Cervical Spondylosis

Cervical Spondylosis

Cervical Spondylosis has become extremely common these days. These are more than 85% people suffering from this condition. Cervical Spondylosis is a degenerative condition of the cervical spine caused by age-related changes in the intervertebral disc. It is very common in people above 50 years of age and those who sit on computers typing or keeping the neck in one position while reading, writing, etc.
This may be ligamentous or muscular and could be either localized or radiating in nature. This involves changes to the bones, disc, and joints of the neck. The disc of the cervical spine break down, lose fluids and become stiffer, resulting in reduced space between two vertebrae later spurs or osteophytes forms on the bones of the neck. The osteophytes formed may compress the cord which will produce weakness of the whole limb.

Causes of Cervical Spondylosis:

Aging – This is age related condition degenerative changes occurs in the intervertebral disc.

Poor Posture – Posture adopted due to wrong habits while sitting or working with keeping the neck in one position, anxiety and stress can lead to severe damage.

Occupational – Typist working on wrongly positioned desks. Person lifting or carrying things on their head. Prolonged driving, Habit of holding the phone on one shoulder while talking, Using a thick pillow while sleeping.

Injury – Any injury or jerky movement may be the cause of cervical spondylosis.

What are the Cervical Spondylosis Symptoms:

Neck Pain – Depends on the site of the cervical spine affected and could be a headache, neck pain, radiating pain in shoulders, arms. Pain is sometimes sharp and cramp type in nature. There could be some stiffness with limited movement and tightness in neck muscles.

Muscle Weakness – Due to compression of the nerves, the muscle that is connected with nerves get affected and weakened.

Sensation – The pain may be present with tingling, numbness which occurs due to compression of nerves sometimes altered sensation.

Inability to move Neck – The neck movements becomes limited either unilateral or bilateral.

Muscle Spasm – There are muscle spasm and tightness present in the neck.

Cervical Spondylosis is usually associated with a headache, vertigo and loss of balance which is due to postural changes. Neck discomfort becomes severe in the morning and at the end of the day. The symptoms improve with the rest.

Cervical Myelopathy

The Cervical Spondylosis results in the pressure on spinal chord and this condition is known as Cervical Myelopathy. It includes tingling, numbness or weakness of the arms, hands, legs and feet. The patient may experience a lack of coordination and difficulty in walking, muscle spasm, abnormal reflexes and loss of control over bladder or bowel.

Cervical Radiculopathy

cervical radiculopathy occurs when bone spurs put pressure on nerves and cause loss of function, irritation, compression of nerve root of the neck. Pain radiates down into one or both arms are the common symptoms.

Diagnosis – Physical Examination, X-Rays, CT Scan and MRI

Treatments – Symptoms improves with the rest. NSAID may be used to relieve pain and inflammation. The cervical collar can be used to limit movement and to provide support. Injecting drugs like corticosteroids can be used to relieve pain. Physical therapy helps in relieving the pain in great amount. Further, the patient has to be educated for posture correction, strengthen the cervical muscles with the use of heat modalities, manipulative therapy, soft tissue techniques, traction, etc.

Surgery – Surgery is required only in rare cases. Surgery is performed to remove the source of pressure on the spinal cord and nerves. The surgery is done for stabilization in the form of implants or through the fusion of the vertebrae. But surgery is considered only when there is severe loss of function like progressive loss of function in arms, legs, feet or fingers. Any cord compression could result in permanent disability.

Surgery is performed on either front or back of the neck bones. The front procedure includes removal of discs and spurs that are causing compression. The disc may be replaced with an implant. Removal of both disc or parts of vertebrae. These parts are replaced with a bone graft or implant.

The back procedure includes Laminectomy or a Laminoplasty. In Laminectomy the lamina and the spinous process of the vertebrae are removed. While in Laminoplasty the vertebrae are left in the place but are cut free along one side. Both the procedures relieve pressure on the spinal cord or nerves and the surgery is usually followed by the rehabilitation program.

For free consultation get in touch with our Physiotherapist in Dehradun – Dr.Sapna Diwaker.

Low Back Pain

Low Back Pain

Low Back Pain or Low Back Ache (LBA):

LBA is one of the most common presenting symptoms which affects most of us in our daily living. Low Back Pain may be associated with the lumbar spine, vertebral discs, ligaments, spinal cord and nerves, muscle, abdomen and pelvic internal organs. The low back functions as a support to the upper body weight when we stand and provides mobility while we bend, extend or rotate. The lower back also protects the tissues of the nervous system, spinal cord and organs of the pelvis and abdomen.

Causes of low back pain:

Strain: Back muscle or ligament strain is the common cause for back pain. Sometimes while lifting a heavy weight or sudden movement can cause muscle or ligament tear.

Lumbar radiculopathy: Pain comes due to compression or inflammation of a spinal nerve. The pain radiates into the lower extremity ie: thigh, back, calf and sometimes foot following a specific spinal nerve.

Arthritis: Osteoarthritis, Rheumatoid arthritis could be the cause of a backache. This condition results from wear and tear of disc and facet joint causes pain, inflammation, instability.

Congenital bone condition: Congenital bone condition like scoliosis, Spina Bifida etc leads to the breakdown of the discs, facet joint, which causes pain.

Trauma: Low back pain develops after a trauma such as a fracture, dislocations of the spine.

Infection: Infection can be caused by after surgery, injections or through the blood stream which can lead to severe pain.

Tumor: The tumor of spine spread from cancer of breast, prostate, kidney, thyroid or lungs and develops a common symptom of back pain.

