When the median nerve that runs through the palm and forearm is twisted or squeezed, a condition called the Carpal tunnel syndrome (CTS) occurs. This carpal tunnel is a passage that is narrow and is present in the ligaments and tendons. This nerve is responsible for offering a feeling sensation to the palm, index finger, thumb, and the middle finger. A part of the ring finger too shares the same. The median nerve is compressed when the tendons are irritated. This leads to pain in the forearm and arm, palm, and wrist. Additionally, this condition can cause numbness and weakness.

How it begins? 

This condition does not occur suddenly but gradually. In the initial stage, the sufferer experiences burning, itching, and numbness in the palm. The thumb, index and the middle finger feel these symptoms. The affected individuals may notice that the hands are swollen and rendered useless. You may feel pain and numbness in one or both the hands during sleep. Slowly, the numbness and pain keeps increasing and can be felt during the day. This is why you may want to shake off hands multiple times.

Factors responsible for this condition: 

Various factors can trigger Carpal tunnel syndrome. If you have had any injury to the wrist in the past that caused swelling, you may suffer from this syndrome. For instance, a sprain or fracture can trigger a Carpal tunnel syndrome. A thyroid gland that is overactive or underactive, arthritis, and overactive pituitary gland, too, can cause this condition. If your occupation involves an excessive movement of the wrists or if your lifestyle involves excessive work stress and the use of vibrating tools, then also this syndrome may affect you. Compression of the median nerve or narrowing of the space for the median nerve are the two other reasons. Fluid retention during menopause or pregnancy can also result in Carpal tunnel syndrome.

Will you be at risk?

Women are more likely to suffer from this condition as compared to men because the carpal tunnel is smaller in the former group. The symptoms are first seen in the dominant hand. The high-risk group includes diabetics and people who suffer from other metabolic disorders. People who are working with industries that deal with manufacturing, cleaning, assembly, sewing, or poultry or fish packing mostly face this disorder.

What can you do?

Surgical and non-surgical treatment methods are available for Carpal tunnel syndrome. When you are diagnosed with Carpal tunnel syndrome, undergo the treatment as advised by the doctor. Wear a splint at nights. During days, when you see swelling or redness of the palm, apply cooling packs. Take breaks from work, if it involves pressurizing the median nerve or if there is any narrowing of the space. Chiropractic therapies, acupuncture, and yoga are known to offer relief as well.

Prevention techniques: 

To prevent Carpal tunnel syndrome, always ensure you stay in the right posture. Use a fingerless glove as this keeps the wrist and palm warm. Take frequent breaks from the task that you are performing, especially the ones that require too much of the wrist movement. Job demands should be considered, however, rotating tasks with colleagues can provide an excellent relief. If your doctor feels that surgery is the only option left to provide relief, then you need to go for the same. With the two options of open release surgery or endoscopic surgery, you can expect symptoms to be relieved as soon as the procedure is conducted. 

Things You Need To Know About Carpal Tunnel Syndrome! 

Being flexible is not always about doing splits or doing some random bending. It is about achieving a level of mobility that will not hold you back from doing whatever you are able to do. Most people think that stretching or flexing your muscles and body as the first method to defend you from pain. But if stretching and flexing can be done correctly, it can lengthen one's muscles and give one relief from pains and aches. Stretching is also done to increase the functional range of one's joints and muscles. There are various ways by which one can stretch their muscles. However, the question which looms over here is which is the correct procedure and which is the wrong one.

The Wrong Vs the Right Way: Before discussing about the correct way, let us talk about the various wrong ways in which stretching can be done. The first rule is that if stretching is causing you pain or if it is hurting you, then you are probably taking it too far. A muscle needs to relax as much as possible, if it needs to stretch. If one is stretching so hard that he or she cannot relax then the muscle will not lengthen. Stretching should never be painful.

One should also avoid stretching for an insufficient length of time. Only a few seconds of stretching will not hold the therapeutic effects of stretching.

The following methods are few of the correct ways to stretch:

Always start with the warm muscles. Warm your muscles by doing some aerobic movement or by applying heat with the help of a warm bath.
After warming your muscles, monitor your level of discomfort. Let it go once you feel pain.
Hold any stretch for at least 30 seconds.
Stretching the Correct Muscle: There are muscles, which need to be stretched and there are muscles, which should not be. So getting to know the correct muscles to be stretched is as important as knowing the correct procedure to stretch your muscles. Every muscle, which does not hurt should not be stretched. There are different types of muscles that cause pain like stiff, tight, short muscles and long muscles. Muscles that are tight should only be subjected to stretching. Stretching muscles that are too long is not a good idea.

Using Physiotherapists: Most people who cannot determine which muscle should be stretched and which should not be should consult a physiotherapist. Physiotherapists can quickly and easily diagnose muscular issues. They will also show ways to stretch which are most effective for particular needs.

Stretching should be made a part of one's life. It is a way by which one can become their healthiest self and avoid muscular imbalances.

Stretches for Tight Muscles 

Spinal trauma, also referred to as spinal cord injury, occurs when a section of your spinal cord or the nerves at the edge of your spinal canal is damaged. The spinal cord acts as a messenger between the brain and other parts of your body. If the spine sustains an injury, all or some of these impulses may not get through. This may result in complete loss of mobility and sensation below the site of injury. An injury closer to the neck can cause paralysis throughout a larger part of the body than in the lower back region.

