Pectus carinatum affects roughly one in every 1,500 children. Generally referred to as ‘pigeon chest,’ it is a non-life-threatening condition. There are two types of pectus carinatum. One type is called chondrogladiolar prominence. It is a deformity of the breast bone in which the middle and the lower sections of the breastbone push forward, giving the appearance of a pigeon. The majority of the children get affected by this more common type.
The second type, called chondromanubrial prominence, is more complex to treat and not so common in children. Pigeon chest occurs more in boys than girls. Most often, it develops during childhood and becomes evident as the child goes through puberty. Generally, pectus carinatum develops in children aged between 11 and 16, undergoing a growth spurt.
Newborns can also exhibit the condition in the form of a rounded chest wall. Vitamin D deficiency in children can also lead to pectus carinatum. At times, pectus carinatum can occur in children following open-heart surgery. Even those with less-controlled bronchial asthma are prone to developing pigeon chests. Pectus carinatum can develop due to genetic predisposition in certain people. However, not all cases are due to genetics.
Often, the only symptom is the pushing outward of the breastbone. Children with the condition develop a normal heart and lungs. However, when they create a barrel-like chest, the normal movement of the chest wall is changed. Some experience breathlessness on exertion. They may experience shortness of breath, especially during exercise, have a fast heartbeat, feel tired, or have chest pain. Some may develop asthma or get a lot of respiratory infections.
In some children, the chest wall may bulge on one side and appears concave on the other side. This condition is pectus excavatum. The position of the heart remains unaffected, though.
If the case is mild, treatment is not required. Through a series of tests, doctors can determine the severity of the condition. An X-ray of the chest will check for scoliosis or any other abnormalities of the bones. Scoliosis is a condition in which there is an abnormal curvature of the spine. A CT scan of the chest is done to check if surgery is required. An electrocardiogram (ECG) and echocardiogram (echo) are performed when a child’s heartbeat is irregular. A blood test can check for risk for Marfan syndrome and Noonan syndrome. None of the tests involve pain. So the child can undergo the examinations without fear.
If the severity of the condition is mild for a child, then surgery is ruled out. Wearing a brace is an effective corrective option as a child is malleable and can be re-shaped. Made of light-weight aluminum, the brace could be adjusted according to the measurement and shape of the protrusion. The brace would apply pressure on the child’s protruding breastbone and cartilage and slowly reshape the chest wall.
The child has to wear the brace at home, sleep at night, and be removed while bathing. The process of correction will take about a year. This is possible only if the child wears the brace consistently. There would be no pain, and the child could go about his routine of going to school. They can wear loose clothes if the child is conscious about his friends or strangers noticing the brace. Usually, there are no problems in wearing a brace except that the skin can get a little red and sensitive. It will turn normal after some time. Along with wearing a brace, the child can practice breathing exercises to improve the condition of the lungs.
In severe cases where surgery is required, wearing a brace could be the first step. At times, the brace can improve the appearance of the chest bone, and surgery may not be required. If the brace is not adequate, then surgery is done. Surgery will involve giving general anesthesia to the child. There will be postoperative pain. A visible scar will also be present. There are two types of procedures. One is the Ravitch technique, and the other is the Reverse Nuss procedure. Under the former procedure, an incision is made across the chest, and the defective cartilage is removed. The breastbone is then fixed in the normal position.
The doctors also pay attention to the child’s mental health. When the shape of the body changes due to pectus carinatum, it will lead to body-image issues. Counseling sessions will help the child to cope with the condition. Mental health must not be ignored at the cost of treating the physical body. Parents of the child can also attend sessions to help the child improve self-esteem and reduce self-consciousness. Often, it is an important reason to seek treatment at the earliest.
If you know a child with pectus carinatum, book an appointment to meet our specialists at Align Clinic. Every patient is provided with individual care, and our staff offers the best possible treatment.
A human spine has natural curves. When the spine develops abnormal curves to the left or right of the center of the spine, it is called scoliosis. It is a painful medical condition that even changes the way a person walks. Scoliosis is generally diagnosed in children and adolescents. However, it can occur in adults, too. When scoliosis begins to form after complete skeletal growth, it is called adult scoliosis.
There are four main types of adult scoliosis:
SymptomsScoliosis developing in adulthood is possibly due to people living longer and leading physically active lives. Just as a machine wears out after years of constant use, the human body undergoes wear and tear with age and regular movement. The spine bears the brunt of it as it supports the weight of the human body. Back pain is usually the first sign of scoliosis in adults that indicates wear out. Besides back pain, other symptoms of scoliosis include a tingling sensation, uneven shoulders, and stooping as the spine degenerates.
When the spine gets narrow, the pain increases when walking or even standing. Nerves surrounding the spine can get compressed and lead to sciatica with pain, numbness, or weakness in the leg.
DiagnosisGenerally, doctors will question the patient about the family’s medical history. Then, a physical examination of the back is done to check the shape of the spine. With the help of a few tools, the reflex, sensation, and muscle strength are checked. Doctors run through specific tests to determine the severity of the person’s condition. An X-ray will gauge the degree of the spine’s curve from the center. It could range from 10 to 100.
If the curve were less than 40 degrees, then simple treatments such as medicines and exercises would be sufficient to prevent further damage to the spine. If the curvature is higher than 50 degrees accompanied with pain, then surgery is considered. However, there is an element of risk attached to spinal surgeries. Therefore, it is essential to find the right hospital to get the surgery done. This is to eliminate further damage to the spine.
