Bone issues are very common. From infection to inflammation to injuries to mere old age, bone issues are very common. Arthritis can happen with any of these conditions. The healing of this has two aspects one is to heal and reduce the pain and the second is to address the underlying condition. The range of motion needs to be improved, and further damage to the bones should be arrested.

Ayurveda identifies two types of joint problems, one is due to poorly nourished bones, which are prone to damage and the second is the over accumulation of toxins, leading to joint pain and stiffness. This joint pain would be further aggravated by damp weather.

Ayurveda also believes that the overdose of vaata leads to bone issues. So food items aimed at reducing vaata should be included so that balance is restored. There is more than one component to this healing. Food, lifestyle changes, herbs, and exercise manage bone issues, arthritis and the pain. Let s see how.

Food: Eating whole grains, fresh fruits and vegetables, as well as a calcium rich diet is very essential for healing bones. Eat freshly cooked food items and include a lot of dairy products.
Lifestyle: A regular sleep schedule, which is in sync with the biological clock, is very essential. Also eat at regular intervals with the meals getting lighter as the day goes by. Exercise, even in the form of brisk walk, helps soothe joints and keeps them agile.
Massages: Oil massages like Abhyanga are very essential to prevent joint problems. They also help in reducing toxins, which are quite high in chronic conditions like arthritis. These oils can be applied directly on the joints too to improve lubrication, movement and reduce pain.
Go anti ama: There is another component known as ama, which is an equivalent of toxins. The diet and lifestyle should be aimed at reducing ama, which gets accumulated with age in the form of digestive toxins. Eat food products that are easy to digest, consume ama reducing spices like turmeric and pepper, avoid daytime napping and exercise regularly.
In addition, the following herbs are known to be beneficial for bone health.

Ashwagandha: It has rich anti-inflammatory properties, produces effects equivalent to steroids and helps in controlling joint pain and inflammation. Swelling and movement are also improved with its regular use.
Boswellia: Combined with Ashwagandha, this is another wonder drug that helps reduce bone inflammation. It suppresses release of chemicals responsible for inflammation and helps control pain and swelling.
Turmeric: One of the most acclaimed anti-inflammatory agents, it releases multiple enzymes and thereby controls inflammation.
So, for bone pain and arthritis, an NSAID is not the only remedy.

Arthritis and Bone Disorders - How Ayurvedic Remedies Can Help?

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

Your knee is guarded and cushioned by a cartilage known as meniscus. A meniscus tear, therefore, is an extremely painful and discomforting situation. It occurs very frequently and has emerged as one of the most commonly occurring cartilage injuries. What makes a meniscus tear an extremely common phenomenon is the way it can tear that is all it takes is a twist of the knee for it to happen.

People involved in sports mostly face the brunt of this form of injury. The risk of getting meniscus torn increases with age and tends to occur at the slightest change of direction of movement. 

Symptoms 
Some of the symptoms of a torn meniscus are:
1. Pain and inflammation: it goes without saying that an internal injury of the cartilage or tearing away of it would inevitably result in extreme pain and inflammation near the knee.
2. Immobility: the extreme pain and inflammation, which follows will inevitably make it difficult to move. Since the pain occurs in the joint, you will have difficulty in walking and any forceful movement will only aggravate the pain.
3. Locking of the knee: locking of the knee refers to a situation when you are unable to move your knee. This occurs most commonly after you have your meniscus torn.

Treatment
Notwithstanding its frequency of occurrence, there are several ways, by which you can treat a torn meniscus. Some of the ways are:
1. Apply ice: in order to get some relief, applying ice is a suitable option. If you apply ice every day for some time, it wonders in reducing swelling and the consequent pain.
2. Use a bandage: in order to control the swelling, it is important that you cover your knee with an elastic bandage.
3. Change the posture: it is important that you keep the affected knee in an elevated plane, in order to ensure an efficient blood supply and a consequent relief from pain.

Some medical treatments
There are many things to consider when deciding how to treat your torn meniscus, including the extent and location of the tear, your pain level, your age and activity level, your doctor's preference, and when the injury occurred. Your medical treatment choices are:
1. Nonsurgical treatment with compression, elevation, and physical therapy. This may include wearing a temporary shoulder brace.
2. Surgical repair to sew the tear together.
3. Partial meniscectomy, which is surgery to remove the torn section.
4. Total meniscectomy, which is surgery to remove the entire meniscus. This is generally avoided, because this option increases the risk for osteoarthritis in the shoulder.
5. Whenever possible, meniscus surgery is done using arthroscopy, rather than through a large cut in the shoulder.

