posture – Hello Doctor

What is dystonia?

August 9th, 2019 by Content Editor

Dystonia contractions cause your body to twist involuntarily, creating abnormal postures and uncontrollable, repetitive movements.

There are different kinds of dystonia. Dystonia can affect just one muscle, an entire muscle group and in severe cases, the entire body.

Women are more prone to developing this disorder and approximately 1% of the world’s population has dystonia.

What are the causes?

Researchers haven’t found a definitive cause for dystonia, but it’s suspected that it’s related to problems with the basal ganglia. The basal ganglia is the part of the brain responsible for muscle contractions. Researchers believe that if there’s a problem with how the nerves surrounding the basal ganglia are communicating, it could result in a condition like dystonia.

Common symptoms of dystonia range from mild to severe, depending on the stage of the condition.

They could include:

A cramping foot.
Uncontrollable blinking.
Involuntary pulling of the neck.
Speech difficulties.
A “dragging leg”.

Parts of the body that may be affected include the:

Hands and forearms. Some cases of dystonia happen only when you do repetitive actions. For example, you could experience symptoms while you’re writing or playing an instrument.

Neck. Involuntary contractions could make your head turn and twist to one side, or make it pull forward and backward, causing pain.

Jaw or tongue. If dystonia affects your jaw or tongue, you could experience drooling, speech difficulties and trouble swallowing and chewing.

Eyelids. Involuntary muscle spasm and rapid blinking could cause your eye to shut.

Vocal cords and voice box. Muscle contraction can manifest as a tight or whispering voice.

Depending on the kind of dystonia, there may be complications:

Vision difficulties that affect your eyelids.
Physical disabilities that affect the performance of your daily activities.
Difficulty with moving your jaw, speech and swallowing.
Pain and fatigue due to the continuous, painful contraction of muscles.
Depression, anxiety and social withdrawal.

Treatment

Treating dystonia focusses on managing the muscle contractions. Your doctor may recommend a combination of treatments, including medications, surgery and therapy.

Medication

A common medication that may be used is onabotunumtoxinA, commonly known as Botox. This medication is injected into specific muscles and aims to eliminate muscle contractions and improve abnormal postures. This injection needs to be repeated every three to six months.

Side-effects are usually temporary and mild. They can include dry mouth, weakness and voice changes. Other medications target your brain chemicals that affect muscle movement.

Therapy

Physical therapy or occupational therapy or both to help ease symptoms and improve function.
Speech therapy if dystonia affects your voice.
Stretching or a massage to soothe muscle pain.

Surgery

For severe symptoms, your doctor may recommend two kinds of surgery:

Deep brain stimulation

During this surgery, electrodes are surgically implanted into specific parts of your brain and connects to a generator that’s placed in your chest. The generator sends electrical pulses to your brain to try and control the muscle contractions.

Selective denervation surgery

This procedure involves cutting the nerves that control muscle spasms. It aims to stop the muscles from contracting involuntarily.

References:

What is cerebral palsy?

August 9th, 2019 by Content Editor

Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain their balance and posture.

According to the Cerebral Palsy Alliance Research Foundation, approximately 17 million people around the world have cerebral palsy.

The disorder is typically diagnosed during the first or second year after birth. If a child’s symptoms are mild, it could be difficult to make a diagnosis until the child is a few years older. CP is no longer considered a disease but rather a chronic, non-progressive neurological disorder.

What causes cerebral palsy?

CP is associated with developmental brain injuries that happen during foetal development, birth, or within the first two to three years of life.

The disorder is characterised by a disruption of motor skills and includes symptoms like spasticity, paralysis, mental retardation, seizures, vision and/or hearing problems.

A small percentage of CP stems from brain damage that happens more than 28 days after birth, called acquired cerebral palsy. Factors like a brain infection, such as meningitis, or a serious head injury, increase the risk for acquired CP.

However, most CP cases are related to brain damage that happened before or during birth and are called congenital CP.

Signs and symptoms

Birth defects like a small head, stiff jaw, irregular shaped spine, drooling, crying, poor sucking or swallowing reflexes etc.
Delayed or abnormal movements of body parts or the whole body.
Stiffness or floppiness.
Uncoordinated movements or a slight limp.

Diagnosis

If your doctor suspects your child has cerebral palsy, your child will undergo a physical evaluation to check for symptoms. The doctor will also review your child’s medical history. You are likely to be referred to a specialist who treats children with brain and nervous system conditions (paediatric neurologist).

To help rule out other possible causes, the doctor may do a series of tests to confirm a diagnosis. This will be done along with the help of brain scans which reveal any damaged areas or abnormal development in the brain.

These tests may include:

Magnetic resonance imaging (MRI). An MRI is usually the preferred imaging test. It uses radio waves and a magnetic field to produce detailed 3D or cross-sectional images of your child’s brain. An MRI can often identify any cuts or abnormalities in your child’s brain.

Cranial ultrasound. This can be performed during infancy. A cranial ultrasound uses high-frequency sound waves to get images of the brain. An ultrasound doesn’t produce a detailed image, but it may be used a preliminary assessment of the brain.

