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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.

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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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Yoga Mudras

 

Definition:
Our physical body is made up of five elements namely – Air, Water, Fire, Earth and Aakash (ether – the tiny intercellular spaces in the human body).

When these elements get imbalanced, the immunity system of our body goes down and we get sick.

This imbelance can be corrected through practing Mudras in particular manner by connecting one part of the body with another.

When a finger representing an element is brought into contact with the thumb, that element is brought into balance. Therefore the disease caused by the imbalance is cured. Mudras start electromagnetic currents within the body which balance various constituting elements and restore health. The joining of fingers creates an effect on the human body.

Five Fingers of our hands are considered as Five Elements

1.Thumb relates to  Fire

2. Index…………Air

3. Middle………..Aakash

4. Ring………….Earth

5. Little…………Water

Benefits and Methods of Mudras:

Gyan Mudra:

The Gyan Mudra is believed to help with concentration and memory, relieve insomnia and stress, and promote general peace of mind.
Join the tips of the index finger and thumb and keep the other 3 fingers stretched and joined. Click to see

Shoonya Mudra
Relief in diseases and pains relating to the ear.
Press the middle finger on the base of the thumb and keep the thumb on middle finger. Keep the other three fingers straight. click to see

Apaan Mudra:
Helps in clearing the body by elimination of waste matter from the mouth, eyes, ears, nose etc. Helps when urine is obstructed, reduces constipation.
Join the tip of the thumb with the tip of middle and ring finger, keeping the other finger straight. click to see

Prana Mudra:
Helps in pumping the life force into your body. Beneficial for all types of diseases. Imparts special power to the eyes.

Join the tip of the thumb with tip of little and ring finger. Keeping other two fingers straight. click to see

Vayu Mudra :
Helps in diseases like arthritis, trembling in Parkinson’s disease. Better results obtained if practices after Prana mudra.

Press the index finger on the base of thumb and keep the thumb on the index finger. Let the other fingers be straight.click to see

Prithvi Mudra:
Makes body sturdy. One experiences happiness.

Join the tip of the thumb and ring finger. click to see

Varun Mudra:
Improves the deteriorated quality of blood due to shortage of water & gives freshness to the body.

Join the tip of the thumb and little finger.click to see

 Surya Mudra
Reduces weight of your body.
Put the tip of ring finger at the base of thumb, with thumb gently pressing on it.click to see

Ling Mudra:
Produces heat in the body and helps in curing cold and cough.
Interlock the fingers of both hands together. Keeping the left thumb up (encircled by right thumb and index finger) i.e. left thumb should be vertically straight and right thumb around it...click to see

When to do?
Can be practiced at all times while sitting, lying, standing, walking or even talking.
For good results should be practiced for 24 minutes continuously. Can be practiced for 4-5 minutes also at one time.
If a mudra cannot be made in both hands, you may do it in one hand only

Resources:
http://www.healthandyoga.com/html/meditation/mudras.aspx
http://health.amuchbetterway.com/yoga-mudra-for-health-and-vitality/

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Going to the Wall

The wall can be an excellent prop when practicing yoga poses or other stretches that require balance and strength as well as flexibility. It helps you feel stable so you can get in the proper position to gain maximum benefit from the exercise.

Stand approximately 3 feet away from a stable wall with your back toward the wall and your feet together. Bend forward at the hips and place your fingertips on the floor directly below your shoulders. (Place your hands on two yoga blocks if you cannot reach the floor.) Place your left foot flat on the wall at hip height, with your knee and toes facing the floor. You may have to adjust to make sure your right ankle is below your right hip. Inhale and look forward, sliding your shoulders down and away from your ears.

Exhale and focus on keeping your hips and legs stationary. On the next inhalation, rotate your ribs, chest and shoulders to the right. Reach your right arm upward, with fingers pointing to the ceiling. Look toward your right thumb. Pause for three to six breaths in this position, feeling a deep stretch in your back. Return your right hand to the floor, change legs and repeat on the other side.

Source :Los Angeles Times

 

Yoga Has Greater Positive Effect on Anxiety than Other Forms of Exercise

Yoga has a greater positive effect on a person’s mood and anxiety level than walking and other forms of exercise, which may be due to higher levels of the brain chemical GABA.
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Yoga has been shown to increase the level of gamma-aminobutyric acid, or GABA, a chemical in the brain that helps to regulate nerve activity. GABA activity is reduced in people with mood and anxiety disorders, and drugs that increase GABA activity are commonly prescribed to improve mood and decrease anxiety.

Tying all of these observations together, the study by Chris Streeter and colleagues demonstrates that increased GABA levels measured after a session of yoga postures are associated with improved mood and decreased anxiety. Their findings establish a new link between yoga, higher levels of GABA in the thalamus, and improvements in mood and anxiety based on psychological assessments. The authors suggest that the practice of yoga stimulates specific brain areas, thereby giving rise to changes in endogenous antidepressant neurotransmitters such as GABA.

“This is important work that establishes some objective bases for the effects that highly trained practitioners of yoga therapy throughout the world see on a daily basis. What is important now is that these findings are further investigated in long-term studies to establish just how sustainable such changes can be in the search for safe non-drug treatments for depression,” says Kim A. Jobst, Editor-in-Chief of The Journal of Alternative and Complementary Medicine.

Source: Elements4Health

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Two Phases of the Half Moon

 

This classic yoga pose, called half moon, is excellent for stretching your back and hip muscles. It also strengthens your legs and ankles while helping you develop balance. At first you might need to use a yoga block under your hand, but as soon as you get more limber and feel stable enough, you can rest your fingers on the floor and straighten your bottom leg.
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With a yoga block, stand upright with the block in front of you, hands on your hips. Bend your right knee and place your right hand on the yoga block approximately 1 foot in front and slightly to the right of your right foot. Shift your weight onto your right foot as you slowly raise your left leg up to hip level. Your left knee and toes should be turned out, and your shin should be parallel to the floor. Pause for three to six breaths. Lower your left leg, stand and repeat on the other side.

Without the block, stand upright to begin. Bend your right knee and place your right hand on the floor approximately 1 foot in front of you and slightly to the right of your right foot. Shift your weight onto your right foot as you slowly raise your left leg up to hip level. Straighten your right leg. Turn your left thigh, knee and toes outward, shin parallel to the floor. Reach your left arm above your left shoulder. Pause for three to six breaths. Bend your right knee and lower your left leg. Stand and repeat on the other side.

Source :
Los Angeles Times

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