diseases-and-management

Tips for prevent your back pain

Sun, 09 Nov 2008 06:49:04 +0100

· Don't lift by bending over.

-Lift an object by bending your knees and squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting.

· Don’t push, when you must move heavy objects pull the object.

· Don’t sit long time.

-If you must sit at your desk or at the wheel of a car or truck for long hours, break up the time with stops to stretch.

· Wear flat shoes or shoes with low heels (1 inch or lower).

· Exercise regularly. An inactive lifestyle contributes to lower back pain.

· When you sit strait your back. It is beater use back support of chair.

You must call doctor if-

· Pain goes down to leg.

· If you feel numb Your leg, foot, groin or rectal area.

· You have fever, nausea or vomiting, stomachache, weakness or sweating.

· You lose control over going to the bathroom.

· If it is injury pain.

Pregnant women and back pain

Eighty percent of women will experience back pain at some point during their pregnancies. The severity of this pain during pregnancy ranges from mild discomfort after standing for long periods of time to debilitating pain that interferes with daily life. Although back pain can be a sign of a more serious condition, including labor, in most cases, it is the result of changes happening within the body.

Factors that influence back pain during pregnancy

The spine is vulnerable due to the following factors during pregnancy:

· Hormone production during pregnancy makes joints less stable (to allow the pelvis to spread as the baby grows)

· Typical weight gain of 25-35 pounds during pregnancy, with the majority or extra weight distributed around the abdomen

· Increase in postural strain as the body compensates for changes in the pregnant woman’s center of gravity

Although it may seem enticing to rest when experiencing pain and not undertake an exercise routine, gentle stretching and movement will often decrease muscle spasm and restore improved spinal function, resulting in decreased pain (1). Exercise also boosts energy levels and contributes to an easier labor, delivery and post partum recovery. The components of a balanced exercise program during pregnancy include cardiovascular, strength and flexibility training.

Cardiovascular exercise for back pain during pregnancy

An activity that increases the body’s heart rate for a sustained period of time is considered cardiovascular exercise. Walking, biking, and swimming are all considered safe for most pregnant women and can be performed for 20 to 45 minutes, 3 to 5 days a week. Pregnant women should take care to exercise at a mild to moderate level, but not to the point of exhaustion. Keep in mind that any exercise is better than none, so even a 10 minute walk at lunch time is beneficial.

Strengthening exercises for back pain during pregnancy

Strengthening the abdominal muscles, back muscles, pelvic floor, buttock, and thigh muscles can effectively help prevent and decrease back pain. It is recommended that the strengthening exercises be performed in a slow and controlled manner. The strengthening poses can be held for 3 to 10 seconds and repeated 10 to 30 times. Breathe out during the exertion phase of the exercise and inhale as you relax. The following are suggested exercises for each of the major muscle groups mentioned:

· Pelvic Tilts (for abdominal muscles): The simplest way to learn the pelvic tilt is to lie on the back with knees bent, feet resting on the floor. Place your hand in the small of your back, and you will most likely notice a space between your back and the floor. Now try to flatten the lower part of the spine against the floor, so that you feel no space between your back and the floor. The buttocks should be relaxed in order to isolate the abdominals. The pelvic tilt can be performed while lying on your back, standing, on your hands and knees, or sitting.

· Arm and Leg Raises (for back muscles and buttock): Kneel on your hands and knees with a straight spine. Do a pelvic tilt to keep your pelvis stable and then lift your right arm and left leg to form a straight line with your spine. Pause in this position and then slowly lower your arm and leg. Alternate lifting the opposite arm and leg. If you have difficulty keeping your balance in this position, modify the exercise by performing only the leg or arm raises separately.

· Kegels (for pelvic floor muscles): To exercise the pelvic floor muscles, try to envision pulling the muscles of the vaginal area up and in towards your baby. You should not feel your buttocks, thighs, or abdominals tightening as you do this.

· Wall Squats (for abdominal muscles, buttock muscles and thigh muscles): Stand with your head, shoulders, and back against a wall with your feet about 1 to 2 feet away from the wall. Press your lower back into the wall and squat as if you were going to sit down, with the knees approaching a 90-degree angle. Come back up slowly, keeping your back and buttocks in contact with the wall.

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Stretching exercises for back pain during pregnancy

Stretching is at least as important as cardiovascular and strength training for back pain prevention and treatment during pregnancy, so try not to sacrifice this crucial component of the exercise program. In order to improve flexibility, it is recommended that stretches be performed daily after you are warmed up. Hold the stretches (never bounce) for 20 to 30 seconds, and repeat 3 times.

Although there are many stretches that can safely be performed during pregnancy, the muscles that most often contribute to back pain are the back, hamstring (in the back of the thighs), and chest and neck muscles.

