Arthritis is a disease usually associated with elderly people, but it can also affect children. When arthritis affects children, it is known as juvenile rheumatoid arthritis. This disorder affects the musculoskeletal structure of a child and can cause pain, stiffness and swelling in the muscles, joints, ligaments and bones. In some cases, it can also affect the internal organs. With medication and therapy, the symptoms of this disorder can be managed and the quality of the child s life can be improved.

Hence, it is important to recognise the signs and symptoms of this disease. Some of the symptoms to look out for are:

Pain: Complaints of pain in the joints or muscles on waking up from bed can be a sign of juvenile arthritis. This may affect a child s jaw, neck, hands, knees and feet. For most children, moving around helps relieve some of the pain. Unlike the pain triggered by an injury, this kind of pain develops slowly and affects both symmetrical joints.

Joint stiffness: Children affected by this disorder may complain of stiff joints which hamper normal movement and activities. As with pain, this stiffness is usually worst in the morning and improves with movement.

Swelling: Redness and inflammation of painful joints is another symptom of this disorder. The joint may also feel warm to touch. This swelling may come and go or persist for several days. The joints of the hands, feet and knees are most susceptible to swelling.

 Fever: Frequent fever accompanied by fatigue can indicate juvenile arthritis. These fevers usually come on suddenly and are relieved after a short time. Also, they do not exhibit any signs of respiratory or stomach infections.

Rashes: Rashes that are symptomatic of this disorder appear commonly over the knuckles, nose bridge or on the trunk, arms and legs. This often takes the form of a faint, pink rash that persists for weeks but unlike other rashes, it does not itch or ooze.

Weight loss: Drastic weight loss and an unexplained loss of appetite can also signal this disorder. In such cases, the child may also appear fatigued and showcase symptoms of associated malnutrition disorders.

 Eye problems: Persistent troubles with eyesight such as pain, blurred vision and redness of the eye can be a sign of juvenile arthritis. In some cases, this disorder also causes the iris and uveitis as well as the middle layer of the eye to appear inflamed. If you wish to discuss about any specific problem, you can consult a rheumatologist.

Juvenile Rheumatoid Arthritis - 7 Signs Your Child Is Suffering from It!

Are you suffering from rheumatoid arthritis and looking for an effective treatment? You can choose homeopathic treatment as it is natural and is free from any side effect. Rheumatoid arthritis is a form of autoimmune disease, which causes inflammation of the joints. The inflammation can be chronic and does not subside on its own. It leads to destruction of your joint tissues. Here are some top homeopathic medicines, which are used for treating rheumatoid arthritis:

Causticum: This is one of the primary homeopathic medicines used to treat rheumatoid arthritis when there are joint deformities. The patient weakens over time and the muscles lose strength eventually. The patient feels extremely restless during the night and the restlessness is associated mostly with the legs. Contractions in the tendons likely result in deformities and intense pain. The pain is tearing in nature. Due to weakness of the forearm muscles, the patient may not have a firm grip on anything. The pain usually improves by keeping the affected the area warm.
Caulophyllum: This is an effective medicine for rheumatoid arthritis and is commonly used for women. It is used when small joints are affected more, compared to the larger joints in the limbs. This medicine is mostly used to treat arthritis of fingers of your hands and feet. The pain keeps on changing positions all the time within a small span of time. At one moment, you may feel it on your right hand, and soon after it may affect your left hand. Gradually, it shifts towards the feet as well.
Colchicum: This homeopathic medicine is usually required during chronic stages of rheumatoid arthritis. It affects several tissues such as periosteum, synovial membranes and other muscle tissues. The inflamed parts turn red, become hot and swollen. The pain is expected to worsen during the evening and night. The fingertips may feel numb and you may feel some joint stiffness as well. A feverish feeling is also likely.
Ledum Pal: This medicine is used in the cases of rheumatoid arthritis where the rheumatoid starts in the feet and travels upwards spreading to the upper joints of the body. The patient feels cold, but still cannot bear any amount of warmth. The small joints present in the feet are commonly affected. Swelling in the toes and ankles is a common symptom.
Bryonia: This is an excellent homeopathic medicine for rheumatoid arthritis. It is used when all the joints and joint membranes are swollen and affected. The pain experienced is unbearable and increases with motion. The inflamed joints become red and swollen.
To know the best homeopathic remedy which is ideal for treating your rheumatoid arthritis, you should visit a homeopathic doctor.

Rheumatoid Arthritis - 5 Homeopathic Remedies For It!

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

Causes and symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease, which is characterized by the inflammation of the joint lining and gives rise to pain, stiffness, warmth and redness in the joints. The inflammation occurs in the tissue that normally produces lubricating fluids for the joint. This condition is progressive in nature, and can cause the destruction of joints, leading to functional and locomotive disability.

Though rheumatoid arthritis is a disease that can last for years, patients may not experience any symptoms for a long time. In some cases, the disease may affect other parts of the body like the eyes, lungs, and the heart.

