Yashashree Orthopedic & Physiotherapy Center

Plantar fasciitis is an orthopedic problem that gives rise to pain in the foot and heel due to strain or pressure on the plantar fascia. This is a ligament or connective tissue which lies in a flat band, connecting your heel with the toes and effectively, providing a basis for the motion of the feet in general. Inflammation, swelling and bruising of this tissue or ligament can lead to excessive pain in the heel.

Let us look at ways that can help you deal with this pain:

Rest: taking rest and giving your feet a break from all kinds of strain inducing activities can help in relieving the pain. Also, you can keep your feet elevated to help in reducing the pain in the area.

Supportive footwear: using pads within your shoes with gel built into them, or using specific footwear that help in walking without feeling too much of pain is a good way of dealing with plantar fasciitis. The shoe inserts must be rubber, felt or plastic so that they are soft for your feet. They also give your heel and its arch good support, while orthotics pulls the ligament so that there is less stress on the same. You can also pull on a pair of night flints which will keep the foot and the ligament stretched while you enjoy a good night of sleep.

Exercise: indulging in mild musclestrengthening exercise that also involves stretching and heel hooks can help in alleviating chronic pain that you may be suffering from. Lie flat on your back and take a towel. Lift your leg and hook your foot into it. Now press against the towel and pull down the towel simultaneously. Repeat at least ten times per foot. This will give you flexibility and strength in the area.

Painkillers: use pain killers only when absolutely necessary and with due advice from the doctor or orthopaedic specialist. The use of ibuprofen and other pain relievers can help in numbing the pain inducing nerves in the brain and give you instant relief.

Anti-inflammatory drugs: your doctor may prescribe anti-inflammatory medication that can bring down the swelling for more comfortable functioning when you are on your feet. Naproxen is one such drug that helps in bringing down the inflammation. Also, corticosteroid injections can relieve severe pain.

Surgery: heel spur removal or plantar fascia release are some of the surgical options for chronic and severe cases.

 

What are carpal tunnel syndrome symptoms? 

People with carpal tunnel syndrome initially feel numbness and tingling of the hand in the distribution of the median nerve (the thumb, index, middle, and thumb side of the ring fingers). These sensations are often more pronounced at night and can awaken people from sleep. The reason symptoms are worse at night may be related to the flexed-wrist sleeping position and/or fluid accumulating around the wrist and hand while lying flat. Carpal tunnel syndrome may be a temporary condition that completely resolves or it can persist and progress. As the disease progresses, patients can develop a burning sensation, and/or cramping and weakness of the hand. Decreased grip strength can lead to frequent dropping of objects from the hand. Occasionally, sharp shooting pains can be felt in the forearm. Chronic carpal tunnel syndrome can also lead to wasting (atrophy) of the hand muscles, particularly those near the base of the thumb in the palm of the hand. 

How a physio can help? 

Determining the cause and contributing factors is important in the management. Reducing inflammation associated with a fracture or an injured tendon will help reduce pressure in the carpal tunnel. If symptoms are related to vibration then modifying work practices to avoid prolonged exposure is important. Similarly avoiding prolonged positioning of the wrist in a flexed or extended position is important. Splints, different equipment, different grips may all be useful to change and support the wrist mechanics. 

• Wear a splint: 
• A specific carpal tunnel splint that helps to keep the wrist in a neutral position helps minimise the pressure in the carpal tunnel. Initially the splint may need to be worn for long periods to allow symptoms to settle. As symptoms settle the splint is worn for shorter periods. 
• Rest: 
• Rest from aggravating activities is important, it helps settle inflammation and alleviates symptoms. 

Exercise program: 

Your physiotherapist will give you stretches and exercises that help to mobilise the median nerve, help strengthen the muscles around the wrist and stretches to stretch the structures around the wrist to help settle and alleviate symptoms and to prevent recurrences. 

Surgery? 

In cases that are left untreated, serious cases, or cases that don’t respond to treatment, surgery is sometimes needed. Surgery involves decompression of the nerve. Most people do well after such surgery. 

Carpal tunnel syndrome: 

Facts: 

1. Carpal tunnel syndrome is caused by irritation of the median nerve at the wrist. 
2. Any condition that exerts pressure on the median nerve can cause carpal tunnel syndrome. 
3. Symptoms of carpal tunnel syndrome include numbness and tingling of the hand. 
4. Diagnosis of carpal tunnel syndrome is suspected based on symptoms, supported by physical examination signs, and confirmed by nerve conduction testing. 
5. Treatment of carpal tunnel syndrome depends on the severity of symptoms and the underlying cause. 

