Infant Skull Fracture – an Overview | Orthopaedics

What is a skull fracture?

A skull fracture is a fracture of the skull bone. There are 4 main types of skull fractures:

  • Linear skull fractures: In a linear fracture, there is a fracture in the bone, but it does not move the bone. In many cases, these children can be observed for a short time in the emergency department or hospital and can resume normal activities within a few days. Usually, no intervention is required.
  • Depressed skull fractures: This type of fracture can be seen with or without an incision in the scalp. In this fracture, part of the skull sinks out of the wound. If the inside of the skull is pressed against the brain, surgery is required to correct this type of skull fracture deformity.
  • Diastolic skull fractures: These are fractures that occur along the suture lines in the skull. The points are the areas between the bones of the head that coincide with the growth of the child. In these types of cracks, the normal seam lines widen. These cracks are more common in newborns and babies.
  • Basilar skull fracture: It is a severe skull fracture and a fracture in the bone at the base of the skull. Children with this type of fracture often have bruises around the eyes and behind the ear. A part of the covering of the brain causes clear fluid to flow from the nose or ears due to tears. These children sometimes require close observation in the hospital.

Head injuries are one of the most common causes of disability and death in children. The injury can be a blow, a bruise (contusion) or a cut to the head, or a concussion, a deep cut or open wound, a skull broken or of a moderate nature from the inside. Bleeding and brain damage.

Head injury is a broad term that describes a wide variety of injuries to the skin, skull, brain, and underlying tissues and blood vessels in a child’s head. Head injuries are also commonly known as brain injury or traumatic brain injury (TBI), depending on the extent of the head injury.

Other types of acute brain injury:

  • Skull Fracture: A skull fracture is a fracture or fracture in one of the bones of the skull. In most cases, the skull fracture only causes injury to the surface of the brain. If the skull bends inward (depressed skull fracture), the broken bone fragments will be pushed to the surface of the brain. Fixing this may require more immediate care and specialized surgery.
  • Epidural Hematoma: The most serious bleeding that occurs inside the head as a result of a skull fracture. This occurs when a sharp piece of bone is cut through one of the major blood vessels in the skull. As the injured character bleeds, a blood clot called a hematoma forms in the space between the skull and the outer layer (dura) that covers the brain. A ruptured blood vessel is usually an artery, and the hematoma expands rapidly and puts pressure on the brain. It can also cause serious injury and even death. Epidural hematomas are more common after major injuries to the temple, baseball hat, or baseball bat.
  • Subdural hematoma: is the accumulation of blood between the covering of the brain and its surface. The head injury occurs when a tear is placed in the large veins that carry blood from the surface of the brain. Subdural hematomas increase in size slowly, sometimes over days or weeks, and symptoms gradually worsen. This type of bleeding can lead to serious brain injury and death if it is not diagnosed and treated right away.
  • Intraparenchymal hemorrhage and contamination (bleeding and trauma to the brain): These lesions remain in the brain. Both types of injuries occur with a direct blow to the head or indirectly when the force of the injury rebounds from one side of the skull to the other side of the brain. This causes the damaged area on the side of the brain opposite the head.

What should I do if my child has a head injury?

  • Check if your baby is breathing or has a pulse. Enable CPR if necessary. The hospital for help.
  • Do not move your child until medical help is available. If your child is vomiting, support both sides of his or her head and shoulders while moving and turning toward him or her. Don’t allow your head and neck to bend, distort or twist.
  • Do not put anything in your child’s mouth.
  • Don’t touch anything that sticks out of your head.
  • Apply direct pressure to your child’s head if they are bleeding. If it is soaked in blood, place another cloth on top of the first cloth.
  • If your child has epilepsy, stay with him until the seizure is over. After stopping, turn it towards him. Don’t move your child when he has epilepsy.

What are the signs and symptoms of a skull fracture?

Signs and symptoms depend on the cause of your child’s skull fracture:

  • Malformed head
  • Headache, dizziness, or jaw pain.
  • Nausea or vomiting
  • Swelling of fontanelles (soft spots) in babies
  • A lump or swelling on the head.
  • Blood or clear fluid draining from your nose or one or both ears
  • Blurred or double vision
  • Injuries behind the ears or around the eyes.
  • Increased sleepiness or confusion
  • Loss of memory (amnesia)
  • Poor coordination
  • Irrational behaviour
  • Aggressive behaviour
  • Seizures (convulsions)
  • Numbness or weakness (paralysis) of part of the body

In addition, physical signs can include:

  • A bump, bruise or cut on the head
  • A visible dent at the site of impact
  • A black and blue discolouration around the eyes or behind the ear
  • Blood coming out of the ear
  • Clear fluid oozing from the nose (this may be the clear fluid that bathes the brain leaking through a skull fracture near the nose)
  • A bulging soft spot between the skull bones (fontanelle) in an infant

How is a skull fracture diagnosed?

Also known as neurological signals, neurological signals, neurological checks, or neurological status to check brain function. During a neurological checkup, the healthcare provider checks how your child’s students respond to light. He or she can check your child’s memory and how easily he or she wakes up. You can also test your hand grip and balance. It shows how your child responds to neurological checks and whether her injury has affected her brain.

You can use X-rays, CT scans, or MRIs to examine your baby’s skull, brain tissue, and blood vessels. You can give your child a contrast liquid to make her skull show up better in the pictures. Tell your healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not enter the MRI room with any metal. Metal can cause serious injury. Inform your healthcare provider if there is any metal on your child’s body.

A nasal CSF test is done to check for cerebrospinal fluid (CSF) leakage caused by a skull fracture. A test strip is used to collect fluid from your baby’s nose. The strip shows whether the fluid is CSF or normal nasal drainage.

Head injury treatment

Children with mild head trauma usually require no more treatment than 48 hours of careful follow-up. Careful vigilance is also important for children with concussions and the child should be kept away from sports for longer periods of time. If your child’s injury is more serious and she is being monitored in the emergency room or hospitalized for an examination, the medical staff will assess your child’s condition from time to time.

Once your doctor is satisfied that your child can be safely sent home, they will allow you to leave with instructions. If your child complains of a headache, her doctor will probably prescribe acetaminophen (Tylenol). You should not give your children aspirin, ibuprofen (Advil, Motrin), naproxen (naprosin), or indomethacin (indocin) because these medications increase the risk of bleeding inside the head.

Your child’s healthcare provider will find the best treatment based on:

  • How old is the boy
  • Your complete medical and health history
  • How sick he is
  • How well your child can handle specific medications, procedures, or treatments
  • How long is this situation expected to last?
  • Your opinion or preference

Depending on the severity of the injury, treatment may include:

  • Ice
  • Relax
  • Topical antibiotic ointment and an adhesive bandage.
  • Observation
  • Seek medical attention immediately
  • Stitches
  • Admission to hospital for examination

It helps with moderate anaesthesia or breathing that may need to be placed in a breathing apparatus, also known as a mechanical ventilator or mechanical respirator.

Prevention of skull fracture

To prevent head injuries in children:

  • Do not leave your child alone on a changing table, bed, chair, or raised surface. Instead, place your baby in a crib, playpen, or on the floor.
  • Do not use baby walkers, as these devices can cause falls and serious injury.
  • Install window bars and place security gates near doors and stairs.
  • If you have a young child, remove rugs and furniture with sharp edges from playgrounds.
  • If your child uses a playground, make sure there is a shock-absorbing surface (a thick piece of rubber or a deep layer of sand, sawdust, or wood chips) under all play equipment.
  • Use car seats that are appropriate for your child’s age and weight until they fit snugly into the normal seat belt.
  • Make sure your child wears a well-fitting safety helmet when riding a bike or scooter. A formal bicycle safety course, if available, can be very helpful.
  • If your child is playing sports, they should wear a professionally fitted and appropriate protective helmet. Helmets are required in football, baseball, ice hockey, skiing, inline skating, skateboarding, skateboarding, and snowboarding.
  • Do not allow your child to play on trampolines unless properly supervised.
  • When you go shopping, wear a seat belt to keep your child safe in the shopping cart seat. Never leave your child unsupervised in the stroller and never put them in the stroller basket.

Causes and Types of Metastatic bone cancer | Orthopaedics

What is metastatic bone cancer?

When cancer spreads to the bones, it is called bone metastasis. Metastatic bone cancer is also known as metastatic bone disease or secondary bone cancer because cancer does not start in the bone. Bone metastasis usually occurs in people who have had cancer in the past or who have advanced cancer. But sometimes pain from bone metastases can be the first sign of cancer.

