SPRAINS, STRAIN, FRACTURE, AND DISLOCATIONS

Traumatic injuries cause damage to tissues. The incidental rupturing of ancillary and primary blood vessels supplying these tissues internally bleed at the site of trauma. The blood supplies normally bring nutrients, oxygen, and remove waste materials and metabolic by-products from tissues. With damage, the delicate piping systems of blood vessels rupture at smaller capillary, aterioli, venule, and even in larger blood vessels yielding profuse bleeding. This bleeding is what causes the swelling at the site of the injury. The injury is enclosed within the skin creating increased fluid/blood pressure inside the body. When the traumatic site fills and expands with bleeding, it tamponades the traumatic site. This occurs by increasing he site’s inner body pressure at or above the person’s normal blood pressure. This pressure is what finally stops the bleeding naturally.

The heart pumps blood out to the tissues in the arteries. About 99% of all blood pumped out of the heart is returned by the venous return system. Being an enclosed plumbing system, the arterial pressure via the capillary bed drives the blood back to the heart by the pressure in the enclosed venous system. The generally low negative right-sided heart, allows natural decreased pressures to direct blood from the venous systems back into the heart. This allows the blood to be re-circulated and be pumped again and again by the heart.

LYMPHATICS:  In addition to the heart, artery, and venous systems, there is a passive lymphatic pip system form the tissue sites back to the heart. This lymphatic system acts as a cleaning sewage system allowing extra fluid not removed by the veins to drain from the capillary beds and trauma site, via the venous system, and finally to the heart. Lymphatic vessels have one-way valves and pumps. These passive pumps called lymph nodes are located behind joints or at sites of pressure from physical movement. They are much like a hose with a bulb and a valve attached to another hose. When the bulb is squeezed, the system pumps fluid in one direction only-towards the heart. When a joint is flexed and extended, the bulb is naturally compressed and it pumps moving fluids from the distal extremity towards the heart. This naturally removes blood, fluid, and potential infections fluid from the site or injury. This reduces the on-site pressure after bleeding is stopped to allow new circulation and healing.

THE DEFINITION OF ELEVATION: The definition of elevation of a traumatic point is applied by measuring from the floor directly vertical to the heart. Then measure from the floor directly vertical to the site of injury. This means that the point of injury should be elevated approximately 12-16 inches higher that the position of the heart at any time and from any position, i.e. sitting in the chair with your foot on an ottoman if the foot is the site of injury IS NOT ELEVATION. The distance to the floor from the foot must be less than the heart to the floor. However, laying flat on a couch with your foot up high on the back of the couch at the head level IS elevation of a traumatic site decreasing pain and removing the fluids.

Therapy:

  • ELEVATION: All traumatic injuries should be elevated 12-16 inches immediately from the time of injury to decrease bleeding and capillary pressure. This is most critical the first 3-5 days after the injury. If you do not have elevation, this is the cause of the thumping and pounding of your heart in the new injury site causing swelling.
  • ICE decreases circulation at an injury site. Ice should be placed gently against the wound of 5-20 minutes per hour as tolerated for at least the first 5-7 days and depending on the injury 10-12 after the injury. Ice in an ice bag or blue ice pack should have at least 1-2 layer of a thick towel. You don’t want to burn or freeze health superficial tissues and cause other substantial secondary damage.
  • HEAT is good only after 7-12 days. This time allows the ripped blood vessels to heal by increasing the circulation. Early heat to a new acute injury will definitively increase bleeding, swelling, and pain and will lengthen the recovery time. Heat should only be on low, not hot, with gentle warming. I.e. a heating pad on low heat with at least 1-2 layer of a thick terrycloth towel.
  • MOVEMENT of joints closer toward the heart occasionally with elevation, pumps traumatic fluids away from the injury. After several days, movement and pumping of lymphatics reverses swelling at the site and promotes healing and circulation.
  • ACE: An external ace bandage gently and lightly applied may compress a new injury, stopping or slowing the bleeding and controlling the injury. Light compression with an ace bandage stops the bleeding by compressing the wound and should NEVER be place on tight.
  • IMMOBILIZATION: A fracture, tendinous strain/pull-partial or complete rip must be initially immobilized with a splint. Splints decrease movement so further bleeding or damage doesn’t occur. The most distal site beyond the injury, i.e. the finger and toes, should always be exposed (splinting permitted) to check to see that there is good distal capillary refill.

DISTAL CAPILLARY REFILL: Squeezing a finger or a toe between the thumb and index finger for 2-3 seconds and getting a whitish blanching under the nail tests for distal capillary refill. Suddenly removing then.

John Drew Laurusonis

Doctors Medical Center 

www.doctorsmedicalctr.com

Kyphoplasty, The Latest Treatment For Vertebral Compression Fractures

Vertebral compression fractures may occur with major trauma, such as a motorcycle accident, or with something as insignificant as a sneeze, or stepping off of a curb. With a compression fracture, the bone compressed and collapses into itself, similar to squeezing a Styrofoam peanut between your fingers.

How much force it takes to cause a compression fracture, depends on the quality of the bone. Elderly women with osteoporosis have frail, thin bones, which are easily crushed. But even the young strong bone of an 18 year old, will collapse if sufficient force is applied. These fractures may also be caused by metastatic disease, and multiple myeloma, which can weaken the bone to the point that it simply collapses.

A large majority of these fractures are termed wedge fractures, which refers to the shape of the fractured vertebra. The anterior, or front part of the vertebra, is compressed, and the posterior or back portion maintains its height. But in some cases, when sufficient force is applied, the entire vertebra is flattened.

Compression fractures cause the sudden severe pain and disability. The compression fracture itself will generally cause only back pain, focused at the sight of the fracture. Occasionally, when fracture fragments are forced out of place and begin pressing on nerves, there may be buttock and lower extremity pain as well.

Historically, the treatment for these fractures has been bed rest, and pain medication. Depending on how stable the fracture was thought to be, sometimes a brace or body cast would be added. Young people were more likely to survive the period of immobility. In the elderly population, with multiple medical problems, there was a high rate of mortality from the immobilization. People often had complications with pneumonia, blood clots, and loss of muscle. In many cases, even though the fracture would heal, people were never able to return to regular activity.

In 1998 the first kyphoplasty was performed. This new procedure has been shown to restore the height of the vertebra, and quickly stabilize the fracture. There is almost an immediate reduction in pain making it possible to mobilize patients the day after surgery. Braces or body casts are generally not necessary.

This surgery is performed through a tiny 1/2 inch incision. A large needle is threaded precisely into the center of the damaged vertebra, using flouroscopic x-ray guidance. Then a balloon is inserted and inflated in the center of the fracture. This pushes the fracture fragments back out to their original position, re-establishing the dimensions of the vertebra, and correcting any deformity.

When the surgeon is satisfied with the shape and height of the vertebra, the balloon is deflated and withdrawn. The void that is left is then filled with methyl methacrylate, which is the same bone cement that is used to glue prosthetic joint replacements in place. Within minutes this hardens and immediately stabilizes the fracture fragments.

Most people are up the next day. If their pain is not completely resolved, is greatly improved. They are generally able to return to their normal activities within a few weeks.

There are risks with any surgery, but kyphoplasty is minimally invasive and the risks are considered to be very low. It is reported that in up to 10% of cases some methyl methacrylate will extrude outside of the vertebra. In most cases this is harmless and does not cause any problems. The American Academy of Orthopedic Surgeons reports that in 1 case in 10,000 this cement may damage or irritate nerves or the spinal cord. A second surgery may be required to remove the excess cement.

The benefits of this procedure are that it greatly shortens the time of pain and disability that people with compression fractures are forced to endure. Because people are mobilized the day after surgery, it greatly reduces the risk of complications associated with prolonged bed rest.

When comparing the risks and benefits of using kyphoplasty to treat a vertebral compression fracture. The benefits seem to outweigh the risks, and this procedure may be worth considering.

Vertebral compression fractures may occur with major trauma, such as a motorcycle accident, or with something as insignificant as a sneeze, or stepping off of a curb. With a compression fracture, the bone compressed and collapses into itself, similar to squeezing a Styrofoam peanut between your fingers.

How much force it takes to cause a compression fracture, depends on the quality of the bone. Elderly women with osteoporosis have frail, thin bones, which are easily crushed. But even the young strong bone of an 18 year old, will collapse if sufficient force is applied. These fractures may also be caused by metastatic disease, and multiple myeloma, which can weaken the bone to the point that it simply collapses.

A large majority of these fractures are termed wedge fractures, which refers to the shape of the fractured vertebra. The anterior, or front part of the vertebra, is compressed, and the posterior or back portion maintains its height. But in some cases, when sufficient force is applied, the entire vertebra is flattened.

