Ankylosing spondylitis refers to a form of arthritis that affects the spinal column. This condition causes the bone vertebrae to fuse together leading to a rigid spine. Depending on the extent of the damage, this could result in mild changes or in a stooped posture. Although the cause of this disease is not known, it is said to be passed down from one generation to another through a gene called the HLA-B27. This gene is also linked to spondylitis.

Ankylosing spondylitis cannot be cured, but with treatment, the pain and stiffness associated with it can be managed. Along with medication, physical and occupational therapy is a must when treating this disease. In some cases where the disease has caused severe deformities, surgery may also be recommended. However, an early diagnosis can also help prevent significant deformity.

A physical exam and an X-ray are the key factors used to confirm a diagnosis of Ankylosing spondylitis. Some of the symptoms associated with this disorder are:

Pain and stiffness: Everyone complains of a backache at some point or the other but a persistent lower back ache could be a sign of something serious. Spondylitis often starts in the sacroiliac joints and hence the lower back, buttocks and hips are the first to be affected. Pain that lasts for more than three months should not be ignored as it could be a sign of Ankylosing spondylitis.
Bony fusion: This condition causes an abnormal growth of bones in the spinal column. This can lead to the fusing of bones in the spine. The bones of the neck, back and hips are most affected by this bone fusion. While this can affect a person s mobility it can also cause complications. For example, the fusing of the ribs to the spinal column or the breastbone can restrict the expansion of the chest while breathing.
Pain in ligaments and tendons: Apart from the bones, this condition also affects a person s tendons and ligaments attached to the bones. For example, pain in and around the heel may be caused by tendonitis.
Other symptoms: The symptoms of ankylosing spondylitis are not restricted only to the joints. Hence, it is also known as a systemic disease. Some of the other symptoms exhibited by people suffering from this condition are fever, fatigue, inflammation of the eyes and a loss of appetite. Some people may also complain of lung and heart problems. 

Ankylosing Spondylitis - How To Know You Are Suffering?

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

Gout is a type of arthritis, which can affect your joints, though usually, it causes maximum harm to your big toe. Symptoms that you are having a bout of gout include having a stiffness and swelling of the joint in question. The pain is very sudden and also causes a burning sensation. Gout is basically a recurrent type of inflammatory arthritis. However, the pain associated with gout can be remedied by ayurveda. Here are some of the best ayurvedic remedies which can be used:

1. Panchatikta ghrita guggulu: panchatikta ghrita guggulu is the most common and most widely recommended treatment for gout. However, it needs to be taken on an empty stomach. It is also worth note that it works best when teaspoons of it are taken two times a day with warm milk.

2. Kaishore guggulu: kaishore guggulu is a type of medicine, which should be accompanying panchatikta ghrita guggulu. It is usually administered after some initial relief is felt from panchatikta ghrita guggulu. Its best to consume this medicine in tablet form thrice a day.

3. Shallaki: this ayurvedic remedy is great for decreasing the pain in the joints affected. It also decreases the swelling in those joints, which have been affected by the bout of gout. Shallaki is also crucial in making sure that cartilage forms and that the blood supply to the joint which is affected by gout is still stable.

4. 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 and also inflammation of muscles. This herb can also work wonders on your blood circulation.

5. Pinda taila: this is a type of oil which needs to be applied externally. Pinda taila is a very rare class of medicines which treats gout externally. Pinda taila or guduchyadi taila is administered by rubbing it on the body part affected.

Ayurveda and Gout

Ever faced a nagging low back ache that just won't quit? You could be dealing with sciatica. Sciatica or sciatic nerve pain is not a diagnosis in itself, but is a symptom of a deeper problem. Conditions that trigger sciatica include degenerative discs, spinal stenosis, a herniated disc in the lumbar region or   spondylolisthesis. Whether your sciatica pain is persistent or sporadic, it can make routine tasks difficult to perform. The good news is that there are a number of remedies to ease this pain and improve the health of your spine.

1. Hot and cold therapy: Sciatic pain that extends down to the thighs can be relieved by alternating between a heat pack and an ice pack. Each pack can be applied for about 20 minutes at a stretch every two hours. However, this does not treat the sciatic nerve itself.

2. Pain medications and steroid injections: Over the counter pain medication like ibuprofen or muscle relaxants can help alleviate pain and reduce inflammation. In chronic cases, epidural steroid injections may also be prescribed to address the inflammation and pain. Pain relief provided by medication and steroid injections can last for a few days or a few months depending on the person.

