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What is Sciatica

What is Sciatica?   Definition Sciatica nerve which originates from the buttock or gluteal area, is subjected to injury or irritation causing sciatica nerve pain. The finger width sciatica nerve which is also the longest nerve in the body comprises five nerve roots of which two originate from lower back or lumbar region and three from the sacrum.  Types Acute sciatica | Chronic sciatica | Alternating sciatica | Bilateral sciatica Causes Sciatica occurs due to disc herniation and may initiate suddenly or gradually. Injury in the lower back, ageing and gradual wearing down of bone tissues and discs, obesity, absence of strong core, jobs that require heavy lifting or prolonged sitting, nerve damage due to diabetes, osteoarthritis, lack of exercise and smoking may cause sciatica. Symptoms A patient observes mild or severe pain anywhere along the sciatica nerve path which also results in muscle weakness in leg or foot, numbness, pins and needles sensation in leg and foot regions. The description of pain varies while few terms it as sharp and jolts of pain, others find it as burning, electric or stabbing. The pain aggravates while standing and sitting for prolonged hours, while twisting the body and during sudden movements like coughing. Treatment Employing heat and ice therapy, sciatica could be treated. Inflammation is reduced through ice therapy while heat promotes blood flow and accelerates the healing process. Walking and stretches like reclined pigeon pose, supine twist, seated forward bend, cat-cow stretches and bird-dog poses also provide relief. While therapeutic massage and bracing, chiropractic care and decompression therapy treats sciatica, platelet-rich plasma therapy enhances healing and tissue regeneration. Proper body mechanics must be employed while lifting weights. Prevention   Few precautionary measures which can prevent the recurrence of sciatica are regular exercises, carefulness while lifting heavy objects, proper posture while sitting and standing, and reducing overweight. Avoiding smoking and intake of anti-inflammatory diet including turmeric and ginger, intake of fruits and vegetables, keep sciatica at bay.   FAQ sciatica Can physical therapy cure sciatica? Physical therapy strengthens and mobilizes tissues in the lower back, pelvis, abdomen, buttocks and thighs. As a result, pain free functional movement patterns are restored and muscle spasms are reduced. Physical therapy and exercises are first-line treatments to relieve and prevent sciatica symptoms. Can sciatica cause paresthesia and vice versa? Sciatica is a combination of pain and numbness radiating into the leg while paresthesia is a tingling sensation associated with numbness. While sciatica is caused by nerve root damage, paresthesia occurs due to diseases and disorders in the spinal cord. Paresthesia does not cause sciatica. Sciatica can cause paresthesia. Are sciatica and piriformis syndrome same or similar? Piriformis syndrome and sciatica are not the same. While both affect nerve function, their causes and treatment procedures are different. Buttocks and hip pain constitute piriformis syndrome while radiating leg pain displays sciatica. What is chronic sciatica? Chronic sciatica is long term sciatica pain which worsens with twisting, bending and coughing and lasts for more than eight weeks and does not subside with self management. It is treated through hot and cold therapy, over the counter medicines, physical therapy, epidural steroid injections under X-ray guidance and minimally invasive procedures. Is spine surgery ever necessary to treat sciatica? Sciatica is treated through spine surgery only if the pain is persistent and progressive and if non surgical treatment fails. If sciatica is caused by cyst, tumour or spinal cord compression, surgery is recommended. If the pain is due to lumbar spinal stenosis, lumbar laminectomy is performed. How do I treat sciatica at home? Sciatica can be treated at home through mild exercises, stretches, proper postures, over the counter medicines, ice and heat therapy, plank exercises and sciatic nerve mobilization. What are sciatica symptoms? Is it required to consult a doctor? Mild sciatica is short-lived and one must approach a doctor when the pain exceeds one week. Changes in bowel and bladder function and worsening neurological symptoms require immediate medical attention. Can B12 shots help with numbness from sciatica? Vitamin B12 deficiency can cause sciatica and patients must add vitamin B12 rich foods like turkey, salmon and eggs in their diet. Vitamin B12 injections are part of combination therapy and regenerate nerves and minimize pain in acute sciatica. How much downtime is there with sciatica? Acute sciatica lasts from 4 to 6 weeks and becomes chronic thereafter. Doctors try to treat sciatica without medical intervention until the pain exceeds 12 months. Sciatica subsides on its own through proper postures, mild exercises and stretches. Duration of sciatica depends on the underlying problem. Can a person with sciatica lie on the floor? Since sleeping on the floor can alleviate sciatic pain, patients can avoid direct contact with the floor by using a yoga mat or towel. Specific sleeping postures are comfortable and minimize stress on the sciatic nerve. Read the full article

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Minimally Invasive Spine Surgery: Advantages and Disadvantages