How do such injuries occur?

Often, spinal trauma or injury results from a violent event or an unpredictable accident. The following may severely damage your spinal cord-

  A violent attack (a gunshot or a stabbing)
  A motor vehicle accident that may cause trauma to the neck, back or head
  Falling from a great height
  Spinal or head injuries during some sports activity
  Electrical accidents

What are the signs of a spinal cord injury?

The followings signs and symptoms can be observed after an injury to the spinal cord-

  Difficulty walking
  Restricted movement of the legs and arms
  Stiffness, pressure and intense pain in the neck/back
  Loss of sensation
  Muscle spasms
  Loss of bowel or bladder control
  A twisted neck or back
  Lack of coordination, weakness or paralysis in any of the body part

When should you see a doctor?

If you experience significant trauma to the neck or head, accompanied by the above symptoms, then visit a doctor immediately. Spinal trauma or injuries is a debilitating condition and can deteriorate further if you do not seek medical intervention. In fact, if such an injury is not detected on time, you may have to face more severe complications. For instance, paralysis or numbness may develop immediately or gradually as blood clots and swelling occur in the surrounding region of the spine.

The doctor can detect spinal injuries using any of the following methods-

  CT Scan
  MRI
  X-ray

What is the treatment for spinal trauma?

An orthopaedic will recommend the correct treatment for spinal trauma or spinal cord injuries, depending on the severity of the condition.

  Medications - Intravenous medications can help reduce the pain and symptoms of acute spinal cord injury
  Immobilization - Braces, corsets, or neck collar can help realign and stabilize the spine
  Surgery - Surgery may be performed to remove bone fragments, herniated disks, foreign objects, or fractured vertebrae that are compressing the spine. Surgery also prevents deformity and pain in the long run.

Recovery starts typically within a week after the treatment. If you undergo surgery, you will have to wait a little longer to get back to your day-to-day activities. It is advisable that you follow up with your doctor and carry on physiotherapy for the first six months at least.

Spinal Trauma - When Should You Consult A Doctor?

Tennis elbow is a condition, which is characterized by the inflammation of the tendons occurring in the elbow region due to excess use of the muscle groups present in the overarm. Tennis elbow can cause a lot of distress once it occurs so it is best to perform certain exercises to strengthen the muscle groups in your overarm so that muscle strain does not occur during your physical activities. Read on more to find about all the different ways to strengthen your muscle groups to prevent tennis elbow.

1. Staying in good physical shape overall tones your body and strengthens your muscle groups, thus reducing the likelihood of tennis elbow.

2. It is also important that the physical activities, which are performed by you are done using proper technique as otherwise undue strain might cause unnecessary discomfort and pain.

3. You should try strengthening the muscles in your shoulder, arm and upper back to reduce the stress your elbow undergoes during physical activity.

4. Using a counterforce brace for activities, which include twisting or grasping of the arm can also help. The use of a counterforce brace is to distribute the pressure throughout the arm, which reduces the stress on the elbow. The brace is highly recommended for people who are likely to develop tennis elbow. One should consult a doctor before opting for a counter brace. 

However, it is not a substitute for rehab exercises. If repeated arm movements or certain physical activities are causing discomfort or pain in the elbow region, check for alternative ways of performing the task. If you have taken up tennis, cricket or golf as a sport, it is highly recommended that you take proper lessons in technique as these sports involve twisting and grasping your arm, which can cause injuries if you do not follow proper techniques. Also keep in mind to choose sports equipments which are at par with your physical fitness, flexibility and strength.

For daily activities, take a note of the activities, which involve putting stress on your elbows. In such instances follow techniques or different ways to perform the tasks, which will put minimum stress or pressure on your elbows. Also, apart from using the technique one has to stay fit, for which getting regular body health check up is very important.

How to Prevent Tennis Elbow

Muscle strain or muscle pull is a condition, which is characterized by damage to the muscles or its adjoining tendons. Undue pressure can be exerted on the muscle when you are carrying out routine activities such as sudden lifting of heavy things or playing contact sports. The damage to the muscle is usually in the form of partial or complete tearing of the tendons and fibres attached to the muscles. The small blood vessels in the muscles can also be damaged by the tearing of the muscles, leading to local bleeding and bruising.

The symptoms of muscle pain are:
1. You will experience pain even while resting
2. There will be bruising, swelling and redness around the affected area
3. You will experience weakness of the muscles and tendons
4. The movement and mobility of the muscle will be impaired
5. You will experience pain when you use the affected muscles

The causes of a muscle strain are:
1. Playing contact sports can lead to injuries
2. Lifting heavy things
3. Exercising without a proper warm up routine
4. Lifting extremely heavy weights during exercise without proper acclimatization
5. Sleeping on one side only for a long period of time
6. Not stretching properly
7. Falling from a height

The treatments for muscle strains are:
1. Pain medications: You can opt for pain relieving medications such as non-steroidal anti-inflammatory medications to help combat the associated pain of a muscle strain.
2. Rice: Rice stands for rest, ice, compression and elevation. This treatment is usually the first step after suffering a strain, before opting for medications. This treatment prevents further aggravation of the problem.
3. Compress: You can alternate between hot and cold compress to reduce the swelling and pain.
4. Stretches: Once the affected area has healed, it is important for you stretch the muscles to improve their mobility and strength.

Not Stretching Properly? It May Cause You Muscle Strain

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

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