Dr. Mukesh Vyas

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!

What is commonly referred to as shoulder, is a combination of different joints which involves various muscles and tendons which allow us to take part in a wide range of motion. Shoulder pain can be classified in a broad spectrum, and even though some people have shoulder pain only, others may experience the pain radiating towards the neck and upper arm.

What are the symptoms of shoulder pain?
The four rotator cuff tendons are the most commonly affected tendons in the shoulder. Besides causing shoulder pain, it may also lead to tendon tears, impingement, and instability.
Impingement occurs when the top portion of the shoulder blade exerts pressure on the soft tissues underneath. As you try to lift the arm, the acromion starts to rub or impinge on the rotator cuff tendons and leads to tendinitis and bursitis. With the passage of time, it may cause rotator cuff tear.

On the other hand, instability of shoulder takes place when the top portion of the upper arm bone is compelled out of the shoulder socket. It may occur from a sudden injury or excessive use. It can be partial or complete in which the entire ball is dislocated.

How can shoulder pain be diagnosed?
The first thing that your doctor may recommend is a plain x-ray since it can detect any narrowing of space in between two spinal bones, tumors, slipped disks, arthritis and similar diseases, narrowing of the spinal canal, instability of spinal column and most importantly, fractures. Other diagnostic tests include mri, electrodiagnostic studies, and ct scanning.

Mri or magnetic resonance imaging is a non-invasive process which can reveal the neural elements along with the problems with ligaments and tendons. Ct scanning is often used as an alternative to mri. Electrodiagnostic studies, as well as nerve conduction velocity, are used for the diagnosis of neck and shoulder pain.

What are the treatments for shoulder pain?
The treatment of shoulder pain from soft tissue includes the use of anti-inflammatory medicines such as ibuprofen, naproxen, and ibuprofen. Sometimes, doctors also recommend pain relievers like acetaminophen. But the drugs must be administered depending on the source of the pain and antidepressants and muscle relaxers may also be used.

Local application of ice and heat therapy can help in relieving the shoulder pain. Besides, your doctor may also recommend resting the affected area and limiting activities concerning the shoulders. When these treatments are not able to give positive results, then you may need to take corticosteroid injections along with some exercises.

When the spinal cord or nerve roots are involved in causing shoulder pain, surgical procedures can be the last resort. Your doctor can be your best guide in determining which course can be the most suitable in the treatment of shoulder pain.

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

Every action we do as a part of our daily lives is bound to have an impact on our body. For example, our nature of work, posture or physical activity can result in back pain, which can become chronic and frustrating. But, with physiotherapy, such issues can be managed efficiently.

Physiotherapy for back pain
Lower back pain can severely reduce an individual’s ability to work and affects his quality of life. If you are experiencing dull or sharp pain, the cause of this can range from a sudden injury or slowly build over time as a result of obesity among other reasons.

Physiotherapy is one of the most effective ways to treat back pain and has proven very useful over time. The practice includes specific exercises, stretching, dry needlingand most importantly massages that are performed by highly skilled physiotherapists. Such methods are beneficial to relieve discomfort and treat back pain. It is essential to receive physiotherapy after an acute episode of back pain since it helps avoid further complications while also reducing your need to visit your doctor frequently. Just like with any form of treatment, chances of prevention and recovery are higher when physiotherapy is received early on.

Physiotherapists shall also show their clients certain stretching and strengthen exercises that help strengthen the back muscles and shall offer expert manual therapy in the form of massages with essential oils to ease back pain and improve blood circulation in the targeted area. The increased blood circulation also helps repair tissue and nerve damage, thus setting the patient on the road to recovery. For some patients, massage is more than enough and is all they need to feel better and get healed. The special techniques used by physiotherapists during massage sessions help relieve tension and relax the aching muscles. There are various techniques of offering massage in physiotherapy and vary in terms of the type of hand movements.

We all experience minor medical issues like pain in the fingers, arms or wrists from time to time. Over exerting any part of the body and stress that area and lead to inflammation or tenderness. One of these most commonly used parts of the body are wrists. Any disease or injury involving the bones, muscles, tendons, and ligaments may also lead to wrist pain.

The wrist is a complicated joint composed of eight small bony structures which are arranged in rows lying between the bones of the forearm and hand. Tough bands of ligament connecting the wrist bones to each other and the bones of hand and forearm may become damaged and cause wrist pain. Here are some of the most prevalent causes of wrist pain.

Injuries-
Sudden impact injuries often take place when a person falls forward on the outstretched hand. This may lead to strains, sprains, and even fractures. A scaphoid fracture involving a bone on the thumb side of the wrist may not be visible on x-rays right after the injury but cause immense pain.

Any activity involving repetitive motion of the wrist can inflame the tissues present in the joints and lead to stress fractures. This applies in particular when you perform any movement for long hours without any break. This disease is known as de quervain’s disease and is a form of repetitive stress injury which leads to pain at the base of the thumb.

Diseases affecting the wrist-
Many diseases and complications may cause a problem in the wrist, and some of them include the following:

Arthritis: An osteoarthritis is a common form of arthritis which takes place when the cartilage cushioning the ends of the bones damage over time. This type of arthritis occurs only in individuals who have injuries in the wrist. Another form of arthritis is rheumatoid arthritis where the immune system of the body attacks its tissues. If one wrist is affected, the other one gets affected as well.

