Knee Dislocation – Painful, But Easily Treated

Among the many painful injuries that can happen to the knee, one of the most painful is knee dislocation. Basically, this happens when the shin and thigh bones (tibia and femur) are not in the proper alignment, or out of place. These bones are held together by ligaments, and when the ligaments become torn, usually due to an injury of some sort, the bones can dislocate.

Most often, knee dislocation is caused by a major trauma to the knee, such as sports injuries, falls and automobile accidents. It is pretty easy to tell if one has a dislocated knee, because the knee will look crooked following the injury. If the injured person is lucky, the knee will go back into place on its own, and the only remaining symptoms will be pain and swelling for a few days, which can be treated by RICE (Rest, Ice, Compression and Elevation).

Symptoms and Care of Knee Dislocation

The most common symptom of knee dislocation is pain. Other symptoms may include swelling, to the point where the patient may not be able to feel a pulse in their foot. The knee will look crooked or deformed, and there may even be numbness in the foot, especially if there is a lot of swelling. If you think that you may have a dislocated knee, it is important that you seek medical treatment right away. Take a trip to your local emergency room, where x-rays will be taken to ensure that it is a dislocation, and not something even more serious, such as a broken bone.

Other tests may include ultrasound or Doppler to see the level of blood flow through the leg arteries. Because it is possible that there could be nerve damage associated with a dislocated knee, the physician may also check for this, testing for numbness and ability to move.

Although there are some treatments that can be done at home, it is not a good idea to completely treat a knee dislocation yourself. Of course, you can ice it to help the pain and swelling until you can see a physician, who will probably have to put the knee back into place. There is almost always artery damage with knee dislocations, and surgery is necessary in 21% to 32% of all knee dislocations, usually with optimal results. Some patients do report chronic pain following the injury and surgery.

Following treatment by a physician, you will be told to rest the knee joint completely, and immobilization will probably be necessary to relieve knee pain. This is done by wearing a brace that will prevent bending of the knee, and usually must be used until the injury is healed. And, because there are often breaks involved with knee dislocations, it is often necessary to see a bone specialist once the dislocation has healed.

Knee dislocation is a common injury, and one that is treatable. But, it is also an injury that is avoidable in a lot of cases. For instance, if you avoid extreme sports that involve jumping from high places, you avoid risking knee dislocation, as well as a host of other injuries. Take care of yourself, and you will be less prone to knee dislocation and other injuries.

Chronic Knee Dislocation – When Things Don’t Line Up Right – Knee Braces That Can Help

How is your kneecap (patella) doing? Do you have problems with it being unstable?

Chronic knee dislocation is a term often used to describe a dislocation or displacement of the knee cap. It is different from a traumatic dislocation, which is a very serious matter, usually caused by severe trauma to the knee. With a traumatic knee dislocation, the upper and lower leg bones are separated at the knee, and significant damage is usually sustained to the structures both in and around the knee joint (i.e. torn ligaments, vascular injury, etc.). A traumatic dislocation is extremely painful, generally requires immediate medical attention, and often requires surgery to repair the damage to the joint. If you have any reason to suspect that you have a traumatic dislocation, you should seek medical attention as soon as possible. A chronic knee dislocation, on the other hand, is also quite painful, but in many instances, can be treated more conservatively.

With chronic knee dislocation, the knee cap (otherwise called the patella) slips out of place and generally causes irritation, inflammation and a sensation that the knee is weak or “giving out.” Basically, the triangular bone we know as the knee cap is designed to move smoothly over the top of the femur (upper leg bone), staying within a certain groove which nature designed for that purpose. When chronic knee cap dislocation occurs, the cap strays outside of that groove, adversely affecting the other structures (i.e. muscles, tendons, ligaments, etc.) in and around the knee. Consequently, the knee does not bend properly, feels stiff, achy or painful, and may appear swollen. Your knee may also make a “popping” sound upon movement. This condition may come and go as the cap slips in and out of the groove, and the pain from chronic knee dislocation may vary in intensity.

Generally, if the condition becomes severe enough and if it significantly interferes with your activities, you may need to discuss your options, including possible surgery, with your physician. However, in the interim, the use of a brace may help relieve the condition and allow you to function more normally without experiencing frequent chronic knee dislocation.

Knee braces come in a variety of styles and types. Generally, though, one of the main purposes of a knee brace in this instance, is to keep your knee cap in its proper position within the femoral groove. A knee brace can also help lend support to the knee joint so that the pressure and stress that might contribute to chronic knee dislocation are somewhat relieved, making it less likely that the knee cap will be pulled out of alignment. Knee braces do allow for movement, and you can likely perform most, if not all, of your usual activities while wearing one. They are adjustable to fit most knees, are easy to use, and are relatively affordable, especially when compared to other treatment options, such as surgery or extensive therapy.

Metatarsal Stress Fractures

A teenage girl presents complaining of pain in her forefoot. The pain first started 2 weeks ago and has gradually worsened. She noticed swelling over the top of her foot a couple days ago. She recently started long distance running and started training for a half-marathon. She states that her pain worsens the longer she runs and gets somewhat better when she is off her feet. What could be the cause of her pain?

What is a Stress Fracture?

Our bones undergo stresses everyday. Every time we take a step, stress is applied to the bones in our feet. The human body has developed ways to lessen these forces by using muscles in the foot that help decrease the load applied to the bones. Additionally, the ability of the bone to repair itself when minor damage occurs prevents the development of a full fracture. A stress fracture is an injury that occurs because of repeated low-grade stress that is applied to the bone over a prolonged period of time, which overpowers this ability for the bone to repair itself. The slow, progressive nature of this injury causes symptoms to occur gradually and worsen with continued exertion. Our feet endure stresses when we walk, jump or even stand. A change in normal routine or increased level of activity introduces new stresses to the bones of the foot and can result in a stress fracture. An area commonly affected by these types of injuries is the metatarsals, which are the long bones of the forefoot. Metatarsal Stress Fractures Stress fractures affecting the metatarsals are a common occurrence, especially in sports that involve running such as track and field and basketball, especially when played on a hard floor [1].

