The problem of morning back and neck pain may be due to the position of sleeping or it may be related to inflammatory arthritis which can be familial. Morning back pain is largely related to wrong sleeping posture and less commonly due to arthritic conditions like Ankylosing Spondylitis or Rheumatoid Arthritis. Whatever be the cause- this condition requires attention by an Orthopedic doctor as it may worsen in due course of time and should not be taken lightly. 

Some common factors causing this are: 

Mattress: Too soft or too hard a mattress might induce back ache after sleep. For people with waist and hips of equal proportion, a firmer mattress would do well. For those with narrower waist than their hips, a flexible and softer mattress that can move with the pelvic weight would be a perfect choice. Refrain from using old hardened mattresses. 
Pillow: The pillow you use must be able to render support to your neck naturally. Instead of using excessively firm or soft pillow, try substituting it with memory foam pillows, refillable water pillows or cervical support pillows. 
Posture: Not changing your position while sleeping or sleeping on the belly exerts strain on the back muscles, causing pain. On the other hand, sleeping on the back or on the sides causes comparatively less strain on the spine. 
Other causes such as strenuous workouts or physical activities or sitting at a stretch during the day might cause pain while sleeping or after getting up from bed. 
Remedies for Morning Back Pain: 

Fortunately, there are some home remedies to cure the morning back pain. 

Switching your mattress is a more expensive remedy for back pain, but may often be the ultimate cure. Most people sleep the best on medium-firm mattresses. Be sure to try out the mattress before you buy it. 
For occasional back pain after sleeping, apply heat to your back to relax your muscles before you go to bed and when you get up in the morning. 
Massage your back with pain relieving creams and apply heat on it with a heating pad for quick relief. 
Specific spinal stretching exercises and Planks (a type of exercise) can greatly help in easing back pain, if done on a regular basis. 
It is always recommended to CONSULT an Orthopaedic doctor if you suffer from morning back pain.

Morning Back Pain And Neck Pain

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

The body s reacts to anything suspicious by developing an allergic reaction. Some of the common substances inducing this reaction include certain food substances, pollen, insect bites and certain metals. This body recognises these suspicious substances as antigens and produces what is known as antibodies. These produce various allergic reactions in the body ranging from something as minor as a skin rash to something drastically fatal as respiratory distress and even death.

Features:

Angioedema is one of the most severe forms of allergic reactions.
Translated literally as swelling of the blood vessels, angioedema causes swelling of the blood vessels in the underlying layers and this can lead to the formation of giant hives.
The hives or rashes are extremely itchy, reddish, and can vary in shape (oval or circular). The hives also are warm and painful when touched.
Angioedema usually affects the skin but can have more severe effects like blocking the airway and leading to respiratory distress
Causes: Angioedema is usually caused by one of the following:

Insect bites or stings
People with allergies to foods like peanuts, eggs, milk, shellfish, chocolates, tree nuts, etc.
Pollen, animal dander, latex, poison ivy, and other common allergens
Medicines like penicillin, aspirin, ibuprofen, and some anti-hypertensives
Autoimmune skin disorders like lupus
Reaction to incompatible blood transfusions
Weather conditions like extremes of cold, heat, or pressure
Infections like hepatitis, cytomegalovirus infections, Epstein-Barr infections, etc.
Conditions like leukaemia and thyroid disorders
Extreme emotional stress
Genetic angioedema, inherited from parents by children, which can last forever
Risk factors: Though hives usually develop without any warning signs, the following are some risk factors for developing angioedema.

Previous history of allergies
Predisposition to develop allergic reactions (overactive immune system)
Genetic history of allergies, especially of angioedema
Diagnosis:

In first-time patients, a detailed history with deep dive into similar instances in the past will be done
A physical exam to check for missed hives (like the back) is then done
Allergy testing may also be required to test if a person has a high predisposition to allergies
Blood testing to check for eosinophils, which is usually high in patients with allergies, is done.
Allergy testing to identify the trigger agent may be done if trigger is not known. This will help in preventing further attacks.
If genetic angioedema is suspected, C1 esterase inhibitor test and complement particles are also checked.
Treatment:
Non-medical treatment including loose clothing, cool compresses, and copiously moisturizing to reduce dryness and itching. This is usually sufficient in majority of the cases.
Medical: Antihistamines like cetirizine and loratadine are the next line of treatment. Very severe cases may require steroids like prednisone.


