Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

Breaking a bone is, needless to say, a painful experience. But, when people have their broken bone put in a cast, they tend to forget about it until it comes out. This is quite wrong! A person would want to be up and running but does not find that the hand or the leg as it has been cast up. For weeks, the person's hand or leg barely moves and also shrinks up quite a lot!

There is a lot of pain, not only due to shrinkage when a fracture occurs. The occurrence itself causes what is known as acute pain. Then, for some weeks, the sub-acute pain just seems to persist, to the person having the fracture. The reason for this is the fact that the bone and the soft tissue are in the process of healing.

Chronic pain is a worry as it does not go away even after the healing process has ended. In order to make sure that there is a quick recovery and there is no chronic pain which is experienced at all, some of the proverbial leaves need to be taken out of the book of physiotherapy.

To start with, sometime between a fortnight and a month after the injury or the bone break has taken place, the doctor will wish to see some movement in the soft tissue that has broken around the bone. The great advantage of this is that while it may be a little bit of effort and time involved, there are great benefits by the way of less pain and swelling as the blood flows as normally as is possible.

If such movements are not done, a person can have related soreness, which can be even more of a pain! An example of this would be a broken foot or ankle causing the stiffness of the knee. When a person is already in pain, adding to his or her trouble makes no sense at all, does it?

Post one month mark, the physiotherapist would want to see more functioning so that the normal levels can be attained. A person who has a fracture should not despair as if he or she is willing to stick to the schedule given by the physiotherapist and perform all the exercises that have been set out, he or she will be back at the normal level much sooner than would have been expected!

Also, getting active again will reduce the risk of a repeat injury, and that is enough justification to do so!

What To Expect When Recovering From Broken Bones?

Wounds and bruises are both injuries. However, they differ widely in terms of the causing factors, the nature of the injury, the pain they cause and the kind of treatment they require. The following are a few of the myriad ways in which the two injuries differ from each other:

1. A wound causes quick damage - the skin tissue is cut or punctured while a bruise (also called a closed wound) is where the skin is not torn. 

2. A wound is usually caused by a sharp object but bruises are the results of blunt force or trauma.

3. A wound almost certainly bleeds due to ruptured tissue and blood vessels. Blunt injury also damages the blood capillaries of the skin and causes blood to accumulate under the skin tissue, creating a dark patch of skin. Blood vessels can also break due to lifting of heavy objects or overexertion of muscles.

4. A wound carries the risk of infection because the skin is open but a bruise does not get infected.

5. A wound has a burning or stinging sensation but a bruise is characterized by swelling and a blunt throbbing pain.

6. A wound can be healed by antiseptic and antibiotic medication. Large wounds need to be closed by stitching them up to avoid severe infection. On the other hand, a bruise usually heals by itself. A cold compress and pain killers may be used to ease discomfort. Heat can be applied to the injured spot to normalize the blood flow and dissolve the blood clot.

7. A wound can lead to complications like bacterial infections or the healing might be delayed by chronic diseases like diabetes. In case of a bruise, it usually does not cause complications but if there's a blunt injury to sensitive areas like the head, the tailbone or the eyes, medical attention is advised.

8. Wounds and bruises can also be differentiated on the basis of their subtypes. The different types of wounds are:

a. Incision (sharp objects cutting the dermis layer of skin)
b. Abrasion (the epithelial tissue is scraped off)
c. Avulsion (a body structure is torn off)
d. Penetration (a sharp object causes an entry and an exit wound)
e. Puncture (only an entry wound caused by a sharp object)

The different types of bruises are:
a. Hematoma (blood pools under the skin)
b. Purpura (tiny spots of blood on the inside of the mouth)
c. Contusion (similar to hematoma and caused by external trauma)
d. Crush injury (caused due to a large amount of force on the body part for a long time)

Wounds VS Bruises

One of the deadly diseases caused by the bite of an infected mosquito is Chikungunya. If you suddenly experience unbearable joint pain with symptoms of fever, consult a doctor immediately. Even the name Chikungunya etymologically means "to become twisted". If you are having the aforementioned symptoms, there is a high chance you are suffering from Chikungunya.

Symptoms of Chikungunya
Chikungunya affects your body within 3-4 days of the mosquito bite. The first sign of Chikungunya is sudden fever, which causes mild tremors in your body accompanied by severe pain and swelling of the joints. A headache and pain in the muscles are other two symptoms of this disease. The most glaring indication that you are suffering from it is the excessive joint pain you experience. This pain usually lasts for a few days to a couple of weeks. If left untreated, this disease can prove to be fatal. 