Bone metastasis is an advanced stage in which the cancer of reliable origin is often incurable. But not all bone metastases develop quickly. In some cases, it develops more slowly and is considered a chronic condition that requires careful maintenance. Bone metastasis may not be curable, but treated people can live longer and feel better.

The exact mechanism by which cancer cells spread to the bones is not fully understood. This is a very active area of ​​scientific research. A new understanding of how metastasis works will lead to new methods of treatment.

Cancer types can spread to the bones

The most common cancers that spread to the bones are breast, prostate, and lung. But many other cancers can metastasize to the bones, including:

  • Thyroid
  • Kidney
  • Melanoma
  • Lymphoma
  • Sarcoma
  • Uterus
  • Gastrointestinal

The third most common site of bone cancer spread. Two lungs and the first two liver.

Cancer cells can metastasize to one or more of your bones at the same time. The most common sites of bone metastases are:

  • Spine
  • Ribs
  • Fruits
  • Breastbone
  • Skull

Symptoms of metastatic bone cancer

Sometimes bone metastasis does not cause any signs or symptoms. When this occurs, the signs and symptoms of metastatic bone cancers are:

  • Bone-ache
  • Broken bones
  • Urinary incontinence
  • Bowel incontinence
  • Weakness in legs or arms
  • Elevated levels of calcium in the blood (hypercalcemia), which causes nausea, vomiting, constipation, and confusion.

When to see a doctor

If you experience persistent signs and symptoms that bother you, make an appointment with your doctor. If you have been treated for cancer in the past, tell your doctor about your medical history and your concerns about your signs and symptoms.

Types of metastatic bone cancer

Usually, your bones are constantly changing. New bone tissue is forming and old bone tissue is broken down into circulating minerals in the blood. This process is called rebuilding. Cancer cells disrupt the normal bone remodeling process, causing the bones to become weak or very dense, depending on the type of bone cells.

Its bone metastases can be:

  • Osteoporosis, if there are too many new bone cells (this usually occurs with metastasized prostate cancer)
  • Osteolytic, with more bone loss (which often occurs with metastasized breast cancer)
  • In some cases, there may be two types of metastases in your bones.

Causes of metastatic bone cancer

Bone metastasis occurs when cancer cells break away from the original tumor and spread to the bones, where they begin to multiply.

Doctors don’t know what causes some cancers to spread. And it is not clear why some cancers travel to the bones rather than to other common sites of metastasis, such as the liver.

Risk factors of metastatic bone cancer

Actually, any type of cancer can spread to the bones, but some of the cancers that cause metastatic bone cancer include:

  • Breast cancer
  • kidney cancer
  • Lung cancer
  • Lymphoma
  • Multiple myeloma
  • prostate cancer
  • Thyroid cancer

Diagnosis of metastatic bone cancer

Imaging tests are used to investigate signs and symptoms that may indicate metastatic bone cancer. Which tests you undergo depends on your specific situation.

Tests may include:

  • X-ray
  • Bone scan (bone scintigraphy)
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Biopsy

Treatment for metastatic bone cancer

Treatment of each individual for metastatic bone cancer is individualized and requires a multisectoral approach. Your treatment plan depends on:

  • The type of primary cancer you have
  • Your stage of cancer
  • No bones
  • Pre-cancerous treatments
  • Your overall health

You may have a combination of treatments including:

  • Radiation to slow the growth of metastases and reduce pain
  • Chemotherapy to kill cancer cells and shrink the tumor
  • Hormone therapy to lower hormones associated with breast and prostate cancer
  • Analgesics and steroids to relieve pain
  • Medications that specifically target the bones
  • If surgery is needed to stabilize your bone, fix the fracture, and help with pain
  • Physical therapy to strengthen your muscles and help you with mobility
  • Excess heat or cold targets cancer cells and reduces pain
  • Bone directed therapy
  • Specific medications that target the bone are an important part of treatment and a growing area of ​​research

It is important to start bone targeting treatment as soon as possible and do not wait until you have a fracture or other bone injury. The breast cancer study reported a lower risk of bone problems in people who started treatment at 6 months. A reliable source of diagnosis of bone metastases.

Drugs targeting bones currently used:

  • Denosumab, a human antibody effective in the prevention of osteoporosis and osteoporosis
  • Bisphosphonates, bone-building drugs used for osteoporosis, strengthen the bones and reduce the pain of metastases.
  • Trastuzumab (Herceptin), which targets specific breast cancer cells
  • Bortezomib, which inhibits proteases that break down proteins, is approved for the treatment of multiple myeloma and in the study of other cancers.
  • Radiopharmaceuticals, which are injected into a vein and detect and destroy cancer cells in the bones.
  • As we learn more about the mechanisms by which cancer cells attack and disrupt bones, scientists are developing new ways to attack and slow these cancer cells as a reliable source.

Be aware that most cancer treatments have side effects. Discuss these with your doctor and evaluate the benefits of your treatment.

Surgery: Surgical procedures can help stabilize a bone that is at risk of breaking or repairing a broken bone.

  • Surgery to stabilize the bone: If there is a risk of bone fracture due to bone metastasis, surgeons can stabilize the bone using metal plates, screws, and pins (orthopedic fixation). Orthopedic fixation relieves pain and improves performance. Radiation therapy is often given when you recover after surgery.
  • Surgery to inject cement into the bone: Bones that cannot be easily strengthened with metal plates or screws, such as the pelvic and vertebral bones, may benefit from bone cement. Doctors inject bone cement into the bone that is broken or damaged by bone metastases. This procedure reduces pain.
  • Surgery to repair a broken bone: If metastatic bone cancer causes a bone to break, surgeons can work to repair the bone. This involves the use of metal plates, screws, and nails to stabilize the bone.
  • Placement of a joint replacement: Such as a hip replacement, maybe another option. In general, broken bones caused by bone metastases will not help by placing a cast over the broken bone.

Cancer cell heating and clotting:

  • Techniques that kill cancer cells with heat or cold can help control pain. These procedures may be an option if you have one or two areas of bone metastasis and other treatments do not help.
  • During a procedure called radiofrequency ablation, a needle containing an electrical probe is inserted into the bone tumor. Electricity passes through the probe and heats the surrounding tissue. The fabric is allowed to cool and the process is repeated.
  • A similar procedure called cryoablation freezes the tumor and then allows it to dissolve. The process is repeated several times.
  • Side effects include damage to nearby structures like nerves and bone damage, increasing the risk of bone fracture.

Physical therapy: A physical therapist can work with you to create a plan that will help you increase your energy and improve your awareness. The physical therapist can prescribe assistive devices to help you. Examples: crutches or walkers to lift a weight off the affected bone while running, cane or weed to stabilize the spine and improve balance.

The physical therapist may also suggest specific exercises to help you keep your strength up and reduce your pain.


Chordoma – an Overview | Orthopaedics

What is chordoma?

A chordoma is a rare type of cancerous tumor that can happen anywhere along the spine, from the base of the skull to the tailbone. Chordomas grow slowly, slowly extending into the bone and soft tissue around them. They frequently recur after treatment, and in about 40 per cent of cases, cancer spreads (metastasizes) to other areas of the body, such as the lungs.

Who is affected by chordoma?

It is diagnosed in only one in a million people per year. That means about 300 patients are diagnosed with this disease each year in the United States and around 700 across Europe. At any given time, less than one in 100,000 people live with chordoma.

It is most often diagnosed in people between the ages of 50 and 60, but it can occur at any age. Skull base chordomas occur more often in younger patients, while spinal chordomas are more common later in life. About twice as many men are diagnosed with this disease than women.

What causes chordoma?

Chordoma tumors develop from cells in a tissue called the notochord, which is a structure in an embryo that helps in the development of the spine. The notochord vanishes when the fetus is about 8 weeks old, but some notochord cells remain in the bones of the spine and the dishonourable of the skull. Very rarely, these cells develop into cancer called chordoma. It is not yet completely known what causes notochord cells to become cancerous in some people, but researchers are working to learn the answer.

What are the symptoms of Chordoma?

It can press on the spine, brain, and nerves as they grow, causing pain and nerve problems exact to the part of the brain or spinal cord where they are located. These symptoms can include tingling, numbness, weakness, lack of bladder or bowel control, sexual dysfunction, vision problems, endocrine problems, and swallowing difficulties. If the chordoma has grown a lot, you may be able to feel a lump.

