Tag Archives: Abdomen

Coccydynia

Definition:
Coccydynia is a medical term meaning pain in the coccyx or tailbone area, usually brought on by sitting too abruptly.
We humans have evolved biologically so much that we tend to forget that we were once animals and had a tail. That is, till we suddenly develop a pain deep down in the cleft between the buttocks, making it difficult to abruptly shift positions, from sitting to standing or getting up after lying down. This pain is called coccydynia.

That last bone in the vertebral column is called a coccyx. It actually is a vestigial tail, which has shrunk over generations. About 2.7 per cent of patients who see a doctor for “backache” actually had pain in the tailbone. It is more likely to occur in physically active youngsters and adults over the age of 40. Women, with their wide pelvis, are more prone to coccodynia.

Coccydynia occurs in the lowest part of the spine, the coccyx, which represents a vestigial tail, or in other words the “tail bone”. The name coccyx is derived from the Greek word for cuckoo due to its beak like appearance. The coccyx itself is made up of 3 to 5 vertebrae, some of which may be fused together. The ventral side of the coccyx is slightly concave whereas the dorsal aspect is slightly convex. Both of these sides have transverse grooves that show where the vestigial coccygeal units had previously fused. The coccyx attaches the sacrum, from the dorsal grooves with the attachment being either a symphysis or as a true synovial joint, and also to the gluteus maximus muscle, the coccygeal muscle, and the anococcygeal ligament.

CLICK & SEE THE PICTURES:

Symptoms:
Pain and local tenderness at the tailbone are the major symptoms of coccydynia. This can lead to difficulty sitting or leaning against the buttocks. Along with the pain with sitting, there is typically exquisite tenderness at the tailbone area. Coccydynia is also known as coccygodynia, coccygeal pain, coccyx pain, or coccalgia.

Causes:
One way of classifying coccydynia is whether the onset was traumatic versus non-traumatic. In many cases the exact cause is unknown and is referred to as idiopathic coccydynia.

The coccyx is prone to injury. Acute dislocations, sprains and fractures can occur. Usually there is a history of having fallen abruptly, on a staircase, the side of the swimming pool or some other hard surface. It can also occur while cycling or rowing. Chronic injury can occur if work or academics involves sitting for prolonged periods on hard surfaces like a wooden bench or a chair without cushions. In women, the coccyx can be injured during childbirth, especially if labour is prolonged. Overweight and obese men and women are more likely to develop problems with the coccyx.

There are common pathophysiological ways that a person may develop coccydynia. The two main causes for this condition are sudden impact due to fall, and coccydynia caused by childbirth pressure in women. Other ways that coccydynia develops are partial dislocation of the sacrococcygeal synchondrosis that can possibly result in abnormal movement of the coccyx from excessive sitting, and repetitive trauma of the surrounding ligaments and muscles, resulting in inflammation of tissues and pain.

Coccydynia is a fairly common injury which can often result from falls, particularly in leisure activities such as cycling and skateboarding. Coccydynia is often reported following a fall or after childbirth. In some cases, persistent pressure from activities like bicycling may cause the onset of coccyx pain. Coccydynia due to these causes usually is not permanent, but it may become very persistent and chronic if not controlled. Coccydynia may also be caused by sitting improperly thereby straining the coccyx.

Rarely, coccydynia is due to the undiagnosed presence of a sacrococcygeal teratoma or other tumor in the vicinity of the coccyx. In these cases, appropriate treatment usually involves surgery and/or chemotherapy.
Diagnosis:
A number of different conditions can cause pain in the general area of the coccyx, but not all involve the coccyx and the muscles attached to it. The first task of diagnosis is to determine whether the pain is related to the coccyx. Physical rectal examination, high resolution x-rays and MRI scans can rule out various causes unrelated to the coccyx, such as Tarlov cysts and pain referred from higher up the spine. Note that, contrary to most anatomical textbooks, most coccyxes consist of several segments: ‘fractured coccyx’ is often diagnosed when the coccyx is in fact normal or just dislocated at an intercoccygeal joint.

A simple test to determine whether the coccyx is involved is injection of local anesthetic into the area. If the pain relates to the coccyx, this should produce immediate relief.

