COCCYDYNIA

COCCYDYNIA - Coccydynia is often caused by an injury, but it may occur seemingly spontaneously. There are many causes of tailbone pain that can mimic coccydynia, including sciatica, infection, pilonidal cysts, sacroiliitis, and fractured bone.Inflammation of the tailbone is referred to as coccydynia. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. The pain is often worsened by sitting.
 
One way of classifying coccydynia is whether the onset was traumatic versus non-traumatic. In many cases the exact cause is unknown and is referred to as idiopathic coccydynia. Coccydynia is a fairly common injury which can often result from falls, particularly in leisure activities such as cycling. Coccydynia is often reported following a fall or after childbirth. In some cases, persistent pressure from activities like bicycling may cause the onset of coccyx pain. Coccydynia due to these causes usually is not permanent, but it may become very persistent and chronic if not controlled. Coccydynia may also be caused by sitting improperly thereby straining the coccyx.

The main symptom is pain and tenderness in the area just above the buttocks.
The pain may:

• be dull and achy most of the time, with occasional sharp pains
• be worse when sitting down, moving from sitting to standing, standing for long periods, having sex and going for a poo
• make it very difficult to sleep and carry out everyday activities, such as driving or bending over

Some people also have back pain, shooting leg pains (sciatica) and painful buttocks and hips.

CERVICAL SPONDYLOSIS

CERVICAL SPONDYLOSIS - Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bone. Cervical spondylosis is a common degenerative condition of the cervical spine. It is most likely caused by age-related changes in the intervertebral disks. These include neck and shoulder pain, suboccipital pain and headache, radicular symptoms, and cervical spondylotic myelopathy. As disk degeneration occurs, mechanical stresses result in osteophytic bars, which form along the ventral aspect of the spinal canal.

Sometimes, cervical spondylosis results in a narrowing of the space needed by the spinal cord and the nerve roots that pass through the spine to the rest of your body. If the spinal cord or nerve roots become pinched, you might experience:

• Tingling, numbness and weakness in your arms, hands, legs or feet
• Lack of coordination and difficulty walking
• Loss of bladder or bowel control

Cervical spondylosis is caused by aging and chronic wear on the cervical spine. This includes the disks or cushions between the neck vertebrae and the joints between the bones of the cervical spine. There may be abnormal growths or spurs on the bones of the spine-vertebrae. Over time, these changes can compress one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.


The pain may get worse:

• After standing or sitting
• At night
• When you sneeze, cough, or laugh
• When you bend the neck backwards or walk more than a few yards

CERVICOGENIC HEADACHE

CERVICOGENIC HEADACHE - Neck pain and cervical muscle tenderness are common and prominent symptoms of primary headache disorders. Less commonly, head pain may actually arise from bony structures or soft tissues of the neck, a condition known as cervicogenic headache. Cervicogenic headache is a syndrome characterized by chronic hemicranial pain that is referred to the head from either bony structures or soft tissues of the neck. The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibers in the decreasing tract of the trigeminal nerve are believed to interact with sensory fibers from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head. A functional convergence of sensorimotor fibers in the spinal accessory nerve and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and might also be responsible for the referral of cervical pain to the head. Neck pain and cervical muscle tenderness are common and prominent symptoms of primary headache disorders. Less commonly, head pain may actually arise from bony structures or soft tissues of the neck, a condition known as cervicogenic headache.

Cervicogenic headaches typically cause pain at the back of the head. This pain may spread to the top of the skull and sometimes to the forehead or temple. It may also be associated with pain or discomfort behind the eye.

Cervicogenic headache usually presents as a constant dull ache, normally situated at the back of the head, although sometimes behind the eyes or temple region, and less commonly, on top of the head, forehead or ear region. Pain is usually felt on one side, but occasionally, both sides of the head and face may be affected.

