Food & health orthopedics lead sep oct 07 09 15

Orthopedics lead

G

oing by definition orthopaedics is the branch of medicine that deals with the correction of deformities of bones or muscles.

Orthopedics is the medical speciality that is related to the preservation, restoration, and development of form and function of the musculoskeletal system, extremities, spine, and associated structures by medical, surgical, and physical methods.

Ortho has become a term that is loosely used to talk about bone and joint related disorder and diseases.

In the era where life has become fast and when everyone is constantly on the move, bone and joint trouble is taken lightly until the trouble becomes unbearable. The human body has more than 200 bones and there are over 200 joints that are connected to the bones. Like heaven has a solution to earth’s every problem, the medical fraternity has a treatment if not at least a solution for the most challenging orthopaedics disease and disorder.

Blame it on the lifestyle change or eating habits or the work culture, we must accept the fact that orthopaedics disease and disorder or Musculoskeletal disorders (MSDs) have become younger. Such disorders and diseases know no age. On one hand, while more and more people have become prone to MSDs these days, thanks to research and advancements in the field of medicine, there is a cure for orthopaedics disease and disorder.

Day after day there is remarkable progress being made across the world in the field of orthopaedics disease and disorder. Knee and hip replacement surgery and reducing the crippling pain of arthritis are to name a few examples of how research in this field has made life easy for patients. Despite the fact that musculoskeletal disease and disorder has become younger, medical treatments and technological advancements have enabled people suffering any form of this disease or disorder has ensured that people live longer.

Almost every household in India has at least one family member suffering from one form of orthopaedics disease and disorder. Doctors have warned that joint damage can happen at any age. Depending on the condition of the disease, doctors prescribe medication and other forms of treatment like physiotherapy, massage and stretch exercise. The possible solution is to replace the damaged joint through surgery.

The term Musculoskeletal disorders (MSDs) is used to describe a variety of conditions that affect the muscles, bones, and joints. There can be severe pain that results in the patient not being able to perform daily routine activities.

Doctors have warned that the risk of MSDs can increase with age.

However, the possible solution to MSDs is early diagnosis. Diagnosing MSDs at an early stage can also reduce the damage caused.

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neutral posture, heavy force or repetition are more prone to MSD risk factors.

Psychological There is a growing awareness among people about the fact that how psychological factors can cause increased muscle tension, increased blood and fluid pressure, reduction of growth functions, pain sensitivity reduction, pupil dilation, body remaining at heightened state of sensitivity.

connective tissues in the body are the most common symptoms of arthritis.

Other factors The risk of people getting MSDs can vary from person to another.

Various differences like gender and obesity can determine people’s tendency of getting MSDs.

Inflammation of the meeting place of two or more bones; a joint actually refers to more than 100 different types of arthritis.

Rheumatic diseases are classified as those that cause pain, stiffness, and swelling in joints or other supportive body structures, such as muscles, tendons, ligaments, and bones.

Diagnosing MSDs A doctor’s visit on time can save the patient a lot of pain. A specialist will carry out a physical examination to test if the muscles for weaknesses or atrophy. Unusual reflexes are a clear indication of the nerve being damaged. Swelling and redness may be signs of the forms of arthritis: gout, osteoarthritis, and rheumatoid arthritis.

MSDs can affect all major areas of the body areas including •

Neck

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Knees

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Feet

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Wrists

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Shoulders

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Back (upper and lower)

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Hips

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Legs

Key elements in the history of determining the severity of MSDs are •

Loss of function

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Pain

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Stiffness

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Deformity

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Swelling

What causes MSDs? Depending on several factors MSDs have a range of causes. However, a few factors can determine the

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severity of the problem. The exact cause of the disease can depend on factors like •

Age

•

Lifestyle

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Activity level

•

Occupation

Causes of MSDs MSDs can arise from interaction of physical factors with economic, psychological, and social factors.

Biomechanical Physical activity involving heavy load can result in acute injury. In many cases, physical activity that does not involve heave weight but when repeated quite often at short intervals can also cause muscle damage. People who are involved in doing tasks which involve maintaining a non-

If bone fractures are suspected, the doctor will likely ensure that the X-rays are taken in order to get a better look at the bones. X-rays may also indicate areas of increasing bone loss. Blood tests may be used to investigate rheumatic diseases.

The most common types of arthritis are Osteoarthritis.