If the anesthetic test proves positive, then a dynamic (sit/stand) x-ray or MRI scan may show whether the coccyx dislocates when the patient sits.

Use of dynamic x-rays on 208 patients who gave positive results with the anesthetic test showed:

* 31% Not possible to identify the cause of pain
* 27% Hypermobility (excessive flexing of the coccyx forwards and upwards when sitting)
* 22% Posterior luxation (partial dislocation of the coccyx backwards when sitting)
* 14% Spicule (bony spur) on the coccyx
* 5% Anterior luxation (partial dislocation of the coccyx forwards when sitting)

This study found that the pattern of lesions was different depending on the obesity of the patients: obese patients were most likely to have posterior luxation of the coccyx, while thin patients were most likely to have coccygeal spicules.

Angle of incidence:
Sagittal coccygeal movement is measured using the angle of incidence—or the angle at which the coccyx strikes the seat when an individual sits down. A smaller angle indicates the coccyx being more parallel to the seat, resulting in flexion (or “normal” movement) of the coccyx. A larger angle indicates the coccyx being more perpendicular to the seat, causing posterior subluxation (or “backward” movement) of the coccyx. CLICK & SEE THE PICTURE : Stand to Sit Coccyx

Treatment:
Once coccydynia has been diagnosed, conservative treatment can make the pain disappear in 8-12 weeks. This involves sitting in a basin of hot water (sitz bath) for 10-15 minutes at least twice a day. A donut shaped cushion makes sitting during work easier. Inflatable rubber cushions are available which can be carried around. When seated on chairs or in the toilet, try to lean slightly forwards.

Stretches can be done for that area. The two common ones are the kneeling stretch, when you kneel on one leg keeping the other bent at a right angle. After 30 seconds switch sides. The other stretch involves lying down, bending the knees, crossing the legs at the ankle and then pulling the legs towards you with your arms.
You may click & see : BACK PAIN REMEDY.. 

Since sitting on the affected area may aggravate the condition, a cushion with a cutout at the back under the coccyx is recommended. If there is tailbone pain with bowel movements, then stool softeners and increased fiber in the diet may help. For prolonged cases, anti-inflammatory medications such as NSAIDS(non-steroidal anti inflammatory drugs) or pain-relieving drugs may be prescribed. The use of anti-depressants such as Elavil (amitriptyline) may help alleviate constant pain. Tailbone pain physicians specializing in Physical Medicine and Rehabilitation at New Jersey Medical School have published that sometimes even just a single local nerve block injection at the ganglion impar can give 100% relief of coccydynia when performed under fluoroscopic guidance.

Additionally if the pain is caused by a malignment of the coccyx, manipulation by a chiropractor, osteopathic physician (D.O.) or physical therapist can offer relief.

In rare cases, surgery to remove the coccyx (coccygectomy) may be required. Typically, surgery is reserved for patients with cancer (malignancy) or those whose tailbone pain has failed to respond to non-surgical treatment (such as medications by mouth, use of seat cushions, and medications given by local injections done under fluoroscopic guidance, as noted above.

Prevention:
Body positioning and alignment is significant for producing less stress in the coccyx region. Bad posture can influence coccyx pain. People may not realize that they are over stressing their coccyx while doing daily activities. Pain in the coccyx can be caused from many incidents like falling, horseback riding, or even sitting on hard surfaces for a long period of time. The main focus is to prevent coccyx pain from occurring, by correcting everyday activities that contribute to tailbone pain.

Proper equipment used to preventing coccyx pain:
There is no definite way to fully prevent coccyx pain because an accident can occur at any given time. However, people who are obese are at a higher risk for developing coccyx pain. Carrying excessive weight contributes to more stress on the coccyx while sitting down causing increased chances of pain.  Prevention of carrying excessive weight gain can help reduce the tension and pressure on the coccyx. In other words the coccyx for obese people may be more posteriorly outward when they are sitting down.  Avoidance of contact sports like basketball, football, and or hockey can decrease the risks of coccyx pain, because it can help reduce the chances of falling. Another method is proper safety equipment for sports is to prevent coccyx pain. For example, there are hockey pants that provide extra cushion that protect the thigh, coccyx, and buttocks. These results will lead to less falls that can cause trauma to the coccyx.