· Back stretch: Start on your hands and knees, with your legs wide apart and hands placed forward just a little in front of your head. Place a small pillow under you to give support to your abdomen, if needed. Sit back on your knees and stretch your arms forward to feel a stretch along the spine.

· Hamstring stretch: Face a chair and place one foot up on it, keeping both hips and feet facing forward. Keep your back straight and lean forward from your hips to feel a stretch in the back of the thigh. If you can’t stand tall or your knee bends, try a lower step.

· Chest stretch: Stand with your head upright and with your back straight. Clasp your hands behind your back, and without leaning your shoulders forward, gently stretch your arms up and back to feel a stretch in the front of your shoulders and arms.

· Neck stretch: Sitting or standing, bring your head forward and tipped to one side. With the hand on the same side as your head is tipped, reach up behind your head and give a gentle pull. Turning your head as you pull can help isolate the specific neck muscles needing stretching.

Due to the multitude of changes happening within the pregnant body, back pain tends to be a common complaint, and exercise is a simple way to achieve comfort and relief during this exciting time. It is important to always discuss your symptoms with your health care provider to ensure exercise is appropriate for you and to be informed of any guidelines or restrictions that may be recommended. Some pregnant women may benefit from more intensive or individualized treatment for their back pain.

Ankle Sprains: Healing and Preventing Injury

Sat, 08 Nov 2008 11:51:40 +0100

What is a sprain?

A sprain is a stretched or torn ligament. Ligaments connect one bone to another bone at a joint and help keep the bones from moving out of place.

The most common site of sprains is the ankle. An ankle sprain can happen when you fall, when you suddenly twist your ankle too far, or when you force the joint out of it's normal position (for example, when you land awkwardly on your foot after jumping). Most ankle sprains occur during sports activities or when walking or running on an uneven surface.

The signs of an ankle sprain can include:

pain or tenderness
swelling
bruising
inability to walk or bear weight on the joint
stiffness

The severity of an ankle sprain depends on how badly the ligaments are stretched or torn. If the sprain in mild, there may not be much pain or swelling, and the ligaments may only be stretched. If the sprain is severe, one of more ligaments may be torn, and the join may be severely swollen. A severe sprain can also be extremely painful.

How are ankle sprains diagnosed?

Your doctor will usually be able to tell if you have a sprain by asking you some questions about how the injury occurred and by examining your ankle. You doctor may also want to take an x-ray of your ankle to make sure that it's not fractured or broken.

How can ankle sprains be treated?

Many doctors suggest using the RICE approach--Rest, Ice, Compression, Elevation--for treating ankle sprains (see the box below).

RICE approach

Rest--You may need to rest your ankle, either completely or partly, depending on how serious your sprain is. Use crutches for as long as it hurts you to stand on your foot.

Ice--Using ice packs, ice slush baths or ice massages can decrease the swelling, pain, bruising and muscle spasms. Keep using ice for up to 3 days after the injury.

Compression--Wrapping your ankle may be the best way to avoid swelling and bruising. You'll probably need to keep your ankle wrapped for 1 or 2 days after the injury and perhaps for up to a week or more.

Elevation--Raising your ankle to or above the level of your heart will help prevent the swelling from getting worse and will help reduce bruising. Try to keep your ankle elevated for about 2 to 3 hours a day if possible.

Will I need to wear a brace?

This will depend on how serious your sprain is, if you have other ankle injuries and how your doctor thinks your sprain should be treated. You may need to wear a brace or padded plaster, plastic or fiberglass splint for 10 days to 6 weeks. A brace or splint keeps the bones and injured ligaments from moving, which reduces pain and speeds healing.

How long before I can use my ankle?

This depends on how serious your sprain is. If your sprain is mild, your doctor may suggest that you start trying to use your ankle again fairly soon--from 1 to 3 days after your injury.

Special exercises are sometimes needed to regain strength and to help reduce the chance of ongoing problems. Your ankle may need to be supported by taping or bracing to help protect it from reinjury.

What about medicine for pain?

If you need medicine to ease the pain, try acetaminophen (brand name: Tylenol) or ibuprofen (brand names: Advil, Motrin, Nuprin).

What is the best way to use ice?

Putting ice on your ankle can be very helpful, but you also need to be careful. The cold can damage nerves if the ice is left in place too long.

Ice can be left on your ankle for up to 20 minutes at a time. When your skin feels numb, it's time to remove the ice. Use ice treatments every 2 to 4 hours for the first 3 days after your injury. Ice treatments can consist of ice packs, ice slush baths or ice massages.

To use ice packs, partly fill a plastic bag with crushed ice. Wrap a thin, wet cloth around your injury. Place the ice pack over this and then wrap an elastic bandage around the ice pack to hold it in place.