3. Yoga: Sciatica patients looking for long term relief often turn towards alternative forms of treatment like yoga. Yoga helps strengthen muscles, increases flexibility and improves posture. This is more beneficial towards preventing sciatica problems from arising than treating ongoing sciatic pain. When practicing yoga with a sciatica problem, it is very important to understand your body's limitations and not over extend your back muscles.

4. Massage: A massage that treats sciatic pain is very different from the usual massage you may get at a spa. A massage to relieve sciatic pain involves putting pressure on the inflamed part of the back and the piriformis muscle. This is the muscle that sits over the sciatic nerve and triggers sciatic pain. In most cases, 3 to 4 massage sessions at intervals of 7 to 10 days can have effective results on sciatic pain.

5. Physical therapy: Sciatica patients often find the slightest movement extremely painful. While lying in a bad is tempting, it can actually worsen the pain. Exercise increases blood flow to the spine and helps flush out toxins. Going for a walk, light aerobics or swimming are ideal ways for a sciatica patient to exercise.

6. Chiropractic manipulation: This involves realigning the spinal column and is an effective way of treating underlying conditions that trigger sciatic pain. These spinal adjustments should only be performed by licensed chiropractors or osteopathic physicians.

Treatments for Sciatica Pain

Concentrated pain in the neck can be especially tormenting. Before you look for a cure for this pain and start treating it, it is important that you try and find out the underlying cause behind it as well. Contacting a physiotherapist in time will allow you not only to avoid any and every side effect posed by neck pain, but also assist you to get good riddance from it.

Causes of Neck Pain:
There can be multiple causes of neck pain. The treatment of the same depends wholly on the factor that is causing the pain. Some of these causes of neck pain include

Misaligned hips,
Misaligned Spine,
Misaligned shoulders,
A constantly forward-tilted head,
Lack of movement of the head from one specific position,
Tensing up of the muscles in the upper back,
Tensing up of the muscles in the neck region, etc.
It is all these factors and a few more that end up resulting in stiffening of muscles in and around the neck and causing you intermediate to unbearable pain.
Side effects of neck pain:
Neck pain also has some side effects, which includes temporary loss of consciousness, nausea, vomiting, blackouts, temporarily blurred vision, headache, spondylitis, etc.

Exercises for neck pain:
Neck exercises are a predominant part of the treatment extended by every physiotherapist, to cure neck pain. Some of the most vital and effective exercises for neck pain are listed below.

Frog: Funny as it way sounds, the frog is one of the best exercises when it comes to treating neck pain. All you have to do is lie down on the floor with your knees apart, your feet joined, your hands laid upward on the floor at a 45-degree angle to your body and just stay there in that position for two minutes. This will force your back to arch naturally, slowly giving some relief to your neck.
Sitting floor: Try sitting floor for neck pain. All you have to do is sit straight with your back rested on a wall, with your legs laid straight forward. Bring together your shoulder blades and bend to help them meet your knees while curling the toes outward to optimal. Stay in this position for a good 3 minutes, without bending the legs.
Static wall: Lie down on the floor with your bottom against a wall and your legs up it. You can always scoot back a bit if there is the slightest of discomfort. The aim here is to help the tail bone lie comfortably on the floor. Tighten your thigh muscles but curling your toes outward and pointing your feet straight out from its previous position. Maintain this position for 3 minutes for maximum effect.
Static back: The static back is the most common and most helpful exercise for neck pain. All you got to do is lie down on the floor, while placing your legs on an elevated surface, such as an ottoman or a chair at a 45-degree angle to your body. Now put your arms at an angle of 45 degrees to your body as well, only sideways on your shoulder. Follow this position by lifting your palms and staying in that position for five to ten minutes.
All these exercises are aimed to positively influence one muscle or the other in and around the neck region and to help you get rid of that pain. Consult a physiotherapist first, and he/she will advise you on the best neck pain exercises.

Neck Pain - 4 Exercises to Control Pain

Why Does Your Back Hurt?

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis

The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles

A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries

Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

- Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.

- Consult the right physician instead of doing exercise that can aggravate your pain.

- Take a break from work and go for short walks, every couple of hours.

If you would like to consult with me privately, please click on 'consult'.

Why Does Your Back Hurt? + What To Do About It

Don't wait any longer, manage your Hip Replacement online with a Lybrate doctor today

Consult for Hip Replacement - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES