SCIATICA

If the sciatic nerve gets trapped or inflamed anywhere along this route, you may feel pain. This is called sciatica. There are several ways that a low back injury may press on the sciatic nerve and cause sciatica. Two common reasons are a herniated disk and spinal stenosis (narrowing of the spinal canal).
Sciatica can also result from a sudden injury. For example, if a buttocks muscle is injured from running too hard or lifting too many weights, it may swell or tighten and put pressure on the sciatic nerve causing pain.
Sciatica causes pain anywhere along the route that the sciatic nerve travels (your buttocks, the back of your thigh, the back of your calf, and even your foot). The sensation may be only a slight tingling or dull ache or it may be severe enough to decrease your ability to move. Sciatica almost always affects one leg or the other. Sometimes, however, you may have symptoms in both legs.

 Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the spine and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.

Common causes of sciatica include:

• Piriformis syndrome (a pain disorder involving the narrow piriformis muscle in the buttocks)
• Slipped disk
• Degenerative disk disease
• Spinal stenosis
• Pelvic injury or fracture
• Tumors

Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or a burning sensation. In some cases, the pain is severe enough to make a person unable to move.
The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts. The sensations may also be felt on the back of the calf or on the sole of the foot. The affected leg may feel weak.

The pain often starts slowly. Sciatica pain may get worse:

• After standing or sitting
• At night
• When sneezing, coughing, or laughing
• When bending backwards or walking more than a few yards, especially if caused by spinal stenosis

HERNIATED DISC

Herniated disks are most common in the lumbar spine -- the part of your backbone between the bottom of your ribs and your hips. Disks are like soft cushions between the bones of the spine. The disks in the spine let you move your backbone.

When a disk between two bones in the spine presses on the nerves around the backbone, it's called a herniated disk. The word "herniate" (say: her-nee-ate) means to bulge or to stick out. Sometimes this is called a ruptured or slipped disk.

How does a disk become herniated?

As you grow older, your disks become flatter -- less cushiony. If a disk becomes too weak, the outer part may tear. The inside part of the disk pushes through the tear and presses on the nerves beside it. The drawing to the right shows how a disk looks when it gets pushed through the tear and presses on a nerve. Herniated disks are most common in people in their 30s and 40s.

What are the signs of a herniated disk?

When part of a disk presses on a nerve, it can cause pain in the back and the legs. The location of the pain depends on which disk is weak. How bad the pain is depends on how much of the disk is pressing on the nerve. In most people with herniated disks, the pain spreads over the buttocks and goes down the back of one thigh and into the calf. This is known as sciatica because the pain travels along the path of the sciatic nerve. Some people have pain in both legs. In some people, the legs or feet feel numb or tingly.

The pain from a herniated disk is usually worse when you're active and gets better when you're resting. Coughing, sneezing, sitting, driving and bending forward may make the pain worse. The pain gets worse because these movements put more pressure on the nerve.

People with painful herniated disks often try to change positions to reduce the pain. You may have found that holding yourself up with your hands while you are sitting helps the pain. Shifting your weight to one side may also help. Don’t Ignore your pain

DEGENERATIVE DISC DISEASE

Degenerative disc disease is part of the natural process of growing older. Unfortunately, as we age, our intervertebral discs lose their flexibility, elasticity, and shock absorbing characteristics. The ligaments that surround the disc called the annulus fibrosis, become brittle and they are more easily torn. At the same time, the soft gel-like center of the disc, called the nucleus pulposus, starts to dry out and shrink. The combination of damage to the intervertebral discs, the development of bone spurs, and a gradual thickening of the ligaments that support the spine can all contribute to degenerative arthritis of the lumbar spine.

Degenerative disc disease is as certain as death and taxes, and to a certain degree this process happens to everyone. However, not everyone who has degenerative changes in their lumbar spine has pain. Many people who have "normal" backs have MRIs that show disc herniations, degenerative changes, and narrowed spinal canals. Every patient is different, and it is important to realize that not everyone develops symptoms as a result of degenerative disc disease.

When degenerative disc disease becomes painful or symptomatic, it can cause several different symptoms, including back pain, leg pain, and weakness that are due to compression of the nerve roots. These symptoms are caused by the fact that worn out discs are a source of pain because they do not function as well as they once did, and as they shrink, the space available for the nerve roots also shrinks. As the discs between the intervertebral bodies start to wear out, the entire lumbar spine becomes less flexible. As a result, people complain of back pain and stiffness, especially towards the end of the day.

CALCANEAL SPUR

A bony spur projecting from the back or underside of the heel bone (the calcaneus) that often makes walking painful. A calcaneal spur is also called a heel spur.

Spurs at the back of the heel are associated with inflammation of the Achilles tendon (Achilles tendinitis) and cause tenderness and pain at the back of the heel that is made worse by pushing off the ball of the foot.

