A Guide to Dealing with Fibromyalgia

Fibromyalgia is a chronic condition marked by constant flu-like symptoms such as fatigue, headaches, insomnia and joint pains. However, the disease has no visible symptoms. There are also no known causes for the disease. While some believe stress to be a trigger for fibromyalgia, other theories suggest that physical and emotional factors such as a prior illness lead to the onset of this disease. This leads to fibromyalgia patients being often misunderstood and misdiagnosed. Almost 80% of fibromyalgia patients are women. While the disease is not lethal, it can make daily life difficult.

The criteria for fibromyalgia were established only in the late 1900s. In addition, the symptoms of this disease present themselves differently in each patient. This makes diagnosis very difficult.

Constant pain all over the body is the most common symptom of fibromyalgia.
You may also feel constantly tired, and unable to get a restful sleep.
Some fibromyalgia patients also suffer from depression or anxiety and an irritable bowel syndrome.
Fibromyalgia patients may also feel hyper sensitive to cold or heat, and feel numbness in fingers and toes.

Fibromyalgia has no known cure, and like arthritis, treatment for this disease addresses its symptoms. Most treatment programs include a combination of drugs, physical therapy, and behavioral techniques.

Pain relievers or anti-inflammatory medication and antidepressants are the two types of drugs administered to fibromyalgia patients. However, these should not be counted on as a long-term solution, as the side effects of these medicines can cause additional problems. Therapeutic massages and chiropractic manipulations can also help ease the pain. Along with this, it is also important to rest and relax. This helps reduce stress which often triggers fibromyalgia symptoms.

To get a better night's sleep, try going to bed and getting up at the same time every day. A warm glass of milk or chamomile tea just before bedtime can also help induce sleep. As far as possible, avoid taking sleeping tablets, as the body can soon become dependent on these.

Though you may constantly feel tired, increasing the day to day activity levels can have a positive effect on your health. Consider adding low-intensity activities such as walking, cycling, yoga or dancing to your daily routine. Complement these with a well-balanced, nutritious diet that includes lots of fruits and vegetables. If you or a loved one has fibromyalgia, bad days may not be prevented. But with treatment, they can be controlled.

A Guide to Dealing with Fibromyalgia

Fibromyalgia is a condition characterised by chronic widespread body pains and increased responsiveness to pressure. Women are at a higher risk of suffering from this disorder than men. Fibromyalgia can be treated with physiotherapy, pharmacotherapy and combined efforts of physician and the patient.

Some of the symptoms that characterize this disorder are:

Pain: Fibromyalgia is characterized by pain that has no apparent reason. It can affect different parts of the body and presents itself in different ways. Some people may experience a stabbing pain while others complain of a persistent dull ache. This pain may be affected by climate changes or stressful situations. There is reduced threshold to pain, because of certain chemical ( neurotransmitters) abnormalities in brain. Pain is generalized, felt above and below the waist, right and left-side of body, arms, legs, neck and back. 
Abnormal Sensitivity: Fibromyalgia patients are extremely sensitive to environmental changes that involve sight, sound and smell. For example, cigarette smoke can make a fibromyalgia patient extremely nauseous while loud music can give the person an instant headache. Lights that are brighter than normal can also make such a person feel uncomfortable. Patients have an abnormal sensitivity to pain, which leads to generalized aching of the body and tender points. 
Muscle & Joint Stiffness: Fibromyalgia patients often experience stiff muscles and joints without any form of strenuous activity or other reason. This may be localised to one group of muscles or affect the whole body. For some patients, this pain is worse in the morning or when sitting for extended periods of time. However, moving around does not provide any significant relief.
Chronic fatigue and exhaustion: There are two main reasons for a fibromyalgia patient to complain of tiredness. Firstly, the condition itself drains a person of energy even without overexerting themselves. Secondly, the pain and joint stiffness can hamper a person s sleep and lead to sleep deprivation. Over time, this can become a vicious cycle of tiredness and insomnia. Chronic fatigue also affects a person s immune system causing his or her energy levels to drop.
Cognitive impairments: Fibromyalgia patients also complain of a compromised short term memory. They often face difficulties recalling names of people they have recently met or other newly acquired information. These people may also have trouble concentrating on tasks for extended periods of time and experience mental sluggishness also known as fibro-fog.
Irritable bowel syndrome: Bowel disturbance is another common symptom of this disease. Passing stool may become difficult due to a combination of pain and muscle stiffness. With time, this problem can worsen unless addressed with laxatives. However, an over-dependence on laxatives can lead to further problems.
Somatic Symptoms: Apart from pain, patient experiences unrefreshing sleep and fatigue throughout the day. Other associated features can be depression, abdominal cramps, chest pain, tingling.
Lab Tests: Fibromyalgia is a clinical diagnosis. There are no definite laboratory tests. In fact, most conducted tests will turn out to be normal. 
Treatment: Foremost important is an education of patient and caregivers, regarding nature of the disease. The patient needs to indulge in recreational activities and undergo supervised physiotherapy. There are potent medicines to correct the chemical imbalance in the body thereby increasing the pain threshold and leading to better quality of life.