Symptoms and Treatment of Torn Meniscus

Gone are the days when bone ailments and damages were detected based on the experience and superficial conversations made by the physicians. These days with the advent of radio waves, medical science has made significant progress that has enabled a detailed overview of what exactly is going on inside your body and what should be the most relevant treatment in that regard. Magnetic Resonance Imaging or more commonly known as MRIs are a boon when it comes to diagnosing orthopedic and musculoskeletal complaints.

Common Uses of the Procedure:

MR imaging is usually the best choice for examining the:

body s major joints.
spine for back pain
soft tissues (muscles, tendons and ligaments) and bones of the extremities.
MR imaging is typically performed to diagnose or evaluate:

degenerative joint disorders such as arthritis.
tears of the menisci, ligaments and tendons (knee) or rotator cuff and labrum (shoulder and hip).
fractures (in selected patients).
spinal disk abnormalities (such as a herniated disk).
the integrity of the spinal cord after trauma.
sports-related injuries and work-related disorders caused by repeated strain, vibration or forceful impact.
infections (such as osteomyelitis).
tumors (primary tumors and metastases) involving soft tissues around the joints and extremities (such as muscles, bones and joints).
pain, swelling or bleeding in the tissues in and around the joints and extremities.
congenital malformations of the extremities in children and infants.
developmental abnormalities of the extremities in children and infants.
congenital and idiopathic (developing during adolescence) scoliosis prior to surgery.
tethered spinal cord (abnormal stretching in the spinal cord) in infants and children.
The Process:

In this process, X-rays and radio waves are subjected upon the affected region to examine the conditions of the bones, tissues, muscles and also detect the presence of tumours. This is majorly a non-invasive test and is painless. It does not use ionizing rays and therefore does not harm the body in any which way. The MRIs capture a detailed picture of the organs and the internal body structures and then transmit them onto a computer screen for the physician to monitor the inside story.

The Benefits: 

MRI is an imaging technique that does not require exposure to radiation.
MR images of the soft-tissue structures of the body (particularly muscles, bones and joints) are often clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in early diagnosis and evaluation of many conditions, including tumors.
MRI can distinguish abnormal tissues from normal tissues much more accurately than most other imaging tests (x-ray, CT, etc.).
MRI enables the discovery of abnormalities that might be obscured by bone with other imaging methods.
The contrast material used in MRI exams is less likely to produce an allergic reaction than the iodine-based contrast materials used for conventional x-rays and CT scanning.
MR images allow the physician to clearly see even very small tears and injuries to tendons, ligaments and muscles and some fractures that cannot be seen on x-rays and CT.

Orthopedic and Musculoskeletal MRI

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

What does neck and shoulder pain indicate?

The stabbing pain that you experience around the neck and shoulder region should never be ignored as they may indicate health problems that require medical attention. There are certain points that you need to keep in mind the if you experience prolonged pain in these areas of the body.

1. Neck injury? your neck and shoulder pain should be seen as a warning sign that you need to take a look at the neck injury you may have sustained during a rear-end automobile accident. More specifically, whiplash injuries that happen when the head experiences a sudden backward and forward jerk, straining the tissues of the neck. 

2. Pain in these areas of the body could indicate abnormalities in the vertebrae of your neck such as herniated disc, causing added pressure on the nerves of the spinal cord.

3. Your neck and shoulder pain complaint may also point towards muscle strains. Lifestyle factors like working long hours in front of laptops or desktops leave you with no time and zero energy to exercise, resulting in serious neck and shoulder pains.

4. Your neck and shoulder pain may also indicate the problem of cervical spondylosis. This is a degenerative disc disease, which is characterised by severe pain that originates from the neck and radiates till the shoulders.

5. Even heart problems, such as a heart attack can cause pain in the shoulder and the neck. When this happens, the condition is known as referred pain.

6. Adopting an improper body posture during lifting of heavy materials can induce pain in your body parts, with neck and shoulders being the most vulnerable areas.

7. You may be suffering from a condition known as rotator cuff injury in which the group of ligaments and muscles that support the shoulder get injured during lifting or playing any sport.

To avoid aggravating the pain from becoming more severe, you shouldn't ignore any ache that arises from these areas.

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

Related Tip: 6 Effective Ways to Keep Away Body Pains, esp. When Temperatures Dip

What Does Neck and Shoulder Pain Indicate?

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