CUBITAL TUNNEL SYNDROME

CUBITAL TUNNEL SYNDROME - Cubital tunnel syndrome is the effect of pressure on the ulnar nerve, one of the main nerves of the hand. It can result in a variety of problems, including pain, swelling, weakness or clumsiness of the hand and tingling or numbness of the ring and small fingers. It often results in elbow pain on the side of the arm next to the chest. The common cause of all these nerve compression syndromes is increased pressure, usually from bone or connective tissue, on a nerve in the wrist, arm, or elbow. In most cases, cubital tunnel syndrome and radial tunnel syndrome can be managed with conservative treatments. But more severe cases may require surgery to reduce pressure on the affected nerve.

Cubital tunnel syndrome is also known as ulnar neuropathy, is caused by increased pressure on the ulnar nerve, which passes close to the skin's surface in the area of the elbow commonly known as the "funny bone.

Sometimes, cubital tunnel syndrome results from abnormal bone growth in the elbow or from intense physical activities that increases pressure on the ulnar nerve. Baseball pitchers, for example, have an increased risk of cubital tunnel syndrome, because the twisting motion required to throw a slider can damage delicate ligaments in the elbow.

Early symptoms of cubital tunnel syndrome include:

• Pain and numbness in the elbow
• Tingling, especially in the ring and little fingers

THE CONDITION CAUSED DUE TO RESTING ELBOWS ON THE HARD SURFACES SUCH AS UNPADDED TABLES/ ARMRESTS. THE ULNAR NERVE, WHICH FEEDS THE RING & LITTLE FINGERS, CAN BECOME IMPAIRED FROM PRESSURE NEAR THE ELBOWS.

CARPAL TUNNEL SYNDROME

CARPAL TUNNEL SYNDROME - Carpal Tunnel Syndrome is numbness, tingling, weakness and other problems in your hand because of pressure on the median nerve in your wrist.

THE SYNDROME CAUSED DUE TO THE COMPRESSION OF MEDIAN NERVE DUE TO EXCESSIVE WORKING ON COMPUTERS OR AS THE COMPLICATION OF COLLE’S FRACTURE.

• CLINICALLY, MOTOR LOSS- INTRINSIC MUSCLE WASTING—WEAK GRIPPING
• APE THUMB DEFORMITY
• LOSS OF OPPOSITION OF THUMB
• PARALYSIS OF FIRST & SECOND LUMBRICALS- UNABLE TO MAKE FIST
• SENSORY LOSS LATERAL 3 HALF DIGITS
• DRY SKIN & WARM DUE TO ARTERIOLAR DILATATION

The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling in your thumb and first three fingers. Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller.

 Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or hand. Some people may have pain in their arm between their hand and their elbow. Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.

CELEBRAL PALSY

CELEBRAL PALSY - Cerebral Palsy is considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development. Cerebral Palsy primarily affects body movement and muscle coordination. Cerebral Palsy is actually caused by brain damage. The brain damage is caused by brain injury or abnormal development of the brain that occurs while a child’s brain is still developing — before birth, during birth, or immediately after birth. Cerebral Palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and oral motor functioning. An individual with Cerebral Palsy will likely show signs of physical impairment. However, the type of movement dysfunction, the location and number of limbs involved, as well as the extent of impairment, will vary from one individual to another. It can affect arms, legs, and even the face; it can affect one limb, several, or all. Cerebral Palsy affects muscles and a person’s ability to control them. Muscles can contract too much, too little, or all at the same time. Limbs can be stiff and forced into painful, awkward positions. Fluctuating muscle contractions can make limbs tremble and shake.

Common Causes of Cerebral Palsy:

• Bacterial and viral infections
• Bleeding in the brain (hemorrhaging)
• A lack of oxygen to the brain before, during or after birth (asphyxia)
• Prenatal exposure to drugs and alcohol, mercury poisoning from fish and toxoplasmosis from raw/undercooked meat
• Head injuries sustained during birth or in the first few years of infancy

 SYMPTOMS

• Poor muscle control, tone, and reflex
• Inability to control body movements, posture, balance
• Inability to control body functions such as eating, urination and defecation
• Impairments of vision, hearing, speech, learning and intellectual development
• Frequent seizures
• Some children may be confined to a wheelchair or may be bed-bound and require invalid-type care.