Minimally Invasive Spine Surgery (MISS) is a type of surgery which is made with smaller incisions compared to the regular surgery done on the spine. Such small incisions mitigate damage of tissues, reduce hospitalization period and increase recovery time. Techniques for performing MISS have evolved in the last two decades. Cameras are used in holes as small as keyholes to view the affected area and Fluoroscopes or X Ray machines keep the spine monitored during the operation. People from all over the globe are visiting India for Minimally Invasive Spine Surgery, thanks to the low cost and highly skilled expertise and state of art facilities. Since Minimally Invasive Spine Surgery is new, it is open to developments. Since disadvantages are found in other surgeries too, detailed discussions with the surgeon and experts are important, before going for MISS. Advantages Since the incisions are small, the pain, chances of infection, tissue damage and other related complications are also reduced. The recovery time is relatively faster than standard surgery methods. Access to deep laden tissues in the vertebrae, nerves and discs, is performed with fewer hassles in MISS. Usually after any surgery, human body undergoes a trauma, which is mitigated in Minimally Invasive Spine Surgery. Need to place instrumentation like rods and screws are less cumbersome. In traditional methods, it requires extensive removal of muscles and tissues on the spine surface. Routes like Direct Lateral Access Routes, where the spine is approached through body sides, minimize pain. In Thoracoscopic Access Routes, front portions of thoracic spine, which is located in chest and surrounded by heart and lungs, is accessed. Such routes are risky in traditional methods. Since medication is minimal, possibilities of getting dependent on medicines is also reduced. Physical therapy is also reduced in MISS. Disadvantages Before going into the disadvantage details, one should be aware that such disadvantage possibilities could be reduced by having a detailed discussion with the doctor before the surgery. Besides drawbacks such as allergic reactions, bleeding, blood clots, infections, paralysis, pseudarthrosis, the versatility of the surgeon in employing MISS, counts. The expertise of the doctor in MISS, if poor, capsizes the entire purpose of performing the operation. Minimally Invasive Spine Surgery is not recommended for all surgeries. Spinal tumours and severe scoliosis are cured by open surgery rather than MISS. The increased exposure to radiation is not advisable for all cases. Spinal fluid leak, if occurred during MISS, would be tough to be repaired. Presence of spinal defect, severe deformity, previous spinal surgery makes one ineligible for Minimally Invasive Spine Surgery. Read the full article

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What is three level cervical fusion surgery?

What is three level cervical fusion surgery? Cervical fusion surgery joins more than one spinal bone by employing screws, bolts and plates, corrects deformities and removes discs which are replaced with bone graft or spacer. Three level fusion surgery replaces three discs with hardware to stabilize the neck. Indications of three level cervical fusion Three level surgery is performed in instances like tumors, spinal bone fractures, osteomyelitis infection, stenosis, trauma, spinal cord injury, scoliosis and severe arm pain accompanied by numbness and tingling. Types of three level cervical fusion Three level fusion surgery may be performed in anterior or posterior region and is referred to as Anterior Cervical Discectomy and Fusion or Posterior Cervical Fusion respectively. The anterior approach provides direct visualization of cervical discs and access to the entire cervical spine and is preferred owing to its uncomplicated pathway. It also has lesser incision compared to the posterior approach. Types of bone grafting in cervical fusion Surgeons may take one’s own bone cells from the hip, known as autograft, since it has a high rate of fusion, though it causes more pain in the hip region. Bone obtained from a donor is known as allograft, which does not have bone growing cells and yet averts harvest of hip bone. Bone graft substitute is made from plastic, ceramic and is packed with shavings of live bone tissues. Post cervical fusion surgery After surgery, range of motion depends on the number of bones fused where single level fusion has better mobility. Post surgery, one must avoid lifting, pushing and pulling of heavy objects and keep the spine in neutral position besides maintaining good posture. Read the full article

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Non surgical treatments for lower back pain

Non surgical treatments for lower back pain A shooting, stabbing or burning sensation in the back muscle which may radiate down the leg is known as back pain. Such pain worsens with excessive lifting, prolonged sitting and lying down in an uncomfortable position. A break in the spine due to fall, osteoporosis, sprains, strains, injuries in the ligaments, muscles and tendons may cause back pain. Back pain can be avoided by muscle strengthening and stretching exercises and healthy diets. Muscle relaxants Muscle relaxants reduce stiffness in the muscle which in turn reduces pain. They form second line treatment which follows pain relieving medications and non-steroidal anti-inflammatory drugs. Muscle relaxants include cyclobenzaprine and carisoprodol.They treat acute back pain especially as sedative when back pain disrupts sleep. They inhibit nerve signals in the brain and spinal cord and break the pain-spasm-pain cycle as a protective response. Narcotic pain medications Narcotics or opioids are used to treat back pain and they provide short term relief from severe back pain. Since they attach themselves to pain receptors and block the feeling of pain, patients return to normal routine life. Narcotics are controlled medicines and taken only by physician’s prescription. They cannot be consumed for more than 3 to 4 months and patients reduce dosages, once the pain subsides. Back braces Back braces unloads weight in the lower back and reduces pressure in the spine, joints, discs and muscles. Back braces may be flexible, semi-rigid or rigid of which rigid braces treat moderate to severe pain and instability and heal fractures after back surgery. Flexible braces like corsets and lumbar belts shift weight from the spinal cord and add spinal support to injured muscles.Rigid and semi-rigid braces reduce range of motion and prevent bending and minimize muscle tension.   Epidural steroid injections   Epidural steroid injections provide temporary relief for back pain and are considered as a part of non surgical treatment of sciatica. It is injected in epidural space around the spinal cord and nerve roots so that inflammation is reduced and mobility is improved. It encourages patient’s participation in rehabilitation programs and physical therapy. Epidural injections are administered in cases like herniated discs, degenerative disc disease and spinal stenosis in the lumbar area.   Manual manipulation   Spinal manipulative therapy consists of moving and joining jolts, massage, exercise and physical therapy to reduce pressure in joints and minimize inflammation while improving nerve function. Practitioners apply controlled thrust to restore muscle imbalances. Soft tissue work applies pressure in soft tissue so that muscles are relaxed, breaks up scar tissue, increases circulation and eases pain. Mobilization employs varying speed, force and distance to pull or push joints which loosens tight muscles.   Acupuncture Back pain may occur due to an extremely busy schedule, poor body posture, prolonged sitting. Acupuncture triggers release of opioids in the brain, muscles and spinal cord which decreases pain and promotes sound sleep.   Massage therapy   Massage therapy enhances blood circulation, increases endorphin levels and reduces muscle soreness. Hot stone massage is massage therapy using hot stones for upper back pain and eases muscle tension. Swedish massage, deep tissue massage, trigger point massage, myofascial massage and sports massage treat back pain.   Meditation   Meditation removes focus from the pain into something pleasant so that the discomfort is decreased. Meditation changes structure of the brain through altering behavior and reduces pain in select segments in the back. It not only reduces stress, anxiety and depression but also increases memory, decreases exhaustion.   Frequently Asked Questions How do I relieve neck pain? Home remedies for neck pain include heat or ice packs, gentle exercises, over the counter medicines which reduce inflammation, rest and temporary break from routine work.   What is the best treatment for frozen shoulder and neck pain? To reduce pain and improve range of motion in frozen shoulders, corticoid injections are used. Joint distension, where sterile water is injected in the shoulder capsule eases movement. Shoulder manipulation loosens shoulder tissue and surgery is considered as a last resort in treating frozen shoulder.   How to numb the pain of a pinched nerve in your neck? Rest is the best treatment for pinched nerves because activity aggravates the same. Diet of bananas and green vegetables, proper sitting posture, adequate sleep, exercise, ice and chiropractic treatment are effective solutions for pinched nerves in neck.   What helps to relieve facet arthropathy pain? Heat therapy, cold pack, supportive lumbar curve, avoiding aggravated activities, low impact exercises and proper braces relieve facet pain. Though it cannot be reversed, lifestyle changes and careful management can keep the issue under control.   How do interventional pain doctors treat spinal pain? Interventional pain doctors use pain blocking techniques to facilitate routine activities. Types of interventional pain doctors employ treatments including nerve blocks, infusions, injections, radiofrequency ablations, spinal cord stimulation and peripheral nerve field stimulation to treat spinal pain.   What are the non-surgical treatment options for a disc bulge? Non surgical treatment options for disc bulge include medication, physical therapy, chiropractic, massage, ultrasound therapy, heat and cold packs, bed rest and braces.   What are some non-surgical treatments for back pain? Acupuncture, massage, biofeedback therapy, laser therapy, electrical nerve stimulation, spinal manipulation, anti-inflammatory diet, weight loss programs and stress management techniques are non-surgical treatments for back pain. Read the full article

