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Joint Contracture


Some people may have chronic loss of joint motion due to structural changes in non-bony tissues like muscles, tendons and ligaments. Joint contractures can occur at any joint in the body and may be a result of some trauma or injury, disease, or nerve injury leading to joint dysfunction. Muscle imbalance, prolonged bed rest, pain, fracture and surgery may also be causes for joint contractures. The patients have limited movement of the joints. Symptoms are significant loss of motion to any joint which may result in immobility and pain can result even if there is no voluntary joint movement.

If muscle contractures are suspected, a doctor or a physiotherapist can identify the indications. An instrument called a goniometer is used to test the condition. Thorough physical examination with an x ray can diagnose the problem. Once the presence of a joint contracture is confirmed, steps can be taken to improve the condition. Since the soft tissues are affected, stretching them is a common technique used to increase the joint elasticity. Some doctors may prefer to use some form of heat before attempting to stretch and mobilize the affected joint. Proper and sufficient exercise is advised to improve the condition further.

There are a few machines, which can be used to achieve proper and good results. These are all tested for individuals and their personal problems. Continuous passive motion machines (CPM) are used to mechanically move the joints and they have been proved that they can accelerate the return motion process, allowing the patients more function in less time. Using casts and sprints also help in providing a constant stretch to the soft tissues surrounding the joint. These are effective in treating contractures resulting from a nerve injury; such casts can be kept in place for a continuous period of seven to ten days. If these physical and conservative methods do not improve the situation, surgery or manipulation of the joint under general anesthesia may produce a desired result.

Alternative treatment in the form of massages or yoga can be beneficial by promoting additional circulation to joint structures causing better elasticity. These methods can facilitate the return of joint mobility. However, treatment of joint contracture should be started as early as possible once the problem has been identified. Earlier the treatment better will be the result. Contractures and the resulting deformities can be prevented or minimized through a program of positioning, splinting and exercises either manually or mechanically. Especially if they are a result of spinal cord injury, or fractures.

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