 

Got a desk job?

You probably find yourself hunched over your laptop or table working long hours. To add to the misery, they don’t make the chairs to really flatter your back. This really makes you wish they provided massage chairs, but not every one of us is that fortunate!The result? a crankier you with a sore back, who comes back home with spirits lower than the monday blues. Even if you truly enjoy your job, it makes you think twice about going back again.It’s probably something you take for granted, but your upper spine receives a lot of support from the muscles in your shoulder, neck, chest, and back. By strengthening those muscles through exercise, you can fend off issues of the neck and upper back pain.It will take a regular regimen of back exercises to make your muscles stronger and better able to support your spine. You should perform these exercises in sessions of 15 to 30 minutes a day, at least two or three times each week, the experts say. Be sure to consult your doctor before undertaking such a program, however, especially if you're already suffering from upper back pain. 

Here is a list of extremely easy exercises that you can do right away -
 

Thoracic extension: put your hands behind your head and stretch back, looking up at the ceiling. Do this at least 10 ten times and keep repeating this throughout the day.

Scapular squeeze: you can do this sitting or standing. Put your arms on either side and squeeze your shoulder blades towards each other. Do two sets of 15.

Knee to chest: lie on your back with your toes pointing up, slowly bend your knees pulling your leg closer to the chest and hold it for 20 seconds. Repeat three times for each leg.

Yoga cat/cow: kneel on all fours, with the hands beneath your shoulders and knees below your hips. While exhaling, gently arch your spine. And while inhaling, tighten your core muscles and arch your back outwards like a cat. Do 2 sets of 10.

The door stretch: stand in an open doorway or wall. Put your hands slightly above your head and lean forward until you feel a stretch on your shoulders. Hold for 15-30 seconds. Repeat this 5 times.

Thoracic stretch: sit with your legs stretched in front of you. Hold the middle of your thighs and lean forward with your head curling up towards your pelvic region.

Arm slide on the wall: while sitting or standing, put your palms or elbows on the nearest wall and slide it up to the highest point without removing contact with the wall.

In case you have a concern or query you can always consult an expert.

Back pain can be debilitating and one of the main causes can be a weak disc. There could be an inflammation of the disc or prolapse which can cause pain. In most people, poor posture along with lack of physical exercise can lead to recurrent disc issues and pain.

The disc is basically a layer of soft tissue, which is present between two vertebrae. This tissue can slip out of its space, causing prolapse or a hernia. Depending on the exact location, it can be cervical, thoracic, or lumbar disc hernia. Though there is treatment available in the form of medicines and exercises to even surgery, recurrent disc pain is best prevented, in ways mentioned below:
1. Strengthen the abdomen: one of the main issues for recurrent disc pain is a bad abdominal musculature. The key is to support the back and improve posture so that the back muscles are strong and disc pain is prevented. Crunches, sit-ups, and other exercises to improve spine stability are highly recommended. When lifting things off the ground, it is always advisable to sit down and pick things up rather than bend down and pick up. Bending down to pick up things, especially heavy ones, can cause severe disc prolapse almost immediately.
2. Weight management: being overweight can put pressure, especially on the low back (thoracic and lumbar spines) and cause a hernia in the lower back. Weight management, therefore, assumes great significance.

3. Stress management: one of the main causes for the increased incidence of back pain is higher levels of stress. This can be improved by stress management techniques including meditation and yoga.
4. Yoga: this not only helps in stress management but also keeps a person flexible. It improves circulation, joint mobility and so helps in preventing back pain.
5. Posture changes: if a person is diagnosed to have poor posture (stooped, drooping, etc.), then they should be taught to sit upright with adequate back support so that recurrent disc pain is prevented.
6. Exercise: if a person has had a herniated disc, then the doctor would recommend a chiropractor or physiotherapist to improve pain control. A set of exercises would be taught to improve abdominal strength. They also would instruct on ways to do this properly, so that recurrent disc pain can be avoided.
7. Pain control: this needs to be followed sequentially. In addition to injections of corticosteroids and painkillers for immediate relief, a person also can have painkillers at disposal to take when required. As a last resort, surgery may be done but needs to be followed up with exercise so that recurrent disc pain is avoided.

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