Insomnia is a disorder where a person has difficulty sleeping. One can have problem falling asleep or staying asleep for long. Some people also have disturbed sleep. This can be a major problem as due to lack of sleep one feels tired and fatigued all day.

Recurring cases of insomnia hamper your daily activities and interfere with the smooth functioning of your life. Therefore, this condition should not be ignored and treated immediately.

Here are the various ways to treat insomnia:
Non-Medical (Cognitive and Behavioral treatment)
Several psychological and behavioral techniques can be used for the treatment of insomnia. Many of these methods can be easily self-taught and others require a therapist to be carried out properly. 

1. Relaxation training, which is also called progressive muscle relaxation involves the patient to tense and relax his muscles systematically in various parts or regions of the body. Relaxation techniques, such as breathing exercises, various forms of meditation, mindfulness and guided imagery are used for treating insomnia people. The use of audio recordings for guidance in these techniques is quite popular.

2. Stimulus control enables building an association between the bedroom and sleep. This is done by limiting several kinds of activities done in a bedroom. This may include going to bed only when very sleepy and leaving bed if you cannot sleep within twenty minutes. A strict bedtime and wake up time schedule has to be maintained.

3. Cognitive behavioral therapy or CBT involves changes in behavior like maintaining a strict sleep time schedule, elimination of afternoon naps and other habits related to sleep. A cognitive component is also added to this method. Unhealthy beliefs and fear regarding sleep are challenged and positive, rational thinking is encouraged. CBT is a very effective procedure for treating insomnia and the track record regarding success is high.

4. Changes in lifestyle are required to treat insomnia and prevent recurrence of insomnia, you should change certain habits and start some new practices. You should limit your intake of caffeine, alcohol and nicotine. Do not consume coffee or tea before going to sleep and avoid smoking. The habits may be stimulating and will keep you awake. Your diet should be balanced. You should avoid having rich and spicy food before going to bed. Avoid late meals and maintain a proper schedule for meals. Regular exercise can improve the symptoms of insomnia and you should try to work out every day.

Medical Treatment
There are many forms of medicines, which can treat insomnia. This includes over-the-counter medicines, as well as prescribed medicines. The type of medicine required completely depends on the severity and symptoms of your insomnia and other factors related to health. Therefore, you must consult a doctor before having any kind of medicine for treating insomnia.

The most common medicines for insomnia, which are usually prescribed by doctors are benzodiazepine hypnotics, non-benzodiazepine hypnotics and melatonin receptor agonists. However, medicines should only be taken after consulting with a specialist. Insomnia not only affects your health but also interferes with all your daily activities. Proper treatment should be taken to treat the same.

Ways to Treat Insomnia

The bones and joints orchestrate very well with each other for smooth movements of various joints and the spine. However, due to various reasons, some identified and others unknown, there could be inflammation of the areas where the bones join the muscles leading to impaired movement. The range of motion could be reduced or it could be painful, thereby, limiting movement. Spondyloarthritis includes a group of inflammatory diseases that involves the bones and joints and enthuses which are areas where the ligaments and tendons attach to the bones. This causes conditions like plantar fasciitis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. The term spondyloarthritis is a blanket term to describe any of the above-mentioned conditions.

Read on to know a little more in detail about it:

Causes: While the exact etiology is not identified for sure, most patients with spondyloarthritis have an autosomal dominant gene (HLA-B27). Chronic infections could trigger the onset of the disease too.

Symptoms:

1. In all forms of spondyloarthritis, there is always inflammation of the spine, joints and entheses. If the fingers or toes are involved, there could be swelling leading to what are typically known as 'sausage digits'.

2. There is sacroiliitis which is inflammation of the joint between the pelvis and the spine, and spondylitis which is inflammation of the joints between the spines. 3. Family history and autosomal dominant gene.

Diagnosis:

A detailed medical history and physical examination form the cornerstone of a confirmed diagnosis. In addition, radiographic examination and diagnostic blood tests also could be done to confirm the diagnosis. Radiographs, especially, of the spine and the low back show typical changes including sacroilitis in suspected cases of spondyloarthritis. If the spine does not show these changes, but there is a high likelihood of spondyloarthritis, then MRI (magnetic resonance imaging) can be used to confirm the diagnosis.

As a final step, a blood test for the HLA-B27 gene can also be confirmatory. However, it is not true that a person with the gene will definitely develop the disease.

