Scoliosis in Adolescents

Normally, a spine when viewed from rear should appear straight but if the spine is lateral or curved or sideways or rotated then it is affected by scoliosis. It gives an appearance as if the person has leaned to a side. According to Scoliosis Research Society the definition of scoliosis is the curving of the spine at an angle greater than 10 degrees on an x-ray. Scoliosis is a kind of spinal deformity and shouldn’t be confused to poor posture. Usually there are 4 common kinds of patterns of curves experienced in Scoliosis which are: Thoracic wherein the right side has ninety percent curves, lumbar wherein left side has seventy percent curves, thoracolumbar wherein right side has eighty percent curves and double major where both right and left sides have curves.

In majority of the cases, as high as eight to eighty five percent, the cause of the deformity is unknown, this is also known as idiopathic scoliosis. It is observed that females have scoliosis more commonly than males. According to some established facts 3 to 5 children per 1000 has chances of developing spinal curves which is a number big enough requiring medical treatment. There are three types of scoliosis that can develop in children namely congenital, neuromuscular and idiopathic. Congenital scoliosis is seen in 1 out every 1,000 births which is caused due to vertebrae’s failure in normal formation, vertebrae is absent, vertebrae is formed partially and vertebrae is not separated. Neuromuscular scoliosis is linked with various neurological conditions and particularly in children who don’t walk like cerebral palsy, muscular dystrophy, spina bifida, tumors in spinal cord, paralytic conditions and neurofibromatosis. The cause of third type of scoliosis called Idiopathic scoliosis is still unknown. It is further divided into infantile, juvenile and adolescent scoliosis. Infantile scoliosis occurs up to the age of 3 years from birth wherein the vertebrae curve is towards left and is more frequently observed in boys. The curve takes normal shape with the growth of child. Juvenile scoliosis is common in children of age three to nine. Adolescent scoliosis is common in kids of age ten to eighteen and this is also the most common form of scoliosis occurring more in girls than boys.

The other possible causes of the deformity include hereditary reasons, different lengths of legs, injuries, infections and tumors. There are numerous symptoms attributed to scoliosis which can vary from individual to individual. The symptoms are: Difference in heights of the shoulders, off-centered head, difference in the height or position of the hip, difference in the position or height of shoulder blade, different arm lengths in straight standing position and lastly different height back sides when the body is bent forward. Other symptoms include leg pain, back pain and change in bladder and bowel habits do not belong to the symptoms of idiopathic scoliosis and require medical checkup by a doctor. The symptoms may be similar to other problems related to spinal cord or other deformities or could result from an infection or injury and consulting a doctor is the best bet in this situation who may conduct diagnosis to know what exactly it is.

The diagnosis of scoliosis requires thorough medical history of the teenager, diagnostic tests and also physical examination. The doctor asks for entire prenatal history, birth history and also would want to know if anyone in the family has scoliosis. The doctor may also ask for the milestones related with the development of the teenager since some kinds of scoliosis are known to be related to neuromuscular disorders. The delay in development may need additional medical evaluation. Doctor may also prescribe x-ray, CT scan and MRI scan of the back to measure the degree of curvature in the spinal. There are various treatments available for scoliosis which is decided by the physician depending on teenager’s age, medical history and health in general. The method of treatment also depends on the extent to which disease has reached. The tolerance of the teenager to certain medicines, therapies and procedures are also taken into consideration. Expectations and opinion of the parents or teenager is also the criteria in deciding the type of treatment. The main aim of the treatment is stop the curve from progressing and avert deformity. The treatments include observation and repetitive examinations, bracing and surgery to correct the defect.

