Anterior Cruciate Ligament (ACL) injury is one of the most common knee injuries. Athletes who play high strain sports like football, rugby and basketball are more at risk in developing this kind of injury.
The ACL is one of the four primary ligaments in your knee. The injury occurs when the ligament is overstretched.

Signs and Symptoms
ACL happens in steps:
a) First, you might hear or feel in your knee a 'pop' sound
b) Next, you might experience pain and an inability to move or continue with your activity
c) Then your knee will swell up
d) Lastly, hemarthrosis develops

Causes
The ACL injury can happen in various ways. Injury may occur if
1. You change directions quickly
2. You stop suddenly
3. You slow down while running
4. You jump and land incorrectly
5. You are tackled, like in football, through direct collision or contact

Diagnosis
The doctor will use the following tests to diagnose ACL injury:
1. Pivot-shift test: This test is done to check for instability
2. Anterior drawer test: This test is done to check for the suspected tear in the ACL
3. Lachman test: This test more or less resembles the anterior drawer test. It is considered far more superior in diagnosing ACL injury than the anterior drawer test.

Treatment
Treatment of ACL depends on the patient's age and lifestyle. A younger patient, who is involved in sports will need surgery to restore agility. An older patient can heal without surgery.
1. Conservative Management: This is recommended for people who are older and lead a quieter lifestyle. Also if the knee is overall stable, the doctor might opt for this treatment. Bracing and physical therapy is enough in this case. To protect the knee stability, braces are given. Crutches are also used to keep from exerting weight on the injured leg. When the swelling subsides, some exercises are performed. This is part of the rehabilitation program. Exercises will strengthen leg muscles that surround the knee.
2. Surgery: If the patient is young and has a very active lifestyle, surgery is very much needed. There are three surgical methods:
a. Primary repair- this method is not recommended barring bony avulsions, which are typically seen in adolescents
b. Extra-articular repair- generally includes a tenodesis of the iliotibial tract
c. Intra-articular reconstruction- this is the standard treatment for ACL injuries.

All About Anterior Cruciate Ligament Injury

One of the most common complaints of men and women is that of a back ache with lower back aches being the most common. Apart from an improper posture, this may be caused by old age, lifting heavy weights or an injury to the back. A consistent back ache can affect your daily life and make performing regular tasks uncomfortable. Luckily, it can be managed quite well with simple ayurvedic remedies.
According to Ayurveda, backaches are triggered by an excess of Vata dosha. Thus, the Ayurvedic remedies for a back ache aim at reducing the Vata dosha. Ayurvedic remedies are natural and have negligible side effects. 

For this reason, they can be prescribed to both children and adults. Some such remedies are:

Cut down on spices: One of the main characteristics of the Vata dosha is dryness. This can be caused by pungent spices such as wasabi and green or red chillies. The internal dryness caused by these spices can lead to constipation which in turn can be one of the causes of low back aches. Hence, if you suffer from a chronic backache that may or may not be accompanied by constipation, cut back on the spices and try eating food that is slightly blander.
Eat food before it gets cold: Eating cold food or cold drinks can also increase the Vata dosha levels in our body. Coldness creates congestion and constricts the internal organs while warm food allows the digestive and stool carrying channels to stay open. This allows for the easy expulsion of waste and reduces toxins in the body. Hence, opt for warm drinks like tea or coffee instead of soft drinks and juices and try to eat your food while it is hot.
Padahastasana or the standing forward fold pose: This yoga asana is very effective when it comes to treating back pain as it allows the Vata dosha to flow easily through the body. In doing this it opens up the digestive channels that may have been causing constipation and back pain. It also relieves problems associated with sciatica. To practise this asana begin by standing upright with your feet beside each other. While inhaling, lift your arms over your head till they touch your ears. Bend forward from your hips while exhaling and try to keep the back and your legs straight. Touch the floor or wrap your hands around your calves. Bring your head as close to the knees as possible and hold for 5   10 seconds. Inhale and the slowly roll your body upright again.

Back Pain - Ayurvedic Remedies for Managing it!

You must have had an ankle sprain or at least heard of it   it is an injury to the ligaments surrounding and connecting the bones of the leg to the foot. The injury occurs when you accidentally turn or twist the ankle in an awkward way. This can tear or stretch the ligaments that hold together the joint and bones of your ankle.

What Could Possible Lead to a Sprained Ankle? 
A sprain occurs when the ankle joint is forced out of its normal position as a result of the following  

  Awkwardly placing the foot while stepping up and down, jumping or running
  Stepping on an irregular surface
  During a sport or any sort of rigorous physical activity
  An injury while exercising
  Wearing inappropriate footwear

Symptoms of a Sprained Ankle-
A sprained ankle causes pain, swelling, and limited range of motion. You are likely to experience the following symptoms you sprain your ankle  

  Tenderness
  Bruising
  Stiffness
  Discolouration of skin
  Instability in the ankle
  Limping
  A popping sound or sensation at the time of the injury
  Inability to put pressure on the injured ankle

The symptoms of an ankle sprain are usually self-diagnosable and treatable at home. Nevertheless, you never know how severe the sprain could be. Therefore, consider seeing a doctor when you are having problems with your foot or ankle. A specialist can determine whether the injury is just a sprain or something more serious, with the help of X-ray and MRI.