Treating MSDs

1. Arthritis

Treatment for musculoskeletal disorders solely depends on the severity of the disease. Pain on and off and mild discomfort is treated with over the counter medications. When the disease is in its advance stage, along with prescribed medications physical and occupational therapy is recommended. Such therapy helps in keeping inflammation and pain under control.

Most common among men and women, arthritis and other rheumatic diseases are often mistakenly associated with old age. However, arthritis and other rheumatic diseases are common among men and women of all age groups. This is a chronic disease and it is progresses slowly. The specific causes of most of the arthritis are yet unknown.

Preventing MSDs

Pain, swelling and limited movement in joints and

Prevention is better than cure, for any disease and disorder. The same holds god for MSDs as well. Lifestyle changes are regarded as one of the sure ways such disorders and diseases can be prevented. Regular stretch exercises do go a long way in keeping the bones, joints and the muscles strong and in shape. Above all a maintaining a correct while carrying out the physical activities can help in not causing damage to bones, joints, muscles and tissues.

This is one of the most common types of arthritis and it is classified as a chronic disease involving the joints, particularly the weightbearing joints such as the knee, hip, and spine.

Osteoarthritis is characterized primarily by the destruction of cartilage and narrowing of the joint space. It can also include bone overgrowth, spur formation, and impaired function.

Osteoarthritis is common in people as they age, however, it may also occur in young people as a result of injury or overuse.

Types of disorders and diseases There are many conditions that affect the working and functioning of the musculoskeletal of our body. Listed below are the most common of them.

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Common types of bursitis Bursitis can occur almost anywhere in the body where bursae are located.

Listed below are the most common types of bursitis.

of this disease. Rheumatoid arthritis may result in low red blood cells, inflammation around the lungs, and inflammation around the heart.

Till date the cause of this disease remains unclear. However, it is believed that the combination of genetic and environmental factors can cause rheumatoid arthritis.

Juvenile idiopathic arthritis (JIA) or juvenile rheumatoid arthritis (JRA): As its name suggests, this form of arthritis affects children and teens.

It is a chronic autoimmune disease.

Based on their symptoms, number of joints involved and the presence of antibodies in the blood JRA are classified into three main types.

In most cases, juvenile arthritis is caused by the body attacking its own healthy cells and tissues causing the joint to become inflamed and stiff.

Gout: Gout most commonly known as podagra when it involves the big toe is characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. Elevated levels of uric acid in the blood may cause gout. Through lifestyle and diet changes, the level of uric acid in the blood can be brought down. Nicknamed as the ‘disease of the kings’, gout has not spared anyone.

Recommended treatment for arthritis Fibromyalgia: This is a rheumatic condition characterized by muscular or musculoskeletal pain with stiffness and localized tenderness at specific points on the body. Other symptoms may include sleeping disorders and feeling tired to eve carry out the normal activities of the day. Some patients also report difficulty with

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swallowing, bowel and bladder abnormalities, numbness and tingling and cognitive dysfunction.

Rheumatoid arthritis: This is an inflammatory disease that involves the lining of the joint (synovium). The inflammation is most common in the wrist and hands and it can affect all of the joints. Fever and low energy levels are symptoms

There is no cure for arthritis.

However, pain and inflammation can be brought under control. Depending on the severity of the disease and the condition of the patient, the doctor recommends treatment and medications for arthritis.

This disease can be treated with medication, joint immobilization, massage, acupuncture, medications, corticosteroids, weight reduction among other forms of treatment.

2. Bursitis A closed, fluid-filled sac that functions as a cushion and gliding surface to reduce friction between tissues of the body is often referred to as a bursa. Bursae often occur in locations adjacent to the tendons that lie in close proximity to the large joints like the knees, shoulders, elbows and hips. Bursa in its inflamed condition is known as bursitis. This condition does not cause deformity. It is a temporary condition that may restrain motion.

Retromalleolar tendon bursitis: Also known as Albert disease where the extra strain on the anterior part of the Achilles tendon, that may caused due to such as injury, disease, or shoes with rigid back support, thus causing this condition.

It is characterized by inflammation of the bursa located in front of the attachment of the tendon to the heel.

Posterior bursitis:

Causes of bursitis Injury is the most common cause of bursitis. However, arthritis, gout, tendinitis, diabetes, and thyroid disease can also cause bursitis.

Achilles

tendon

Also known as Haglund deformity and it is located between the skin of the heel and the Achilles tendon.

Most common among young women, this condition is aggravated by a type of walking that presses the soft heel tissue to the hard back support of a shoe.

