Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

Myofascial pain syndrome refers to a chronic condition that affects a person s musculoskeletal system. With this disorder, pressure on the sensitive points (known as trigger points) in the muscle induces pain in various parts of the body.

Myofascial pain syndrome mostly affects people in the age group 40-60 years.

What causes myofascial pain?

Typically, myofascial pain syndrome occurs because of repetitive muscle contraction or overuse, or due to an injury. Sensitive areas of the tight muscle fibres can develop following an injury/trauma, and ultimately lead to pain and strain throughout the muscle.

Symptoms to watch out for-

Common signs and symptoms of myofascial pain syndrome include-

  Severe pain in localized muscle areas
  Pain that worsens when you stretch or strain the affected muscle
  Muscle pain that persists for longer than usual, or worsens with time
  Painful, tender knots in the muscles that lead to severe pain when pressed
  Weakness and stiffness in the muscles
  Inflexibility or a reduced range of motion

Although muscle pain is temporary in most cases, and usually subside on its own, you should visit a doctor immediately if the pain becomes intense and severe. Otherwise, the symptoms of myofascial pain syndrome can aggravate and impede your daily routine.

What is the treatment for myofascial pain syndrome?

Treatment for myofascial pain syndrome include a range of pain management options such as the following-

  Medications
Your doctor will likely prescribe medications that include anticonvulsants, analgesics, and over-the-counter Non-steroidal Anti-inflammatory Drugs (NSAIDs). These work as painkillers and help relieve pain and reduce muscle spasms.

  Dry-needling
Dry-needling is a quicker way of getting rid of myofascial pain symptoms. The doctor inactivates the trigger points by directly inserting a needle into it. He/she will then slowly move the needle around and poke it inside and out. The initial process can be a little painful, but it certainly helps manage the pain in your muscles. Alternatively, acupuncture needles can be used for the same procedure since they are small and are less painful.

  Local injections
Local injections, also known as trigger point injections, are similar to dry-needling. The only difference is that local injections involve injecting a solution (saline/steroid/or a local anaesthetic) into the trigger points. The method yield similar results as does dry-needling.

  Therapy
Different types of therapies can be used to ease the pain associated with this chronic pain disorder.

Ultrasound therapy where sound waves are transmitted into the muscle tissues through a sound-conducting gel applied on the skin. The sound waves heat up and relax the muscles, thereby improving blood circulation and removing the scar tissues. Ultrasound therapy is also effective in reducing muscle stiffness and increasing one s mobility.
Massage therapy also is very effective in treating myofascial pain syndrome. The therapist usually uses his/her fingers or some sort of equipment to induce pressure on the various trigger points. When performed, this procedure may first aggravate the muscle pain and then release muscle tension.
Apart from these, the doctor may prescribe regular exercising or physiotherapy treatment for patients suffering from chronic muscle pain.

Myofascial pain syndrome can be managed well using the techniques mentioned above. In addition, it is very important that you stick to some sort of physical activity. Talk to your doctor and incorporate these pain management techniques to live a pain-free healthy life.

Myofascial Pain - Causes, Symptoms & Treatment Of It!

Are you prone to slipped disc problem? + the ideal way to treat it

A slipped disc, also known as a prolapsed disc or herniated disc, is the term given to the phenomenon that occurs when a cartilaginous disc found between the vertebrae in the spine becomes slightly displaced or protrudes, thereby pressing on the nerves in the adjacent areas and causing back pain.
This happens when the soft inner part of the disc, known as nucleus pulposus, bulges out through a weakness in the exterior part of the disc. A prolapsed disc usually occurs in the lower region of the spine and can be of varying sizes. There might even be the development of inflammation around the disc in some cases.

Who is likely to get affected?
Most cases of herniated disc occur in patients between the ages of 30 and 50. The number of men affected is twice as many as the number of women.
Although the root cause of this problem is not yet known, there are a number of factors that may trigger it. These factors include working at a job that requires a lot of lifting, an occupation that involves remaining in a seated position for a long time, weight-bearing sports, obesity, smoking habits and increasing age.

Effective ways of treating the problem
The different methods that are commonly used to treat the problem are:
Medications
There are many different kinds of medicines that are effective in providing relief. These include painkillers, muscles relaxants, anti-inflammatory pills, etc.