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Asthma in Adolescents

Most of the teenagers who have asthma are also allergic to many things. The asthma can get severe even if the people with asthma are exposed to allergens of low grade. Allergies play an important role in asthma cased which are undiagnosed. Other factors that also trigger childhood asthma include upper respiratory infections like colds, second hand smoke, and certain climate conditions like cold air and due to emotional physical expressions like laughing, crying or yelling. However, it is not the end of the road for asthmatics as they can live active and healthy if they manage asthma properly by avoiding asthma triggers, regular intake of prescribed medications, being alert of the warnings and be aware of the ways to deal with an asthma attack.

There is a great consensus among the parents whether their children would outgrow asthma as they grow up. But the truth is it depends from child to child. While some children experience improvement in their teens others see asthma becoming even more severe. But almost half of the children who have asthma outgrow asthma as they grow although some symptoms may come back later.

Many parents have questions like whether their children can take part in sport activities. The answer is both yes and no. Some kids may get an asthma attack when they participate in exercises like running. But with proper management a teenager suffering from asthma can actively participate in sports. Special aerobic exercises can improve airway function. This strengthens the breathing muscles. Some of the ways that one can participate in sports is to follow the regimen of stretching the muscles prior to and after exercising, nose-breathe instead of breathing through the mouth and make sure that humidified air passes through the airways. Also parents should make sure that the adolescent has taken all prescribed medication supposed to be taken before they begin exercising. Carrying a reliever is a must for asthmatic teens which would come handy if asthma attack occurs. Asthmatic teenagers should make sure that they wear something over their mouth and nose to stop cold air from entering.

It is not easy for adolescent teens to attend school when they have asthma but it is not difficult also at the same time if proper coordination is made among the teenager, doctor, family and school employees. It is a good idea to consult teachers, nurses and other pertaining employees of the school and let them know that the teenager has asthma and may have special requirements. Also, let the school management know on medications the teenager regularly takes and how to help the teenager when an attack occurs. The school staff should be asked to treat the teen normally once the attack subsides. The physical education coach should also be informed about the condition so that he/she can let the kid stretch the muscles before any exercises or to deal with asthma attack induced due to exercises. Also, before admitting the teenager to a new school care must be taken to check the quality of air, irritants and allergens if any present in the school. The school staff should take considerations to avoid symptoms which could hamper the energy level kids. Also asthmatic teens should be assured from time to time that they are no different from others and asthma in any way does not slow them down, They need this emotional confidence otherwise they may have personality problems.

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High Blood Pressure in Adolescents

High blood pressure is a condition where the blood pressure is more than normal. It is also known as hypertension. Heart pumps out blood, so that oxygen can reach to different parts of the body via blood. The pressure with which heart pumps blood is known as blood pressure. The blood pressure comprises of two measures, the systolic pressure and diastolic pressure. Systolic pressure is the larger figure and represents the pressure within the artery of the heart, when contractions take place which pump blood to different parts of the body. Diastolic pressure is the pressure within the artery of the heart, when the blood is filling in the heart and it is at rest. Both the pressures are measured in millimeters of mercury or mmHg. High blood pressure is abnormal increase in systolic pressure or diastole pressure.

Blood pressure is measured by putting a blood pressure cuff on the arm and placing a stethoscope on the chest. There can be very little variation in blood pressure depending upon the time, emotional moods, age, gender, weight, height, physical activity, stress and other illness such as heart disease and kidney disease. Children and adolescents become anxious when they visit the doctor. This is also an important factor which affects the blood pressure and the readings taken get tampered because of it. That is the reason why many blood pressure readings are taken in order to determine whether the adolescent has high blood pressure or not. The nurse may even ask the adolescent to calm down while taken the readings. Time gap is given between each reading, so as to give time to the adolescent to calm down. Emotions can also affect the blood pressure reading.

An infant will have a normal blood pressure reading of 80/45, where as an adolescent will have a normal blood pressure reading of 110/70. Therefore, age, gender, and height are important factor when determining the normal blood pressure level. Adults will have a higher blood pressure than the infants and teenagers. Also, boys have a higher blood pressure when compared to girls and tall people have a higher blood pressure than short people. An adolescent is said to have high blood pressure when the blood pressure is more than the blood pressure of ninety percent people of his/her age, gender and height.

