Sunday, 19 April 2020

Painful Discs and Sciatica: How To Fix Them Yourself

(Following are my own findings and experience ,however for the sake of bit convenience  I took the help of work done by  By Dr. Jolie Bookspan)

Despite the fact that discs usually can heal quickly and easily, people are commonly told that a disc problem is a difficult and long-term condition.

They are told to accept and “live with” pain and reduced ability.

They may stay on pain and anti-inflammatory drugs for long periods.

Recent news reports from Time Magazine and The New York Times quote spine specialists as saying that back pain is mysterious, and that commonly used modalities like acupuncture, strengthening, surgery, massage, chiropractic just aren’t working. However, the case is that back pain is usually simple to understand, and simple to fix without surgery or special beds or equipment.

Back Pain Is Not Mysterious


People do an astonishing number of things every day to strain, weaken, and pressure their backs. You know you shouldn’t lift wrong, but you do — all day, every day — picking up shoes,

 petting the dog,


                           

 for laundry, trash, making the bed, looking in the refrigerator, and all the dozens of times you bend over things. You work bent over your desk or bench. You drive bent forward.

If you go to the gym, you probably lift weights bent over, stretch by touching your toes, do yoga by bending over at the waist, then bend over to pick up your gym bag to go home. No wonder your back hurts. Most people know that bending wrong will injure your back. But they stand, bend, sit, and lift wrong many dozens of times a day, day after day.


They wonder 

 


 why they still get pain even though they take their medicine and “do their exercises.




Many wind up in back surgery, or long term or recurring pain, not understanding why their physical therapy, pills, or yoga “didn’t work.”

What Are Discs?

Discs are little fibrous cushions between each of your vertebrae (back bones).

have a look on how they are placed between two consecutive bones 

Now watch one segment out of these 

There are 23 discs in the human spine: 6 in the cervical region (neck), 12 in the thoracic region (middle back), and 5 in the lumbar region (lower back).
A.The Yellow vertical cord is spinal cord and roots are extending from the cord.
B.The light sky blue color is of disc.

Discs do many things like absorb shock, and keep your bones from grinding against each other. When you abuse them by bad habits, they can break down.

How Discs Herniate

Years of forward rounding, squashes your discs and pushes them out toward the back. The discs eventually break down (degenerate) and push outward (herniate). Think of a water balloon.
A. 
When you squeeze the front (as it happens when we bend forward), it bulges toward the back. The resulting herniation can press on nearby nerves, sending sciatic pain down your leg.
B.
 if you squash and push the discs in your neck with a forward head posture - letting your head tilt “chin-forward” instead of holding it up straight, the disc in your neck may herniate and press on nerves, sending pain down your arm. 

or may be while lifting your water jar gas cylinder.



THE INTRADISCAL PRESSURE is proportional to body weight as well.

Friday, 17 April 2020

Physiotherapy: Importance of Flexion exercise in Lumbar Canal Ste...

Physiotherapy: Importance of Flexion exercise in Lumbar Canal Ste...: Stenosis means   the abnormal narrowing of a passage  Lumbar canal is lumbar part of whole spinal column,                             ...

Importance of Flexion exercise in Lumbar Canal Stenosis

Stenosis means  the abnormal narrowing of a passage 

Lumbar canal is lumbar part of whole spinal column,
                                                   
                                          so where is spinal column ,look at the diagram below,Number 1 blue inked spinal cord and number 2 is spinal column.

  • The spinal column shown above is formed by back part of vertebral body (which forms canal's front wall) and  laminae and pedicles (which forms its side and back wall) 



  • In Lumbar Canal Stenosis this canal gets narrowed by degenerative changes in vertebral bodies ,discs,lateral foraminae and apophysial joints,



  • So in normal situation whenever we bend forward the the column or canal opens up and has more space but when bend backwards the space reduces.



  • In pathological conditions as in degenerative changes the canal size decreases spontaneously by the debris of wear and tear bony spurs  and this process continues and gets limited by itself sometimes it keeps on getting narrowed day by day.