1. The joint pain will have a paralyzing effect on your body resulting in extreme pain.
2. Your finger joints and foot exhibit signs of swelling, causing severe pain.
3. You will experience pain in your hip, wrists and elbows.

Other symptoms of the disease include neurological and mild cardiac complications. You may even complain of having an eyesore. Also, there are chances of you suffering from gastrointestinal problems. However, none of these symptoms will be as severe as the excruciating joint pain you experience.

Some preventive measures can be taken, them being:
a. Drink plenty of water to keep yourself hydrated.
b. Get plenty of sleep. It might be impossible for you to sleep especially when you are having body aches. Thus ask your doctor for some painkillers which will let you rest.
c. Paracetamol is a must to beat fever and joint pain.
d. Anti-inflammatory pills will be strictly recommended by your doctor to treat the inflammation.
e. Use a mosquito net at night
f. Keep your house clean so that the Chikungunya mosquitoes don't thrive

Suffering From Severe Joint Pain? It Could Be Due to Chikungunya

One part of the human body is essential for the efficient functioning of another. The hip joint provides support to your overall body weight while you are at ease or in motion. Suffering from medical problems pertaining to the hip can impede free movement; walking, running, stooping, sitting or even lying down will cause immense pain and discomfort in such a situation. While certain bodily disabilities come with old age and are in most cases unavoidable; some others can actually be controlled through physical exercise.

Take a look at a few stretches to improve your hip mobility:-

Stretch like a pigeon- this yoga loosens up muscle tension in and around a person's hip. Your right leg must be stretched behind while the upper part of your body bends over a folded left leg in front. Your head rests on your coupled hands. This stretch improves the shape of your hip as well.
Try to be an eagle for hip firmness- to align your body in the perfect eagle pose; you probably need to be a conjurer; that is the kind of flexibility the posture requires. Be a half chair making your hands intersect above your head while your left leg crosses the right one. The pressure is on your hip making it strong. Your body has to be in one single line.
Sit in the chair pose- crouching on your haunches with your torso inclined to the front is a good way to better hip mobility. This exercise also relieves you of back pain. It adds potency to the muscles of your upper thighs thus giving a well- rounded hip extra support.
Stoop in the downward doggy pose- the downward doggy pose helps you concentrate on the fullness of your hips. The back muscles are stretched and the problem of a small, rickety hip is dealt with through this yoga. Your legs should be erect at the knees and should be stretched apart depending upon the width of your hip. The rest of your body should bend in a forward arch while your spread hands touch the ground.
Try out the benefits of world's greatest stretch- world's greatest stretch involves a series of stretches that not only accentuates your hipline making your hip muscles adaptable to stress but also tones muscles in other parts of your body. It is a three- fold exercise. The second step is the most difficult where your body is balanced on a half folded right leg and you're required to touch the ground with your right elbow.

Tips to Improve Hip Mobility

Your knee is a very complex structure consisting of bones, ligaments, cartilage, tendons, muscles and meniscus. Most people encounter knee pain at some point in their lives. If your knee pain is chronic in nature, then it may last for a prolonged period.

Many causes may be responsible for your knee pain. Some of the causes are stated as follows:
1. Your knee is very much prone to injuries. Knee injuries may happen due to accidents, falling down carelessly or while playing sports. The most common knee injuries that may be the cause for your knee pain are mentioned as follows: 
a) Fractures may cause you to feel pain in the areas of your knee bones.
b) Anterior Cruciate Ligament injury (ligament injury caused by twisting and a sudden motion) or Medial Collateral Ligament injury (injury to the tissue in the insides of your knee) is very common to sportspersons and may be the reason for severe knee pain.
c) Sometimes your knee bones may get dislocated from their usual alignment. This can also make you experience severe knee pain.
d) Ligament injuries, meniscus tear or tendon tear can also be responsible for your knee pain.

2. Sometimes pain in your buttock or foot region can also result in mild knee pain.

3. At times chronic problems like osteoarthritis that affects the cartilage can cause the problem of knee pain. Other chronic problems like Gout, rheumatoid arthritis can also cause severe knee pain.

4. Being overweight can also result in knee pain.
The symptoms of knee pain may be different in each case. The most common symptoms are mentioned below:
a) Stiffness of knee
b) Swelling of your knee
c) You may also feel unstable
d) Difficulty in walking or bending of your knee.
e) You may notice redness in your knee area.

Knee pain must not be ignored. It is highly recommended for you to seek advice from an orthopedic as soon as you encounter any of the above mentioned symptoms.

Suffering from Knee Pain - Know What Causes it? 

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