HEMIPLEGIA

HEMIPLEGIA - Hemiplegia is a condition that affects one side of the body. We talk about a right or left hemiplegia, depending on the side affected. It is caused by injury to parts of the brain that control movements of the limbs, trunk, face, etc. This may happen before, during or soon after birth, when it is known as congenital hemiplegia, or later in life as a result of injury or illness, in which case it is called acquired hemiplegia. Generally, injury to the left side of the brain will cause a right hemiplegia and injury to the right side a left hemiplegia. The causes of congenital hemiplegia are mostly unknown, and usually parents only become aware of their child’s hemiplegia during infancy or early childhood as the child’s difficulty with movement on one side gradually becomes obvious. There is a higher risk in very premature babies and with multiple pregnancies, and it is unclear whether a difficult birth may be an occasional factor.

Injury to the brain cells that control movements in one half of the body cause hemiplegia. Hence, symptoms largely depend upon the part of the brain affected. The same can be said about the severity of individual symptoms.

• Difficulty in walking.
• Problems in balance, losses balance when trying to walk
• Difficulty in swallowing
• Trouble with vision. Blurred vision or weakness of the eyes.
• Speech becomes difficult.
• Numbness, tingling or loss of sensations on one half of the body.
• Loss of control over bladder and bowel movements leading to an inability to hold on to stool or urine.
• Unable to perform tasks like holding objects, tying laces, dressing oneself, buttoning etc.
• Feeling depressed
• Heightened emotional sensitivity with inability to handle stressful situations.
• Memory seems poor. Unable to recall recent or past events concerning people, places and activities.

'Hemiplegia' means complete paralysis of one half of the body, including one arm and leg. Any disease or injury in the motor centers of the brain can cause hemiplegia. Hemiplegia is a more severe form of 'hemiparesis' wherein one half of the body is only weakened. It is also very different from the conditions of paraplegia & quadriplegia, which are commonly confused with hemiplegia. Stroke: is the commonest cause of hemiplegia. Insufficient blood supply to the brain leads to loss of brain functions. A clot formed within the blood vessel blocking the blood supply'. A thrombus breaks away from its site of origin and forms a block elsewhere in the circulation. A bleed from a blood vessel supplying the brain.

HEEL PAIN

HEEL PAIN - Heel pain is a common foot condition. It's usually felt as an intense pain when using the affected heel. Heel pain usually builds up gradually and gets worse over time. The pain is often severe and occurs when you place weight on your heel. The pain is usually worse first thing in the morning, or when you first take a step after a period of inactivity. Walking usually improves the pain, but it often gets worse again after walking or standing for a long time. Some people may limp or develop an abnormal walking style as they try to avoid placing weight on the affected heel.
The pain is usually worse first thing in the morning, or when you first take a step after a period of inactivity. Walking usually improves the pain, but it often gets worse again after walking or standing for a long time. Some people may limp or develop an abnormal walking style as they try to avoid placing weight on the affected heel.


Heel pain has a number of causes that are typically associated with overuse of the heel bone. You can strain your heel by pounding your feet on hard surfaces, being overweight, or wearing shoes that do not fit properly. These strains can irritate the heel’s bones, muscles, or tendons. Other common causes of heel pain include the following conditions. our foot and ankle are made up of 26 bones, 33 joints, and more than 100 tendons. The heel is the largest bone in your foot. If you overuse or injure your heel, you may experience heel pain. This can range from mild to disabling. In many cases, if you have heel pain, you will need a doctor or podiatrist to diagnose the cause.

There are two different categories of heel pain. The first is caused by over-use repetitive stress which refers to a soreness resulting from too much impact on a specific area of the foot. This condition, often referred to as "heel pain syndrome," can be caused by shoes with heels that are too low, a thinned out fat pad in the heel area, or from a sudden increase in activity. Plantar fasciitis, a very common diagnosis of heel pain, is usually caused from a biomechancial problem, such as over-pronation (flat feet). The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the midfoot and into the forefoot. Over-pronation can cause the plantar fascia to be excessively stretched and inflamed, resulting in pain in the heel and arch areas of the foot. Often the pain will be most intense first thing in the morning or after a prolonged period of rest. The pain will gradually subside as the day progresses.