Diagnosis of chordoma

The tests and procedures used to diagnose chordoma include:

  • Removing a sample of cells for laboratory analysis (biopsy). A biopsy is a procedure to eliminate a sample of suspicious cells for laboratory testing. In the laboratory, specially trained doctors called pathologists examine cells under microscopes to check for cancer cells.
  • Determining how the biopsy should be performed requires careful planning on the part of the medical team. Doctors should perform the biopsy in a way that does not interfere with future surgery to remove cancer. For this reason, ask your doctor for a referral to a team of experts with extensive experience treating this disease.
  • Obtaining more detailed images. Your doctor may recommend imaging tests to help visualize your chordoma and determine if it has spread beyond the spine or skull base. Tests may include an MRI or CT scan.

After getting a chordoma diagnosis, your doctor will develop a treatment plan tailored to your needs in discussion with experts in ear, nose, and throat medicine (otorhinolaryngology), cancer (oncology), and radiation therapy (radiation oncology) or surgery. Your care side may also involve experts in endocrinology, ophthalmology, and rehabilitation, as wanted.

Treatment of chordoma

Your treatment will depend on:

  • Your age
  • Your Health
  • Tumor size

Where is the tumor?

Doctors often remove the tumor with surgery. Removing as much of the tumor and some of the tissue around it as possible can prevent it from coming back.

Sometimes surgeons cannot remove the entire tumor because it can damage healthy cells in the brain or spine. Radiation (high-energy x-rays) can kill any cancer cells that are left after surgery. This reduces the chance that cancer will come back.

Still, It usually comes back after treatment. For the first year after your surgery, your doctor will check you with an MRI about once every 3 months to make sure you haven’t. If it comes back, you may need another surgery.

Researchers are studying several new treatments for this disease. They test them in clinical trials to see if they are safe and if they work. These are often a way for people to try a new therapy that is not available to everyone. Your doctor can tell you if there is a trial that might be right for you.


What is Spinal Stenosis? | Orthopaedics

Overview of spinal stenosis

Spinal stenosis is a narrowing of the spaces inside the spine, which may put pressure on the nerves that travel through the spine. Spinal stenosis frequently happens in the lower back and neck.

A few people with spinal stenosis might not have side effects. Others may encounter torment, shivering, deadness, and muscle shortcoming. Symptoms can worsen over time.

Spinal stenosis is most commonly caused by the wear changes in the spine associated with osteoporosis. In serious instances of spinal stenosis, specialists may prescribe medical procedures to make extra space for the spinal rope or nerves.

Types of spinal stenosis

Sorts of spinal stenosis are ordered by where the condition happens in the spine. You can have more than one type. The two main types of spinal stenosis are:

  • Cervical stenosis: In this condition, the stenosis occurs in a portion of the spine in your neck.
  • Lumbar stenosis: In this condition, the stenosis occurs in a portion of the spine in the lower back. It is the most well-known type of spinal stenosis.

What are the symptoms of spinal stenosis?

Symptoms usually develop over time, as the nerves become more pinched. May experience you:

  • Weakness in a leg or arm
  • Lower back pain while standing or walking
  • Numbness in your legs or buttocks
  • Balance problems

Usually sitting in a chair helps relieve these symptoms. However, they will return with periods of standing or walking.

What are the causes of spinal stenosis?

The most common cause of spinal stenosis is aging. Degenerative processes occur throughout the body with age. The tissues of the spine may begin to thicken, and the bones may enlarge, putting pressure on the nerves. Conditions such as osteoporosis and rheumatoid arthritis may also contribute to spinal stenosis. The inflammation it causes can put pressure on the spinal cord.

Other conditions that can cause stenosis include:

  • Spinal defects present at birth
  • Normally narrowing of the spinal cord
  • The curvature of the spine or scoliosis
  • Paget’s disease of bone, which causes the bone to be destroyed and regrowth abnormally
  • Bone tumors
  • Achondroplasia, which is a type of dwarfism

How is spinal stenosis diagnosed?

Your healthcare provider will review your medical history, ask about your symptoms, and perform a physical examination. During the physical exam, your healthcare provider may feel your spine and apply pressure to a different area to see if this is causing pain. Your provider will likely ask you to bend in different directions to see if different positions of the spine are causing pain or other symptoms. Your provider will check your balance, monitor how you move and walk, and check the strength of your arm and leg.

You will have imaging tests to examine your spine and determine the exact location, type, and extent of the problem. It may include imaging studies:

  • X-rays: X-rays use a small amount of radiation and can show changes in bone structure, such as loss of disc height and the development of bone spurs that narrow space in the spine.
  • Magnetic resonance imaging: Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create cross-sectional images of the spine. MRI images provide detailed images of nerves, discs, the spinal cord, and the presence of any tumors.
  • Computed tomography or myelography: a computerized tomography (CT) scan is a combination of X-rays that create cross-sectional images of the spine. CT myelography adds a contrast dye to see the spinal cord and nerves more clearly.

Spinal stenosis treatment

The treatment that you need for spinal stenosis depends on the location of the stenosis and the severity of your symptoms. You may need:


You might take:

  • Over-the-counter pain medication: Common pain treatments such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen can provide short-term analgesia. They are all available in low doses without a prescription.
  • Antidepressants: Taking a tricyclic antidepressant, such as amitriptyline, can help relieve chronic pain.
  • Opioids: For short-term pain relief, your doctor may prescribe drugs containing codeine, such as oxycodone (Oxycontin, Roxycodone) and hydrocodone (Norco, Vicodin). These medications can be habit-forming and have dangerous side effects.
  • Muscle relaxants: They can help control muscle spasms.
  • Anti-seizure medications: You can take them to relieve pain from damaged nerves.
  • Corticosteroid injections: Your doctor will inject a steroid such as prednisone into your back or neck. Steroids reduce inflammation. However, due to side effects, they are used sparingly.
  • Anaesthesia: When used carefully, an injection of a “nerve block” can stop the pain for some time.


If you have a severe case of this disease, you may have difficulty walking or have bladder and bowel problems. Your doctor may recommend a type of surgery to make space between the bones so inflammation subsides. May get:

  • This procedure removes the back of the affected vertebrae.
  • Your doctor places metal devices in your vertebrae to create a bridge in the open section of your spine.
  • Incision of the vertebral plate. The doctor removes a portion of your vertebrae to relieve pressure.
  • Minimally invasive surgery. This type of surgery helps to avoid spinal fusion by removing the bone in a way that minimizes damage to the surrounding healthy tissue.
  • Decompression procedure. The doctor uses needle-like tools to remove a portion of the thickened ligament in the spine. You can only have this procedure if you have lumbar spinal stenosis caused by thick ligaments.

Surgery has its own risks. Talk to your doctor about how much help can help, recovery time, and more before taking this step.

Risk factors for spinal stenosis

Most people with spinal stenosis are over the age of 50. Although degenerative changes can cause spinal stenosis in young adults, other causes must be considered. These include trauma, a congenital spine deformity such as scoliosis, and a genetic disease that affects the growth of bones and muscles throughout the body. Spinal imaging can distinguish these causes.

Complications of spinal stenosis

In rare cases, untreated severe spinal stenosis may develop and cause a permanent condition:

  • Numbness
  • Weakness
  • Balance problems
  • Incontinence
  • Paralysis

Early Signs and Causes of Spondylosis | Orthopaedics

What is spondylosis?

Spondylosis is a type of arthritis caused by wear and tear of the spine. It occurs when the disks and joints degenerate, or when bone spurs grow on the vertebrae or both. These changes can impair movement in the spine and affect nerves and other functions.

Cervical spondylosis is the most common type of progressive dislocation of the neck during old age. According to the American Academy of Orthopedic Surgeons, more than 85 per cent of people over the age of 60 have cervical spondylosis.

Other sorts of spondylosis create in different parts of the spine:

  • Thoracic spondylosis influences the centre of the spine.
  • Lumbar spondylosis affects the lower back.
  • Multilevel spondylosis affects more than one part of the spine.

The effects of spondylosis vary from person to person, but they usually do not cause serious problems. When a person has symptoms, these are usually pain and stiffness that tend to come and go.

Spinal osteoarthritis is another term for spondylosis. Osteoarthritis portrays joint inflammation that outcomes from the mileage. It can affect any joint in the body.