There are many risks associated with hypertension or high blood pressure. The risk of developing coronary heart disease increases proportionally. The arteries will develop greater resistance towards the blood flow, because of which the heart will pump blood harder. Stroke is also another risk. Adolescents who have had high blood pressure as a child, develop harmful effects on the blood vessels and heart till the time they turn twenty.

The causes of high blood pressure can be classified as primary and secondary. If the causes are definite, they are primary and if the cause is linked to some illness, it is secondary. Primary causes are high blood cholesterol levels, smoking, stagnant lifestyle and overweight. Secondary causes are obesity, immobility due to chronic illness, prescription drugs, intense pain due to burns or cancer and illegal drugs. High blood pressure can develop due to hereditary reasons.

Hypertension is diagnosed by blood test and urinalysis. The kidney function will also be checked, along with blood cholesterol levels. Family history check is another important factor. Adolescents’ eating habits, exercise levels, activities in school and home will also be studied thoroughly. High blood pressure is dealt with by weight reduction, healthy diet, and increase in physical activity. If hypertension is due to illness, the illness is treated first. These treatment measures will decrease the systolic blood pressure and diastolic blood pressure. It will also strengthen the heart and decrease the level of cholesterol in blood. This also helps to keep heart diseases at bay. The good thing is that only one percent of the adolescents, who have high blood pressure, need medication to bring back the blood pressure to normal.

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Sprains and Strains in Adolescents

Sprains and strains are among the majority of the injuries caused while playing sports. Sports injuries can be caused by small trauma which involves ligaments, muscles and tendons including bruises, sprains and strains. The body part which is most commonly involved in spraining or straining is the ankle. The 3 ligaments that are involved during ankle sprain or strain include anterior talofubular ligament, posterior talofibular ligament and calcaneofibular ligament.

An injury caused to the soft tissue as a result of a direct force like fall, kick and blow is called a contusion or a bruise. A sprain is nothing but a ligament injury which is wrenched or twisted. Sprains usually affect knees, wrists and ankles. On the other hand a strain is an injury caused to a tendon or muscle which usually results from force, stretching and overuse.

Sprains/Strains are usually diagnosed by a physician after a physical examination. The physician asks for thorough medical history of the adolescent and asks various questions that lead to the cause of the injury. Various diagnostic procedures are also available which also helps in evaluating the problem. X-ray is one of the oldest and common diagnostic tests done to know the extent and exact location of the injury. An x-ray uses electromagnetic waves to get photos of internal tissues, organs and bones onto a film. MRI scan is one of the recently evolved diagnostic procedures which also help in evaluating a physical injury. This procedure actually called Magnetic Resonance Imaging makes use of bug magnets, computer and radio frequencies to get detailed pictures of structures and organs inside the body. Another diagnostic procedure called Computed Tomography Scan or CT scan is also used to evaluate the extent and location of injury. This procedure uses a blend of computers and x-rays to get cross sectional pictures in horizontal and vertical alignment. It shows thorough pictures of any part of the body like muscles, bones, fat and organs. They provide more information than conventional x-rays.

There are various symptoms of strain and sprain depending on each teen’s physical condition and they may vary accordingly. One of the symptoms includes pain in and around the area injury. There could also be a swelling around the injured area. Some teens also experience difficulty when they use or move the area of the body that is injured. Some teenagers also undergo bruises or redness in the area that is injured. Many times the symptoms of sprains and strains may look similar to other medical conditions and a doctor’s advice is the best option in this scenario.

Depending on various factors the treatment of sprains and strains will be prescribed by the teenager’s physician that include teenager’s age, overall health of the teenager, and medical history of the adolescent. To what extent the teen is injured is also a factor in determining the nature of treatment. A teenager’s level of tolerance to certain medications, therapies and procedures is also taken into consideration before opting for a particular method of treatment. The treatment also depends of what expectations one has and also preference and opinion.