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Physiotherapy: what it is and when it is needed

We are used to talking about physiotherapy, but not everyone knows exactly what it is, or what the physiotherapist does and what the physiatrist does. The correct term is physiatry, which is a branch of medicine aimed at restoring full functionality to injured or diseased parts of the body, which affect the musculoskeletal system or the nervous system. The physiatrist is therefore the doctor who diagnoses and coordinates therapies to improve the lifestyle through a "technical-motor" approach. Specifically, the physiatrist brings together numerous skills in orthopedics, neurology, rheumatology, geriatrics, cardiology, pulmonology, pediatrics, stomatognathics. The physiotherapist, his "main ally", also works in these many areas. The difference between physiotherapist and physiatrist Do we often tend to confuse these two figures, who actually have different roles, paths and skills? But what is the difference between physiatrist and physiotherapist? Without going into technicalities, the main difference is that the physiatrist is to all intents and purposes a doctor (therefore a medical graduate) specialized in physiatrics. The physiotherapist, on the other hand, is a health professional (who has therefore followed a specific degree course). Therefore generally the physiatrist is the one who makes the diagnosis on the patient, while the physiotherapist consequently puts into practice the appropriate therapy for the diagnosis of the physiatrist. When is physiotherapy needed? Aimed at fully involving the patient through education, awareness and empowerment, thanks to physiotherapy it is also possible to improve the process of symptoms that characterize neurological diseases such as stroke, multiple sclerosis and Parkinson's, or neuromusculoskeletal disorders such as back, whiplash, sports injuries, arthritis, or cardiovascular problems such as chronic heart disease, as well as post-heart attack or respiratory rehabilitation for conditions such as asthma, chronic obstructive pulmonary disease, cystic fibrosis. In fact, physiotherapy helps to: - fight back pain and sudden injuries, - to manage health conditions such as asthma, - prevent disorders related to aging, - manage muscle or bone and joint problems, - solve problems related to joint dysfunctions, it is also an excellent ally in preparing for childbirth or in anticipation of a sporting event. In therapeutic practice, it mainly uses physical or mechanical means such as light radiation (phototherapy), heat (thermotherapy), electricity (electrotherapy), water (hydrotherapy) or even pure physical exercise. To define the most adequate and most effective technique, the type of injury and also the type of pain must be taken into consideration. The most common method remains that of mechanical force exerted with the use of the hands on the body, giving life to the well-known techniques of massage, kinesitherapy, manipulative therapy with chiropractic techniques, functional re-education and medical gymnastics. Often, the various techniques are used together to ensure more satisfying results. How the physiotherapist can help you Moving in an area that requires precise knowledge, the profession of physiotherapist can only be exercised by graduated health professionals, physiotherapists in fact, who deal with everything related to the musculoskeletal system to restore the right balance and recovery after trauma. , managing physical pain and preventing future illness. Physiotherapy: for which pathologies it is indicated Back pain is one of the classic pathologies for which physiotherapy is used. It consists of a musculoskeletal disorder that also affects the neck and is often caused by repetitive strain injuries. Physiotherapy, in this case, is particularly effective. Another reason to go to a physiotherapist is when you get hurt while playing a sport. Children under the age of 12 have a strong ability to recover in the event of an injury and physiotherapy is not always necessary for them, while it turns out to be so in adulthood, after an injury or even just for preventive purposes, considering that they often take wrong positions or you are subject to a sedentary lifestyle, both factors that lead to many ailments.     Read the full article

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Comprehensive approach to cervical spine spondylosis