There are five metatarsals in each foot. It is important to note the function of the individual metatarsals in order to understand which bones are likely to be affected. The first and fifth metatarsals are unique in that they have their own independent range of motion apart from the other middle three metatarsals. This means that they have the liberty to move upward when forces from the ground are applied to them. This helps prevent injury to these two bones, making stress fractures of the first and fifth metatarsals relatively rare. The central three metatarsals (referred to as #2, #3, #4), on the other hand, are more rigid. This is important because their immobility provides stability to the forefoot. However, this anatomical configuration makes the central metatarsals more likely to develop stress fractures. The second metatarsal is particularly susceptible because it is the longest of the five metatarsals. The term "March" fracture has been applied to stress fractures of the second and third metatarsals because of their increased incidence in military personnel. In fact, metatarsal stress fractures were first described in Prussian soldiers in 1855 [2].

Clinical Presentation

Metatarsal stress fractures typically present as pain in the forefoot that increases with weight bearing activity. The pain can be generalized in the front part of the foot or localized to a certain area in advanced cases. The pain usually subsides when the inciting activity is ceased. Over time, however, if left untreated the pain can remain even when at rest. Since the pain usually slowly worsens, the patient may not be able to indicate a specific time when an injury took place. Swelling over the site of injury is very common.

What are the Risk Factors?

The patient should be asked if they recently changed their level of physical activity. Stress fractures commonly occur when people abruptly increase their level of activity. Biomechanical abnormalities in the foot can also lead to development of a fracture. Other risk factors include corticosteroid use, smoking and disorders of Vitamin D (rickets, osteomalacia). Also, smoking can affect bone healing.

Physical Examination

Visual examination of the patient may reveal swelling in the forefoot. The affected metatarsal can be identified by pushing the metatarsal heads to elicit pain over the site of the fracture. Placing a vibrating tuning fork over the suspected metatarsal may also elicit pain.


X-ray imaging is always obtained. However, they may not reveal a visible fracture line early in the course of metatarsal stress fractures. Usually, the diagnosis of stress fracture is made based on the clinical history, even when the radiographs look normal.

MRI scans are useful to visualize a stress fracture, but are not always required especially if the fracture is clearly seen on the x-ray film. These scans can rule out other suspected causes of pain because of the level of detail it reveals. Bone scanning is another method that can be used and involves injection of technetium-99 isotope to visualize uptake of the agent in the area of injury.

Treatment of Metatarsal Stress Fracture

Metatarsal stress fractures can usually be treated non-surgically, especially if the symptoms are addressed early in the course of the disease. The activity that caused the injury must be discontinued until the fracture is healed. The patient should also elevate the injured limb. Crutches may be needed for ambulation to relieve stress. The affected limb may require immobilization with a CAM walker. NSAIDs such as ibuprofen (Motrin) can be used as needed to alleviate pain. When someone chooses to ignore symptoms of a stress fracture and refuses to rest, the injury can progress to a full fracture that could require surgical intervention. Surgery may also be necessary if the injury fails to heal properly or heals in a poor position. Once the patient feels comfortable and the fracture appears healed on imaging physical activity can be resumed. After healing the fracture, return to activity should start off slowly and modified to reduce chances of recurring injury.

Source Material

1. Iwamoto and Takeda. Stress fractures in athletes: Review of 196 cases. J Orthop Sci 2003; 8: 273 – 275.

2. Gehrmann and Renard. Current Concepts Review: Stress fractures of the foot. Foot and Ankle Int 2006; 27:250


What Happens With Clavicle Fractures?

If you are reading this article you would have probably suffered a recent clavicle fracture or know of someone who has. This is because this sort of injury is extremely common and makes up for around 5% of hospital admission cases.

In the entire human body, the clavicle bone is one of the most easy to fracture a bone in the body. The fracture normally happens around the weakest point of the bone which is at the middle third section. This type of fracture often happens in younger children as well as babies. Sometimes this occurs even in newborn babies. If they go through a rough delivery procedure, collarbone fractures can happen.

The most common symptoms experienced by injury sufferers consists of swelling around the area of the clavicle as well as sharp pains whenever the patient moves his or her arm or shoulder – this is referring to fractures and not completely broken clavicle bones.

Generally, if you were to fracture your clavicle, the doctor would advice you to rest the area using a clavicle brace or shoulder sling to support the entire arm. The fractured bone will normally heal on its own within several weeks to a couple of months, this really depends on the age of person as well as the state of health he or she is in. Normally for adults, the shoulder needs to be immobilized for around a month via a sling, however with kids the rate of healing is much faster (this usually takes only around two weeks).

Sometimes clavicle surgery is required but this only happens in about 5% of cases (according to recent studies). In these cases, the fracture has caused the bone to be slightly displaced and deformed and cannot be left to heal on its own. You can usually tell when this has occurred due to a bump that shows up through the skin. The clavicle surgery involves fixing a steel plate along the clavicle bone, and this device is often known as “open reduction internal fixation”.

Cerebral Palsy

Cerebral palsy or CP is a general term that includes disabilities in the neurological functions involving movement and posture. It is a disorder that is non-progressive and begins from disruptions in the development of the child’s brain during pregnancy, at birth or after.

As of yet, cerebral palsy has no known cure. The only way to manage it is through medical intervention that includes prevention and treatment of possible complications that may occur as a result of the condition.

What causes cerebral palsy?