Stretches & strengthening exercises for prevention:
A kneeling groin stretch can help prevent coccyx pain from occurring after long periods of sitting. The adductor magnus is involved in the kneeling groin stretch, and when it is tight it can contribute to tailbone pain, so stretching can help prevent tailbone pain. Other stretches like piriformis stretch, and hands to feet stretch, can relieve stress off the muscles around the coccyx, after sitting for a long time. These release tension built up around the muscles in the coccyx.
Every part of our body (even the coccyx) needs looking after.

*While cycling on a stationery bike or on the road, make sure the cycle seat is soft and comfortable. Special “cycling innerwear” is available with padding and should be used.

*Do not run on slippery surfaces like the edges of the swimming pool.

*Wear footwear that is rubber soled or has a “grip”, not smooth leather.

*Maintain ideal body weight. This can be calculated as height in metre squared X 23.

*Walk and sit with the correct posture. If you feel you are slouching, stand with both shoulders touching the wall and balance a book on your head.

*Do not sit on hard surfaces for prolonged periods of time.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Coccydynia
http://www.medicinenet.com/coccydynia/article.htm
http://www.telegraphindia.com/1160201/jsp/knowhow/story_66774.jsp

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Some Health Quaries & Answers

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Q: I live near a park and have often been stung by bees. Apart from being painful, I have heard that bee stings are also dangerous. How should a sting be treated?

A: The bee sting has a venom sac attached. If this sac breaks, chemicals are released into your body that cause pain, redness, local swelling and also allergic reactions. If you get stung, pull out the sting using your fingernail or a stiff card. Take care not to damage the venom sac. Wash the area with soap and water and apply ice. If the area is red and irritated, apply calamine lotion or hydrocortisone ointment. If there is swelling, see a doctor. You might be prescribed antihistamines.

Xanthoma ...CLICK & SEE

Q: I have yellow deposits near my eyelids. They are soft and painless but look very ugly.

A: These are called xanthomas. They are caused by deposits of fat under the skin. Although they can occur anywhere —such as the elbows, knees and buttocks — eyelids are the commonest place. Xanthomas are harmless but indicative of high cholesterol, diabetes, liver cirrhosis or certain cancers. The pills you take to lower cholesterol may cause xanthomas to shrink. You can have them surgically removed, but if you do not get high cholesterol or diabetes treated (the reason they appeared in the first place), xanthomas can recur.

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Painful jog ...CLICK & SEE

Q: I recently started jogging and have developed knee pain. My friends have all advised me to stop. They say all runners develop knee pain. Is this true?

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If you develop pain after jogging, apply an ice pack. It will reduce inflammation and pain.

Party pooper

Q: I frequently develop diarrhoea after I eat at social functions. I cannot refuse to eat without giving offence. Is there a preventive tablet that I can take?

A: You may not be able to tolerate the oil or the colouring and other condiments added to the food. The mineral water provided might also not be of ISI standard. You can avoid diarrhoea, if you stick to vegetarian food, avoid fried items and not drink any water. The safest food is curd rice.

If you do develop diarrhoea, take equal quantities of rice and moong dal and cook it in a pressure cooker with salt. Eat only this for 24 hours.

Idiot box blues

Q: My son used to do well in school (he is in Class VII). Now he complains of inability to recall what he has studied and poor mathematical ability. He does his homework in front of the television.

A: Why do you allow him to do homework in front of the television? He cannot possibly solve maths problems correctly while watching serials or cartoons. The rapidly flashing images also deplete the brain chemicals responsible for attention, learning and memory.

Physical activity for an hour a day improves memory. Encourage your son to play outside for an hour and then start his homework in a quiet room with no television. I think you will notice a vast improvement.

Keep walking

Q: I am 86 years old and active. Unfortunately my family members keep telling me to “take rest”. They feel that since I worked hard all my life, I should now just sit quietly. I think if I sit long enough I will die.

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Yellow liver

Q: I heard that jaundice causes liver cancer. Is this true?

A: Jaundice” just means that the blood has high levels of bilirubin. It can be due to several reasons — infection, blood destruction, gall bladder disease etc. One of the causes is primary cancer of the liver or secondary tumour deposits there.

Jaundice because of hepatitis B infection can also cause liver cancer. This can be prevented by immunisation with three doses of hepatitis B vaccine.