Causes of spondylosis

  • The spine helps give the body structure and supports the majority of its weight. It also holds and protects nearly all major nerve branches that extend from the brain.
  • The spine is curved rather than straight, and the cervical, thoracic, and lumbar parts of the spine contain 24 bones known as the vertebrae.
  • Between these vertebrae are joints that permit the spine to move deftly. These are called facet joints.
  • Also, soft, rubbery tissues called the intervertebral discs separate the vertebrae. These consist of cartilaginous plates and a solid outer shape, the annulus fibrosus, surrounding the inner core, the pulpal nucleus.
  • Intervertebral discs help achieve smooth movement and protect the bones from any impact on bones.
  • As a person ages, the tablets become drier, thinner, and harder, and they lose some of their cushioning ability. This is why an older person is more likely to have a vertebral compression fracture than a younger person.
  • A vertebral compression fracture results from the breakdown of the bones in the spine. It usually occurs with osteoporosis.
  • The superficial joints between the vertebrae also function less well with age due to wear on the cartilage surfaces.
  • As the cartilage wears away, the bones begin to rub together, which causes friction. This can lead to the formation of bony growths, called bony spurs.
  • Loss of elastic tissue and the development of spurs make the spine stiffer. The back movement also becomes less smooth and the friction increases.

Symptoms of spondylosis

For the fewest people, cervical spondylosis does not reason any symptoms. When symptoms do appear, they usually include pain and stiffness in the neck.

At times cervical spondylosis limits the space required by the spinal rope and the nerve roots that go through the spine to the remainder of the body. If the spinal cord or nerve roots become pinched, you may feel this:

  • Shivering, deadness, and shortcoming in your arms, hands, legs, or feet
  • Lack of coordination and difficulty walking
  • Loss of bladder or bowel control

Risk factors for spondylosis

Risk factors for developing cervical spondylitis:

  • Age: Cervical spondylosis is a normal part of aging.
  • Profession: Jobs that involve frequent neck movements, awkward postures, or a lot of overhead work put extra pressure on your neck.
  • Neck injuries: Previous neck injuries seem to increase the risk of developing cervical spondylitis.
  • Genetic factors: Some individuals in certain families will experience more of these changes over time, while others will not suffer.
  • Smoking has been connected to expanded neck torment.


In the event that your spinal line or nerve roots are seriously packed because of cervical spondylosis, the harm might be perpetual.

How do healthcare providers diagnose cervical spondylosis?

Your healthcare provider will do a physical exam to find the cause of your neck pain or other symptoms.

Your symptoms and their severity give clues to how much pressure might be under your cervical spine. During a physical exam, your healthcare provider can monitor your:

  • Elastic neck.
  • Muscle strength and reflexes in hands, arms, or legs.
  • Walking (how you walk).
  • Neck and shoulder, to look for trigger points (a small bump or knot in the muscle of your neck or shoulder that may be the source of pain and tenderness).

Now and then medical services suppliers can determine cervical spondylosis to have quite recently an actual test. Other times, they may order tests to learn more about the causes of your symptoms. These tests may include the following:

  • An X-ray shows the bones in your neck, their alignment, bone loss, and bony spurs (if any). Not all bone changes cause symptoms. Healthcare providers may use X-rays as a starting point. X-rays or other tests can also help rule out other causes of discomfort, such as a spinal tumor.
  • Computerized tomography (CT) scans provide more detail than an X-ray. This examination can help to better view the spinal canal and bony spurs.
  • The MRI images show details of soft tissues such as cartilage, nerve roots, muscles, the spinal cord, and discs. This test can show compression of the spine or a herniated disk more clearly than an X-ray. An MRI can help determine the source and location of the pain
  • Other tests may include a myelogram (a type of computerized tomography scan) or an electromyogram (a test of nerve function). These tests provide more details about how cervical spondylosis affects your nerves.

Treating cervical spondylosis

Treatments for cervical spondylosis focus on relieving pain, reducing the risk of permanent damage, and helping you lead a normal life.

Non-surgical methods are usually very effective.

Physical therapy

Your doctor may send you to a physical therapist for treatment. Physical therapy helps you stretch your neck and shoulder muscles. This makes them stronger and ultimately helps relieve pain.

You may also have neck traction. This involves the use of weights to increase the space between the cervical joints and relieve pressure on the cervical discs and nerve roots.


Your doctor may prescribe some medicines if the over-the-counter (OTC) medicines are not working. These include:

  • Muscle relaxants, such as cyclobenzaprine (Fixed), to treat muscle spasms.
  • Analgesic medications, such as hydrocodone (Norco), for pain relief
  • Antiepileptic medicines, such as gabapentin (Neurontin), to relieve pain caused by nerve damage
  • Steroid injections, such as prednisone, to reduce tissue inflammation and thus reduce pain
  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac (Voltaren-XR), to reduce inflammation


If your condition is severe and does not respond to other forms of treatment, you may need surgery. This can include removing bony spurs, parts of the neck bone or herniated disks to give the spinal cord and nerves more space.

Surgery is rarely necessary for cervical cancer. However, a doctor may recommend this if the pain is severe and affects your ability to move your arms.


Spondylosis is a common problem that affects the spine, and most people are likely to develop some degree of spondylosis as they age. Many will experience no symptoms or the symptoms will be mild.

However, if the pain is severe and the numbness and weakness affect a person’s quality of life, the doctor may recommend surgery.


Cauda Equina Syndrome (CES) – an Overview | Orthopaedics

What is cauda equina syndrome (CES)?

In spite of the fact that leg torment is normal and typically disappears without medical procedure, cauda equina syndrome, an uncommon issue that influences the heap of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord, is considered a surgical emergency.

An extension of the brain, nerve roots send and receive messages to and from the pelvic organs and the lower extremities. Cauda equina syndrome happens when the nerve establishes in the lumbar spine are packed, cutting off sensation and development. The nerve roots that control bladder and bowel function are particularly vulnerable to damage.

On the off chance that patients with cauda equina syndrome don’t look for surefire treatment to mitigate pressure, it might prompt perpetual loss of motion, helpless bladder and/or entrail control, loss of sexual sensation, and different issues. Even with prompt treatment, some patients may not fully recover their function. The best outcomes for cauda equina syndrome occur with early treatment.

Causes of cauda equina syndrome

Cauda equina syndrome most commonly results from a massive herniated disc in the lumbar region. Excessive straining or excessive injury may cause a herniated disc. However, disc material naturally dissolves as a person ages, and the ligaments that hold them in place begin to weaken. As this degeneration progresses, a relatively slight torsion or stress movement can cause a ruptured disc.

Here are the other possible causes of CES:

  • Tumors and lesions of the spine
  • Infections of the spine or infections
  • Lumbar spinal stenosis
  • Violent lower back injuries (gunfire, falls, car accidents)
  • Birth defects
  • Spinal arteriovenous malformations (AVMs)
  • Bleeding in the spine (subarachnoid, subdural, epidural)
  • Lumbar spine surgery complications after surgery
  • Spinal anaesthesia

Symptoms of cauda equina syndrome

Cauda equina syndrome can be difficult to diagnose. Symptoms vary and may appear slowly. It also mimics other conditions. On the off chance that you have any of these indications, see your PCP right away:

  • Severe lower back pain
  • Pain, numbness, or weakness in one or both legs causing you to stumble or get up from a chair
  • Loss or change in sensation in your legs, buttocks, inner thighs, or the back of your legs or feet that is severe or worsening. You may experience this as having trouble feeling anything in areas of your body that might be sitting on a saddle (called saddle anaesthesia).
  • A recent problem with bladder or bowel function, such as trouble passing urine or waste products (retention) or difficulty keeping it (enuresis)
  • Impotence that appeared suddenly

Who’s at risk for CES?

People at the greatest risk of developing CES are those who have a herniated disc, such as the elderly or athletes in high-impact sports.

Other risk factors include a herniated disk:

  • Being overweight or obese
  • Get a job that requires a lot of heavy lifting, twisting, pushing, and sideways bending
  • Presence of a genetic predisposition to a herniated disc

In the event that you have had an extreme back physical issue, for example, a physical issue from a fender bender or a fall, you are likewise bound to create CES.

How is CES diagnosed?

When you visit your doctor, you will need to provide your personal medical history. If your parents or other close relatives have had back problems, share this information as well. Your doctor will also need a detailed list of all your symptoms, including when they began and how severe they are.

During your appointment, your doctor will perform a physical examination. They will test stability, strength, alignment, and reflexes in your legs and feet.