The cause or causes of congenital cerebral palsy has not yet been determined. However, it is known that children born under certain conditions are at the highest risk of developing it. These conditions are: premature birth, the presence of hemorrhage in the brain, an infant requiring a ventilator for more than 4 weeks, an undersized baby who doesn’t cry during the first 5 minutes after being delivered, internal system malformations in the kidneys, spine or heart and the occurrence of seizures.

A small number of incidents of cerebral palsy arise from head injuries during early childhood and may occur after severe malnutrition, infections or extreme head injuries during infancy or early childhood.

What are the types of cerebral palsy?

Spastic or athetoid cerebral palsy refers to movement problems while quadriplegia, hemiplegia and diplegia refers to certain body parts involved in the condition. Spastic cerebral palsy refers to the lack of ability to relax the muscles while athetoid CP refers to the lack of muscle movement control. The spastic type may also occur along with other types and this is usually true in about 30% of cerebral palsy cases.

Quadriplegia is the inability to control the muscles of the arms and legs as well as those of the neck and trunk. An individual with quadriplegia will not be able to walk or even to stand. Diplegia involves both legs while hemiplegia involves an arm and a leg on the same side. An individual with diplegia may be able to walk either independently or with the aid of crutches, canes or walkers.

Another type of cerebral palsy is ataxia, which is the inability to have control over balance and coordination. The degree of this condition varies from child to child and therefore generalizations cannot be made as easily.

How is it diagnosed?

Infants with cerebral palsy cannot perform normal developmental skills like basic motor functions such as reaching for an object, sitting on their own and even walking. Other than these developmental delays, a doctor may also consider abnormalities in the muscles and muscle tones, reflexes and movements.

It is often not easy to make a definite diagnosis of cerebral palsy because it requires an indefinite period of waiting. The child could be over one year old before cerebral palsy is diagnosed, or he could be two years old and discovered not to have the disorder after all.

Blood tests and x-rays will not establish cerebral palsy. They are only used to rule out other medical conditions that may be affecting the child’s development. Oftentimes, tests and scans like CT or Computed Tomography and MRI or Magnetic Resonance Imaging may be used. Again, these tests will not determine whether a child has cerebral palsy, but it will provide evidence of other conditions that may seem proof of cerebral palsy but are actually another medical condition altogether.

The prognosis

There is no single correct way of predicting what and how a child with cerebral palsy will be like when he grows older. However, by the time the child reaches the age of two, a doctor can determine if his condition is quadriplegia, diplegia or hemiplegia. These conditions may be used to inform the parents of what they could expect from then on.

It will also be very difficult to predict the degree of how motor and mental skills will be affected later on. In general, the child’s intellectual capability will determine how his motor or physical skills will fare in the future.

Medical problems related to cerebral palsy

Children suffering from cerebral palsy have problems such as mental retardation, learning disabilities, epilepsy, hyperactivity and attention deficit disorders. For children with conditions like spastic quadriplegia, common problems like difficulty in swallowing may also occur. A child with cerebral palsy will also require lifelong treatment and caregiving.

Paralysis of Will

Most of us don’t know exactly what to do with our Earth Experience! Our identity eludes us, our sexuality confuses us, our minds obliterate us, our bodies ignite/subdue, our spirit exploits while luring us. In other words, we don’t recognize, relate or revere the converging ‘how to’ maximize human potential. In order to grasp/ indulge/satisfy our incessant sexual needs, establish and maintain financial freedom, invest the effort, energy and dedicated interest in spiritual growth, sustain physical well-being, (including optimal health), gratify our mind with rewarding stimulating challenging mental pursuits, while committing, focusing, and fulfilling our deepest inclinations to personal relationships, we slothfully ‘get by.’ Lazy and disinterested we “put it off” until “things get better” or we “have more time.” Sorry folks: we don’t have any more ‘time.’ Celestial calculated Time is exchanged in your very next breath. Milliseconds are escaping while we’re busy making excuses, apologies and explanations.

How long will you bemoan your present situation? Haven’t you bitched loud enough, almost to the point of making yourself sick? You can only gripe until the “water turns to wine”. Then, you’re drunk on your own prefabricated disillusions, regrets, and yes, left over resentments. How fast the words: “I’ll love you for all eternity” or “I’ll never leave you”, quickly dissipate when you no longer see tangible benefit.” Cold, but true. Sure, we get subtle glimpses along the way we oft’ times misinterpret and/or over analyze; stumble into this or that attracting hopeful situation, relationship or career only to find out “it’s not for me.” We pursue goals and aspirations others have set for us simply because we’d be ‘good’ at it or it’s the ‘logical’ thing to do. Sometimes, we even convince ourselves to engage our energy, attention, effort and time in a so-called worthy causes. We follow to the best of our ability, what we believe to be, obvious signposts and symbols, nebulously perceiving that’s certainly where our passions lead. Yet, somewhere just before the end of THAT journey, sometimes, even sooner, we lose our momentum. We begin asking ourselves why we are doing what we are doing and WHO are we doing it for? Certain romances/relationships/positions reflect the irresolute anxiety much sooner than others. It all depends how much expectation is involved. It all starts out like a gang fire, then fizzles into a flint. What went wrong? At what point did we lose our bubbling enthusiasm, childlike innocence, sense of wonderment and awe? When did our ‘this time’ inspiration fade?

It faded in the initial spark of desire. It began to dwindle the instant our human will “set out to get something from it.” Yet again, our guileful motivations beset us! Instead of simply experiencing the event for the sheer enjoyment or pain involved, we, as humans, lust after a specified result becoming so attached to that result, we putrefy the experience. Therefore, leading to grotesquely identified exaggerated magnified disappointment! A Paralysis of Will sets in to defeat and disengage us. Immobilization follows. Until, once again, we turn our attention to another diversion. It’s just that simple. Instead of embarking upon the unassuming path (Earth Walk) with no expectations, by simply placing one foot in front of another, we get tripped up, having confused our minds with such unruly unsettled beliefs, that something better, more wonderfully fabulous, exciting and sexually thrilling is going to come along, “make us writhe and groan in blissful ecstasy.” Aint true, my earthy comrades! Total misconception.