What is the Treatment for Ankle Sprain?
The line of treatment depends on the type of sprain your ankle sustains. Treatment options include  

  RICE   Many people resort to simple home remedies such as RICE and cold compress to treat a sprained ankle. RICE refers to Rest, Ice, Compression, and Elevation. It is a first-aid cure for strains and sprains.
  Cold Compress    Helps reduce inflammation and dulls pain sensation
  Medications   If you visit an orthopaedic, he/she will prescribe the NSAIDs to ease pain and reduce inflammation and fever
  Braces and Splints   These are applied to aid in stabilizing and protecting the injured joint and its movement
  Elastic Bandage   Stretchy bandages are used to wrap strains and sprains. These provide compression and support during recovery.

Apart from medications and devices, the doctor may also recommend stretching, physiotherapy, and massage. Mild physical movement and exercise will help relax your muscles and restore flexibility and muscle strength.

An ankle sprain cannot be prevented; it can happen anytime. What you can do is consult a specialist and seek treatment to get back to your daily activities.

Know More About Ankle Sprain!

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

Osteoporosis is an age-related condition characterized by low bone density and fragile bones. Lack of calcium and vitamin D are the most common triggers of this condition. These are vital elements for healthy teeth as well. Osteoporosis has a direct relationship with oral health and can trigger a number of issues such as loss of teeth, gum and can cause periodontal disease. The effects of osteoporosis on oral health and affect more women. This risk increases when talking of menopausal women.

The jawbone is one of the areas that bear the brunt of osteoporosis. The loss of bone density in this area can cause tooth loss and make teeth lose. It can also affect the gum ridges that hold dentures in their place. This can result in ill-fitting dentures that need to be frequently changed.
Medication for osteoporosis is also linked to dental health. In rare cases, antiresorptive medicines that are prescribed to strengthen the bones can lead to a condition known as osteonecrosis. This refers to the death of a bone due to poor blood supply. Antiresorptive medication can be administered orally or intravenously with the latter having a higher risk of triggering osteonecrosis. Though it affects the hips and shoulder bones in most cases, it can also affect the jaw bone. It is marked by pain, swelling, infection and exposed bone. Loose teeth, gum infections and numbness or heaviness of the jaw are also symptoms of osteonecrosis of the jaw bone.
The risk of suffering from osteonecrosis cannot be determined beforehand. Hence it is a good idea to see your dentist before or just after starting antiresorptive treatment for osteoporosis and to schedule regular checkups for the duration of your treatment. Dental problems if any should be treated before starting medication for osteoporosis. Osteonecrosis of the jaw bone is most commonly seen after undergoing a dental procedure that affects the jawbone and associated tissues such as a tooth extraction. Ideally, invasive dental procedures should be avoided if you are taking antiresorptive medicines. However, it can also occur spontaneously.
Bisphosphonates are also commonly prescribed to treat osteoporosis. This type of medication slows down the breakdown of bone tissue. However, this can lead to the development of new bones. This is not a troublesome issue when it comes to bones like the hip, leg or arm bones but can be very disruptive if it affects the jawbone. This is because the jaw bone is constantly reforming and reshaping itself.

Osteoporosis - Can It Impact Your Oral Health?

Our skeletal structure is truly a work of art however, when we are faced with bone related disorders, our lives is no less than a roller coaster ride. Arthritis is one such ailment which can really alter the quality of life of a person who suffers from it. Taking into account the impact, would it not be good to know the symptoms of early arthritis, so it can be detected before it gets too bad?

There are a few symptoms of the condition, but it is to be noted that the intensity of the symptoms even in the earlier stages of the issue do vary widely. As a matter of fact, the problem can be developing for months on end without a person even knowing that he or she has arthritis while on the other hand, there are quite a few cases in which a person is provided with an almost instant  notification  that arthritis has started having its degenerative impact on his or her joints.

What signs to watch out for?
There are three areas that need attention if trying to detect arthritis:

Knees: When a person is in the process of developing arthritis, the signs he or she should be aware of include his or her knees being shaped like an outward curve; if he or she is developing the condition in the knee. Apart from this, a limp can also be seen for a lot of people who develop arthritis which affects the joints which bear the weight of the body. The best example of this is a case of arthritis affecting the ankle or the knee.
Neck: If a person has a near constant pain in the lower back or also of the neck, he or she should be aware of the fact that there could be arthritis developing and it is important for a doctor to be consulted about the same.
Fingers: In some cases, the signs of arthritis may not even be the cause of pain to a person. This is true when a person begins to develop something such as Bouchard s node; which affects the fingers when arthritis begins to set in on the digits. These nodes are not painful, in most cases, but, it is to be kept in mind, that they have the ability to limit the motion of the fingers which are affected.
Arthritis is something that can and should be limited to as far an extent as possible, rather than being allowed to worsen a person s condition and not allow him or her to have the freedom he or she is used to having in life. When in doubt, a quick consultation with a doctor can really save the person a lot of pain later on!

If You Have These Symptoms Check For Arthritis!

Don't wait any longer, manage your Osteoarthritis Specialist online with a Lybrate doctor today

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