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

When somebody is diagnosed with a short term or a life-threatening disease, one of the main things they are likely to stress over is pain. Though, there are many effective medicines for pain, it is important to realize that medicines are not by any means the only treatment method for pain. For instance, radiation treatment can be very useful in treating pain from cancer and also in facilitating bone pain identified with the disease.

The term "alternative therapy" for the most part is used to describe any treatment or alternative that does not require medicinal attention. Alternate treatment includes a combination of controls, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, relaxation, biofeedback, massage, homegrown cures, aromatherapy and numerous others.

There are various non-medicinal methods for adapting to pain. They can be used all alone or as a part of a mix with medication treatments. Some of the alternatives patients have discovered include:

Massage: Many individuals discover relief from delicate back rub, and some clinics and massage parlors have trained massage specialists. A few studies have found that a back rub is extremely successful in soothing pain.
Relaxation: Guided imagery, spellbinding, breathing procedures and relaxation arts like tai chi are effective and viable, especially when a patient is experiencing debilitating pain.
Acupuncture: A few studies have found that acupuncture can be useful in calming pain for individuals with genuine ailments, for example - cancer.
Physiotherapy: In case a person has been very active before and is currently bed-ridden, even simply moving the hands and feet a little bit with proper physiotherapy movements can offer help.
Pet treatment: If you have episodes of pain that last 5, 10, or 15 minutes, attempting to discover something pleasant - like petting an animal's delicate fur can divert and help in relaxation.
Gel packs: These are basic packs that can be warmed or cooled and used to ease pain.
Chiropractic treatment: It is the most widely recognized non-surgical treatment for back pain. It is usually done by a chiropractor who will tune your nerves and other parts for pain relief. Qualified chiropractors are a rarity and hence one must be careful while dealing with them.
Diet: A few people trust that dietary fat intake and consumption of plants that contain calming operators can ease pain by restricting irritation.
Herbal treatment: The effectiveness of herbs is questionable. Do consult a doctor or a specialist since they could have a side effect of their own. Some of them can interact with the medicines you might be taking. This may cause harm to your health.
Alternative therapies to pain relief are not always harmless. As mentioned above, herbal remedies could have few side effects too. Likewise, one should always take a second opinion or consult someone before taking a decision on the kind of alternative therapy they opt for. It is better if you consult an interventional pain physician first and then follow his advice on how to follow these methods for maximal pain relief.

Using Non-medicinal Ways to Treat Pain

Our body is composed of many elements that carry out emotional and physical functions that are usually in sync with one another. It is important for these organs and other elements to be in sync for good health. All nerves are connected to the brain and are responsible for sending important signals throughout your body. Therefore, even one pressed nerve may send you warning signals such as pain to the body. It is advisable not to overlook these signals. Damage from a pressed nerve might be minor or extreme. It might bring about persistent and chronic issues. Therefore, the sooner you get a treatment for nerve compression, the more relieving experience you will have. In a few cases, you cannot reverse the damage caused by a pressed nerve. However, treatment does relieve you from the pain in most cases.

Nerves are the most vulnerable at spots in your body where they go through narrow spaces and have very less tissue to protect them. These are the places they are more likely to get pinched. A number of the causes may include:

If the nerve is pressed between tissues, for example, your tendon, ligament or bone.
Nerve compression in your neck or arm may likewise bring pain in zones, for example, your elbow, hand, wrist or fingers.
Aggravation or weight on a nerve root leaving the spine may bring about neck or low back pain.
In case a disc tears, it is known as a herniated circle that can put weight on a spinal nerve.
Some of the common symptoms of pinched nerves are:

Pain in the region of pressure, for example, the neck or low back
Transmitting pain, for example, sciatica or radicular pain
Numbness
Tingling
Blazing sensation
Weakness
To what extent you are affected depends from individual to individual. Treatment fluctuates, based upon the seriousness and reason for the pinched nerve. You may find that you benefit from just resting the affected area and by maintaining distance from any exercises that may cause you harm. If side effects endure or torment is serious, it is best to see your specialist. You may require one or more types of treatment to contract swollen tissue around the nerve.

Treatment may include:

NSAIDs - Non steroidal inflammation mitigating drugs (NSAIDs, for example, headache medicine, ibuprofen, or naproxen may diminish swelling).
Oral corticosteroids - These are utilized to lessen swelling and agony.
Opiates - These are utilized for brief periods to lessen extreme pain.
Steroid infusions - These infusions may diminish swelling and allow the affected nerves to recover.
Exercise based recuperation - This will extend and reinforce muscles.
Brace - A prop or delicate neckline limits movement and permits muscles to rest for brief periods.
Interventional Pain Procedures: They are the most cost effective and non invasive methods for pain relief as recommended by the WHO. Your pain will be taken care of by the interventional pain physician or the pain specialist.
Surgery - Surgery might be required for more serious issues that do not react to different sorts of treatment.

What to Do When You Have a Pinched Nerve?

Nerve compression is a condition caused by direct pressure on a nerve. It occurs when a nerve is squeezed or compacted. It is also known as compression neuropathy or entrapment neuropathy. 

It typically occurs at a single location. Nerves in the torso, limbs, and extremities may be affected. Common symptoms include pain, numbness, and muscle weakness at the site of the nerve.