After the surgery, the rehabilitation process starts. The patient must undergo therapy sessions to build strength to the spine, improve flexibility and fitness.
TreatmentIf the individual does not feel any pain or discomfort, then treatment is not required. Painkillers can be taken to reduce pain. Exercises can help maintain weight and reduce pain. Otherwise, chiropractic treatment and even acupuncture can be explored to reduce and possibly avoid the need for surgery. Injections are another option. However, they offer only a short-term solution to the pain. A brace can also be used when the individual is not healthy enough for surgery. In some cases, it may weaken the muscles that support the back.
Surgery is recommended for spinal curves that have increased to more than 50 degrees and whose routine has changed due to limited mobility or those who cannot stand up straight. The most common type of surgery is a spinal fusion using artificial implants inserted from the back. Screws are placed on the vertebrae and welded with bone chips.
The patient must avoid bending and lifting heavy things for the first month after surgery is performed. Then, with proper exercise, they may return to everyday life and work.
Risks Associated with SurgerySurgeries involving the spine involve a lot of risks. Patients take a long time to recover from surgery. The surgery could fail if the pain in one area shifts to another rather than getting eliminated. Also, an infection could develop or perhaps a blood clot. In rare cases, the patient can even develop paralysis. However, if a team of specialists works together using the latest tools and techniques, then the rate of success is high.
At Align Clinic, we use the latest technology and take a holistic approach to treat adult scoliosis. If you experience back pain, then book an appointment with us for a check-up.
Orthotics are special shoes or heel inserts designed to address foot, leg, or back problems. They help to reduce several foot problems such as flat feet and foot pain. They offer support, absorb shock and provide a cushion-like effect. Orthotics minimize minor pain and prevent severe complications from foot problems, especially for those with diabetes.
Diabetes is a complicated disease that can cause potential damage to the individual’s foot is careless to cause injury or damage to the foot. The foot experiences trauma through frequent contact with the ground. So it requires particular attention. Therefore, it is imperative for the patient to understand proper foot care and how orthotics can help manage diabetes. With the increasing number of people diagnosed with diabetes, the demand for orthotics has grown multi-fold.
Heel inserts are used to reduce foot pain, heel pain, and other minor foot issues. One can buy them over the counter or customize them as per the needs of the patient. Over-the-counter inserts include arch supports inserted into the shoes to help correct overarched or flat feet. Gel insoles provide comfort and relief from foot and heel pain by reducing pressure.
Orthotics are made to order to address more severe foot issues such as plantar fasciitis. If a diabetic patient develops painful calluses or severe foot ulcers, the footwear can be made to mold the foot, thereby providing full support and comfort.
Choosing the Right Orthotics
It is always recommended to consult a podiatrist before using orthotics. Wearing the wrong footwear will only worsen the existing condition. A professional will assess the medical issue and help the patient in choosing the proper footwear. This will enable in reducing the heel pain or any other problem which has to be addressed.
Well-designed footwear is crucial for persons with diabetes, even at the early stage of the disease. There are two ways in which a diabetic individual can be affected when injured in the foot. One is diabetic neuropathy which is a condition when there is a loss of sensation in the foot. It involves nerves, and the individual cannot feel pain when injured.
A foot ulcer due to diabetes will never heal completely. A significant health risk for diabetics is the development of foot ulcers, and the forefoot is the most commonly affected. In such a case, orthotics will reduce the pressure and stress on the foot that may prevent injuries, and eventually avoid foot ulcers.
The other way is when the vascular system gets affected. The lining of blood vessels tends to thicken for a person with diabetes. This means that the blood flow will reduce. If the blood flow to the foot reduces drastically, then the skin and the tissue get affected. These tissues take a long time to heal for a person with diabetes as their immunity gets compromised. If left unchecked, the feet, especially the toes, turn dark and risk developing gangrene and even lead to amputation. However, the extent of the damage reduces by using the appropriate orthotics. Prevention is better than finding a cure. This is where orthotics play a crucial role in preventing foot ulcers and thereby more damage.
Proper Foot Care is Essential
Besides wearing proper footwear, people with diabetes will have to be extra careful about their feet. Even if there are no signs of damage, it is still essential to take precautions against any possible injury or damage to the foot. Avoid walking barefoot even at home. Also, avoid footwear with high heels or shoes with pointed toes. Every day, one must wash the feet and dry them well, paying attention to the areas between the toes. Apply a good moisturizer and wear good-fitting shoes that prevent injury to the foot. Trim the toenails. If the patient is unable to do so by themselves, get a professional to do it.
Conduct a self-check of the feet to ensure they are healthy. If you notice any discoloration, swelling, blisters, or experience numbness, do consult your family doctor or a podiatrist immediately. If the foot has any deformities, it will increase foot pressure. Insoles can help offload such pressure.
Replace the footwear if it is worn out slightly. There must not be any sharp edges that could hurt the feet. Wear diabetic-safe socks that do not have seams that can apply pressure and result in blisters. If possible, it is better to own two or more pairs. Even if one pair gets damaged for whatever reason, the other pair is ready for use. When buying new footwear, take it to the podiatrist to check if it is safe to wear.
If you have diabetes and want to know about orthotics, make an appointment to visit your podiatrist soon.
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