Dr. Atul Kumar Garg

Lack of oxygen to the brain that occurs during, before or shortly after the birth of a child results in the disorder of movement, which is referred to as cerebral palsy. It is regarded as a common childhood disability that makes the movement of certain parts of the body very difficult. There are different categories of cerebral palsy and each of them has different characteristics and symptoms. The disorder of movement includes jerky and stiff movements such as spastic cerebral palsy. It may also lead to movements that are uncoordinated such as athetoid cerebral palsy. These include athetoid-dyskinetic, hypotonic, spastic and ataxic.

Effects of Cerebral palsy
In some, the disorder of movement is very severe and the patient is restrained to a wheelchair. In cases where movement is limited, it could be a slight limp in the arms or hands. The disorder cannot be considered as lack of intelligence or mental disability. The condition requires the medical diagnosis for treatment, but it cannot be cured. The involuntary and voluntary movements of the body are affected to a great extent due to the damage to the brain. The condition is not contagious and it also does not affect the cognitive ability of a child. In some cases the symptoms reduce over time. Further, since it is not progressive, it does not worsen with an increase in age. The lifespan of these individuals is also normal. The damage to the cerebrum can be caused during the birth of the infant or within 5 years of their birth.

Symptoms of Cerebral Palsy
The main symptoms that an infant with cerebral palsy can have include movement and muscular problems. The muscles of the child are underdeveloped, which leads to floppy and stiff movements. The child suffers from poor coordination and his movements of writing are also very slow. The stiff muscles of the body contract abnormally and this condition is also referred to as spastic paralysis.

The other signs are the infant would crawl in an unusual way and would lie down in awkward positions. The range of movements in these children is very limited and they often they suffer from eyesight and hearing problems. They have problems controlling their bladder and bowel movements, in swallowing food and even in walking.

Reasons Behind Its Occurrence
The three possible reasons behind the occurrence of Cerebral palsy include PVL or Periventricular leukomalacia, abnormal development of the brain and due to intracranial damage. The Periventricular leukomalacia mainly affects the white matter of the brain due to lack of oxygen in the womb. Mothers who suffer from low blood pressure, use illegal drugs or contract infections such as German measles are prone to this condition of lack of oxygen. Lack of oxygen to the brain can also be caused because of preterm delivery. There is also a higher risk of cerebral palsy due to a damaged placenta and multiple births. In case you have a concern or query you can always consult an expert & get answers to your questions!

With the advancement in the medical field, we are blessed to have doctors who specialize in various fields. We have cardiologists who specialize in the treatment of the heart, orthopedics who specialize in treating disorders that are related to the development and growth of muscles, skeleton, and joints in children and neurologists that determine treatment for the brain. Spine and limb deformities mainly occur in children as their bodies are still growing and they react differently to disorders, infections and injuries. Some of the deformities of the limb and spine that are treated by orthopedics include clubfoot, scoliosis, and limb length discrepancy.

Limb Length Discrepancy
Limb length discrepancy is referred to as a deformity when the legs and arms differ in their length. The difference in the length of legs and arms in several cases does not cause any change in the quality of life or in its functioning. However, in certain cases when there is an extreme difference in the length of the legs and the arms, the health of the patient is affected to a great extent. Limb length discrepancy is also caused due to injury to the leg, bone disease or due to bone infections that occur during growth. Depending on the severity of the injury or bone disease it becomes very difficult for the individual to even walk. In certain cases, when the condition is not very severe, then to help the patient to walk comfortably a shoe lift is suggested. It is only in extreme conditions that orthopedics suggest limb length surgery mainly to correct the discrepancy.

Limb Lengthening Surgery
Future proof and innovative solutions are provided these days to the patients for bone reconstruction. The surgery for limb lengthening is performed in many countries all over the world and by professional orthopedics. The patient is at first put under anesthesia after which a large slit is made in the legs, all the way through. The leg bone is sawed, after which a supporting bracket is placed which the patient needs to wear for nearly a year or till the completion of the procedure.

The area of the bone that is fractured is widened every week by the patient by inserting a key into the bracket and by turning it a little. Healing of the bone happens over time and two inches can be added to the height of the patient in six months. The bracket used during the surgery for the legs are very bulky and it is very important that the patient does not put more pressure on them. Immense pain is caused during this time as the limbs are bound to crutches. Hence, proper care should be taken to avoid more stress on the limbs.

Dislocation refers to an injury, which causes the bones to abnormally separate from each other in the joint, which is the meeting place of the bones. Dislocation causes intense pain and is most common in the fingers, shoulders and the elbows. Although a timely diagnosis can make your pain go away, any future injury in the tendons or the ligaments might bring back the injury. 