The severity and duration of the symptoms are unpredictable, and the symptoms experienced are:

- At times, people experience increased disease conditions called flare-ups.

- They may also experience alternating periods when the symptoms fade or diminish, which is referred to as remission.

- Some of the common symptoms of the disease include lasting pain and stiffness for more than an hour in the morning, inflammation, fatigue, fever, and a general sense of discomfort.

- Inflammation in the joints close to the hands like wrists and fingers and other parts like neck, shoulders, elbows, knees and hips can also be affected.

- In some cases, both sides of the body are affected at the same time, which is known as inflammation in a symmetric pattern.

Rheumatoid arthritis is usually caused by the body's weakened immune system, which produces antigens to attack itself. The trigger to this reaction is not yet clearly deciphered.

It is diagnosed by clinical examination (American association of Rheumatology criterion) supported by relevant Investigations.

Management

Management for Arthritis includes the following aspects:

1) To control disease activity and control of symptoms of pain, stiffness.

2) Medical treatment to prevent system effects of the disease.

3) Nonmedical treatments comprise of dietary therapy, physiotherapy, immunomodulation therapy.

4) Minimal surgical therapy like arthroscopic synovectomy to confirm the diagnosis as well as reduce disease activity. At times, with the advanced decline of joints, a major surgery like replacement therapy may be required for specific cases.

What's more important is to know that at any stage of the disease patient can adopt and live an active life with appropriate treatment.



What Really Causes Rheumatoid Arthritis?

A Simple Guide to Arthritis

One of the most common ailments the elderly suffer from is arthritis. However, arthritis can affect people of all ages. It is a rheumatic disease as in, it affects joints and bones. It can be of many types and the term covers a number of inflammatory and non-inflammatory joint diseases. Some of the most well-known types of arthritis are rheumatoid arthritis, bone spurs, gout, and osteoarthritis.

The causes of arthritis have not been defined but there are a number of factors that increase a person's chances of getting it. Foremost amongst these is increasing age and excess weight. Arthritic conditions such as rheumatoid arthritis, ankylosing spondylitis, and lupus are said to be hereditary and linked to certain genes. Sometimes, injuries can also cause arthritic conditions. Misuse of steroids can also result in arthritis.

Here is a look at the most common symptoms of the disease :-

Pain around the joints is the most well-known symptom of arthritis. Along with pain, you may also notice swollen or stiff joints.
Increased body temperature around the affected joints and redness in the area is also a symptom of arthritis. These symptoms range from mild to severe, and can be constant or may come and go.
Everybody suffers from occasional joint pains but if any of the above symptoms persist for a long duration, it is best to consult a doctor. The sooner you seek treatment, the easier it becomes to deal with arthritis. If left untreated for too long, arthritis can result in permanent joint damage.

While there is no single cure for arthritis, it can be effectively controlled if treated in time. Since the type and severity of arthritis differ from person to person, treatment for the same must also be tailored to the needs of the individual.

Drugs for arthritis can be categorized as those that treat symptoms such as pain and stiffness, and those that suppress inflammatory conditions.

In some cases, surgery may be advisable. 

Physical therapy and regular exercise are very important when dealing with arthritis.

It is equally important to eat a healthy, nutritious and well-balanced diet. If you are overweight, try and lose the excess kilos.

You must also look after your joints to ensure that there is no further degradation of bone or muscle tissue. Avoid staying in one position for a long time, and try and maintain a good posture. These simple techniques can be very effective when dealing with all types of arthritis.

A Simple Guide to Arthritis

A spinal cord injury is a damage to the spinal cord. It s an extremely serious type of physical trauma that s likely to have a lasting and significant impact on most aspects of daily life.

The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.

If the spinal cord sustains an injury, some or all of these impulses may not be able to  get through . The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

Causes-

A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:

a violent attack such as a stabbing or a gunshot
diving into water that s too shallow and hitting the bottom
trauma during a car accident (specifically, trauma to the face, head and neck region, back, or chest area)
falling from a significant height
head or spinal injuries during sporting events
electrical accidents
severe twisting of the middle portion of the torso
Symptoms-

Some symptoms of a spinal cord injury include:

problems walking
loss of control of the bladder or bowels
inability to move the arms or legs
feelings of spreading numbness or tingling in the extremities
unconsciousness
headache
pain, pressure, stiffness in the back or neck area
signs of shock
unnatural positioning of the head
If you suspect that someone has a back or neck injury:

Don t move the injured person   permanent paralysis and other serious complications may result
Call 911 or your local emergency medical assistance number
Keep the person still
Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck
Prevention-

Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.

 Some risk-reducing measures include:

always wearing a seatbelt while in a car
wearing proper protective gear while playing sports
never diving into water unless you ve examined it first to make sure it s deep enough and free of rocks

Spinal Cord Injury - Signs, Causes & Prevention

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