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Chronic kidney disease occurs when your kidneys are too damaged to filter the blood properly. It is termed chronic as the damage to the kidneys occur over a period of time. Malfunctioning kidneys result in a build-up of toxins in the body which can in turn have serious repercussions.
CKD is often associated with ageing. However, it can happen to anyone and at any age. In this article let us take a closer look at this silent disease and how we can prevent it from interfering with our daily life.
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Kidneys are two fist-sized organs which are situated at either side of the spine at the lowest level of the rib cage. Kidneys contain millions of nephrons where the blood is filtered.
Most of us know that the basic function of the kidneys is to remove toxins, waste and excess fluid from the blood and push it out of the body in the form of urine. Kidneys also play a major role in regulating the body’s salt, potassium and acid content. Apart from this, kidneys produce hormones that affect other bodily functions such as blood production.
CKD is often considered to be a silent disease as it does not show any symptoms in its early stages. This condition worsens over time and can eventually result in complete renal (kidney) failure. In many cases, CKD is diagnosed during routine check-ups or during investigations for other concerns.
In the early stages, your kidneys may still function well enough that they do not cause any obvious symptoms. People can even lead normal lives with just one kidney. Detecting CKD in early stages is the best way to prevent further damage to your kidneys and avoid kidney failure.
In advanced stages, people with CKD can experience
If left unmonitored, CKD can lead to other health conditions such as heart disease, high blood pressure etc. It also increases your risk of having strokes and heart attacks. There is also a greater risk of developing acute kidney injury (AKI) which is a sudden change in kidney function due to medication, illness or injury.
When we think of any kidney disease, the first word that comes to our mind is dialysis. This is a common misconception. Many also think that CKD means kidney failure. This is far from true. In fact, most people with kidney disease do not even need dialysis as long as they make certain lifestyle and dietary changes on time to protect their kidneys.
The most important thing to remember is that CKD is a progressive disorder. Basically, it worsens with time eventually resulting in kidney failure. Kidney failure occurs when the kidneys are so damaged that they work at less than 15% of capacity. So, if you start your treatment on time and make lifestyle changes, you can avoid long term effects of CKD.
CKD is generally the result of excessive strain on the kidneys. In many cases, a combination of a number of factors causes kidney damage. Some of the most common causes of CKD include diabetes, hypertension, high cholesterol, kidney infections, polycystic kidney disease (genetic disease) and prolonged use of certain medications.
Chronic kidney disease or CKD is diagnosed with the help of blood and urine tests. The presence of increased levels of certain proteins in urine and/or blood generally indicate kidney damage. These tests are also used to define the stage of kidney disease or the degree of damage to the kidneys.
If you are identified as a high-risk candidate for CKD (having a family history of kidney disease or diabetes, high blood pressure etc) then you are advised to go for routine check-ups so as to monitor your renal (kidney) health.
Unfortunately, there is no permanent cure for CKD as the damage to the kidneys is permanent. However, further damage can be avoided with a combination of the following treatments:
The most basic steps to take for better kidney health are:
The trick is to drink the right amount of water. Too little water intake can prevent your kidneys from effectively filtering the blood causing issues such as kidney stones. Too much water can cause an imbalance in the salt levels in your body. According to the National Academies of Sciences, Engineering, and Medicine, the appropriate daily fluid intake is approximately 3.7 litres for men and 2.7 litres for women.
Your fluid intake also depends on the amount of physical activity you do, your environment and your general health.
Diet plays a major role in maintaining renal health. The most important things to keep in mind are:
Many doctors recommend keeping a “food journal” to record and monitor whatever you eat.
Physical activity and exercise are essential for overall health including renal health. Most adults are advised to perform any form of physical activity for at least 30 minutes a day. The amount of exercise as well as the intensity of the physical activity depends on your overall health. So, consult your doctor for a better idea of what would be best for you.
People with obesity or overweight are more prone to a wide range of secondary conditions such as heart disease, high cholesterol etc. Kidney disease is also one such complication that can arise due to overweight or obesity. If you have any of these conditions, you can consult bariatric surgeons for long term solutions in case exercise and diet are not showing the desired results.
Sleep disorders can be associated with a wide range of physiological and psychological issues such as obesity and depression. Medical experts recommend an average of 7-8 hours of sleep every night for adults.
What makes maintaining kidney health so important is that kidney damage occurs over a long period of time with barely any outward signs. So, by the time symptoms start to show, it might be too late to prevent kidney failure. This is especially relevant for people who are more prone to kidney damage such as diabetic patients. In such cases, routine check-ups are advised to monitor renal health.
Also, read: Types of Kidney & Renal stones, and it’s symptoms
Deciding how you want to deliver your baby is quite an important decision to make during pregnancy. Many expectant women turn pale at the thought of labour pains. They may also find themselves overwhelmed with advice given by well-meaning friends and family. Water birthing to manage labour pains is one such advice that seems to keep popping up.
Let us take a closer look at this birthing technique to see if it is actually enough to effectively manage labour pains.
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To understand if water birthing is the best way to manage labour pains, we need to know more about water birthing. Water birthing is an ancient way of giving birth in water with the help of a deep bath or “birthing pool”. The modern definition states that water birth means having at least a part of your labour and/or delivery in a pool of warm water. It is performed under the guidance of a medical practitioner (doctor or midwife).
The first mention of water birthing dates as far back as 1805, it rose to popularity in the 1980s and 1990s. The idea behind water birthing is to provide a birthing environment as similar to the uterine environment. This is thought to ease the baby’s transition from the womb into the world while also reducing the stress of birthing for the mother.
In the first stage of your labour, when your contractions start but your cervix is not completely dilated, water immersion (in temperature-controlled water) can help ease the pains and make you feel more in control. Studies also suggests that giving birth in water can decrease the risk of severe vaginal tearing however conclusive evidence for this fact is yet to be found.
During stage two of your labour when your cervix is completely dilated and you start pushing to bring your baby into this world, you can choose to step out of the birthing pool or have your baby in the water itself.
If the doctor feels that there is a risk of complication, you might be asked to exit the pool to deliver your baby.
Being immersed in water during labour is a proven way to manage labour pains. Some women also claim to have felt calmer and more controlled during water birthing with an increase sense of privacy.
Warm water is known to encourage relaxation, reduces stress and stimulates the release of endorphins, kicking in the body’s own defence mechanism against pain. This also lowers the mother’s blood pressure which might have risen due to anxiety.
In some cases, water has also been shown to increase a woman’s energy in the latter stages of labour. The water’s buoyancy promotes more efficient uterine contractions and improves the blood circulation to the uterine muscles. This means lesser pain for the mother and more oxygen for the baby.
The water also makes the perineum more elastic and relaxed hence reducing the risk of severe tears while birthing. Perineum is the area between the vaginal opening and the anus. Perineum tears are quite common during childbirth, especially for larger or multiple babies. Based on the extent of the tear, it can be classified into 4 grades. Grade 3 and grade 4 perineum tears require surgical treatment while grade 1 and grade 2 can heal generally heal on their own.
There are several other benefits that are associated with water birth including shorter labours, lower postpartum blood loss, decreased physical contact (hands-off delivery), and greater feeling of satisfaction. However, more research needs to be done for conclusive results.
Many women do report that they felt significantly lesser labour pains when they were immersed in water. The temperature of the water helps relax the muscles, making labour pains more bearable for the mother.
However, pregnancy and birthing experience varies greatly from woman to woman. And water birthing does not take away labour pains entirely. While some women may feel almost zero pain while giving birth in the water, others may need to exit the pool for other pain management alternatives.
Unfortunately, water birth is not suitable for everyone. The following factors can make water birthing an unsuitable birthing option for you:
If your obstetrician or midwife feels that your labour needs to be monitored closely, or if any complications arise, water birth might not be advised. In case this occurs in the middle of water birthing, you may also be asked to exit the birthing pool.
Read: Home remedies to combat Gestational Hypertension
There is no conclusive proof indicating that giving birth in water is any riskier than giving birth out of water. Further research is required to understand the benefits and risks associated with water birthing.
However, before deciding to opt for a water birth, an important factor to note is that the water makes continuous electronic fetal monitoring tough. Hence this birthing technique is possible only for low risk pregnancies.
Hospitals are extremely meticulous about maintaining the hygiene of their birthing pools following strict protocols set by medical authorities. While there is no statistical evidence suggesting that water birthing increases the risk of the baby getting an infection, there have a few exceptions.
If you have a smooth, complication-free pregnancy and you are leaning towards natural birth with alternate, conservative pain management; water birthing is definitely an option you should take a closer look into.
Ques: What do I wear during water birthing?
You should wear something that makes you feel comfortable. Just remember you are essentially in a large tub of water. Many women may choose to wear comfortable robes while birthing, others might wear a bra, vest or t-shirt if they desire more privacy. You can also decide to forgo clothing if that is comfortable to you.
Ques: What is hypnobirthing?
Hypnobirthing using self-hypnosis, deep breathing and other relaxation techniques to manage labour pains. It can also be used in combination with other forms of pain relief. In some cases, it is shown to even shorten the labour. The research in the field of hypnobirthing is limited. Hence the true extent of benefits and risks of hypnobirthing is yet to be explored.
Ques: What are some of the benefits of water birthing?
Benefits of giving birth in water include:
In some cases, water birthing is also shown to have significantly lowered labour time.
एक रिसर्च के अनुसार, प्रत्येक 1000 जन्मों में से 1 बच्चा क्लबफुट से अवश्य प्रभावित होता है। यह संख्या अलग अलग देशों में अलग-अलग हो सकती है। यदि क्लबफुट का इलाज (Clubfoot treatment in Hindi) सही समय पर और सही तरीके से न किया जाये तो इसका परिणाम आजीवन विकलांगता और असहनीय दर्द हो सकता है। इसके विपरीत, यदि इस बीमारी का जन्म के ठीक बाद इलाज कर लिया जाये, तो इस स्थिति में सुधार के लिए सर्जरी की भी आवश्यकता नहीं पड़ेगी।
दरअसल यह बीमारी इतनी सामन्य नहीं है जिस कारण अधिकतर लोग इससे अभिज्ञ हैं। जागरूकता के आभाव के कारण यह आसानी से सुधारात्मक विकृति बहुत सारे बच्चों में स्थायी विकलांगता का कारण बन जाती है। अतः आवश्यक है कि आपको पूरी जानकारी हो कि क्लबफुट (Clubfoot in Hindi) क्या होता है? इस लेख में, हम आपको विस्तार से बतायेंगे कि क्लबफुट क्या होता है (What is clubfoot in Hindi) और किस प्रकार सही समय पर इसका पता लगाकर इसका इलाज (Clubfoot treatment in Hindi) किया जा सकता है।
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क्लबफुट एक प्रकार की पैर से सम्बन्धित जन्मजात विकृति (जन्म के समय उपस्थित) होती है जिसमें जन्म के समय से ही बच्चे का पैर उसके सामान्य आकार का नहीं होता है। यह या तो बाहर की ओर या अंदर की ओर मुड़ा होता है। यह नवजात शिशुओं में पायी जाने वाली सबसे आम विकृति है जो हड्डियों और जोड़ों से सम्बन्धित होती है।
यह स्थिति सामान्य भी हो सकती है और कुछ परिस्थितियों में यह स्थिति गंभीर भी हो सकती है और शिशु के एक पैर या दोनों पैरों में भी दिखाई दे सकती है। पैर की मांसपेशियों को पैर की हड्डियों से जोड़ने वाले टेंडन्स के छोटे और तंग होने के कारण यह विकृति होती है जिस कारण शिशु का पैर अंदर की तरफ मुड़ जाता है।
यधपि क्लबफुट क्यों होता है इसका सटीक कारण अभी तक स्पष्ट नहीं है, किन्तु कुछ प्रतिष्ठित अनुसंधानों के अनुसार यह स्थिति किसी एक जीन संचरण के कारण नहीं अपितु कुछ आनुवंशिक और पर्यावरणीय कारकों की परस्पर जटिल क्रिया के कारण होती है।
जन्म के साथ क्लबफुट स्थिति की संभावना को बढ़ाने वाले जोखिम कारकों में निम्न शामिल हैं:
आनुवंशिक या न्यूरोलॉजिकल समस्याओं के साथ पैदा होने वाले बच्चों में कभी कभी क्लबफुट का एक अन्य रूप भी देखने मिलता है जो मांसपेशियों के असंतुलन का कारण बनता है। क्लबफुट के इस रूप को “द्वितीयक क्लबफुट” कहा जाता है।
प्रेगनेंसी के दौरान, 20वें सप्ताह के अल्ट्रासाउंड स्कैन में भी क्लबफुट का पता लगाया जा सकता है। हालांकि, अधिकांश मामलों में इस स्थिति का पता जन्म के बाद बाल रोग विशेषज्ञ या बाल रोग आर्थोपेडिक सर्जन द्वारा मेडिकल जांच के बाद ही लगाया जा सकता है।
सौभाग्यवश, क्लबफुट का इलाज पूरी तरह से किया जा सकता है, बशर्ते इसका इलाज सही समय पर किया जाए। इस स्थिति के इलाज की प्रक्रिया में शिशु के पैर के प्रभावित हिस्से पर क्रमिक प्लास्टर (अनुक्रमिक मलहम) किया जाता है जो इसके दीर्घकालिक प्रभाव को रोकने में भी सक्षम होता है। वास्तव में, सही इलाज के बाद इस विकृति के साथ पैदा हुए बच्चों को भविष्य में किसी भी कार्यात्मक कठिनाई का सामना नहीं करना पड़ता।
अच्छे परिणाम के लिए आवश्यक है, विकृति का पता चलते ही जितना जल्दी हो सके इलाज शुरू करा दें। डॉ हर्षवर्धन हेगड़े के अनुसार – जन्म के 5-7 दिनों के बाद कास्टिंग शुरू करा देनी चाहिए। उचित समय पर इलाज से लगभग 95-98% प्रभावित बच्चे पूरी तरह से बिना किसी सर्जिकल सुधार के ठीक हो सकते हैं। यदि गर्भावस्था के दौरान या जन्म के तुरन्त बाद क्लबफुट का निदान कर लिया जाता है, तो इस स्थिति में माता-पिता को चिंतित होने की आवश्यकता नहीं है।
यहाँ यह याद रखना अत्यन्त महत्वपूर्ण है कि यदि समय पर इलाज नहीं कराया जाये तो यह स्थिति उम्र के साथ और बिगड़ सकती है, इसलिए बच्चे के स्वस्थ और सामान्य जीवन जीने के लिए शुरुआती चिकित्सा हस्तक्षेप आवश्यक है।
बिना सर्जरी किये भी क्लबफुट का इलाज (Clubfoot treatment in Hindi) किया जा सकता है। इसके इलाज के प्रोटोकॉल में प्रारंभिक स्ट्रेचिंग, साप्ताहिक कास्टिंग और ब्रेसिंग का समायोजन होता है।
5-7 दिन बाद, बच्चे के पूरी तरह स्वस्थ होने के बाद ही इसका इलाज शुरू किया जा सकता है। यदि शिशु का समय से पहले जन्म हुआ है या उसका वजन जन्म के समय बहुत कम (2.5 किलोग्रा से कम) है, उस स्थिति में शिशु के स्वस्थ हो जाने के बाद ही स्ट्रेचिंग प्रारम्भ करनी चाहिए।
साप्ताहिक कास्टिंग का उपयोग करते हुए पैर के क्रमिक सुधार की इस प्रक्रिया को “पोंसेटि तकनीक” कहा जाता है। स्थिति की गंभीरता के आधार पर, यह प्रक्रिया कुछ महीने लम्बी हो सकती है और इसमें विशेष बूट और बार के उपयोग की भी आवश्यकता हो सकती है।
कार्यात्मक, दर्द मुक्त, सीधे पैर और भविष्य में चलने में किसी प्रकार की परेशानी न होना ही इस इलाज प्रक्रिया को करने का मुख्य उद्देश्य है। सही समय पर सही इलाज शीघ्र रिकवरी में सहायक होता है।
कुछ मामलो में पोंसेटि तकनीक वांछित परिणाम नहीं दे पाती, ऐसा उन परिस्थितियों में होता है जब स्थिति अत्यंत जटिल हो या अंतर्निहित स्थिति (द्वितीयक क्लबफुट) इसका कारण हो। ऐसे मामलों के इलाज (Treatment of clubfoot in Hindi) के लिए सर्जिकल सुधार का उपयोग किया जा सकता है।
इग्नेसियो वी. पोन्सेटि (चिकित्सक जिन्हे आर्थोपेडिक्स के क्षेत्र में अपने योगदान के लिए पहचाना जाता है) के नाम पर रखी गयी पोंसेटि तकनीक दुनिया भर में क्लबफुट के इलाज (Treatment of clubfoot in Hindi) के लिए सबसे व्यापक रूप से इस्तेमाल की जाने वाली तकनीक है। इस तकनीक में एक समयावधि में इस विकृति को ठीक करने के लिए सौम्य स्ट्रेचिंग और अनुक्रमिक कास्टिंग के संयोजन का उपयोग किया जाता है।
इस तकनीक में, बच्चे के पैर को धीरे से स्ट्रेच किया जाता है और उसे सही स्थिति में जोड़ दिया जाता है और इसे एक कास्ट (आमतौर पर पैर की उंगलियों से जांघ तक) की मदद से सही करने का प्रयास किया जाता है। यह प्रक्रिया हर सप्ताह दोहराई जाती है जब तक वांछित परिणाम प्राप्त नहीं हो जाते हैं। इसमें 6-8 सप्ताह या उससे अधिक समय भी लग सकता है।
एक बार जब स्ट्रेचिंग और अनुक्रमिक कास्टिंग पूरी हो जाती है, तो सर्जन एक छोटे से प्रोसीजर की मदद से एच्लीस टेंडन (एड़ी की हड्डी) में टाइटनेस को कम कर देता है। अगले चरण में एक और छोटा प्रोसीजर किया जाता है जिसे टेनोटॉमी कहा जाता है। इस प्रोसीजर में टेंडन को काटने के लिए बहुत पतले उपकरण का उपयोग किया जाता है। इस प्रक्रिया में टाँके लगाने की आवश्यकता नहीं होती है।
इसके बाद 3 सप्ताह के लिए सर्जन टेंडन को सपोर्ट और रक्षा देने के लिए एक कास्ट का प्रयोग कर सकता है। एक बार जब टेंडन वापस से एक निश्चित लम्बाई तक बढ़ जाता है तब क्लबफुट (Clubfoot in Hindi) को पूरी तरह सही माना जाता है।
पोन्सेटि तकनीक में, पैर को धीरे से उसकी स्थिति सही करते हुए कास्ट को हर हफ्ते बदल दिया जाता है। हर बार जब प्लास्टर लगाया जाता है, तो पैर को थोड़ा और सही किया जाता है। इसलिए, आवश्यक प्लास्टर की संख्या विकृति की गंभीरता पर निर्भर करती है। हालांकि, आम तौर पर, औसतन 4-10 कास्ट का उपयोग किया जाता है। बच्चे की उम्र अधिक होने पर यह बढ़ सकता है, यदि विकृति अधिक जटिल है, या लंबे समय तक अनुपचारित छोड़ दिया गया हो। ऐसे मामलों में, सप्ताह में दो बार कास्टिंग की भी आवश्यकता हो सकती है।
एक बार अंतिम कास्टिंग पूरी हो जाने और कास्टिंग हटाने के बाद, बच्चे को मेटल की पट्टी से जुड़े विशेष जूते पहनने की आवश्यकता होगी। इसे डेनिस ब्राउन / मिशेल पोंसेटि स्प्लिंट कहा जाता है। ये जूते आमतौर पर 3 महीने तक एक दिन में 23 घंटे के लिए पहनाये जाते हैं। 3 वर्ष की आयु के बाद इन जूतों को बच्चे के सोने के समय रात में पहनने की सलाह दी जाती है।
माता-पिता को भी बच्चे की स्ट्रेचिंग जारी रखने की आवश्यकता होती है। क्लबफुट विकृति को ठीक करने में जूतों का उचित उपयोग अत्यंत आवश्यक है।
निम्नलिखित मामलों में, क्लबफुट के इलाज के लिए सर्जरी (Surgery for clubfoot treatment) की आवश्यकता हो सकती है:
ऐसे सभी मामलों में, यदि बच्चे में चलने फिरने के दौरान हाइपरएक्टिव टेंडन के लक्षण दिखते हैं तब आमतौर पर टेंडन स्थानांतरण की आवश्यकता होती है।
क्लबफुट के अन्य सर्जिकल उपचारों में सॉफ्ट टिस्सु रिलीज, बाहरी फिक्सर के साथ क्रमिक सुधार, बोन कटिंग सर्जरी या पैर के जोड़ों का संलयन शामिल है।