Compression fractures cause the sudden severe pain and disability. The compression fracture itself will generally cause only back pain, focused at the sight of the fracture. Occasionally, when fracture fragments are forced out of place and begin pressing on nerves, there may be buttock and lower extremity pain as well.

Historically, the treatment for these fractures has been bed rest, and pain medication. Depending on how stable the fracture was thought to be, sometimes a brace or body cast would be added. Young people were more likely to survive the period of immobility. In the elderly population, with multiple medical problems, there was a high rate of mortality from the immobilization. People often had complications with pneumonia, blood clots, and loss of muscle. In many cases, even though the fracture would heal, people were never able to return to regular activity.

In 1998 the first kyphoplasty was performed. This new procedure has been shown to restore the height of the vertebra, and quickly stabilize the fracture. There is almost an immediate reduction in pain making it possible to mobilize patients the day after surgery. Braces or body casts are generally not necessary.

This surgery is performed thru a tiny 1/2 inch incision. A large needle is threaded precisely into the center of the damaged vertebra, using flouroscopic x-ray guidance. Then a balloon is inserted and inflated in the center of the fracture. This pushes the fracture fragments back out to their original position, re-establishing the dimensions of the vertebra, and correcting any deformity.

When the surgeon is satisfied with the shape and height of the vertebra, the balloon is deflated and withdrawn. The void that is left is then filled with methyl methacrylate, which is the same bone cement that is used to glue prosthetic joint replacements in place. Within minutes this hardens and immediately stabilizes the fracture fragments.

Most people are up the next day. If their pain is not completely resolved, is greatly improved. They are generally able to return to their normal activities within a few weeks.

There are risks with any surgery, but kyphoplasty is minimally invasive and the risks are considered to be very low. It is reported that in up to 10% of cases some methyl methacrylate will extrude outside of the vertebra. In most cases this is harmless and does not cause any problems. The American Academy of Orthopedic Surgeons reports that in 1 case in 10,000 this cement may damage or irritate nerves or the spinal cord. A second surgery may be required to remove the excess cement.

The benefits of this procedure are that it greatly shortens the time of pain and disability that people with compression fractures are forced to endure. Because people are mobilized the day after surgery, it greatly reduces the risk of complications associated with prolonged bed rest.

When comparing the risks and benefits of using kyphoplasty to treat a vertebral compression fracture. The benefits seem to outweigh the risks, and this procedure may be worth considering.

David Stevens PA-C
Living with Back Pain

Collarbone Injury

The clavicle or “collar bone” connects the scapula bone in the shoulder to the sternum in your chest. It functions to hold the shoulder upward and backward.

Clavicle fractures are common bone injuries. A break in the clavicle bone is usually a closed fracture that normally takes approximately 6 weeks to heal in an adult, 4 weeks in a child. The injury rarely requires surgery.

There are some common causes of a fractured clavicle. It may be due to a birth injury, as the clavicle may fracture during passage through the birth canal. The fracture is frequently not noticed until the healing bone callus is noticed as a hard lump. It usually needs no treatment and the lump will disappear as the baby grows.

In older children and adults, accidents such as falls against the shoulder or on an outstretched hand are a common cause of fractures of the clavicle. These fractures are also sometimes a result of a blow from a blunt object or a collision of some sort.

The symptoms of a fractured clavicle are pain, swelling, tenderness, bruising, and a deformity or bump at the fracture site. Patients with a broken clavicle cannot lift their arms without extreme pain.

When a patient presents with a fractured clavicle, the attending physician will examine the fracture site for neurovascular damage and take x-rays of the injured area, including the joints above and below the primary injury site.

A patient with a broken clavicle will have to wear a simple arm sling for about 6 weeks. Children with broken clavicles are often fitted with a figure-8 clavicle strap to keep their clavicle immobilized until it heals, usually in 3 to 4 weeks. Most adult fractures are treated with a figure-8 splint or strap and will have to sleep in a chair or in bed with extra pillows because the fracture takes a week or two to set and it is vital to prevent rolling onto the bone during sleep. Usually patients will be able to start exercising their shoulders after three weeks of immobilization.

Healing is considered complete when there is no motion at the fracture site and x-rays reveal complete bone union.

A less common injury is separation of the acromoclavicular, or AC joint, where the clavicle meets the acromion process of the scapular. It is a bony protuberance on the top of the shoulder. The ligaments of this joint can be injured by falling onto the shoulder, elbow or an outstretched arm. Symptoms can range in severity from slight pain to a complete rupture of the joint resulting in a lump where the collar bone sticks up out of the neck.

Symptoms include pain and tenderness the end of the collar bone, as well as pain upon moving the shoulder joint, especially when raising the arm above the shoulders.

If the injury is a minor partial separation, it can be treated with ice compresses and rest. However, more serious separations may need to be taped down in order to heal. A complete separation will require orthopedic surgery. AC joint injuries should be evaluated by a physician, as if this injury is neglected and allowed to heal out of place it will increase the wear and tear on the joint causing future shoulder problems.

What Is Cerebral Palsy? – Andrew Brereton

Spastic Cerebral Palsy.

The word ‘spastic’ means ‘stiff’ and so children who have spastic cerebral palsy have a tendency to have stiff muscles. That stiffness may show itself only in one limb, two limbs. Three limbs or four. There are various names for the different combinations of limbs which are affected in all types. I will not highlight these at the end of this section.

Spastic cerebral palsy is usually caused by injury to the cortex, especially the motor cortex and to a bundle of nerve fibres called the corticospinal tract. Obviously, spasticity is very uncomfortable and has negative consequences for the child’s development, depending upon how many limbs are involved and it’s severity.

Athetoid Cerebral Palsy.

This type of cerebral palsy is caused by injury to a structure below the cortex called the ‘basal ganglia.’ The basal ganglia plays a role in motor function, cognitive processes, emotional processes and our ability to learn. It also acts as a ‘braking’ mechanism on the thalamus, a part of the brain which mediates our sensory experiences. So, without this inhibitory role, one can imagine a thalamus in effect operating without its ‘braking system’ which might produce many of the sensory distortions we see in some children who have cerebral palsy. It also acts as a ‘braking system’ for movement, which enables us for instance, to sit still. In order to sit still a ‘brake’ has to be placed on all other movements. Consequently injury at this level hampers the ‘braking system’ and we see children who cannot sit still and are in constant movement and children whose sensory perception is distorted. Injury to this part of the brain also exhibits itself in many children by retention of the primitive postural reflexes, as it is the role of the basal ganglia to suppress these in order to enable the child to move.
Children with basal ganglia injury are also more likely to have hypotonia, (floppy muscle tone) and persistently impaired balance and ambulation performance.

Ataxic Cerebral Palsy.

Children who have this type of cerebral palsy are usually injured in a structure right at the back of the brain called the ‘cerebellum.’ The word ‘cerebellum’ actually means ‘little brain’ and it is not without justification, as at first sight it does look like a smaller version of the brain. It is located behind the brainstem and it forms massive connections with this structure and with the cerebral cortex. It is the only structure within the brain which is not fully formed at birth, taking a further two years to develop to it’s full complement of neurons.
The proper functioning of the cerebellum ensures that any movements we make are smooth and well coordinated. It seems that the motor cortex supplies commands to the body musculature, which are then refined by the cerebellum to ensure smooth coordination. Feedback on the success of the movement is then supplied from the cerebellum back to the motor cortex where the original movement command can be refined if the movement has been unsuccessful.

One might imagine then that an injury to the cerebellum will interfere with these functions. Movement can become slow and uncoordinated, the child may display problems with balance and equilibrium, the child might experience an ‘intention tremor’ – (a tremor which is made worse when the child tries to move). Injury to this part of the brain causes ‘Ataxia’ – this is where the muscle tone is hypotonic (floppy).

Higher cognitive functions, like language and visual processing, have long been thought to reside primarily in the brain’s cortex, however recent research involving premature infants is documenting an important role for the cerebellum — previously thought to be principally involved in motor coordination and shows that cerebellar injury can have far-reaching developmental consequences. This work also demonstrates that the cortex and cerebellum are tightly interconnected. Sophisticated MRI imaging of 74 pre-term infants’ brains revealed that when there was injury to the cortex, the cerebellum failed to grow to a normal size. This means that our children with spastic cerebral palsy will usually also experience some of the difficulties associated with injury to the cerebellum.

When the injury to the cortex was confined to one side, it was the opposite cerebellar hemisphere that failed to grow normally. The reverse was also true: when injury occurred in one cerebellar hemisphere, the opposite cerebral hemisphere was smaller than normal. So, there seems to be an important developmental link between the cortex and the cerebellum, – it seems that the two structures modulate each others growth and development. So it appears that the way the brain forms connections between structures may be as important as a direct injury to a brain structure itself.

