The pectoral muscle is the large muscle in the chest; that appears just below the collar bone and runs down through the sixth rib. This muscle is used when you flex and raise your arms over your head.
A strain on this muscle is self-treatable in most cases. The most common cause of pectoral strain is its overuse. Bodybuilders who perform extensive strength training are more prone to pectoral strain due to heavyweights they lift on a regular basis.

Lack of adequate warm-up before exercising can be another cause of this condition.

Symptoms
Pain in the chest is one of the most significant signs of pectoral strain. At times, shoulders and front of the arm may also be hurt if one has ruptured the pectoral muscle. Injuring the pectorals makes it difficult in moving the arms. According to diagnosis, although first degree strain on the pectoral muscles does not lead to a loss of muscle power, a more serious second or third degree tear in the pectoral muscles can cause significant weakness in the muscle strength.

Treatment and cure
A natural treatment for treating pectoral muscle strain at home is to put a temporary hold on all the workout regimes and allow the muscle to heal on its own. During this time, icing the inflamed zone can also help to control the pain. Icing the inflamed pectoral muscle for two to three days along with an application of a compression bandage helps in reducing the swelling.
In worst cases, surgical intervention may also be required for third degree muscle tear in the pectoral zone, especially when other tendons are also involved in the injury.

Prevention
One should always remember to stretch the muscles properly before any extensive workouts, to prevent this particular condition. Doing a chest stretch exercise helps in loosening the pectoral muscles in a faster and effective way.

Pectoral Strain - Signs You Are Suffering From It!

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!

Frozen shoulder is a condition where the patient encounters continuous shoulder stiffness and pain. It could last for several weeks. Inflammation around the shoulder increases the inability to move or stretch properly. This happens when somebody is recovering from an injury. Frozen shoulder can also occur when somebody is wearing a sling or a cast. It also occurs if someone is recovering from surgery or experiencing joint pain. It may also be experienced as a symptom of thyroid, joint disorders or diabetes.

Some of the causes and risk factors for creating a frozen shoulder are as follows:

    If you are 40 years or older, your chances of a frozen shoulder are higher than others
    Recovering from a damage or surgery
    Hormonal imbalance
    Ladies are more prone to a frozen shoulder
    Cervical disc infection that influences the nerves around the shoulder
    Not moving your arm because of other pain or wounds
    Having a previous medical condition like diabetes or other heart diseases
    Open-heart surgery or spinal surgeries
    Poor diet and unhealthy lifestyle

The most widely recognized symptoms of a frozen shoulder include:

    Stiffness around the shoulder usually happens in one shoulder at a time (not both) and will probably return in the same shoulder. Muscle, joint and bone agony in and around the shoulders or arms may be experienced.
    Restricted scope of movement
    Having difficulty moving and using the shoulders or arms ordinarily, (for example, experiencing difficulty in getting dressed, driving, holding objects before you, and gestures.)

Treatment:

    Stretch the Shoulder: Before beginning shoulder exercises for a frozen shoulder, try to warm up your shoulder by doing a few warm up exercises. This will improve the blood supply in the affected area and avoid future injuries by making your body more comfortable with the motion. The best approach is to extend and warm up the shoulder by applying heat for 10 to 15 minutes, scrubbing down or showering with Epsom salt.
    Non-intrusive treatment: While these activities mentioned above can be easily performed at home, if pain continues and makes it difficult to move around or work ordinarily, see a physiotherapist who can appoint particular activities and can enhance your scope of movement, flexibility and strength.
    Acupuncture: Acupuncture is considered one of the best treatment choices for any joint and nerve related problem. The treatment is based on focusing on the trigger points of the pain and putting pressure on them via needles. The treatment is not painful and is known to produce good results in the long run.
    Dietary Supplements: Various supplements can be taken with the recommendation of a doctor, in order to improve recovery. Alfalfa (horse feed) and turmeric are two of the most regularly recommended elements that relieve swelling and repair the tissue in the shoulder.

Best Remedies for a Frozen Shoulder

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 

Sciatica pain can be mild to intense. Many with lumbar herniated disc and sciatica often wonder whether or not they require a surgery. Needless to say, it is never an easy decision. But the good news is that micro discectomy surgery has a higher rate of success when it comes to relieving sciatica pain. When compared to many other options, this one is relatively minimally invasive. It doesn t alter the structure of the spine permanently since it works by removing a small portion of the disc, which has herniated or extruded out of the disc.