जब तक सही उपचार प्रोटोकॉल का पालन किया जाता है, इस उपचार तकनीक में कोई महत्वपूर्ण जोखिम शामिल नहीं हैं। कुछ मामलों में, यदि बच्चे की त्वचा अधिक संवेदनशील है या यदि कास्ट का उपयोग उचित तरीके से नहीं किया गया है, तो प्लास्टर त्वचा पर घावों का कारण बन सकता है। इनका आसानी से एंटीबायोटिक्स द्वारा इलाज किया जाता है और लगभग एक सप्ताह तक कास्टिंग की जाती है।
यदि पोन्सेटि तकनीक को सही तरीके से नहीं किया जाता है, तो इसके परिणामस्वरूप रॉकर बॉटम फुट (मिडफुट ब्रेक) या आईट्रोजेनिक कॉम्प्लेक्स क्लबफुट जैसी जटिलताएं हो सकती हैं। कास्टिंग के बाद एड़ी की हड्डी को काटने के लिए इस्तेमाल की जाने वाली प्रक्रिया से रक्तस्राव भी हो सकता है, हालांकि यह आसानी से मैनेज हो सकता है।
सौभाग्यवश, सही उपचार के साथ, इस विकृति के साथ पैदा हुए बच्चे लगभग सामान्य जीवन व्यतीत कर सकते हैं, वो अच्छे से चल सकते हैं, भाग सकते हैं, खेल सकते हैं और सामान्य जूते पहन सकते हैं। कुछ मामलों में प्रभावित पैर, दूसरे पैर से 1 से 1.5 इंच छोटा हो सकता है।
कॉल्फ मसल्स भी छोटी हो सकती हैं, जिससे बच्चे को दर्द या थकान महसूस हो सकता है। हालांकि, यह शायद ही कभी किसी महत्वपूर्ण समस्या का कारण बनता है।
इस स्थिति का इलाज एक प्रशिक्षित बाल चिकित्सा आर्थोपेडिक सर्जन द्वारा किया जाता है। लंबी अवधि की जटिलताओं से बचने और बच्चे के चलने के समय तक पैर की पूर्ण कार्यक्षमता प्राप्त करने के लिए विस्तार पर ध्यान देना महत्वपूर्ण है।
भले ही यह प्रक्रिया अपेक्षाकृत सरल और गैर-सर्जिकल हो, लेकिन पैर को सही ढंग से संरेखित करने के लिए सही इलाज की आवश्यकता होती है। अपने शिशु की स्थिति के इलाज के लिए एक अनुभवी बाल चिकित्सा आर्थोपेडिक सर्जन चुनें, जो क्लबफुट का इलाज (Treatment of clubfoot in Hindi) करने में पारंगत है।
यदि आपके शिशु में गर्भावस्था के दौरान या जन्म के तुरंत बाद क्लबफुट का पता लगता है, तो सबसे महत्वपूर्ण बात यह है कि तुरंत उपचार शुरू किया जाए। बेहतर परिणाम के लिए होम केयर निर्देशों का पालन करें जैसे कि डॉक्टर द्वारा दिए गए बच्चे के लिए व्यायाम कराना इत्यादि ।
Also, read this in English: Finding the permanent solution for clubfoot!
PCOS or polycystic ovary syndrome is an extremely common health problem amongst women of childbearing age. In fact, it is so common that in an effort to raise awareness about this condition, the month of September has been declared “PCOS awareness month”. Awareness is the first step in the fight against the spread of this condition. Let us educate ourselves about PCOS and take a closer look into this syndrome, its impact and how diet & exercise can help in stopping this condition from taking over our lives.
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Polycystic ovary syndrome, commonly known simply as “PCOS” is a condition characterised by an increased production of male sex hormones (androgens). The three main characteristics of PCOS are:
Every month, the ovaries release a mature egg for fertilisation. This process is called ovulation. If the egg is not fertilised, it is released from the body (periods). In some cases, women may experience irregular periods, indicating problems in ovulation.
Small quantities of androgens or “male” hormones are produced by the adrenal glands, ovaries and fat cells. They are vital to normal reproductive function, emotional stability, cognitive function, muscle function and bone strength. High levels of androgens can result in abnormal hair growth (especially facial hair), acne and male patterned baldness.
Polycystic ovaries are characterised by enlarged ovaries containing large number of cysts (fluid-filled sacs). These cysts surround the eggs making it difficult for the ovaries to release the eggs. This results in anovulation.
Women with PCOS experience at least two of the above characteristics.
Read: First period post pregnancy: what is normal and what is not?
Earlier, PCOS was considered to be a simple endocrine disorder, causing hormonal imbalances. However, today with advances in research, we have a better understanding of this syndrome. It is now treated as a complex condition with metabolic, hormonal and psychological factors. Patients too are treated holistically by addressing the phycological impact of the disorder as well as the physiological one.
PCOS can be devastating for women in their childbearing years. It is one of the leading causes of female infertility. For many women, giving birth is an important aspect of their identity, and they face judgment by their partners, family and society if they are unable to do so. It is important to educate the family as well so that they can give the required emotional support to the patient.
Studies also indicate that women with PCOS have higher levels of psychological distress. This can be in part due to symptoms of PCOS such as obesity, hirsutism (excessive hair growth) and infertility.
PCOS is also known to increase the risk of several complications such as developing metabolic syndrome and cardiovascular disease. Early intervention, lifestyle changes and long-term monitoring is key to relieving the symptoms of PCOS.
Read: Pregnancy and Polycystic ovary syndrome
Many women mistakenly feel that something they did cause PCOS. This adds on to the psychological impact of this condition. The exact cause of PCOS is still not known, it is believed that it is caused by a combination of several factors including genetics and having insulin resistance. Obesity is also known to increase the likelihood of developing PCOS.
The symptoms of PCOS depends on the severity of the condition. In a large number of PCOS cases, diagnosis is made when the woman experiences difficulty in conceiving. This is because the symptoms may not be severe enough to cause the patient to seek medical help. Some of the most common symptoms of PCOS are:
As the symptoms need not be evident all the time, especially in the early stages, routine gynaecological check-ups are advised as soon as you start menstruating, especially if you are at a higher risk of developing PCOS.
Read: What to do when you suspect infertility
Home remedies for PCOS are usually the first line of defense against this condition. This can further be classified into two categories i.e.: Dietary changes & Lifestyle changes. Let us take a closer look into home remedies for PCOS management.
Diet tends to influence our health to a great extent. Women affected with PCOS are likely to have higher levels of insulin than the ones without PCOS. This is because insulin resistance is one of the symptoms of PCOS. Insulin resistance indicates that the insulin produced by the pancreas is not utilized for digestion of the sugar in the body, resulting in excess blood sugar.
In addition to this, due to insulin resistance many affected women find it difficult to lose weight, especially around their abdomen. Excess insulin is also linked to increased production of androgens (male hormones) causing male patterned baldness and hirsutism.
Keep the following guidelines in mind while coming up with your own unique PCOS diet plan.
Regular physical activity and weight management are important aspects of PCOS management. The following exercises will help you relieve PCOS symptoms.
In more severe cases, medication can be used to manage PCOS symptoms. Following a healthy lifestyle and managing your weight with regular exercise is the best way to minimise the impact of PCOS.
Over the past few years, recovery time, scarring and pain associated with a wide range of general surgeries have reduced significantly. This is all thanks to the rising popularity of “laparoscopic” procedures or keyhole surgeries. With the help of laparoscopic surgery, surgeons can now treat patients in outpatient procedures itself avoiding unnecessary risks, scarring, pain and expenditure, enabling the patient to recover comfortably at home. In this article we will be exploring the laparoscopic risks and benefits that need to be factored in while deciding to opt for the procedure.
While laparoscopic procedures can be traced as far back as 1805. However, it was Dr Heinz Kalk, a German gastroenterologist who popularised it by inventing a superior laparoscope. This earned him the title of “Father of Modern Laparoscopy”. In the 1930s, Laparoscopy gained popularity in the United States through the work of internist John Ruddock. In the last few decades, laparoscopy has become the first choice of surgical treatment for both doctors and patients.
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According to the National Health Service-UK, laparoscopic surgeries or keyhole surgeries are defined as “a type of surgical procedure that allows a surgeon to access the inside of the abdomen or pelvis without having to make large incisions in the skin”
In this procedure, the surgeon makes one or more small incisions. A small tube is used to pump gas into the body cavity through one of these incisions. This is to help the surgeon get a clearer view inside the body. Using a laparoscope (a small tube with a light source and camera), the surgeon can either see inside the body to make a diagnosis or use it to guide other surgical instruments. Over the years, laparoscopy has become a common procedure to diagnose and treat gynaecological, GI, minimal access and urological conditions.
Laparoscopy is used to treat a wide range of GI, gynaecological and urological conditions. It can be used to perform tubal sterilization, hysterectomy, gallbladder removal, appendectomy, kidney stone removal etc.
Laparoscopy is also a common way to conduct a number of diagnostic tests such to diagnose and treat conditions such as endometriosis, fibroids, ovarian cyst, ectopic pregnancy, pelvic floor disorders and some forms of cancer.
Read: What you need to know about an Ectopic pregnancy
The most obvious and basic benefit of laparoscopic surgery is that large open wounds and incisions can be avoided. This in turn significantly decreases blood loss, pain, discomfort and scarring. Even the side effects caused by anaesthesia can be reduced or avoided. The instruments used in laparoscopy also cause less trauma to the tissue.
Owing to the nature and size of incisions in laparoscopic procedures, the risk of developing postoperative complications associated with the wound is much lower. This includes complications such as dehiscence, infection and incisional hernia amongst others.
Laparoscopic procedures also help avoid cooling, drying, excessive handling and retraction of internal organs that can occur in traditional open surgeries.
These benefits together aid in minimising recovery time and post op pain hence reducing the risk of developing conditions associated with prolonged bed rest and inactivity (such as bone loss, muscle atrophy and urinary retention). Most of the time, laparoscopic surgeries can also be performed as outpatient procedures.
In a more practical sense, laparoscopic procedures minimise direct contact between the surgeon and patient. Consequently, there is a much lower risk of transmission of any type of infection between the two, making it a preferred surgical option for a wide range of treatment and diagnostic needs.
The benefits of laparoscopic surgery are quite obvious and widely accepted. However, like all surgical procedures, it does not come without its own risks. One of the main risks is that laparoscopy takes longer time to perform as compared to open surgery. This increases the exposure of the patient to general anaesthesia which can result in complications.
Other serious complications that can occur (rarely) in laparoscopic procedures are:
Just like any traditional surgical procedure, the complications may not be evident right after surgery. Rather they can start developing over a period of time following the surgery. So, it is generally advised that the patient is not left alone for the first 24 hours after surgery. Even if they have been discharged from the hospital. If you observe any of the following symptoms after a laparoscopic procedure, seek immediate medical attention:
In some cases, due to complications arising during the procedure, the surgeon might also have to switch to open surgery instead of laparoscopic surgeries. Further surgery may also be required to treat some of the serious complications that may arise after a laparoscopic procedure.
Now, let us come back to the main question. Is laparoscopic surgery safe? Considering all of the above facts, it is clear why laparoscopic surgeries are rising in popularity. As compared to traditional open surgeries, they are considered safer as they minimise the time spent by the patient in the hospital or on bed rest. In fact, in many cases, patients are discharged a few hours after the procedure itself.
It is important to remember that laparoscopic surgery is by no means a magic cure to all surgeries. Not all patients are suitable for this procedure. Based on the severity of the condition and the patient’s general health, the doctor can decide between open or laparoscopic procedures.
Laparoscopy during procedure is not considered unsuitable or dangerous to the health of the fetus and the mother during any trimester. However, precautions are to be taken to ensure the safety of the baby and mother such as carefully deciding the type and dosage of anaesthesia as well as ensuring the facility is equipped to handle any complications should they arise.
Patients are generally advised not to eat or drink anything for at least 8 hours before the surgery. This is because laparoscopic procedures are usually performed under general anaesthesia.
The recovery time after a laparoscopic procedure depends on several factors such as the type of treatment and your general health. Surgeries such as appendectomy can take around 3 weeks for recovery.
