The knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

Sciatica is a neurological condition that mainly arises due to problems in the sciatic nerve. The sciatic nerve is believed to be the largest nerve originating from the spinal nerves L4 to S3. It extends downward from the lower spine into the back of each leg (thighs) right down to the foot. The sciatic nerve acts as a connecting link between the spinal cord and the foot and the leg muscles. People with sciatica often experience a tingling sensation along with a shooting pain radiates downwards from the lower back (mostly the lumbar region) to the back of one of the legs. Some may also experience the sciatic pain down both the legs (rare).

Types of Sciatic Pain:

Sciatica that affects a person can be of two types depending on the severity of the associated symptoms

Acute sciatic pain: In this case, a person experiences a sudden radiating pain which often heals by itself within a week or two. More than often, the pain is triggered by an injury to the spinal joints, nerves, or the disc.
Chronic sciatic pain: This is a more serious condition where the pain may linger for long, often more than three months. The chronic sciatic pain may affect a person with severe Arthritis and nerve injury and damage.
Symptoms associated with Sciatica:

One of the characteristic symptoms of Sciatica is a shooting pain that radiates from the lower back (often the lumbar) to the back of one (or both) of the legs.
In some, the sciatic pain may result in weakness and a tingling sensation down the affected leg.
A person with sciatica may find it difficult to move his/her foot and legs (restricts their movement).
Some people may experience a shooting pain even while they are in a sitting position. In some others, the pain may be at its worst when a person is in a standing position.
Sciatica can also trigger a hip pain.
What triggers sciatica and the associated symptoms?

The disc is a protective shield that prevents any damage or injury to the vertebrae. A degenerative disc problem can interfere with the normal functioning of the disc triggering sciatica.
Spondylolisthesis: In Spondylolisthesis, also known as a Slip Disc, a bone (mostly in the lumbar region) slips over the bone which is located just below it. People with prolonged and untreated spondylolisthesis are often known to suffer from sciatica.
The sciatic pain can also affect a woman during her pregnancy.
Lumbar spinal stenosis: This condition is is characterized by the spinal canal narrowing down in the lumbar region. Lumbar spinal stenosis exerts pressure on the sciatic nerve, giving rise to sciatica.
A muscular strain or spasm in the buttocks can also be a contributing factor.
Proper management and prevention for sciatica are possible. One should be alert and consult a doctor in case they experience the associated symptoms or any discomfort.

Sciatica Pain - What Can Trigger It?

A sprained thumb is a painful condition caused due to an injury on the ligament of a thumb. A ligament is a soft tissue, which connects bones to each other at a joint. The ligament might get partially or fully torn due to extreme backward bending of thumb causing the ligament connecting the thumb and index finger to suffer injury.

The problem is quite common among basketball, rugby and football players. For this reason, it is known as a sports injury. Skiing may also cause extreme pressure to the thumb, causing a ligament tear. Injury due to skiing is called skier s thumb.

The injury causes pain, bruising and tenderness. It can cause swelling on just the thumb or sometimes on the entire hand. In severe cases, weakness and instability in the region can be seen. A sprained thumb weakens the ability to pinch and grasp things. The patient will have trouble holding a glass, turning a knob or writing. An untreated injury may lead to joint stiffness, muscle weakness, scar tissue formation, instability of the thumb or even arthritis. It is strongly advised to visit a professional therapist for an early diagnosis and treatment.

Usually, an X-ray leads to an apt diagnosis of the injury. The doctor also ascertains damage to the bone and ligament and develops a treatment plan. Some ligament tears can be treated using a splint or cast. A chronic ligament tear might not heal and would require surgical intervention.

A partial or mild ligament tear can be managed through useful home remedies like putting an ice pack, bandage or splint. It is also advised to keep the thumb elevated and restrict its movement. A heat pack is beneficial as it can ease pain and relax the muscles. However, heat pack must be avoided during the first 48 hours of injury as it can lead to bleeding.

If there is a chronic injury and the ligament is completely torn, a surgery is needed. A surgery helps join a new ligament to the bone in case the torn ligament fails to heal. It also helps reconnect the injured ligament to the bone. Sometimes, there might be bone damage as bone fragments might get pulled away with the ligament. In such cases, bone fragments need to be put back in their position through surgery. After the surgery, a cast or splint is put till it heals completely.

An early visit to a physiotherapist has potential advantages. A therapist can fasten the healing process, help relieve pain and improve a person s ability to resume daily tasks. Massages and strengthening exercises are initiated to avoid re-injury and instill strength in the injured region. Physiotherapy also helps immensely after surgery through planned mobility exercises that regain movement and strength.  

