Radiology is a special branch of medical science that uses various techniques of imaging for the diagnosis and the treatment of several types of diseases in the body. The different types of imaging techniques used in radiology are X-rays, Computerised Tomographic scan (CT Scan), ultrasound, Magnetic Resonance Imaging (MRI) and nuclear medicine which includes Positron Emission Tomography(PET).

Role played in evaluating hip replacement
Hip replacement surgeries have become extremely common in the recent times, and radiological evaluation remains the mainstay of the overall hip replacement procedure. Thus, the role played by radiology is quite significant in such situations. All the specific anatomical landmarks and the measurements are used to make sure the placement is perfect during the hip replacement surgery. Radiological imaging helps in the assessment of the following conditions that are as discussed below.

The length of leg
The inequality in the length of the two legs is prevalent after a hip replacement surgery which can create a great deal of discomfort and inconvenience to the patients. A greater difference in the length of the two legs increases the chances of dislocation, and this is a situation where radiological evaluation plays a crucial role. With the help of radiological imaging, the length of the legs can be made almost equal.

The horizontal center of rotation
In this case, horizontal center of rotation helps in the assessment of the acetabular component of the prosthesis. This is calculated by the measurement of the distance between the center of the head of the femur and the acetabular teardrop. This distance should be bilaterally equal, and it is just not possible without the help of the imaging techniques of radiology.

Acetabular inclination
The acetabular inclination is the angle formed between the face of the cup and the transverse axis. If the angle is less, then it results in a stable hip, but the abduction is limited. On the other hand, if the angle increases then there are high chances of dislocation of the hip. Thus, with the help of radiological evaluation, proper and effective angular inclination is given which is optimum for the patient.

The stem positioning of the femur
The main aim of the stem positioning of the femur in a hip replacement surgery is placing the stem in a position which is neutral within the shaft. To get a proper idea of the positioning, the imaging techniques are of utmost importance which cannot be achieved perfectly without the imaging.

Thus, the crucial role the different techniques of radiological imaging plays during the overall procedure of a hip replacement surgery can be perceived. With the use of the different imaging techniques, the results obtained are closer to perfection.

How Radiological Evaluation Can Help In Case Of Hip Replacement?

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 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.

Know if You Have Arthritis in the Knee

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!!

Joint Replacement Surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced with artificial joints, such as metallic, plastic and ceramic joints.
These surfaces closely replicate the original anatomy.

When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade IV osteoarthritic knees of  people over 50 years when have pain, swelling and deformity fail to respond to medicines, physiotherapy, injections and rest.

Aim of the surgery

    Correct the deformity: Relieve the pain and give near full movements almost immediately after the procedure. Details including techniques and safety, it is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.
    Anaesthesia: Usually it is the spinal cord epidural where one is rendered numb for 3 to 4 hours waist down. Sometimes a general anaesthesia is given. A 4 to 5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimetres) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.
    Recovery: Stand up and walk a few steps with a walker the day after the procedure i.e. in 24 hours. Physiotherapy in hospital for 5 to 7 days and/or walking, progressively longer walks and exercises over the following 15 days. Stitches are removed in 15 days. The patient can return back to normal activity in 4 to 8 weeks the surgery.
    Activities: Normal walks of 3 to 5 km per day Climbing stairs, cycling, swimming, and driving can be performed with the new implant(s) now.
    Avoid: Squatting/kneeling Prohibited: contact sports like football, cricket, tennis; jumping; adventure sports Longevity of joints: 15-35 years depending on the materials used.

Joint Replacement Surgery - When Should You Go for  it

The pain in the lower extremity of the body caused by the irritation of the sciatic nerve (the large nerve running down from the lower back of the body to each one of the legs) is referred to as Sciatica. Sciatica is caused by injury, inflammation or compression of the sciatic nerve and causes pain or numbness spreading to leg, buttocks, and hips. In Ayurveda, Sciatica is known by the name of Gradhrasi. It is believed to be aggravated by the imbalance of Vata Dosha.


Causes -

Sciatica can be caused by strenuous physical activity such as heavy weight lifting, or to exposure to extreme cold. Pressure on buttocks due to sitting or lying continuously for long hours, injury due to a fractured pelvis or trauma to thighs also damages the sciatic nerve.


Symptoms -

Pain in the back and the lower extremity of the body is the primary symptom of Sciatica. Also, there is a burning or tingling sensation in the affected area. It can also become numb. One may even find it difficult to walk. In severe cases, it becomes impossible to bend the knee or move the foot.


Treatment Through Ayurveda -

Through Ayurveda, Sciatica can be treated internally and externally by balancing the energies involved in the doshas:

Internal methods of treatment: Yogaraja Guggulu is the herbal pill consisting of Guggulu resin, twenty-five types of herbs and ghee effectively treats all types of pain associated with the nervous system. Dashamula Arishta, an elixir having sixty-three herbs, jaggery, plums, honey, and water has anti-inflammatory properties which help in toning up the affected nerve.

External methods of treatment: Application of Sarshapadi medicinal oil (made up of camphor, mustard oil, and vegetable turpentine as a base) on the affected area helps in relieving pain.

Panchakarma therapies are very effective in the treatment of this condition. They aim to relieve inflammation and release nerve compressions and spasms for strengthening the entire spine and the surrounding tissue. Generally, treatment through the Panchkarma therapies takes four to five weeks depending upon the severity of the condition. Following are some of the processes involved in treatment through Panchakarma:

Kativasti and Elakizi, Naranga Kizhi, Navarakizhi are very important in the treatment of sciatica.

Sarwang Abhyang is the full body massage with medicated warm oils for lubricating and nurturing the body for the pacification of Vayu.

Swedana refers to steaming the body for detoxification.

Vasti refers to the administration of medicated oils and decoction through anal route for treating the vatic disorder that is Sciatica as per Ayurveda. It pacifies dryness and strengthens intestines and is one of the permanent cures for most of the vatic disorders.

Siravedha is the venous puncture or venesection.

Agnikarma is the Cauterisation or burning the affected part.

Raktamokshan is the process for Blood purification.

Take Away-

Sciatica refers to the pain in the lower body due to an irritated sciatic nerve, caused due to nerve compression or trauma or injury. Through Ayurveda, Sciatica can be treated through internal or external methods as well as through Panchakarma therapies.

Sciatica - Panchakarma Therapy To Heal It!

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.



What Should You Know About Morning Back Pain And Neck Pain?

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