Kienbock’s disease: This type of disorder generally affects young adults and involves the collapse of one or more small bones in the wrist. It takes place when the blood supply to the bone is hampered.

Ganglion cysts: It is a type of soft tissue cysts which typically affects the part of the cyst opposite to the palm. Smaller ganglion cysts tend to cause more pain than larger ones.

Carpal tunnel syndrome: It develops when there is too much pressure on the median nerve since it passes through the carpal tunnel which is a passageway on the palm side of the wrist.

Wrist pain may affect an individual of any age regardless of whether he leads an active or sedentary lifestyle. But some people are more at risk than others. Wrist injuries are a common occurrence in sports like bowling, golf, gymnastics, and tennis. Repetitive work that involves the working of hand and wrist may also lead to wrist pain. Other conditions such as obesity, pregnancy, and diabetes may lead to wrist pain as well.
Hence, necessary precautions should be taken in such circumstances to prevent this issue.

रीढ़ की हड्डी में मौजूद हड्डियों (कशेरुका) को सहारा देने के लिए छोटी-छोटी गद्देदार डिस्क होती हैं जो रीढ़ की हड्डी को झटकों से बचाती हैं और उसे लचीला रखती हैं लेकिन जब एक डिस्क क्षतिग्रस्त हो जाती है तो यह सूज या टूट कर खुल सकती है जिसे स्लिप डिस्क कहते हैं. स्लिप डिस्क का मतलब यह नहीं है कि डिस्क अपनी जगह से फिसल जाती है इसका मतलब है कि डिस्क अपनी सामान्य सीमाओं से आगे बढ़ जाती है या फूल जाती है या फिर डिस्क की बाहरी दीवार छिज्ज जाती है जिससे उसमें मौजूद द्रव (न्यूक्लियस पल्पोसस) का रिसाव रीढ़ की हड्डी या नज़दीकी तंत्रिका पर हो जाता है. स्लिप डिस्क से एक हाथ या पैर में स्तब्धता या कमज़ोरी हो सकती है. रीढ़ की हड्डी के किसी भी हिस्से में स्लिप डिस्क हो सकती है लेकिन अधिकांश यह पीठ के निचले हिस्से को प्रभावित करती है.
स्लिप डिस्क के लक्षण
आपको आपकी रीढ़ की हड्डी के किसी भी हिस्से में स्लिप डिस्क हो सकती है (गर्दन से लेकर पीठ के निचले हिस्से तक) लेकिन पीठ के निचले हिस्से में यह सबसे आम है. रीढ़ की हड्डी, तंत्रिकाओं और रक्त वाहिकाओं का एक पेचीदा जाल-तंत्र होता है. स्लिप डिस्क तंत्रिकाओं और मांसपेशियों पर और इनके आस-पास असामान्य रूप से दबाव डाल सकती है. स्लिप डिस्क के निम्नलिखित लक्षण हो सकते हैं - शरीर के एक तरफ के हिस्से में दर्द या स्तब्धता होना.
1. दर्द का धीरे-धीरे फैलना
स्लिपडिस्क में होने वाला दर्द धीरे-धीरे फैलता है. यानी ये जहां से शुरू हुआ था वहां से बढ़ते-बढ़ते आपके हाथ या पैरों तक फैलता जाता है. इसके आधार पर स्लिप डिस्क की पहचान कर सकते हैं.
2. रात के समय दर्द का बढ़ना
स्लिपडिस्क से पीड़ित व्यक्ति की पीड़ा कई बार बढ़ जाती है. अक्सर रात के समय उनका दर्द बढ़ जाता है. इसके साथ ही कई बार कुछ गतिविधियों में उन्हें ज़्यादा दर्द का अनुभव भी हो सकता है.
3. खड़े होते या बैठते समय ज्यादा दर्द महसूस करन
यदि आपको खड़े होने या बैठने के बाद दर्द का ज़्यादा अनुभव हो तो आप इससे स्लिप डिस्क होने का कारण मान सकते हैं. क्योंकि इसमें ऐसे लक्षणों की गुंजाइश रहती है. इसलिए इस दौरान इस तरह का अनुभव हो सकता है.
4. थोड़ी दूरी पर ही दर्द का अनुभव होना
कुछ लोगों में ऐसा भी देखा जाता है कि उन्हें थोड़ी दूरी पर ही चलते समय दर्द का अनुभव होना शुरू हो जाता है. यदि आपको भी कभी ऐसा महसूस हो तो ये स्लिपडिस्क का लक्षण हो सकता है. इसलिए चिकित्सक से सम्पर्क करना चाहिए.
5. अस्पष्टीकृत मांसपेशियों की कमज़ोरी
स्लिपडिस्क के कई लक्षणों में आपको एक लक्षण ये भी नजर आ सकता है कि इसमें अस्पष्टीकृत मांसपेशियों में कमज़ोरी महसूस हो. इसलिए ऐसे लक्षणों को भी अनदेखा नहीं करना चाहिए.
6. झुनझुनी, दर्द या जलन महसूस करना
यदि आपको प्रभावित क्षेत्र में झुनझुनी, दर्द या जलन दर्द से स्तब्धता या झुनझुनी होती है जो आपकी मांसपेशियों को नियंत्रित करने की क्षमता को प्रभावित करता है तो अपने चिकित्सक से सलाह लें. दर्द के प्रकार व्यक्ति से व्यक्ति भिन्न हो सकते हैं.