You will probably be asked:

  • Sit down
  • Stand up
  • Walk on your heels and toes
  • Raise your legs while you are lying down
  • Bending forward, back, and side

Depending on your symptoms, your doctor may also examine your anal muscles to check for tone and numbness.

You may be advised to have an MRI scan of your lower back. An MRI uses magnetic fields to help produce images of spinal cord nerve roots and the tissues surrounding your spine.

Your doctor may also recommend a myelography test. For this test, a special dye is injected into the tissues surrounding your spine. A special x-ray is taken to show any problems with the spinal cord or nerves resulting from a herniated disc, tumor, or other problems.

Treatment of cauda equina syndrome

  • Surgery
  • Usually corticosteroids

Treatment usually focuses on the disorder that causes cauda equina syndrome, usually by relieving the pressure. If cauda equina syndrome causes sphincter dysfunction (for example, causes urinary retention or enuresis), immediate surgery (eg, discectomy, laminectomy) is required.

Analgesics should be used as needed to relieve pain. If symptoms are not relieved with non-opioid analgesics, corticosteroids may be administered systemically or as an epidural injection; However, analgesia tends to be modest and temporary. Corticosteroids can also reduce swelling.


Soft Tissue Injuries (STIs) – an Overview | Orthopaedics

What Exactly Soft tissue injuries (STIs)?

Soft tissue injuries (STIs) when an injury or overuse of muscles, tendons, or ligaments occurs. Most soft tissue injuries are like a sudden uncomfortable or uncontrolled movement that results in an uncomfortable step off a sidewalk and over the ankle. These are the injuries our physical therapists see every day at our Edinburgh Physiotherapy and Sports Injury Clinics.

However, excessive tissue damage can also occur from excessively or chronically fatigued structures, especially muscles and tendons. For example, if you are already tired (from a previous run or training) and need to do more, running your calf muscles or Achilles tendons can cause injury or stress on key musculoskeletal structures, such as “how to avoid injury while running.”

Soft tissue injuries that damaged tendons, ligaments, or muscles throughout the body can cause major disruptions in daily life. These types of injuries can also occur during sports, exercise, or daily activities. Knowing the types of soft tissue injuries is one of the best ways to prevent them, and at IMPACT Physical Therapy, our goal is to educate. Below we delve into the causes and details of six types of soft tissue injuries. Soft tissue injuries are classified as follows:

6 Common soft tissue injuries

  1. Anterior cruciate ligament (ACL) knee injuries

Commonly known as ACL, the anterior cruciate ligament allows the rotational stability of the knee joint by preventing anterior tibial translation and internal tibial rotational movement. This ligament is usually injured when jumping, landing, turning, or changing direction while participating in sports or similar activities. Symptoms of an ACL injury include severe pain, swelling, loss of range of motion in that area, and feeling unsteady.

While surgical treatment is often required to repair the ACL, our team of clinical therapists at IMPACT Physical Therapy works with your physician to accurately assess your injury and design a treatment program for your needs. To provide proper healing, one must focus on strength, stability, range of motion, agility, proprioception (your perception of your body’s position and movements), and pain reduction. 4 Tips to Prevent Anterior Cruciate Ligament (ACL) Injuries Check out our blog.

  1. Bursitis

A soft tissue injury called bursitis usually affects bursae, small fluid-filled sacs that protect the bones, tendons, and muscles around the joints. This painful condition can occur when the bursa is inflamed, which generally affects the bursa of the hips, elbows, and shoulders.

The inflammation is caused by repeated movements and overuse, and symptoms can include pain or tightness and swelling in the affected area. Physical therapy for bursitis includes techniques that reduce pain and inflammation and therapeutic exercises that help stretch and strengthen muscles to prevent future injury.

  1. Sprains

Sprains, overuse, or tearing of fibrous ligament tissue is one of the most common soft tissue injuries that affect both athletes and non-athletes. While most people who experience sprains experience them within the ankle, sprains affect different areas of the body where this tendon tissue sits between the two bones. At IMPACT Physical Therapy, we offer comprehensive asthma therapy, which helps heal tendon, ankle, and elbow sprains.

This comprehensive process reduces the regeneration of healthy tissue and scar tissue. In addition to astym® treatment, sprains are more effectively resolved through the rest of the affected area, the use of ice, compression, and height. Our clinical therapists will assess the extent of your sprain and provide you with the best guidance and assistance necessary to heal this soft tissue injury.

  1. Tendinitis

Tendonitis, similar to bursitis, involves inflammation or irritation of the tendon or fibrous cords that attach muscle to bone. This inflammatory condition generally affects areas like the shoulders, wrists, knees, and elbows. Common symptoms of tendonitis are dull pain, tenderness, or mild swelling in this area.

Tendonitis can occur suddenly, but most cases of this uncomfortable condition occur in people who regularly perform the same repetitive action. Tendonitis treatment aims to reduce pain and inflammation, and physical therapy methods designed to stretch and strengthen muscles have proven to be an effective treatment method.

  1. Controversies

While the term “contusion” refers to common injuries, people may also experience a small lump in the injured area and discolouration, as well as pain. The conditions are a type of hematoma that refers to a more serious injury to a tendon, ligament, or bone.

While confusion is mild, the combination of relaxation, ice, compression, and elevation promotes healing, while more serious controversies that affect more than the surface of the skin require physical therapist treatment.

  1. Concussions

Because concussions primarily affect brain tissue and often cause damage to brain function, they are considered soft tissue injuries. Those suffering from a concussion would most benefit from our comprehensive Concussion Rehab, wherein our trained therapists assess the cardiovascular, neurological, and orthopaedic effects of your concussion.

Treatment of soft tissue injuries

There are basically three steps to treating and recovering from soft tissue injuries, such as ankle sprains.

  • Step 1: During the first 24 to 72 hours, it is important to protect the injured area, get an accurate diagnosis, and follow the PRICE regimen (see below). If possible, a smooth and painless movement should be encouraged.
  • Step 2: Reduce swelling and stiffness and begin to regain normal movement.
  • Step 3: Return to normal performance and return to normal activities.

Price rule for soft tissue injuries

To protect

Minimize the use of the affected area and avoid stretching initially, as this will further weaken the damaged tissue.

If the injury is serious, protect it from further damage. Stop any activity that could aggravate the injury. It may be necessary to use crutches to lift weights from an injured knee, hip, or ankle injury. The sling helps protect the arm or shoulder.

Chill out

Relax and avoid activities that cause significant pain (for example, walking, raising your arm). Allocate adequate rehabilitation time even for minor injuries. Choose an alternative.


Wrap the ice cubes in a damp kitchen towel, use frozen peas or a sports ice pack. Use an ice pack for 15 to 20 minutes every three to four hours when you are awake.

It’s best to wrap ice in a cloth, as most cold products can trigger hypothermia or cold burns.


Apply a bandage that does not block circulation or cause additional pain. The bandage should cover the entire joint.


If possible, elevate the organ beyond the level of your heart to help reduce inflammation. Support the link with cushions or a sling.

Pain relief may also be necessary. If you do not know which medicine to use, your specialist physiotherapist, pharmacist, or GP can advise you.

What to avoid when you have Soft tissue injuries?

During the first 48 to 72 hours, it is important to avoid the following:

  • Hot
  • Increases blood flow and inflammation.
  • Alcohol
  • Increases blood flow and inflammation and slows down the healing process.
  • Massage
  • It promotes blood flow and increases inflammation and therefore increases damage if started too quickly.

Physical therapy treatment of Soft tissue injuries

An experienced physical therapist can evaluate your injury and confirm both the diagnosis and the extent of the damage. They will provide advice, treatments, and hand exercises that will promote a quick and effective recovery, as well as reduce the risk of further injury in the future. (See also “How to prevent running injuries”) Your specialist physical therapist will also advise you on a progressive return to normal activities and alternative exercises to follow when injured.

Prevent soft tissue damage

Serious soft tissue injuries happen suddenly, usually due to falls or slips. It is not always possible to avoid a traumatic accident. However, there are some steps you can take to reduce your risk, such as following safety protocols to prevent work-related injuries.

Chronic soft tissue injuries are usually caused by improper use of muscles or joints. Follow these tips to prevent chronic soft tissue injury:

  • Schedule rest periods between physical activities.
  • Do a variety of exercises.
  • Warm-up before exercise, then cool down

Dupuytren’s Contracture | Symptoms and Causes | Orthopaedics

What is Dupuytren’s contracture?