Spurs under the sole (plantar area) are associated with inflammation of the plantar fascia (the "bowstring-like" tissue stretching from the heel underneath the sole) and causes  localized tenderness and pain made worse by stepping down on the heel.

Not all heel spurs cause symptoms. Some are discovered on X-rays taken for other purposes.
Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases which cause arthritis (inflammation of the joints) such as Reiter's disease, ankylosing spondylitis, and diffuse idiopathic skeletal hyperostosis.

A plantar calcaneal spur is an outgrowth from the bone at the back of the foot known as the calcaneus. This outgrowth is the cause of severe discomfort on the sole of the foot (plantar surface) and pain and is commonly known as heel spur pain. These spurs may develop over a long period of time and are initially unidentifiable, even upon x-ray, although the symptoms are present. Calcaneal spurs may be mistaken for plantar fasciitis, which is the inflammation of the thin fibrous layer between the skin on the sole of the foot and the bones of the foot.

Tennis Elbow

Tennis Elbow Overview

Tennis elbow is a condition caused by inflammation of the tendons on the outside (lateral side) of the elbow at a bony prominence (lateral epicondyle) of the upper arm. Certain repetitive movements of the wrist can cause this condition. It is not limited to tennis players.

Tennis Elbow Causes

• Any repetitive motion of the wrist, including tennis, hedge clipping, excessive use of a hammer or screwdriver, painting, or any activity that requires excessive constant gripping or squeezing can cause the condition known as tennis elbow.
• In the game of tennis, the following maneuvers can lead to tennis elbow:
• One-handed backhand with poor form
• A late forehand swing resulting in bending the wrist significantly
• Snapping and turning the wrist while serving with full power

FROZEN SHOULDER

Frozen shoulder is characterized by pain and loss of motion or stiffness in the shoulder. It affects about two percent of the general population. Frozen shoulder most commonly affects patients between the ages of 40 and 60 years, with no clear predisposition based on sex, arm dominance, or occupation

Cause:-

The process involves thickening and contracture of the capsule surrounding the shoulder joint.

Frozen shoulder occurs much more commonly in individuals with diabetes, affecting 10 percent to 20 percent of these individuals. Other medical problems associated with increased risk of frozen shoulder include: hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease or surgery.
Frozen shoulder can develop after a shoulder is immobilized for a period of time. Attempts to prevent frozen shoulder include early motion of the shoulder after it has been injured.

Symptoms:-

Pain due to frozen shoulder is usually dull or aching. It can be worsened with attempted motion. The pain is usually located over the outer shoulder area and sometimes the upper arm.
The hallmark of the disorder is restricted motion or stiffness in the shoulder. The affected individual cannot move the shoulder normally. Motion is also limited when someone else attempts to move the shoulder for the patient.
Some physicians have described the normal course of a frozen shoulder as having three stages:

·  Stage one: In the "freezing" stage, the patient develops a slow onset of pain. As the pain worsens, the shoulder loses motion. This stage may last from six weeks to nine months.

·  Stage two: The "frozen" stage is marked by a slow improvement in pain, but the stiffness remains. This stage generally lasts four months to nine months.

·  Stage three: The final stage is the "thawing," during which shoulder motion slowly returns toward normal. This generally lasts five months to 26 months.

SLIPPED DISC

What is a slipped disc?

A slipped disc occurs when the outer part of your disc ruptures, allowing the gel inside to bulge and protrude outwards from in between your vertebrae. The damaged disc can put pressure on your whole spinal cord or on a single nerve fibre. This means that a slipped disc can cause pain both in the area of the protruding disc and in any part of your body that is controlled by the nerve the disc is pressing on.
A slipped disc is most common in the lower back, but it can also occur in the neck and upper back.

Causes and risk factors

Pain-Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.

Tissue-Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.

Spine-The spine supports the skeleton, and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae.

Spinal cord-The spinal cord is a column of nervous tissue located in the spinal column. It sends messages between the brain and the rest of the body.

Ruptures-A rupture is a break or tear in an organ or tissue

Slipped Disk Symptoms

The nerves of the body exit the spine at each spinal level. A herniated disk can therefore produce symptoms anywhere along the course of that nerve, though the injury and irritation of the nerve are at the spine itself (this is known as referred pain). A slipped disk can produce varying degrees of pain in the back or neck along with numbness or weakness.

• For slipped disks in the neck - Numbness, tingling, weakness, or pain in the shoulder, neck, arm, or hand
• For slipped disks in the lower back
• Numbness, tingling, weakness, or pain in the buttocks, back, legs, or feet
• Numbness and tingling around the anus or genitals
• Pain down the back of each leg from the buttocks to the knee (this is called sciatica)
• Pain with movement, straining, coughing, or doing leg raises
• Difficulty controlling bowel movements or bladder function