For ice slush baths, fill a large bucket with water and ice. Place your ankle in the bucket until the skin gets numb.

Ice massages can work well for small areas. Freeze water in 4- to 8-ounce styrofoam (coffee) cups. Tear the top part of the cup away from the ice. Hold the covered end and slowly rub the ice over the sprained area with a circular motion. Don't hold the ice on one spot for more than 30 seconds.

How do I wrap a sprained ankle?

Start by cutting out a horseshoe-shaped pad from 1 x 4- to 3 x 8-inch-thick felt. Put this pad around the outside of your ankle joint on both sides of your foot, with the open end facing up.

Then wrap an elastic bandage, such as an Ace bandage, in a basket-weave "figure-of-eight" pattern. Leave your heel exposed. Reinforce your wrap with 21 x 2-inch adhesive tape over the elastic bandage.

Ask your doctor to show you how to do this. The ankle shouldn't be wrapped so tightly that the blood flow is cut off.

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How soon can I exercise or play sports?

If you're an athlete, you'll probably be able to return to your sport in several weeks, depending on how serious your injury is and what sport you're involved in. When participating in sports, you may need to keep your ankle braced or wrapped for support and protection.

Bicycling, swimming or even running are usually okay to return to right away if they don't cause pain during or after exercise. But you'll still need to avoid pivoting and twisting movements for 2 to 3 weeks.

How can I prevent reinjury?

When your doctor feels you're ready to exercise again, you can help prevent further sprains and setbacks by wearing a semirigid ankle brace when you exercise for another 1 to 2 months.

Special wraps that use hook and loop fasteners, or air-filled or laced braces may also help prevent reinjury. Wearing high-top tennis shoes may also help prevent ankle sprains if your shoes are laced snugly and if you also tape your ankle with a wide, nonelastic adhesive tape. Elastic tape or braces are usually not helpful because the elastic gives too much around the joint.

Once your sprain has completely healed, a program of ankle exercises will also help prevent reinjury by making the muscles stronger, which provides protection to the ligaments. Ask your doctor to recommend an exercise program.

KNEE PAIN

Thu, 06 Nov 2008 13:27:43 +0100

Understanding what is causing your knee pain must be understood in the context of the pain. How old are you? Was there a traumatic event? Where is the pain located? Did the symptoms develop immediately or over time?

Once these questions are answered, you can begin to investigate the symptoms. Putting the symptoms together with the history often leads to a diagnosis.

Common Knee Symptoms

Popping
Popping and snapping within the knee is quite common, and often not a symptom of any particular problem. When the pops or snaps are painless, there is usually no problem--the bigger concern is when these sounds are associated with pain. A pop is often heard or felt when a ligament, such as the ACL, is torn.

Crunching/Grinding
A sense of grinding or crunching is most often associated with bone grinding against bone once the cartilage is worn away. This is commonly found in arthritis. Patients who are young (under 50 years old) seldom have arthritis that will cause these severe symptoms, unless there has been a severe injury to the knee in the past.

Locking

Picture of knee locking

Locking is a symptom that occurs when a patient cannot bend or straighten their knee. The locking can either be due to something actually blocking motion of the knee (this can occur when a piece of cartilage wedges within the joint) or when pain prevents the patient from moving the knee. These two causes must be differentiated, as something physically caught in the joint should be evaluated in a timely manner. Often injecting the knee with numbing medication can help determine the cause of locking.

Giving-Way/Instability
The stability of the knee is provided by the ligaments that connect the shin bone (tibia) to the thigh bone (femur). When the ligaments are stretched or torn, the knee may feel as though it is giving way beneath the patient. A sensation that the knee may give out from beneath you is a common symptom of ligament injury.

Swelling

Picture of knee swelling

Swelling of the knee is common with several different knee problems. When there is swelling immediately after an injury (within an hour), the most common causes are an injury to the anterior cruciate ligament or a fracture of the top of the shin bone. When swelling develops gradually over hours to days, the injury is more likely a tear of the meniscus or a ligament sprain. Swelling that occurs without the presence of a known injury can be due to arthritis (common), gout (less common), or a joint infection (uncommon).

Location of Pain
The location of the pain can be an important part of tracking down the symptoms.

· Front of the knee: Pain over the front of the knee is most commonly related to the knee cap. Kneecap pain can be caused by several different problems.

· Inside of the knee: Pain on the inside, or medial aspect, of the knee is commonly caused by medial meniscus tears, medial collateral ligament injuries, and arthritis of the joint.

· Outside of the knee: Pain on the outside of the knee, or lateral aspect of the knee joint, is commonly caused by lateral meniscus tears, lateral collateral ligament injuries, IT band tendonitis, and arthritis of the joint.