  • Narrower the space in canal more is the pressure on spinal cord    and patient feels urge to sit after walking few distance as a result of pain in legs (because of pressure in spinal cord)but it gets dramatically reduced to almost zero when patient sit down.This is known as neurological claudication



  • SO WHY DOES PAIN GETS REDUCED ? ANSWER TO THIS IS IDEA OF FOLLOWING EXERCISE IN SPINAL CORD STENOSIS.


https://youtu.be/NPMoxDQ0id0


  • So when you do strengthening of flexors of spine you  create more space for spinal cord and hence you tolerate walking more.
PLEASE VISIT www.dhirajphysiotherapy.com for more detail or conact us.



What to Do If You have hand or arm swelling after Shoulder rest in sling.

1.First of all make sure you are advised by your doctor to do exercises.
2.Ensure self that there is no abnormal or severe pain after every time you do exercise.
3.Inform or take caution if pain persists.

With above precautions in mind,You can start following.
1.Keep your arm elevated on a supporting very soft surface,so that the plane of the surface is above your heart level.

so if you are in sitting position,then the plane of surface just above your shoulder height is good enough.




2.While in lying position,keep a pillow longitudinally  by your one side so that the whole of arm is well supported,and the plane is making inclination down to shoulder(you may add one more pillow from elbow to wrist.


3 While keeping arm elevated with elbow bent or straight whichever way you wish squeeze soft smiley or gel balls as explained in this video.
For Any doubt please visit www.dhirajphysiotherapy.com .Or contact us.





Friday, 3 April 2020

Deeper Understanding of Cervical Spondylosis

what to do when you got know you have cervical spondylosis.

KNOW what is cervical spondylosis.

1.It comes from two words cervical and spondylosis.Cervical term is used to denote first seven vertebra of spinal column present in your neck.

2.Spondylosis comes from spindulos( means vertebra) and osis(means denoting a process or condition.denoting a pathological state like neurosis, metamorphosis)

3.Cervical spondylosis is a chronic degenerative condition of the cervical spine(doesnot always mean that all 7 vertebra are degenerating) that affects the vertebral bodies(in the form of spurs) and intervertebral discs(in the form of disc herniation)

4.Spondylosis progresses with age and often develops at multiple interspaces.

5.Chronic cervical degeneration is the most common cause of progressive spinal cord and nerve root compression.
6.Spinal canal stenosis can lead to myelopathy whereas the latter 2(stenosis at lateral recess and foramina) can cause radiculopathy.

7.Pathophysiology
A.Intervertebral disks lose hydration and elasticity with age, and these losses lead to cracks and fissures.

B.The surrounding ligaments also lose their elastic properties and develop traction spurs/
C.The disk subsequently collapses as a result of biomechanical incompetence, causing the annulus to bulge outward.

D.As the disk space narrows, the annulus bulges, and the facets override.

E.This change, in turn, increases motion at that spinal segment and further hastens the damage to the disk.

F.Annulus fissures and herniation may occur. Acute disk herniation may complicate chronic spondylotic changes.
AT SPINAL CANAL
1.As the annulus bulges, the cross-sectional area of the canal is narrowed.
2.Neck extension causes the ligaments to fold inward, reducing the anteroposterior (AP) diameter of the spinal canal.
AT FORAMEN
1.As disk degeneration occurs, the uncinate process overrides and hypertrophies, compromising the ventrolateral portion of the foramen.
2. Facet hypertrophy decreases the dorsolateral aspect of the foramen.
3. This change contributes to the radiculopathy
WHAT EXACERBATES THIS PROCESS OF DEGENERATION
Additional stresses, such as trauma or long-term heavy use.
Marginal osteophytes begin to develop.
WHICH PATHOLOGICAL PROCESS LIMIT FURTHER DETERIORATION MECHANISM?
These osteophytes stabilize the vertebral bodies adjacent to the level of the degenerating disk and increase the weight-bearing surface of the vertebral endplates
WHICH PATHOLOGICAL PROCESS LIMIT FURTHER DETERIORATION MECHANISM?
LiMITED motion because of degeneration of joint surfaces and ligaments

I would add some pictures later to make it more comprehensible.
Big Questions in My mind now

1.How come so powerful nations and their Head got this Corona.(BJ,PM of UK)

2.If he couldn't keep himself well aware of research available,how he is supposed to lead a mass.