THIS is as good as it gets!!! Whatever you are inwardly feeling (aware of) at this precise moment, you will carry that level of consciousness with you in the next. “Don’t say that!” I hear you screaming. “Anything would be better than what I’m going through.” Just aint so. Nothing on the outside of you, in any situation, relationship, job, partner, circumstance, and/or event financial or physical won’t/can’t make your tweeter twat. The truth is girls, guys, aint nothing to get. We already have it. No need waiting for our ship to come in. Our ship has come in; we are sailing in it. We are carrying the infusion of our Earth Experience momentarily unfolding. IT don’t get ‘NO’ better than this! NO need to prepare, fret or anticipate. Whatever rendition you could imagine in your mind, would be far limited compared to what you are actually carrying in those cells, ‘bustin’ to express. I said, “This” is as good as it gets.

Whatever issue you are currently involved in and no matter from what state of/or frame of mind or point of reference you are drawing from, you find yourself in at this precise moment is: the best there is in you, for and round you. No other THING could be taking place. Nothing else. No one else. No place else. Surprise! The gig is up and the sky didn’t fall. How can a person possibly cope with the overt ‘piss in your cornflakes’ truthfulness of this revelation? Try to change it. Aint gonna happen! The truth stands while the rest falls away. Of course, you will have to come down from your lofty made up place of superiority and touch base with the rest of us on the ground. You will have to concede that the world can survive without your vital input and most of all you will have to settle for being plain ordinary. The divine reason we came to Earth in the first place, to learn how to be truly human. You can remember how to place value and appreciation in the tiniest things insignificant, ugly, vulgar, in the run of a so-called mundane day.

The truth is: it’s easy to be special – no talent needed, but quite another thing to be simply human. Being ordinary is the absolute most extraordinary feat to be accomplished in this life. What does that entail? Whatever comes naturally and conveniently in your delegated life. Don’t chase it!!! No one can take away from you what belongs to you on your path, to be used as part of an Earth Experience. Never. IF it’s inside of you: YOU will do it! You get what’s coming to you. Fame, fortune, notoriety, riches, recognition, love, sex,… “OH! Did I negate to mention you also get a certain amount of the other side of the coin, too?” But, only in the exact precise amount, allocated for you and your perfectly designed Earth Experience. [Nobody gets out of this place alive.]

Your name is stamped on that box of goodies. What has been commissioned to you, in you, for you. You are carrying the only expression of it. You are destined to reveal it in your lifetime. So, relax and let the good or bad times roll. The season will change and you, with it! An irresistible peace of mind and heart full of contentment is yours, right now. Here in the moment. Will you take it? Can you be hu-man? Not possible if you continue with your babbling criticizing idiotic games in love, romance, business and war. Of course, you can continue with them, if you so choose; just remember not to take them so personally. Accept your life as it presently exists, with lucid perception that every single thing that happens to you in your life and that has ever happened from divorce to death and birth to bliss has been ordered precisely and exactly (without error or unnecessary disturbance) in the exact fashion of how you wanted it to be. It’s your call. From the beginning of your countless soul’s journeys in this sphere of cosmic activity throughout the dispensation of time called Earth, you are the walking embodiment of your sacred expression of artistic talent. “Be still and know that you are…”

Hernia – Causes, Symptoms, Treatment

Hernia is a problem that is caused by the weakening of muscles of the abdominal wall. It is a painful disease that can be seen both in children and adults. The causes that may lead to hernia are genetic ones or poor lifting techniques.Because of the weakness of the abdominal wall some internal organs especially intestines bulge into the peritoneum. This type of hernia is an uncomplicated case because the organs can be manipulated back into the body. Even so no one can guarantee that these organs will stay in place without surgical help. This type of hernia is termed a reducible hernia.

Hernia occurs when a part of an organ protrudes through the muscular fiber that has the role of keeping that organ in its place. This usually happens due to a weakness that appears in the muscles that are around the organ, and causes them to tear and let a part of it come out through the small opening that is created. That part of the organ that protudes will create a proeminent bulge that can usually be seen.


Paraesophageal hernia may cause some incarcerations or more acute epigastric pain, because of a strangulation. This type of hernia is rare but it is dangerous, life threatening maybe. Sometimes complications like stomach strangulation appear but in most cases this does not happen.


Hernia symptoms are usually related to the bulge that hernia causes. In The early phases you only notice that small lump that does not hurt when it is touched. As the illness advances the bulge, or herniation as some specialists call it becomes painful and keeps swallowing. The lump becomes more visible when you cough or sneeze and in most cases it can be pushed back with your hand, but it will come out again in a couple of minutes. If it cannot be pushed back then it is possible that you are suffering from a strangulated hernia.

Hiatal hernia doesn’t cause any symptoms or trouble in the body, so in most cases people have it and they don’t even know about it, but they aren’t exposed to any risks. The only time when treatment is required is when strangulation occurs. In this case the patient needs surgery to put the stomach back in its normal position. Hiatal hernia surgery can be done with the help of the laparoscope, an instrument used in many types of surgeries, that enables the doctor to operate without making a large incision in the chest, but through a very small one.


Hiatus hernia is a condition usually diagnosed in later stages due to the lack of symptoms and the initial symptoms very assembling to other digestive diseases. Hiatal hernia is most common in persons of 55 years and more but can theoretically occur at any age. It is caused by a weakening of the diaphragm hiatus (esophageal opening) allowing the upper part of he stomach to turn up into the chest cavity. This condition is known as hiatus hernia and is responsible for the occurrence of gastric reflux.


