Dr Snehal's The Physio 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. 
 

Lateral epicondylitis, which is the medical name for tennis elbow, is a condition wherein the tendon in the upper arm develops a tear due to repeated motions. This is a very painful condition and can make your daily life difficult. It usually tends to affect your dominant arm i.e. the arm that you use the most.

Who does it affect and why does it happen?
As mentioned earlier, tennis elbow occurs due to repetitive similar movements of the elbows, forearms and wrists over a prolonged period. The common name for this condition came due to repeated occurrences with tennis players although it can happen to players of other sports as well as people in other profession too. Some of the people who are most susceptible to this could be from the following fields:

1. Sporting activities such as squash, tennis, fencing, cricket and many other sports where repeated arms movements are required.
2. Carpenters
3. Painters
4. Musicians playing certain instruments
5. Typing
6. Knitting work
7. Chefs and waiters
8. Cleaning
9. Road and construction workers

Symptoms

1. A slow exacerbation of pain over a period and gradual worsening can be a major symptom.
2. In certain cases, the pain may manifest suddenly which will make any movement very difficult.
3. Moving your arm may become very difficult, especially during any up or down movement of the arm.
4. In some cases, the pain may be experienced only when shaking objects or actions wherein squeezing or hard gripping is required.
5. Performing daily activities such as a tooth brush, trying to open jars or even trying to use a knife or fork can get extremely difficult.

How it can be treated?
Most treatment methods include keeping the elbow in a resting position and giving it time to heal automatically. However, some medication may also be given to relieve pain and quicken healing. Some of these are mentioned below.

1. Elbow straps: These fix the elbow in a comfortable position and don’t allow it to move helping it heal on its own.
2. Ice treatment : This is the most common home treatment prescribed to relieve pain. You can use homemade icepacks or even buy gel pack, which can then be held against the area to relieve pain.
3. Painkillers: Ibuprofen and aspirin can be used to lessen the pain, although it is advisable to consult your doctors first.
4. Various physical therapies: Physiotherapy, acupuncture or specific doctor recommended exercises could be done to not only relieve pain but also quicken healing and to strengthen the tendons and the muscles of that area.

In Ayurveda, joint pain is known as 'Sandhigata Vata'. Arthritis and Joint pain are among the most prevalent problems faced by adults, mostly old people. As per ayurveda, 'vata Dosha' Is responsible for joint pains and other discomforts associated with it. Natural remedies and proper lifestyle techniques can be utilized to balance the 'vata' to lessen the occurrence and severity of joint pain. Factors including, old age, obesity, injury and strenuous physical activities (that require a lot of joint movements) are responsible for disturbing the balance of your 'vata'.

The following are some ayurvedic home remedies that can be utilized to treat joint pain:

1. Massage therapy - Warm coconut, castor, mustard, olive or garlic oil can be utilized to massage the affected areas to lessen the intensity of pain. If you massage the affected joints with natural oils, it improves blood circulation and relaxes the swelling and stiffness in the region.

2. Hot & Cold Compress - Cold and hot compresses can be utilized to ease your joint pain effectively. Heat compression decreases the pain, increases the blood circulation and relaxes the swollen joints and muscles. On the other hand, cold therapy lessens the inflammation of the affected joint. Place hot and cold towel alternatively on the affected area to achieve immediate relief from persistent pain.

3. Fenugreek - Ingest a teaspoon of ground fenugreek seeds and drink a glass of lukewarm water. Fenugreek has anti-inflammatory and antioxidant properties that make it effective for joint pains. Follow this remedy every morning on a regular basis to achieve optimal results.

4. Turmeric - Add a pinch of turmeric and a teaspoon of honey in a glass of lukewarm water and drink this solution on a regular basis for a week. Turmeric contains anti-inflammatory and antioxidant properties, which makes it an excellent remedy for treating joint pains.

5. Apple cider vinegar - Add 2 teaspoons of apple cider vinegar and a little honey to a cup of lukewarm water. Drink this solution twice daily, before your meals. Apple cider vinegar has an alkalizing effect, which makes it an effective remedy to remove the toxins that are responsible for causing joint pain.

6. Healthy diet - A balanced diet that comprises a lot of green leafy vegetables and fresh seasonal fruits is good for your joints. The uncontrolled intake of fatty food, dairy products, and high sodium diet must be avoided in order to avoid arthritis and joint pain.

One of the most common health issues of the present age is a backache. It is no more restricted to the elderly but has infiltrated among people of all age groups. Back pain may result from a medical condition or an injury.

A backache among the Elderly:

For persons near and above the age of 50, lower backache is a major health condition. It is characterized by the following symptoms-

• Acute pain in the morning and evening
• Tenderness around the affected area of the spine
• The stiffness of the waist

Certain medical conditions namely Facet Joint Osteoarthritis, Degenerative Spondylolisthesis, and Spinal Compression fracture are common causes of a backache in the aged.

A backache among Young Adults:

With the rise in the number of working young adults in the country, more and more people between the ages 18-25 are falling prey to back pain. With the advent of technology, teenagers and young adults tend to spend most of their time on phones and laptops for work or leisure. This has negative effects on their posture.

Back pain may also result due to injuries acquired from any sport or excessive and extreme exercises at the gym.

Neurological Treatment to cure Backache:

Proper neurological treatment can go a long way to treat issues of the lumbar region and spinal discs. There are several ways to diagnose a backache like-

• X Rays
• CT Scans
• Discography
• Nerve Conduction Studies

Surgical Methods to Cure Backache:

• Spinal Infusion - This is the most common form of surgery for chronic back pain where the doctor joins the spinal bones together.
• Laminectomy - This surgery is used to treat lumbar spinal stenosis. Here the doctor removes the affected part of the bone or ligament. This surgery relieves acute pain and is often accompanied by spinal fusions.
• Foraminotomy - This surgery is used to cure pain associated with a compressed nerve in the spine and is accompanied by spinal fusion.

Ways to Relieve Yourself from Age-Related Backache:

To cure a backache one can opt for physical therapy under the guidance of a trained physiotherapist. For treating acute pain, cold ice pack and warm baths are effective. Other measures to adopt are-

• Exercise Daily - There is no better way to prevent back pain other than this. Take out an hour every day from your busy schedule and indulge in moderate exercises like meditation, yoga, swimming etc.
• Improve Posture - If you spend 7-8 hours daily in front of the laptop, you should maintain a correct posture. Make sure the height of the desk and chair align with each other. Do not slouch while working on your desktops and phones.
• Keep your weight in Check - Overweight exercises pressure on your lower back involuntarily forcing you to slouch forwards. This can prove to be fatal for your back. Eat healthy and exercise minimum 3 days a week to stay in shape.
• Quit Smoking - Apart from the damage it causes to the lungs, smoking restricts the supply of nutrient to your spine and narrows blood vessels. Consult your doctor for programs designed to prevent addiction to smoking.

A backache among all age groups can be prevented easily just by resorting to a healthy lifestyle. In case of severe cases, it is essential to seek expert medical advice regarding the correct surgical procedures.