Hip bursitis: Injury, overuse, spinal abnormalities, arthritis, or surgery can cause hip bursitis. This condition

is more common in middle age and the older women. Knee bursitis.

Located between the shin bone and the 3 tendons of the hamstring muscles, on the inside of the knee, knee bursitis is popular by the name goosefoot bursitis or Pes Anserine bursitis. Lack of stretching before exercise, tight hamstring muscles, being overweight, arthritis, or outturning of the knee or lower leg are believed to be the common cause of this type of condition.

Kneecap bursitis: This type of bursitis is common among people who use their knee to sit. This condition is common among carpenters and plumbers.

Elbow bursitis: Inflammation of the olecranon bursa located between the skin and bones of the elbow can cause elbow bursitis. It can also be caused by injury or constant pressure on the elbow (for example, when leaning on a hard surface). Elbow bursitis can cause pain and also restrict movement.

Recommended treatment for bursitis Regardless of the type of bursitis, the treatment will highly depend on the weather or not the bursitis involves a infection of any kind.

Listed below are the recommended treatments for bursitis. A specialist will decide on the treatment based on age, medical history and the condition of the patient.

The severity of the disease also will play in a major role in determining the kind of treatment that has to be followed. Lastly, the individual patients tolerance towards specific medications, procedures, or therapies are taken into consideration.

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Medication, stretching and strengthening exercises, wrist braces, straps and cortisone shots are used to treat tennis elbow. However, surgery is recommended when the above mentioned treatment does not work.

Medial Epicondylitis (Golfer's and Baseball Elbow)

3. Elbow Pain and Problems Cubital Tunnel Syndrome The pain that is caused by Cubital Tunnel Syndrome is a similar kind of pain that occurs when the funny bone in the elbow is hit. This syndrome occurs when the ulnar nerve, that passes through the cubital tunnel that is a tunnel of muscle, ligament, and bone found on the inside of the elbow, becomes compressed due to chronic irritation, injury, or pressure. Cubital Tunnel Syndrome may be caused when a person constantly leans on the elbow or sustains direct injury to that area. It can also occur when the elbow is constantly bent in order to perform activities such as reading, pulling or lifting.

Numbness in the hand, pain in the hand and weakness of the hand muscle are the symptoms of Cubital Tunnel Syndrome. Nerve

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conduction test and Electromyogram (EMG) are the most common tests to diagnose cubital tunnel syndrome in addition to complete medical history and physical examination of the patient. As treatment for this syndrome, doctors recommend that patients use an elbow pad as this one serves as a protection against chronic irritation from hard surfaces. At night an elbow pad can be worn in order to restrict movement and bring down the irritation.

Tennis Elbow Lateral Epicondylitis

Inflammation of the tendons (tendinitis) attached to the outside, or lateral side, of the elbow at the bony prominence of the arm bone (humerus) condition is known as tennis elbow. This bony prominence is called the lateral epicondyle; hence this condition is also called "lateral epicondylitis." Those who suffer from tennis elbow may experience pain in the lateral side of their elbow. Such kind of pain is usually accompanied with weakness may become especially unbearable when the hand is used to grasp something. Sudden violent injury can cause tennis elbow. Activities because of which tendons are essentially overloaded, may also cause this condition. People who play a lot of tennis experience the overload of tendons. They are more prone to develop pain in the outer elbow. This is why this condition is also called tennis elbow.

This condition is not a serious problem. However, if undetected and untreated, tennis elbow can become severely painful. A majority of cases of tennis elbow do not require surgery.

Also nicknamed as golfer's elbow, baseball elbow, suitcase elbow, or forehand tennis elbow, Medial Epicondylitis is characterized by pain that occurs in the elbow to the wrist on the inside (medial side) of the elbow. It is believed that damaged to the tendons that bend the wrist toward the palm cause this pain. A tendon is a tough cord of tissue that connects muscles to bones.

Such injury is caused when using the force to bend wrist toward the palm. This condition can especially occur when swinging a golf club or pitching a baseball. Throwing a javelin, chopping wood with an axe, operating a chain saw, frequent usage of hand tools on a regular basis for long durations, weak shoulders and muscles, while playing tennis serving with great force, carrying a heavy suitcase can also cause Medial Epicondylitis.

Pain in the palm side of the forearm, from the elbow to the wrist, on the same side as the little finger is the most common symptom of Medial Epicondylitis. Such pain can be experienced while bending the wrist toward the palm against resistance, or when squeezing a rubber ball.

