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Spasmodic Torticollis Tips

Physiotherapy Treatment for Torticollis

Dr. Vishwas Virmani 91% (22667 ratings)
MPT, BPT
Physiotherapist, Noida
Physiotherapy Treatment for Torticollis

Torticollis:

A development defect is one sternomastoid muscle or mal-position of the neck in the uterus can give rise to the deformity. The shortening of the sternomastoid is the principal causative factor. There may be an associated shortening of the scalenii, platysma, splenius or trapezius muscles. Incidence is more common in girls, and the side affected is usually left. Occasionally, it may bilateral. The affected sternomastoid may get atrophied and facial asymmetry may occur in untreated cases. 

Nature of the deformity: 

The head is fixed inside flexion to the same side (i.e, on the side of the affected muscle) while it is rotated to the opposite side. The shoulder on the affected side is raised. 

Scoliosis with convexity to the sound side may be present in the cervical region. Facial asymmetry with smaller eye and lowering of the corners of the mouth and eye with a deviation of the nose on the affected side may be present. In rare bilateral affections, both the sternomastoid are contracted. The head is protruded forward with associated kyphosis.

Treatment:

The basic objectives are: 

  • To correct the deformity by release of the contracted soft tissues and 
  • To maintain the correction by suitable exercise regime; avoiding recurrence. 

Early mild cases

Children with a mild degree of deformity reporting early for the treatment can be managed with physiotherapy

The physiotherapy procedures employed are:       

 I. Evaluation: Careful evaluation of ROM and the degree of deformity.      

II. Massage: Massage can relax the muscle preceding the stretching manoeuvres.  

III. Thermo Therapy Modality: Carefully administered thermo-therapy modality induces relaxation.  

IV. Passive movements: The child is placed in supine position with head beyond the edge of the table with the neck in extension by positioning a pillow under the thoracic region; Shoulders are stabilized by an assistant.

  • To attain relaxation, all the movements of the cervical spine are done in a form of slow relaxed passive movements.
  • This should be followed by sustained passive stretching to the affected sternomastoid. E.g. when the right sternomastoid is involved the head should be gradually bent inside flexion to the left, held there for a while and then rotated gradually to the right. Try to gain as much overcorrection as possible by applying gradual traction to gain further stretching.
  • Maintenance of Correction: Once the correction is achieved. It has to be maintained by passively holding or keeping a sandbag.
  • The same manoeuvre can be repeated during the subsequent visits.
  • Active correction: Active correction is best achieved by assisting the child head to follow an object moved in the proper arc of correction. The bright-coloured sound producing object is ideal to attract the child attention.
  • PNF: patients with neck extension can be used to an advantage with emphasis on stretch and traction
  • Home treatment programme: This assumes an important role as these manipulations needs to be repeated. The mother should be trained properly for this. The best method is to put the child in prone and the teach the mother to carefully move the head towards the affected side and the child is encouraged to look back over the right shoulder.
  • Positioning: Exact positioning of the head during sleep is important. The child should be made to sleep on the opposite side of the lesion and the position of head adjusted by pillow or sandbag in a maximally corrected posture during sleep. This positioning has two advantages:- First, there is natural relaxation of the muscle- Secondly, whatever correction is achieved, it is maintained for a longer period during sleep.However, the mother should intermittently check the correction.
  • Older children and adults: With advancing age the deformity gets organized and does not get corrected by conservative management.
  • Surgical: The sterna and the clavicular heads of sternomastoid are divided close to the origin along with the release of the tight fascia. The head is then immobilized in a plaster cast in over-corrected position for 2 to 4 weeks. Mobilization is begun as soon as the cast is removed.
3 people found this helpful

Massaging Your Body - 9 Reasons Why You Must!

Dr. Kant Veer Vikram 90% (74 ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS), C.C.Y.P.
Ayurveda, Faizabad
Massaging Your Body - 9 Reasons Why You Must!

In order to know the benefits of abhangya, it is important to understand what exactly abhangya is. We do, at times, massage ourselves unconsciously. However, the practice of massaging oneself from head to toe with nice and warm oil lovingly is known as abhangya. According to Ayurveda, like being loved by another person, abhangya too provides individuals with a deep sense of stability. Ayurveda states that daily practice of abhangya helps in restoring the balance between the three doshas of our body - the pitta dosha, kapha dosha and vata dosha.

Ayurveda states that the individuals who practice this self massage technique regularly become vey less affected and even less subjected to accidental injuries. These individuals also tend to become charming and very less affected by age. Now that we have discussed a bit of what abhangya is, here is a list of the benefits that come with it. 

  1. This self massage technique helps in nourishing the body and slowing down the ageing process considerably.
  2. This technique helps is bestowing individuals with good vision.
  3. This process helps in stimulating the internal body organs and increases and improves blood circulation. This results in lesser blood pressure and a healthier body.
  4. This technique helps in imparting a sort of firmness to the limbs and hands, thereby strengthening the body’s tolerance.
  5. This technique also benefits the skin. Well, the thing about our body is each organ in our body is interrelated with each other. So when any one organ starts working perfectly, everything else follows suit. It has been seen that this technique helps impart a sort of tone and vigour to the tissues of the body itself.
  6. Abhangya helps pacify the vata and the pitta doshas.
  7. If applied to the scalp, it helps in growing luxurious, soft, thick and really glossy hair.
  8. This is also said to reduce wrinkles on the face.
  9. When applied to the ears, stiffness of neck and jaw can be eased.

We have discussed how this practice benefits us, but here are some of the situations when we aren’t supposed to perform abhangya.

  1. During menstrual cycle
  2. During pregnancy
  3. In swollen or painful areas
  4. Over skin that has any sort of rash or infection
  5. During any acute illnesses
  6. During any health condition until and unless the doctor said that it was perfectly fine to do abhangya

All in all, Abhangya is a process that should definitely be carried out for personal well-being. If you wish to discuss about any specific problem, you can consult an ayurveda.

5339 people found this helpful

Migraine - Identifying the Early Signs!

Dr. Sankalp Mohan 89% (98 ratings)
MBBS, MD - Internal Medicine, Fellow In Pain Management, DM - Neurology
Neurologist, Delhi
Migraine - Identifying the Early Signs!

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them—and possibly even prevent them. The two types of migraine are- 

  1. Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
  2. Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.

Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

  • Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
  • Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
  • Motor: Usually related with the movement problems like the limb weakness
  • Verbal: It is related with the speech problems

Headache: In case of a migraine attack one might experience:

  • Pain on both sides or one side of the head
  • Pain is throbbing in nature
  • Vomiting and nausea
  • Sensitivity to smells, sound and light
  • Vision is blurred
  • Fainting and lightheadedness

Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

  1. Onset of headaches >50 years 
  2. Thunderclap headache - subarachnoid haemorrhage 
  3. Neurological symptoms or signs 
  4. Meningism 
  5. Immunosuppression or malignancy 
  6. Red eye and haloes around lights - acute angle closure glaucoma 
  7. Worsening symptoms 
  8. Symptoms of temporal arteritis

These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

  1. Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
  2. CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
  3. MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
  4. Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.

Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

  • Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
  • Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Consult a doctor find the right medication for you.

1962 people found this helpful

Fever - What, When And Why?

Dr. Jasmeet Singh 89% (13 ratings)
DNB (General Medicine), MBBS
General Physician, Mohali
Fever - What, When And Why?

Fever is not a disease! It's a known fact that normal human body temperature is 98.6°F (37°C). If temperature goes beyond that, then it's called fever. But one must not worry every time if there is a rise in the temperature. 

Why?
The reason is that immune system is designed to raise temperature as a defence mechanism, if there is any attack by a foreign body (such as bacteria). So body temperature may fluctuate between 97 and 100.4. But there is no need to worry.