Degeneration of bones and discs in the neck are referred to as cervical spine disease or cervical spondylosis. As age progresses, bones and cartilages in this region face wear and tear which results in problems such as herniated discs and bone spurs. How to detect cervical spine spondylosis? Neck pain, nagging soreness in the neck, muscle spasms, clicking or grinding sound while rotating or moving the head, dizziness and headaches might suggest presence of cervical spine spondylosis. Since spondylosis invokes pressure on the neighbouring nerves, pain could be felt at chest, ribs and abdomen areas. Cervical spine spondylosis narrows the space around spinal cord and results in numbness, strain and lack of coordination in walking and loss of bladder and bowel control. Imaging tests like neck x-ray, CT scan, MRI and Myelography would confirm the ailment. Nerves affected by cervical spine spondylosis First three cervical spines namely C1, C2 and C3 control head and neck and movements around them while C4 controls upward shoulder movements. Decompression surgery suggestions Spondylosis surgery includes removal of pain agent and fusion of spine. To remove the tissue that evokes nerve pressure, surgeon conducts decompression surgery and to conduct fusion, stabilization surgery is done. Before going into decompression surgery let’s familiarize with terms such as ‘ectomy’ which means removal and ‘otomy’ which refers to opening. Facetectomy and Laminoectomy removes facet joint and lamina or part of lamina (bony plate that protects spinal cord) respectively. Foraminotomy creates an opening in the vertebra exit also known as foramen, so that nerve can exit smoothly. Laminotomy creates or enlarges opening in the bony plate so that the lamina does not press the nerve structure. Laminoplasty is performed to create a hinge to lift lamina and mitigate compression. Surgical approaches The spine is accessed from the front to reach the abdomen and is known as anterior approach. Incision in the back enables posterior approach and access through the sides is lateral approach. However, anterior and posterior approaches are risky. Risks associated with cervical spine spondylosis surgery Complications associated with cervical spine spondylosis surgery include paralysis, inability to walk, anesthetic complications, infections associated with improper handling of wounds and complications associated with related injuries. Non surgical suggestions for cervical spine spondylosis Non surgical remedies include acupuncture, bed rest, using brace, muscle relaxants, physical therapy, spinal injections. Chiropractic methods like employing ice, heat, ultrasound, massage, spinal manipulation can also be employed to cure the ailment. About Dr Karunakaran Dr Karunakaran, spine specialist for more than two decades, has performed more than 3000 surgeries for various complications including scoliosis, cervical spine diseases, thoracotomies, laparotomy and disc replacement surgeries, to name a few. Dr Karunakaran is also a pioneer in Tamil Nadu to perform percutaneous endoscopic lumbar discectomy under local anesthesia for disc prolapse and INSPACE-interspinous implant for lumbar canal stenosis-key hole spine surgery local anesthesia besides being fluent in pain management techniques of spine such as foraminal epidural steroid injection, facetal blocks and discography. Read the full article

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Motion preservation surgery-The emerging angle

As in any surgery, spine surgery also has complications attached to it, which could lead to pain, impairment or supplementary surgery. Inabilities to create enough space around spinal nerves and spinal cord and creating too much space around nerves results in spinal instability. Spinal surgery comprises of three attributes namely decompression of neural elements, stabilizing motion and balance of vertebrae. Drawbacks of traditional surgery Apart from resection of herniated disc, eliminating osteophytes and curing spondylolisthesis, only arthrodesis can maintain surgical outcomes of extreme cases like scoliosis, fixation of multiple spine segments and bone fusion. However, arthrodesis is susceptible to loss of motion and has the risk of initiating junctional kyphosis and adjacent segment disease (ASD) to name a few. Though cervical disc arthroplasy (CDA) and many equivalent approaches have proven their effectiveness compared to anterior cervical discectomy and fusion (ACDF), CDA has not proven to mitigate ASD. When a patient browses treatment options for spinal pain, it is advisable to research the cause of pain and isolate it so that the best device and procedure to could be arrived at. One should keep in mind that no device or set of device handles all causes of pain. Motion preservation spine surgery Motion preservation spine surgery is gaining prominence in the past decade especially in total disc replacement in cervical and lumbar spine. Motion preservation spine surgery or MPSS is a surgical alternative for normal surgeries which are cumbersome and time consuming. They also provide the patient with the advantage of avoiding spinal fusion, which has adverse risks of infection and pain that should be borne by patients from 4 weeks to 6 months approximately. Spinal fusion also immobilizes vertebrae to avert pain, a condition which is not affordable to bear with. Motion preservation preserves spinal motion, diminishes need for revision surgery and doubles up recovery time. It aims to create a normal biomechanics condition which enables motion in patients and mitigate adjacent segment disc disease. In spinal fusion, the possibilities of developing degenerative disc disease (DDD), whereas are averted in motion preservation techniques. Annular repair or nucleus replacement can postpone or prevent possibilities of spinal fusions. Though considered as a new development in spine surgery, motion preservation techniques were previously carried out at appendicular skeleton, especially in hip and knee joint replacement. Unlike these appendicular joints, surgery in functional spinal unit is complicated as it involves interaction of disc space and two facet joints. After cervical artificial disc replacement, the patient can gradually return to routine life, under the supervision though. While even a regular shower needs approval, physical therapy could put the patient back on feet. Neck mobility must be ensured to drive though running and other sports activities should be put on hold. CDR and LDR Cervical artificial disc replacement (CDR), lumbar artificial disc replacements(LDR) are two motion preservation techniques. In the lumbar spine, motion preservation is classified as anterior and posterior techniques while in cervical spine it is limited to total disc replacement. Alternate approaches to motion preservation include total disc replacement, disc nucleus replacement, interspinous process spacers, posterior dynamic stabilization devices and facet replacement or total element replacement devices. Popular discs Prodisc C, since its inception in 1990, is developed using the ball and socket formula. Composed of three components including two cobolt chrome alloy endplates and an ultra high molecular weight polyethylene (UHMWPE) inlay, Prodisc C is validated in 125,000 device implantations. Besides removing the diseased disc and restoring normal height, the surgery decompresses surrounding neural spaces, Prodisc C not only provides motion to the vertebrae but also enables patient function. 18 anatomical sizes based on 6 foot prints and 3 heights (5, 6 and 7 mm) enable to accurately match patient anatomy. Other cervical discs include Mobi-C cervical disc, Medtronic Prestige LP and M6-C artificial cervical device. Such artificial disc replacements last for 7 decades with no necessity for revision. ProDisc L is the most popular and longest studied ADR. Artificial lumbar disc replacement is usually suggested only if one or two discs in the lower spine cause back pain besides absence of joint disease and compression of nerves in the spine. SB Charite, Maverick, Flexicore, Mobidisc are few other lumbar disc replacement where the last three are under trial. Lumbar discs are planted from the anterior in minimally invasive approach. Interspinous process spacers like X-STOP, Wallis and DIAM, for instance, open the central canal and the opening where nerve roots come out of spinal canal in order to mitigate pain and activity limitations in spinal stenosis. The devices are advantageous to senior citizens and avert elaborate open surgery. Posterior dynamic stabilization devices employ controlled motion in spine so that normal movement is successfully achieved. Currently, they are employed with fusion and not independently. Facet replacement or total element replacement devices are used in degeneration of facet joints and replace the same. They replace all elements back of the spine. Interspinous process spacers, Posterior dynamic stabilization devices and facet replacement devices are still under investigation. Future of motion preservation surgery The previous decade saw a dramatic development in spine surgery techniques and tools and the innovations are expected in future too. Surgeons are excited over addressing spinal pathology sans morbidity in conventional methods. Few others feel that following convergence of cardiovascular surgery and interventional cardiology, similar events would occur among spine interventionalist and surgeons. Amidst other technologies such as spinal medicine, new image guidance technologies, informatics and artificial intelligence, they see motion preservation technologies are on the horizon. Patients could now return home, hours after their surgery. A drive towards minimally invasive procedures especially in lumbar spine is expected along with the hope to shorten the learning curve, fading complications and low radiation exposure to patient and surgeon. Surgeons are also happy with the evolution in pain diagnosis. They accolade the innovation in past decade that cured chronic back or neck pain (CBNP) and assert that a clear comprehension of pain cause, helped produce solutions. The trends in diagnosis enabled physicians to pin point cause of pain to the patients within hours of their visit. Read the full article