Umbilical hernia is not surgically repaired in the small children’s case because usually until the child reaches the age of 3 the hernia shrinks and heals by itself. Some mothers try to increase the speed of the healing by tapping a coin to the bulge and forcing it to stay there and push it back, but this method is not medically tested or recommended. However, in some special cases umbilical hernia does require surgical intervention.

Femoral hernias can show no actual symptoms and may cause severe complications if left untreated. The actual surgical maneuver is pushing the hernial content back into the abdomen and repair the problem causing the weakening of the abdominal wall. If the hernia consists out of an intestinal fragment, it must return to its proper place to avoid complications such as a bowel obstruction.

The best treatment for primary inguinal hernias is considered to be the Lichtenstein repair. Not being a hard to do procedure this type of treatment may be used by non-specialist surgeons too. The results of this intervention are less pain and a smaller period of recovering. For bilateral hernias a laparoscopic repair is not only recommended, but necessary. There are some factors that influence the choice. One of them and one of the most important factors are the pores size. The mesh should not contain pores smaller than 10 um in diameter because these may develop bacteria that makes the pores inaccessible to leukocytes.

High School Sports Injuries – Stress Fracture of the Spine

Playing sports without a spine would be quite a challenge, so it’s of the utmost importance to keep it healthy when participating in athletic activities! While spine injuries are common among athletes of all age groups, stress fracture of the spine is one of the most common ones among high school athletes.


Stress fracture of the spine results in overextending the spine. The athlete can suffer from a stress fracture on one or both of the bones that comprise the spine, or vertebra. This often involves a scenario in which the vertebra has slipped out of its normal position. Symptoms of this condition include spasms that occur in the hamstring muscles, and the incapacity to bend forward.

Experts have discovered that sports-related injuries have a greater impact on teens’ backs, than they previously believed. In fact, they’ve discovered that roughly half of 20-year-olds have experienced lower back pain at least once during their lives!


There are two main types of stress fractures in the spine. One is spondylolysis, which is a stress fracture in one of the bones in the spine. The other main type of stress fracture in the spine is spondylolisthesis, which occurs when a bone becomes so weak that it begins to shift out of position.

Teen athletes that are most susceptible to stress fractures of the spine are those whose sports require extreme flexibility and heavy pressure or weight on the back. That includes sports such as football, weightlifting, and gymnastics.


While the types of treatments used for stress fractures of the spine vary from one physician to another, the objective is always to prevent the injury from worsening. One common treatment is a brace, which will prevent the teen athlete from bending his or her back. The duration that the brace stays on the patient varies, though it’s common for an athlete to wear it for three or four months! Physical therapy often happens concurrently with the use of the brace, or following it.

If the initial treatments are unsuccessful, then the next option is surgery. The good news is that it’s typically unnecessary. The process involves the surgeon removing the section of the vertebrae that’s contacting one or more nerves. Another option is to combine multiple vertebrae.

Treating a stress fracture of the spine means that the teen athlete will have to take a time out from the sport that he or she plays. While this can definitely be a frustrating time, it’s necessary in order for the spine to begin healing.


There are several ways to prevent stress fractures of the spine from occurring. It’s crucial that teen athletes do stretching and warm-ups before practice or competitions. They should also wear protective equipment to provide their back with a sufficient amount of support. And it’s also of the utmost importance for teen athletes to use the proper techniques when practicing their sport, or participating in a game or match. While taking these steps won’t guarantee that the athlete won’t suffer back injuries, it will significantly reduce the likelihood that they will occur.

Disc Desiccation

Disc desiccation is a mysterious medical term for many patients who undergo MRI imaging of their spinal structures. Almost every adult patient will demonstrate desiccation in some areas of the spine, as the condition is normal and expected. However, patients who do not know the objective facts about disc conditions may be incredibly frightened when the desiccation diagnosis is made. It is for this reason that every back pain sufferer needs to know all about intervertebral discs and how they age as part of their natural lives.

So what exactly is disc desiccation? Many of you are more familiar with the term degenerative disc disease. This diagnosis is used interchangeably with desiccation and describes a condition where the spinal discs lose moisture and their ability to hold moisture. Young and healthy discs are full of water content, much like a gel, but they change as the person ages. The results of desiccation are easily seen on virtually any type of advanced diagnostic imaging, including MRI or CT scan. The discs will become smaller and thinner, shrinking in diameter, thickness and circumference. In some cases, the outer disc wall will also degenerate, suffering from small holes called annular tears. While this all sounds very bad, it must be reinforced that these processes are not inherently painful or harmful and typically affect every adult to one degree or another in their lumbar and cervical spinal regions.

Desiccation also facilitates herniations, bulges, protrusions, protractions and ruptures of spinal discs. All these terms (and more) are used to describe conditions where the nucleus of the disc creates an abnormal bubble in the outer disc wall and in some cases, actually breaks through and leaks into the body cavity. I am sure that all of you have heard the various horror stories about herniated discs, but once again, there is often much ado about nothing. There is little or no clinical evidence linking herniations to chronic back pain in most cases. Herniations can enact symptoms in some patients, although these aches and pains are mostly temporary and not debilitating. In only a very few patients are herniated discs actually the root source of ongoing severe dorsopathy or related neurological effects.

So, basically desiccation is normal, but it helps to create the ideal environment for herniations to occur, which is also normal. This is why so many people have herniated discs in the lower lumbar region and the mid to lower cervical region. These are the areas of notable desiccation and the areas of the spine which must bend, flex and work the most. It is no coincidence that these are also the common areas of arthritic change in the spine.