CP management

Physical therapy and rehabilitation

Physical therapy is one of the most important parts of treatment. It involves exercises and activities that can maintain or improve muscle strength, balance, and flexibility. A physical therapist helps the child learn skills like sitting, walking, or using a wheelchair. Other types of therapy include occupational, recreational and speech and language therapy.

Treatment

Certain medications can help relax stiff or overactive muscles and reduce abnormal movement. They may be taken by mouth, injected into affected muscles, or infused into the fluid surrounding the spinal cord through a pump implanted near the spinal cord.

Orthotic devices

To improve movement and balance, braces, splints, and casts can be placed on affected limbs. Wheelchairs, rolling walkers, and powered scooters can also help with movement and posture.

Assistive devices and technologies

These include special computer-based communication machines, Velcro-fastened shoes, or crutches, which can all help to make daily life easier.

Surgery

Your child may need surgery if symptoms are severe. A surgeon can place arms or legs in better positions or correct or improve an abnormally curved spine. Sometimes, if other treatments have not worked, a surgeon can cut certain nerves to treat abnormal, spastic movements.

Not all therapies will be suitable for everyone with cerebral palsy. It’s important for parents, patients, and healthcare specialists to come up with the best treatment plan for the patient.

Good to know

In most cases, cerebral palsy can’t be prevented, but you can reduce the risks. If you’re pregnant or planning to become pregnant, follow these steps to keep healthy and minimise any complications.

Get vaccinated against diseases like rubella to help prevent an infection that could cause foetal brain damage.
Take prenatal vitamins, including folic acid and omega 3 fatty acids to aid in brain and spine development
Take good care of yourself. The healthier you are going into your pregnancy, the less likely you are to develop an infection that may result in cerebral palsy.
Go for regular doctor visits during your pregnancy. This is a good way to reduce health risks and will also help prevent premature birth, low birth weight and infections for you and your unborn baby.
Ensure good child safety at all time. Prevent head injuries by providing your child with a car seat, bicycle helmet, safety rails on beds and appropriate supervision.

References:

How your sleeping position affects your health

August 9th, 2018 by The Hello Doctor Team

Sleeping should be as easy as closing your eyes and dozing off, right? It turns out that you may be doing it wrong. Besides too much or too little sleep, snoozing in certain positions has different effects on your health.

Here’s how.

On your side

Benefits
If your go-to-sleep position is on your left or right side, you’re a snoozing champ! Sleeping on your side is one of the best positions for overall health. Research shows that almost two-thirds of all people sleep in this position. Those who lay on their side are less likely to suffer from conditions like snoring and sleep apnoea than people whosleep on their back. Snoozing on your side also reduces the risk of neck and back pain.

Risks
Although sleeping on your side has benefits there are risks, too. This position may put too much pressure on your stomach, liver and lungs. Side sleeping may also contribute to breast sagging and wrinkles. On the other hand, sleeping on your right may constrict some blood vessels and circulation if you move too much while sleeping.

On your back

Benefits
About eight percent of the world’s population sleep on their back. This position helps to evenly distribute your weight. This allows your neck, spine and head to stay in a neutral position while you sleep. This is also the best position to prevent breast sagging and wrinkles. It also helps minimise the risk of acid reflux.

Risks
This position increases the risks of snoring and sleep apnoea.

On your stomach

Benefits
Snoozing on your stomach may help ease snoring and sleep apnoea.

Risks
Consider a different way to sleep as this may be the worst sleeping position for your health. This stance flattens the natural curve of your spine, and can lead to back pain. This is because most of your weight is in the middle of your body. Sleeping with your head turned to one side can also place strain on your neck. If you often sleep in this position and are struggling to sleep in other positions, use a pillow to train your body to sleep on its side.

Find the best position

If you sleep on your side, keep your back as straight as possible. Invest in a mattress that supports the natural curve of your body and the pressure points of your shoulders and hips. You could also try placing a tall pillow between your legs to better align your neck with your back.
When sleeping on your side, snoring aids like nasal strips can help with snoring.
It’s best to choose another position, but if you choose to sleep on your stomach, prop a thin pillow under your head, and place a pillow under your pelvis to add a curve to your spine.
If you’re trying to transition to a different sleeping position, block out all the natural sunlight in your room and put away your electronic devices before bedtime!

References

Is your backache due to scoliosis? How to find out.

September 5th, 2017 by The Hello Doctor Team

A constant pain in the back can place a real dampener on your day. This pain can stem from sports injuries or simply bad posture. But if yours persists, you may have scoliosis.

A curve that hurts

Scoliosis is the condition where your spine curves and rotates sideways in an unnatural way (almost like an S- or C-shape). This can affect your posture and movement, and cause pain and discomfort. There’s no known cause for scoliosis. In some cases, it may have been caused by an impact injury, an infection or disease. In other cases, the curve is only temporary and improves with age.

Do I have scoliosis?