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Physiotherapy: what it is and when it is needed

We are used to talking about physiotherapy, but not everyone knows exactly what it is, or what the physiotherapist does and what the physiatrist does. The correct term is physiatry, which is a branch of medicine aimed at restoring full functionality to injured or diseased parts of the body, which affect the musculoskeletal system or the nervous system. The physiatrist is therefore the doctor who diagnoses and coordinates therapies to improve the lifestyle through a "technical-motor" approach. Specifically, the physiatrist brings together numerous skills in orthopedics, neurology, rheumatology, geriatrics, cardiology, pulmonology, pediatrics, stomatognathics. The physiotherapist, his "main ally", also works in these many areas. The difference between physiotherapist and physiatrist Do we often tend to confuse these two figures, who actually have different roles, paths and skills? But what is the difference between physiatrist and physiotherapist? Without going into technicalities, the main difference is that the physiatrist is to all intents and purposes a doctor (therefore a medical graduate) specialized in physiatrics. The physiotherapist, on the other hand, is a health professional (who has therefore followed a specific degree course). Therefore generally the physiatrist is the one who makes the diagnosis on the patient, while the physiotherapist consequently puts into practice the appropriate therapy for the diagnosis of the physiatrist. When is physiotherapy needed? Aimed at fully involving the patient through education, awareness and empowerment, thanks to physiotherapy it is also possible to improve the process of symptoms that characterize neurological diseases such as stroke, multiple sclerosis and Parkinson's, or neuromusculoskeletal disorders such as back, whiplash, sports injuries, arthritis, or cardiovascular problems such as chronic heart disease, as well as post-heart attack or respiratory rehabilitation for conditions such as asthma, chronic obstructive pulmonary disease, cystic fibrosis. In fact, physiotherapy helps to: - fight back pain and sudden injuries, - to manage health conditions such as asthma, - prevent disorders related to aging, - manage muscle or bone and joint problems, - solve problems related to joint dysfunctions, it is also an excellent ally in preparing for childbirth or in anticipation of a sporting event. In therapeutic practice, it mainly uses physical or mechanical means such as light radiation (phototherapy), heat (thermotherapy), electricity (electrotherapy), water (hydrotherapy) or even pure physical exercise. To define the most adequate and most effective technique, the type of injury and also the type of pain must be taken into consideration. The most common method remains that of mechanical force exerted with the use of the hands on the body, giving life to the well-known techniques of massage, kinesitherapy, manipulative therapy with chiropractic techniques, functional re-education and medical gymnastics. Often, the various techniques are used together to ensure more satisfying results. How the physiotherapist can help you Moving in an area that requires precise knowledge, the profession of physiotherapist can only be exercised by graduated health professionals, physiotherapists in fact, who deal with everything related to the musculoskeletal system to restore the right balance and recovery after trauma. , managing physical pain and preventing future illness. Physiotherapy: for which pathologies it is indicated Back pain is one of the classic pathologies for which physiotherapy is used. It consists of a musculoskeletal disorder that also affects the neck and is often caused by repetitive strain injuries. Physiotherapy, in this case, is particularly effective. Another reason to go to a physiotherapist is when you get hurt while playing a sport. Children under the age of 12 have a strong ability to recover in the event of an injury and physiotherapy is not always necessary for them, while it turns out to be so in adulthood, after an injury or even just for preventive purposes, considering that they often take wrong positions or you are subject to a sedentary lifestyle, both factors that lead to many ailments.     Read the full article

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Tecar therapy - how it works

