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Spondylitis

Introduction: -

It is Inflammation of a spinal joint; characterized by pain and stiffness.

Types of Spondylitis are as follows.

Ankylosing Spodylitis: - A chronic form of spondylitis primarily in males and marked

by impaired mobility of the spine; sometimes leads to ankylosis.

In this type there is rheumatoid involvement of the spine particularly sacro-iliac joints,

In young male patients.The condition has a strong HLA-B27 association and may

have associated inflammatory diseases such as inflammatory bowel disease, anterior

uveitis and Reiters syndrome.

It is also called Marie-Strumpell disease or Rheumatoid Spodylitis.

Occasionally patients with ankylosing spondylitis will present after minor trauma

With unstable fractures.

Causations: -

Epidemiology: -

It is present in about 6 per cent of the normal population, is usually asymptomatic and is a common incidental finding.

General Management: -

1. In young individuals presenting with back pain nonoperative measures such as physiotherapy are usually successful in resolving pain, and occasionally a plaster jacket can resolve symptoms.

2. Develop stress-management skills through relaxation techniques, such as progressive relaxation or abdominal breathing. For progressive relaxation, find a quiet place where you won't be disturbed. Sit or lie down and close your eyes. Then, starting with your head and neck and working down the entire body, tense and then completely release muscles.

For abdominal breathing, sit quietly and take a deep breath all the way into your abdomen. Then exhale completely, gently sucking in your stomach. Breathe deeply like this for several minutes.

3. Use massage.

Massage can help ease tense muscles and give temporary relief, and it may help you sleep better. First, take a hot bath or shower to relax the muscles. Then, have a partner use oil or lotion and rub your neck and shoulders using small circles with gentle pressure. Next, have him or her rub your neck and shoulders using firm pressure and long, downward strokes. Don't forget the chest area. If you don't have a willing partner, try rubbing your own neck and chest area with oil or lotion for 10 or 15 minutes.

4. Practice good posture.

The head and spine balance in relation to gravity. When poor posture pulls the curve of the lower back forward, the upper back curves further backward to compensate.

5. Strengthen stomach muscles.

Just as poor posture and obesity can cause the neck to become overstrained, poor muscle tone in the stomach muscles forces the upper back to curve farther backward and the neck to curve forward. Do exercises like bent-knee sit-ups to strengthen abdominal muscles.

6. Do neck exercises.

Two types of neck exercises can help ease and prevent neck pain:

  1. gentle range-of-motion exercises
  2. isometric exercises.

Apply moist heat to the neck before performing the exercises. Each exercise should be done five times per session, three sessions per day.

  1. Gentle range of motion exercises: - Range-of-motion exercises help stretch neck muscles. Sit erect and relaxed. Slowly turn your head to the right as far as you can, hold, and return it to the center. Repeat to the left. Then drop your chin down slowly toward your chest, hold, and relax. Bring your head back up. Now tilt your head toward your left shoulder, hold, and return to the center. Do the same on the right side. And finally, tilt your head backward so you're looking at the ceiling, hold, and then bring it back to the center.
  2. Isometric exercises: - Isometric exercises are performed against resistance without moving your head. Sitting erect and relaxed, press your forehead into your palm, and resist any motion. Then press your hand against the right side of your head. Push your head, trying to bring your ear to your shoulder, but resist any motion. Press both hands against the back of your head. Try to pull your head up, but resist the motion. And finally, press your hand against your temple, try to turn your chin to your shoulder, but resist the motion.

7. Work at eye level.

People often get "desk neck" from looking down for long periods or from reaching up to work. If possible, always work at eye level. Change the height of your chair, desk, or computer screen; use an upright stand to hold reading material; and use a stepladder instead of reaching up.

8. Take frequent breaks.

Change positions often, especially if you have to be in a physically stressful position.

Get up and walk around at least once an hour.

9. Unlearn "neck-bashing" habits.

Do you crimp the phone between your neck and shoulder? Do you shave with your head tilted back? Do you shampoo your hair in the sink? All of these habits can cause neck strain. Become aware of habits that strain your neck and replace them with neck-healthy ones.

