Orthopaedic problems: Dr Sanjay Desai, Arthroscopy Surgeon shares the price we pay for living in the modern urbanised world.
Rapid socio-economic changes and increasing urbanisation are a lethal combination to blame for a substantial rise in orthopaedic troubles along with several other factors. With rising life expectancy, increasingly sedentary lifestyles, addiction to mobile phones, and a surge in the incidence of obesity, the rise in orthopaedic problems is only a natural consequence. Backache is the most common problem that is seen, especially among people who ride two-wheelers. The rise in chronic spinal injuries among motorists brings a renewed focus on roads' pathetic condition in the country. Intervertebral disc prolapse is a common consequence of repeated jerk on the low back. Besides back spasm, this may lead to nerve impingement or sciatica. Not just the back, but people who ride two-wheelers are susceptible to neck strain as well. With the capital splitting at its joints, driving long distances has become the pattern, and those who travel in four-wheelers are exposed to several muscle-skeletal afflictions. The culprits are long hours of inactivity and bad posture while sitting in the car. Even those in chauffeur-driven vehicles are not spared of the perils of long hours of inactivity in the rear seat. Prolonged periods of inactivity during travel induce people to keep texting or fiddle with their mobile phones, often leading to tenosynovitis of the thumb or ‘SMS Thumb’. Failure to stretch feet for ampere-hours can also expose a person to the conceivably serious condition of leg clots, known as (DVT) deep vein thrombosis. Here are some common orthopaedic conditions:
- Ankylosing spondylitis and frozen shoulder.
- Anterior cruciate ligament (ACL) injuries.
- Arthritis of the ankle, shoulder and foot.
- Achilles tendinitis, tendon rupture.
- Abnormal walking patterns.
Common Orthopedic Disorders
- Arthritic conditions: Arthritis is a disease associated with inflammation and pain of joints. The disease usually occurs in the form of osteoarthritis and rheumatoid arthritis. The risk of infection also increases with increasing age. Women are more vulnerable to this disease than men.
- Rheumatoid Arthritis: Rheumatoid arthritis is a condition that can be treated throughout life. In this, the body joint changes its shape along with pain, swelling. Rheumatoid arthritis is an inflammatory ailment that hits the joints and the body's system, skin, eyes, lungs, heart, and blood arteries.
- Osteoarthritis: Osteoarthritis is a condition that causes stiffness and joint pain. No complete treatment is possible, but many treatments can prevent it if it gets caught in time. This disease mainly damages the articular cartilage between the bones of the joints.
- Treatment for Arthritis: Castor oil helps to get relief from Arthritis Keep on tax affected area. It provides comfort from pain and redness.
- Ligament Injuries to the Knee: By playing, running and going up and down incorrectly, suddenly, the cushion inside the knee or the ligament (fibres) connecting it are damaged. Apart from this, the ligament is also injured in a road accident. In such a situation, the patient has severe pain. With this, he gets relief from pain medications.
- Fibrositis (Fibromyalgia syndrome): Fibromyalgia is a severe disease. Fibrositis can be defined as muscle dysfunction, pain or swelling of muscle and joint bones, tendons, and connective-tissue layers of muscles. The areas regularly affected in fibrositis are the lower back, legs, hips, arms, chest, neck, shoulders, and thighs.
- Lateral Epicondylitis (Tennis Elbow): Tennis elbow can happen to anyone when he uses his one hand most for any heavy work, and he does it daily. By doing this, the fibres of the muscles connecting the elbow to the wrist become swollen and cause pain. This fibre is called the common extensor tendon.
- Osteoporosis: Osteoporosis is a bone condition that raises the risk of fractures. In osteoporosis, bone mineral density (BMD) is reduced, the bone microstructure is disintegrated, and the amount and diversity of nonassociated proteins in bone is altered.
Types of pain: Most common is the knee, followed by shoulder and hip
Among patients, it is being seen that knee pain is the most common joint pain, followed by hip and shoulder.
- Anterior knee pain after a prolonged driving period is often due to overloading the patella (knee cap). This is also known as the pain in the front of the knee.
- When a shoulder hurts, in the young, this could be due to a labrum (a rubber-like ring around the shoulder socket) tear, and in the elderly, it could be due to injury to the Rotator Cuff tendon. Both can happen due to an indirect jerk, e.g. motorcycles riding over potholes!
- If left untreated, these shoulder injuries can lead to a Frozen shoulder means more pain, stiffness, decreased quality of life, disability, frustration and time out from work.
- If a person has shoulder pain, it's essential to keep the shoulder joint mobile with light and gentle movement. Not using the shoulder can cause muscles to waste away and may make any stiffness worse.
However, it is best to take professional help, preferable from a shoulder specialist, before things get out of hand. The specialist may advise some specific exercises or sometimes a pain-relieving injection, and occasionally, arthroscopic surgery may be the only option.
Stress factor and orthopaedic issues
Another reason for orthopaedic issues is the stress factor at work compounded with prolonged commute fatigue, leading to a lack of physical activity as Indians are genetically predisposed to orthopaedic problems such as osteoarthritis. At the same time, lack of exercise and sedentary lifestyles are making matters worse. So, it is not unusual that India is the world capital of ischaemic heart disease and diabetes.
Here are a few precautionary measures to reduce orthopaedic problems
However, a few steps can be taken to ensure that orthopaedic issues do not aggravate.
- Keeping good posture and using an ergonomic seat can go a long way in protecting the lumbar spine.
- Core exercises, simple stretching, Theraband and light weights can be easily incorporated into one’s daily routine.
- At the same time, some form of physical activity is essential for both mental and physical health.
- It is common in countries like the United States to have gymnasium facilities at the workplace. It has also been found that taking exercise breaks at work is refreshing and increases work output. This should be adapted to the work culture in India too.
- Besides, the importance of an appropriate diet and disciplined food habits cannot be overstated.
- One of the critical steps to ensure that one’s fitness level stays the same throughout life is to exercise a habit. This allows a person to continue to be fit and active without trying hard to maintain fitness levels.
Most importantly, despite such pains being extremely debilitating, many people continue to live with them and fail to seek timely medical help. So, while prevention strategies have to be adequately underlined, raising awareness about proper medical care availability is also essential. Today is the age of specialised care. It is necessary to see a specialist in that field. Depending on a person’s condition, the doctor will make a treatment plan, including exercise, medications, physical therapy and a few lifestyle modification steps. Medical science and technology are progressing relentlessly, and it is a great relief that most orthopaedic problems that need surgical intervention can be managed by minimally invasive Arthroscopic technique. Which means less pain, small scars and faster, predictable recovery of function.
(Inputs contributed by Dr Sanjay Desai, Arthroscopy & Joint Replacement Surgeon, Bhatia Hospital, Mumbai)
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