In recent years, this therapy has become increasingly popular in physiotherapy, especially in treating trauma and skeletal inflammation. This diffusion is the result of the properties that distinguish it and which represent its strengths: versatility of application, effectiveness (even in a few sessions), the pleasant sensation it generates and leaves in patients. But what exactly is Tecartherapy? What are the benefits? What are the contraindications? Tecar therapy, also called only Tecar (an acronym for Capacitive and Resistive Energy Transfer), is a relatively recent therapy that has taken hold lately. It is instrumental in eliminating pain and inflammation affecting the joints, muscles, and spine. Tecar is indicated for treating both acute and chronic problems and has shown itself to be particularly effective in treating joint and muscle pathologies, trauma, tendinopathies, pathologies of the nerves, pain, and inflammation of various kinds. TECAR THERAPY: HOW IT WORKS To perform its energy transfer function and produce the beneficial effects we have talked about, tecar therapy uses a particular machine (which generates a high-frequency magnetic field using the condenser principle) connected to a metal plate, which acts as a "Grounding" and closes the circuit, and a handpiece, which can be capacitive (consisting of a unique ceramic) or resistive (composed of a metal alloy), and which is passed by an expert on the area to be treated. In the area between the plate and the handpiece's cone of action, an energy flow is generated, precisely due to the effect of the magnetic field, which, passing through the tissues, heats them from the inside. This increase in temperature, defined as "endogenous" precisely because it develops from the inside and remains concentrated (the machinery is, in fact, able to stimulate the production of the internal heat of the body itself), triggers a cascade of beneficial reactions in the organism, which help to speed up the recovery process: the heat promotes vasodilation at the level of the blood and lymphatic vessels in the treated area, thus causing a greater flow of blood. This concretely means that the body is helped and stimulated to heal itself by itself, as the resolution of the inflammatory process in progress and the disposal of its catabolites are made faster. The greater vascularization that is determined also favors tissue relaxation (especially the connective and muscular ones) and the drainage of swelling (edema and hematomas). All this determines the final result: the reduction of painful symptoms and the restoration of the treated area's physiological functionality. As we have mentioned, with the Tecar, depending on the handpiece used, you can work in two ways: capacitive and resistive. The first is used in case of soft tissue problems, such as muscles and connective tissue, blood, and lymphatic vessels. While the second is indicated in point, the problem is deeper or involving more complex or more resistant tissues, such as bones, cartilages or joints, fibrotic formations, and chronic scar tissue. Often, however, both methods are used alternately during a treatment. On Tecar therapy we must therefore know that: - Increases vasodilation -  Increase the heat from the inside - Increases blood circulation - Increases tissue oxygenation - It stimulates the body to heal itself - Stimulates lymphatic drainage - It is an endogenous thermotherapy - Depending on the problem, it can work in capacitive or resistive mode stimulates the release of endorphin (and therefore acts on pain) The big difference that Tecar therapy offers compared to other techniques in which the healing power of heat as it is generated directly inside the tissue ("endogenous" thermotherapy) and not conveyed from the outside the inside (as instead happens for the so-called "exogenous" therapies, such as, for example, laser therapy), so there is no dispersion, and the whole effect is concentrated in the area to be treated. ENEFICI OF TECAR THERAPY Tecar therapy can accelerate the body's natural regenerative processes and, in particular cellular repairs. It can also reduce pain with the advantage of speeding up recovery from trauma or the problem that has affected the body. Furthermore, Tecar is widely used in the treatment of athletes thanks to its remarkably rapid results. Tecar therapy is able to: - Help the body's regenerative processes - Reduce the pain - Speed up recovery after trauma - Treat problems in almost all parts of the body - Helping sportsmen TECAR THERAPY: HOW MANY SESSIONS ARE NEEDED? A session usually lasts about 30 minutes, and it may be necessary, depending on the area to be treated and the acute or chronic situation, to do a cycle of 5-10 treatments. The benefits are noticeable, however, from the first treatment. As we have seen, the possible problems that can be treated with Tecar therapy are innumerable. Of course, it must be performed by specialized personnel, who will assess the situation of the person as a whole and establish an appropriate therapeutic action plan. The technical professional will evaluate when and how to use this therapy, alone or in combination with others to enhance its effect (in our Physiokinetics center, for example, it is very often combined with laser therapy, and inserted in more articulated rehabilitation paths, which also include manual therapies and postural and rehabilitative gymnastics). How the session takes place: the patient is made to lie down on a bed or comfortably positioned on a unique chair, depending on the area to be treated, which must be uncovered and easily accessible. At this point, the therapist places the plate (which closes the circuit) in a region suited to the area to be treated and distributes a creamy substance on the point of the body affected by the problem (called "conductive cream," precisely because it is designed to facilitate the conduction of the heat). CONTRAINDICATIONS OF TECAR THERAPY Tecar therapy is a safe, non-invasive treatment suitable for everyone since it does not have particular contraindications. Not recommended only for pregnant women. Tecar therapy efficacy in musculoskeletal disorders The fast moving lifestyle in urban India is also spreading fast towards remote areas. Such erratic lifestyle demands human resources to take spine health for granted and engage in abrupt and rough physical movements. As a result Musculoskeletal Disorders (MSD) or injuries of muscles, nerves, tendons, joints, cartilage and spinal discs have become more common, especially in the working population. Tecar therapy, an endogenous thermotherapy, has proven to be more effectual than other treatments, not only in MSD, but also in curing other body ailments. The balance between the therapist’s dexterity and special energy involved has made Tecar therapy in Chennai, successful and has accelerated its popularity in the city. The therapy is used in physical therapy, rehabilitation and pain management of bruises and sprains. Tecar therapy treats diseases in acute and sub-acute phases, without increasing inflammation (which is usually susceptible to increase in temperature). The therapy is inclusive of two electric charge modes namely capacitive and resistive modes. Capacitive mode is used in tissues with higher electrolyte content such as soft tissues and muscles and resistive mode is employed on larger and more resistant tissues such as tendons, bones and articulations. The nerve stimulation that the therapy causes stops nerves from worsening the initial pain, thus minimizing both inflammation and pain. Tecar therapy is popular among top athletes across the globe and effectually treats sports pathologies. Tecar therapy with aid of these modes of energy transfer increase vasolidation and oxygenation besides increasing microcirculation and internal temperature. Such rise in energy reduces muscle spasms, promotes hemorrhagic re-absorption and activates major metabolic reactions. Lower back pain has heterogeneity of causes and diagnosis could rarely be specific. Since tecar machine allows to measure the energy transferred, the same could be done without increasing temperature of the tissue. Tecar therapy in Chennai enhances reconstruction of joints, muscles, tissues and cells besides healing ailments for long term benefits. The therapy offers 2X faster healing and has 97 per cent pain relief effectiveness. The therapy treats lumbago or pain in lower part of lumbar vertebra area and relieves pain besides relaxing the muscles spontaneously. Being sedentary alleviates back pain and tecar therapy enables patients to move again effortlessly without any apprehensions. Tecar therapy also treats pain in conditions such as disc herniation, disc bulge, disc dessication, disc rupture, disc protrusion, cervical spondylitis, lumbar PIVD, loss of cervical lordosis, loss of lumbar lordosis, sciatia, spinal canal stenosis, spondylosis, osteoarthritis, rheumatoid arthritis, plantarfascitis, frozen shoulder, muscle sprains, ligament fractures and all major non-traumatic musculoskeletal painful conditions. Dr Karunakaran Spine Center offers expert tecar therapy besides other spine treatments including discography, PRP method to treat discogenic issues, fusion techniques for spine, posterolateral gutter fusion surgery, posterior lumber interbody fusion (PLIF) surgery, transforaminal lumbar interbody fusion (TLIF) surgery, MISS technique, endoscopic surgery and scoliosis surgery. Dr Karunakaran, backed by more than 22 years of experience, is prime surgeon in Minimally Invasive Spine Surgery (MISS) for spondylodiscitis and offers expert surgeries to heal bones, muscles and ligament damages.     Read the full article