BAKER'S CYST

BAKER'S CYST - A Baker's cyst is a fluid-filled cyst that causes a bulge and a feeling of tightness behind your knee. The pain can get worse when you fully flex or extend your knee or when you are active. A Baker's cyst is caused when excess joint fluid is pushed into one of the small sacs of tissue behind the knee. When this sac fills with fluid and bulges out, it is called a cyst. The excess fluid is usually caused by conditions such as rheumatoid arthritis or osteoarthritis that irritate the knee. It may also be caused by an injury.

Often a Baker's cyst causes no pain. When symptoms occur, they may include:

• Tightness or stiffness behind the knee.
• Swelling behind the knee that may get worse when you stand.
• Slight pain behind the knee and into the upper calf. You are most likely to feel this when you bend your knee or straighten it all the way.

Symptoms can include pain, swelling and tightness behind the knee. Rarely, a Baker's cyst can split open (rupture) and cause similar symptoms to a deep vein thrombosis (DVT). A Baker's cyst often gets better and disappears by itself over time. However, there are various treatments that may help if you do have symptoms associated with it.

 In general, the larger the Baker's cyst, the more likely it is to produce symptoms. You may be able to see or feel the swelling behind your knee. Sometimes you may also notice that the knee joint itself is swollen. Some people feel an ache around the knee area. It may be difficult to bend your knee if you have a large Baker's cyst and the area behind your knee may feel tight, especially when you are standing up. Less commonly, you may feel a sensation of clicking or locking of your knee.

ANKYLOSING SPONDYLITIS

ANKYLOSING SPONDYLITIS - #Ankylosing #spondylitis is an inflammatory disease that can cause some of the vertebrae in your spine to fuse together. This fusing makes the spine less flexible and can result in a #hunched-forward #posture. If ribs are affected, it may be difficult to breathe deeply. Ankylosing spondylitis affects men more often than women. Signs and symptoms of ankylosing #spondylitis typically begin in early adulthood. Inflammation also can occur in other parts of your body. Constant pain and stiffness in the low back, buttocks, and hips that continue for more than three months. Spondylitis often starts around the sacroiliac joints. Ankylosing spondylitis can cause an overgrowth of the bones, which may lead to #abnormal joining of bones, called "bony fusion." Fusion affecting bones of the neck, back, or hips may impair a person's ability to perform routine activities. Spondylitis also may affect some of the ligaments and tendons that attach to bones. Ankylosing spondylitis is a long-term disease that affects the joints near the center of the body, especially the spine and sacroiliac joints. The sacroiliac joints are located at the lowest end of the spine where the sacrum meets the iliac bone in the pelvis. AS can lead to eventual fusion of the spine. Peripheral joints away from the spine, such as the hips and knees, may also be involved.

 SYMPTOMS

• The joint between the base of your spine and your pelvis
• The vertebrae in your lower back
• The places where your tendons and ligaments attach to bones, mainly in your spine, but sometimes along the back of your heel
• The cartilage between your breastbone and ribs
• Your hip and shoulder joints

 Ankylosing spondylitis is a type of arthritis that primarily affects the spine. The disease is characterized by inflammation and resulting stiffness and pain in the joints along the spine. The knee and shoulder joints may also be affected.

BACK PAIN - INDRAPRASTH PHYSIOTHERAPY CENTRE

BACK PAIN - Pain in the low back can be a result of conditions affecting the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area. Back pain may be acute, sub-acute, or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain, or a burning sensation. The pain may radiate into legs or feet, and may include tingling, weakness or numbness in the legs and arms.Back pain is one of the most common reasons people go to the doctor or miss work and a leading cause of disability worldwide. Most people have back pain at least once. Fortunately, you can take measures to prevent or relieve most back pain episodes. If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks and keep it functional for the long haul.

