Insomnia is a disorder where a person has difficulty sleeping. One can have problem falling asleep or staying asleep for long. Some people also have disturbed sleep. This can be a major problem as due to lack of sleep one feels tired and fatigued all day.

Recurring cases of insomnia hamper your daily activities and interfere with the smooth functioning of your life. Therefore, this condition should not be ignored and treated immediately.

Here are the various ways to treat insomnia:
Non-Medical (Cognitive and Behavioral treatment)
Several psychological and behavioral techniques can be used for the treatment of insomnia. Many of these methods can be easily self-taught and others require a therapist to be carried out properly. 

1. Relaxation training, which is also called progressive muscle relaxation involves the patient to tense and relax his muscles systematically in various parts or regions of the body. Relaxation techniques, such as breathing exercises, various forms of meditation, mindfulness and guided imagery are used for treating insomnia people. The use of audio recordings for guidance in these techniques is quite popular.

2. Stimulus control enables building an association between the bedroom and sleep. This is done by limiting several kinds of activities done in a bedroom. This may include going to bed only when very sleepy and leaving bed if you cannot sleep within twenty minutes. A strict bedtime and wake up time schedule has to be maintained.

3. Cognitive behavioral therapy or CBT involves changes in behavior like maintaining a strict sleep time schedule, elimination of afternoon naps and other habits related to sleep. A cognitive component is also added to this method. Unhealthy beliefs and fear regarding sleep are challenged and positive, rational thinking is encouraged. CBT is a very effective procedure for treating insomnia and the track record regarding success is high.

4. Changes in lifestyle are required to treat insomnia and prevent recurrence of insomnia, you should change certain habits and start some new practices. You should limit your intake of caffeine, alcohol and nicotine. Do not consume coffee or tea before going to sleep and avoid smoking. The habits may be stimulating and will keep you awake. Your diet should be balanced. You should avoid having rich and spicy food before going to bed. Avoid late meals and maintain a proper schedule for meals. Regular exercise can improve the symptoms of insomnia and you should try to work out every day.

Medical Treatment
There are many forms of medicines, which can treat insomnia. This includes over-the-counter medicines, as well as prescribed medicines. The type of medicine required completely depends on the severity and symptoms of your insomnia and other factors related to health. Therefore, you must consult a doctor before having any kind of medicine for treating insomnia.

The most common medicines for insomnia, which are usually prescribed by doctors are benzodiazepine hypnotics, non-benzodiazepine hypnotics and melatonin receptor agonists. However, medicines should only be taken after consulting with a specialist. Insomnia not only affects your health but also interferes with all your daily activities. Proper treatment should be taken to treat the same.

Ways to Treat Insomnia

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

The human body is so amazing yet sometimes, it is delicate. The condition of cervical spondylitis is one of the examples of this being the case. It is also known as cervical disc disease and is reputed to cause a pretty large amount of pain! That being said, it is not as if this pain cannot be reduced. After all, physiotherapy can make almost any situation better and this is pretty much the case with cervical spondylitis, as well!


Neck traction happens to be one of the popular methods prescribed by physiotherapy to help people who are suffering from cervical spondylitis pain. What is done in this process is that the neck is extended but at a very slow rate. While this may not seem like much itself, why this helps is that it goes a pretty long way in taking a lot of pressure off the discs of the spine. While it is true that neck traction is a thing which can be performed at home, it is very important to check with a professional physiotherapist to make sure that the technique that one is practicing is faultless so as to make sure that any painful accidents are not allowed to take place and make the situation worse than it already is!


Physiotherapy is all about engaging in activities which help make the condition better. So, when a person has cervical spondylitis pain, the therapist will spend some time with him or her so that the neck can be slowly adjusted and this will help the range of motion of the person s neck improve by quite a large margin.


There are quite a few other ways to go about relieving the pain caused by cervical spondylitis by making use of physiotherapy. For example, deep tissue massage does have a large number of fans who swear by it. This is also the case when it comes to electrical stimulation. As a matter of fact, both of these are quite popular as a means to get the patient in the right condition for healing exercises to have their full effect.


After all the effort which is put in by the person by the way of exercise, it can be said to be important that he or she makes use of a cervical pillow, which is more commonly known as a neck pillow and a cervical collar, which can help the process of realignment. With correct physiotherapy, cervical spondylitis pain will soon be history!


How Can Physiotherapy Help Alleviate Cervical Spondylitis Pain?

Gridhrasi is what Sciatica is known as in Ayurveda. It is the disorder that causes mild to agonizing pain in the sciatic nerve or neuralgia. These nerves, emerging from the pelvis, run along the hamstring and may cause intense pain in one or both the legs when a person suffers from Sciatica. Sciatic pains fill your life with misery as the simplest of daily activities cause sudden and excruciating pain. There are two types of sciatica i.e. true sciatica and pseudo sciatica. Sciatica may be caused due to bulging disc or herniated disc, degenerative disc disease, piriformis syndrome, pregnancy or trauma etc. 