10. Sleep on a firm mattress.

If you wake in the morning with a stiff or sore neck, your mattress, pillow, or sleeping habits are probably the culprit. Use a firm mattress and keep your head level. Don't sleep on your stomach, since it forces your head up. Avoid pillows that are too thick. Try feather or crushed-foam pillows rather than those of solid foam rubber.

Surgical Measures: -

Surgical stabilization leads to satisfactory results in most cases.

Homoeopathic Treatment: -

In Homoeopathy there is Successful & effective treatment for the spodylitis

Homoeopathic Therapeutics: -

Phosphorous : Rigidity of nape of neck. Pressure on shoulders. Swelling of neck. Engorgement of axillary glands and of those of nape of neck. Softening of the spine.Weak spine. Heat between shoulder blades.

Worse by lying on left side, change of weather, evening, during thunderstorm, ascending stairs.

Better by lying on right side, cold, sleep, open air.

Natrum Mur: Aching, rigidity, and tension in nape. Stitches in back and back of head. Painful stiffness of the neck. Throat and neck emaciate rapidly, esp., during summer complaint. Paralytic weakness nearly all day, better from lying, worse from eating. Nocturnal pains in back. Oversensitiveness of spine. Pain in back better by lying on something hard. Lassitude, pressive tension, and pulling in back. Contusive pain and feeling of paralysis in sacrum, especially in morning. Shootings, incisive-pains, and violent pulsations in sacral region.

Worse by heat, mental exertion, about 10 a.m., warm room, at seashore

Better by open air, lying on right side, pressure against back, tight clothing.

Silicea: Weak spine; very susceptible to draughts on back. Spinal irritation after injuries to spine; diseases of bones of spine.Purulent ulcer in nape. Stiffness of nape, with headache.Swelling of glands of nape,in the neck,and under the axillae (with suppuration), sometimes with induration. Pimples and furunculi in nape. Weakness and paralytic stiffness in back, loins, and nape. Tearing and shooting in the back. Burning in back when walking in open air and becoming warm. Aching, shooting, burning and throbbing in lumbo-sacral region. Swelling and distortion of spine (curvature of the vertebrae).Contusive pain between the shoulder-blades.

Worse by new moon, in morning, during menses, lying down, damp weather, lying on left side, cold.

Better by warmth, wrapping up head, summer, in wet or humid weather.

Sulphur: Stiffness of neck, in nape, with paralytic, sprained pain. Child cannot hold head up neck muscles so weak. Tetters on nape. Swelling and inflammation of glands of nape and of neck. Fetid perspiration in axillae. Swelling and suppuration of axillary

glands. Cracking in vertebrae of neck, especially on bending backwards. Sensation as if vertebrae glided over each other. Drawing pain between shoulder. Cannot lie on back on account of rush of blood to head. Pain in back after manual labour. Shootings in loins, back, and shoulder-blades, sometimes with obstructed respiration. Sharp and rheumatic pains, drawing, tension, and stiffness in loins, back and nape. Pinching and burning sensation between the shoulder-blades. Tension and bruised pain between scapulae and in nape, which on moving head goes to shoulders. Stitches beneath scapulae which take away the breath. Drawing in right scapula, evening on going to sleep. Tearing in left scapula while sitting. Needle-shoots at point of left scapula. Sprained pains in back.

Worse at rest, when stading, warmth in bed, in morning, 11 a.m., night, periodically

Better by dry, warm weather, lying on right side, from drawing up affected parts.

Asafoetida: Fine burning stitches in and behind right scapula, extending to ribs. Very violent sacral pains. Cannot work on account of the backache. Crawls run over back in afternoon.

Worse, at night, left side, during rest, warm aplications.

Better, open air, from motion, pressure.

Calcaria Fluor: - Lumbago from strains, severe backache after a long ride, worse after rest, better after moving a little and from warmth. Tired aching, as from a long ride, with restlessness.

Worse during rest, changes of weather.

Better by heat, warm aplication.

Calcaria Phos: Rheumatic pain and stiffness of neck with dulness of head, from

slight drought of air. Cramp-like pain in neck first one side then the other (right to left). Throbbing or jerking pains below scapula. Violent pain in region of back when making the least effort. Backache and uterine pains. Curvature of the spine to the left, lumbar vertebrae bend to the left, spina bifida.

Worse by draughts of air, exposure to damp. Cold weather, melting snow

Better in summer, warm, dry atmosphere.

Hepar Sulph: Bruised pain in the nape of the neck, on bending the head backwards. Bruised pain in the cervical muscles, with pain in the throat on swallowing, as from an internal swelling.The muscles of the nape of the neck, especially at the two sides beneath the ears, are very painful to touch (eighteenth day). Great weakness of the whole spine. Shootings and pulling in the back, between the shoulder-blades and in the muscles of the neck. Stitches and rheumatic pains in the back. Nocturnal tension in the back, on turning in bed.

WORSE, from dry cold winds; cool air; slightest draught; touch; lying on painful side. BETTER, in damp weather, from wrapping head up, from warmth, after eating.

Iodum: Tension in the neck. Swelling of the neck when speaking. Swelling of the glands of the neck, of the nape of the neck, and of the armpits. Spinal complaints, with gressus vaccinus. Rheumatic pain in the nape of the neck and upper arms. Rheumatic tension in the right side of the neck. Constriction of the neck. Throat very much constricted. Rheumatic pinching on the lower portion of the neck near the shoulder, aggravated by touch, apparently relieved by some eructations, though frequently repeated afterwards. Tearing on the right side of the neck. Severe pain under scapula of left side. Burning in the right scapula, Stitches in the scapulae, on lifting anything (after fourteen days). Yellowish spots on the neck and redness, as from ecchymosis.

WORSE, when quiet, in warm room, by touch, right side.

BETTER, walking about,by reuctations in open air.

Calcaria Carb: Hard swelling of the cervical glands. Painless swelling of the glands, of the size of a hazelnut, in the neck, on the margin of the hair. The neck feels stiff, on stooping. Effects of taking cold; stiffness in the neck, and cervical muscles; stitches in the neck and in the head, over the eyes, with cough . Pain in the neck, on turning the head, as if a tumor would protrude there. Itching sticking burning, in the neck, and between the shoulder-blades, with heartburn . Sudden pain in the neck, as if burnt, on twisting and turning the head. Tension in the neck, so that she could not turn the head. Sticking pain in the neck. Tearing in the muscles of the neck. Stitches in the nape of the neck, and shoulder-blades, with confusion of the head. Swelling in the glands on the left side of the neck, as large as a pigeon's egg, with sticking pain in the throat on swallowing. Tearing in the sides of the neck. Pain in the back. Intolerable pain in the back. The spine pains on bending backward. Painful stiffness in the spine, with indolence and heaviness in the legs, in the morning on waking, and after rising. Pressive pain in the middle of the back and beneath the shoulder-blades .

WORSE, from exertion, mental or physical; ascending; cold in every form; water, washing, moist air, wet weather; during full moon; standing.

BETTER, dry climate and weather; lying on painful side. Sneezing (pain in head and nape).

Belladonna: Swelling of the glands on the left side of the neck, at which spot he also frequently complains of a burning pain. Inflammation and swelling of the glands of the neck and of the back of the throat. Swelling and stiffness of the neck and nape of the neck, especially on the left side, with crampy pains at the least movement. Drawing pains and pressure at the nape of the neck. Pressive pain externally in the neck, when bearing the head backwards and when touching the part. In coughing, a violent pressing pain in the nape of the neck, as if it would break. Sharp pain between the last cervical and first dorsal vertebrae . Sensation as if the nape of the neck was struck with a hammer. Weakness of the spine, with heaviness of the head, and stooping walk.

WORSE, touch, jar, noise, draught, after noon, lying down.

BETTER, semi-erect.