Fibromyalgia is a disorder that causes widespread body pain along with sleep deficits, memory loss, mood problems and fatigue. Symptoms may be triggered after a surgery, physical trauma, infection, or stress. Women are much more vulnerable to this disease than men. Many people affected with fibromyalgia may have suffered from headaches, backaches, depression, anxiety, tension, temporomandibular joint 
disorders and irritable bowel syndrome. Most of these patients have undergone multiple consultation with various doctors and undergone many tests, but no diagnosis could be made. These patients are often ignored by doctors and family members as always "complaining of pain".

Symptoms of Fibromyalgia:
1.Extensive Pain- Pain related to fibromyalgia is often depicted as a dull pain that lasts for at least three months. Pain can involve any body part like back,neck, chest, arms, legs. Patients have pain in multiple areas of body and painful areas change over time.

2.Fatigue- Patients afflicted with this disorder feel tired even after sleep. Such people are reported to sleep for longer hours than normal people, but their sleep often gets disrupted due to sleep apnoea and restless leg syndrome.

3.Cognitive Difficulties- These patients find it difficult to concentrate at work and also suffer from memory deficits in daily activities.

4.Other Symptoms: These patients may also have symptoms like burning urination, urgency of urination, numbness,loss of appetite, tingling sensation,diarrhoea, constipation, tinnitus, depression etc

Diagnosis of fibromyalgia:
There are no specific test to diagnose fibromyalgia. Diagnosis is made by a doctor specialised in Pain Medicine using clinical methods based on symptoms and examination. Blood tests like Haemogram, Thyroid function test, RA Factor, ESR are done to rule out other diseases which can cause similar symptoms. 

Treatment of Fibromyalgia
1.First step in treating these patients is to accept their problem and discuss with patient and family members regarding the presence of such disease entity.

2.Lifestyle changes like active involvement in cardiovascular exercises, swimming, yoga, meditation are important to control symptoms.

3.Conventional painkillers do not work in these patients. They requires special medications prescribed by a Pain Specialist for control of symptoms.

4. Counselling of patient is beneficial for associated depression.

Are You Suffering From Body Pains ? It Could Be Fibromyalgia!!

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

Insomnia is the condition of acute sleeplessness, and it takes a heavy toll on your mood, your energy levels, and your ability to concentrate and work during the day. Some of the most common symptoms of the condition are:

You find it difficult to fall asleep even if you are tired
Once you wake up in the middle of the night, you cannot get back to sleep
You cannot work or concentrate on anything during the day
You stay mostly fatigued, or irritated throughout the day
You have to depend on pills or alcohol to fall asleep.
You wake up very early in the morning, no matter how late you sleep

What could be the causes for insomnia?

Insomnia might last just a few days if it is induced by some temporary cause, like stress at your workplace, or any other personal issue you can be facing. However, when the cause is a long rooted one, insomnia might persist for a long time. There can be a mix of many causes for that to happen:

Psychological stress or other emotional discomforts

Common psychological problems like anxiety, depression, chronic work stress, grief, and also bipolar disorder can be the causes for insomnia.

Illness or other medical problems

There can be many medical causes or other illnesses at the root of insomnia like allergies, acute asthma, hyperthyroidism, Parkinson's disease, kidney related diseases and cancer as well.

Medications

There can be many drugs, which might be prescribed by your doctor, but still be responsible for insomnia. These include antidepressants, corticosteroids like thyroid hormone medicines, few blood pressure medications, certain contraceptives and stimulants for ADHD (Attention Deficit Hyperactivity Disorder).

Sleep Disorders

Insomnia, though in itself is a sleep disorder, can also be the symptoms for other sleep disorders like sleep apnea, restless leg syndrome, and other disorders related to jet lag or if you are working on a late night shift.

In addition to these causes, some daily lifestyle habits might act as triggers to insomnia, which include:

Consumption of large amounts of caffeine on a regular basis
Developing irregular sleep schedules
Taking your smartphone to bed and ending up spending a lot of time with it in the night
Eating late in the evening

Causative Factors Behind Insomnia

Knee pain is something that can affect anyone - irrespective of their age. While sometimes it may be of minor importance - and can easily be handled by self-care, often, lingering pain is a manifestation of some other serious underlying problem, such as arthritis. In this case, it is imperative that you consult a doctor and take appropriate measures to combat it.

Causes :

Arthritis: The chief cause of lingering knee pain, arthritis itself can be of a number of types:
 Osteoarthritis, which is a result of deterioration of cartilages due to wear and tear
 Rheumatoid Arthritis, an inflammatory chronic disorder
 Septic Arthritis, causing pain, swelling and redness.
 Gout caused due to the development of uric acid crystals in the joints
Fractures: These are caused by the breaking up of the kneecap due to falls or collisions.
ACL Injuries: Caused due to the tearing of the anterior cruciate ligament (that connects the femur and the shinbone). Especially common in sportspersons such as footballers or basketball players.
Meniscus tears: The meniscus or the rubber-like cartilage (that acts as a shock absorber) can be torn by sudden jerks or excess pressure.

Symptoms:The major symptoms of knee pain include weakness, redness, instability, stiffness or the inability to properly straighten or move the leg. Often, a deformity is also visible, such as a bone sticking out of the leg - in which case it is advisable to consult a doctor immediately.

Possible risks :Factors which include the odds of being inflicted by knee pain and cause serious complications include :
Being overweight: This exponentially increases the stress or pressure that is applied on the knee joints - even in doing mundane tasks like walking up and down stairs.
Excessive physical activity: Some activities, such as sports apply excess stress on the knees as compared to other tasks.
Loss of muscle flexibility: Tightness or weakness in muscles causes increasing number of problems in the knees.

All About Knee Pain

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 knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

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