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

If you are suffering from gout, you should try undergoing a homeopathic treatment. Gout is a type of arthritis and is considered to be the most painful type. It is featured by the inflammation of joints accompanied by great pain. The pain and inflammation occur because of the deposition of urate crystals in a joint. The accumulation occurs when there is excessive uric acid present in the blood.

Here are some effective homeopathic remedies for the treatment of gout:

Colchicum: This medicine is the primary homeopathic medicine for treating gout because of its effectiveness. It is mostly used in chronic cases of gout. Usually, a patient experiences extreme pain in the big toe, which is too intense to be touched. The toe and other parts which get affected become swollen, red and hot. The pain worsens in the evening and at night. Patients who require this medicine should keep away from warm weather conditions. This medicine is also used in case of increased weakness and internal cold.
Ledum Pal: This effective medicine is used in cases where the pain travels in an upwards direction from below. The pain is likely to start at the feet and gradually move upwards, affecting the knees and legs. The pain also shoots through limbs. Small joints are commonly affected. There is a sensation of decreased warmth in the joints and in the body. The patient will find it difficult to tolerate any kind of external warmth. The pain improves by cold applications. The ankle balls or big toe may be swollen.
Benzoic acid: This homeopathic medicine is used for treating gout where offensive urine is experienced. The urine becomes very offensive with a very strong odor, which can be detected from a distance. The odor is usually repulsive and the color of the urine is brown. Extreme pain is experienced in the big toe and the knees are swollen.
Antim Crudum: This is an efficient homeopathic medicine used for treating gout. It is used when a patient experiences gastric symptoms along with joint pain and inflammation. The patient may develop an increased craving for food and hence, several problems occur due to over eating. Pain is experienced in the heels and fingers.
Sabina: This homeopathic medicine is important for treating gout in women, when the patient already suffers from another female disorder. Uterine symptoms are experienced along with the basic symptoms of gout. Shooting pain is experienced in the toes and heels. The joints get swollen and look red and shiny.
Homeopathy offers a completely natural treatment for different types of gout and goes beyond just curing the symptoms. You need to consult your doctor before starting a homeopathic treatment for gout.

5 Homeopathic Remedies for Treating Gout Pain

Natural Ways To Manage Arthritis

You might be aware that there is no way that you can prevent arthritis to happen except for being car. But what you can do is delay and reduce the risk of its potential onset. If your joints are healthy now, there is no guarantee that they will always be, unless, you take good care. 

Do you know a few kinds of arthritis can be modified. They are:

1. Gout - Have a healthy, balanced diet which is low in cholesterol, alcohol and sugar. This will help you fight against the onset of gout.

2. Osteoarthritis - To modify the risk factor of osteoarthritis, it is important to maintain a healthy weight.

How to defeat arthritis?

1. Keep a check on your weight: If you are obese, you are putting more pressure on your joints and as a result, they wear out soon. By losing weight, you can make a lot of difference in your joint health.

2. Ensure good water intake: Our body is 70% water. And water is one of those things which is the most important for us. Staying hydrated is very important, even for your joints. Because when the body is dehydrated, and the body needs water, it uses the water stored in our bodies, incl the water in the cartilage.

3. Try to avoid any injury: No one really wants to get injured but it is important to be careful and cautious against injuries of any kind. The more injured your joints are, the more susceptible they are to wear and tear now, and arthritis later in life.

4. Don’t stress with physical tasks: There is a way and correct posture to do them, but many people ignore those and perform the tasks clumsily. This puts additional pressure on your joints.

5. Get Your share of Vitamin D: Vitamin D is very important for us. If your body has adequate amount of vitamin D, then you are less susceptible to arthritis. It is wise to get the levels tested and if low, a doctor consulted for proper medication.

If you would like to consult with me privately, please click on 'Consult'.

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Pain- free Arthritis? Here’s How To Make It Happen!

Pain in the joints continues to bug mankind till this very day. There are different types of joint pains, which might occur all of a sudden, with no signs of receding. The most common of them all are arthritis, tennis elbow, frozen shoulder, back pain and repetitive muscular strain. These joint pains are sometimes impossible to diagnose properly by the regular modes of diagnosis. In those cases, resorting to the homeopathic mode of medication might be a good idea as it is a medication based on treating the actual cause of the disease and sustained use might result in complete remission of the pain.

Some commonly used homeopathic medications for pain in the joints are as follows:
1. Rhus Tox: This is the most commonly used in homeopathic preparation for severe joint pains, the symptoms of which include severe pain after relaxation, pain triggered by slightly wet weather and pain after walking or running for a long time.

2. Arnica Montana: When the symptoms are pain in every joint of the body resulting in body aches and pertaining injuries due to accidents, Arnica Montana serves as the perfect medication.

3. Actea Spicata: This medicine is primarily used as a remedy for pains in the small joints of the hands. The symptoms for which the medication can be implemented are rheumatoid arthritis in the joints of the finger and swollen wrists after usage of the hand.

4. Colchium: This medicine can be used in case of Rheumatoid Arthritis (inflammatory and chronic form of arthritis).

5. Bryonia Alba: This medication can work wonders if the symptoms include severe pain in the knee joints while walking, severe swollen joints and osteoarthritis (affects the flexible tissues present at the bone ends).

However, it is always advisable to take medication as prescribed by your doctor, as the potency and frequency can only be decided by your doctor.

Homeopathic Treatment for Pain in the Joints

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

Three Ways to Protect Your Knees

The knee is known as the largest and one of the most complex joints in the human body, and also one of the most vulnerable, as it supports the weight of the entire body. The knee joint is made up of several elements including the knee cap, meniscus, connective tissue, tendons, ligaments, cartilage, and muscles. Damage to any part of the knee can cause chronic pain. So how can you protect your knee from damage and injury? Take a look at these three points!

Dealing with Load: Weight is a big one. Carrying around extra pounds and kilograms can be detrimental for your knees in the long run. Your knee is not equipped to handle the excessive weight. It already supports three to five times your weight when you get up and walk around or indulge in some mild jogging. One must be careful of those extra pounds to take the load off the knee and keep it from falling prey to damage.

Exercise: Moderate to intense exercise is prescribed for one and all. This, of course, depends on one's overall health and age. If you are already suffering from joint pain, then you may want to go easy on the exercise with a focus on building muscle strength and foundation. If you are healthy, then some amount of daily exercise as a routine will keep those knees in prime working condition and well lubricated as well. Inactivity and a sedentary lifestyle can affect the knees very badly.

Do not Ignore: Warning signals such as chronic or acute knee pain should not be ignored. Remember to see a doctor or an orthopaedic specialist to find out if you have contracted an infection or if you may have suffered a fracture due to an injury. Also, it is important to take a bone density test regularly, especially after the age of 40 or for women going through menopause, as this will point to any deficiencies and even warn you in case there is any trace of osteoporosis.

Rest, exercise, and food should be kept in fine balance for a healthy body. These are a few measures that one can take to keep knee pain at bay. Yet, it is also advisable to speak with a doctor at length regarding measures to protect your knees.

Remember to ask us for a private consultation today!

Three Ways to Protect Your Knees

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