People have a common perception that most injuries, medical conditions only affect those who spend several hours working outdoors. But what if we tell you that people who stay indoors- such as homemakers - are also susceptible to numerous health problems?

There s a saying:  Home is where the heart is.  But for countless homemakers, home is the place where  hurt  is! Scores of Indian homemakers encounter various injuries every year while engaging in household chores like cleaning and washing. The most common ones are-

Sprain- if you re a neat freak, you wouldn t mind spending half of your day cleaning the entire house. Here s a small tip- go slow if your cleaning duties include shifting heavy appliances and furniture from one place to another. There s a high chance that you may end up with a sprain injury. Sprains occur when you accidentally twist your ligaments. Another major cause of sprain injuries is a sudden fall. If you re mopping the floor or cleaning the bathroom, there s a fair chance that you may slip or lose balance. One must be cautious when working with water.
Back injuries- These are the most common types of injuries at home. Bending, lifting a heavy bucket or an abrupt movement, can strain your back muscles or ligaments leading to back injury. Many times the injury can result in a persistent, sharp stabbing pain, and hinder your usual routine.
Joint compression- Homemakers spend a considerable amount of time standing in the kitchen. As tiring as it is, standing for prolonged periods puts pressure on your joints- knee joint, hip joint as well as those in the feet and the ankle. This leads to wear and tear of the synovial joints, eventually causing them to tear. In due course of time, you will find it difficult to move around and walk even a meagre distance.
Prevention-
Starting to get worked up? Don t be. These problems can easily be prevented if you follow these steps-

Avoid overstretching, bending and twisting
Avoid lifting heavy weights. If possible, use a waist belt to keep away from traumatic injuries.
Keep your body weight in check. Mild exercises can help you with that.
Maintain a healthy diet- calcium intake can help your bones get stronger.
Use muscle braces to keep your joints protected.
Treatment-
The most preferred and effective choice of treatment for curing muscle injuries and joint inflammation is physiotherapy. Physiotherapy uses manual therapy, mechanical force and exercise therapy to promote mobility.

The most common method of treating such injuries is the RICE technique.  RICE  stands for Rest, Ice, Compression and Elevation. Keep the injured part at rest. Put an ice bag on the injured portion. Compress the injured area. Elevate the wound/injury for faster relief.
Anti-inflammatory drugs like Ibuprofen and Aspirin are prescribed to reduce inflammation and swelling. Painkillers can offer you instant relief from pain.
Physiotherapy treatment can effectively cure you of such injuries, that too in a short span of time. If you follow the treatment guidelines, recovery will take about 2-4 weeks. 

Common Problems Faced By Homemakers Who Stay Indoors - How Physiotherapy Can Be Of Help?

The movement between bones and muscles is possible due to the fluid filled sacs that enable smooth gliding of the bones. When there is an inflammation of these sacs, condition known as bursitis results, leading to friction, reduced movement, painful movement, discomfort, and irritation.

Some of the common causes of bursitis include age, which brings along reduced elasticity of the tendons and ligaments.  Additionally, sudden injury to the bursa area, repetitive stress, overuse of the ligaments or tendons, incorrect posture, and improper exercise can all lead to bursitis.

The most commonly affected parts are the elbows, shoulders, hips, knees, and ankles. The dull, aching pain that ensues is accompanied by stiffness. Movement can worsen this pain.  The area can be red, hot, and swollen indicating infection. Whatever the area affected, some of the common ways to manage bursitis pain are listed below.

1. Rest - As soon as bursitis is identified, the area must be rested. As noted, in most cases, repetitive stress and injury is the most common cause, and resting the area really helps.

2. Ice only - If bursitis is happening for the first time, then an ice pack alone should help reduce the pain in 1 to 2 days.

3. Ice and moist heat - If it is happening repeatedly, then alternating moist heat and ice for 15 minutes each will help.  This can be done two to three times a day. 

4. Anti-inflammatories: In most cases, if rest and topical therapy are not working, then the regular anti-inflammatory agents may be given. 

5. Physical Therapy - In some cases, mild exercises can help reduce inflammation and pain. 

6. DMSO (dimethyl sulfoxide) - This clear, colorless, oily liquid is made from wood pulp and helps in reducing the inflammation caused by bursitis. A 70% DMSO mixture can be applied with cotton on the affected area 3 times a day for 3 days, then 2 times a day for the next 3 days, and then 1 time a day for the next 3 days.  If there is no improvement in the first 3 days, it needs to be discontinued.

7. Foods to remove calcium deposits - In a number of cases, bursitis that is present for months or years is worsened due to the calcium deposits. Foods like apple cider vinegar can help dissolve the calcium deposits that could have formed in the bursa.