Angioedema - 11 Reasons Why It Can Happen!

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

Osteoporosis wreaks havoc in many senior citizens, especially women. This is a disorder that systematically weakens the bone and can fracture the spine and the hip. If not treated early, it poses a serious threat to mobility. While medicine is a prerequisite to treating this condition, exercise goes a long way in helping patients of osteoporosis. Regular exercise can improve balance and strengthen the muscle. This being said a doctor should be consulted for a fitness assessment and bone density test before going ahead with any exercise routine.

What is the right exercise for you?
Exercises are recommended depending on the degree of osteoporosis a person is suffering from. Some exercises may not be suitable for a person while some can greatly help. It is therefore suggested that a doctor or physiotherapist is consulted before starting any exercise. Here is a list of exercise that doctors often suggest:

    Strength training: Strength training aims at strengthening the spine and other muscles. It includes the usage of free weights and lifting own body weight. In case the exercise involves the usage of weight machines, utmost care should be taken to ensure that the spine does not get twisted. Resistance training, on the other hand, should be designed in such a way that it fits the tolerance and ability to cope up.
    Flexibility exercises: When the joints are allowed to go through the range of motion, it helps in muscle function. Stretching, for instance, should only be done when the muscle is warmed up. Care should be taken that stretching is done gently which is devoid of any bouncing. The spine should not be flexed. Any exercise that demands to bend towards the waist should also be avoided. An experienced physiotherapist should be able to suggest which stretching exercise is suitable for patients with osteoporosis.
    Aerobic training: Aerobic training necessarily means that the bone supports the body weight. This exercise helps the bone from mineral loss and is good for body balance strength and flexibility. Some aerobics that can be easily performed by patients with osteoporosis include dancing, stair climbing, cycling and walking. These exercises also help in blood circulation and cardiovascular diseases.
    Exercises you must avoid: High-impact body activity exercises such as jogging, jumping and running should be strictly avoided in order to avoid bone fracture and weaken muscle. Unlike exercises with controlled movements, these exercises can twist the spine and cause severe immobility in movement.
    Twisting: For patients with osteoporosis, an exercise that involves forward bending resulting the waist to come down should be avoided. Exercise such as this can cause compression fractures leading to restriction in physical movement for a temporary to longer duration. Any sort of bending and twisting, therefore, should be avoided. 

Suffering from Osteoporosis - Know Which Exercise is Right and Wrong for You?

Ayurveda is a very old system of medicine, which originated in India. Using herbs found in nature to cure various illnesses, knee pain can also be permanently cured with this method indigenous to India. It reduces knee pain caused by various illnesses including arthritis, inflammation of the cartilage and wearing of the patella among others. Here are some common Ayurvedic remedies, which help reduce knee pain:

1. Alfalfa: Alfalfa is medically known as Medicago Sativa. Alfalfa is excellent for making sure that your joint pain reduces, when taken in liquid form four times a day.

2. Ashwagandha: Ashwagandha is medically known as Withania Somnifera. In the West, Ashwagandha is popularly known as Winter Cherry. Also, it has a lot of therapeutic properties, which include reducing joint pains. 

3. Banyan: The Banyan tree's medical name is Ficus Benghalensis. It has a sap very similar to the form of rubber known as latex is derived from the Banyan tree. The Banyan tree's sap is externally applied over the joints and the pain usually disappears after a few regular applications. 

4. Bishop's weed: The medical name for Bishop's weed is Trachyspermum Ammi. The oil extracted from this herb is usually applied to the knees to reduce the intensity of such knee pains.

5. Celery: The medical name for celery is Apium Graveolens. Celery is not only an effective treatment for rheumatoid arthritis and associated pains in the knees, but it is also helpful in treating gout. It is usually agreed upon that this particular treatment is usually long lasting because of its alkaline nature.

6. Dandelion: Dandelion's biological name is Taraxacum Officinale. It is rich in magnesium and is crucial for the correct mineralization of the bones. This mineralization allows the bones to become stronger and also prevents knee pain.

7.  Garlic: The medical name for garlic is allium sativum. Five to six cloves eaten everyday has proved to reduce knee pains.

8. Ginger: Ginger is biologically called Zingiber Officinale. These can be easily included in your diet and go a long way in curbing knee pain.

Ayurveda and Knee Pain

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