If you have mild scoliosis, you won’t notice it immediately. It’s only when the condition progresses that you may notice your clothes hanging unevenly, that one hip or shoulder is higher than the other, or you struggle to sit up straight. While there’s nothing too much to worry about when you have scoliosis as a child, it can become more painful and visible as you age. If the scoliosis gets worse, your hip may rotate at the waist, causing your rib to abnormally stick out further than usual.

Treating the condition

Your doctor will review your family’s health history and your experience of pain and discomfort. You will most likely be referred to a back or spine specialist, who will do a spine examination to get an idea of how the curve of your spine is affecting you. Pain caused by scoliosis can be controlled with medication and spinal injections, and surgery in rare causes. There’s no need to wear a back brace.

Perfect your posture

Choose a backpack rather than a sling bag. Avoid carrying heavy loads.
Do exercises to strengthen your back and improve your posture.
Make sure your desk area is ergonomically friendly – that means comfortable, but also functional for your posture.
Sit up straight with your feet flat on the ground when you work at your desk.
Give Pilates a try. A study published in the Journal of Bodywork and Movement Therapies has shown that Pilates improves flexibility and pain in young adults suffering from scoliosis.

References

10 ways to alleviate your foot pain

February 10th, 2017 by The Hello Doctor Team

Painful feet? Don’t worry. You’re not the only one. Foot pain is a very common problem, affecting as many as 75 percent of people at some point in their lives, according to the College of Podiatry in London.

The foot is a complex structure with 26 bones, 33 joints and over 100 ligaments! Your feet support your weight, act as shock absorbers, and help maintain balance. But as important as they are, it’s easy to take them for granted – until they cause you pain. Speak to one of our doctors if your foot pain is persistent and untreated.

What’s hurting your feet?

Unsuitable footwear. Shoes that are too tight or poorly fitted, like high heels, can be a pain in the feet. Too-tight shoelaces can also cause pain and bruising on the top of the foot. Exercising in the wrong shoes can also wreak havoc on your foot health and cause discomfort. In the short term, ill-fitting footwear can cause blisters, bruising, and athlete’s foot. Long-term effects include bunions, corns, calluses, nerve and joint damage, and misalignment of the toes.
Walking incorrectly. An abnormal walk or posture can hurt your feet. Add the wrong shoes, and you could get bunions, osteoarthritis, fallen arches, malformation of the toes, and permanent misalignment of the joints of the bones of the feet. Inflammation can also cause arthritis.
Medical conditions, e.g. arthritis and gout, which cause inflammation of the bones, ligaments, or tendons in the foot. Diabetes, obesity and neurological disorders like Parkinson’s disease may also cause pain or numbness in the feet.
High-impact exercises like running or jogging can injure your feet and other parts of your leg. Besides severe foot pain, it can also cause corns, blisters, and calluses, which can aggravate painful feet.

Stop the pain

Find the right fit. Your feet change shape as you age. Have yours measured the next time you buy shoes. Shop for shoes later in the day when your feet might be slightly swollen.
Slip on some socks. Wear thick socks to absorb pressure and allow your feet to breathe. Avoid socks that are too tight.
Wear the right shoe for specific activities. Whether you’re walking or running, athletic shoes should feel comfortable right away. Forget about “breaking your shoes in”. It’s also a good idea to get a new pair every six months. Running or walking in worn-out shoes may lead to injury.
Put your comfort first. Trade in your high heels for low-heeled shoes with stiff soles and soft padding inside.
Alternate shoes. Avoid wearing the same pair of shoes every day. This puts repeated pressure on the same areas of your foot.
Avoid walking barefoot as this can increase your risk for injury and infection.
Trim your toenails. Another major source of foot pain is ingrown toenails (when the edge of your nail grows into the skin around the toe). Prevent this by cutting your toenails straight across.
Stay flexible. Do heel and foot muscle stretches. Stretching your calves can also go a long way in preventing foot pain.
Take a break. If you’re on your feet for most of the day, do your feet a favour and take a load off whenever you get the chance.
Maintain a healthy weight. Your feet bear the weight of your entire body. The more you weigh, the greater your foot stress. Prevent this by keeping your weight in check.

If the foot pain interferes with your daily living, see your doctor immediately. Don’t ignore foot pain, especially if the affected area is swollen, tender, changes colour, looks deformed, or causes you to move differently.

References:

Workplace health round up

July 1st, 2015 by The Hello Doctor Team

Don’t panic when we tell you this: you’re probably going to spend roughly a third of your life at work! We’re not trying to bring you down with that statistic; we just want you to get the best possible value out of time spent at work. C’mon, let’s take back the workplace! Continue reading “Workplace health round up”

Could your desk job be affecting your posture?

September 3rd, 2014 by The Hello Doctor Team

Do you slouch when walking, or lean forward when working on a computer? Then it’s time for you to straighten up! We’re not kidding either – bad posture can affect your health and can cause a great deal of pain. Desk jobs are notorious for giving us posture problems because we tend to lean forward and stay in that lazy position for hours. Let’s take a deeper look into some of the most common forms of bad posture: Continue reading “Could your desk job be affecting your posture?”