Causes and symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease, which is characterized by the inflammation of the joint lining and gives rise to pain, stiffness, warmth and redness in the joints. The inflammation occurs in the tissue that normally produces lubricating fluids for the joint. This condition is progressive in nature, and can cause the destruction of joints, leading to functional and locomotive disability.

Though rheumatoid arthritis is a disease that can last for years, patients may not experience any symptoms for a long time. In some cases, the disease may affect other parts of the body like the eyes, lungs, and the heart.

The severity and duration of the symptoms are unpredictable, and the symptoms experienced are:

- At times, people experience increased disease conditions called flare-ups.

- They may also experience alternating periods when the symptoms fade or diminish, which is referred to as remission.

- Some of the common symptoms of the disease include lasting pain and stiffness for more than an hour in the morning, inflammation, fatigue, fever, and a general sense of discomfort.

- Inflammation in the joints close to the hands like wrists and fingers and other parts like neck, shoulders, elbows, knees and hips can also be affected.

- In some cases, both sides of the body are affected at the same time, which is known as inflammation in a symmetric pattern.

Rheumatoid arthritis is usually caused by the body's weakened immune system, which produces antigens to attack itself. The trigger to this reaction is not yet clearly deciphered.

It is diagnosed by clinical examination (American association of Rheumatology criterion) supported by relevant Investigations.

Management

Management for Arthritis includes the following aspects:

1) To control disease activity and control of symptoms of pain, stiffness.

2) Medical treatment to prevent system effects of the disease.

3) Nonmedical treatments comprise of dietary therapy, physiotherapy, immunomodulation therapy.

4) Minimal surgical therapy like arthroscopic synovectomy to confirm the diagnosis as well as reduce disease activity. At times, with the advanced decline of joints, a major surgery like replacement therapy may be required for specific cases.

What's more important is to know that at any stage of the disease patient can adopt and live an active life with appropriate treatment.



What Really Causes Rheumatoid Arthritis?

Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

Head Injury is any trauma to head other than superficial injuries to face. It results in high morbidity & mortality. Head injuries are an important cause of loss of young people at their productive age.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Street fights

Fall from height

Child abuse

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of the possible symptoms of brain injuries:  

Nausea and vomiting, fatigue or sleepiness, severe headache, confusion, amnesia,  loss of consciousness, seizures, loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected, coma, dilation of the pupils and disturbance of vision, Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood, difficulty in breathing, low pulse rate, increase in blood pressure, difficulty in swallowing, loss of hearing, problems in cognitive functions.

Brain damage is a process, not an event. 80% are minor head injuries, 10% are moderate head injuries and 10% are major head injuries.

Management of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Glasgow Coma Scale

Pupillary reaction to light

Brain stem reflex tests

Head to toe examination

CT scan of head is the initial study of choice. MRI Brain is helpful in cases of non-haemorrhagic contusions, diffuse axonal injury and deep lesions.

Surgical Indications

Head injuries with intracranial hematomas causing significant mass effect

Massive cerebral edema

Hydrocephalus

Infection

Precautions for Head Injury

Use Helmets- both riders

Use Seat Belts

Keep vehicle speed under control

Follow traffic rules

Take adequate precautions during trekking, diving

Take Away-

No head injury is minor enough to be neglected nor severe enough to be given up.

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.



Head Injuries - All You Must Know!

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 sciatic nerve is the longest nerve in the human body. It runs from the lower back, through the buttocks, your hamstrings and into the lower leg. Sciatica means pain in the leg, numbness or any kind of weakness in the lower back. There can be many reasons for a leg pain such as an injury to the leg or it can be due to the main nerve which travels in the lower back. Many times, it is not diagnosed properly and hence it will take a lot of time to respond to the treatment or in some cases, it may not respond at all. 

Symptoms of Sciatica: 

You will experience pain in the lower back only on one side of the body. 
The pain continues from the lower back to the sciatic nerve. 
Rarely, you will see the pain on both sides of the body or buttocks. 
The pain is very sharp. 
In some cases, the patient may experience a needles or pins sensation in the leg and in some cases, it is weakness or numbness in the lower back. 
The pain gets so severe that you will not be able to walk or even stand. 
If you have lower back pain combined with leg pain, then lower back pain is not going to be as severe as the leg pain. With the help of the symptoms, your doctor will be able to diagnose sciatica but in order to know the exact cause and origin of this pain, you will have to undergo other tests and examinations. 
Physiotherapy for Sciatica: 
There are many surgical treatments available for sciatica, but it is always good to go for non-surgical treatments. So you can opt for physiotherapy. You will be able to see better and long lasting results with this treatment. As it involves a thorough assessment of it on which the treatment protocol is laid. 

Physiotherapy involves four phases: 

Pain relief 
Restoration of normal flexibility 
Restoration of full functionality 
Prevention of recurrence 
In sciatica, it is due to unbearable pain, you seek treatment. So that has to be treated initially. When you can see that the pain is under control, then the physiotherapist will start working on the range of motion for your joints. The muscle tension will be reduced and muscle strength will be improved. In the third stage, your physiotherapist will start working on restoring the normal function of your body, especially your legs and your lower back. In the last stage, the physiotherapist will help you with some exercises that will stop its recurrence. Usually, sciatica will return after some time but taking a little care at the early stage can prevent it.

Physiotherapy For Sciatica - Why Is It The Best Treatment Option?

Plantar fasciitis is the inflammation of fascial ligament (the plantar fascia) at the base of the heel bone. It is a commonly experienced heel pain condition which is caused due to injury or even wear and tear as well as excess weight gain, in some cases. The plantar fascia is the name given to a flat band of connective tissue that holds the foot and the rest of the leg in place with the heel in between. This also supports the foot s arch and helps in connecting the heel bones to the toes. When there is inflammation as well as weakness in this tissue band, then pain may occur and is known as plantar fasciitis.

It may occur in one foot or both feet and may also be caused due to old age, for many individuals. Also, those who are heavily into athletics can also face this kind of wear and tear of the plantar fascia. As with many pain-related conditions, this one can also be treated with regular and moderate exercises that can be practiced to build flexibility and strength. 

Let us find out more about the three exercises that are most suited for treating this condition.

Stretching: Stretching is an exercise that can help in repairing most joint and tissue pain as it helps in pulling the damaged parts back into the right place, especially if any kind of misalignment has occurred. This kind of action can also have a soothing effect when the pain increases. You can stretch your calves in order to help the pain that is caused by plantar fasciitis. You can start by facing the wall and placing your right foot over the left one. Then, place your palms on the wall and remain at a distance of one arm. You will then need to bend you left leg in a forward motion as your right leg and heel press against the ground. Hold for 30 seconds and release. Then, repeat with the other leg.
Chair stretch: Another way of doing stretch exercises is with the help of a chair. You will need to sit on a chair and remain in an upright position for this exercise. Keep a frozen water bottle or cylinder under your foot and roll it back and forth as you maintain a firm grip using your foot and heel.
Big toe stretch: While you are still seated on the chair, you can do a big toe stretch by crossing your leg over the knee and pushing and pulling your big toe. This will help in stretching the tissue that is causing the pain. You will need to pull and hold for at least 15 to 30 seconds for each toe. Practice on both feet.

Plantar Fasciitis - 3 Exercises That Can Help Relieve Pain!

One month, the injury is still healing, two months, just a little bit longer, three months? Well, you, believe it or not, it has probably become a chronic pain and is affecting every aspect of your life. Chronic pain may be a novel notion to accept but is now understood to be a disease and generally defined as pain persisting for longer than 12 weeks. Pain management in such cases is traditionally treated through prescription drugs, the other option being amputation.

This is a major cause of patients having qualms about these pills and a need for an alternative. In response to this, doctors have a new tool to help decrease the perception of pain which is a small implant placed in the back to help patients shake off the pain. This small device that could bring you back to your feet is the spinal cord stimulator.

What is spinal cord stimulation?

Theoretically, the spinal cord stimulation is a type of neurostimulation which produces an effect that interferes with the brain s ability to interpret the signal as pain by using electrical pulses. The brain, instead, experiences it as a pleasant numbing sensation. The implant is placed which takes place in two parts i.e. placing the lead device in the spine and placing the pulse generator in abdomen or buttock.

For test stimulation, the several stimulation settings are tried so that the pulse generator can be programmed using these settings. The procedure typically takes 1-2 hours and post-procedure, patients are given a handy device to control the simulations which they are to use in their day-to-day lives.

It has been observed to reduce the pain by at least 50%. However, this too has its limitations. Typical candidates are people with chronic back and limb pain who may have a failed back or disc procedure. The most common risks associated are device-related, example, unintended movement of the leads. Serious effects include hemorrhage in the epidural space or injury to a spinal cord leading to neural damage, but these are highly uncommon.

Quick facts about it

The best product which works for spinal cord stimulation is a long-lasting solution with a need to change the battery of the lead device every 9 years.
The most recommended device today is the implant because of its compact size and the device costs is quite nominal.
The quality of the product matters a lot as there are ample of cheap products available on the same lines. The same can be fitted within the body via a procedure.
The procedure conducted is also called the pain pacemaker.
Earlier, the procedure was used to conduct only in the international countries, but nowadays the implant can be done in India as well. If you are apprehensive about consuming painkillers for your chronic pain, you can explore this option with your Interventional Pain Specialist.
As it is said, lasting pain can lead to damage, hence don t wait until the damage repair has a complete null chance, rather reach out to your doctor to understand more about the concept of SCS so that you can get treated in no time. Explore the option with your "Interventional Pain Specialist".

Spinal Cord Stimulator - How Is It Beneficial In Pain Management?

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