Treatment:

The most important aspect of treatment is the use of pain medications and anti-inflammatory drugs (NSAIDs) which help manage pain and inflammation.
Corticosteroid injections may sometimes be given directly into the joint spaces or the membranes to provide quick relief of these symptoms.
ESWT / RSWT has a definite role to cure enthesopathy. Plantar fasciitis, and achillodynia can be cured with ESWT. Even small joints of hand and feet are amenable to treatment with RSWT. It is nonoperative and noninvasive treatment and has no side effects.
Very rarely, stronger drugs such as methotrexate or sulfasalazine may be used.
Another set of drugs known as TNF-blockers (tumor necrotizing factor blockers) are also shown to be highly effective in controlling the pain of the spine and joints.
In very severe cases, surgery may be required to correct joint damages or correct severe degenerative changes.
Exercise plays a very vital role in controlling the issue and improving range of motion.

What You Should Know About Spondyloarthritis?

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

Being diagnosed with cancer is something no one looks forward to and Gynaecological Cancer is every woman s worst nightmare. However, if diagnosed in time, it can be treated. Cancer in any part of a woman s reproductive system is termed as gynecological cancer. It is of five types:
Cervical cancer
Ovarian cancer
Vaginal cancer
Vulvar cancer and
Uterine cancer
Paying attention to your body and understanding its natural rhythm can help you recognize signs of gynecological cancer. This is because signs of gynecological cancer can be difficult to identify unless you know your body. Here are a five signs to watch out for-
Abnormal Vaginal Bleeding: Bleeding in between periods is okay once in a while but if it happens continuously over a period of 2 to 3 months, do not ignore it. Vaginal bleeding after menopause should also never be ignored. Abnormal bleeding could be triggered by a number of conditions including cancer of the lining of the uterus. Sudden changes in your menstrual blood that persist for over 2 cycles such as heavy bleeding can also be a symptom of uterine cancer. Heavy bleeding can be defined as a period that lasts for over 7 days.
Changes in the Vulva: Any change in colour of development of bumps, sores of thickened skin should be immediately shown to a gynecologist. Any form of vulvar itching or burning should also not be ignored. These conditions could be symptoms of vulvar cancer. Hence, it is important to know what your vulva looks like normally.
Bloating: Persistent bloating that lasts for over a fortnight can be a sign of ovarian cancer. This is especially true in cases of bloating accompanied by sudden weight loss or between-period bleeding.
Change in Bathroom Habits: Due to the proximity of the bladder to the reproductive organs, a tumour or swelling in the reproductive organs can trigger symptoms similar to those of a urinary tract infection. This includes pain while urinating, difficulty passing urine, diarrhea or constipation. Urinary incontinence could also a sign of gynecological cancer.
Abdominal or Back Pain: In rare cases, lower back pain could be a sign of ovarian cancer or uterine cancer. Pain in the lower abdomen or pelvic area can also be a sign of ovarian cancer.
The above could also be signs of other health disorders. The only way of knowing for sure is by consulting a doctor. Hence, understand your body and if you notice any of these symptoms consult your gynecologist at the earliest. 

Signs of Gynecological Cancer

Heavy medication is often not required to treat fatigue. Homeopathy is an effective approch to deal with fatigue as it stimulates the body to heal itself. In most cases, simply replenishing phosphate cell salts in the body can have a beneficial effect and give you more energy. These salts help regulate disturbances in the constitution of a person at a cellular level. Phosphorus salts or phosphate compounds can be found in our body fluids, tissues and organs. These salts are essential for energy production, communication between cells and other regulatory responses. It is also vital for healthy bones, teeth and membrane structures. 

Take a look at these five cell salts and how they can revitalize you and help fight fatigue.

Calcarea phosphate: This compound is a building block cell salt. It is essential for the healthy growth of teeth, bones and blood cells. It helps with a number of conditions created by structural stress and helps fight tiredness and restlessness. It is also a beneficial tonic for children exhausted by long periods of mental exertion such as studying. 
Ferrum phosphate: This is an iron compound that is critical to the health of blood cells. By fighting cold, cough and slight fever in the initial phase, it keeps the body healthy and helps build up the immune system. When alternated with calcarea phosphate, the iron in this cell salt is absorbed more easily. Thus Ferrum phosphate can also help regulate the hemoglobin levels in the blood and reduce physical weakness and fatigue. 
Kali phosphate: This potassium and phosphorus compound is considered as a nerve nutrient cell salt. It can be used to treat agitation and depression by calming the nerves. It also fastens the healing of damaged nerve structures. It can also help treat insomnia that follows a day of excitement and physical strain.
Magnesium phosphate: This is an antispasmodic cell salt and is also known as the homeopathic asprin. It is essential for well structured muscles and their connective tissues. Magnesium phosphate helps muscles move smoothly and can be used to treat minor spasms, radiating pains and to relieve pen up tension and cramps. It can also ease painful menstrual cramps.
Natrum phosphate: The body depends on this compound to break down acids and help with the digestive system. Thus this is considered as an acidity cell salt, which also helps with issues like headache, muscle ache, stiffness and fatigue.

Battling Fatigue with Cell Salts

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?

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