Robotic-assisted laparoscopy is the latest innovation in the field of laparoscopy. In this procedure, the surgeon uses a console located in the operating theatre to perform the procedure using robotic arms attached with a special camera and surgical equipment. The greatest advantage of this technique is that the system offers a magnified 3D vision and increased range of movement for the instruments inside the body cavity. This helps the surgeon be more precise and accurate. There is also evidence suggesting that robotic assisted laparoscopy can have lower risk of complications as compared to traditional laparoscopy or open surgeries.
Read: Treatment of fibroadenoma without surgery – here’s how you can dissolve it naturally
Most of us have experienced bouts of back pain at some point of our adult lives. Today, back pain and related conditions is said to be one of the most frequent medical complaints. It is also one of the most common reasons for lost work time, coming second only to the common cold. Here we explore the common causes of back pain and explore tips for maintaining a healthy back.
Back pain is broadly divided into two categories. These are chronic back pain and acute back pain. Chronic back pain is defined as back pain that persists after an injury/surgery or if its cause is hard to determine. Acute back pain on the other hand refers to a brief episode of pain that manifests suddenly. It can develop into chronic back pain eventually if not treated correctly on time.
Mechanical conditions of the spine such as back strain, disc herniation, disc disease, osteoarthritis and spinal stenosis reportedly cause almost 98% cases of back pain.
Common causes of back pain include:
This condition refers to the rupture or tear of the cartilage surrounding the vertebral discs. This occurs when the pressure from the vertebrae on either side of the affected disc squeezes out the nucleus pulposus (cushioning substance in the inner core of the vertebral disc). Studies show that the pressure on the nucleus pulposus is greater when you are sitting. Hence, this condition is especially prevalent amongst individuals in a sedentary occupation.
Osteoarthritis is a form of arthritis associated with ageing. Osteoarthritis of the spine can be accompanied by a condition called spinal stenosis. Patients with spinal stenosis complain of tingling, weakness, numbness and/or pain radiating down the arm or leg.
This is a chronic inflammatory condition that first affects the spine and its nearby structures. It eventually results in the vertebrae fusing together. Ankylosing spondylitis has strong genetic links and is generally seen in men aged below 30 years.
Spondylolisthesis is a condition of the spine that affects the lower vertebrae. In this condition, one vertebrae slips forward over the vertebrae below it. It can be congenital (present at birth), isthmic (caused by a defect such as a fracture in the bony supporting vertebral structure at the back of the spine) or degenerative (caused by degenerative disc disease). People with a family history of this condition are more likely to develop it. Performing some activities such as gymnastics, weight lifting etc can also increase the risk of developing this condition.
Any type of injury due to any traumatic event such as an accident can result in fracture or muscle injury causing back pain.
Infections can cause (very rarely) acute and chronic back pain.
Cancer causes less than 1% of all back pain cases.
Other conditions such as abdominal aortic aneurysms, kidney stones or perforating stomach ulcers are also known to cause back pain. Although such cases are not very common.
It is without a doubt that today, our sedentary lifestyle is one of the leading causes of chronic and acute back pain. Lack of exercise combined with long hours of sitting in wrong postures renders the back so weak that even simple movements like bending or even coughing can result in conditions such as herniated discs.
Maintaining a healthy and strong back is extremely important, as the spine forms the core of our skeletal structure. Any damage to this region can cause extreme pain and sometimes loss of mobility.
Also, read: Severe pain in heels during the morning: do I have Plantar Fasciitis?
To help you keep your back strong and straight, we have compiled a few tips for how to keep your back healthy.
Posture is one of the key factors to consider to maintain spinal health. Many of us are guilty of ignoring the way we sit. Especially since it is natural to slouch or hunch after many hours of sitting in the same position.
The thing to keep in mind while sitting is that it is best to sit with a relatively straight back. The best way to do this is to sit with your posterior right back in your seat. Straighten yourself, push your shoulders back and then relax a little. Using ergonomic furniture will also help you to maintain a good posture.
Sitting or staying inactive for prolonged periods of time is not good for the spine (or the rest of your body). Staying active and physically fit is one of the most basic ways to stay healthy. You don’t have to do high intensity workouts, just a simple stretch and a walk around the office every couple of hours can have a significant positive impact.
On an average, we spend anywhere between 6-8 hours sleeping. What we sleep on plays a significant role in maintaining the health of our backbone and spine. Many of us get so comfortable with a specific type of mattress that we tend to put off changing it. There is no specific magic mattress that suits everyone so it is important that you choose a mattress that feels the most comfortable to you. If you are experiencing stiffness and pain in the back that does not seem to go away, it is a good idea to think about changing your mattresses. You can also try changing the position you sleep in.
One common cause of chronic and acute back pain is poor lifting technique.
Even lifting moderately heavy objects, or the simple act of bending down to pick up something can strain the back and result in pain.
The first thing to keep in mind is to never lift things which are too heavy, especially if your body is not used to the stress. The ideal lifting technique is to bend at the knees and lift keeping your back straight
When you are walking, it is advised to avoid leaning forward or backward. Bring your stomach in slightly, engage the core, tuck the buttocks in and tilt your hips forward a little. This is considered the best walking posture
These days, along with minding our backs while going about our day to day life, we also have to pay attention to our neck. Especially as we spend the majority of our day looking down on one screen or the other. Remember to practice simple neck exercises and rotations every couple of hours to avoid stiffness and pain.
There are three main factors to keep in mind while selecting footwear. These are “form”, “fit” and “function”. While form refers to the visual aspect of the shoe, fit and function are the most important factors associated with how the shoe feels and impacts the body. Ill-fitting or uncomfortable shoes have a huge impact on how we walk and our general posture. Opt for cushioned and supportive shoes and avoid high heels or heavy shoes etc.
Also, read: From bunions to hammertoes : How to avoid the shoes that kill your feet
A well balanced diet has a number of benefits on the body. It is also important to follow a healthy diet to maintain good spinal health. Excessive weight gain and obesity can result in excessive pressure on the back. Diet also impacts the nutrients going into the spinal cord. So, it is essential that you make your eating choices carefully.
Most spine health exercises focus on improving flexibility and strengthening the core. The core refers to a band of muscle that wraps around our stomach. It is essential in maintaining good posture and having a healthy back. You can enroll in pilates and yoga for a healthy back, as these activities focus on flexibility and core strength.
There is nothing like a massage to squeeze out the stress from our body. The occasional massage is the ultimate treat for our backs. It improves circulation and releases the tensions in the muscles to relieve pain and stiffness.
Gestational hypertension is a pregnancy condition characterised by high blood pressure in pregnancy. This condition should not be confused with other blood pressure conditions such as chronic hypertension or preeclampsia. Gestational hypertension generally develops in the second trimester and goes away after you give birth. Don’t be alarmed if your doctor observes high blood pressure during your pregnancy, many women with high blood pressure deliver healthy babies. Your doctor would closely monitor your condition as well as your baby’s health and growth.