Nerve compression syndrome is also known as:

nerve entrapment syndrome
compression neuropathy
entrapment neuropathy
trapped nerve
Types

Mentioned below are few of the most common types of nerve compression syndromes:

Carpal tunnel syndrome
Cubital tunnel syndrome
Suprascapular nerve compression syndrome
Guyon s canal syndrome
Meralgia paresthetica
Radial nerve compression syndrome
Causes

Prolonged or repeated external force, such as sitting with one's arm over the back of a chair (radial nerve), frequently resting one's elbows on a table (ulnar nerve), or an ill-fitting cast or brace on the leg (peroneal nerve).
Accidents such as sprains, fractures, and broken bones can also cause nerve compression syndrome
Diabetes
Autoimmune disorders, such as rheumatoid arthritis
Thyroid dysfunction
High blood pressure
Tumors and cysts
Pregnancy or menopause
Obesity
Neural disorders
Signs and Symptoms

Pain in the area of compressions, such as the neck or lower back
Radiating pain, such as sciatica or radicular pain
Numbness or tingling
Pins and needles or a burning sensation
Weakness
Symptoms worsen when you try specific movements, such as turning your head or straining your neck
Management

Lifestyle changes: Avoiding movements that cause pain.  Changing job duties may relieve symptoms. Losing weight can improve symptoms if obesity is the cause of nerve compression syndrome,
Physical therapy: Flexibility, strength, and range of motion in the affected area can be improved by working with a physical therapist. Physical therapy can also relieve symptoms, such as pain and numbness.
Medication: Drugs commonly prescribed to manage symptoms caused by nerve compression syndrome include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and aspirin. Corticosteroids, such as dexamethasone, are injected directly around the nerve.
Prosthetic devices: In few cases of nerve compression syndrome, a doctor or physical therapist may advise a splint or a brace to help avoid putting pressure on the nerve.
Surgery: The surgical procedure required depends on the type of nerve compression syndrome, the degree of compression, and the nerves and structures affected. Surgery also depends on several factors, which include the duration of the symptoms, the severity of symptoms, and any other underlying health conditions you might have. 
Home remedies: The following home remedies may stop or ameliorate symptoms of nerve compression syndrome:
Stop activities that cause pain
Apply icing on the affected area for 10 15 minutes
Taking regular breaks when doing repetitive tasks
Applying topical creams, such as menthol
Elevating the affected area
Keeping the affected area warmPerforming stretches and exercises to improve strength and flexibility
Using relaxation exercises

Pinched Nerve (Compressed Nerve) - How Can It Be Managed?

There are various neurodegenerative disorders and Huntington Disease is one of them. It is characterized by loss of thinking ability, chorea or uncontrolled writhing and jerking movements, and psychiatric difficulties. 

Nerve cells in the brain are impaired in this disease. This leads to loss of coordination and involuntary movements. As the disease progresses, patients slowly fail to control their throat and mouth muscles and simple tasks like eating, swallowing, and speaking becomes challenging.

Huntington's Disease may also affect the reasoning and thinking abilities of an individual and makes communication and conversations more challenging. The problem of swallowing food can lead to choking as food can go down the wrong way or a lung infection in more severe cases. 

Speech-Language Pathologist or Speech Therapist helps the patients with speaking and swallowing problems with the help of various therapies.

Visiting a Speech-Language Pathologist in the initial stage of Huntington's Disease is advised. This helps in planning in advance about the ways to handle changes as the disease progresses. The therapist can help the patients when they begin showing an inability to speak or understand and swallowing problems. The symptoms showing swallowing difficulties may include choking, coughing and altered eating habits of the patient and loss of weight.

Symptoms

Dysarthria, in which the ability to remember words, understanding and forming a sentence is not lost but clear speech becomes difficult.

Stammering.

Slow or imprecise speech.

Aphasia, inability to understand what is being said and inability to remember grammar and vocabulary, and the pattern of losing a word in between the sentences.

Weak voice or low volume because of respiration issues.

Scanned Speech or unusual lengthy pauses between words.

Problem with pitch control and resonance.

Treatment

The progression of Huntington s disease varies from patient to patient and the therapy also varies as per the needs and challenges of the patients. The therapy usually starts with the discussion of problems and symptoms faced by the patients. 

For swallowing difficulties, patients may be recommended to maintain a journal of swallowing problems and fixing a time for meal intake every day. He/she may be recommended to eat soft food items, and eat slowly and chew the food properly.

As for speech therapy, one may be recommended breathing exercises. The therapist may demonstrate the patients how to overemphasize certain mouth movements to make the words easier to understand. The family of the patient is advised to reduce distraction while communicating with the patient. 

Assistive devices can also help with communication such as computers, smartphones or tablets. Other low-tech objects from everyday life, such as calendars, picture boards with a depiction of daily life activities, and object images and notebooks can also be helpful.

Take Away
Huntington Disease is a brain disorder where it becomes difficult for a person to control mouth muscles. In this, speaking, swallowing, and eating becomes a task for them. There are speech therapies that can help the patients to gather control over their words and communication problems.

 Huntington's Disease - How Effective Is Speech Therapy In It?

Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.

What are the common causes?

Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.

How can you control nerve pain?

Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:

Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.

Painkillers: There are painkillers available OTC which can curb nerve pain. However, painkillers such as ibuprofen, aspirin and acetaminophen do not really work well for severe pain of the nerves.

Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.

Acupuncture: This time-honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.

Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.

Relaxation Techniques: In combination with the abovementioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.

Lifestyle Modifications: This one s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder.

How To Control Nerve Pain?

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