Dupuytren’s contracture is a fibrous layer of fibrous tissue that attaches to the skin under the palm and fingers. In patients with dupuytren, the attached fibrous tissue hardens and then hardens over time. This causes the fingers to be pulled inward toward the palm, resulting in what is known as the “Dupuytren’s contracture.”

In some patients, Dupuytren’s degenerative contractile function interferes with the function of the hand, making it difficult to maintain daily activities. When this happens, there are surgical and non-surgical treatment options available to help slow the progression of the disease and improve mobility of the affected fingers, complicating daily activities like putting hands in pockets and wearing them. Gloves or handshake.

Symptoms of Dupuytren’s contracture

Dupuytren’s contract tends to grow slowly, over the years. Usually, the condition begins as a tightening of the skin on the palm of the hand. As it develops, the skin on the palm of your hand may appear puffy or dull. A tight lump of tissue forms in the palm of your hand. This paste may be tender to the touch but is usually not painful.

In the later stages of Dupuytren’s contracture, strands of tissue form under the skin of the palm of the hand and can extend to the fingers. When these cables are taut, your fingers can pull into your palm, sometimes with great force.

Usually, two fingers of the big toe are affected, but the middle finger is also affected. The thumb and forefinger are rarely affected. Dupuytren’s contracture occurs in both hands, although one hand is usually more severely affected.

Causes of Dupuytren’s contracture

Doctors don’t know what caused Dupuytren’s contract. There is no evidence that occupations with hand injuries or hand tremors are the cause of this condition. Although reports of the Dupuytren contract first appeared in the medical literature in the 17th century, doctors still don’t know what causes scar tissue to form. This condition is inherited, so genes may be involved. Dupuytren’s disease is more common in middle-aged men, especially men of Northern European descent. The consumption of alcohol and tobacco also increases the risk of diabetes and epilepsy.

Risk factors for dupuytren’s contracture

Many factors are believed to increase your risk of disease, including:

  • Years: The Dupuytren contract occurs most often after 50 years.
  • Gender: Men have more serious contracts to develop duputrens than women.
  • Ancestors: People of Northern European descent are at increased risk of contracting the disease.
  • Family history: The Dupuytren contract is often hereditary.
  • Tobacco and alcohol: Smoking is associated with an increased risk of Dupuytren’s contracture, possibly due to microscopic changes in the blood vessels caused by smoking. Alcohol use is also associated with duputrens.
  • Diabetes: People with diabetes have been reported to have an increased risk of getting dupuytren.

Diagnosis of dupuytren’s contracture

Your doctor can usually determine if you have Dupuytren’s by feeling for thick scar tissue and seeing if your fingers are pulling inward. You can also have a “table” test where you can see if your hand, palm, is flat on the table. If not, you may have a contract that requires surgery. Your doctor may also test your grip and range of motion in your fingers.

Dupuytren’s contracture treatment

In mild cases, especially if hand function is good, only observation is needed. A lump in the palm does not mean that treatment is required or that the disease will progress. For more severe cases, various treatment options are available to straighten the finger(s). These options may include needles, injectable medicine or surgery.

Although it varies from patient to patient, Duputren generally develops very slowly and may not bother for many years. In fact, for some patients, the condition may go away without lumps developing in the palm of the hand. If the condition develops, your doctor may first recommend non-surgical treatment to help delay the disease.

Non-surgical treatment

  • Steroid injection: Corticosteroids are powerful anti-inflammatory drugs that are inserted into painful nodules. In some cases, the injection of corticosteroids slows the progression of the contracture. The effect of the steroid injection varies from patient to patient.
  • Neckline: Splinting to prevent the progress of finger contraction is unknown. Forced stretching of the contracted finger may not help and can actually cause injury to the finger or hand.
  • Splinting after surgery can be used for the Dupuytren contract to protect the surgical site; however, it is not known whether this reduces the risk of recurrent contraction or wound healing.

Surgical treatment

If the contraction interferes with the function of the hand, your doctor may recommend surgical treatment. The goal of the surgery is to reduce the contracture and improve the mobility of the affected fingers.

There is no known treatment for Dupuytren’s contracture; However, the surgery aims to “reset the clock” by reducing the limiting effect by interrupting or removing the strings. Unfortunately, healing tissue is formed with the same ability to develop cords in the future, but the gains in hand function remain significant.

Commonly performed surgical procedures for Dupuytren’s contracture:

  • Fasciotomy
  • Total palmar fasciectomy

Your doctor will discuss with you which procedure is best for you.


In this procedure, your doctor will make an incision in the palm of your hand and then divide the thickened cord (s) of tissue. Even if the cord is not removed, dividing it can help reduce the contracture and increase the mobility of the affected finger.

Fasciotomy is done with a local anaesthetic that numbs your arm before falling asleep. After the procedure, your wound will be left open and allowed to gradually heal. You will need to wear a splint during your recovery.

Total palmar fasciectomy:

During this procedure, your doctor will make an incision and then remove as much of the abnormal tissue and cord (s) as possible to straighten your fingers. A variety of incisions can be used in a fasciotomy, however, often a “zigzag” incision is made along the natural folds of the hand.

In some cases, your wound will be left open to gradually heal after a fasciotomy. In other cases, a skin graft is needed to heal the wound. For the skin graft, your doctor will take healthy skin from another area of ​​your body and use it to close the wound. You will need to wear a splint during your recovery.

Subcutaneous palmar fasciotomy is a much more complete procedure than fasciotomy. It typically involves more wound care and physical therapy, longer healing time for the patient, and more effort from the patient during recovery.

After Dupuytren’s surgery

Once the wound has healed, you will need physical therapy for a few months. The physical therapist will teach you exercises that will help you regain strength and mobility in your fingers. Even with successful surgery, Dupuytren’s contract may return. If that happens, you must have another focus.


As with any surgery, there are risks associated with Dupuytren’s contracture. The probability of problems increases with the following:

  • The intensity of the contract
  • Number of contracts settled in a single procedure
  • The presence of any other medical condition.

Your doctor will discuss each risk with you and take specific steps to prevent possible complications. Possible risks and complications of Dupuytren surgery:

  • Pain
  • Scar
  • Injury to nerves and/or blood vessels
  • Wound infection
  • Strength
  • Loss of sensation. Temporary loss of sensation may be due to prolonged stretching of a contracted nerve.
  • Loss of viability/loss of finger (rare)

Recovery of dupuytren’s contracture

Serious complications after surgery are not uncommon, but you should expect some pain, swelling, and stiffness. Although the goal of surgery is to improve digital straightening, patients sometimes lose flexion of the affected finger due to stiffness. Placing your hand over your heart and gently moving your fingers will help reduce swelling and improve visibility.

Physical therapy can help improve the strength and performance of the fingers and hands, reducing inflammation. Often, a hand therapist will make a splint for you to wear during recovery.


Plantar Fasciitis | Lifestyle and Home Remedies | Orthopaedics

What is plantar fasciitis?

Plantar fasciitis causes pain in the heel. The fibrous tissue attached to the sole of the foot is a thick tissue ligament that connects the heel to the forefoot. It acts as a shock absorber and supports the arch of your foot, helping you walk.

Plantar fasciitis is one of the most common orthopaedic complaints. The tendons that stick to your soles experience a lot of wear and tear in your daily life. Excessive pressure on your feet can damage or tear tendons. The fibrous tissue attached to the sole of the foot is inflamed, and the inflammation causes pain and stiffness in the heel.

Doctors once thought that bone growth called a heel spur caused pain. They now believe that heel spurs are the cause, not the cause, of plantar fasciitis.

Symptoms of plantar fasciitis

The main complaint of people with plantar fasciitis is pain in the lower part of the heel, or sometimes in the lower part of the middle part of the foot. It usually affects only one foot, but it affects both feet.

Plantar fasciitis pain develops gradually over time. The pain can be dull or sharp. Some people experience swelling or pain in the sole of the foot that extends outward from the heel.

The pain is usually in the morning when you take your first steps out of bed or when you sit or lie down for a while. Climbing stairs is very difficult due to the stiffness of the heel.

After prolonged activity, the pain becomes inflamed due to increased irritation or inflammation. People with plantar fasciitis generally do not experience pain during the operation, but only after stopping it.

Causes of plantar fasciitis

Active men and women between the ages of 40 and 70 are at increased risk of developing plantar fasciitis. It is slightly more common in women than in men. Pregnant women often experience plantar fasciitis, especially during pregnancy.

