Dr. Sharad Mahar Physiotherapy Clinic

Sciatica - All You Must Know About It!

Carpal tunnel syndrome is a painful disorder of the hand caused by pressure on your median nerve as it runs through the carpal tunnel of the wrist. Symptoms include numbness, pins and needles, and pain (particularly at night). Anything that causes swelling inside the wrist can cause carpal tunnel syndrome, including repetitive hand movements, pregnancy and arthritis.

Cause of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome symptoms begin when the pressure inside the tunnel becomes too high. This results in your median nerve becoming compressed as it passes through the small tunnel. 

The carpal tunnel pressure increase occurs when either of two things happens:

1. The tunnel space decreases, such as when the wrist swells eg after a traumatic injury, partial subluxation of the carpal bones or fracture or tenosynovitis.
2. When the contents of the tunnel (median nerve, blood vessels and tendons) enlarge. 
3. Both of these situations increase the pressure on the nerve, leading to the carpal tunnel symptoms.

Symptoms of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) sufferers will usually experience the following symptoms in their hand or fingers:

1. hand pain or aching
2. pins and needles
3. numbness esp at night of with wrist flexing
4. burning
5. weakness or cramping
6. perceived swelling

The symptoms are usually worse at night and your grip will weaken as the condition progresses. Eventually you will notice muscle atrophy of the thenar (thumb) muscles and loss of hand function or clumsiness. If this sounds like you, suspect carpal tunnel syndrome.

Physical Therapy Treatment

1. Gliding Exercises: Moving your fingers in a specified pattern of exercises may help your tendons and nerves glide more smoothly through your carpal tunnel. While there’s some evidence that gliding exercises can help relieve symptoms when used alone, these exercises appear to work better in combination with other treatments -such as splinting.
2. Graston Technique/Manual Therapy: The Graston Technique incorporates a patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively detect and treat scar tissue and restrictions that effect normal function. Manual therapy techniques such as myofascial release or Active Release Technique are hands-on techniques that release tight tendons and musculature.
3. Ultrasound: Deep, pulsed ultrasound directed at the carpal tunnel can reduce pain and numbness, and improve hand strength. Continuous superficial ultrasound doesn’t help.
4. Traction: Some people obtain relief from carpal tunnel symptoms by using a hand traction device, called C-Trac. You might try this device, which can be purchased for home use, if other conservative treatment options have failed.
5. Splints: Splints (braces) are the most commonly used nonsurgical treatment for carpal tunnel syndrome. Splints that immobilize the wrist in a neutral (unbent) position are most likely to relieve discomfort. An unbent wrist maximizes the size of the carpal tunnel, which reduces pressure on the median nerve, relieving your symptoms.

The anterior cruciate ligament (acl) is a rope like connective tissue that gives support and stability to the knee, along with other related tissues. If you do not repair it, you can still perform many functions, and carry on with your life with little difficulty. However, a surgery to correct the ligament tear is recommended if you do not want the injury to impede your sporting activities and want a 100% normal knee.

The acl reconstruction surgery can be performed in two ways, the arthroscopic method with incisions in the front and the new one which is more cosmetic and has lesser complications. Both of which you will find detailed below.

The latter is a wiser and more popular decision, and you will require a suitable surgeon well versed in the newer technique to perform the operation.

How is the surgery done?

Acl reconstruction surgery involves the following steps-

1. The surgeon, after examination, makes sure whether you actually need to be operated on if you have approached in the early stages, a repair may be possible. This avoids the need for reconstructing a new ligament altogether.
2. For an acl reconstruction the tissue, which will be inserted afresh in your body is extracted and prepared, either from your own body or from a donor’s body.
3. A camera is affixed onto the surgical instrument, which makes your knee interiors visible to the surgeon during the operation.
4. Anaesthesia is administered to you, and new tissue is inserted in place by passing it through a tunnel in your bone in a pioneering new technique, the tissue is derived from the back of your knee instead of the fron. This leaves minimal scars in your physical appearance on the front of your knee. This procedure is also not very invasive.

Surgeons are increasingly favouring acl reconstruction nowadays. The reasons for that are-

• It helps patients who cannot do without their acls, like those engaged in competitive sports like football or mountain climbing.
• It can help repair the chronic weakness of the knee and help people who have locomotive difficulties.
• One can repair several ligaments including your acl if they are damaged at once, following an accident or fall.
• To minimise tissue damage from surgery, the minimally invasive arthroscopic method is the way to go acl surgery including repairs are gaining in popularity, and those mentioned above are some of the reasons. The doctor will recommend this in case you have an injury like a vehicle crash, sports accident, or related trauma to the knee and surrounding regions.

Make sure you know your requirements and seek out a physician accordingly!

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.

Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. There are 2 types of arthritis the knee joint in the human body can get afflicted with. They are:

• Osteoarthritis: The form of arthritis which, with increasing pain, slowly wears down the joint cartilages is called osteoarthritis. This form of arthritis usually affects people after the age 40. The symptoms of osteoarthritis include:

  • severe pain in the knee joints

  • pain after walking up the stairs and it subsiding once you are on rest

  • severe pain after the movement of joints for a long time

  • pain that becomes worse in rainy days

  • joints becoming stiff after waking up in the morning but they improve in the latter part of the day

  • pain which also occurs in the thighs and the genital regions coupled with joints swelling and joints getting stiff after rest.