What can cause a dislocation?
The causes of dislocation are as follows:

1. A body joint can get dislocated if you have suffered a fall.
2. If you are into any form of sports that requires strenuous physical activity and intense exertion on certain body parts like gymnastics, football or volleyball you have a chance of suffering from dislocated body joints.
3. Automobile accidents can also cause dislocation of joints.
4. Some People who are with a loose ligament and are more likely to get a dislocated joint than other people. This may happen without the influence of a major physical trauma or stress.

Understanding the signs and symptoms
In the majority of the cases, a dislocation of the joint is easily detectable as it induces inflammation along with redness and deformation of the affected area. Some of the other symptoms that might occur as a result of the dislocation of the body joints could be: 

1. You might experience severe pain while moving the dislocated joint.
2. There will be a lack of sensation near the dislocated portion.
3. There might be a stinging sensation in the dislocated area.
4. In certain areas you may not be able to move the joint at all

If you have a dislocated joint, the doctors can easily relocate them. Depending on the amount of swelling and pain you are experiencing, the doctor might administer local anesthesia during the process. If the joint dislocation is too severe or has multiple instances of dislocation, then you may have to undergo surgery. Surgery may also be suggested if the adjoined ligaments or tendons are severely affected along with the joints.

Foot arch pain is used in broader context for describing pain in bones, ligaments, muscles and nerve on the foot bottom. Slight damage to any of the components in the foot bottom can cause great pain. For starters, the pain lasts for a brief period, but increases over time if the condition is left untreated. Foot arch pain is more commonly witnessed in people over the age of 60 and among athletes engaged in sports of high impact.
The treatment plan of the pain totally depends on the cause. An early and right diagnosis goes a long way in treating the condition faster. For occasional mild to moderate pain, simple solutions such as footwear change can do the trick. Doctors often suggest four simple methods. This starts with rest followed by applying ice and then trying compression and elevation.

Anti-inflammatory medications are used to treat foot arch pain. Cases that are severe in nature can be treated with steroid and anti-inflammatory injections. For extreme cases, cortisol injections are prescribed too. This is done to relieve pain and release plantar fascia. Even stretching exercises are known to give relief from the pain. Some of the recommended exercises during this period are:

1. Stretch-related to plantar fascia: This exercise should be performed by crossing the legs at the junction of the knee. The body weight should be rested on the unaffected leg and it should gradually come down to touch the toe. The idea is to stretch the plantar fascia. A set of 20 such movements should be practised on a daily basis. Each movement should last for about 10 seconds.
2. Foot flexing: This exercise can be practised before getting out of bed. This is the tie when the pain from the plantar fascia is felt the most. This exercise should be repeated 20 times each lasting for about 10 seconds.
3. Rolling stretch: This exercise should be started by sitting in a chair. A tennis ball should be placed under the foot arch and the same should be rolled back and forth for ten times at a time. The same should be repeated with the second foot. Once this posture gets comfortable, the same should be practised by standing on the ball. It is known to be extremely useful for people suffering from foot arch pain.

How to prevent foot arch pain?
1. Wear shoes that are half an inch lose as they will make feel comfortable while walking
2. Losing weight; obese tends to cause pain in the foot arch
3. Performing free hand exercise and simple stretching on a daily basis
4. Not to overuse the foot. People who stand for more than 5-6 hours at stretch on a daily basis are observed to have foot arch pain.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

 

Perthes disease of the hip is a childhood disorder, which occurs due to the disruption of blood flow to the femoral head. Inadequate supply of blood flow results in softening of the bones which result in the breakdown of the bones. Perthes disease is also referred to as Legg-Calve-Perthes disease or avascular necrosis.

Reasons Behind Occurrence of Perthes Disease
With the advancement of the latest techniques and bio-materials, it is possible to attain successful outcomes for hip arthroplasty. It is the activity level that mainly decides the need for hip replacement surgery and not the age of the patient. An individual with good bone quality can live young for a longer time and take part in physical activities. The main cause of this disease is not known, but it is not caused due to genetic factors. The bone abnormalities in certain cases are caused due to mutations in the COL2A1 gene, which is the characteristic of Perthes disease. The reason behind the occurrence of the blood vessel problem is not known and does not occur due to an injury. A child suffering from this condition is generally well and it takes several months for the blood vessels to regrow and for the blood supply to return to the dead bone tissue.

Symptoms of Perthes Disease
Perthes disease is actually not a disease and the main symptoms that are noticed include pain in the hip, limb or groin. The pain in these regions cause stiffness in the hip or shortening of the leg and results in constrained movements. It also causes a restricted range of motion of the hip joint. It causes a lot of pain while walking and the affected leg appears thinner and shorter. In some cases, both the hips of children are affected by this condition and mostly at different times. The important tests that are performed by a specialist to check for Perthes disease include ray of the hip and a bone scan. The extent of damage caused by Perthes disease is assessed by an MRI scan.