HALLUX VALGUS

HALLUX VALGUS - A hallux valgus deformity, commonly called a bunion, is when there is medial deviation of the first metatarsal and lateral deviation of the great toe (hallux). The condition can lead to painful motion of the joint and shoe wear difficulty. It is important for a treating physician to understand the pathogenesis and surgical treatment options to correct hallux valgus deformities to provide the utmost care for patients with this painful forefoot deformity. Hallux valgus is a common, painful orthopaedic foot and ankle deformity. Most hallux valgus deformities can be treated conservatively with appropriate shoewear modifications, orthotics, and bunion splints. Surgery is indicated for pain relief and appropriate counseling of patients and their expectations are essential for a successful outcome. It is important to understand the pathogenesis of a hallux valgus deformity because surgical treatment options are based on the clinical examination findings. Appropriate surgical management results in improvement in the patient’s pain and overall function.​ The toe tilts over towards the smaller toes and a bony lump appears on the inside of the foot. Sometimes a soft fluid swelling develops over the bony lump. The bony lump is the end of the "knuckle-bone" of the big toe which becomes exposed as the toe tilts out of place.

 Many people do not experience symptoms in the early stages of bunion formation. Symptoms are often most noticeable when the bunion gets worse and with certain types of footwear. These include shoes that crowd the toes and/or high-heeled shoes. When symptoms do occur, they may include:

• • Physical discomfort or pain
  • A burning feeling
  • Redness and swelling
  • Possible numbness
  • Difficulty walking

   

GOUT

GOUT - Gout is a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, usually a big toe. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men.Gout is caused by too much uric acid in the blood. Most of the time, having too much uric acid isn't harmful. Many people with high levels in their blood never get gout. But when uric acid levels in your blood are too high, the uric acid may form hard crystals in your joints.

The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe. You can also get gout attacks in your foot, ankle, or knees, or other joints. The attacks can last a few days or many weeks before the pain goes away. Gout is characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe. Gout — a complex form of arthritis — can affect anyone. Men are more likely to get gout, but women become increasingly susceptible to gout after menopause. An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.


Gout, a painful form of arthritis, occurs when high levels of uric acid in the blood cause crystals to form and accumulate around a joint. Uric acid is produced when the body breaks down a chemical called purine. Purine occurs naturally in your body, but it's also found in certain foods. Uric acid is eliminated from the body in urine. A gout diet may help decrease uric acid levels in the blood. While a gout diet is not a cure, it may lower the risk of recurring painful gout attacks and slow the progression of joint damage. Medication also is needed to manage pain and to lower levels of uric acid.

GOLFER'S ELBOW

GOLFER'S ELBOW - Golfer's elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist.
Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer's elbow.

The pain of golfer's elbow can come on suddenly or gradually. The pain might worsen when you:

• Swing a golf club or racket
• Squeeze or pitch a ball
• Shake hands
• Turn a doorknob
• Lift weights
• Pick up something with your palm down
• Flex your wrist

The condition is called Golfer's Elbow because in making a golf swing this tendon is stressed, especially if a non-overlapping grip is used; many people, however, who develop the condition have never handled a golf club. It is also sometimes called Pitcher's Elbow due to the same tendon being stressed by the throwing of objects such as a baseball, but this usage is much less frequent.

Golfer's elbow is also known as medial epicondylitis and causes pain and inflammation at the point where the flexor tendons of the forearm are attached to the upper arm. The pain is focused on the bony bump on the inside of the elbow and may radiate along the forearm. Golfer's elbow is usually caused by overuse of the muscles in the forearm that allow you to rotate your arm and flex your wrist. Repetitive flexing, gripping or swinging can cause pulls or tiny tears in the tendons close to where they are attached to the bone.