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Cycling and spine: friends or foes?

Cycling has a plethora of benefits like weight loss, cardiovascular fitness, improved joint mobility, decreased stress levels, strengthened bones which are all ransacked through poor back posture while on the saddle. Lower back pain is a common complaint amidst cyclists which could be averted by proper saddle position, proper cadence or revolutions per minute, appropriate increase of speed. Actually cycling is supposed to be a remedy for lower back pain than being a cause for the ailment. Though cyclists do stretching and warm-ups diligently, very few of them attend to shoulders and mid back. Bad posture can cause tightness in thoracic spine. Besides bad posture (or rather we can term it as main cause of bad posture), bike fit is an important cause of back pain. Riding a cycle which is too big results in lack of flexibility, where length inconsistency and misalignment of spine, causes back pain. Bike fit Adjusting the bike so that the cyclist is comfortable is known as bike fit. It also enhances the cyclist’s performance. To avert problems such as pain in buttock, lower limb, upper limb and neck, cyclist accentuate accessories such as gel pad gloves and upright handle bars, besides adjusting foot position for pedals, saddle height, provision of stem to adjust handle bars and favourable handle bar position. Poor saddle height which is also uneven, handle bars too far encouraging over stretch cause back pain. Riding style and body pain Bad posture while riding bike uphill, especially with bigger gears, plays an important role in back pain. Professional cyclists usually have core strength training along with their cycling schedules. Sometimes it is gym, yoga or Pilates or perhaps cross training. If the knee is less than 25% bend, it compels the cyclist to rock the pelvis sideways thereby adding stress to lower back muscles. Using big gears slowly like 90 revolutions per minute, adds stress on back muscles. Besides these, bumpy terrain also causes compression to spine. Cycling and lumbar spinal stenosis It is surprising that when lumbar spinal stenosis is strictly against long walks or running, it is recommends cycling though. This is because while you lean forward during cycling, more space opens around the nerves in the spine. While put through a four month cycling in stationary cycles, most patients did not need spine surgery. Cycling and degenerative disc disease Due to degenerative disc disease, the spinal canal area in lower back gets narrower. As age advances, disc is deprived of nutrition and height, due to which narrowing increases. Cycling accentuates health in elderly people, thanks to the fresh oxygen pouring in. In septuagenarians who tried this, those who had apprehensions lagged behind, while those who tried it pleasantly improved, with significant change. Stretches for cyclist to avert back pain To promote flexible spine and hips, cyclists must practice stretches such as hip opener and glute stretcher, supine body rotation, downward facing dog and hug stretch. On a concluding note, cycling can aggrevate or ease back pain, depending upon how far cyclists adhere to body posture and other recommendations that were discussed above.     Read the full article

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Types of back pain during pregnancy

Back pain during pregnancy are classified as those of lumbar and pelvic origin. Pregnant women suffer due to lumbar back pain which occurs in the lower back due to hormonal and postural changes. While increase in progesterone levels and stress contribute to pain during the first trimester, leaning backwards, weight gain and muscle separation in the abdomen region cause pain during the second and third trimester.b However, intense pain in lower back or abdominal cramps may also signal miscarriage. Why does back pain occur during pregnancy? Shifting of centre of gravity, weight gain, muscular imbalances, muscular fatigue, joint laxity caused by pregnancy related hormones which deprives support from joints cause back pain. Weak abdominal muscles along with inflexibility and sedentary lifestyle also cause pregnancy related back pain. During pregnancy women undergo postural changes which disrupt mechanical aspects of the musculoskeletal system in the lower back causing pelvic discomfort, especially from the fifth and seventh months. What are the symptoms of back pain during pregnancy? While some symptoms subside after pregnancy in few cases, they develop into chronic disorders especially when the woman suffers lower back pain before pregnancy. The symptoms include either dull or burning pain in lower back, one sided pain in left or right side of lower back, radiating pain like that of sciatica, inability to lift front part of foot while walking. The pain aggravates at night owing to expansion of the uterus which puts pressure in vena cava, a prominent blood vessel, causing congestion in the pelvis and lumbar spine areas. Treatment for back pain during pregnancy Back pain during pregnancy is treated by exercises such as swimming, weight training, walking and stretching, good posture, appropriate footwear, lifting objects properly, suitable sleep postures, relaxation techniques and chiropractic treatment. Despite temptations to lie in the bed during back pain, pregnant women should involve in simple chores that strengthen the back besides keeping them active. Read the full article