Treatment
Most children suffering from this condition are treated with a brace or plaster cast. Recently, even surgery has been performed to treat Perthes disease. There are certain milder cases that have healed even without any treatment, particularly in children who are below the age of 5 years. To keep the hip joint active some doctors advise parents to encourage children to swim and to avoid high impact exercises such as jumping or running. The main aim of the treatment provided by the specialist is to support the healing process and make certain that the femoral head is well seated in the hip socket. The treatments that are provided include a plaster cast, crutches and bed rest, observation, special leg brace and surgery.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Every day we use our hands the most to get everything done. From drinking water to typing on the keyboard (and today on mobile phones); from holding the newspaper still when reading it to taking down academic notes- we use our hands for everything. But our hands like all other parts of the body have the capacity to carry out their functions. At times, we unknowingly put a lot of strain on our hands and they start to pain. Hand pains are quite common in everyone and it is equally common to practice certain exercises to control them quickly.

If you experience frequent pains in the hands, these are some of the exercises you can resort to.

1. Fist: You do not always make a fist while punching people. Sometimes you make a fist to tighten your hand muscles and nerves and smoothen the blood flow in your hands. This helps in reducing the pain in your hands to a great extent. In fact, folding your hand to a fist can also help in preventing hand pain.

2. Finger Bends: Bend each finger tightly towards your palm for at least a minute and then release it. Do it separately for each of the five fingers on your hand. This would ease out the tension in each of the fingers and normalize blood flow. This helps in curing any finger pain that you might be experiencing. It is especially a great exercise to prevent pain from developing in your thumb and index finger.

3. Thumbs Up: Usually, we show the thumbs up sign to signal all is well and best wishes to people. But it is also an exercise if continued for some time. All you have to do is place your palm on a table and curl all your fingers except the thumb inwards. Stretch the thumb outwards and hold it in this position counting up to ten. Then curl your thumb towards the palm. This exercise too helps in stretching the muscles.

4. Wrist: An important part of the hand is the wrist. The wrist joints are a very crucial set of bones and they tend to get injured very fast. They are also delicate enough to be sprained if the hand is turned abruptly. To avoid such injuries, strengthen the wrist and reduce wrist pain, a lot of wrist exercises are also prescribed. The simplest one is to extend your hand and move the wrist in anti-clockwise and clockwise directions.

Thus, these are some of the ways in which you can ease the pain in your hand in no time and go about normally with your daily chores.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don’t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we’re only going to skim through them here.

1. Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
2. Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.

Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn’t subside on its own and pain. In such a case it’s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it’s important that the patient doesn’t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it’s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Torn cartilages are quite a common form of injury occurring in the human body. While one can’t always be too cautious of injuries, one can still try to be conscious of their muscles and do not move about in an abrupt manner to cause injury to themselves. Further, even though torn cartilages are very common, they are quite painful and most often they occur in the knee. Here are some tips to ensure that your torn cartilage heals well and you are exposed to less pain during the healing period:

1. Rest: You must take rest. While it is advised to take bed rest, humanly it is impossible to spend all day in bed. Thus one can move about a little but avoid walking and straining their legs and knee too much. At times crutches can be taken while taking a few steps in the room.

2. Ice Therapy: Putting ice bags in the affected area helps in relaxing the muscles and reducing the pain quite a lot. Though previously people adhered to putting hot water bags, the scenario is slowly changing to ice therapy.

3. Compress: When you are suffering from a torn cartilage, the doctor often puts a bandage on the knee to compress the area. This is done so that the muscles are brought together and they can heal on their own with time and rest.

4. Elevate the Knee: Often it is seen that during such cases, the knee or the hands are rested in an elevated platform. This platform is created with the help of a pillow mostly. This lets the cartilage get time to rest and heal on its own.

5. Avoid Strenuous Activities: This includes jumping, running, jogging, kicking etc, when it comes to the legs and writing, lifting weight etc. when it comes to the hands. These activities require a lot of strength and power and most of all the use of the cartilages. Since the cartilages are torn and in their healing mode, it is best to avoid such activities for a certain amount of time to not put pressure on the cartilages and damage them further.

6. Painkillers: It has been already mentioned that the healing period can be painful. Thus, the doctor may prescribe some painkillers to ease the pain during this time.

Thus, these are some of the easiest ways to deal with a torn cartilage. The recovery period may be painful, but it happens to many people and is completely healable in nature.

In case you have a concern or query you can always consult an expert & get answers to your questions!