Sprained Thumb- Causes and Treatment

Ever faced a nagging low back ache that just won't quit? You could be dealing with sciatica. Sciatica or sciatic nerve pain is not a diagnosis in itself, but is a symptom of a deeper problem. Conditions that trigger sciatica include degenerative discs, spinal stenosis, a herniated disc in the lumbar region or   spondylolisthesis. Whether your sciatica pain is persistent or sporadic, it can make routine tasks difficult to perform. The good news is that there are a number of remedies to ease this pain and improve the health of your spine.

1. Hot and cold therapy: Sciatic pain that extends down to the thighs can be relieved by alternating between a heat pack and an ice pack. Each pack can be applied for about 20 minutes at a stretch every two hours. However, this does not treat the sciatic nerve itself.

2. Pain medications and steroid injections: Over the counter pain medication like ibuprofen or muscle relaxants can help alleviate pain and reduce inflammation. In chronic cases, epidural steroid injections may also be prescribed to address the inflammation and pain. Pain relief provided by medication and steroid injections can last for a few days or a few months depending on the person.

3. Yoga: Sciatica patients looking for long term relief often turn towards alternative forms of treatment like yoga. Yoga helps strengthen muscles, increases flexibility and improves posture. This is more beneficial towards preventing sciatica problems from arising than treating ongoing sciatic pain. When practicing yoga with a sciatica problem, it is very important to understand your body's limitations and not over extend your back muscles.

4. Massage: A massage that treats sciatic pain is very different from the usual massage you may get at a spa. A massage to relieve sciatic pain involves putting pressure on the inflamed part of the back and the piriformis muscle. This is the muscle that sits over the sciatic nerve and triggers sciatic pain. In most cases, 3 to 4 massage sessions at intervals of 7 to 10 days can have effective results on sciatic pain.

5. Physical therapy: Sciatica patients often find the slightest movement extremely painful. While lying in a bad is tempting, it can actually worsen the pain. Exercise increases blood flow to the spine and helps flush out toxins. Going for a walk, light aerobics or swimming are ideal ways for a sciatica patient to exercise.

6. Chiropractic manipulation: This involves realigning the spinal column and is an effective way of treating underlying conditions that trigger sciatic pain. These spinal adjustments should only be performed by licensed chiropractors or osteopathic physicians.

Treatments for Sciatica Pain

The backbone is made up of multiple small bones which are connected together by a softer bone. The spine is what allows important body movements including bending and walking. The issue is, with age, the backbone also loses its elasticity and becomes rigid. Though this is a natural process with ageing, lack of exercise and sedentary lifestyle makes it worse.

Lumbar spondylosis is the medical term for this chronic, degenerative condition of the lumbar and the sacral spines (the lower portion of the backbone). This leads to chronic stiffening of the spine, affecting movement. This joint is very crucial in all bending movements and spinal movements.

Causes of Lumbar Spondylosis:

Ageing: As the condition progresses, the nerves that run through the spines can get exposed and there could be pain and irritation
Genetic abnormalities that produce a weak bone
Spinal trauma like accident or falls
Sedentary lifestyle: Sitting in front of the computer for prolonged hours also causes lumbar spondylosis
Overuse: People who are weightlifters tend to put excessive pressure on the spine, causing lumbar spondylosis
Symptoms:

Stiffness and pain in the low back
Pain with continued sitting
Numbness and tingling if nerves are getting affected
Loss of balance, leading to frequent falls
Losing control over bowel and bladder movement
Pain radiating to the lower legs
Ayurvedic remedies: This includes a combination of external applications, yoga, and food preparations including kashayas and tailas.

This condition is caused by increased Vata and Kapha. Maharasnadi kashayam, Astavarga kashayam, and Dashamoola kashayam reduce these elements.
Pain and inflammation is relieved by the use of various Guggulu including Mahayogaraja Guggulu, Simhanada Guggulu, Trayodashang Guggulu, and Dhanvantara Vati  
The affected joints can be hydrated with the use of gandha taila and dhanwantharam.
Kukkutandatvak bhasma is known to strengthen the bone.
Ashwagandha is known to lubricate the vertebral disks and joints
External treatments like Abhyanga are useful in improving joint movement. They improve circulation and help in removal of toxins so that pure blood can flow and reduce inflammation.
Vasti: This helps in improving nutrition to the joints and bones, thereby helping them repair themselves and heal.
Yogas for lumbar spondylosis: The five most effective asanas are:

Ardhakati chakrasana
Pada hastasana
Matsyasana
Ardha chakrasana
Vakrasana (sitting in a chair)
Additional measures:

Sit in a comfortable position with adequate back support
Take short breaks to avoid continued sitting
Sleep comfortably, by resting the back adequately
Strengthen the back muscles by regular exercises.
Eat healthy, avoid junk, and drink plenty of water.

Lumbar Spondylosis & Ayurveda - What To Expect

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!

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