When discs degenerate, the vertebral bodies become closer together and may touch end to end on occasion. This increased bone on bone friction causes the wearing away of protective cartilage and results in the condition known as osteoarthritis. This is the same form of arthritis which can (and often does) affect many of the major joints in the body, including the elbows, shoulders, hips, knees and hands. Most cases of osteoarthritic change are nothing to be concerned about and although some may enact small aches and pains, the condition is not conclusively linked to severe back pain in almost any case. The exception to the rule is when osteophytes, also known as bone spurs, form in particularly problematic areas of the spinal canal. These hard little nuggets of bone can truly impinge on the spinal cord, causing spinal stenosis, or the neuroforaminal openings, causing foraminal stenosis, and may require professional and even surgical treatment in some cases.

So, desiccation is the root universal condition which usually facilitates both osteoarthritis and herniated discs. However, none of these 3 conditions are the typical causes of chronic back pain, although they are mistakenly diagnosed as such in a great number of cases. Treatments for the various conditions are rarely successful, proving the error of the diagnostic conclusion, while therapies which do nothing to change the spinal structure often provide a lasting cure, further dispelling the myths of the structural nature of back pain based on Cartesian medial philosophy.

I always recommend that patients learn the facts about their diagnosed source of pain. With a bit of enlightened research, patients can understand the real facts about dorsopathy and why it rarely responds to medical treatment and especially surgery. For patients who have already tried everything without success, you have even more reason to become clued in to the truth. Continue on your present path and you are sure to become a victim of failed back surgery, if this cruel condition is not already your fate. Get back on the right road and a lasting cure may be just around the corner…

Stoppping the Suicide Disease – Trigeminal Neuralgia Or Tic Douloureux

Trigeminal neuralgia (TN) , also known as tic douloureux, is considered by many to be among the most painful of conditions of mankind, and was once labeled the “suicide disease” because of the significant numbers of people taking their own lives before effective treatments were discovered. The disease entity of Trigeminal Neuralgia has been known now for centuries. It is probably one of the worst kinds of pains known to man. An estimated one in 15,000 people suffers from trigeminal neuralgia, although numbers may be significantly higher due to frequent misdiagnoses. Trigeminal neuralgia is relatively rare. An estimated 45,000 people in the United States and an estimated one million people worldwide suffer from trigeminal neuralgia. It usually develops after the age of 40 and affects women in a 2:1 ratio.

Trigeminal neuralgia results from a disorder of the trigeminal nerve and it is thought that TN results from irritation of the trigeminal nerve. This nerve supplies the face, teeth, mouth, and nasal cavity with feeling and also enables the mouth muscles to chew. The fifth cranial nerve gives sensation to almost the entire face, explaining why the disorder can cause pain in different areas of the face. Trigeminal neuralgia is the most frequent of all neuralgias.

People with trigeminal neuralgia become plagued by intermittent severe pain that interferes with common daily activities such as eating and sleep. They live in fear of unpredictable painful attacks. It is an acute, piercing, electric shock-like pain in those regions of the face served by the Trigeminal (5th) Cranial Nerve (CN V) . CN V serves three areas of the face; the forehead and eye, the cheek, and the jaw. Although trigeminal neuralgia cannot always be cured, there are treatments available to alleviate the excruciating pain. Historically anti convulsive medications were normally the first treatment choice, such as Tegretol or Neurontin. In trigeminal neuralgia, painful attacks may occur frequently over the course of a few hours to several weeks at a time, and then diminish for a period of weeks or months. Each attack can last from a few seconds to up to 2 minutes. It may go into remission or stop completely for months or years.

Due to trial and error use of medications the pain may be best controlled by the use of interferential stimulation, IFT, since the treatment can be rendered prior to the onset of the pain. The IFT brings immediate sensory relief and prevents pain or reduces the severity of the pain. Due to the face having less moisture because of the tissue types the interferential treatment may be best when used in conjunction with moist packs to allow greater penetration of the interferential current to block the pain to the brain. The elimination of the first primary attacks by interferential therapy can prevent the reoccurence of future attacks.

Unlike drugs, the interferential treatment efficacy is immediate for the patient. Upon beginning treatment the relief is instant and can be long lasting due to the physiological changes caused by the interferential treatment itself. It is not uncommon for one 30 minute treatment of interferential to be sufficient to stop any recurrences of pain for months. With prolonged frequency of use, when needed, the trigeminal neuralgia may potentially be effectively eliminated and the patient remains free of the disease.

Carpal Tunnel Syndrome – Pinched Median Nerve at the Wrist

Carpal tunnel syndrome is by far the most common and widely known of the “pinched nerve” conditions. This article addresses: What is it? Who is at risk for this condition? How is it diagnosed? What kinds of treatments work best?

Carpal tunnel syndrome refers to symptoms caused by entrapment of the median nerve in the carpal tunnel. “Carpal” itself means “wrist,” so a carpal tunnel is nothing more than a wrist tunnel. This particular tunnel can be a crowded place, as it contains not just the median nerve, but nine tendons as well. The “syndrome” consists of some combination of pain, numbness and weakness.

Pain, numbness, or both, are the usual earliest symptoms of carpal tunnel syndrome. Pain can affect the fingers, hand, wrist and forearm, but not usually the upper arm or shoulder. Numbness affects the palm side of the thumb and fingers, but usually spares the little finger because this finger is connected to a different nerve.

When weakness is present, it usually indicates that the condition is already severe, and when muscles atrophy (wither) it means the condition is even worse. The affected muscles are those downstream from where the nerve is pinched, and can include those controlling any of three motions of the thumb. In addition, bending of the first knuckles of the index and middle fingers can be affected, as can straightening of the second knuckles of the same fingers. When muscle atrophy is present, it is most evident in the muscular ball at the base of the thumb.