The cerebellum has also been implicated in the development of some types of literacy problems, including dyslexia.

Mixed Cerebral Palsy.

This quite simply is where several brain structures are injured, producing a mixture of symptoms of all three of the previous types mentioned.

Cerebral palsy is not limited to injury to the brain structures I have mentioned here, it is just that in the overwhelming majority of cases there is injury to one or more of these structures. An injury to one or more additional brain structures or nerve pathways can also add to the mix of symptoms, which is why no two children with cerebral palsy are exactly the same. They may have some shared symptoms, but they will not be totally alike.

What is the difference between hemiplegia, diplegia, quadriplegia, etc ?

These terms are quite simply a reference to how many limbs are affected.

Quadriplegia indicates that all four limbs are affected.

Diplegia indicates that the legs are affected.

Hemiplegia indicates that one arm and leg on the same side of the body are affected.

Double Hemiplegia is a term which is used when all four limbs are affected, but with different features on the right and left sides.

Alternatively, your doctor might use the term, hemiparesis instead of hemiplegia, and quadriparesis instead of quadriplegia. ‘plegia’ indicates a form of paralysis or difficulty in moving the affected limbs, whereas the term ‘paresis’ indicates a weakness in the affected limbs.

What problems can cerebral palsy produce in a child?

A child with cerebral palsy can experience difficulties in one, several or all areas of development, to a greater or lesser degree, depending upon the nature and severity of the brain injury. An injury can be so mild as to merely slow down development a little in just one area, or can be so severe as to completely stop development in all areas, rendering the child totally dependent in every way for every aspect of his care. Let’s do a quick A – Z tour of the kind of problems you could be facing.

Anxiety. – Some children with cerebral palsy suffer from anxiety. This can be due to the discomfort produced by stiff musculature, or can have other neurological causes such as the overproduction of norepinephrine in the brain, leaving the child on a hyper-anxiety inducing ‘high.’ There are techniques, which Snowdrop employs to relieve this situation, but in the most severe cases intervention can be necessary with anti – anxiety medications.

Breathing. – The respiratory rate of a newborn baby is between 40 – 70 breaths per minute, but by the time he is ready for pre-school at four years of age this has dropped to 25 breaths per minute. By the time a child is ready for secondary school, this has again dropped to approximately 16 breaths per minute and by adulthood the rate is around 12 per minute. In many children who have cerebral palsy this developmental pathway is either slowed or stopped, leaving for example a four year old child, who should have a rate of 25 breaths per minute, with a rate of 50 breaths per minute. As the breathing rate of a newborn is also shallow, this can mean that the oxygen levels in the brain are more difficult to maintain, exacerbating other problems such as epilepsy. It also makes the coordination of swallowing, chewing and breathing more difficult.

Constipation. – This is a big problem in many children who suffer spastic cerebral palsy, but to a lesser extent in the other types too. It is produced by lack of mobility, muscular stiffness, lack of muscular strength and bad co-ordination. Fortunately there are medications such as lactulose, senna and sodium picosulfate, which can ease the problem. On a more natural note, there is also Magnesium Oxide which can have a beneficial effect. Even so, many children still have have regular enemas. It is important to try to control this problem as constipation exacerbates so many more of the child’s problems, such as muscle tone, anxiety and epilepsy.

Digestion. – The digestive system of the child with cerebral palsy might also be compromised, with the child having poor absorption of nutrients, or having trouble in keeping food down, through excessive vomiting.

Epilepsy – This is more prevalent in spastic cerebral palsy, but does occur to a lesser frequency in all types. Epilepsy can be a big problem. I have seen children who are taking the most powerful medication cocktails you could imagine and still they have seizure after seizure. Often it is well controlled by medication, but sometimes depending upon the severity of the brain injury, it is more problematic. Epilepsy is simply the propensity of brain cells to misfire. Sometimes this sets of a chain reaction causing other cells to misfire and we then see the child having a seizure. Depending upon the extent of that chain reaction, the child may have a mild seizure such as an ‘absence’ where he simply ‘fazes out’ and stares into space for a few seconds, or he might experience a more violent, generalised seizure where he loses consciousness and his body rhythmically shakes.

Usually there is no danger from the fit itself, – even in the most violent looking seizures, the child will regain consciousness within a few minutes, the only danger being that when the fit begins, he might lose consciousness, fall and hurt himself. Very rarely however, some children will experience repeated seizures from which they cannot be roused, this is called ‘status epilepticus’ and is a situation where medical help should be sought without delay. For a more detailed description of different types of epilepsy, go to my book ‘Brain Injured Children. – Tapping the Potential Within.’

Feeding and drinking. – These are two more areas which are affected by breathing. It is sometimes difficult for the child with brain injuries to co-ordinate swallowing, chewing and breathing, – something we do unconsciously and which we take for granted. This can result in the child aspirating (breathing in) liquid and food with the consequent risk of infection such as pneumonia. Other problems include the fact that the child might not have the required muscular co-ordination to chew, or might have so strong a suckling reflex that instead of chewing, he suckles his food. Actually getting some children with severe cerebral palsy to take solid food at all can be a difficult task. Sometimes, as a result of all these difficulties a doctor might recommend that a naso-gastric tube be fitted, or that the child has an operation called a gastrostomy, through which they are fed.

Homeostasis. – Some children with cerebral palsy who have injuries to a part of the brain called the ‘hypothalamus,’ or connections to and from it have trouble with several aspects of maintaining their equilibrium. This may display itself as a lack of a drive for hunger, thirst, etc, or too much of a drive for these. So some children might not realise they are hungry, whilst others might be incessantly so. It may also display itself as an inability to maintain body temperature, the child either becoming cold or hot easily.
Learning Difficulties. Many people assume that most children who have cerebral palsy also have learning difficulties, – this is not the case. Many children with cerebral palsy have difficulty in displaying their intelligence because of their sensory, physical, and / or communication difficulties, but that intelligence is often most certainly there! Only approximately three out of ten children with cerebral palsy have severe learning difficulties.

Orthopaedics, Orthopaedic impairment can take many forms in the person with cerebral palsy. One or more limbs can be impaired, different muscle groups in the body can be affected, there can be difficulty due to stiffness of the muscles with ligaments and tendons tightening, there can be difficulties due to low muscle tone too. Children can suffer from contractures and dislocations. There can also be problems with scoliosis of the spine. There are surgical procedures which can help to alleviate some of these difficulties, and there are also medications such as muscle relaxants. The best way of maintaining your child’s body however is regular physiotherapy. The physiotherapist is so important to the child with cerebral palsy and to Snowdrop. They help to prevent the development of orthopaedic and associated problems, thereby preserving a clear developmental base upon which to build.

Salivation. – Many children with cerebral palsy produce excess amounts of saliva. This can cause big problems with choking, aspiration and infection, chewing and eating, drinking and language development. It can signal an imbalance in the autonomic nervous system, which has two branches, – the sympathetic and parasympathetic nervous systems. When the parasympathetic branch is over-active, production of saliva increases. Over salivation can also be stimulated by problems with the brain’s vestibular system. There are medications which can be used to help slow down the rate of salivary production, one of the more common being ‘scopolomine patches,’ which are gently stuck on behind the ear.

Sensory Problems. – This is a huge problem area for many children with cerebral palsy, whose sensory perception can be dulled, distorted or amplified in one or more of the sensory modalities. Children can have a mixture of these problems in different senses, so that a child might for instance have acutely oversensitive hearing and simultaneously be undersensitive in vision. As specific sensory systems supply the information necessary for the efficient operation of motor systems, problems here can have the effect of retarding the development of mobility, hand function, language and communication and socialisation.

Let’s take a brief look at this. If a child’s visual development is delayed or stopped, then language development, socialisation, mobility and hand function can be affected. Mobility speaks for itself, if a child cannot see it could be dangerous to move. Language and socialisation development will be affected because the child will not be able to complete the essential developmental stages of making eye – contact, regulating mutual attention and will not be able to see the face of a communicating partner. All of which are vital precursors to the development of language and socialisation.
If a child’s auditory development is affected then it is obvious that language and consequently socialisation, which in turn depends so much on language development, will also be affected. The development of spoken language is dependent upon exposure to spoken language. If tactile development is affected then mobility and hand function will also be problem areas. If you cannot feel where your body, limbs and hands are, then you will have difficulty in the conscious control of them. So we can see how important sensory development is in enabling other developmental functions to operate normally.