FROZEN SHOULDER

FROZEN SHOULDER - In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.
The hallmark sign of this condition is being unable to move your shoulder - either on your own or with the help of someone else. Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm. The pain is usually located over the outer shoulder area and sometimes the upper arm. Frozen shoulder (adhesive capsulitis) is stiffness, pain, and limited range of movement in your shoulder. It may happen after an injury or overuse or from a disease such as stroke. The tissues around the joint stiffen, scar tissue forms, and shoulder movements become difficult and painful. The condition usually comes on slowly, then goes away slowly over the course of a year or more.

 The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. The shoulder has a spheroidal joint, in which the round part of one bone fits into the concavity of another. The proximal humerus fits into socket of the scapula. Frozen shoulder is thought to cause the formation of scar tissue in the shoulder, which makes the shoulder joint's capsule thicken and tighten, leaving less room for movement. Therefore, movement may be stiff and even painful.

• CHARACTERISED BY PAINFUL & STIFF GH JOINT D/T LOSS OF RESILIENCE OF JOINT CAPSULE , POSSIBLY WITH ADHESIONS B/W ITS SYNOVIAL FOLDS.
• DENSE ADHESIONS, CAPSULAR THICKENING, CAPSULAR RESTRICTIONS IN FOLDS OF JOINT CAPSULE
• GLOBAL LOSS OF ACTIVE & PASSIVE GH MOTION.
• LOSS OF ER *HALLMARK*

FIBROMYALGIA

FIBROMYALGIA - Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. Other symptoms include feelind tired to a degree that normal activities are affected, sleep problems, and troubles with memory. Some people also report restless legs syndrome, bowel or bladder problems, numbness and tingling, and sensitivity to noise, lights or temperature. Fibromyalgia is frequently associated with depression and anxiety. Other types of chronic pain are also frequently present.

The treatment of fibromyalgia can be difficult. Recommendations often include getting enough sleep, exercising regularly, and eating ahealthy diet. Cognitive behavioral therapy may also be helpful. Use of opioid pain medication is controversial with some stating they are poorly supported and others saying that weak opioids may be reasonable if other medications are not effective.

Symptoms of fibromyalgia include:

• Chronic muscle pain, muscle spasms, or tightness
• Moderate or severe fatigue and decreased energy
• Insomnia or waking up feeling just as tired as when you went to sleep
• Stiffness upon waking or after staying in one position for too long
• Difficulty remembering, concentrating, and performing simple mental task.
• Abdominal pain, bloating, nausea, and constipation alternating with diarrhea
• Tension or migraine headaches
• Jaw and facial tenderness
• Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
• Feeling anxious or depressed
• Numbness or tingling in the face, arms, hands, legs, or feet
• Increase in urinary urgency or frequency.
• Reduced tolerance for exercise and muscle pain after exercise
• A feeling of swelling in the hands and feet

ERB'S PALSY

ERB'S PALSY - Erb's palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5-C6 nerves. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5–C8 and thoracic nerve. The paralysis can be partial or complete; the damage to each nerve can range from bruising to tearing. The most commonly involved root is C5 as this is mechanically the furthest point from the force of traction, therefore, the first/most affected. Erb–Duchenne palsy presents as a lower motor neuron syndrome associated with sensibility disturbance and vegetative phenomena.

The signs of Erb's Palsy include loss of sensation in the arm and paralysis and atrophy of the deltoid, biceps, and brachialis muscles. "The position of the limb, under such conditions, is characteristic: the arm hangs by the side and is rotated medially; the forearm is extended and pronated. The arm cannot be raised from the side; all power of flexion of the elbow is lost, as is also supination of the forearm". The resulting biceps damage is the main cause of this classic physical position commonly called "waiter's tip."

The brachial plexus is a network of nerves near the neck that give rise to all the nerves of the arm. These nerves provide movement and feeling to the shoulder, arm, hand, and fingers. Palsy means weakness, and brachial plexus birth palsy causes arm weakness and loss of motion.

