Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

In most cases, pain anywhere in the body can be explained as a symptom of some other problem, but sometimes, there is no reason for abdominal pain. This type of pain is known as chronic functional abdominal pain. This is a gastrointestinal disorder that cannot be explained through X-ray or laboratory findings. It can be triggered by altered sensitivity to nerve impulses in the brain and gut. People suffering from this condition are often so debilitated by the pain that it becomes the central focus of their life.

This condition cannot be cured, but with proper treatment, it can be managed so that it does not affect the quality of your life. The aim of treatment for this condition is to control the symptoms and improve functioning. When it comes to treating this condition, the patient s relationship with his or her doctor plays an important role as the condition cannot be proven through any form of testing and it has a great psychological effect on the person. Regular checkups are also a key to managing this condition effectively.

The first step towards achieving this is to identify possible emotional and situational triggers. Maintaining a journal that records these experiences can help with this. Further treatment is usually either through psychological treatment or antidepressants.

Psychological treatment is based on the understanding that the brain can block pain by diverting attention elsewhere. Nerve impulses that travel from the abdomen to the brain must pass through a type of  gate  that is controlled by nerve impulses generated by the brain. When these impulses close the gates, pain is blocked while when these gates are open, the pain can be magnified. Psychological treatment for chronic functional abdominal pain can be in the form of relaxation techniques, imagery, hypnosis and cognitive behavioral therapy. While relaxation techniques such as meditation and hypnosis help a person shift focus from the pain, cognitive behavioral therapy teaches a person how to change thoughts and perceptions in order to control the pain.

Antidepressants can also act as pain relievers. This form of medication stimulates the production of brain signals that close the  gates  of nerve transmissions. This blocks the pain but can take several weeks to be effective. Some people may experience side effects such as drowsiness and nausea and hence should never be taken without a doctor s supervision. In some cases, antidepressants may also be combined with cognitive behavioral therapy or medication to regulate bowels.

Ways to Treat Chronic Functional Abdominal Pain!

If you suffer from chronic pain of any kind, it is important for you to know that it is associated and linked with your emotions. Other than your physical activities and personal relationships getting hampered, unwanted feelings like resentment, stress and frustration are also common. These emotions and feelings are capable of making your chronic pain condition more worse. 

The Relationship between your mind and body: Your mind and body work together and cannot be separated. Your mind controls all your thoughts and also affects the way in which pain is controlled or perceived by the body. Pain and the fear of pain may lead you to avoid activities. This may reduce your physical strength and cause disruption in the functioning of your body.

Stress: Stress affects your body both physically and emotionally. It may lead to an increase in your blood pressure, breathing rate, heart rate and muscle tension may also occur. These may lead to fatigue, appetite changes and sleep disruption. Stress also causes depression, anxiety, make you dependent on drugs and make you dependent on other people.

Depression: Depression is common among chronic pain patients. Chronic pain can make cases of existing depression much more worse and the existing pain is also worsened. There are chances of developing depression from chronic pain if depression runs in your family or genes. 

Symptoms of Depression are as follows:

Feeling sad, angry, worthless and hopeless frequently
Lack of energy
Lack of interest in regular activities
Difficulty in sleeping
An increase or decrease in appetite, which may lead to major weight gain or weight loss
Difficulty with concentration
Having suicidal thoughts and thoughts about dying or harming oneself
How to Handle your Emotions during Chronic Pain: A common therapy, which people with chronic pain undertake is called Cognitive Behavioural therapy. You should seek the help of a therapist. In this therapy, you will learn about thinking in a positive way instead of drowning in negative thoughts. Your fear of pain will be reduced and you will learn how to strengthen important relationships. You will be able to develop a sense of freedom from chronic pain. 

If your chronic pain occurs due to an accident or emotional trauma, you may be assessed for post-traumatic stress disorder (PTSD) by your healthcare provider. Many patients suffering from PTSD cannot deal with their pain until the emotional stress is dealt with. If you feel depressed and cannot control your emotions, you need to consult a doctor.

Chronic Pain - Is it Linked to Our Emotions?

The Hijama or Cupping Therapy is an ancient form of Alternative medicine that has long been practiced in Egypt, China, and few Middle Eastern countries. The cupping therapy work wonders to deal with problems ranging from body pain, skin lesions to inflammation. It also plays a significant role in improving the circulation and blood flow. But what is the Cupping Therapy and how does it work? In this article, we will discuss some important points related to the cupping therapy along with its merits.