Source: The Telegraph ( Kolkata, India)

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Hernia in Children

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Definition:
Hernia in children is a medical condition in which a tissue or structure or part of an organ is protruded through a weakness or hole in other body muscular tissue or membrane. A soft bulge is seen underneath the skin where the hernia has occurred.

In children, a hernia usually occurs in one of two places:

1.around the belly-button
2.in the groin area

A hernia that occurs in the belly-button area is called an umbilical hernia. A hernia that occurs in the groin area is called an inguinal hernia.

 

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Hernias in children mostly occur in the umbilical region. A weak abdominal wall in the children can be a reason for development of umbilical hernias. Hernias are present during the first year of child and may keep on coming and going at any age.

The disease condition is common among all the age groups. Boys are more prone to this disease than girls. Approximately 1 out of 50 boys are affected.

 

Symptoms:
Hernias usually occur in newborns, but may not be noticeable for several weeks or months after birth.

Straining and crying do not cause hernias; however, the increased pressure in the abdomen can make a hernia more noticeable.

*Inguinal hernias appear as a bulge or swelling in the groin or scrotum. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If your physician pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the abdomen.

*Umbilical hernias appear as a bulge or swelling in the belly-button area. The swelling may be more noticeable when the baby cries, and may get smaller or go away when the baby relaxes. If your physician pushes gently on this bulge when the child is calm and lying down, it will usually get smaller or go back into the abdomen.

A hernia usually causes a visible lump or swelling, which appears intermittently as the herniating tissue slips back into place and then protrudes again (umbilical hernias are more constant).

Crying, straining, coughing or anything else that increases pressure within the abdomen can make the hernia more obvious, as this forces out the contents.

If the hernia is not reducible, then the loop of intestine may be caught in the weakened area of abdominal muscle. Symptoms that may be seen when this happens include the following:

*a full, round abdomen
*vomiting
*pain or fussiness
*redness or discoloration
*fever

Symptoms of a hernia may resemble other conditions or medical problems. Please consult your child’s physician for a diagnosis.

Causes:

A hernia can develop in the first few months after the baby is born because of a weakness in the muscles of the abdomen. Inguinal and umbilical hernias happen for slightly different reasons.

Inguinal Hernia...click & see
As a male fetus grows and matures during pregnancy, the testicles develop in the abdomen and then move down into the scrotum through an area called the inguinal canal….Shortly after the baby is born, the inguinal canal closes, preventing the testicles from moving back into the abdomen. If this area does not close off completely, a loop of intestine can move into the inguinal canal through the weakened area of the lower abdominal wall, causing a hernia.

Although girls do not have testicles, they do have an inguinal canal, so they can develop hernias in this area as well.(

Femoral hernias are more common in women, usually elderly and frail (although they can happen in children).)

Umbilical Herniaclick & see
When the fetus is growing and developing during pregnancy, there is a small opening in the abdominal muscles so that the umbilical cord can pass through, connecting the mother to the baby.

After birth, the opening in the abdominal muscles closes as the baby matures. Sometimes, these muscles do not meet and grow together completely, and there is still a small opening present. A loop of intestine can move into the opening between abdominal muscles and cause a hernia.
Risk Factors:
Hernias occur more often in children who have one or more of the following risk factors:

*a parent or sibling who had a hernia as an infant
*cystic fibrosis
*developmental dysplasia of the hip
*undescended testes
*abnormalities of the urethra

Inguinal hernias occur:
*in about one to three percent of all children.
*more often in premature infants.
*in boys much more frequently than in girls.
*more often in the right groin area than the left, but can also occur on both sides.

Umbilical hernias occur:
*in about 10 percent of all children.
*more often in African-American children.
*more often in girls than in boys.
*more often in premature infants

Why is a hernia a concern?
Hernias are usually painless. However, if the contents become trapped, the blood supply to the tissues may become restricted causing pain. This pain may be intermittent, but if the hernia is stuck permanently – known as an irreducible, strangulated or incarcerated hernia – the pain becomes constant and there’s a risk of damage to the trapped intestines or surrounding tissues. In this case the child may vomit and appear unwell.