Sleeping, – There are two categories of children to talk about here, the first is the child who cannot sleep. The second is the child who can sleep but does not do so at the correct times. The effect is the same for the parents who have to stay awake to ensure the child’s well-being. In the first category, the child has a neurological reason why he cannot sleep, – he perhaps for some reason does not produce enough serotonin, or maybe he overproduces ‘noradrenaline.’ In the second category it could be the child’s body clock which is askew, or it might be sensory oversensitivity which is preventing him from sleeping. Ultimately this child will sleep, usually when he collapses from exhaustion.

Teeth, Dental problems can occur, especially if the child is hypersensitive to touch in his mouth, or if he produces excess saliva, or grinds his teeth.

Teeth grinding, – Apart from being like the Chinese water torture for the person having to listen to it, this can cause dental pain for the child who does it. Often, it is done when the child feels stressed and more often than not is linked to overproduction of saliva.

Can Cerebral Palsy be Treated?

The answer to this problem is an emphatic ‘yes!’ Snowdrop treats many children who have all types of cerebral palsy. We believe that treatment in the past has either focussed upon treating symptoms, -which is why it has failed, or it has focussed upon erroneous theories about the way in which the brain works and how children develop. Indeed, we point to plentiful evidence in the literature, which can be seen in my book, ‘Brain Injured Children: Tapping the Potential Within,’ which prove these systems of treatment to be failures.

We point to the fact that our system of treatment, which we call ‘neuro-cognitive therapy,’ is informed by the evidential findings of eminent researchers such as Vygotsky, Bruner, Rogoff, Dunn, Woods and Mercer to name but a few.

Our approach is based upon certain irrefutable facts concerning brain function, which are applied to the treatment of children’s developmental difficulties. The first of these is brain plasticity. It is now unchallengeable that the brain is capable of changing its structure and functioning in response to the environment in which it finds itself. We can see this in the growth of new synaptic connections and the pruning of inefficient ones.

The question then is, what do I mean by ‘environment’ and how can we manipulate this variable in order to encourage the brain to respond in the way we wish?

The brain takes in information from the sensory environment, through the eyes, ears, nose, mouth and skin. It processes this information and then re-routes it to the appropriate part of the cortex for further attention, evaluation and action. When the brain is working as it should, then all of this is achieved with the maximum efficiency, without us noticing what is going on. However, as both you and I are aware, the brain does not always work as it should.

In many children with cerebral palsy, this sensory information has great difficulty in reaching the relevant part of the brain at all, or if it does, the signal has been weakened sufficiently so that processing becomes almost impossible. In other children, the sensory stimuli is passed to the cortex for processing in a distorted manner and the child is overwhelmed by the world it perceives.

These ‘distortions of sensory processing’ are primary problems which affect many neuro-developmental conditions, not just cerebral palsy. What I try to do is to manipulate the sensory environment to which the child is exposed in order to encourage the regions of the brain which are responsible for processing the sensory stimuli, (the sensory attentional filter of the brain, – the ascending reticular activating system, the thalamus and the limbic areas), to re-tune and to process information more normally. I do this sometimes by providing an adapted sensory environment designed to dampen the incoming sensory stimuli (in cases where children are hypersensitive) and sometimes by designing activities intended to enrich sensory experience. In this way, because as I have said, we know as fact that the brain grows new synapses and prunes disused ones, we can influence not only brain function, but it’s development.

Another aspect of my approach is aimed at any learning difficulties the child might have and is informed by research from Vygotskian psychology. Recent research has provided ample evidence concerning how children learn. (unfortunately, often children do not learn in the manner by which schools teach)

As I have already pointed out, the research findings which inform my work in this field are all provided by respected, mainstream psychologists so you know in advance that I am not operating some ‘fly by night’ fanciful theory on brain plasticity and learning; – everything I do has an evidential basis.

Basically, utilising Vygotky’s concept of the ‘zone of proximal development,’ I look at the child’s current developmental level in terms of his / her cognitive development and reinforce this. I then look at the next stage of development for the child (his proximal development) and in recognition that learning is a social activity, provide support to enable him to attain that ability (this support is Bruner’s concept of ‘Scaffolding.’). This may also entail breaking the developmental task down into smaller, simpler sub-components thus enabling the child to succeed. As the child improves his functioning at the desired task, the scaffolding (support) is gradually removed until he is performing the desired task automatically. This is not just the way in which children learn, – this is the way we all learn.

What does a Snowdrop programme look like?

This would depend upon the specific difficulties faced by a child and how much time the family could practicably spend on it. It might consist of as little as thirty minutes of structured stimulation per day, up to two hours per day. The programme consists of a series of activities, each lasting a few minutes, which are designed to stimulate development in the seven major areas, visual, auditory, tactile, language, mobility and social development, in addition to the seventh, – hand function. What the programme is designed to do is to ameliorate the symptoms of developmental delay in all these areas of development.

Where do I go from here?

After many years as a parent of a profoundly brain-injured child, almost as many years in academic research and working in schools with children who have special educational needs, I decided the time had arrived to fulfil a long held ambition. Having travelled internationally to clinics, both as a parent and as a researcher, I have become aware of just how little of the vast amount of knowledge possessed by the discipline of psychology is being applied to the treatment of children with cerebral palsy.

I have personal experience and knowledge of the serious consequences for the family, which the presence of a child with cerebral palsy can bring, not least of all the problem of stress, which family members bear. As I have previously stated, a child with brain-injuries, with his myriad of associated difficulties, is likely to create tired, stressed parents, – understandably so! This needs to be taken into account when dealing with the family and in this sense, we are not merely treating the brain-injury, nor merely the child; – We are treating the whole family and if we are to have a significant impact upon the problems presented by cerebral palsy and other brain-injuries, we must surely do so!
With these thoughts in mind, and having worked alongside parents and brain-injured children for many years, I have established a child development consultancy called ‘Snowdrop.’ Snowdrop is already successfully treating many children (and adults) both in the UK and in many other countries.

My personal crusade is to ensure that Snowdrop remains ‘research friendly’ and eclectic. By this, I mean we should not develop a set philosophy or rationale, which will effect our methodology. – Down that road lies academic egoism and inflexibility, which I have witnessed at so many other institutions and which would lead to stagnation. We should always look to research and to evidence to provide our treatment methods and not be afraid to change.

It is my hope that this short text has been informative and that most of all it has given parent some good information about cerebral palsy and also some hope that their children can make progress! To make an appointment, simply use the contact details below.

Vocal Cord Paralysis – Causes, Symptoms and Treatment Methods

Vocal cord paralysis is a voice disorder that occurs when one or both of the vocal cords (or vocal folds) do not open or close properly. Vocal fold paresis/paralysis can happen at any age – from birth to advanced age, in males and females alike, from a variety of causes. Vocal cord paralysis is a common disorder, particularly among the elderly, and symptoms can range from mild to life threatening. People with one paralyzed vocal cord often complain of choking when drinking liquids, but they rarely have difficulty swallowing solid foods. Vocal cord paralysis may result from lesions at the nucleus ambiguus, its supranuclear tracts, the main trunk of the vagus, or the recurrent laryngeal nerves. The cause of vocal cord paralysis can indicate whether the disorder will likely improve over time or whether it is likely to be permanent. The vocal cords are two elastic bands of muscle tissue located in the larynx (voice box) directly above the trachea (windpipe). The most common symptoms of vocal cord paralysis or paresis include hoarseness, vocal fatigue, pain for tightness in the throat when speaking, aspiration, and breathing difficulties.

Vocal cord paralysis can result from injury, tumors, or surgery in the neck and upper chest. People with one paralyzed vocal cord often complain of choking when drinking liquids, but they rarely have difficulty swallowing solid foods. One of the most important things to distinguish from vocal cord paresis/paralysis is vocal cord fixation. Someone who has vocal cord paralysis often has difficulty swallowing and coughing because food or liquids slip into the trachea and lungs. This happens because the paralyzed cord or cords remain open, leaving the airway passage and the lungs unprotected. During swallowing, the vocal cords shut the airway so that food is not inhaled. When vocal cords are paralyzed, all three functions are affected. The most dangerous form of vocal cord paralysis is one that affects the opening function, controlled by the recurrent laryngeal nerve. Treatments for vocal cord paralysis range from voice therapy to help you strengthen your vocal cords and improve your ability to speak, to surgical options, or both.

Causes of Vocal cord paralysis

The common causes and risk factor’s of Vocal cord paralysis include the following:

A viral infection.

Lung or thyroid cancer.

Exposure to smoking.

Tumors, both cancerous and noncancerous, can grow around the muscle and cartilage of your voice box and can cause vocal cord paralysis.

A neurologic insult such as a stroke.

If you have certain neurological conditions, such as Parkinson’s disease or multiple sclerosis, you may experience vocal cord paralysis.

Endocrine or Hormonal imbalance.