When to Consider Checking?
Routine check up is unnecessary. You may consider to check when:

  • You feel the warmth while you touch
  • You feel very tired, dizzy and lose appetite
  • You feel nauseated, see rashes on the body, experience loose motion, sore throat, muscle pain, headache, etc.

Is it Time to Worry? 
Normally, fever is not dangerous. However, if you see the following conditions, then it's time to worry and call a doctor. 

  • If the body temperature is more than 103 degree F 
  • If fever lasts for more than five days
  • If you feel difficulty in breathing
  • If there is severe vomiting or diarrhoea
  • If you feel stiffness in the neck and have headache
  • If you feel excessively sleepy and lethargic
  • If you see redness in skin, rashes or blood in stool.

If the condition worsens, it is time to rush to a hospital. There could be following:

  • Meningitis is life threatening and highly transmissible in case of bacterial infection. A combination of a fever, extreme headache and stiffness in the neck is an indication that you must rush to the emergency department of a hospital near you.
  • Difficulty in breathing or chest pain along with fever should prompt you to call for emergency medical assistance.
  • If someone has fever along with blood in stool, urine or mucus, it's one of the reasons to seek for emergency medical help.
  • If one has fever and is quite disturbed or puzzled unnecessarily, then the person should be taken to the emergency department.
  • A person with low immune responses (such as one who is suffering from cancer or AIDS) needs doctor's help in case of fever development.
  • Hyperthermia: it's a condition of very high fever, i.e., more than 104 degree F. The person seems to be confused and may not respond to verbal stimuli or commands. It's time for medical emergency.

What should You Do?
For mild fever, even home remedies can help. Aspirin shouldn't be the first choice and an absolute no for individuals less than 18 years. Other drugs that people usually tend to consume are ibuprofen or acetaminophen. One should also drink plenty of water. In case of a heat stroke, body needs to be cooled.
Other severe causes such as viral infection should lead you to a doctor. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

3310 people found this helpful

Headache - 5 Ways to Deal With it!

Dr. Anshu Jain 92% (515 ratings)
MBBS, DMCH, DEM
General Physician, Jaipur
Headache - 5 Ways to Deal With it!

Frequent headaches can be uncomfortable at best, and debilitating at worst. While a chronic migraine can come with a throbbing pain on one side of the head, headaches due to tension can cause mild to moderate pain on both sides. Also, daily headaches happen in at least 15 days, Hemicrania Continua is a condition that brings about constant pain, and usually happens on one side of the head. Other causes of headaches include eye problems like myopia, presbiopia, squint, long sitting on computer screen, low sugar, acidity etc. A proper eye checkup, neurologist opinion, diet, meditation for treatment is important. Read on to learn more about dealing with these different kinds of headaches.

1. Medical treatment: Inflammation, infections like meningitis and brain injuries that have been proven to be traumatic should be treated with due medication after a proper consultation with a doctor. In certain cases, headaches can be caused due to brain tumours and they must be treated at once. Also, headaches that come with fever, stiff neck, confusion and constant vomiting must be treated by a doctor immediately.


2. Take an over the counter drug: Taking an over the counter drug for instant pain relief can stop the pain and give temporary or long term relief, depending on the kind of headache you are experiencing. It is advisable to speak with a doctor before taking any kind of drug.

3. Find your triggers: Find and limit your triggers like certain food types as well as stress and certain seasonal changes. Stepping out in the summer with an umbrella and avoiding caffeine or too much of chocolate and cheese can also help in alleviating the pain. Stress is also a major factor that contributes to headaches and should be avoided in order to prevent or stop the pain.

4. Drink plenty of water: Staying hydrated is a good way to treat headaches instantly. The consumption of water is known to soothe the pain effectively.

5. A soothing break: Find a quiet place with dim lighting to take a break that should ideally last at least half an hour to one hour, or even more. This will help in diminishing and removing the pain. You can also use a cold compress and get yourself a massage.