To effectively manage gestational hypertension, let us first understand this condition better.
Medical experts are still to identify the exact causes of gestational hypertension. A few factors that can increase the risk of developing high bp in pregnancy include:
During your prenatal visits, your doctor would evaluate the risks to your pregnancy based on your medical and family history. Apart from high blood pressure, you might also experience the following symptoms of high BP in pregnancy:
It is important to carefully monitor and manage signs of high blood pressure during pregnancy as it can result in severe blood pressure conditions such as preeclampsia. If you notice any new symptoms bring it to the notice of your obstetrician right away.
If you are detected with high blood pressure, your doctor might run additional tests to rule out any other conditions. These include:
The main goal of treatment for gestational hypertension is to prevent the condition from worsening. Your treatment would include the following:
Gestational hypertension on its own doesn’t necessarily be a cause of worry. However, if not managed correctly it can lead to complications such as preterm labour and preeclampsia. Preeclampsia is a serious blood pressure condition that affects various organ systems in the body including the nervous system. The only course of treatment in this event is performing an emergency delivery.
Watch the video as Dr Deepika Aggarwal, consultant obstetrics and gynaecology at the CK Birla Hospital discusses “Hypertension and Preeclampsia – Silent dangers to pregnancy” in full detail.
If you do have high blood pressure during your pregnancy, the following tips can help you have a healthier pregnancy
Remember, it is always better to err on the side of caution and check with your doctor in case you aren’t sure whether something is out of the ordinary or not.
Ques: Is gestational hypertension and chronic hypertension the same?
Ans: Gestational hypertension is a blood pressure condition characterised by high bp after the 20th week of pregnancy. Chronic hypertension is high bp that existed before the pregnancy. If you have high blood pressure and are planning to or have become pregnant, consult your doctor for ways to manage the condition. In case you are overweight, your doctor might ask you to lose some pounds with diet and exercise to help manage your blood pressure. Also, consult your OBGYN for any medications that you might be taking for any pre-existing conditions.
Ques: What is preeclampsia?
Ans: Preeclampsia is a type of hypertensive disorder in pregnancy characterised by high blood pressure and a significant amount of protein in the urine. It can cause multiple organ systems to fail and can also be fatal to the mother and child. Preeclampsia also hinders foetal growth by restricting blood flow to the placenta. The exact causes of this condition are not known however, it is more commonly seen in first time pregnancies, pregnant teens and pregnant women over the age of 40. Signs and symptoms of preeclampsia include:
If you notice any of the above symptoms seek immediate medical attention.
Ques: Can gestational hypertension be prevented?
Ans: There are no ways to completely eliminate the risk of developing gestational hypertension. Early diagnosis and treatment are the most effective ways to manage this condition. So, make sure to go on regular prenatal visits to monitor the progress of your pregnancy.
The bladder is a bag-like organ, the size of a grapefruit, located behind the pelvic bone. The bladder is connected to the kidneys through a set of tubes called the ureters. Kidneys make urine and transport the same to the bladder through the ureters.
The bladder consists of muscles that stretch to accommodate the urine produced by the body. The bladder can hold up to half a litre of urine for two to four hours at a time. When the body relieves the urine, two valves open up and allow the urine to pass out of the body through the urethra.
Like every vital organ in the body, the bladder is prone to issues that cause difficulty in functioning. Some of these issues are:
Cystitis is the medical term for bladder inflammation, commonly referred to as painful bladder syndrome. If the pain and inflammation lingers for more than six weeks, with no underlying infection, the doctor might diagnose it as Interstitial Cystitis (IC).
Common symptoms of cystitis include:
The pain resulting from cystitis can be mild to severe depending differing from person to person.
The symptoms of IC could worsen because of improper diet, mental or physical stress. In women, menstruation could cause additional pain to the bladder.
The treatment for IC includes:
In case the treatment options are ineffective, the doctors might suggest surgery as a last resort.
You can also control IC by keeping an eye on your diet to identify and avoid the food which causes bladder irritation.
A urinary tract infection (UTI) could affect the kidneys, ureters, bladder, or urethra, which form part of the urinary system. While the condition affects 8 million people each year, UTI is more likely to cause bladder pain in women as compared to men.
The more common symptoms of UTI are:
You should treat UTIs as soon as possible to avoid severe infections to the kidneys and other parts of the urinary system. Your urologist will conduct a urine analysis to check the level of infection and also to identify the bacteria causing the infection.
UTI could be caused by:
UTIs are generally treated with oral medications that include antibiotics as a first defence. Depending on the severity of the infection, your doctor will dictate the course of antibiotics. In the case of extreme cases, antibiotics are given intravenously.
Drinking lots of water and using heating pads are simple remedies for reducing the effects of the infection and manage side effects of the antibiotics.
Bladder stones are stones made of accumulated mineral deposits in the bladder. When the kidneys form highly concentrated urine, it can lead to the formation of stones. Urine becomes concentrated due to dehydration or a problem in emptying the bladder fully.
The more common symptoms of bladder stones are:
The most usual sign of bladder stones could be by not keeping the body hydrated. As urine is almost 90% water, the reduction in water quantity makes the mineral deposits stronger.
Other signs of bladder stones include:
In the case of small bladder stones, drinking lots of water is enough to flush it out with urine. However, if the stones are bigger in size, lasers or ultrasound are used to break the stones into smaller pieces and flush them out. Surgery is the last option considered when all other treatments are ineffective.
The ninth most common cancer in India, bladder cancer entails the abnormal growth of cells of the inside lining of the bladder. This type of cancer usually causes bladder irritation in men between the ages of 50 and 70.
The more common symptoms of bladder cancer are:
The usual cause of bladder cancer is the abnormal growth of cells without control in the bladder. The growth of these cells is aggravated by:
Different procedures like cystoscopy, biopsy, urine cytology and imaging tests help identify any cancerous areas in the bladder and urinary tract system. Cancer could be at either of the four stages.
Bladder cancer treatment includes:
Doctors might recommend a different mix of treatments for most effectiveness. However, there is a relapse in more than 50 % cases, which often infects the surrounding tissue of the bladder too.
Ques 1: What causes bladder pain without infection?
Ans: Kidney stones could move from the kidney and lodge the bladder’s walls, causing bladder irritation and pain. In some cases, the reason could be bladder cancer.
Ques 2: How do I get my bladder to stop hurting?
Ans: If you have a bladder infection, constant hydration will help flush the bacteria out of your body. Using heating pads and avoiding intercourse until your bladder stops hurting are effective ways to combat bladder pain.
Ques 3: What causes bladder pain in females?
Ans: One of the main causes of bladder pain in women is a bacterial infection from a UTI or IC. Women are more susceptible to bacteria because they tend to have a shorter urethra than men, which is also located closer to the anus. To avoid contracting a bladder infection, women must pay special attention to their intimate hygiene.
