If you are suffering from arthritis, it is important for you to know about how it affects your knee and other joints. Arthritis is a chronic, systematic inflammatory disease which damages your joints and connective tissues. Your knee is commonly affected by arthritis and there are three primary types of arthritis that occur in the knees. They include osteoarthritis, rheumatoid arthritis and post-traumatic arthritis.

Types of arthritis 
The different types of arthritis affecting the knees occur due to different reasons. Osteoarthritis is a progressive condition, which wears away the joint cartilage over time. Rheumatoid arthritis is an inflammatory condition, which may occur at any age. Post-traumatic arthritis occurs after an injury is inflicted to the knee and may occur several years after a ligament injury or knee fracture.

Major symptoms

Arthritis pain may occur all of a sudden, but commonly develops slowly. In the early stages, the pain is observed in the morning after you have been inactive over the night. Pain is likely when you want to move around. Pain may be experienced even when immobile.
Periodic inflammation is a common symptom of arthritis of the knee. This happens because of the formation of bone spurs or excess fluids in your knee. The swelling gets pronounced after being inactive for a long period. The skin on your knee may look red and feel warm while you touch it. This may lead to chronic inflammation, which is very difficult to manage.
Treatment
There are several ways of treating knee arthritis. The mode of treatment depends on the severity and cause of knee arthritis. NSAIDS or nonsteroidal anti-inflammatory drugs are commonly prescribed for dealing with arthritis pain temporarily. Other medicines used for knee arthritis treatment are as follows:

Analgesics, which help in pain reduction act as good alternatives to NSAIDS.
Corticosteroids are used for reducing inflammation.
Certain DMARDs or disease-modifying antirheumatic drugs are used.
Certain injections that are used for helping with knee arthritis. They include:

Hyaluronic acid supplements, which ease the pain and inflammation by lubricating your knee joints.
Corticosteroid injections also soothe inflammation and pain.
You may also require a surgery for dealing with knee arthritis when other modes of treatment fail. The most common surgeries are as follows:

Total joint replacement, where your knee is replaced with a prosthetic made of metal, plastic or ceramic.
Osteotomy, where the knee bones are modified for controlling pressure and damage in the knees.
Arthroscopy, where an incision is made in the knee for removing damaged parts.
It is recommended for you to consult a doctor, if you experience any symptom of knee arthritis. Early treatment will prevent the condition from worsening.

Knee Pain - It May be a Sign of Arthritis?

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?

Psoriasis is a skin disease, which develops in men and women often during middle age and above. Although tests and researches are being carried out in various laboratories around the world, the exact cause of this condition is yet unknown. Psoriasis is not infectious. In other words, it does not spread by coming in contact with someone suffering from it. In case you see that you are just developing psoriasis or it is in its early stages, then you can opt for some simple and natural methods of curing it. These home remedies fall under Ayurvedic treatments and help you in getting rid of this disease before it spreads further into your body.

Moist skin: Apply lots of moisturizer on your body. This is done to keep the skin moist and supple. The more your skin becomes dry, the chances of it bleeding and causing infections increase. It is often recommended to apply body oil or sesame oil before taking a bath as it softens the skin.
Use natural body soaps: Sometimes the body soaps that you use are made of harsh chemicals. These chemicals come in contact with your body and aggravate the infection furthermore. You can use home made natural soaps, which are made of natural ingredients and are gentle on your skin.
Avoid skin injuries: Skin injuries like a cut, bleeding, blisters etc. can be harmful for psoriasis. They can aggravate the inflammation and cause more damage. In fact, it is recommended that you apply moisturizer and sunscreen every time you step out of the house in order to protect your skin from further damage.
Use medicines after consultation: Certain medicines have the ability to flare up the effects of psoriasis. Thus, when you develop this disease, it is advised that you meet a general physician and discuss your medicines with him/her in order to control the same.
Reduce stress: Stress levels contribute a lot to psoriasis. Thus, you need to relax as much as possible. You can try out yoga and meditation to keep the stress level down and in turn control this disease as well.
Wear cotton clothes: Wear clothes that you are comfortable in and those which do not cause irritation on your skin. Synthetic clothes sometimes cause a lot of irritation and rashes on the skin. It is something that should be avoided.
These are some of the quick and natural remedies to cure yourself of psoriasis as early as possible.

Psoriasis - 6 Ayurvedic Remedies That Can Help!

Anterior Cruciate Ligament (ACL) injury is one of the most common knee injuries. Athletes who play high strain sports like football, rugby and basketball are more at risk in developing this kind of injury.
The ACL is one of the four primary ligaments in your knee. The injury occurs when the ligament is overstretched.

Signs and Symptoms
ACL happens in steps:
a) First, you might hear or feel in your knee a 'pop' sound
b) Next, you might experience pain and an inability to move or continue with your activity
c) Then your knee will swell up
d) Lastly, hemarthrosis develops

Causes
The ACL injury can happen in various ways. Injury may occur if
1. You change directions quickly
2. You stop suddenly
3. You slow down while running
4. You jump and land incorrectly
5. You are tackled, like in football, through direct collision or contact

Diagnosis
The doctor will use the following tests to diagnose ACL injury:
1. Pivot-shift test: This test is done to check for instability
2. Anterior drawer test: This test is done to check for the suspected tear in the ACL
3. Lachman test: This test more or less resembles the anterior drawer test. It is considered far more superior in diagnosing ACL injury than the anterior drawer test.

Treatment
Treatment of ACL depends on the patient's age and lifestyle. A younger patient, who is involved in sports will need surgery to restore agility. An older patient can heal without surgery.
1. Conservative Management: This is recommended for people who are older and lead a quieter lifestyle. Also if the knee is overall stable, the doctor might opt for this treatment. Bracing and physical therapy is enough in this case. To protect the knee stability, braces are given. Crutches are also used to keep from exerting weight on the injured leg. When the swelling subsides, some exercises are performed. This is part of the rehabilitation program. Exercises will strengthen leg muscles that surround the knee.
2. Surgery: If the patient is young and has a very active lifestyle, surgery is very much needed. There are three surgical methods:
a. Primary repair- this method is not recommended barring bony avulsions, which are typically seen in adolescents
b. Extra-articular repair- generally includes a tenodesis of the iliotibial tract
c. Intra-articular reconstruction- this is the standard treatment for ACL injuries.

All About Anterior Cruciate Ligament Injury

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!

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

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