There is a risk of plantar fasciitis if you are overweight or behind. This is due to the increased pressure on the ligament that is attached to the sole, especially if you have a sudden weight gain.

If you are a long-distance runner, you are more likely to develop hair tissue problems. Being on your feet as often as working in a factory or a restaurant waiter also puts you at risk if you have a very active job.

If you have structural foot problems, such as very high arches or very flat feet, you can develop plantar fasciitis. Tight Achilles tendons, which are the ligaments that attach the calf muscles to the heels, can also cause pain in the hair tissue on the soles of the feet. Wearing shoes with soft soles and a poor arch can also lead to plantar fasciitis.

Plantar fasciitis is not usually the result of heel spurs. Doctors believe that heel spurs cause pain in people with plantar fasciitis, but this is not the case.

Risk factors for Plantar fasciitis

Although plantar fasciitis develops without an obvious cause, certain factors increase the risk of developing the condition. Among them are:

  • Years: Plantar fasciitis is most common between the ages of 40 and 60.
  • Some types of exercise: Activities that put a lot of pressure on the heel and attached tissues, such as long-distance running, ballet dancing, and aerobics, can contribute to plantar fasciitis.
  • Mechanics of the foot: Flat feet, high arch, or abnormal gait affect the way weight is distributed while standing and put additional pressure on the fibrous tissue attached to the soles of the feet.
  • Ob arrears: The extra pounds put extra pressure on the fibrous tissue that clings to the soles of the feet.
  • Occupations that put you on your feet: Factory workers, teachers, and others who walk most of their work hours or stand on rough surfaces can damage the plantar fascia.

Diagnosis of Plantar fasciitis

Plantar fasciitis is diagnosed based on your medical history and physical exam. During the test, your doctor will check the sensitive areas of your feet. The location of your pain can help determine its cause.

Imaging tests

Testing is generally not required. Your doctor may prescribe x-rays or magnetic resonance imaging (MRI) to make sure another problem, such as a stress fracture, is not causing you pain.

Sometimes an x-ray shows a piece of bone sticking out of the heel bone (spur). In the past, these bone spurs used to be the cause of heel pain and were removed surgically. But most people who have bone spurs in the heel do not have pain in the heel.

Plantar fasciitis treatment

Most people with plantar fasciitis recover in several months with conventional treatment, such as resting, applying ice, and stretching the painful area.


Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Olive) reduce pain and inflammation caused by plantar fasciitis.


Stretching and strengthening exercises or the use of special equipment can relieve symptoms. Among them are:

  • Physical therapy: The physical therapist can show you a series of exercises to stretch the capillaries and the Achilles tendon and strengthen the muscles in the lower leg. The therapist can teach you how to apply athletic taping to support the sole of your foot.
  • Night cracks: Your physical therapist or doctor may recommend wearing a splint that stretches your calf and arch of your foot while you sleep. Keeps fibrous tissue and the Achilles tendon attached to the sole of the foot at night to promote stretching.
  • Orthotics: Your doctor may prescribe ready-to-wear or custom arch supports (braces) to help distribute pressure more evenly on your feet.

Surgery or other procedures

If more conventional measures don’t work after several months, your doctor may recommend:

  • Injections: Injecting steroid medications into a sensitive area can provide temporary pain relief. Multiple injections are not recommended because they can weaken the fibrous tissue attached to the plant and cause it to break. Using ultrasound imaging, platelet-rich plasma obtained from the patient’s own blood can be injected to promote tissue healing.
  • Extracorporeal shock wave therapy: In this procedure, sound waves are directed to the site of heel pain to promote healing. It is commonly used for chronic plantar fasciitis that does not respond to conventional treatments. Some studies show good results, but it has not been shown to be consistently effective.
  • Ultrasound tissue repair: This minimally invasive technology was developed to some extent by doctors. It uses ultrasound imaging to guide a needle-like probe into the connective tissue of the damaged sole. Using the power of ultrasound, the probe tip rapidly vibrates to break down damaged tissue, which then absorbs it.
  • Surgery: Few people need surgery to separate the fibrous tissue that connects the sole of the foot to the heel bone. This is usually an option only when the pain is severe and other treatments fail. This can be done as an open procedure or through small incisions under local anaesthesia.

Lifestyle and home remedies

To reduce plantar fasciitis pain, try these self-care tips:

  • Keep a healthy weight: Carrying extra weight puts extra pressure on the fibrous tissue that clings to the soles of the feet.
  • Choose assistive shoes: Buy shoes with low to moderate heels, thick soles, good arch support, and extra cushioning. Don’t walk without sandals.
  • Don’t wear worn sports shoes: Change your old athletic shoes to support your feet and stop the cushion.
  • Change your sport: Try a low-impact sport like swimming or biking instead of walking or jogging.
  • Apply ice: Hold an ice pack covered with a cloth over the sore spot for 15 minutes three to four times a day. Icing helps reduce pain and inflammation.
  • Spread your bows: Simple home exercises can stretch the fibrous tissue, the Achilles tendon, and the calf muscles that attach to the soles of the feet.

Essential oils for plantar fasciitis

There is little research on treating plantar fasciitis with essential oils. However, some studies suggest that the use of essential oils can reduce pain and inflammation in some cases. These oils:

  • Lavender essential oil
  • Lemon essential oil
  • Eucalyptus oil
  • Rose essential oil

Make sure to dilute your essential oil with a carrier oil, like coconut oil, before using it for massage. You can inhale essential oil vapour mixed with hot water.

Since it is unclear if there is irritation or inflammation in plantar fasciitis, using these essential oils may not help much. However, if you use essential oils correctly, there is generally no harm in trying to see if you get the result.

Prevention of Plantar fasciitis

You can prevent plantar fasciitis by making a few lifestyle changes.

  • Wear supportive shoes with good arch support and replace your athletic shoes regularly. If you are a runner, the limit for each pair of shoes is 400 to 500 miles before buying new ones.
  • Include low-impact exercises like swimming or biking in your daily routine. Avoid overreacting the fibrous tissue that clings to your soles when you run too often. Before exercising, stretch your calves, your Achilles tendon, and the fibrous tissue attached to the soles of your feet.
  • Do your part to maintain a healthy weight. If you are overweight, try to lose weight to reduce pressure on the fibrous tissue that clings to your soles.

Recover from plantar fasciitis

For most people, plantar fasciitis improves within a few months after home treatment. These include relaxation, icing, and stretching.

You can also help the fibrous tissue that clings to your soles to heal by taping your foot down. This limits the amount of movement of the tendon. The source of several studies reviewed by the 2015 review suggested that pressing on the feet may also provide temporary pain relief.

You can use zinc oxide tape or kinesiology tape. It takes some practice, but you can bandage your foot yourself and help with the recovery process. Learn how to tape your foot to ease plantar fasciitis.


Osteoporosis | Everything You Need to Know | Orthopaedics

What is osteoporosis?

Osteoporosis is a condition that affects the bones. Its designation comes from the Latin for “porous bones”. The inside of healthy bone has small spaces, like a honeycomb. Osteoporosis rises the size of these seats, causing the bone to lose strength and density. Also, the outer part of the bone becomes weak and thin.

Osteoporosis can occur in people of any age, but it is more common in older adults, especially women. More than 53 million people in the United States have osteoporosis or are at high risk of developing it.

People with osteoporosis are at high risk for bone fractures or fractures while doing routine activities, such as standing or walking. The bones most commonly affected are the ribs, hips, and wrist and spine bones.

Symptoms of osteoporosis

Osteoporosis can be current without any symptoms for decades because osteoporosis does not cause symptoms until the bone disruptions (fractures). Also, some osteoporotic fractures can escape detection for years when they do not cause symptoms. Therefore, patients may not be conscious of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures is usually pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are alike to the symptoms of osteoporosis in women.

Fractures of the spine (vertebra) can cause severe band-like pain that emits from the back to the sides of the body. Over the years, repeated spinal fractures can lead to chronic low back pain, as well as a loss of height and/or curvature of the spine due to the collapse of the vertebrae. The collapse gives individuals a hunched appearance of the upper back, often called a “widow’s hump” because it is commonly seen in older women.

A fracture that happens during the course of normal activity is called a minimal trauma or a stress fracture. For example, some patients with osteoporosis develop stress fractures in their feet while walking or stepping off a sidewalk.

Hip fractures frequently occur as a result of a fall. With osteoporosis, hip fractures can happen as a result of trivial slip and fall accidents. Hip fractures can also heal slowly or poorly after surgical repair due to poor bone healing.