Signs and symptoms of back pain may include:

• Muscle ache
• Shooting or stabbing pain
• Pain that radiates down your leg
• Limited flexibility or range of motion of the back

 Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly. Poor physical fitness. Back pain is more common in people who are not fit. Being overweight. A diet high in calories and fat can make you gain weight. Too much weight can stress the back and cause pain.


Back pain can also occur with some conditions and diseases, such as:

• Scoliosis
• Spondylolisthesis
• Arthritis
• Spinal stenosis
• Pregnancy
• Kidney stones
• Infections
• Endometriosis
• Fibromyalgia.

ANTERIOR CRUCIATE LIGAMENT INJURY (ACL) - INDRAPRASTH PHYSIOTHERAPY CENTRE

ANTERIOR CRUCIATE LIGAMENT INJURY - One of the most common knee injuries is an anterior cruciate ligament sprain or tear. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments.

An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament in the knee. A tear may be partial or complete.

An ACL injury can occur if you:

• Get hit very hard on the side of your knee.
• Overextend your knee joint
• Quickly stop moving and change direction while running, landing from a jump, or turning.

 The Anterior cruciate ligament (ACL) is an important internal stabilizer of the knee joint, restraining hyperextension. Anterior cruciate ligament injury occurs when the ligament's biomechanical limits are exceeded, often with a hyperextension mechanism. The combination of "pop" during a twisting movement or rapid deceleration, together with inability to continue participation, and followed by early swelling, is said to indicate a probability of rupture of the anterior cruciate ligament.

An anterior cruciate ligament, or ACL, injury is a tear in one of the knee ligaments that joins the upper leg bone with the lower leg bone. The ACL keeps the knee stable.Injuries range from mild, such as a small tear, to severe, such as when the ligament tears completely or when the ligament and part of the bone separate from the rest of the bone.

ANKLE SPRAIN - INDRAPRASTH PHYSIOTHERAPY CENTRE

ANKLE SPRAIN - An ankle sprain is an injury to the tough bands of tissue that surround and connect the bones of the leg to the foot. The injury typically happens when you accidentally twist or turn your ankle in an awkward way. This can stretch or tear the ligaments that hold your ankle bones and joints together.

All ligaments have a specific range of motion and boundaries that allow them to keep the joints stabilized. When ligaments surrounding the ankle are pushed past these boundaries, it causes a sprain. With most sprains, you feel pain right away at the site of the tear. Often the ankle starts to swell immediately and may bruise. The ankle area is usually tender to touch, and it hurts to move it. You will probably have extreme pain at first and will not be able to walk or even put weight on your foot. Usually, the more pain and swelling you have, the more severe your ankle sprain is and the longer it will take to heal.

An ankle sprain can range from mild to severe, depending on how badly the ligament is damaged and how many ligaments are injured. With a mild sprain, the ankle may be tender, swollen, and stiff. But it usually feels stable, and you can walk with little pain. A more serious sprain might include bruising and tenderness around the ankle, and walking is painful. Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems.

Ligaments help stabilize joints, preventing excessive movement. A sprained ankle occurs when the ligaments are forced beyond their normal range of motion. Most sprained ankles involve injuries to the ligaments on the outer side of the ankle.

BELL'S PALSY

BELL'S PALSY - Bell's palsy is a form of temporary facial paralysis resulting from damage or trauma to the facial nerves. The facial nerve-also called the 7th cranial nerve-travels through a narrow, bony canal in the skull, beneath the ear, to the muscles on each side of the face. When Bell's palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis.

Symptoms of Bell's palsy can vary from person to person and range in severity from mild weakness to total paralysis.  These symptoms may include twitching, weakness, or paralysis on one or rarely both sides of the face.  Other symptoms may include drooping of the eyelid and corner of the mouth, drooling, dryness of the eye or mouth, impairment of taste, and excessive tearing in one eye. Bell's palsy occurs when the nerve that controls the facial muscles is swollen, inflamed, or compressed, resulting in facial weakness or paralysis.

