Knee pain: causes and tips to manage knee pain

The knee is the largest joint of the body and is made up of upper and lower bones that are separated by two discs known as menisci. While minor knee pain may be experienced by many people, it should be handled with medical intervention when it becomes a serious and debilitating problem. Sudden injury or injury due to overuse as well as myriad conditions that affect the joints and muscles can bring about knee pain. Underlying conditions like osteoporosis or arthritis, which affect the bones and joints, can also cause knee pain. The symptoms include painful swelling and stiffness as well as severe discomfort. Let us learn more about the causes of knee pain and the ways in which it can be managed-

Injury: exercise and sports injuries are one of the most common causes that can be the start of acute knee pain, as well as chronic condition. These kinds of injuries can affect the ligaments and cartilage which leads to severe pain. The pain can even affect the way one functions in one's daily life. Knee ligament injuries can also cause this kind of pain. These ligaments are bands of tissues that connect the thigh bone with the lower leg bones. Sprains and tears in the acl or pcl are common in sports injuries, and may even require surgery in many cases. Knee cartilage tears can also take place in the hard yet flexible cartilage of the knee which can affect the meniscus around the knee. This condition may also require surgery.

Arthritis: this condition can affect the knees specifically and is one of the most common types of arthritis. This is a chronic condition which gets progressively worse over time and may even require surgery. Stiffness and inflammation are common symptoms. Rheumatoid arthritis is also a degenerative auto-immune disease that can affect the knees and cause knee pain. Furthermore, post traumatic arthritis can also be experienced after an injury. Osteoarthritis is another common condition that leads to knee pain. It basically occurs due to wear and tear of the knees over a prolonged period and is usually experienced by patients over the age of 50.

Managing knee pain: while pain medication and anti-inflammatory drugs may be prescribed for most cases, along with surgery in the long run, it is also possible to manage knee pain with the help of better lifestyle choices like regular knee and muscle strengthening exercises as well as rest - rest, ice, compression and elevation. These methods can help in relieving inflammation and pain. But very severe cases will require medical intervention, so it is imperative to get in touch with your doctor if the condition does not improve.

Knee Pain: Causes and Tips to Manage Knee Pain

Arthritis, which is quite a common ailment among people aged above 40, is painful regardless where it affects a person, be it the hands or the toes. However, the Ayurvedic field of medicine has come up with historic ways of treating the issue. Over the course of time, these methods have proved to be quite effective, and especially popular as they have no side effects. A person only needs to spend a little time to get to know how to go about using Ayurveda to cure the arthritic aches and pains, which plague daily life!


One of the best things about Ayurveda is the fact that the solutions are generally made using ingredients that are very easy to source. For example, there is a solution for arthritis, which involves mixing a cup of mustard oil with about 10 grams of camphor and then heating the combination. This oil mixture then needs to be massaged on the affected areas. Now, isn t that simple?


The common potato, long considered to be a vegetable of the masses, also finds its use in Ayurveda when it comes to treating arthritis. If you soak a few unpeeled slices of potato in a glass of water overnight and drink this water the following morning, you are sure to find an improvement in your condition quite soon. 


Additionally, there are a few other food items that are recommended in the Ayurvedic treatment. These include bitter gourd, which is not only low in calorie content, but also very high on vitamins and ginger which improves metabolism. Consuming garlic and buttermilk is also considered advantageous. 


Moreover, you may also need to make some changes to the lifestyle habits, which have been deeply ingrained. For instance, sleeping as per a regular schedule and not going to sleep very late at night has a positive impact.


As you have probably be discerned, when it comes to health, the devil is in the eating! If a person who has arthritis makes an effort to conform to a good and healthy diet, which does not contain fried or sugary food, or even those which have spices in excess, he or she will not only find the pain symptoms of arthritis reducing, but also gain a general sense of health.


As long as a person has the patience to follow the way of treating arthritis set out by Ayurveda, the benefits will truly be bountiful!

Arthritis - How Ayurveda Can Help Treat it?

Muscle contusion is a condition that is characterized by bruising in the muscles. It generally tends to occur in athletes who play a lot of contact sports. Repetitive blows in any part of the body may cause damage to the underlying muscle tissues. These blows may lead to internal bleeding, resulting in blood clot formation. The most common site where it occurs are the quadriceps.


The various causes of this condition are:
1. Direct repetitive blows to a part of the muscle in contact sports such as football
2. If you fall on a hard surface 
3. It may also occur if the muscle comes in contact real hard with sports equipments like soccer balls

The symptoms of a muscle contusion are:
1. You may experience swelling of the muscle
2. Excessive pain
3. Decrease in range of motion in the concerned body part
4. It may lead to leaking of blood vessels
5. You may also experience hematoma where a lump is formed over the affected spot
6. Symptoms of broken bones, dislocations and fractures may also occur

Complications
This disorder may also lead to various complications such as compartment syndrome, which leads to compression of blood vessels resulting in pain. 

