-threatening. 
Mycoplasmas: Mycoplasma is a type of bacteria that doesn't have a cell wall around the cell membrane which is why they are usually unaffected by most antibiotics which target cell wall synthesis. The symptoms of pneumonia caused by mycoplasmas are mild and the patient does not require bed rest. This type of pneumonia is known as 'Walking Pneumonia'. 
Fungi: People with weakened immune systems or chronic health problems usually develop pneumonia due to fungi. You may also develop fungal pneumonia by inhaling large doses of it mainly found in soil or bird droppings.
Prevention against Pneumonia

It is important for all of us to prevent ourselves from pneumonia and for that we can follow the below mentioned steps:

Know about the symptoms of pneumonia first: It is difficult to detect or diagnose pneumonia, especially in people over the age of 65. In older patients, the common symptoms such as fever, chills, cough may not be experienced. You should watch out for non-respiratory symptoms like weakness, dizziness, delirium and confusion. It is even more difficult to diagnose pneumonia in people who are suffering from preexisting conditions.
Practice good hygiene: Common respiratory Infections, influenza and cold may cause pneumonia. You should follow hygienic habits. Wash your hands regularly before meals and use hand sanitizers in order to prevent the illness from spreading. You should also maintain proper oral hygiene as several oral infections may also lead to pneumonia. You should also keep away from people who are affected by pneumonia or any other illness like flu, cold and serious diseases such as measles or chicken pox. All these factors may cause pneumonia.
Get vaccinated: It is recommended for people of all ages who may be at a risk of getting pneumonia to get vaccinated and immunized against pneumonia causing virus called pneumococcal pneumonia. This is a one-time vaccine, which prevents and reduces the severity of pneumonia. A booster vaccine after every five years may also be prescribed. Elderly people should be vaccinated against all diseases which cause pneumonia.
Quit smoking: Smoking accounts for being a major cause or risk factor for pneumonia. It increases a person s chance of getting pneumonia as the lungs  ability to defend themselves from the infection is reduced. By quitting smoking, you will be able to prevent pneumonia.
Maintain a good general health: Maintaining an overall good health and following healthy habits will help you in preventing pneumonia. This is because your immune system stays strong and is able to fight efficiently against pneumonia-causing infections. A proper diet with all essential nutrients is also recommended along with regular physical exercise and proper rest.
Severe cases of pneumonia are capable of making you suffer and you may be admitted to a hospital. According to studies, it has been estimated that more than 60% of people over the age of 65 need to be hospitalised because of pneumonia. If you wish to discuss about any specific problem, you can consult a pulmonologist.

World Pneumonia Day - How Best Can You Prevent Yourself?

Spinal fusion is a surgery in which two or more vertebrae in the vertebral column or back are fused or joined to treat a slew of spinal problems and diseases, which cause debilitating back pain. This surgery helps to remove bone and tissue that are narrowing the spinal canal, squeezing the spinal cord and nerves, reducing pain and improving function.

There are many different causes of back pain like injury, poor posture, age, osteoarthritis, herniation of disc between two vertebrae, degenerative disc disease, narrowing of spine called stenosis, and spondylosis or lessening of space between the vertebrae- most of these can be treated using spinal fusion.

All of these causes put tremendous pressure on the vertebrae and pinch spinal nerves that pass through the back and radiate out into the arms, legs and torso. Apart from the pain, patients experience nerve and muscle weakness and irreversible damage affecting normal life.

Spinal fusion started off as just a treatment for fractures but now it has become the surgery of choice for a number of spine problems. Though it can be done anywhere in the spine, it is very effective when done in the lower part of the spine called lumbar spinal fusion or arthrodesis.

Spinal fusion is done by forming a direct bony connection between the vertebrae surrounding the painful discs, the cushioning between the vertebrae. Pain is stopped by stopping the motion of the painful discs.

There are different methods of spinal fusion each with its own advantages and limitations.