Fibromyalgia - 6 Main Symptoms!

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

Throwing a ball, lifting something or even eating requires the use of the elbow joint. This is one of the most overused joints in the body and hence is very susceptible to wear and tear, which mostly causes pain. Pain in the elbow could be the result of an issue with the arm muscles, ligaments, tendons, bones or bursae. The treatment for this pain depends largely on the factors causing it. Some of the most common conditions that cause elbow pain are:

Golfer s Elbow
This condition is also known as 'Medial Epicondylitis'. It is caused by an overuse of the elbow muscles and affects the elbow s inner tendons. Resting the elbow, cold packs and the use of over-the-counter pain killers can usually relieve this sort of pain.

Tennis Elbow
This condition is also caused by repetitive actions and affects the elbow s outer tendons. It is also known as lateral epicondylitis. Resting the elbow can help this type of pain. In addition, patients may also need to wear an elbow strap or brace to support the joint. In some cases, physiotherapy may also be needed.

Student s Elbow
This is also commonly known as draftsman s elbow or olecranon bursitis. This condition affects the small fluid sacs or bursae in the elbow. These fluid sacs aid in the movement of the elbow. Leaning on the elbow for a long time, a sharp blow or an infection could be the cause of this condition. It can be treated with medication and elbow pads. In chronic and severe cases, surgery may also be needed.

Fracture or Dislocation
Falling on the elbow can lead to a bone being dislocated or a fracture in the joint. In such cases, the pain will be accompanied by swelling, discoloration and difficulty in moving the elbow. Fractures and dislocated bones need medical attention. Your doctor may advise you to wear a brace or a cast depending on the severity of the issue.

Sprains and Strains
Repeated stress or a trauma can result in a sprained or strained ligament. In such cases, the joint will feel unstable. Pain caused by these ligament conditions can be relieved by resting the elbow, applying a cold pack and wearing a brace to support the elbow. Sometimes, a doctor may also advise physiotherapy.

Panner s Disease
This condition is caused by dislodged pieces of bone and cartilage that could be the result of an injury. Young men are the most affected by it. Resting the joint and abstaining from lifting any weights can help relieve pain caused by Panner s disease. In some cases, physical therapy may also be recommended.

Elbow pain can be tricky to treat. Sometimes, it can just go away with rest or with the application of cold packs or rehabilitation exercises. The most important thing is to be patient and get the treatment process started. Make sure to consult with a doctor before treating any kind of elbow pain. Home remedies are best avoided when it's the elbow at stake.

Pain In Elbow - Know The Causes and How to Manage It

The Hijama or Cupping Therapy is an ancient form of Alternative medicine that has long been practiced in Egypt, China, and few Middle Eastern countries. The cupping therapy work wonders to deal with problems ranging from body pain, skin lesions to inflammation. It also plays a significant role in improving the circulation and blood flow. But what is the Cupping Therapy and how does it work? In this article, we will discuss some important points related to the cupping therapy along with its merits.

What is a cupping therapy?
A Cupping Therapy is a non-invasive procedure that involves the use specially designed cups (made of silicone, bamboo, glass, or earthenware) placed on the target skin area to create a vacuum or a suction to help treat a particular health condition.

What happens in a cupping therapy?
The cupping therapy can be Dry or Wet

In both the types, before using the cup, the cupping therapist uses a flammable substance such as herbs or alcohol (placed inside the cup) and sets it on fire. With the fire slowly going off, the therapist carefully puts the hot cup in the target area of the skin in an inverted (upside down) position (for around 3 minutes). This is done to create a suction inside the cup triggering an expansion of the blood vessels. Alternatively, a rubber pump can also be used to create a suction.
In Wet cupping therapy, the steps involved in creating the first suction (generally a mild one) is identical to those used in Dry Cupping. However, in wet cupping, following the first suction, small incisions or scratches are made in the target skin area. During the second section, it is through these cuts that the elimination of the toxic or impure blood takes place.
Soon after the therapy, the cuts are well bandaged along with the application of medicated creams or lotions to ensure a fast healing sans any complications.
For better lubrication and movement of the cups, the therapist may apply a herbal or medicated oil to the skin.
Some people may also opt for Needle Cupping. As indicative of the name, needle cupping involves the use of Acupuncture needles (inserted into the skin over which the cups are then placed to carry out the suction and the subsequent therapy).
Merits of a cupping therapy

The cupping therapy is a nonsurgical therapy that can be used to treat many health complications such as high blood pressure, varicose veins, gynecological problems (including infertility), anemia, dermatological conditions (such as eczema and acne), fibromyalgia, migraines, arthritis, hemophilia, to name a few.
The cupping therapy ensures a better pain management.
It works wonders in the case of stress and anxiety.
The cupping therapy goes a long way to restore the balance between the three Doshas.
It comes with negligible side effects (light bruises, mild burns, or minor skin infections).

Cupping Therapy - Know How It Works!

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

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