What is Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip or DDH, is a condition that affects the hip joint in newborns and young children. The hip is like a ball-and-cup, formed by the round top of the thigh bone - called the femur - and a cup-shaped socket in the pelvis. The hip joint is stable in spite of its large range of motion and is kept in place by ligaments and other soft tissue structures. The normal infant hip is not mature at birth but develops into a strong and stable joint as the child grows.

What happens in hip dysplasia?

In DDH, the hip does not develop normally as the cup and ball are either partially or completely out of alignment. DDH can vary from mild to severe depending on whether the cup is shallow, soft tissue structures are lax or a combination of all. These problems may cause the hip to become unstable, and even come out of the joint. This is known as a dislocated hip and is believed to occur in around one in 1000 infants. One or both hips can be affected. DDH isn't painful in babies and young children. Untreated DDH can result in limping in young children. This can progress to hip pain and arthritis at a later date.

How common is it?

DDH is more common in girls and first-born children. It's more likely to occur if there's a family history or if the baby was breech. Swaddling or wrapping a baby's legs too tightly can also lead to DDH. Certain traditional practices like wrapping the children, etc. are known to increase the risk, while carrying them with limbs separated apart is known to decrease the risk of dysplasia. All newborns should have both hips carefully examined by a health professional. 

Treatment options

Treatment depends on the child's age and the severity of the condition. Young babies with confirmed DDH are usually treated in a brace or harness that holds the legs apart. This helps the hip socket to deepen and the hip to become stable with growth. Regular monitoring of the hip position is necessary to ensure good outcomes. Surgery may be necessary if brace treatment is unsuccessful, or if a hip dislocation is first noticed when the child is older.

What is the long-term outlook?

Most infants who are diagnosed and treated early do not have any hip problems in later life. Earlier the diagnosis and treatment, the better the outcome, as late diagnosis often requires surgical treatment and can mean a higher likelihood of ongoing hip problems.

Developmental Dysplasia Of Hip - How Common It Is?

Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.
Since prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips.
Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.
Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.
Lift objects correctly and maintain proper posture:While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed.
While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.
Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.
Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pinpoint the diagnosis and appropriate management.

3 Essential Tips to Prevent Back Pain

As you age, many parts of the body start to wear down. Your spine is no different in this regard. When age affects the condition of the cervical section of the spine, it is known as cervical spondylosis. Other names for the disorder are neck arthritis or cervical osteoarthritis.

Even though age causes most cervical spondylosis, other factors may also be responsible for the onset of the disorder. Here is a look at some common causes for the same.

Causes for cervical spondylosis:

  Bone spurs - Your body may try to strengthen the joints by growing additional bone tissues. These are known as bone spurs. These spurs can pinch down on the nerves and the spinal cord, leading to pain and other symptoms.

  Dehydrated discs - The spine houses shock-absorbing pad-like structures between the vertebrae, called discs. These discs contain a gel-like substance that gives them its unique shock absorbing properties. Over time, the gel dries out, causing greater friction between bones during movement.

  Injury - A neck injury can lead to cervical spondylosis. The disorder may not appear as soon as you suffer from the injury but may take years to develop.

  Excessive physical strain - Some profession may require people to lift heavy weights or overexert themselves physically. These people may develop cervical spondylosis later on because of this work.

Symptoms of cervical spondylosis:

Here are some symptoms that are commonly associated with cervical spondylosis.

  Shoulder pain - Patients suffering from cervical spondylosis often complain about pain in the shoulder blade. This pain increases while the person is standing, sitting, coughing, sneezing and tilting their head backwards.

  Weakness - People with cervical spondylosis also suffer from muscle weakness. For instance, you may not be able to grab things tightly in your hands, if you suffer from the spinal disorder. Furthermore, lifting the arms may be difficult.

Other minor symptoms of cervical spondylosis include stiffness in the neck that grows worse with time and headache that affects the back part of the head.

Treatment for cervical spondylosis:

Treatment is not necessary in many cases due to the absence of any distinguishing symptoms. However, if the spondylosis interferes with normal life, medical intervention is required. Treatment for the disease includes-

  Physical therapy - Physical therapy sessions often help deal with the pain and stiffness resulting from the cervical spondylosis. Your doctor will prescribe weekly sessions, which will aid to reduce the symptoms of the condition after some time.

  Medications - Pain medications help manage the discomfort related to the condition. However, these drugs do not have any long-term effect on the body. They only provide temporary relief from the pain.

  Surgery - Surgery for cervical spondylosis is uncommon. However, if the condition does not respond to other forms of treatment, the operation may be required to remove bone spurs, herniated discs and rectify parts of the spinal column.

You can also ask your doctor about home remedies to follow to manage the symptoms of the disease.

Cervical Spondylosis - How Can It Be Treated?

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?

Leg bypass surgery is needed when the patient suffers from peripheral artery disease. PAD is a very common condition in elderly people, where the rate of flow of blood to the limbs (in this case, the legs) is reduced due to narrowing of the blood vessels.

Causes and risk factors-

The narrowing of the blood vessels occurs due to excess calcium accumulation and fat deposits in the walls of the arteries. The following are the risk factors of PAD-

  Age (60 years and above)
  Smoking
  Diabetes

The condition may be life-long or can last for years.

Symptoms that indicate you might need a leg bypass surgery-

The following are the signs and symptoms of PAD, which suggest you should consider having a leg bypass surgery-

  Pain in the legs, especially when walking
  Pain in the buttocks
  A sore on a foot/leg that does not seem to heal
  Thinning of the skin on the legs
  Loss of hair on the legs
  Tingling, weakness, or numbness in the legs
  One or both the feet/legs may feel cold
  The feet or legs may appear bluish, pale, or dark reddish in colour

You should get yourself checked by a specialist in the initial stage, or else the condition may get worse and affect your day-to-day activities.

Vascular surgery for PAD in the legs:

Vascular surgery is a surgical sub-specialty, which manages vascular system disorders- disorders of the veins, arteries, and lymphatic circulation- by surgical reconstructions, minimally invasive procedures, and medical therapies.

The most commonly used surgical procedure is the leg bypass surgery. The surgery aims to reroute the supply of blood around an obstructed artery in one of the legs.

How is leg bypass surgery performed?

The surgeon performs leg bypass surgery using a graft (usually made of plastic tube) to bypass or replace the blocked portion of the artery. On some occasions, the graft may be a vein or blood vessel taken from the patient s body (usually, the other leg).

During the surgery, the surgeon will first administer anaesthesia so that you are not able to feel pain or discomfort. He/she will make an incision over the portion of the blocked artery. After carefully removing the skin tissues, the surgeon will place clamps on each side of the narrowed artery and sew the grafts in place. The surgeon will ensure that the flow of blood in your lower extremity (legs) is good. An arteriogram (an X-ray of the arteries/blood vessels) is recommended to make sure that the graft is working fine after the leg bypass surgery.

For most people, leg bypass surgery helps improve the flow of blood in the arteries. The prognosis is better if underlying medical conditions like diabetes are controlled.

Leg Bypass - Treating It Through Vascular Surgery!

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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