· Pain in the back of the knee: Pain in the back of the knee can be due to the formation of a cyst, called a Baker's Cyst, in the back of the knee joint. Also common is for kneecap pain to be felt in the back of the knee.

Timing of Pain
Some common situations cause pain typical of certain conditions.

· While going down stairs: Pain while walking down steps is very commonly associated with kneecap problems, such as chondromalacia.

· Morning pain: Pain after first waking in the morning that resolves with gentle activity is typical of early arthritis. Often patients loosen the knee over the course of the day.

Tests to Detect a Meniscus Tear

memiscus tear test

Joint Line Tenderness

· Joint line tenderness is a very non-specific test for a meniscus tear. The area of the meniscus is felt, and a positive test is considered when there is pain over the area where the meniscus is found.

· McMurray's Test
McMurray's test is performed with the patient lying flat (non-weight bearing) and the examiner bending the knee. A click is felt over the meniscus tear as the knee is brought from full flexion to 90 degrees of flexion.

· Ege's Test
Ege's test is a specific maneuver to detect a meniscus tear. With a patient squatting, an audible and palpable click is heard/felt over the area of the meniscus tear. The patient's feet are turned outwards to detect a medial meniscus tear, and turned inwards to detect a lateral meniscus tear.

Tests to Detect Ligament Injury

Picture of posterior ligament test

· Lachman Test
The Lachman test is the best test to diagnose an ACL tear. With the patient lying flat and relaxed, the examiner bend the knee slightly, about 20 degrees. The examiner then stabilizes the thigh while pulling the shin forward. Both the amount of translation (shifting) as well as the feel of the endpoint offer information about the ACL.

· Anterior Drawer Test
The anterior drawer test is also performed with the patient lying flat. The knee is bent 90 degrees and the shin is pulled forward to check the stability of the ACL. An intact ACL will only allow the shin to come forward slightly. A torn ACL will allow the shin to move further forward.

· Pivot Shift Test
The pivot shift test is a difficult maneuver to perform on a patient who is not under anesthesia. This test places a stress on the knee joint that forces a subluxation (partial dislocation) in patients who do not have an ACL. This test recreates the type of instability that caused the ACL injury.

· Posterior Drawer Test
The posterior drawer is performed similarly to the anterior drawer test. This test detects injury to the PCL. By pushing the shin backward, the integrity of the PCL is tested. Excessive movement of the shin backwards is a sign of PCL injury.

· Varus and Valgus Instability
Varus and valgus instability tests check the LCL and MCL, respectively. With the patient lying flat, and the knee held at about 30 degrees of flexion, the shin is shifted to each side. Insufficiency of the LCL or MCL will allow the knee to "open up" excessively. The test is repeated with the leg straight. If the knee still opens up excessively, then more than just the LCL or MCL was torn.

· Dial Test
The dial test checks the rotation allowed at the knee joint. Patients who have posterolateral rotatory instability, may have excessive rotation at the knee joint. The test is done with the patient lying face down, and the knees bent about 30 degrees. The feet are turned outwards and compared to each other. Excessive rotation is a sign of posterolateral corner injury.

Tests to Detect Kneecap Problems

· Patellar Grind Test
Patellar grinding is a nonspecific test where the examiner feels for abnormal grinding sensations under the kneecap with movement of the joint. If pressure on the kneecap recreates the symptoms this may indicate the kneecap is the culprit.

· Patellar Facet Tenderness
The examiner can slightly lift up the kneecap and place direct pressure on the undersurface of the kneecap. By doing so, the examiner is looking for sensitive regions of cartilage underneath the kneecap.

· Patellar Apprehension Test
Patellar apprehension is a sign of an unstable kneecap. While the examiner places pressure on the kneecap, the patient may complain of the sensation that the kneecap is going to 'pop out' of its groove. This is a sign of kneecap instability.

Some tips to prevent neck pain

Thu, 06 Nov 2008 12:33:20 +0100

Neck pain:-

Neck pain is the common in our life. Usually after 50 years old every body suffer neck pain. The pain may referred up to fingers. Shoulder some time chest.

Now young people also suffer neck pain because of bad posture and job related.

Below some picture of bad and correct posture:-

Correct posture when work with computer

Correct and incorrect posture when driving

Correct and incorrect posture when sleeping

Some tips to prevent neck pain:-

1. Avoid longtime (usually not more than 15 minutes) one position.

2. Do not carry heavy weight in one hand.

3. If need carry both hand.

4. If you feel pain in neck do not try move neck.

5. Do regular neck exercise that show the physiotherapist.

6. Do not bend neck forward longtime.

7. If you do deck jobs sit strait.

8. Use hand support when write longtime.

9. Computer monitor must be eye level

10. Maintain correct posture.

11. Use orthotic pillow when suffering neck pain.

Cervical collor

Hard cervical collor

Orthopedic Neck Pillow-