Total Hip Replacement is also known as Total Hip Arthroplasty, in which the damaged cartilage and bones in the hip area are removed and replaced with prosthetic components. On the other hand, Total Knee Replacement, also known as Total Knee Arthroplasty or resurfacing, involves replacing the bone surface of the knee area. 

Causes of Hip and Knee Pain 

Arthritis is the most common cause of chronic hip and knee pain or disability. Other causes include: 

  Avascular necrosis or Osteonecrosis is a condition where there is an inadequate supply of blood to the femoral head due to a hip injury. The inadequate supply of blood may cause the bone surface to collapse and this can result in arthritis. 

  Rheumatoid Arthritis is the most common inflammatory Arthritis. In this condition, the synovial membrane surrounding the joint begins to thicken and become inflamed. This results in cartilage loss, stiffness, and pain. 

  Osteoarthritis is the type of arthritis, usually related to old age but can occur among young people too. The cartilage cushioning the hip and knee bones becomes soft and gradually wears off. The bones eventually start rubbing against each other which causes stiffness and pain in the knee and hip area. 

  Post-Traumatic Arthritis can follow a severe hip and knee fracture or injury. 

  Some children with hip disease or problem, even after treatment, can develop into arthritis later. This may be caused by uneven or unusual growth of hip which affects the joint surfaces. 

Knee Replacement Procedure 

  Bone Preparation: The surface of impaired cartilage at the end of the tibia and femur are separated besides a small extent of the underlying bone. 

  Locating the Metal Implants: The removed bone and cartilage are substituted by metal implants creating the joint surface. These metal pieces may either be press-fit or cemented into the bone. 

  Resurfacing the Patella: The undersurface of the kneecap or Patella is cropped and reformed with a plastic button. This process is variable depending upon the condition. 

  Inserting a Spacer: To form a smooth gliding surface, a plastic spacer of medical-grade is positioned between the metal components. 

Hip Replacement Procedure 

  Metal stem replaces the damaged femoral head and positioned into the femur s hollow center. 

  On the upper portion of the stem, a ceramic or metal ball is planted. This ball acts as a substitute for the damaged/detached femoral head. 

  The damaged Acetabulum or cartilage surface of the socket is discarded and supplanted by a metal socket. Cement or screws are used to sustain the socket in place. 

  A spacer, either metallic, plastic or ceramic is placed between the socket and the new ball for a smooth gliding surface. 

Take Away 

Knee and Hip Replacement are taken as the last option for the patient. The surgery and its outcome vary depending upon various factors. One should consult the doctor before undergoing for the Hip and Knee Replacement Surgery.

Primary Knee & Hip Replacement - Know More About Them!

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Rheumatoid arthritis (RA) is an auto-immune disorder which induces inflammation in the joints. What causes the condition is not exactly clear, but a lot of studies have been done to establish a connection between various factors such as, diet, exercise, etc., with this condition. These studies have come up with correlation between foods and rheumatoid arthritis. There are some foods which should be a part of your diet, and some that should definitely be avoided if you have to keep the joint inflammation under control. Read on to know the top 5 foods to eat and to avoid.

What to eat?

Soy: Being rich in protein and fiber and low in fat, soy is a great food for RA. It also contains omega-3 fatty acids and vegetarians especially should ensure they get enough soy in their diet.
Fish: Salmon and tuna are fish that are rich in omega-3 fatty acids and these are proven to be natural anti-inflammatory agents. Therefore, it is highly recommended that people with RA eat fish about 3 to 4 times per week.
Oils: While an oily diet is definitely to be avoided, some healthy oils should be included. These include sunflower oil, walnut oil, olive oil, and avocado oil. These are known for their anti-inflammatory properties and are beneficial in people with RA.
Green tea: Known for their polyphenols and antioxidants, green tea reduces damage caused by inflammation in RA. People with RA are recommended to have at least 2 servings of green tea daily.
Beans and legumes: The high content of fiber, protein, folic acid, zinc, iron, potassium, and other minerals makes beans a must-have for RA patients. The red and kidney variety of beans are the preferred ones.
What to avoid?