Occasionally, the loop of intestine that protrudes through a hernia may become stuck, and is no longer reducible. This means that the intestinal loop cannot be gently pushed back into the abdominal cavity. When this happens, that section of intestine may lose its blood supply. A good blood supply is necessary for the intestine to be healthy and function properly.

Diagnosis:
Hernias can be diagnosed by a physical examination by your pediatrician. Your child will be examined to determine if the hernia is reducible (can be pushed back into the abdominal cavity) or not. Doctor may order abdominal x-rays or ultrasound to examine the intestine more closely, especially if the hernia is no longer reducible.

Treatment:-
Specific treatment will be determined by your pediatrician based on the following:

*your child’s age, overall health, and medical history
*the type of hernia
*whether the hernia is reducible (can be pushed back into the abdominal cavity) or not
*your child’s tolerance for specific medications, procedures, or therapies
*your opinion or preference

Inguinal hernia:……………..

An operation is necessary to treat an inguinal hernia. It will be surgically repaired fairly soon after it is discovered, since the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off, and the intestine can become damaged. Inguinal hernia surgery is usually performed before this damage can occur.

During a hernia operation, your child will be placed under anesthesia. A small incision is made in the area of the hernia. The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes, a piece of meshed material is used to help strengthen the area where the muscles are repaired.

A hernia operation is usually a fairly simple procedure. Children who have an inguinal hernia surgically repaired can often go home the same day they have the operation.

Umbilical hernia:
By 1 year of age, many umbilical hernias will have closed on their own without needing surgery. Nearly all umbilical hernias will have closed without surgery by age 5.

Placing a coin or strap over the hernia will not fix it.

There are many opinions about when a surgical repair of an umbilical hernia is necessary. In general, if the hernia becomes bigger with age, is not reducible, or is still present after 3, your physician may suggest that the hernia be repaired surgically. Always consult your child’s physician to determine what is best for your child.

During a hernia operation, your child will be placed under anesthesia. A small incision is made in the umbilicus (belly button). The loop of intestine is placed back into the abdominal cavity. The muscles are then stitched together. Sometimes a piece of meshed material is used to help strengthen the area where the muscles are repaired.

A hernia operation is usually a fairly simple procedure. Children who have an umbilical hernia surgically repaired may also be able to go home the same day they have the operation.

Prognosis:-
Once the hernia is closed, either spontaneously or by surgery, it is unlikely that it will reoccur. The chance for re-occurrence  of the hernia may be increased if the intestine was damaged.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:

Femoral Hernia


http://www.childrenshospital.org/az/Site1018/mainpageS1018P0.html
http://www.bbc.co.uk/health/physical_health/conditions/hernia2.shtml

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Target these Muscles to Trim the Tummy

When it comes to training your abdominals, it’s important to include the deepest layer of this muscle group — the transversus abdominis, which is responsible for flattening the stomach. Here is a great way to target this area.

CLICK & SEE

Lie face up on a flat, level surface. If you have a Pilates Circle, place it between your inner ankles and straighten your legs above your hips. (If you don’t have this piece of equipment, you can do the same exercise without it.) Extend your arms to the sides and bend your elbows so that your hands are over your head.

CLICK & SEE

On an exhalation, press your naval toward your spine to flatten your abdominals. Focus on keeping your abs flat as you slowly lower your legs to a 45-degree angle. Pause for a few seconds, then raise your legs back to vertical. Repeat 12 times.

Source:Los  Angeles Times

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On the Strong and Balanced Side

When your core is strong, daily activities become easier and you’ll get more from your exercise routines as well. Remember to incorporate this straightforward yet challenging move for a more balanced practice.
CLICK & SEE 

Begin on your hands and knees. Turn to the side and position your right hand directly below your right shoulder and your right knee below your right hip. Straighten your left leg with your left foot flat on the floor, toes and knee facing forward. Reach up with your left arm so it is above your shoulders. Engage your abdominals and move your tailbone in toward your body to avoid over-arching your lower back. Look up to the ceiling and pause.

Keeping your hips and shoulders stacked, push through your left heel and lift it to hip level. Concentrate on maintaining your balance with minimal movement in your torso. Hold this position for three to six breaths. Then lower your leg, come to all fours and repeat on the other side.

Source:Los Angeles Times

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