Pregnancy: During pregnancy, there is gaining in weight and the spine has to support that weight. Also, the weight of uterus puts pressure on nerves and blood vessels which cause pain in the back.

Types of Low Back Pain:

There are two types of low back pain.
1) Mechanical pain: The mechanical cause of pain is from muscles, ligaments, joints or bones of the spine. Pain is localized and tends to the lower back, buttocks and sometimes top of the legs.

2)Radicular pain: The pain can occur if a spinal nerve root becomes impinged or inflamed. Pain follows nerve root pattern with numbness or weakness.

Diagnosis:
The x-ray, MRI or CT scans findings can diagnose for any degenerative changes, herniated disc, problem with muscles, tissues, nerves, ligaments, aggravate the blood vessels and bones. Blood test helps to determine for any infection.

Physical Therapy: Physical therapy contributes a major role in low back pain rehabilitation

Rest: Rest helps in relieving pain and improves healing.

Heat and Ice Therapy: Heat increases blood flow and relaxes tightened muscles and improves healing and increases flexibility. Whereas ice or cold packs helps in reducing inflammation and swelling present in the muscles which cause painful low back.

Exercises: Stretching and strengthening exercises are beneficial for the low back, buttocks, hips and legs and helps in relieving low back pain and stiffness. Regular exercises are useful in maintaining the range of motion and flexibility of the spine.

Back Braces: Use Back braces to support and comfort to reduce the pain of the low back.

Massage: Massage can retrieve the muscle spasm and relieve pain by increasing blood flow to the low back which promotes healing.

Other common medical treatments:

Muscle relaxants: It helps in relieving pain, increases the mobility of muscles, reduces muscle spasms and tightness.

Pain Medication: Mostly usage of Opioids or painkillers are often seen for treating acute pain. As they have side effects they are rarely used for long-term.

Epidural steroid injections: The steroid injections is used to temporary pain relief and reducing inflammation due to nerve compression.

Surgery for low back pain: Surgery may be advised in severe back pain only when patient is unable to perform daily living functions or low back pain does not get better even after nonsurgical treatment.

Back Care Advice:

  • Always stand and walk tall.
  • Make sure your back is fully supported while sitting.
  • Always try to maintain good posture.
  • Make sure your mattress should be firm.
  • Exercise regularly to keep strengthen your back.
  • Always lift objects close to your body. Bend your knees and hips and never bend or twist your back.
  • Avoid prolonged standing and sitting.
  • Maintain a healthy diet and stop smoking.
  • At the workplace, while working on a computer make sure the chair is at the right level of the desk and has proper back and arm rest.

For free consultation get in touch with our Physiotherapist in Dehradun – Dr.Sapna Diwaker.

Frozen Shoulder and Diabetes

Frozen Shoulder

Frozen Shoulder

Nowadays Frozen Shoulder (Adhesive Capsulitis) has become the most common condition and a very common complication associated with it is Diabetes.

Yes, Diabetes could be the cause of frozen shoulder. Let us know that why Diabetes is a common complication of frozen shoulder and what actually happens in this condition.

Frozen Shoulder or Adhesive Capsulitis is a pathological condition where two layers of synovial membrane become adherent to each other. It is a restrictive condition of the shoulder with pain, stiffness and limited range of movement. It may happen due to injury, diabetes, stroke or surgery. Usually, it takes 2-8 months to develop this condition and shoulder movement becomes difficult and painful.

Mostly in Diabetes, due to a high level of glucose, there may be a change in the connective tissues. The collagen fibers in the joint slide along one another during movement and furthermore sticks together by the level of glucose. This will limit the capacity of joint and become frozen shoulder.

How to diagnose Frozen Shoulder:

Mostly, In X-Ray evaluation, there is no specific diagnosis except degenerative changes. Only physical examinations would be helpful for any limited range of shoulders.

What are the treatments:

The patient with diabetes responds very slow and feels more pain as compared to Non-diabetic.

Drugs:

Mostly NSAIDs or Corticosteroid injections may also be used to reduce pain and inflammation.

Physiotherapy:

Physiotherapy helps to reduce pain, stiffness and increase the range of movement. Heat application to the affected part followed by gentle exercises or stretching is quite helpful. One can use ice to reduce pain and swelling. Furthermore, Exercises play a major role in the management of frozen shoulder. Regular stretching exercises are must even after the relieve from pain and stiffness to avoid reoccurrence.

Benefits of Exercise on Frozen Shoulder and our body:

In today's tough and hectic schedule of life, we have almost lost ourselves and are not actually aware that our negligence would affect our physical, mental and social activities. Therefore, we should take out time to concentrate and to maintain a good and healthy life.

For a good and healthy life, make regular exercise as a part of your daily routine. According to a scientific research people who exercise regularly are healthier, physically and mentally have more energy, think more clearly and sleep better. So, let us see what are the benefits of exercises:

  • Exercises maintain and increases muscle strength, improves balance, coordination, reaction time and finally flexibility.
  • Helps to control hypertension, high blood cholesterol and diabetes.
  • Improve immune system and hence reduces the risk of any illnesses.
  • Helps in reducing body fat.
  • Exercises improve oxygen flow to the brain, improves memory and oxygenate the body.
  • Manages chronic pain like OA and RA by increasing mobility of joints.
  • Exercise reduces stress by releasing a chemical called endorphins from the brain to fight stress and make us feel good.
  • More physical activity helps to sleep better.

Hence, exercises have many physical and phycological reasons to live a happy and healthier life. Before you start any exercise consult your doctor and fitness trainer. They will definitely guide you according to your age and health.

For free consultation get in touch with our Physiotherapist in Dehradun - Dr.Sapna Diwaker.