Through physical examination the doctor can identify if the patient suffers Medial Epicondylitis.

Treatment may include ice pack application (to reduce inflammation), anti-inflammatory medications, corticosteroid injections, strengthening exercises and surgery if required.

4. Fibromyalgia Widespread pain in muscles and soft tissues surrounding the joints throughout the body is termed as fibromyalgia. It is believed that this disease affects middle age women.

The symptoms of fibromyalgia are common similar to the symptoms of other joint diseases like arthritis.

However, fibromyalgia is actually a form of soft tissue or muscular rheumatism that can cause pain in the muscles and soft tissues. Sleep disturbance, psychological stress, or immune, endocrine, or biochemical

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abnormalities are believed to be the most common causes of this condition. Fibromyalgia can affect the muscles and also the points at which the muscles attach to the bone (at the ligaments and tendons).

Fibromyalgia is a chronic condition and pain is the most common symptom of fibromyalgia. In this condition, pain normally occurs in one particular part of the body and it spreads across the entire body.

Depending on the severity pain is classified as burning, soreness, stiffness, aching, or gnawing pain.

Depression, sleepless nights, headaches, anxiety, moderate to severe fatigue, restless legs and decreased exercise endurance are the symptoms of fibromyalgia.

While there are no tests to diagnose fibromyalgia the doctor concludes if the patient suffers from this medical condition based on the physical condition and the medical history of that patient. Antidepressants, pain killers, anti-inflammatory medications (to relieve pain and improve sleep), exercise and physical therapy (to stretch muscles and improve cardiovascular fitness), massage and occasional cold applications are used to treat fibromyalgia.

5. Foot Pain and Problems Made up of 26 bones connected by numerous joints, muscles, tendons, and ligaments, the foot is regarded

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as one of the most complex parts of the human body. The foot is also prone to stress and when damaged, the foot can restrict mobility.

Bunion Bunions may occur at the base of the great toe or at the base of the little toe, and often occur when the joint is stressed over a period of time. A bunion is a protrusion of bone or tissue around a joint. It is believed that women are prone to this condition as they are known to use wear tight, pointed, and confining shoes. Bunions can also be a result of arthritis, which often affects the big toe joint. Treatment can vary depending on the nature and severity of bunions. Treatment can include surgery, application of pads, medications and wearing comfortable footwear.

Most common foot problems Improper foot functions and continues of footwear that is not comfortable to wear can cause foot problems. It is recommended to use footwear that fit well and also can support the parts of the feet and the skin. There are several problems that can affect the toes, nerves, tendons, ligaments, and joints of the foot. A few common foot related problems have been discussed.

Heel spurs Heel spur is the growth of the bone that is usually located underside of the heel bone where it attaches to the plantar fascia, a long band of connective tissue running from the heel to the ball of the foot. This connective tissue acts like a shock absorber and it holds the arch together. Performing activities like running, or wearing poor-fitting shoes and being overweight can result in the plantar fascia being overstretched. This can result in can result stress and inflammation of the tissue pulling on the bone.

Over some time, the body builds extra bone in response to this stress resulting in heel spurs. Cold packs, proper footwear or shoe inserts, corticosteroid injections, antiinflammatory medication, such as

Morton neuroma ibuprofen, rest and proper stretching prior to activity are regarded as the best treatment for heel spurs Corn Yellowish, callus growths that develop on top of the toes is called corn. Stress and abuse can cause corn. Known to cause extreme pain and discomfort, it is believed that corn is caused when a toe rubs against another or when a toe rubs against a shoe. Treatment may include surgery, using a footwear lager than normal size, applying pads around corn affected area and trimming the corn by shaving the layers of dead skin.

When two bones rub together squeezing the nerve that lies inbetween them the condition is termed as Morton neuroma. Morton neuroma is a buildup of benign (noncancerous) tissue in the nerves running between the long bones of the foot. Most often, neuromas develop between the bones leading to the third and fourth toes.

Swelling, tenderness, and pain is caused by this condition. Severe pain can cause tingling, numbness, and burning in the toes. It usually occurs post standing or walking for a long period of time. Treatment for this condition may include rest or a change in footwear that does not restrict the foot. If the problem

persists, cortisone injections or surgery is looked as an option.