Although bladder pain has many different causes, almost all of them can be treated. Bladder pain should be treated right at the start of the discomfort for maximum relief. You can book an appointment with the doctor in case your symptoms persist or are aggravated.
Also, Read: Gallbladder stones – everything you need to know
“Dancing is like dreaming with your feet” this age-old quote quite rightly reflects the beauty of dance. Many of us can vouch to have felt the same while dancing to our favourite beats. Dance can be an exhilarating experience, keeping us fresh and fit if done regularly. But without proper care and precautions, this dream can quickly turn into a nightmare for our feet.
Dance is a form of art that has been around for centuries. It requires a lot of physical and psychological dedication. Professional dancers train for years to achieve the motor control and flexibility required to flawlessly execute complex dance routines. These training sessions can be extremely rigorous and last for several hours at a time. Foot and ankle injuries are extremely common amongst dancers, especially female ballet dancers. These can be a result of sudden trauma due to improper landing or more commonly due to repetitive insults during excessive training.
The most common foot and ankle problems that plague dancers are:
Almost every dance form from ballet to freestyle and even contemporary places importance on leg and foot stretches. Every dancer can claim to have had an ankle sprain at least once in their career. This usually happens due to any injury while performing dance moves. Improper training or overexertion can weaken the ankle and increase the risk of developing this problem.
There are multiple joints, ligaments and tendons located in the foot and ankle region holding the ankle joint in its place and allowing up-down and side-to-side motion of the foot. In a typical ankle sprain, any one of these ligaments are torn or severely stretched.
Based on the severity of the condition, ankle sprains can be classified into three different grades. Grade 1 means mild severity while grade III suggests severe injury to ligaments on both sides of the ankle. Common symptoms of an ankle sprain include inflammation, swelling, bruising, redness and rise in temperature of the affected ankle.
Many of us are guilty of underestimating sprained ankles and regretting the decision later on. Ankle sprains should always be checked by a medical expert. An untreated ankle sprain can result in far more severe problems such as:
The initial management of ankle sprain is commonly remembered using the acronym “RICE”. It stands for
If the pain in the ankle is extremely severe, the doctor may recommend other treatments such as a brace, cast etc. Physiotherapy may be required after the pain settles to combat stiffness, weakness and regaining stability of the ankle is needed to get back to pre-injury status.
Long gruelling practice sessions are almost synonymous with dance. These strenuous practice sessions result in a lot of pressure on the foot muscles and bones. Over a period of time, this habitual overexertion and recurring pressure or stress on the bones can result in a type of fracture called stress fractures. It is usually diminutive and as small as a tiny crack in the bone.
Symptoms of stress factors include pain while performing any particular activity that involves the affected bone, pain in touching the affected area, and swelling over the region of fracture.
If stress fractures remain untreated, they can worsen resulting in a major fracture. Experts generally suggest a reduction in activity and use of orthopaedic devices such as braces, walking boots, cast among others to reduce the load on the bone. For severe cases, surgery can also be performed.
One tiny misstep or trip during a complex dance routine can result in a fracture in the outer aspect of the foot (fifth metatarsal bone). The fifth metatarsal bone is found below the little toe. The line of the fracture is usually spiral-shaped throughout the bone and can also cause cracking of the bone into smaller parts. This type of fracture is also commonly called the “dancer’s fracture”. Some of the most common mechanisms of dancer’s fracture include awkward landing after jumps or rolling on the outer border of the foot during demi-pointe position in ballet dancers.
Dancer’s fracture usually presents as swelling, pain, and bruising in the outermost region of the foot. The treatment protocol is similar to other foot fractures and can take 6-12 weeks to heal.
Notice a hard bump at the backside of your ankle? It is probably a “Dancer’s heel”. Dancer’s heel, also known as posterior ankle impingement syndrome, develops when the tissue and bone present behind the ankle gets compressed to form a hard bone-like bump. Ballet dancers who practice the pointe technique for prolonged periods of time often complain of the dancer’s heel. There might also be a bony growth at the back of the ankle (Os trigonum or Steida’s process) which may exacerbate the problem. In these dancers, achieving a full pointe position can trigger pain in the back of the ankle on the outer aspect. Many of them may have adjoining inflammation of the tendon (muscle) of the big toe. This condition is called FHL tenosynovitis and moving the big toe may cause pain.
If the ankle pain caused by the dancer’s heel is limiting one’s daily activities and/or dance, they should seek medical attention for proper diagnosis. The treatment procedure generally includes physical therapy to strengthen and mobilize the ankle, avoiding movements and positions that trigger the pain and medication to manage the pain. If the patient does not respond satisfactorily to these treatments, the doctor can also suggest surgical treatments.
After years of ballet, one may notice slight bending of the toes. This can result in a deformity called hammertoes. Hammertoes is a deformity where the middle joints of all the toes except the big toe bend. This deformity is commonly seen in ballet dancers attempting the full-pointe position as well as individuals wearing small/tight-fitting shoes. This deformity results in an additional force on the toes while wearing shoes. This in turn results in pain and callus formation on top of the toe.
Hammertoes, if untreated can become worse and more prominent with time. Doctors treat hammertoes through non-surgical methods like a change of footwear, padding and stretching exercises. Although if the condition becomes too severe, surgery might be the only treatment option.
Anyone who has had an ingrown toenail can vouch for how uncomfortable and painful it is. Training in shoes that are too tight can result in this condition. Ingrown toenail refers to a medical condition wherein the nail grows into the skin from the edges and corners rather than outwards. This results in inflammation, pain, redness and even infection. This problem is especially dangerous for people suffering from peripheral vascular disease or diabetes. It is also a common issue amongst dancers with sweaty feet. Cutting nails too short, injury, history in the family are some other common causes of an ingrown toenail.
It would require medical intervention if the ingrown toenail results in an infection. In some cases, the doctor may pull out the nail from the affected region and apply medication to heal the wound and protect it from infections. But if the problem persists, then toenail avulsion may be recommended. Toenail avulsion is a surgical method to remove the nail partially or completely. If you frequently face the problem of ingrown nails, you should seek medical consultation to know the available treatment options
Also, read: From bunions to hammertoes: How to avoid the shoes that kill your feet
When it comes to personal grooming, we often overlook our feet. Little do we realise that if foot problems go untreated, it can result in lifelong disability. For dancers, their feet are their livelihood and are at a higher risk of injury. Dr Praveen Tittal who is known to be one of the best orthopaedic doctors in Gurgaon (at present, consultant – orthopaedics at the CK Birla Hospital, Gurgaon) suggests some preventive measures which can be helpful to avoid common dance induced foot conditions:
Read: Severe pain in heels during the morning: do I have Plantar Fasciitis?