Treatment
The basic treatment for this condition is the rice protocol which is rest, ice, compression and elevation. You should rest the muscle, then apply ice to the affected area to reduce the pain. You can also take nsaids (non steroidal anti-inflammatory drugs) to reduce the pain. In severe cases, the doctor may drain the lump surgically.


It is advisable to not return to your normal sports routine in order to allow the muscle to recover. If you carry on with your regular routine, it may result in further complications like the formation of scar tissue. You may undergo various stretching exercises to relieve the pain and make a gradual return to your normal sporting activities.


Causes and Symptoms of Muscle Contusion

Fibromyalgia is a condition that causes chronic pain in muscles, soft tissues, tendons, and joints. For some, it can also cause memory problems, fatigue, mood swings and lethargy. Fibromyalgia is not a disease but a syndrome. The same can be effectively managed through wellness, medicine, massage and alternative medicine. This condition is more observed in women than man. Luckily through, this condition is not life threatening and does not damage muscle and joints.

What are the symptoms?
The most common symptom of Fibromyalgia is the pain. The experience of pain can be burning, deep, shooting or ache at regular intervals. Tender points around the soft tissue can be visible. This worsens at night. Some common indications of this condition include less sleep, headaches, depression, fatigue and other cognitive issues. With proper care the symptoms do improve, it, however, is a long-term condition and chances are that the pain might return in the long run.

How does massage help?

Massage can prove to be extremely beneficial for this lot. Research indicates that massages such as Shiatsu, myofascial release and Swedish improve the condition for better. Mentioned below are few benefits that have been observed in patients of different age group:
An evening session with a massage therapist will help a patient to get sound sleep at night. This ensures that the body rejuvenates and repairs during the sleep. The patient feels more energetic than ever before.
Massage improved muscle tonicity: Massage helps to improve the lethargic muscle aid strength and vitality to the body. It is essential to include more petrissage strokes during the massage session to accomplish the goal.
Massage helps a great deal to improve mental clarity. A healthy, relaxing massage session can relieve mental stress, gives clarity to thinking and resolves the cognitive issues that a person is facing.
A person suffering from Fibromyalgia can get relief from headache with proper massaging. Massage greatly improves the flow of blood to the brain and the spinal cord region thereby, ensuring that headache is greatly reduced. Relief from headache can improve the overall health of a patient.
Massage can reduce the level of depression and anxiety faced by a person suffering from fibromyalgia. Depression and anxiety leads to hormonal fluctuations leading to appetite, mood swings, constant irritation etc. A regular massage session can restore the body homeostasis thereby keeping the body condition normal.
Regular massage session will improve the overall pain level of the patient and give a chance to the muscle to gain extra strength. With proper care and therapy, it is entirely possible to cure the condition for good. 
However, it is also necessary to continue with the session. Giving up massage therapy after temporary relief won t serve the purpose for long-term pain relief.


Fibromyalgia Pain - Can Massage Help Reduce It?

Arthritis is a common musculoskeletal condition that affects elderly men and women. Joint pain, stiffness and inflammation are the most common symptoms of this condition. This pain can get so bad as to affect your movement and leave you unable to do simple things like walking up stairs or even simply turning a doorknob. 

Arthritis cannot be reversed but with medication and a few lifestyle changes, your quality of life can be improved.

Exercise and weight loss: Though it is difficult to do, losing weight can help relieve the pain of arthritis. This takes the pressure off your joints and increases the range of possible motions. Though exercising may be the last thing you want to do, it can help increase your flexibility and help strengthen your muscles. Aerobics, stretching and strength training are ideal for arthritic patients.
Assistive devices: Arthritis can make a person knock kneed or bow legged. Wearing unloading braces, shoe inserts or walking with a cane or shoe inserts can help redistribute your weight and take the pressure of your joints. It can also help relieve pain and prevent arthritis from worsening.
Eating right: Some types of food can worsen arthritic symptoms. This includes processed foods like white flour and sugar, yeast, chemical additives, gluten, hydrogenated and trans fats, milk products, caffeine, alcohol and tobacco. Hence, avoid consuming these foods and instead have a diet rich in fruits, vegetables, nuts and whole grain. You could also try alkaline foods like green leafy vegetables, wheatgrass and aloe vera.
Massage therapy: A massage not only de-stresses the body, but can also relieve muscle and joint pain by improving blood circulation. Massages also help break up muscular waste deposits and increase the amount of oxygen circulated in the body. This helps transport nutrients to tissues and carries toxins away. Ideally, an arthritic patient should have a massage 2-3 times a week in the beginning and at least twice a month once the condition has stabilised.
Supplements: Along with eating healthy, including a few supplements in your daily diet can also help alleviate arthritic symptoms. When it comes to rheumatic arthritis; the anti-inflammatory properties of vitamin C help fight arthritis by promoting bone and cartilage growth and reducing infection. Fish oil is rich in Omega-3 fatty acids that help reduce inflammation, Vitamin D is another supplement that helps relieve arthritic pain by helping the bones absorb calcium faster and preventing further loss of cartilage.

Arthritis - 5 Easy Ways You Can Ease Your Suffering

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

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