Causes of osteoporosis

Possible causes of osteoporosis include sure medical circumstances such as hyperthyroidism. They also include the use of certain medications.

Examples of these medications include long-term injected or oral corticosteroids, such as prednisone or cortisone.

Osteoporosis treatment

The treatment aims to:

  • Delay or prevent the development of osteoporosis
  • Maintain healthy bone mineral density and bone mass
  • Prevent fractures
  • Reduces pain
  • Maximize the person’s ability to go about their daily life
  • People at risk for osteoporosis and fractures can use preventive lifestyle measures, supplements, and certain medications to achieve these goals.

Drug therapy

Medications that can help prevent and treat osteoporosis include:

  • Bisphosphonates: These are antiresorptive drugs that slow bone loss and reduce a person’s risk of fracture.
  • Estrogen Agonists or Antagonists: These selective estrogen receptor modulators are also called SERMS by doctors. Raloxifene (Evista) is an example. These can reduce the risk of spinal fractures in women after menopause.
  • Calcitonin (Calcimar, Miacalcin): This helps prevent spinal fracture in postmenopausal women and can help control pain after a fracture.
  • Parathyroid hormone, such as teriparatide (Forteo): The United States Food and Drug Administration (FDA) has approved this hormone for the treatment of people at high risk of fracture, as it stimulates bone formation.
  • Monoclonal antibodies (denosumab, romosozumab): These are immune therapies that some people with osteoporosis take after menopause. Romosuzumab carries a black box warning from the FDA due to possible adverse effects. Other types of estrogens and hormone therapy can help.

The future of osteoporosis treatment

Doctors can use stem cell therapy to treat osteoporosis in the future. In 2016, researchers found that injecting a particular type of stem cell into mice reversed osteoporosis and bone loss in a way that could benefit humans as well.

Scientists trust that genetic issues strongly determine bone density. Researchers are investigating which genes are responsible for bone formation and loss in the hope that this may offer a new treatment for osteoporosis in the future.

Diagnosis of osteoporosis

Your healthcare provider may order a test to give you information about your bone health before problems start. Bone inorganic density (BMD) tests are also recognized as dual-energy X-ray absorptiometry (DEXA or DXA) scans. These x-rays use very small amounts of radiation to determine how strong the bones of the spine, hip, or wrist are. Regular X-rays will only show osteoporosis when the disease is very advanced.

All females over 65 should have a bone density test. The DEXA scan may be done earlier in women who have risk factors for osteoporosis. Men older than 70, or younger men with risk factors, should also consider having a bone density test.

Risk factors for osteoporosis

The risk of getting osteoporosis rises with age as bones naturally become thinner. After age 30, the rate at which bone tissue melts and is engrossed by the body slowly increases, while the rate of bone formation decreases. So in general, you lose a small amount of bone each year after age 30.

In women, bone loss is faster and typically begins after monthly menstrual periods stop, when the manufacture of the hormone estrogen in women decreases (usually between the ages of 45 and 55). The thinning of a man’s bones usually begins to develop gradually when his production of the hormone testosterone decreases, around 45 to 50 years of age. Women tend to have lesser and lighter bones than males. As a result, women develop osteoporosis much more often than men. Osteoporosis generally doesn’t have a noticeable effect on people until they are 60 years old or older.

Whether a person develops osteoporosis depends on the thickness of the bones (bone density) in the first few years of life, as well as future health, diet, and physical activity. Factors that raise the risk of osteoporosis in both males and females to include:

Having a family history of osteoporosis. If your mother, father, or brother has been diagnosed with osteoporosis or has suffered broken bones from a minor injury, you are more likely to develop osteoporosis.

Lifestyle factors for osteoporosis

These include:

  • Of smoking: People who smoke lose bone density faster than people who don’t smoke.
  • Alcohol consumption: Excessive alcohol consumption can decrease bone formation and increase the risk of falls. Heavy alcohol consumption is more than 2 drinks a day for men and more than 1 drink a day for women. See pictures of standard alcoholic beverages.
  • Get little or no exercise: Weight-bearing exercises, such as walking, jogging, stair climbing, dancing, or lifting weights, keep bones strong and healthy by working muscles and bones against gravity. Exercise can improve your balance and lower your risk of falls.
  • Being small or thin in complexion: Thin people and those with small bodies are more likely to develop osteoporosis. But being overweight puts women at risk for other serious medical conditions, such as type 2 diabetes, high blood pressure, and coronary artery disease (CAD). For more information, see the topic Weight Management.
  • A diet low in foods that contain calcium and vitamin D.
  • Have certain medical conditions: Some medical conditions, such as hyperthyroidism or hyperparathyroidism, increase the risk of osteoporosis.
  • Taking certain medications: Various medications, such as corticosteroids used for long periods of time, cause thinning of the bones.
  • Having certain surgeries, such as removal of the ovaries before menopause.

Other risk factors for osteoporosis can include:

  • Being of European and Asian descent, people are most likely to have osteoporosis.
  • Being sedentary or bedridden for long periods of time.
  • Dieting disproportionately or having an eating disorder, such as anorexia nervosa.
  • Being an athlete, if you have infrequent menstrual cycles due to low body fat.
  • Women who have finished menopause are at the highest risk of osteoporosis because their stages of the hormone estrogen decrease. Estrogen protects women from bone loss. Similarly, women who no longer have menstrual periods, either because their ovaries are not working properly or because their ovaries have been surgically removed, may also have lower levels of estrogen.

Complications of osteoporosis

How osteoporosis can cause vertebrae to wrinkle and collapse.

  • Bone fractures, mainly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures are often caused by a fall and can result in disability and even an increased risk of death in the first year after the injury.
  • In some cases, spinal fractures can happen even if you haven’t fallen. The bones that make up the spine (vertebrae) can weaken to the point of wrinkling, which can lead to back pain, loss of height and a stooped forward posture.

Prevention of osteoporosis

Good nutrition and regular exercise are essential to keep your bones healthy throughout your life.


Protein is one of the structure blocks of bones. However, there is conflicting evidence on the impact of protein intake on bone density.

Most people eat a lot of protein in their diets, but some don’t. Vegetarians and vegans can get enough protein in their diet by intentionally seeking out suitable sources, such as soybeans, nuts, legumes, seeds for vegans and vegetarians, and dairy and eggs for vegetarians.

Older adults can eat less protein for a number of reasons. If you think you are not getting enough protein, ask your doctor if supplementation is an option.


Being underweight increases the chance of bone loss and fractures. It is now known that being overweight increases the risk of arm and wrist fractures. As such, maintaining appropriate body weight is good for your bones as well as your overall health.


Males and females between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when females turn 50 and men turn 70.

Good sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products, like tofu
  • Calcium-fortified cereals and orange juice

If you find it difficult to get sufficient calcium from your diet, consider taking calcium supplements. However, too much calcium has been related to kidney stones. Although it is not yet clear, some experts suggest that too much calcium, especially in supplements, can increase the risk of heart disease.

The Division of Health and Medicine of the National Academies of Sciences, Engineering, and Medicine (formerly Institute of Medicine) recommends that total calcium intake, from supplements and diet combined, should not exceed 2,000 milligrams per day for older people 50 years.

Vitamin D

Vitamin D recovers your body’s aptitude to absorb calcium and recovers bone health in other ways. People can get some of their vitamin D from sunlight, but this may not be a good source if you live at a high latitude, are confined to your home, or use sunscreen regularly, or avoid the sun due to the risk of skin cancer.

To get enough vitamin D to maintain bone health, adults ages 51 to 70 are recommended to receive 600 international units (IU) and 800 IU per day after age 70 through food or supplements.

People without other sources of vitamin D and especially with limited sun exposure may need a supplement. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for most people.


Exercise can help you build strong bones and decrease bone loss. Exercise will benefit your bones no matter when you start, but you’ll get the most benefits if you start exercising regularly when you’re young and continue to do so throughout your life.

Combine strength training exercises with weight lifting and balance exercises. Strength training helps strengthen the muscles and bones in the arms and upper spine. Weight-bearing exercises, such as walking, jogging, running, stair climbing, jumping rope, skiing, and impact sports, primarily touch the skeletons of the legs, hips, and lower spine. Balance exercises, such as tai chi, can reduce the risk of falls, especially as you age.

Swimming, biking, and exercising on machines like elliptical can provide good cardiovascular exercise, but they don’t improve bone health.