Grilled foods: Grilled chicken or red meat have high levels of advanced glycation end products (AGEs) which are known to worsen inflammation. So, while they are good for weight watchers, not so if you have RA. These also contain higher levels of saturated fat, which is again not advisable for RA.
Fried foods: These contain 6-omega fatty acids, which have been proven to worsen inflammation. They are also high in saturated fats, which is a strict no-no for inflammation.
MSG: Monosodium glutamate which is used generously in various Oriental dishes including soups, salad dressings, etc. should be avoided as it affects liver health and worsens inflammation.
Salt: Reduce overall salt intake. Limiting the intake of pickles, salad dressings and processed foods, etc., which contain high amounts of sodium.
Alcohol: This again increases inflammation and should be avoided in RA.
A healthy lifestyle improves not just the overall quality of life, but also reduces the severity of symptoms of RA.

Rheumatoid Arthritis - What To Eat & What To Avoid?

Are you suffering from arthritis and looking for effective treatment options? Arthritis is a chronic, systematic inflammatory disease that causes damage to your joints and connective tissues. The knee is primarily affected by this condition and there are three main forms of arthritis which occur in your knees. There are several treatment options and procedures for treating arthritis. They are as follows:

Several medications are used for arthritis treatment. They are:

Analgesics: These medicines help in pain reduction but do not heal inflammation.
NSAIDS: NSAIDS or non-steroidal anti-inflammatory drugs are used for reducing inflammation and pain as a result of arthritis.
Counter-irritants: These include creams and ointments containing capsaicin or menthol. Applying these creams on the skin helps with pain relief.
DMARDS: Disease-modifying antirheumatic drugs are used in case of rheumatoid arthritis. These help in slowing down your immune system from targeting your joints.
Corticosteroids: This form of medicine includes cortisone and prednisone and helps in reducing inflammation and suppressing your immune system. These can be injected into your joint or taken orally.
Therapy
Physical therapy is beneficial for certain types of arthritis. Exercising helps in improving your range of motion, and the strength of your muscles which surrounds the affected joint. Splints and braces are prescribed in some cases.

Surgery
When all other treatment measures fail, a surgery may be required to be carried out.

Joint repair: In some cases, the surface of your joints can be realigned and smoothened in order to improve function and eliminate pain. These surgeries are arthroscopically performed via incisions made on the joint.
Joint replacement: During this surgery, your damaged joint gets removed and replaced with an artificial joint. The hip and knee joints are commonly replaced surgically.
Joint fusion: This surgical procedure is used in case of smaller joints of your body. The ends of the two bones in your joint are removed and the removed ends are locked together till they heal into one unit.
Alternative treatment options
You can also opt for certain alternative remedies for arthritis. Some of them are as follows:

Acupuncture: In this therapy, fine needles are inserted at certain points on your skin for reducing arthritis pain.
Yoga and tai chi: The movements associated with yoga and tai chi are slow and stretching in nature. These help in improving joint flexibility. Your range of motion gets improved as well.
Light massages which involve stroking and kneading of your muscles help in increasing blood flow. This warms up the affected joints, providing temporary relief from arthritis pain.

Arthritis - How to Treat It Effectively?

The human body is so amazing yet sometimes, it is delicate. The condition of cervical spondylitis is one of the examples of this being the case. It is also known as cervical disc disease and is reputed to cause a pretty large amount of pain! That being said, it is not as if this pain cannot be reduced. After all, physiotherapy can make almost any situation better and this is pretty much the case with cervical spondylitis, as well!


Neck traction happens to be one of the popular methods prescribed by physiotherapy to help people who are suffering from cervical spondylitis pain. What is done in this process is that the neck is extended but at a very slow rate. While this may not seem like much itself, why this helps is that it goes a pretty long way in taking a lot of pressure off the discs of the spine. While it is true that neck traction is a thing which can be performed at home, it is very important to check with a professional physiotherapist to make sure that the technique that one is practicing is faultless so as to make sure that any painful accidents are not allowed to take place and make the situation worse than it already is!


Physiotherapy is all about engaging in activities which help make the condition better. So, when a person has cervical spondylitis pain, the therapist will spend some time with him or her so that the neck can be slowly adjusted and this will help the range of motion of the person s neck improve by quite a large margin.


There are quite a few other ways to go about relieving the pain caused by cervical spondylitis by making use of physiotherapy. For example, deep tissue massage does have a large number of fans who swear by it. This is also the case when it comes to electrical stimulation. As a matter of fact, both of these are quite popular as a means to get the patient in the right condition for healing exercises to have their full effect.


After all the effort which is put in by the person by the way of exercise, it can be said to be important that he or she makes use of a cervical pillow, which is more commonly known as a neck pillow and a cervical collar, which can help the process of realignment. With correct physiotherapy, cervical spondylitis pain will soon be history!


How Can Physiotherapy Help Alleviate Cervical Spondylitis Pain?

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