Symptoms of Vocal cord paralysis

Some symptoms related to Vocal cord paralysis are as follows:

Discomfort from vocal straining.

Changes in voice quality, such as loss of volume or pitch, may also be noticeable.

Shortness of breath with exertion.

Ineffective or poor cough.

Noisy breathing.

Inability to speak loudly.

Inability to “bear down” while lifting.

Treatment of Vocal cord paralysis

Here is list of the methods for treating Vocal cord paralysis:

Voice therapy is often a first treatment option, especially if the cause of the condition is unknown.

An adequate airway is immediately necessary, usually secured with an endotracheal tube in the windpipe.

Sometimes an operation that permanently shifts a paralyzed cord closer to the center of the airway may improve the voice.

Botanical medicine and deep tissue massage to the area can also bring some resolution, although it may not be long term.

A tracheostomy (surgery to create an opening into the trachea through the neck) may be needed.

What are the Symptoms of a Hiatal Hernia?

A hiatal hernia occurs when part of your stomach bulges upward out of your belly and into your chest cavity.

There are three main types of hiatal hernia: sliding, paraesophageal, and mixed. A sliding hiatal hernia is the most common type and is generally not a serious condition. Paraesophageal and mixed hiatal hernias may progress and are more serious.

Hiatal Hernia Symptoms

Midlife spread may be partly to blame – in fact, I think it plays a major role. Consider this: Theaverage woman gains about a pound a year from age twenty-five onward. This means by yourmid-forties, you could be sporting twenty extra pounds. What’s more, as you get older, your bodyfat tends to shift from your hips and thighs to your belly. Excess belly fat may increase pressure onyour LES, increasing reflux episodes and putting you at greater risk developing some hiatalhernia symptoms. The rise in obesity may also be responsible for the increase in GERD inchildren. Childhood obesity in the United States has reached epidemic proportions, and todaygastroenterologists prescribe more reflu medications for childhood GERD than ever before.

Belching
Heartburn, worse when bending over or lying down
Swallowing difficulty
chest pain

The vast majority of hiatal hernias are of the sliding type, and most of them are not associated with symptoms. The larger the hernia, the more likely it is to cause symptoms. When sliding hiatal hernias produce symptoms, they almost always are those of gastroesophageal reflux disease (GERD) or its complications. This occurs because the formation of the hernia often interferes with the barrier (lower esophageal sphincter) which prevents acid from refluxing from the stomach into the esophagus. Additionally, it is known that patients with GERD are much more likely to have a hiatal hernia than individuals not afflicted by GERD. Thus, it is clear that hiatal hernias contribute to GERD.

Hiatal hernias occur when part of the stomach protrudes into the diaphragm, causing a tear in the muscle. A small bulge, or tenderness may ensue, or the hernia may not cause troublesome symptoms. In fact, many people do not know they have a hernia, until symptoms develop. One of the most troublesome symptoms of hiatal hernia is pain, and acid reflux, or Gerd. This is a controversial subject, because there has not been direct proof that hiatal hernias are the cause of reflux, but they are considered a culprit behind the disease, especially if the hernia is large, say five centimeters or more, and if conventional acid reflux treatment doesn’t work.

Knowing the common cause of hernias symptoms can be advantage to everybody as it can help if it is the beginning to save more pain and surgery. Hernias are located in areas of our abdomen and mostly located in our groin area. The pain in our abdomen will give a tearing sensation in our stomach and always appears like swelling as our abdominal wall become weaken. The symptom of the first hernais are always pain in the abdomen area with tearing sensation, feeling full all the times and bulging.

The most common hiatal hernias are the sliding hernias. These are not that dangerous, one of their bad symptoms is reflux esophagitis, which was noticed in any people that suffer from hiatal hernia. Some of them were also affected by Barrett’s esophagus because of the hernia. Barrett’s esophagus may present dysphagia or reflux symptoms.

Cervical Spine Fracture Treatment Information

A fracture (break) of the cervical spine is commonly referred to as a broken neck. Approximately 5-10% of unconscious patients who present to the ED as the result of a motor vehicle accident or fall have a major injury to the cervical spine. Injuries to this region of the spine are frequently a combination of sprain, dislocation and fracture. The most serious can injure the spinal cord, leading to paralysis or death. This type of accident may not cause a fracture but instead injure the muscles and ligaments of the neck. The resulting injury is a neck sprain, which is commonly called whiplash.

Cervical spine injuries are ranked according to several mechanisms of injury. These include flexion, flexion-rotation, extension, expansion and compression vertical rotation, lateral flexion, and vaguely understood the mechanisms that can lead to odontoid fractures and atlanto-occipital dislocation. Cervical spine fractures and other injuries to the neck less frequent because people are more educated on how the fractures occur and how to prevent them. Protect yourself and your family to always wear a seat belt, supervision of children and teenagers who are swimming and diving in lakes and ponds.

Cervical Spine Fracture Treatment and Prevention Tips

1. Always wearing a seatbelt.

2. Surgical is also recommeded

3. Take whirlpool treatments, if available.

4. Using the proper equipment and training during athletic participation.

5. Drink only water before manipulation or surgery to treat the fracture.

6. Massage gently and often to provide comfort and decrease swelling.

7. Use a “spotter” when attempting difficult moves in gymnastics.

8. Use appropriate protective equipment, such as padded collars and shoulder pads.

Herniated Disc – Ayurveda

A herniated (also called a slipped or ruptured) disc is a fragment of the disc nucleus which is pushed out of the annulus, into the spinal canal through a tear or rupture. Discs that become herniated are usually in an early stage of degeneration. The spinal canal has limited space which is inadequate for the spinal nerve and the displaced herniated disc fragment. Due to this displacement, the disc presses on spinal nerves, often producing pain, which may be severe.

Herniated discs can occur in any part of the spine. Herniated discs are more common in the lower back (lumbar spine) especially at the L4-L5 and L5-S1 levels (L = Lumbar, S = Sacral). This is because the lumbar spine carries most of the body’s weight. The second most common area is neck (cervical spine). The area in which you experience pain depends on what part of the spine is affected.

People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age. But currently even the people at the age group of 20’s are also getting affected because of their lifestyle and stress.

The progression to an actual Herniation varies from slow to sudden onset of symptoms. There are four stages: (1) disc protrusion (2) prolapsed disc (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain resulting from herniation may be combined with a radiculopathy, which means neurological deficit. The deficit may include sensory changes (i.e. tingling, numbness) and/or motor changes (i.e. weakness, reflex loss). These changes are caused by nerve compression created by pressure from interior disc material.

Causes
A single excessive strain or injury may cause a herniated disc. However, disc material degenerates naturally as you age, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.

Certain individuals may be more vulnerable to disc problems, and as a result may suffer herniated discs in several places along the spine. Research has shown that a predisposition for herniated discs may exist in families, with several members affected.

Herniated disc symptoms

Symptoms vary greatly depending on the position of the herniated disc and the size of the herniation. If the herniated disc is not pressing on a nerve, you may experience a low backache or no pain at all. If it is pressing on a nerve, there may be pain, numbness, or weakness in the area of the body to which the nerve travels. Typically, a herniated disc is preceded by an episode of low back pain or a long history of intermittent episodes of low back pain.

Lumbar spine (lower back): Sciatica frequently results from a herniated disc in the lower back. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling, and numbness that radiates from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is affected. This pain often is described as sharp and electric shock-like. It may be more severe with standing, walking or sitting. Along with leg pain, you may experience low back pain.

Cervical spine (neck): Symptoms may include dull or sharp pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. The pain may increase with certain positions or movements of the neck.

Thoracic spine: pain radiates into the chest.

Cauda Equina Syndrome: occurs from a central disc herniation and is serious requiring immediate surgical intervention. The symptoms include bilateral leg pain, loss of perianal sensation (anus), paralysis of the bladder, and weakness of the anal sphincter.

Diagnosis
Diagnosis is made by a Doctor based on your history, symptoms, a physical examination, and results of tests, including the following:

X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine are obtained to search for other potential causes of pain, i.e. tumors, infections, fractures, etc.

Computed tomography scan (CT or CAT scan): A diagnostic image created after a computer reads x-rays; can show the shape and size of the spinal canal, its contents, and the structures around it.

Magnetic resonance imaging (MRI): A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology; can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and tumors.

Myleogram: An x-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces; can show pressure on the spinal cord or nerves due to herniated discs, bone spurs or tumors.

Electromyogram and Nerve Conduction Studies (EMG/NCS): These tests measure the electrical impulse along nerve roots, peripheral nerves, and muscle tissue. This will indicate whether there is ongoing nerve damage, if the nerves are in a state of healing from a past injury, or whether there is another site of nerve compression.

Treatment

Though the management of herniated disk is controversial, the first step is bed rest. For those not responding to rest, surgical removal of the bulging disk followed by fusion of the vertebrae is the only option in modern medicine.

Ayurveda holds that Herniated disc is a result of vitiation of the three principal ‘doshas’ especially the Vata.

Treatment in Ayurveda is aimed at restoring the equilibrium through correction of the underlying functional in-equilibrium. Ayurvedic treatments for Herniated disc concentrate on bringing the aggravated vata back to the state of equilibrium and thereby to the state of health. Treatment comprises of three approaches, Elimination (Sodhanam) of the accumulated toxic products of digestion, metabolism and the disease process, Pacification (Samanam) and correction of the entities responsible for altered functioning and Rasayanam (Rejuvenation) of the bodily tissue to regain and maintain natural strength and vitality.

The strength of Ayurveda in the area of spinal ailments is globally appreciated. Since it addresses the root cause of the issue the results are better than surgical procedures.

The therapies like Abyanga swedam, Nasyam, Pathrapotala swedam, Choornapinda swedam, Pizhichil, Shirodhara, Kadeevasthy, Greevavasthy, Navarakizhi, Vasti etc. are done as per the necessity and condition. These therapies are directed towards relieving the inflammatory changes and herniation, releasing the spasms and nerve compressions in the affected area, strengthening the supportive tissues holding the spine/joints, nourishing entire spine & re hydrating the discs. Usually the treatment period is 3 – 5 weeks according to the severity of the disease.

In four to six weeks, the majority of patients find their symptoms are relieved without surgery. If patient can come for the treatment in early stages, even total cure without recurrence is also possible.

What is Neuralgia?

Neuralgia is a general term for nerve pain affecting the peripheral nerves. Neuralgia often results in head and neck pain that is spasmodic, and is an extremely painful disorder that can completely destroy a person’s quality of life. The most common cause of neuralgia is neuritis, an inflammation of the nerves that can be caused by injury. There are several types of neuralgia, namely trigeminal, postherpetic (caused by shingles) and occipital. The nerves affected by neuralgia are usually responsible for sensing touch, temperature and facial pressure. Trigeminal neuralgia, one of the most painful conditions seen in medicine, may cause a great disruption in the lifestyle of the sufferer. However, neuralgia is extremely rare, especially in those under 30. Women are most likely to succumb to neuralgia than men.

What are the symptoms of Neuralgia?

Neuralgia often affects the face, with symptoms manifesting in episodes of excruciating, electric shock like, or stabbing pain. It can also showcase as a burning and itchy type of symptom. This pain generally only lasts a few minutes and occurs on only one specific side of the face. Symptoms of Trigeminal neuralgia are extremely severe, resulting in sharp spasms on one side of the face, often affecting the forehead, eyes, scalp, lips, nose or jaws. Victims of Postherpetic neuralgia suffer from a complex form of shingles, and can be brought on by illness, stress, medications or advancing age. Occipital neuralgia often causes spasms of pain to the back or the front and sides of the head and usually occurs after a spinal injury, such as whiplash. It can also be caused by or conditions like gout or diabetes.

Neuralgia can occur at any age, but is most common in the elderly.

What causes Neuralgia?

The causes of Neuralgia can depend on the type. As stated before, spinal injury or certain diseases can cause occipital neuralgia. Chemical irritation, inflammation, recent trauma, compression of nerves by tumors, and infections may all lead to neuralgia. In many cases, however, the cause is unknown. The most frequent cause of trigeminal neuralgia is a blood vessel pressing on the nerve near the brain stem. Over time, changes in the blood vessels of the brain can result in a blood vessels rubbing against the trigeminal nerve root. The constant rubbing with each heartbeat wears away the insulating membrane of the nerve, resulting in nerve irritation.

Will Painwave X4000 Help with Neuralgia?

Yes indeed! If you suffer from neuralgia, then the Painwave X4000 is a non-invasive, drug-free alternative to traditional medicines and treatments, which can have horrible side effects that alter your lifestyle. Not so with Painwave X4000. This unit actually works in concert with the body’s own bioelectromagnetic ecosystem. Painwave X4000 has no known side effects and is extremely easy to use. Simply hold the unit over the infected area, moving gently over the surface of the skin in a small circular motion. After a short period of time Painwave X4000 can improve circulation, cell activity and lymphatic movements, all of which are beneficial in the relief of pain and other discomforts. In many cases, this stimulation will greatly reduce or eliminate the pain associated with Neuralgia for good.

Note: The contents provided in this article are not meant to replace the evaluation of a physician, If you think you may be experiencing complications due to neuralgia, contact your primary care physician immediately for diagnostic testing.

How to Treat a Pinched Nerve in Your Lower Back

If you suffer from back pain caused by a pinched nerve in your lower back there are a multitude of ways that are safe and effective for providing pain relief. Millions of people across the world suffer from aches and pains on a daily basis. The sad fact is that the majority of these people think that it is normal to go through every day of life, suffering from these conditions.

I hate to tell you that back pain and tight muscle spasms are not caused by a muscle relaxant and anti-inflammatory medication deficiency. You have a serious problem that needs to be taken care of. Many people cannot even get out of bed before they have taken some type of medication to help relieve their aches. In fact, the medication really does nothing more than hide your pain, and does nothing to help in curing your actual problem.

The good thing is that there are many ways to treat back pain.

First, you always want to maintain proper body posture. Good body mechanics is always the best way to effectively prevent any injuries from happening. You will be presently surprised how easily back pain can be prevented by doing easy things such as bending your knees when you were picking up anything from the ground. Whether it is a package or a child always remember to bend your knees.

Keeping your body hydrated is also a great way to help relieve any type of back conditions. It will also help prevent any issues as well. A good goal is to try to drink 2 L of water every day. This helps the muscles and ligaments of the body to maintain adequate flexibility and elasticity.

Stay loose and number. Stretching exercises work wonders at preventing and alleviating any type of painful conditions. Focus on keeping the low back muscles, quadriceps, and hamstrings and calve muscles loose. A good daily routine would be to take a nice warm shower every morning and then spend about 10 or 15 minutes stretching these muscles.

Keeping the abdominal and lumbar spine muscles nice and tone is also a great way to treat and prevent any type of injuries. Keeping these muscles nice and strong will help protect your spine and the discs of your spine.

Spinal elongation is huge in treating pinched nerves and low back pain. Simple methods of spinal elongation include yoga. More clinical and therapeutic methods include spinal decompression therapy with Saunders 3-D active track. Clinical studies show that 8 out of 10 people experienced significant pain reduction with this technique.

Most definitely can not stay in bed and hibernate all day long. You want to stay active. Your physical activity actually pumps a lubricating fluid called synovial joint fluid throughout your body. It’s is like the body’s own natural oil. Staying active is a great treatment for back pain. In fact, bike riding every day plus spinal decompression therapy actually cured my own disc herniation pain.

Now if these recommendations did not help get rid of your pinched nerve pain in your low back then. You have to go see your Family Chiropractor and Medical Doctor. If the above noted recommendations do not provide any relief then you probably are suffering from a disc herniation and your doctor will have to do the proper examinations and order diagnostic procedures like an MRI and / or EMG & NCV studies.

Ouch! Pain in the Neck?

Oh! Pain in the Neck?!

Neck pain, at times, can become pain in the neck’ quite literally. People who have experienced neck pain alone know how painful the neck pain can turnout to be.

Neck is one of the most flexible regions of the spine, which consists of vertebrae, seven shock absorbing discs, muscles, and vertebral ligaments to hold them in place. The uppermost cervical disc connects the top of the spinal column to the base of the skull. The spinal cord, which sends nerve impulses to every part of the body, runs through a canal in the cervical vertebrae and continues all the way down the spine.

What Causes neck pain?

Most people experience neck pain at some point in their lives. Neck pain can be acute, lasting for few hours or a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain.

Neck pain can be caused by an activity or injury or by a medical condition. Your head and neck region is vulnerable to many different stresses. Bad posture can cause misalignment of your neck, head, and spine. Car accidents can cause whiplash. Age and wear and tear can cause arthritis. Even activities such as chewing gum and reading in bed and cause pain. How do we avoid these potential problems? And if we can’t avoid them, how can we recover as quickly as possible.

Non-specific neck pain

Many people develop a stiff and painful neck for no obvious reason. It may happen after a minor twisting injury, for example while gardening. Since the underlying cause for this type of neck pain is not fully understood hence it is called ‘non-specific neck pain’ Having non-specific neck pain does not mean that your neck is damaged. Often it happens in people whose necks would appear completely normal under an x-ray. It is the most common type of neck pain and disappears after a few days.