Signs and symptoms of Bell palsy include the following:

• Acute onset of unilateral upper and lower facial paralysis (over a 48-hr period)
• Posterior auricular pain
• Decreased tearing
• Hyperacusis
• Taste disturbances
• Otalgia
• Weakness of the facial muscle

• Poor eyelid closure
• Aching of the ear or mastoid
• Tingling or numbness of the cheek/mouth
• Epiphora
• Ocular pain
• Blurred vision
• Flattening of forehead and nasolabial fold on the side affected by palsy
• When patient raises eyebrows, palsy-affected side of forehead remains flat
• When patient smiles, face becomes distorted and lateralizes to side opposite the palsy.
  
  

SCIATICA - INDRAPRASTH PHYSIOTHERAPY CENTRE

SCIATICA - Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Sciatica affects only one side of your body. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg. Although the pain associated with sciatica can be severe, most cases resolve with non-operative treatments in a few weeks. 

• Sciatica is nerve pain from irritation of the sciatica nerve.
  
• The sciatic nerve is the largest nerve in the body.
• Sciatica pain is typically felt from the low back to behind the thigh and radiating down below the knee.
• Treatments for sciatica depend on the underlying cause and the severity of the pain.

Sciatica is a symptom of a problem with the sciatic nerve, the largest nerve in the body. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh and the sole of your foot. When you have sciatica, you have pain, weakness, numbness, or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It's usually on only one side of your body.Sciatic nerve pain can be so excruciating and debilitating. Common causes of sciatica can include a ruptured disk, a narrowing of the spine canal called spinal stenosis, and injury.

Spinal stenosis a condition in which the spinal canal narrows and compresses the spinal cord, sciatic nerve roots. This narrowing can be caused by bone spurs, inflammation, or a slip disc, which decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord that travel to the sciatic nerves.

TORTICOLLIS - INDRAPRASTH PHYSIOTHERAPY CENTRE

TORTICOLLIS - Torticollis is a fixed or dynamic tilt, rotation, or flexion of the head and/or neck. The type of torticollis can be described depending on the positions of the head and neck.
-laterocollis : the head is tipped toward the shoulder
-rotational torticollis : the head rotates along the longitudal axis
-anterocollis : forward flexion of the head and neck...
-retrocollis : hyperextension of head and neck backward
A combination of these movements may often be observed. Torticollis can be a disorder in itself as well as a symptom in other conditions. Other symptoms include:
-Neck pain
-Occasional formation of a mass
-Thickened or tight sternocleidomastoid muscle
-Tenderness on the cervical spine

The cause of congenital muscular torticollis is unclear. Intrauterine malposition is considered to be the cause of damage to the sternocleidomastoid muscles in the neck. Other alterations to the muscle tissue arise from repetitive microtrauma within the womb or a sudden change in the calcium concentration in the body which causes a prolonged period of muscle contraction. Any of these mechanisms can result in a shortening or excessive contraction of the sternocleidomastoid muscle, which curtails its range of motion in both rotation and lateral bending. The head typically is tilted in lateral bending toward the affected muscle and rotated toward the opposite side. In other words, in the direction towards the shortened muscle with the chin tilted in the opposite direction. Congenital Torticollis is presented at 1–4 weeks of age and a hard mass usually develops. It is normally diagnosed using ultrasonography and a colour histogram or clinically through evaluating the infant's passive cervical range of motion. Congenital torticollis constitutes the majority of cases seen in clinical practice.  The reported incidence of congenital torticollis is 0.3-2.0%.^. Sometimes a mass, such as a sternocleidomastoid tumor, is noted in the affected muscle at the age of two to four weeks. Gradually it disappears, usually by the age of eight months, but the muscle is left fibrotic.