When your sciatica pain stems from lumbar disc herniation, a small open surgery with the help of magnification is the prevalently opted surgical approach. On the other hand, a laminectomy is done when the bone or disc pinching the nerve root is required to be removed.

When should you consider undergoing surgery for sciatica?
Typically, neurosurgeons recommend considering surgery for sciatica in a host of situations which include the following:

Severe pain in the leg lingering for more than six weeks, which mainly affects one side of the leg or buttock
Intense pain in the low back and buttock, which continues through the course of the sciatic nerve andextends to the lower leg and even foot. This pain can be described as sharp and searing rather than a dull thud.
When pain has not alleviated even after non-surgical treatments that may include non-steroidal anti-inflammatory drugs (NSAIDs),oral steroids, injections, manual manipulations, and physical therapy
When the patient is not able to take part in the day to day activities due to intense lower back pain and the symptoms tend to become severe during movements like sneeze and cough.
When the symptoms are continuing to worsen, thereby indicating nerve damage, particularly when the progressive signs have their root in neurological issues
It is important to note here that surgical intervention may only be needed when the patient experiences progressive weakness in the lower portion of the body or sudden loss of bladder or bowel movement, which may stem from cauda equina syndrome. Two surgeries, namely lumbar laminectomy and microdiscectomy are performed on the basis of the cause as well as the duration of the sciatica pain.
In some cases, the symptoms are unique on the basis of the underlying causes of sciatica. For instance, trying to bend the body backward or walking a longer distance than normal may trigger unbearable symptoms. On the other hand, when the affected individual tries to bend the body forward, it can lead to symptoms stemming from the lumbar herniated disc.
In case sciatica occurs after an accident, injury or trauma, or if it happens in tandem with other symptoms, then it requires an immediate medical attention.
Thus, choosing to go for a surgery depends on several factors that only your doctor can assess and decide upon.

Sciatica - When Do You Have To Go For Surgery?

Restless leg syndrome is a condition where the nervous supply to the lower legs (and sometimes hands) is affected. The person has a constant urge to move the legs due to the tingly sensation or the pins and needles sensation and so this condition is called as restless legs syndrome (RLS). It is almost never a standalone condition and is often associated with other nervous system conditions.
It is a progressive condition and aggravates with time. The patient may experience episodes of this disease. Most people might experience this problem at night due to which a lot of patients complain of disturbed sleep and restlessness while sleeping.

While there is no permanent solution to this condition, there are various home remedies and techniques which can help control the condition. Read on to know more.

Trigger agents: Some people are able to identify triggers like caffeine or chocolate which induce the condition. The first step would then be to avoid using these, especially before sleeping.
Exercise: Any form of exercise, which gives a good workout for the leg muscles is recommended. This could range from a 30-minute brisk walk to stretches depending on the person s overall health status. This is known to induce a good sleep, reduce muscle tension and relax the mood. Choose yoga, gym, cycling, or any form which suits your overall health and schedule.
Massages:Hot or cold massages, often used alternately, can help in relaxing the muscles. This also helps in reducing tension and improving overall sleep. The ideal time for the massage is the evening so that RLS does not affect during nighttime.
Diet: A diet rich in vitamins and minerals can prove to be helpful. This is because proper muscle and nerve function requires various minerals like zinc, potassium, calcium, sodium, etc. Diet rich in these helps in improving muscle and nerve function and thereby control RLS.
Sleep pattern: Sound sleep practices like having an early dinner, a quiet room free of digital media, optimal temperature, and relaxing ambience helps in a better sleep. This has shown to reduce the incidence of RLS and evidence of sound sleep.
Medications: RLS can also cause mild to moderate pain in the affected legs, and so pain killers can be used once in a while if the pain is not bearable. These should be used only rarely and continued use can lead to stomach ulcers and bleeding. The above mentioned nonmedical methods should be tried before trying medications. Anticonvulsants have been used to control RLS if pain killers alone are not adequate. In more severe cases, antiparkinson drugs are used with great success.

Restless Leg Syndrome - How It Can Be Controlled?

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