What is a cupping therapy?
A Cupping Therapy is a non-invasive procedure that involves the use specially designed cups (made of silicone, bamboo, glass, or earthenware) placed on the target skin area to create a vacuum or a suction to help treat a particular health condition.

What happens in a cupping therapy?
The cupping therapy can be Dry or Wet

In both the types, before using the cup, the cupping therapist uses a flammable substance such as herbs or alcohol (placed inside the cup) and sets it on fire. With the fire slowly going off, the therapist carefully puts the hot cup in the target area of the skin in an inverted (upside down) position (for around 3 minutes). This is done to create a suction inside the cup triggering an expansion of the blood vessels. Alternatively, a rubber pump can also be used to create a suction.
In Wet cupping therapy, the steps involved in creating the first suction (generally a mild one) is identical to those used in Dry Cupping. However, in wet cupping, following the first suction, small incisions or scratches are made in the target skin area. During the second section, it is through these cuts that the elimination of the toxic or impure blood takes place.
Soon after the therapy, the cuts are well bandaged along with the application of medicated creams or lotions to ensure a fast healing sans any complications.
For better lubrication and movement of the cups, the therapist may apply a herbal or medicated oil to the skin.
Some people may also opt for Needle Cupping. As indicative of the name, needle cupping involves the use of Acupuncture needles (inserted into the skin over which the cups are then placed to carry out the suction and the subsequent therapy).
Merits of a cupping therapy

The cupping therapy is a nonsurgical therapy that can be used to treat many health complications such as high blood pressure, varicose veins, gynecological problems (including infertility), anemia, dermatological conditions (such as eczema and acne), fibromyalgia, migraines, arthritis, hemophilia, to name a few.
The cupping therapy ensures a better pain management.
It works wonders in the case of stress and anxiety.
The cupping therapy goes a long way to restore the balance between the three Doshas.
It comes with negligible side effects (light bruises, mild burns, or minor skin infections).

Cupping Therapy - Know How It Works!

A menstrual cramp is something which every woman complains of for a day or two every month. Menstrual cramps are usually the pains felt in the lower abdomen, which can occur both before and during a woman's menstrual period. These cramps are caused by a hormone called prostaglandin that causes the uterine muscles to contract during menstruation. When the uterus contracts to shed its natural lining during your period it releases a hormone called prostaglandins which causes pain and inflammation. So higher the level of prostaglandins more severe the menstrual cramps.

It might be just a minor discomfort for some, but for others it can be severe. The symptoms of menstrual cramps include pain in the abdomen, pressure in the abdomen and pain in the hips, lower back, and inner thighs as well. However, if the cramps are severe you might have an upset stomach, loose stools and vomiting too.

Three out of four women experience menstrual pains and every one out of 10 women experiences severe cramps. Here are few remedies that might help in relieving the pain:

Exercise, brisk walking or any type of physical activity can help to ease your belly pain as by being physically active your body pumps more blood, which helps in releasing endorphins to counteract the prostaglandins and reduce your cramps.
Apply heat on the lower abdomen or the area where you feel the pain as it helps to relax the contracting muscles in your uterus.
Improve your diet by reducing fat and increasing vegetables. However, avoid foods that contain caffeine and salt.
Take a warm bath as it may also provide some relief.
Add ginger in your food as it helps in lowering the levels of the pain-causing prostaglandins.
Drink chamomile tea at least three times a day.
Take fish oil supplements, vitamin B1 or both.
Make sure to get enough vitamin D.
Have an orgasm as it releases endorphins which has a pain-relieving effect and helps in boosting your mood as well.
Include more dietary magnesium such as dry almonds and boiled spinach as it helps to ease the pain of cramps.
Acupuncture also has an anti-inflammatory effect.
Take a safe painkiller to reduce pain.
Birth control pills may help relieve painful cramps, but they do come with side effects which may include spotting, breast tenderness, nausea and low sex drive.
Refrain yourself from smoking and drinking alcohol.
Finally, have appropriate rest.
Note: If you still do not get any relief despite trying some of these options then you must visit your doctor to rule out more serious health issues as the menstrual cramps are sometimes caused or worsened by other conditions and any sort of medications for such cramps are to be taken after consulting a Gynaecologist.

How to Get Relief From Severe Menstrual Cramps

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