5571 people found this helpful

Ginger - 13 Health Benefits You Never Knew

Dr. Mayur Surana 86% (586 ratings)
MD, DYA, PGDCR
Ayurveda, Nashik
Ginger - 13 Health Benefits You Never Knew

There is probably no house in India, where dishes are prepared without the use of ginger. It forms an amazing spice that is savoury, both for spicy and sweet dishes and as a result, most Indian dishes include this spice for making them tastier and healthier. But did you know that both fresh and dried ginger has medicinal properties as well?

Here are the top 13 benefits proffered by ginger

  1. Healing properties: Ginger can be used as a fresh root or a milled powder for healing all kinds of sores and cuts and it prevents spread of infections.

  2. Helps in relieving pain: If you can boil ginger for a short time and drink the liquid, it can help in alleviating the chronic and acute pain caused by arthritis, rheumatism, abdominal cramps, back pain, bronchial asthma and bronchitis, neck stiffness, inflammation in the kidney and liver.

  3. Regenerating properties: Ginger can help in increasing the blood circulation, eliminating toxins and regenerating the tissues that have been harmed with any kind of disease.

  4. Fat burning abilities: Ginger can act as a fat burner and aids in weight loss. It can create a feeling of fullness and reduces sudden food craving so that you will not have to snack in between meals.

  5. Anti-inflammatory properties: Regardless of what has triggered the cause of pain, ginger has the potential to set you free from it owing to the anti-inflammatory properties contained in ginger roots.

  6. Helps in relieving sinusitis: Ginger has a notable impact on the health of those suffering from sinusitis. If you are suffering from asthma, you may have it too.

  7. Alleviating nausea: Ginger root can soothe the nerve and can prevent headache, vomiting and migraine. It can relieve you from tiredness and soreness of muscles caused due to long voyages.

  8. Fighting abdominal discomfort: By consuming ginger tea on regular basis, your digestion, as well as food absorption, can be prevented.

  9. Reduction of inflammation: Ginger root helps in soothing swollen joints and tired muscles. It is also recommended for relieving pain and burning sensation.

  10. Fighting menstrual problems: Dipping a towel in ginger tea and putting in the region of the uterus can aid in relaxing the muscles.

  11. Relieving stress: A cupful of ginger tea can aid in improving the mood and reducing stress and tension.

  12. Empowering the immune system: The antioxidants contained in ginger roots can help in strengthening the immunity system by reducing stroke risk and cleaning arteries.

  13. Treating cancer: It has been proven that ginger tea can kill cancer cells.

There are specific rules and ways of consuming Aadrak (ginger) by people of different constitutions and regions. An Ayurvedic constitutional examination can help you in understanding which and when is the best way for you to consume ginger. If you wish to discuss about any specific problem, you can consult an ayurveda and ask a free question.

10547 people found this helpful

Botox - Is It Really Beneficial?

Dr. Vivek Mehta 92% (104 ratings)
Diploma In Trichology - Cosmetology, PG Diploma In Clinical Cosmetology (PGDCC), Diploma In Aesthetic Mesotherapy, PG Diploma In Clinical Research
Aesthetic Medicine Specialist, Ahmedabad
Botox - Is It Really Beneficial?

Are you planning on undertaking a cosmetic procedure for rejuvenating your skin? Botox treatment is considered to be effective for this purpose. Botox is a drug made from a certain neurotoxin, and it is produced by a bacteria known as Clostridium botulinum. Botox is also used for medical purposes, especially for the treatment of muscle related conditions. It is primarily used for removing wrinkles via a procedure in which your facial muscles are temporarily relaxed.

Major uses
Except for reducing the appearance of your wrinkles and facial lines, which appear because of aging, botox is used for the treatment of conditions which include leaky bladders, migraines, excessive sweating, and eye squints. Over 20 medical conditions utilize botox as a part of treatment.

How it works?
Botulinum toxin or botox is a poisonous substance. A single gram of botox can kill over one million people. But it acts as an ideal therapeutic protein when utilized in a proper, required dosage.

About botox procedure
Botulinum toxin powder is diluted in saline to be administered. It is injected into a patient’s neuromuscular tissue and takes around 72 hours to show results. This time reflects the amount of time that is required for disruption of your body’s usual synaptosomal process. It takes around 5 days for the full effect of botox treatment to show. Pregnant or lactating women, and people who are allergic to it from a previous treatment should avoid any form of botox treatment.

Side effects and associated risks
Although injections containing botox are well tolerated, there are several side effects involved. They are as follows:

  • A person having a genetic predisposition in which a mild, transient response to botox is received. Some patients taking type A botox injections are likely to develop antibodies to the toxins. This makes the treatment ineffective. Antibody development is also indicated in cases of patients taking a type B botox injection for treating cervical dystonia.
  • Along with the intended effects, botulinum toxin may cause some other side effects, which are quite undesirable. They may include headache, malaise, mild cases of nausea, transient numbness, mild pain, local edema and erythema at the site where the injection is given.
  • Temporary fatigue, of your surrounding musculature are also likely because of the toxin and its actions.
  • Temporary upper lid and brow ptosis or drooping is another side effect involved with botox.

The results obtained from treatment by type B botox is said to be more effective than botox A treatment. You may expect better results when your muscles remain contracted instead of being relaxed. If you wish to discuss about any specific problem, you can consult a dermatologist and ask a free question.

2634 people found this helpful

What Can You Expect From A Botox Treatment?

Mch - Plastic Surgeon , MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Hyderabad
What Can You Expect From A Botox Treatment?

Are you planning on undertaking a botox treatment? Botox is a drug which is made from a neurotoxin. This is produced by the bacteria called Clostridium botulinum. Botox is used for medical purposes, commonly for treating muscular conditions. It is also used for cosmetic procedures, which help in removing wrinkles. This process is carried out by paralyzing the facial muscles temporarily. Botulinum toxin is also sold commercially under certain names.

Medical and Cosmetic Uses-

Botox is most commonly used as a treatment procedure for reducing the appearance of facial lines and wrinkles in middle-aged adults. It is also used for medical purposes, for the treatment of conditions such as eye squints, excessive sweating, leaky bladders and migraines. Botox is used for treating more than 20 medical conditions.

How Does Botox Work?

Botox or botulinum toxin is a very poisonous substance, and a single gram of it is capable of killing more than one million people. It is considered to be an effective therapeutic protein when used in ideal dosage, and frequency. It is used in several medical procedures and treatment therapies.

How is Botox Procedure Undertaken?

Botulinum toxin is administered by diluting the power in saline. It is injected directly into your neuro-muscular tissue. A duration of 24 to 72 hours is required for it to take effect. This time reflects the time required for disruption of the normal synaptosomal process of the body. It may take over five days for experiencing the full effects of botox. Botox must not be used in women who are pregnant or lactating, or by people having a previous allergic reaction to it.

Risk and Side-Effects:

Injections which contain botox are usually well tolerated. They have several side effects as well.

  1. In some cases, a person may have a genetic predisposition which causes a mild, transient and unusual response to Botox. Some people who are receiving botox type A injections may develop antibodies to the toxins, which may make the treatment ineffective. In people who are using botox type B for cervical dystonia, antibody development may occur.

  2. Along with the effects intended, botulinum toxin may lead to several other undesirable effects. They may include conditions such as transient numbness, headaches, malaise, mild cases of nausea, mild pain, local edema and erythema on the site of injection.

  3. Temporary tiredness, fatigue or the paralysis of nearby musculature may also be experienced because of the reaction of the toxin.

  4. Drooping or temporary upper lid and brow ptosis are also indicated.

Among the two types of botox treatments, the results from abobotulinum toxin A is considered to be more effective than onabotulinum toxin A treatment. Better results are experienced when the muscles are contracted instead of being at rest. If you wish to discuss about any specific problem, you can consult a dermatologist and ask a free question.

2828 people found this helpful
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