Various options available for treatment include things like restriction of the activity after the injury, application of cast/splint on the injured spot, crutches or wheelchair, physical therapy which involves stretching exercises to give strength to the muscles, tendons and ligaments that are injured and last but not the least is the surgery which is opted for in worst case scenario.

In the long-term scenario bruises, sprains and strains heal pretty quickly in kids and teenagers but it is important that the adolescent sticks to the restrictions imposed during the treatment and healing process like restriction of activity and regularly attending physical therapy sessions if any. It is noted that majority of the sports related injuries results either due to traumatic injury or excessive use of muscles and joints. But, they can be avoided and prevented with right training, by wearing right protective gears and by using right equipment for training.

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Tennis Elbow in Adolescents

Tennis elbow is a condition in which tendon fibers that attach on epicondyle on the elbow’s exterior degenerates. The tendons talked about here anchor the muscles that help wrist and hand to lift. Although tennis elbow occurs mostly in patients of thirty to fifty years of age but it can happen to people of any age. Also tennis elbow affects almost fifty percent of teenagers who are in racquet sports thus the name “tennis elbow”. But still most of the patients who suffer with tennis elbow are people who don’t play racquet sports. Majority if the times there isn’t any specific injury before the symptoms start showing up. Tennis elbow can also happen to people who use their forearm muscles frequently and vigorously for day to day work and recreational activities. Ironically some patients develop the condition without any of the activity related reasons that leads to the symptoms.

The symptoms of tennis elbow include severe burning pain on the elbow’s exterior region. In majority of the cases this starts as a slow and mild pain gradually worsening with the passage of few weeks or sometimes months. The pain worsens when one tries to lift objects. In some cases it may pain even while lifting light objects like a book or full coffee cup. In the severest cases it can pain even at the movement of the elbow.

The diagnosis of the tennis elbow involves physician enquiring about the medical history of the teenager and a physical examination of the elbow by pressing directly on the part where bone is prominent on the elbow’s exterior to check if it causes any pain. The physician may also ask the teenager to lift the fingers or wrist and apply pressure to check if it causes any pain again. X-rays are never opted for diagnosis. However a MRI scan may be done to see changes in tendons at the attachment to the bone.

There are many treatment options available and in majority of the cases non-surgical treatment is given a try. The ultimate goal of the 1st phase of the treatment is pain relief. Be ready to hear from the physician to stop any activity leading to the symptoms. The doctor may also tell the teenager to apply ice to elbow’s exterior and he/she may also tell the teenager to take anti-inflammatory medicines for relief from pain.

The symptoms also diminished with the help of orthotics. The physician may also want to go for counterforce braces and also wrist splints which can greatly cut down symptoms by providing rest to tendons and muscles. The symptoms should show signs of recovery within 4 to 6 weeks otherwise next option would be to go for a injection called corticosteroid in the vicinity of the elbow. This greatly reduces pain and is also very safe to use. There are many side affects involved if it is overused.
Once there is a relief from pain the treatment’s next phase starts which involve modification of activities in order to prevent the symptoms from returning. The doctor may also prescribe the teenager to go for physical therapy which may include stretching exercises to gradually increase the strength of the affected tendons and muscles. Physical therapies have high success rates and return your elbow back to normal working again. Again non-surgical procedures are highly successful in eighty five to ninety percent patients.

Surgical procedure is considered only when patients undergo relentless pain that doesn’t improve even after 6 months of non-surgical treatment. The procedure involves removal of affected tendon tissue and attaching it back to bone. The surgery is done on outpatient basis and does not need stay at the hospital. The surgery is done by making a small incision on elbow’s exterior’s bony prominence. In recent years a surgery known as arthroscopic surgery has also been developed but no major benefits have been seen using it over the traditional method of open incision.

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