Carpal tunnel syndrome occurs more frequently in women than in men. People who work with their hands a lot – for example to sew, operate hand-tools or perform assembly-line work – are at increased risk for developing this condition. Various medical conditions can also increase the risk of carpal tunnel syndrome, including injuries, arthritis, diabetes, low levels of thyroid hormone and pregnancy. In the case of pregnancy, carpal tunnel syndrome often appears in the third trimester and resolves after the woman delivers.

Optimum diagnosis of this condition combines the time-honored methods of a doctor’s history-taking and physical examination with tests of nerve function called nerve conduction studies. Nerve conduction studies are exquisitely sensitive in detecting impairment of the median nerve at the wrist, particularly when the median nerve is compared with a nearby healthy nerve in the same patient.

In nerve conduction studies, the nerve on one side of the carpal tunnel is activated by a small shock to the skin. An oscilloscope measures how long it takes for the resulting nerve-impulse to arrive on the other side of the carpal tunnel. When the median nerve is pinched, the nerve-impulse is delayed or blocked. Nerve conduction studies are so sensitive that sometimes they show problems that aren’t even causing symptoms. That’s why nerve conduction studies don’t stand alone in diagnosing carpal tunnel syndrome. The examining physician needs to decide if the results make sense for the particular patient in question.

Nerve conduction studies not only show whether or not the median nerve is impaired at the wrist, but also provide precise data concerning how bad the impairment is. In addition, these studies survey the function of other nerves in the arm and hand. Occasionally, a nerve in an adjacent tunnel (the ulnar nerve in Guyon’s canal) can also be pinched. In other cases, nerve conduction studies show that the problem is not one of single nerve-pinches, but rather a more diffuse pattern of nerve-impairment called polyneuropathy. Of course, sometimes the studies are completely normal and suggest that the symptoms are due to something else.

To treat carpal tunnel syndrome, starting with “conservative” treatment makes sense in most cases, especially when the symptoms are still in the mild-to-moderate range. Conservative treatment usually includes a wrist-splint that holds the wrist in a neutral position. In a study published in 2005 researchers at the University of Michigan investigated the effectiveness of wrist-splinting for carpal tunnel syndrome in workers at a Midwestern auto plant. In a randomized, controlled trial – the gold standard method for judging treatments – about half the workers received customized wrist-splints that they wore at night for six weeks. The remaining workers received education about safe workplace procedures, but no splints. After treatment the workers with splints had less pain than those without, and the difference in outcome was still evident after one year.

Conservative treatment might additionally include use of anti-inflammatory medications like aspirin or naproxen, or even steroid drugs. A more intrusive, though still non-surgical, treatment consists of injecting steroid medication into the carpal tunnel itself. This might benefit selected patients, but in a 2005 randomized, controlled study of patients with mild-to-moderate symptoms, researchers at Mersin University in Turkey showed that patients receiving splints did better than those who received steroid injections.

Surgeons can relieve pressure on a pinched median nerve by cutting a constricting, overlying band of tissue. A 2002 study at Vrije University in Amsterdam compared surgical treatment to six weeks of wrist-splinting. After 18 months 90% of the operated patients had a successful outcome compared with 75% in the splinted group.

In some cases it can be reasonable to try conservative treatments without first confirming the diagnosis with nerve conduction studies. However, in the author’s opinion, this risk-free form of testing should be performed prior to any carpal tunnel surgery. (Full disclosure: The author performs nerve conduction studies!)

(C) 2005 by Gary Cordingley

Torticollis Or Acute Wry Neck

Acute wry neck or torticollis is relatively uncommon and precipitated typically by the sudden onset of significant neck pain which leads to reflex neck muscle contractions and the maintenance of an abnormal neck position. This abnormal posture is known as torticollis and is a sign of an underlying problem of some kind, but this article discusses an acquired torticollis secondary to an acute neck pain of mechanical origin. It is typical for patients to report they woke with severe neck pain and torticollis, with the process often assumed to be secondary to sleeping in an inappropriate position during the night.

Typical initial presentation a high level of neck pain with muscle spasms and the inability to restore the head to the central posture. A few days or up to a fortnight is enough to resolve most of these pains and treatment is analgesia, collar if needed, physiotherapy such as neck massage, neck stretching and neck exercises. When examined a patient exhibiting torticollis will keep their head flexed to the painful side to some degree and also rotated away from the painful side. The usual symptoms are stiff neck, limited range of motion and neck and scapular pain, with onset often sudden such as when hair drying with a towel or turning the head fast.

The first thing a person is aware of is the sudden pain on one side of the neck, often severe and lower in the neck. There may be pain radiating also down over the scapula and out over the shoulder. If a considerable amount of arm pain is present then this should raise the suspicion of a lesion of one of the cervical nerve roots. Nerve root problems are usually somewhat slower in onset but if the symptoms presented on waking this could be the diagnosis. The outcome is very likely to be just as good as the muscle or joint strain which is more common, but recovery typically takes longer over a period of weeks.

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.

Any thoracic, shoulder blade, shoulder or arm pain will also be recorded. The physio may decide to test the reflexes of the biceps and triceps muscles to check if the C6 or C7 nerve roots are involved should the symptoms indicate the possibility. The sensibility of the skin to light touch can also be investigated for similar reasons. The physiotherapist is less likely to choose to test the muscle power in the shoulders and arms as this would cause an increase in pain and not reflect the patient’s true muscle strength. The usual questioning to exclude potentially serious underlying causes or complicating medical conditions will be undertaken.