Techniques include fusion approached from the front, the back, or both of the vertebral column. Sometimes surgeons decide to use intervertebral cages or metal screws to provide internal structural support while the bone fuses. These cages may be placed between the vertebrae and packed with bone graft material taken from the patient or constructed out of synthetic materials.

What to expect?
Spinal fusion is not a risk-free procedure. It is a major surgery lasting several hours and carrying a number of risks like-

Failure of the vertebral fusion and breaking of metal implants
The vertebrae above and below the fusion can wear away aggravating problems
Blood clots may be formed that can travel to lungs causing embolism
Injury to spinal nerves causing permanent weakness in legs and problem with bladder and bowel function
Infections and blood loss
Heart attack or stroke during surgery
The patient has to be kept in hospital for a couple of days for post-operative care after which he will have to undergo rehabilitation for months. Hence, one should really think before going for spinal fusion. And when it is recommended, seek a second opinion before making a decision. 

Spinal Fusion Surgery - What To Expect?

Pilonidal Sinus is the small channel in your skin near the tailbone that may sometimes be filled with pus or fluid. This accumulated pus leads to the formation of abscess or cyst. Pilonidal cysts occur near the coccyx or tailbone, right at the top of the buttock crease. Pilonidal sinus consists of dirt, hair and debris that penetrates your skin, becomes embedded and thereby causes infection. Once the cyst gets infected, you may see blood or pus oozing out of the channel, which causes severe pain.
Pilonidal sinus usually affects men and young adults (after puberty). This type of skin disease is mostly observed in people who sit for a prolonged period, such as desk-job workers, truck drivers etc.

What are the causes and symptoms? 
Doctors suggest pilonidal sinus or cysts is caused due to factors such as - hormonal changes during puberty, friction resulting from wearing tight clothes, prolonged sitting, hair growth etc. The hair growing in the region is forced to burrow back beneath your skin. In certain cases, the patient may develop multiple sinuses which connect under the skin.

The signs and symptoms of pilonidal sinus include-

  Pain when standing or sitting for long
  Swelling of the cyst
  Redness and soreness around the affected skin
  Formation of multiple holes (sinus tracts) in the skin
  Foul odor
  Blood or pus oozing out of the abscess
  Hair sticking out of the lesion
Pilonidal sinus can be embarrassing and painful if left untreated for long.

What is the treatment for this condition?
Pilonidal sinus usually goes away on its own, without medical intervention. However, if the cyst becomes infected, it may have to be operated or drained. The commonly used treatment procedures are-

  Conservative treatment - if the condition is diagnosed at an early stage, your doctor will prescribe a broad-spectrum antibiotic to treat a broad range of bacterial infection. This will relieve you from the pain and discomfort resulting from infection.

  Lancing - this procedure involves using a scalpel to open the abscess. Your doctor will give you an anaesthetic prior to the operation. The channel is then cleaned properly to drain out blood, pus or hair. The wound is packed with a sterile dressing and left to heal. It usually takes about a month for the wound to heal, after which no further treatment is required.

  Phenol injections - for this procedure, first and foremost, your doctor will give you anaesthetic so that you don t feel any pain. A chemical compound known as Phenol is injected into the cyst. Phenol acts as an antiseptic and is used to harden and eventually close the lesion. This procedure needs to be repeated multiple times to achieve the desired result.

  Surgery - if the pilonidal sinus tends to recur, or if you develop multiple sinus tracts, the most preferred choice of treatment is surgery. The surgeon will open the lesion, remove the debris and pus, and then suture the wound. You will be given an anaesthetic prior to the surgery, and once the treatment is done, you will need to change the dressing more often.
If you suffer from pilonidal sinus, you will also need to maintain good hygiene. Make sure you clean and wash the area with a mild soap, and rinse properly. If your job requires you to sit for a prolonged period, take a break in between your work. Avoid wearing skin tight clothes. Adopting these measures will help prevent the occurrence of pilonidal sinus.

Treatment For Pilonidal Sinus!

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

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