• Rheumatoid Arthritis: Rheumatoid arthritis is a chronic form of arthritis caused because of the knee joint inflammations. This form of arthritis can occur at any age. Being an auto-immune disease, its symptoms include, but are not limited to:

  • severe pain in the morning

  • mild fever accompanying the pain

  • joints suddenly becoming swollen, red and warm causing, immense pain

  • sudden stiffness of the joints

  • pain that increases in cold weather

  • mild fever, extreme tiredness and weakening of the muscles

Doctors are still doubtful about what exactly causes the disease; but the deformation of the immune system might cause the damage of the joints, causing people who are already suffering from obesity, smokers, and women, in general, more prone to this disease.

When the knee pain is diagnosed as a form of arthritis, the following treatments are suggested:

1. If you are overweight or obese, losing some of those extra pounds can go a long way in reducing the pain.

2. Muscle-stretching exercises are effective in keeping the knee joints flexible.

3. Acupuncture and devices such as knee braces and knee caps can relieve the pain.

4. Prescribed dosage of anti-inflammatory drugs such as Tylenol, Motrin, and Advil or injections of hyaluronic acid might relieve your pain.

5. If regular treatments do not work, you might opt for knee-replacement surgery and osteotomy (the process of cutting a bone with the help of surgery) which might better the alignment of the knee by transforming the bone shapes.

Physiotherapy For Knee Arthritis-

Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions.

The main goals of physiotherapy for your knee arthritis are:

1. Reduce your knee pain and inflammation.
2. Normalise your knee joint range of motion.
3. Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
4. Strengthen your lower limb: calves, hip and pelvis muscles.
5. Improve your patellofemoral (knee cap) alignment and function.
6. Normalise your muscle lengths.
7. Improve your proprioception, agility and balance.
8. Improve your technique and function eg walking, squatting.

Homeopathy world has currently brought unique solutions for reducing unbearable back pain. You can get speedy recovery, and on the other hand, your back muscles will also become much more flexible than ever. 

Top 5 homeopathic medicines for curing back pain

- Arnica: Injured back often leads to severe back pain, and it can be well treated by this homeopathic medicine. Both recent and past back-injuries can be treated using this medicine. This medicine is absolutely safe, and thus you will not face any side-effects at all. Unwanted back stiffness and soreness within back muscles can also be minimized to a great extent with the consistent application of this medicine. Back motions can be made much more flexible by curtailing restlessness.

- Rus Tox: If you want to stop chronic condition of your back pain, then nothing can be the best option other than this medicine. Most of the homeopathic practitioners are now strongly recommending this medicine for severe cases. Only limited dosage of this medicine taken in a consistent manner can offer you more relief from your back pain, and you can get greater relaxation. 

- Mag Phos: This medicine is very much useful for alleviating all kinds of back pains, and this medicine can be accompanied by external heat. Cramping muscle pains are simply unbearable and thus cannot be gotten rid of at times. In such a condition, there is no other safest alternative other than this medicine.

- Bryonia: There are some prominent symptoms of back pain, and they can be easily and efficiently alleviated by this medicine. If you have become pretty tired of applying homemade therapies, then you can try out this solution. This medicine can reduce your pain and inflammation within a few hours, and you can get back to your daily activities with great energy. Apart from taking this medicine, you have to take enough rest so that your back can get relaxed. Your back motion can be smoothened and made flexible by taking the concerned medicine. 

- Kali carb: This medicine is the best back-pain solution for females. Those females who have severe back pain immediately after delivery can get greater relief from this medicine. In this case, back muscles often develop cramping pains and these pains are very much irritating, and thus you might feel disturbed. This is the reason doctors often recommend taking this medicine to fix the problem.

Gridhrasi is what Sciatica is known as in Ayurveda. It is the disorder that causes mild to agonizing pain in the sciatic nerve or neuralgia. These nerves, emerging from the pelvis, run along the hamstring and may cause intense pain in one or both the legs when a person suffers from Sciatica. Sciatic pains fill your life with misery as the simplest of daily activities cause sudden and excruciating pain. There are two types of sciatia i.e. true sciatica and pseudo sciatica. Sciatica may be caused due to bulging disc or herniated disc, degenerative disc disease, piriformis syndrome, pregnancy or trauma etc. 

According to Ayurveda, Sciatica is caused due to impairment in Vata i.e. the dosha responsible for the functional ability and movement of the body, and also in some cases due to impairment in the Kapha i.e. the dosha that is responsible for body fluids and lubrication.

Ayurvedic herbs that improve the symptoms of Sciatica are:

1.        Babunah is also known as Bitter Chamomile. Not only is it used to relieve and reduce the pain faced by a sciatica patient, but it is also used for treating problems such as rheumatism due to the advancement of age. Compressed bitter chamomile flowers are prescribed for sciatica.

2.        Guggulu is also known as Indian Bdellium. Since guggulu is well known for its anti-inflammatory properties, it relaxes the sciatic nerves.

3.        Rasna is also known as Vanda Orchid. Intense or agonizing pain due to the sciatic nerve issues can be reduced by this ayurvedic herb due to its anti-inflammatory properties. 

4.        Juniper oil is extremely helpful when massaged onto the thigh muscles with firm strokes or pressure. It is used extensively in massage therapy for treating sciatica since the extent of reduction in sciatic nerve pain is tremendous. 

5.        Jaiphal is also known as Nutmeg. After being mixed with sesame seeds oil, nutmeg is coarsely powdered and then fried till it turns brown. This is then applied to those areas where the sciatic pain is intense for instant relief.

6.        Kumari is also known as Indian Aloe. Properties of Indian Aloe are extremely helpful in treating lower back ailments such as sciatica and lumbago.

7.        Shallaki is also known as Boswellia or Frankincense. Containing anti-inflammatory properties, shallaki is applied externally to get relief from sciatic nerve pain. 

Ayurvedic preparations such as yogaraja guggulu, Vataganjakusha, Saindhavadi taila are also very useful in treating Sciatica.