 Symptoms

• Weakness in one arm
• Loss of feeling in the arm
• Partial or total paralysis of the arm

DIABETIC NEUROPATHY

DIABETIC NEUROPATHY - Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet.Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart.Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Neuropathy is damage to nerves, and diabetic neuropathy is damage to nerves that occurs as a result of diabetes. Diabetes is thought to damage nerves as a result of prolonged elevated levels of blood glucose. Diabetic neuropathy can affect different parts of the body, and symptoms can range from mild to severe. Diabetic neuropathy is the most common complication of diabetes.

SIGN AND SYMPTOMS

• Numbness or reduced ability to feel pain or temperature changes
• A tingling or burning sensation
• Sharp pains or cramps
• Increased sensitivity to touch
• Muscle weakness
• Loss of reflexes in the ankle
• Loss of balance and coordination
• Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain.

 About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

DE QUERVAIN'S TENDINOSIS

DE QUERVAIN'S TENDINOSIS - De Quervain's tendinosis occurs when the tendons around the base of the thumb are irritated or constricted. The word "tendinosis" refers to a swelling of the tendons. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist. This is particularly noticeable when forming a fist, grasping or gripping something, or when turning the wrist.

Symptoms of de Quervain's tenosynovitis include:

• Pain near the base of your thumb
• Swelling near the base of your thumb
• Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching
• A "sticking" or "stop-and-go" sensation in your thumb when moving it

Patients often describe a feeling of inflammation, but studies have shown that the process is not inflammatory.  People of all ages get it.  When new mothers develop de Quervain syndrome, it typically appears 4 to 6 weeks after delivery.  The old theory that it was caused by wringing out cloth diapers has been replaced by concerns about holding the baby, but changes in hormones and swelling seem more probable.

Signs
Pain may be felt over the thumb side of the wrist. This is the main symptom. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.

• Swelling may be seen over the thumb side of the wrist. This swelling may accompany a fluid-filled cyst in this region.
• A "catching" or "snapping" sensation may be felt when moving the thumb.
• Pain and swelling may make it difficult to move the thumb and wrist. 

COPD - Chronic Obstructive Pulmonary Disease

COPD - Chronic Obstructive Pulmonary Disease - COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

The main symptoms are:

• A long-lasting cough
• Mucus that comes up when you cough
• Shortness of breath that gets worse when you exercise.

COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time. COPD can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long term poor airflow. The main symptoms include shortness of breath and cough with sputum production. COPD typically worsens over time. Eventually walking up stairs or carrying things will be difficult.

 Other causes of COPD can include:

• genetic reasons (alpha-1 antitrypsin deficiency)
• occupational dusts and chemicals
• second hand smoke
• frequent lung infections as a child
• wood smoke and other biomass (animal dung, crop residues) fuel used for cooking.

COLLES FRACTURE

COLLES FRACTURE - A colles' fracture a fracture of the distal radius in the forearm with dorsal and radial displacement of the wrist and hand. The fracture is sometimes referred to as a "dinner fork" or "bayonet" deformity due to the shape of the resultant forearm. Colles' fractures are often seen in people with Osteoporosis. Colles fracture are very common extra-articular fractures of the distal radius that occur as the result of a fall onto an outstretched hand. They consist of a fracture of the distal radial metaphyseal region with dorsal angulation and impaction, but without involvement of the articular surface.

 

    CAUSES, if you:

• have osteoporosis.
• have low muscle mass, poor muscle strength, or lack agility
• walk or do other activities in snow, on ice, or that require a lot of forward momentum, such as in-line skating and skiing
• have an inadequate intake of calcium or vitamin D

Make sure you are getting enough calcium by eating dark, leafy green vegetables, and low-fat dairy products fortified with calcium. If your diet isn’t giving you enough calcium, you can make up for it by taking calcium supplements. A broken wrist usually causes immediate pain, tenderness, bruising, and swelling. In many cases, the wrist hangs in an odd or bent way.