Activities that cause neck pain

Neck pain mostly is caused by activities that result in repeated or prolonged movements of the neck’s muscles, ligaments, tendons, bones, or joints. This can result in a strain(an overstretched or overused muscle), a sprain (injury to a ligament), a spasm of the neck muscles, or inflammation of the neck joints.

           1. Holding your head in a forward or odd position for long periods of time
               while working, reading, watching TV, or talking on the telephone.

           2. Sleeping on a pillow that is too high or too flat or doesn’t adequately 
               support your head, or sleeping on your stomach with your neck twisted
               or bent.

           3. Spending long periods of time resting your forehead on your upright fist
               or arm.

           4. Work that uses the upper body and arms, such as painting a ceiling or 
               other overhead work.

Injuries that cause neck pain
The Spine consists of interlocking bones(vertebrae) and discs that separate the vertebrae. The portion of the spine that runs through the neck is known as the cervical spine. Muscles and ligaments in the neck hold the cervical spine together. Injury to any of these structures may result in neck pain.

Minor injuries may occur from tripping or from excessive motion of the cervical spine. Severe neck injuries may occur from whiplash in an accident, falls from significant heights, direct blows to the face or the back or top of the head, sports-related injuries , a penetrating injury such as a stab wound, or pressure applied to the outside of the neck, such as strangulation.

Pain from an injury may be sudden and severe. Bruising and swelling may develop soon after the injury. Sudden (acute) injuries can result in strain and pain in the neck, dislocation of the spin, or a ruptured disc.

Medical conditions that cause neck pain 

                  1. Neck pain may be caused by or related to medical conditions such as:

                  2. Cervical Spinal Stenosis

                  3. Cervical Spondylosis

                  4. Illnesses, such as meningitis, which cause inflammation around the
                      tissues of the brain and spinal cord.

                  5.Chronic conditions such as fibromyalgia, rheumatoid arthritis, or
                     ankylosing spondylitis

Torticollis (wryneck): Torticollis is
caused by severe muscle tightness or a shortened muscle on
one side of the neck, causing the head to be tilted to one side.

Referred pain: Referred pain occurs when
a problem in one place in the body causes pain in another
place. For example, a problem with your jaw or your heart can
cause neck pain.

Infection or a tumor in the neck area.

Signs and Symptoms

Neck pain takes many forms. Signs and symptoms of neck pain may include:

           1. Pain in your neck that may be sharp or dull

           2. Stiffness in your neck

           3. Difficulty going about your daily tasks because of pain or stiffness in
               your neck

           4. Shoulder pain in addition to neck pain, in some cases

           5. Back pain in addition to neck pain, in some cases

Help yourself to prevent neck pain

Take frequent breaks: Don’t sit in one place for a long time, such as your car or at your desk.
Arrange some of the items in your office that cause inconvenience. This will force you to get up, stretch or walk around.

Maintain good neck posture:
Adjust the seat of your computer or desk chair so that your hips are slightly higher than your knees. Your head and neck will naturally follow in the correct position. While traveling in a car, airplane or train, place a small pillow or rolled towel between your neck and a head rest to keep the normal curve in your neck.

Avoid too many pillows:
Avoid sleeping with too many pillows or falling asleep in front of the television with your head on the arm of a couch.

Exercise: Treat your body to a consistent regimen of stretching and strengthening to balance your muscle groups. This protects your neck as well as helping your whole body. Walking at any pace is excellent exercise for your neck. The rotation of the spine provides a great natural workout for the neck muscles.

Eat smart and Drink water:

Good nutrition and staying well hydrated are not only important to stay healthy, but vital in the healing process.

For more Health Tips:http://fitnus.blogspot.com/

Acute Wry Neck or Torticollis

Torticollis or an acute wry neck occurs relatively uncommonly and consists of the onset of sudden and severe neck pain which causes the cervical neck muscles to contract reflexly. This leads to the neck being kept in an abnormal posture to minimise pain, a posture known as torticollis. Torticollis is not a diagnosis of itself but a reflection of a problem occurring in the neck or head area, however this article concentrates on torticollis from a mechanical cause. A common report from patients is that they awoke with the severe pain and the neck deformity, assuming it was a result of sleeping awkwardly that night.

Patients report severe neck pain often with muscle spasms and an inability to bring the head to the normal central position. This pain usually settles down in a few days or up to two weeks at most and is managed with painkillers, wearing a collar if required, physiotherapy massage or mobilisations, neck exercise and neck stretching. On examination a patient with torticollis will have their head side flexed towards the painful side and the face rotated away towards the opposite side to some degree. Typical complaints are pain, stiff neck and a limited range of movement, with a sudden onset such as turning the head quickly or drying the hair relatively common.

Once the onset has occurred the patient feels an immediate and often quite severe pain in one side of the neck, often low down, and perhaps some vague referral out towards the shoulder or down the back towards the shoulder blade. With significant shoulder or arm pain then a diagnosis of cervical root compression should be considered. Sudden onset root lesions are less common, with the syndrome typically coming on over a few days, but if the patient reports the symptoms on waking this could be the diagnosis. If so the prognosis is still good but the length of time to recovery will likely be a few weeks rather than a few days.

On examination by a physiotherapist the patient will be distressed by the severity of the pain and may have found it hard to sleep. They may guard the head by moving carefully to avoid jarring the aggravated structures. The head will be stuck in the typical abnormal posture and any attempt to bring it back towards normal will be met with a significant increase in pain. The posture of the head will be recorded by the physio with ranges of motion achievable and the resulting symptoms. The physiotherapist will take the history including previous episodes and how this one came on, either suddenly or during the night.

It is important to enquire after any arm, scapular, thoracic and shoulder pain. The physiotherapist may need to test the C6 and C7 nerve root reflexes of the biceps and triceps muscles respectively should the situation require this and they may also test the sensibility to light touch of the skin for the same purpose. Muscle strength testing may be omitted due to the likelihood of increasing pain and the probability of an inaccurate result. The physio will include asking the standard series of exclusion questions which allow him or her to conclude the problem is mechanical and not due to medical illness.

Physiotherapists follow the same management principles for acute wry neck as for all soft tissue damage. The inflammation and pain of the injury are the first targets of physiotherapy so as to reduce spasm in the muscles which is maintaining the pain. Drugs such as pain killers and anti-inflammatories are employed as the target of treatment is the pain itself and not a specific anatomical lesion. Physio management consists of non-vigorous manual traction to relax the neck musculature, wearing of a collar if required (especially at night) and the pain reduction following ice treatment.

Reduction in the neck pain signals that the physio can start to employ more vigorous manual techniques such as stretching of the neck muscles to further relax them, massage of the neck and joint mobilisation. Active neck exercises are encouraged within the restrictions of the pain to avoid aggravating the situation. Once movements of the neck have improved and head posture is more normal then physiotherapy can progress to muscle strengthening and working on the endurance of the neck muscles to allow normal functioning.

Aphonia Causes Symptoms Information With Treatment

Some voice disorders are idiopathic and may occur due to stress. Vocal abuse (e.g., smoking, drinking excessive caffeine or alcohol, excessive exposure to fumes/toxins, etc.) is another potential cause of aphonia. Fear also is often a concomitant and a contributor. Therapy should first be aimed at correcting those conditions which might produce a disturbance in the centers of coordination between the three nervous systems. Then the overtaxed nerve forces of the body as a whole should be relieved, the incoordination which has been a factor in the disease process should be eliminated, and the forces of the body should be coordinated. General therapy should first be aimed at a cleansing of the system with special reference to the hepatic circulation. Osteopathic manipulations and neuropathic manipulations are both recommended, but in differing degrees. Hypersensitive nervous systems must be handled cautiously and gently. Hypnosis was mentioned but was to be used. Surgery and therapy or either one of these may be recommended. The diet should be corrected and sufficient stimulus of a medicinal nature should be added to keep the body in a normal force. Some cases that are psychological – where the body is amenable to suggestion – would benefit by suggestive therapy.

Causes of Aphonia

Common Causes and Risk factors of Aphonia

Injuries.

Poor eliminations.

Psychological factors.

Signs and Symptoms of Aphonia

Common Sign and Symptoms of Aphonia

Loss of speech.

Aphasia.

Confusion.

Treatment for Aphonia

Common Treatment of Aphonia

General therapy should first be aimed at a cleansing of the system with special reference to the hepatic circulation. 

Osteopathic manipulations and neuropathic manipulations are both recommended, but in differing degrees. 

Hypersensitive nervous systems must be handled cautiously and gently. 

Hypnosis was mentioned but was to be used.

Surgery and therapy or either one of these may be recommended. Therapy is usually brief.

Diet should be corrected and sufficient stimulus.

Some cases that are psychological – where the body is amenable to suggestion – would benefit by suggestive therapy.