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What is Text Neck Syndrome

Text neck syndrome refers to a repetitive stress injury to the neck caused by having your head in a forward position for an extended period. The forward-facing posture impacts neck curvature, shoulder and neck muscles, and the ligaments that support them. At Signature Physiotherapy, we have tailored rehabilitation plans that are geared at enhancing posture and regaining normal muscular function for more details, feel free to contact us. Read the full article

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Why does your neck hurt in the morning?

The pain in your neck that occurs during the morning may be the result of what you're doing when you're sleeping. Consider things such as an unsuitable mattress for sleeping or a mattress that has an incline in the middle. Eight hours of your neck bent at an awkward angle can cause stiffness in the joints and muscle pain when you wake up. This is also true for sofa sleepers and people who use a couch or who sleep in a small portion. Read the full article

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How does aging affect your back?

How does aging affect your back? Nearly 85% will experience some type of back or neck pain in their lifetime. As you age, your likelihood of experiencing back pain in the lower portion of your spine increases. This is because your spine changes with age. The 33 bones that make up your spinal column are called vertebrae. Between each vertebrae is a rubbery disc called an intervertebral disk. This protects them from rubbing against one another. Your vertebrae together protect your spine and nerves, while also creating flexibility and movement in your back. Your intervertebral disks start to dry out and wear away as you age. As your vertebrae rub against one another, this can lead to stiffness and pain in the back. The area surrounding your spinal cord can also become narrower. This condition is known as spinal Stenosis. It puts pressure on the spinal cord and nerves, which can cause pain.  There are other age-related changes that can cause pain in your back. - Arthritis - Osteoporosis or the loss of bone mass. - Loss of muscle strength and elasticity Mild aches and pains in the back can be expected as part of aging. They shouldn't be severe and they aren't inevitable. Feel free to contact us, We can advise you on the most appropriate alternative treatment options for your specific condition. Read the full article

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Backpacks and Back Pain in Children

Carrying a heavy bag on one shoulder can lead to chronic back problems. Risks include muscle strain, distortion of the natural ‘S’ curve of the spine, and rounding of the shoulders. It might strain the back, neck, or shoulders. It can cause a person to lean forward, reducing balance and making falling easier. Below points mentioned must be taken into consideration to avoid this scenario. • Making sure the child has a backpack with the right size • Make sure that the child isn't carrying a load that is too heavy • Holding the bag in one hand by its straps. • Carrying the bag over one shoulder. • An incorrectly fitted backpack. If your child complains of persistent back pain, especially if it wakes them up at night or is connected to prolonged pain and stiffness, always contact your doctor for a diagnosis.   Read the full article

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Learn Proper Walking posture

A better posture for walking can benefit the lower back by reducing the amount of strain the lower legs, calves and foot muscles endure. Because you're placing the majority of the weight on your foot while walking in a straight line, your low back and spine is affected by the force of your movements. It is one of the most effective methods to treat chronic pain because this type of pain is caused by your body was misaligned for a prolonged period of time. After it has acclimatized to the correct posture, you'll discover that chronic and acute pain walking decreases dramatically. Find Help for Your Back Pain Today with physiotherapy that is a signature treatment. The holistic way we work is devoted to improving the lives of our clients. We provide top quality physical therapy, as well as other therapies. The causes of back pain are numerous However, it's important to have it checked by a doctor before it becomes more severe. The absence of back pain does not only cause a decline in your life quality and you may also miss the signs of a more serious health issue. Read the full article

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How can a therapist assist you in overcoming back pain?

Ten to twenty years ago, those suffering from back pain would most commonly be advised to rest at home and the immobilization of their back. Most people are increasingly getting more and more sedentary. Prolonged sitting and no exercise weaken the muscles of your midsection. Exercise On the other hand improves muscle strength and flexibility and also helps in healing by increasing the flow of blood to the area of injury. Healthy muscles offer protection to joints and bones. Although back pain sufferers should always consult their physician about the most appropriate method to treat their issue Many are directed to a physical therapist. The role played by the physical therapist in providing relief from pain and rehabilitation as well as education is usually crucial for a successful recovery. Top Three Reasons to consult Signature physiotherapy in chennai For pain relief To design an exercise program Learn proper exercise techniques and techniques to provide muscles protection for joints and bones There are a variety of mechanical techniques and physical agents used by therapists to ease pain, for example, using heat packs or ice or ultrasound as well as the stimulation of muscles with electrical currents (see passive Physical Therapy). Alongside exercises, certain manual therapy methods include massage and mobilization. The pain can also be relieved by active exercises and exercise therapy, which are exercises that stretch the muscles and improve their flexibility.  How the physiotherapist can help you Moving in an area that requires precise knowledge, the profession of physiotherapists can only be exercised by graduated health professionals, physiotherapists in fact, who deal with everything related to the musculoskeletal system to restore the right balance and recovery after trauma.  managing physical pain and preventing future illness. If you are looking for the best physiotherapist in Chennai, Kindly visit the hospital to have a comprehensive health check in order to tell what is going on inside your body.  Read the full article