Spinal injections
A number of spinal injections are used to treat slipped discs. The injection is done at the opening where the inflamed nerve roots are found and reduces pain, swelling and irritation in the area.

Radiofrequency ablation
This procedure makes use of an electrical current produced by radio waves to reduced pain and sensitivity in the affected area.

Ozone discectomy
As opposed to the surgical removal of the prolapsed disc, this new process makes use of an ozone-oxygen mixture that is injected into the spine to treat the problem. Many international studies have proved its superiority to traditional methods and surgeries.

Those affected by this problem are advised to keep exercising and continuing with their everyday activities as best as possible.



Why You Can Get a Slipped Disc Problem?

6 Bodily Pains You Must Never Ignore

Any pain in the body is an indication and demands attention. Some pains go away by themselves or by home treatment, while few need medical attention. 

Here are 6 types of pains which should never be ignored.

Chest Pain - Chest pain that doesn't go away and is accompanied by shortness of breath can prove to be fatal if not treated at the earliest. Do not wait for it to subside, nor should you try self medication. Consult the doctor immediately.
Abdominal Pain - While abdominal pain could be because of various smaller reasons, if it is unbearable, consult a doctor at the earliest. This pain could be because of ruptured appendix, stomach ulcer, problems in your pancreas or gallbladder or even intestinal blockages.
Severe Headache - Normally we tend to take headaches lightly, believing that all we need to do is pop a medicine or rest it out. However, if the pain is excruciating, consult the doctor as soon as possible.
Prolonged Backache - If you are experiencing pain in the back with tingling in your toes, this could be associated with your discs. Give it medical attention at the earliest, as it could turn fatal.
Lower Abdomen  - Appendicitis' indicator is sharp pain on the side. If you feel a sharp pain in your lower abdomen on the right side along with symptoms like nausea, vomiting, fever, shaking, constipation and diarrhea, reach out for medical assistance as soon as possible.
Leg Pain - Yet another pain one should not ignore is deep vein thrombosis which is blood clots in the legs? deep veins.

If you would like to consult with me privately, please click on 'Consult'.

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6 Bodily Pains You Must Never Ever Ignore

Stitches or sutures act as a closure for either surface wounds or deep wounds. Procedure to close a deep wound comprises of sewing the two edges and applying stitches under the skin surface.

Catagories of sutures

    Non-absorbable stitches: Such stitches are applied in case of skin wounds or internal wounds. Such stitches get healed quickly and are easy to remove. Non-absorbable stitches are made of natural fibers or synthetic threads like nylon polypropylene. As the name suggests, these stitches are either permanent or persist for a long time.
    Absorbable stitches: Such stitches are applied on layers, which have the property of healing quickly. They are very firm during the initial days. Then they start getting dissolved in the body.

Precautions taken by medical team before applying stitches to prevent infection

    Careful checking of nose for occurrence of germs before the start of operation.
    Skin must be cleansed prior to surgery.
    Sanitizing hands prior conducting the surgery.
    Usage of germ free gloves and sterile clothes while applying sutures.
    Prescribing antibiotics to the patients who may fear high risk of infection.

Precautions to be taken by patient to prevent infection

    Take a bath prior to surgery.
    Avoid using razor at the surgical site. The same can be carried out by using clippers by the surgery team itself.
    Keep all your jewellery aside before the operation starts. Do not apply nail polish.
    It is advised to cover up the wound. Try to keep the adjacent areas germ free. This is a crucial step in avoiding infection.
    Visit your doctor at once on finding redness around the wound.

When to see the doctor
Pain up to a certain threshold is normal. In case pain gets unbearable, the scene can be alarming. It may be an indication of infection. Taking immediate remedial steps is necessary to avoid infection or any other side effects post the surgery. On meeting with any of the following signs, it is better to consult doctor at once.

    If the skin around the wound gets swollen.
    If you detect redness around the wound.
    If the pain becomes unbearable.
    If the wound starts developing pus.
    If your body temperature increases abnormally or if you have fever.
    If you observe red streaks around the wound.
    If in case a stitch gets opened up and the edges of the suture start widening. This is the most alarming sign. In case a suture gets opened, you must immediately seek a remedy.

Ask your doctor for the precautions you can take to avoid experiencing any of the above signs. If you come across such alarming symptoms, rush to the nearest hospital and get the appropriate treatment.

Pain in Stiches - When You Should See Your Doctor?

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

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