Sore Throat

Sore throat means the inflammation of the pharynx (back of the throat). It occurs  normally when a person has a cold or an attack of influenza. Strep throat is an infection of the pharynx, caused by group A streptococcus bacteria, while sore throat may be a viral or a bacterial infection. Strep throat is common amongst  children and teenagers, between the ages of 5 to 15.

Sore Throat Symptoms:

Pain, irritation of throat and fever:
   In acute sore throat,the patient complains of pain, irritation and inflammation in the throat – followed by chills, fever, and some hoarseness or laryngitis

Lymph glands turn out to be swollen and tender:
  The lymph glands along the sides of the neck may turn out to be swollen and tender. The back of the throat may develop into very red and even covered with a grayish-white membrane. The patient may experience obscurity in swallowing, especially during the acute stage. There may also be some postnatal discharge if the inflammation has stretch to the nasal passages In addition to the above talk about symptoms some of the symptoms of strep throat are difficulty in swallowing, headache, rash, stomach pain and so on. But having all these symptoms does not essentially mean that your child is suffering from strep throat

Sore Throat Causes:

Common cold and influenza:
 The major causes of a sore throat are common cold and influenza. Other causes include sinusitis, measles, diphtheria and even leukaemia in uncommon cases

Sore Throat Remedies:

Sore Throat treatment with Mango Bark:
 Mango bark is effective in the treatment of a sore throat and other throat disorders. Its fluid, which is extracted by grinding, can be applied nearby with beneficial results and can also be used as a throat gargle. This gargle is made by mixing 10 ml of the fluid extract with 125 ml of water

Sore Throat remedy via Belleric Myroblan:
 The herb “belleric myroblan” is an expensive sore throat remedy. A mixture of two grams of the pulp of the fruit, a quarter teaspoon of salt, half a teaspoon of powdered long pepper and two teaspoons of honey must be managed in the treatment of this condition. The fried fruit can also be roasted after wrapping it with wheat flour, and used as a cure for a sore throat.

Sore Throat treatment with Bishop’s Weed:
 Bishop’s weed is precious for sore throat treatment. An infusion of the seeds mixed with common salt can be used helpfully as a gargle in an acute condition caused by a cold.

Sore Throat treatment with Cinnamon:
 Cinnamon is considered as an effective remedy for a sore throat resulting from a cold. One teaspoon of roughly powdered cinnamon, boiled in a glass of water with a pinch of pepper powder, and two teaspoons of honey can be taken as a medicine in the treatment of this situation. Two or three drops of cinnamon oil, mixed with a teaspoon of honey, also give vast relief

Sore Throat remedy with Fenugreek Seeds:
 A gargle prepared from fenugreek seeds has been found to be a very useful remedy for treating a sore throat. To prepare this gargle, two tablespoons of fenugreek seeds should be put in a litre of cold water and permitted to simmer for half an hour over a low flame. This should then be allowed to cool to a bearable temperature, strained, and then used totally as a gargle.

Sore Throat cure with Henna:
 The leaves of henna are helpful as a sore throat cure. A decoction of the leaves can be used as a gargle for this reason.

Sore Throat cure via Holy Basil:
 The leaves of holy basil have also been found helpful in the in curing sore throat. Water boiled with basil leaves can be used as a drink, and also used as a gargle to relieve a sore throat

Sore Throat remedy with Kantakari:
 The herb kantakari is a precious in sore throat remedy. An extract of the plant should be used as a gargle for this reason. This extract is prepared by constantly boiling the plant in about two litres of water after washing it thoroughly

Sore Throat treatment via Liquorice:
 Liquorice is a well-known home remedy for sore throat in all parts of India. A small piece of raw liquorice should he chewed or sucked for treating this situation. The healing property of the herb soothes inflammation speedily

Sore Throat remedy with Tea Decoction:
 A decoction made from tea leaves is very helpful in the treatment of a sore throat. This decoction, mixed with a little bit of salt, should be used as a gargle. It can be used two or three times daily for acquiring relief. It is not essential to use fresh leaves for this purpose. Boiling water can be discharge over used tea leaves in the tea jug and this decoction can be used as a gargle.

Sore Throat treatment via Tamarind:
 Tamarind is also helpful in the treatment of sore throat. Tamarind water must be used as a gargle. A powder of the dry leaves and an infusion of the bark can also be used for preparation of a gargle for curing sore throat

Sore Throat Diet:

All-fruit diet:
 A person suffering from a sore throat should fast on orange juice and water for three to five days, depending on the severity of the situation. When the severe symptoms collapse, the patient may adopt an all-fruit diet for three or four further days

Well-balanced diet:
 Thereafter, he may adopt a well-balanced diet, with importance on seeds, nuts, grains, raw vegetables, and fresh fruit.

Sore Throat treatment: Other Proposals

Warm-water enema and wet pack:
 During the initial juice and water fast, the bowels should be cleansed every day with a warm-water enema. This should be done twice daily in more severe cases. A wet pack should be applied to the throat at two-hourly gaps during the day, and one at night. The process is to wring out some linen cloth in cold water, wrap it two or three times around the affected part, and cover it with flannel. Gargles may be done many times.

Hot Epsom salts bath and exercises:
 A hot Epsom salts bath, taken every day during this period, will be highly helpful. Dry friction, deep breathing, and other exercises should form part of the every day health regimen.

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Tonsillitis

Tonsillitis refers to acute inflammation of the tonsils, which lie, one on each side of the throat. Chronic tonsillitis is a term applied to cases in which there is enlargement of the tonsils accompanied by repeated attacks of infection

  The tonsils are situated at the back of your throat – one on the right and one on the left. These two balls of tissue are part of your bodys infection fighting system – to help you prevent from getting sick. Usually, tonsils do their job well. But sometimes bacteria or viruses get into the tonsils. As a result, tonsils become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing tonsillitis.

Causes:

  Your tonsils are filled with nooks and crannies where bacteria and other materials, including dead cells and mucous, can become trapped. When this occurs, the debris can become concentrated in white formations that occur in the pockets.

  Tonsil stones, or tonsilloliths, are formed when this trapped debris hardens, or calcifies. This tends to occur most often in people who suffer from chronic inflammation in their tonsils or repeated bouts of  tonsilitis.

  While many people have small tonsilloliths that develop in their tonsils, it is quite rare to have a large and solidified tonsil stone.

  Tonsillitis is mainly characterized by swelling within the tonsils, which become red and inflamed and may even show a surface coating of white spots.

Some of the causes are:

   Repeated throat infections.
   Excessive use of spices, condiments, acrid, pungent and astringent food items.
   Constant dry, hawking, dog-like cough.
   Forcible and constant use of voice – often at a high pitch.
   Chronic Congestion, blockade of nose, when nose is blocked by viscid and tenacious mucus.
   Excessive eating of toffees, sweets, tamarind, tartaric acid, chewing gum etc.

Symptoms:

  1.Pain while swallowing.
  2.Sensation of chill and presence of fever.
  3.Tonsils are engorged, enlarged and inflamed like Small balls.
  4.Enlarged, tender glands (lymph nodes) in the jaw and neck.
  5.In Acute state, they also discharge purulent fluid.
  6.Tone and rhythm of respiration is affected.
  7.Headache.
  8.Nasal congestion and runny nose.
  9.Severe sore throat.

Home Remedies:

1.Tonsillitis treatment using Lime:

  Lime is one of the most effective remedies in the treatment of acute tonsillitis. A fresh lime squeezed in a glass of warm water, with four teaspoons of honey and a quarter teaspoon of common salt, should be sipped slowly in such cases

2.Tonsillitis treatment using Milk:

  Milk has been found valuable in tonsillitis. A glass of pure boiled milk, mixed with a pinch uf turmeric powder and pepper powder, should be taken every night for three nights in the treatment of this condition. It will bring beneficial results.

3.Tonsillitis treatment using Vegetable juices:

  Juices of carrot, beet, and cucumber, taken individually or in combination, are especially beneficial. The formula proportion recommended, when used in combination is 300 ml of carrot juice, 100 ml of beet juice, and 100 ml of cucumber juice.

4.One of the best home remedies for tonsillitis includes a glass of warm water with four teaspoons of honey, a quarter teaspoon of common salt and a fresh lime squeezed in it. Drink it twice in a day.

5.Another useful home remedy would be to boil some dry figs and grind them. Add water to it, to make a paste. Apply it over the throat.

6.An effective home remedy would be to cut a lemon into two halves. Sprinkle some black pepper and salt on one of the halves and press it inside with a spoon. Keep licking the lemon till the entire juice has been extracted. Repeat the process two times a day.

7.Gargling two teaspoons of onion juice mixed with lukewarm is used to gargle which helps in curing the tonsillitis problem.

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