Physiotherapy management of an acute wry neck is based on the same principles for all injuries of soft tissues. Firstly the physio attempts to reduce the inflammation and pain of the injury and thereby the muscle spasms which exacerbate the pain. Analgesics and anti-inflammatory drugs can be very useful as the pain is the primary problem and not some anatomical abnormality of the neck. Typical physiotherapy management includes ice, use of a collar if indicated and gentle tractioning of the neck relax the neck muscles and settle pain.

Progression on to further therapy techniques is planned once the pain is under control such as neck massage, gentle muscle neck stretches for muscle tightness and mobilisation of the joints. The patient is asked to perform active movements within reasonable pain limits. On restoration of more normal neck ranges of motion and head position the next stage of physiotherapy is to increase the neck muscle strength and endurance so that the person can return to normal.

Torticollis – What You Need to Know

The muscles in your neck are in uncontrollable spasms, and your head is twisted to one side. You suffer from pain daily and sometimes that pain radiates into your shoulders. You may have torticollis, also called spasmodic torticollis or cervical dystonia.

Torticollis is a disorder where the neck muscles contract uncontrollably, causing the head to be twisted or turned in various positions. Sometimes a jerking of the head will also occur. This condition is usually painful and certain activities such as standing and walking can make spasms worse, making even simple tasks difficult. Severe headaches are not unusual with torticollis.

While anyone can get this condition it is more common in middle aged females, usually between 35-60 years old. Symptoms usually begin gradually then plateau to a place where they don’t get any worse. For certain patients torticollis can be a debillatating condition that leads to depression.

There is no cure for torticollis but there are different treatment options. Some people take different medications, pain relievers and may get routine massage to help relax muscles and relieve discomfort.

Others go a more holistic route using acupunture and reike therapies. While others will opt for surgery.

Currently there are two different brain surgeries for torticollis:one called “lesioning procedures”, which involves destruction of targeted, abnormal brain tissue and the other is called “deep brain stimulation” which mimics the effects of lesioning using electrical impulses.

If this condition is affecting you, see your doctor, take care of yourself and take heart-there is plenty of hope and help on the way!

Tips to Make the Most Out of Your Physician Assistant Program

Physician assistant programs have increased in number of the last few years. There a well over 136 programs in the country to choose from. While PA program does not last as long as physician programs, there is considerable difficulty too in the study of this program. Here are some tips to guide you in your study and in the process make the most out of it.

Much like the Information Technology (IT) field, the medical field also constantly changes when new research reveals new information about a specific health issues. As such, students of this program ought to read up on various reading materials to keep themselves abreast of new findings in this field.

By developing understanding in statistics and medical study design, you are able to judge the quality of studies and know how the various flaws can affect conclusion about a particular issue. Many institutions offering Master programs in PA requires that applicants have a foundation in statistics. As such, you should plan your study in undergraduate level properly. This is because there are cases where students are not able to graduate on time as a result of not taking the stated prerequisites in their undergraduate programs.

In regard to your training experience, you should make sure that you can obtain a good experience by working with a certified PA. Whilst undergoing your training, you should carry a notebook with you so that you can jot down whichever new concepts or terms leant. For instance, you may learn about the words dysarthria and aphonia when attending to a patient with stroke. Just be sure to write down things that you learn and never depend solely on your memory.

Effective Home Remedies for Strep Throat

Strep throat is inflammation of the throat, tonsils and lymph nodes due to infection with group A streptococcus bacteria. Strep throat is very common during the flu seasons and it can be preceded by mild symptoms such as runny nose, sneezing or cough. The incubation period of strep throat is around 3-5 days and most symptoms occur within this period of time. Common symptoms of strep throat are: throat inflammation and swelling, difficult swallowing, difficult breathing, mucus-producing cough, fatigue, body weakness, headache, nausea, poor appetite, enlargement of the lymph nodes and tonsils, excessive sweating and fever.

Strep throat is very contagious and the bacteria responsible for causing the illness can be easily transmitted from a person to another by direct touch, sneezing or coughing. In order to prevent infection with streptococcus bacteria, it is very important to maintain proper personal hygiene and to avoid entering in contact with infected people. The persons affected by strep throat should also take measures in avoiding spreading the bacteria to others.

Untreated strep throat can lead to serious complications and doctors usually recommend a course of antibiotics to most people affected by strep throat. With appropriate medical treatment, the illness can be overcome quickly, minimizing the risk of developing complications.

Although they can’t replace medical treatments completely, there are various home remedies that can quickly relieve the symptoms of strep throat and speed up the process of recovery. Corroborated with proper rest, an appropriate diet and plenty of fluids, natural remedies can quickly deal with the undesirable effects of strep throat.

Chamomile tea is one of the best natural remedies for strep throat. Its analgesic properties can provide rapid relief for throat pain and headaches. Administered every few hours, chamomile tea can also reduce fever and prevent dehydration. A very strong natural remedy, sage can reduce inflammation, protecting the soft tissues of the throat and respiratory system. Sage can be used either under the form of tincture or under the form of capsules. Thanks to its antibiotic properties, garlic is also an appropriate home remedy for strep throat.

Gargling with salt water can fight against bacteria and can reduce throat inflammation and pain, while saline nasal sprays can help decongest the airways clogged with mucus. When suffering from strep throat, it is very important to maintain a warm temperature in your bedroom and to increase the air humidity by using mist humidifiers. You should avoid exposure to chemicals or irritants such as cigarette smoke and alcohol vapors. You should keep away from any substance with strong, persistent odor in order to prevent further inflammation of the respiratory system’s soft tissues and membranes.

It is recommended to avoid drinking cold or very hot beverages, as they can cause throat irritation and pain, slowing down the process of healing. Also, keep away from spicy and irritant foods, as they are not tolerated well by an inflamed throat. When suffering from strep throat, you should only eat soft foods such as soups, yogurts, mashed potatoes, and non-irritant fruits.