Hammertoes When the toe buckles, causing the middle joint of the affected toe to poke out, this condition is referred to as hammertoe. Using tight-fitting shoes that put pressure on the hammertoe aggravate this condition.

Application of toe pads that are specially positioned over the bony protrusion, changing the footwear to accommodate the deformed toe and surgical removal are regarded as the best treatment for hammertoes.

Ankle sprain Injury caused to the foot's ligaments in the ankle is referred as ankle

sprain. Ligaments are tough bands of elastic tissue that connect bones to each other. Rolling, twisting or bending the ankle beyond the normal permissible range can cause a sprain in the ankle. Awkward foot placement, irregular surfaces, weak muscles, loose ligaments, or wearing shoes with spiked heels can also cause ankle sprain. The symptoms

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of a sprain will depend on how severely the ligaments are stretched or torn, but usually include swelling, pain, or bruising. Treatment may include resting the ankle, elevating the ankle, application of ice pack, wrapping the ankle with elastic bandage or tape, physical therapy and Surgery (for severe sprains).

Foot fracture When a foot is fractured it is swollen and painful. A majority of fractures do not require surgery or a cast as the fractured foot tends to heal on its own. The most common fractures are Ankle joint fracture: If the bones in the fractured ankle are separated or misaligned the doctire may call for surgery.

Metatarsal bone fractures: When the bones that are located in the middle of the foot are fractured, it is referred to as metatarsal bone fracture.

Most often this

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kind of fracture does not require a cast. However, the fractured region must be supported preferably with a stiff-soled shoe. In some cases doctors recommend surgery to correct the misaligned bones.

resting signals the possibility of plantar fasciitis. Doctors share that this condition can occur due to an overuse injury of the sole surface (plantar) of the foot. It can result in inflammation of the fascia, a tough, fibrous band of tissue that connects the heel bone to the base of the toes.

Sesamoid bone fractures: There are two small round bones that are located at the end of the metatarsal bone of the big toe. A fracture in this region of the big toe is referred to as sesamoid bone fractures.

In some severe cases of fracture, doctors recommend surgery. In most cases, padded soles can help relieve pain.

Toe fracture: Fractures in the toe are not very serious and occur due to careless movement of the toe. They can be healed with or without a cast.

Foot pain Pain in the foot is normally occurs due to lifestyle change. Foot pain can have many sources, from fractures and sprains to nerve damage. However, the most common areas of foot pain and what causes such pain have been discussed.

Pain in the ball of the foot: This kind of pain occurs in the bottom area of the foot right behind the toes. Such pain can damage the nerves and joints located in this area. In addition, a benign (noncancerous) growth, such as Morton's neuroma, may cause the pain. For this condition, doctors recommend corticosteroid injections and advice wearing supportive shoe inserts.

Plantar fasciitis: Severe pain in the heel of the foot especially when standing up after

This condition is common in women and especially in obese people. People who are involved in the occupation that require a lot of walking or standing on hard surfaces are also prone to this condition.

People with flat feet and people with high arches have high chances of developing plantar fasciitis.

Walking or running, especially with tight calf muscles, may also cause the condition. Application of ice pack, rest, non steroidal anti-inflammatory medications, stretching exercises of the Achilles tendons and plantar fascia are used to treat this condition.

Achilles tendon injury: The tendon that connects the calf muscle to the heel bone is the achilles tendon and it is the largest tendon in the human body. However, this tendon is also the most common site of rupture or tendonitis, an inflammation of the tendon due to overuse.

Achilles tendonitis condition is caused by overuse of the tendon and calf muscles. Symptoms may

include mild pain after exercise that worsens gradually, stiffness that disappears after the tendon warms up, and swelling. Treatment for this condition may include Massage therapy, strengthening exercises, supportive devices, bandages for the affected muscle and tendon, nonsteroidal anti-inflammatory medications, rest and in severe cases surgery is recommended.

6. Fractures Complete or partial breakage of the bone is called fracture. A fracture may be classified as open or close depending on its nature. An open fracture also known as bone exits and is visible through the skin, or a deep wound that exposes the bone

through the skin. When the bone is broken and the skin is intact, the fracture is classified as closed or simple fracture.

Fractures have a variety of names. A few common names given to fractures are Greenstick fracture: When a portion of the bone is broken, causing the other side to bend it is termed as Greenstick fracture. This fracture is most common in children.

Transverse fracture. The bone breakage is in a straight line perpendicular to the bone.

Spiral fracture. The breakage spirals around the bone; common in a twisting injury.

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