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Spinal Traction

July 23, 2009 By Leave a Comment

Note: This article on traction relates to traction used in physiotherapy. For traction for acute problems, please refer to other article.

This is a stretching force applied in a longitudinal direction of the spine.  Traction is supposed to separate vertebral bodies, stretches fibrous tissue, improve movements of facet joints,  better drainage of fluid around the nerve roots, and improves circulation.

Traction is of two types – sustained and oscillatory. While sustained hold is used for injuries, root compression and muscle spasm, oscillatory  is used for degenerative changes. [Read more...]

Filed Under: Physiotherapy Tagged With: , ,

Bisphosphonate Therapy Does Not Require Bone Mineral Density Monitoring Up to 3 Years After Starting

July 21, 2009 By Leave a Comment

In a recent online publication dated June 24th, a study has quoted in British Medical Journal that monitoring bone mineral density  in postmenopausal women in the first 3 years after starting treatment with a potent bisphosphonate is not needed and may even be misleading. Bisphosphnates are very commonly prescribed for postmenopausal osteoporosis.

It is further reported that there is a difference in guidelines for treatment of postmenopausal osteoporosis. The US National Osteoporosis Foundation and the American Association of Clinical Endocrinologists recommend routine monitoring of bone mineral density within two years of starting treatment. The UK guidelines recommend that further research is needed and the North American guidelines recommend that treatment should not be stopped or changed because of a modest observed loss in density. [Read more...]

Filed Under: Osteoporosis Tagged With: , , , ,

Complications of Skin Traction

July 19, 2009 By Leave a Comment

Skin traction is used where a smaller amount of force is required to correct the deformity. It may cause following complications

Skin Trauma

The skin is easily traumatized by this method and can cause various degrees of injury, from abrasion to partial-thickness skin loss.

If the elastic bandages are wrapped too tightly or unevenly, it may result in circulatory impairment and may lead to development of  pressure area. This is especially true for  bony and soft tissue prominences. [Read more...]

Filed Under: Traction-Aids-Appliances Tagged With: , , ,

What is Countertraction

July 18, 2009 By 2 Comments

Traction is often applied to part of the body to negate the effect of the forces causing the deformity. To be an effective traction the traction should act on the deformity and not whole body. To counter the effect on the whole body we need another force that acts in opposite direction.

Let us understand this with an example. Suppose that there is a fracture of shaft of femur bone. Shaft femur fracture would produce a deformity because of pull of the muscles and broken bone. To straighten it one requires to put a pulling force distal to tyhe fracture site. Let us say on holds the foot and pulls the limb so as to correct the deformity. Some of deformity would be corrected but the force of the pull would also pull the body towards the person who is pulling. [Read more...]

Filed Under: Traction-Aids-Appliances Tagged With: , , , ,

What Is Traction And Its Uses?

July 17, 2009 By 2 Comments

Traction is a directional pull on the trunk or on an extremity. Its applications include immobilization and reduction of fractures, correction of deformities, and elevation of extremities for the management of soft tissue injuries and burns.

Traction is accomplished by attaching immobilizing devices either to the skin or to the skeleton. Depending upon this the traction is called skin traction and skeletal traction.

Skin  traction is used in the treatment of conditions for which only a small amount of pull is required. It is often used for [Read more...]

Filed Under: Traction-Aids-Appliances Tagged With: , ,

Non Operative Management of Backpain – An Overview

July 15, 2009 By 2 Comments

With changing lifestyles, backpain is becoming more and more common. While there are many causes of back pain and when identifiable should  be treated accordingly, many a times no identifiable cause of back pain can be found.and  patients suffer from mechanical back pain.

Time heals a lot of low back pain problems. In fact most of the symptoms associated with lumbar disc diseases are self limiting and will go away spontaneously whether or not a doctor, physical therapist or a chiropractor is involved.

Therefore non operative measures to deal with back pain should be first line of treatment if there is no contraindication to it. Three are many considerations involved before initiating the treatment. [Read more...]

Filed Under: Back Pain Tagged With: , , ,

Skeletal Dysplasias Causing Short Limbs

July 14, 2009 By Leave a Comment

Dysplasia is a term that is used to denote abnormality in maturation of cells within a tissue. That means that the tissue developed would have abnormalities.

The skeletal development can be hampered by many causes and is classified according to the embryological segment affected.

Rhizomelic Dysplasia

The proximal segment of the limbs is affected. It can be due to

Hypochondroplasia

It resembles resembles a mild form of achondroplasia.

Achondroplasia

Chondrodysplasia punctata

Chondrodysplasia punctata has both autosomal dominant and  autosomal recessive types. Recessive type is rare. [Read more...]

Filed Under: Pediatric Disorders Tagged With: , , ,

Reflexes of Spinal Cord and Conus Medullaris

July 13, 2009 By 1 Comment
Reflex

Location of Lesion

 Stimulus Normal Response Abnormal Response
Bahinski Upper motor neuron Stroking the plantar aspect of foot proximal lateral to distal medial Toes plantar flex Toes extend and splay
Oppenheim Upper motor neuron Rubbing the tibial crest proximal to distal Toes plantar flex Toes extend and splay
Cremasteric T12-L1 Stroking the tibial crest proximal to distal Upward motion of the No motion of the scrotum
Anal wink S2-S4 Stroking skin around anus Anal sphincter contracts No anal sphincter contraction
Bulbocavernosus S3-S4 Squeezing the penis in males, applying pressure to clitoris in females, or tugging the bladder catheter in either Anal sphincter contracts

No anal sphincter contraction
Filed Under: Spine, Spine Injuries Tagged With: , , , ,

Incomplete Patterns of Spinal Cord Injury

July 10, 2009 By 1 Comment

Each case of of spinal cord injury is unique and needs to be assessed in detail. A complete injury of the spinal cord results in total loss of sensations and motor control at or below the level of injury. However in incomplete injuries there might emerge some patterns of neurological distribution that may indicate towards type and level of injury.

These patterns result from typical arrangement of neural fibres in the spine. These are the common injury patterns when the lesion is incomplete. However, it must be remembered that not every case would present with classical picture of these lesions. There would be pointers but all the features might not be present. [Read more...]

Filed Under: Spine Injuries Tagged With: , , , ,

What Is Bunion?

July 9, 2009 By 2 Comments

hallux-valgusBunion is an enlargement of bone or tissue around the joint at the base of the big toe (metatarsophalangeal joint).th bunion is usually associated with hallux valgus [hallux refers to the great toe, "valgus" refers to the abnormal angulation of the great toe], a deformity of the toe where big toe may turn in toward the second toe. This leads to swelling and tenderness of the tissues and forms bump.

The bump can be swollen bursal sac and/or bony deformity.

For maintence of normal alignment muculotendinous forces  act. When there is imbalance tendons, ligaments, and supportive structures of the first metatarsal do not functioning correctly and lead to deformity.Hallux valgus, the primary deformity responsible for bunion can occur in any person and the cause is not known. Footwear has been implicated as a cause but needs to be substantiated. Asociation with  flat feet, excessive ligamentous flexibility, abnormal bone structure, and certain neurological conditions has been found. [Read more...]

Filed Under: Foot Disorders Tagged With: , , , ,
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