8. Steroids: Local injections of corticosteroids may be necessary in some cases. Though inflammation can be curtailed with this, there is always the fear of hampered immunity and altered sugar levels.

9. Surgical drainage - In very rare cases, the bursa may need to be surgically drained.
Bursitis is a very common issue and can be managed easily as well. Consult your doctor and avoid medicating on your own.

Ways to Treat Bursitis

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

In recent times, there has been an upsurge in the instances of leg pain. People from all age groups, irrespective of their gender, are being affected. Needless to say, this painful and uncomfortable condition throws life in jeopardy and adversely affects and interfers with a person's daily activities. While the pain can be in both the legs, many people also suffer from severe radiating pain in one leg.

What causes radiating pain in one leg?
More than often, this kind of pain is triggered by nerve problem or disorder. If you experience a shooting pain that originates in the lower back and gradually radiates down to one of the legs (from the buttocks to the back of the leg), chances are you are experiencing sciatica.

In sciatica, the nerve affected is the sciatic nerve. The sciatic nerves originate from the spinal nerves L4 to S3. From the lower back, the nerves (two sciatic nerves) extend downwards to the back of each leg. The sciatic nerves further divide into a tibial and peroneal nerve. These nerves are mostly responsible for the sensation and motor functions of the legs and the feet.

Sciatica can be an outcome of
The discs present between the vertebrae provides them with a much-needed cushion, preventing injury or damage. In case, of a degenerative disorder of the disc, the protective cushion gets affected resulting in the pain and associated symptoms.

Lumbar spinal stenosis: A medical condition where the spinal canal in the lumbar area narrows down, exerting pressure on the sciatic nerve.
Spondylolisthesis or a slip disc: The condition mostly affects the lumbar area (base of the spine) whereby there is slippage of one of the bones over the adjacent bone (the bone located just below it).
A muscle pull in the buttocks can also trigger sciatica and many times, a pregnant woman may also experience sciatica. The sciatic pain can be:

Chronic sciatic pain: As the name suggests, chronic sciatic pain is intense and more severe, with the symptoms persisting for a longer time (more than three months). Arthritis, severe nerve damage or scarring (tissues) are often responsible for chronic sciatic pain.
Acute sciatic pain: An injury to the nerves, muscles, spinal joints or discs can cause the pain. However, as instantly as the pain starts, the condition improves within days (at times weeks).
In addition to the radiating pain, there may be other symptoms associated with sciatica such as

Difficulting in leg or foot movement.
Weakness
Sciatica can also trigger a pain in the back of the leg which aggravates when a person is in a sitting position
Hip pain
Numbness, and often a tingling or burning sensation radiating down the leg
In some people, sciatica can cause a shooting pain (which worsens when a person tries to stand up)
The pain (in some cases) can extend to the foot and toes
There can be many underlying factors responsible for the pain radiating to one leg. Neglecting the condition will only worsen the situation further. 

Radiating Pain In One Leg - What Can Be The Reason Behind It?

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! 

A bone fracture occurs when a strong external force is applied on the bones causing it to break. It is an extremely painful condition that results in days of immobility and rest. There are several reasons which can result in bone fracture, some of them being:

1. Injuries caused in sports
Any sport requires and demands extreme physical exertion and participation. Being involved in any sport therefore automatically increases your risk of incurring injuries. Bone fractures therefore are mostly reported during sports.

2. Osteoporosis
Due to the deficiency of calcium, the bones of both men and women tend to get weak and more susceptible to fracture and breakage. It is one of the primary causes that lead to bone fracture.

3. Osteomalacia
This also refers to a condition wherein the bones become weak and brittle. Much like osteoporosis, osteomalacia too significantly contributes to instances of bone fractures.

4. Osteosarcoma
This is a rare form of bone cancer that most often develops either near the femur or near the shinbone. An instance of this form of bone cancer is most often found in children and weakens the bone, consequently leading to fractures.

Though there may be different causes of broken fractures, its symptoms remain similar. Some of them are-

1. Swelling
One of the most common symptoms of bone fracture is perceptible swelling. If any of your bone is fractured, that particular part will be visibly swollen.

2. Deformity
Bones give your body the shape it has, thereby, any fracture anywhere would inevitably manifest itself as a clear deformity of that particular part.

3. Extreme pain
It goes without saying that a bone fracture would entail excruciating and extreme pain. This pain sharply increases with mobility thereby necessitating complete rest.

4. Temporary loss of function
The part of the body where the bone is broken temporarily becomes dysfunctional. For instance, if the bone in your hand is broken, you will find it extremely difficult to move and do any work with it.

Causes and Symptoms of Bone Fracture

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