According to Ayurveda, Sciatica is caused due to impairment in Vata i.e. the dosha responsible for the functional ability and movement of the body and also in some cases due to impairment in the Kapha i.e. the dosha that is responsible for body fluids and lubrication. Ayurvedic herbs that improve the symptoms of Sciatica are:

1. Babunah is also known as Bitter Chamomile. Not only is it used to relieve and reduce the pain faced by a sciatica patient, but it is also used for treating problems such as rheumatism due to the advancement of age. Compressed bitter chamomile flowers are prescribed for sciatica.
2. Guggul is also known as Indian Bdellium. Since guggulu is well known for its anti-inflammatory properties, it relaxes the sciatic nerves.
3. Rasna is also known as Vanda Orchid. Intense or agonizing pain due to the sciatic nerve issues can be reduced by this ayurvedic herb due to its anti-inflammatory properties. 
4. Juniper oil is extremely helpful when massaged onto the thigh muscles with firm strokes or pressure. It is used extensively in massage therapy for treating sciatica since the extent of reduction in sciatic nerve pain is tremendous. 
5. Jaiphal is also known as Nutmeg. After being mixed with sesame seeds oil, nutmeg is coarsely powdered and then fried till it turns brown. This is then applied to those areas where the sciatic pain is intense for instant relief.
6. Kumari is also known as Indian Aloe. Properties of Indian Aloe are extremely helpful in treating lower back ailments such as sciatica and lumbago.
7. Shallaki is also known as Boswellia or Frankincense. Containing anti-inflammatory properties, shallaki is applied externally to get relief from sciatic nerve pain. 

Ayurvedic preparations such as yogaraja guggulu, Vataganjakusha, Saindhavadi taila are also very useful in treating Sciatica.

Ayurvedic Treatment of Sciatica

The testes are an important part of the human reproductive system and are susceptible to injuries as well as internal problems. One such problem which is known to afflict younger men mostly from the age of 12 to 16 is testicular torsion. It can affect older men, but is commonly seen in the aforementioned age group. It is a painful condition that will require medical attention and if left untreated might even result in removal of the organ in rare cases.

What is testicular torsion?
There are many intricate functions performed by multiple blood vessels within the scrotum that supply the testes with blood. However, one of the testicles might rotate and thus end up twisting the spermatic cord. This cord brings blood to the testicles and if twisted, will reduce the flow of blood significantly. Thus the scrotum may swell up and also become quite painful.

Symptoms of testicular torsion
1. Significant swelling of the scrotum
2. Mild to extreme pain in the scrotum.
3. Abdominal pain, especially in the lower abdomen
4. Unusually positioned testicle such as one significantly higher, behind, or in front of the other one.
5. Fever
6. Feeling nauseated and may be accompanied by vomiting
7. Pain during urination
8. Inability to sleep or waking up in the middle of the night due to the constant pain

What causes testicular torsion?
In certain cases, testicular torsion may occur and then go away on its own when the testicle rotates, resulting in the untwisting of the spermatic cord (which is also known as de-torsion). However, it is still advisable to visit a doctor and ascertain what caused it so that the risk factor could be eliminated as torsion and de-torsion could keep happening frequently. Some of the common causes for testicular torsion are mentioned below.

Hereditary factors: If someone in your family has suffered from this condition, you could be susceptible to it.
Injuries: If you receive minor trauma such as the one during playing any kind of contact sports, outdoor activities or even while doing house work, it can be a reason of this condition as well.
Activities that put stress on the scrotum: Heavy exercising or running in an unbalanced or improper manner can cause torsion as well.
Improper sleeping positions: This can also cause torsion and is a common cause behind frequent torsion and de-torsion.
Other factors: These factors can include excessively cold temperatures wherein the scrotum contracts rapidly and prolonged contraction can cause torsion. Even the rapid growth of the scrotum during the adolescent years after puberty may cause this.

Torsion of Testes - 5 Common Causes Behind It

Pain is unpleasant suffering caused by injury or illness. Back pain may be sudden/constant, dull, severe or not responding to short rest and medication. Constant pain in back in any region of spine for more than few days to weeks needs intervention.

Pain which is intense especially at night requires urgent visit to a specialist.

Sudden onset of pain in back with or without injury needs urgent attention.

Back pain with difficulty in walking, pain while getting up from position of comfort, pain during change of posture or pain after prolonged sitting (for work) can lead to serious permanent damage, if left untreated.

Pain which travels to one or both legs may be due to pressure on the nerve/s and if left untreated for long can lead to permanent weakness or damage.

Pain associated with numbness, tingling or weakness in legs, especially below the knees, commonly called Sciatica, needs to be investigated. Various spinal ailments can lead to weakness in one or two limbs or all four limbs. There may be associated or isolated numbness (loss of sensation to touch, pain or temperature) without back pain.

Numbness, tingling or weakness may be the only symptoms without any complaint or without history of back pain.

Problems related to bladder control which may be difficulty to control, hesitancy in passing or dribbling of urine. There may be associated constipation. Loss of bowel/bladder control is caused by pressure on spinal cord &/or nerves which may be due to injury, infection, disc prolapse or tumor.

Sudden swelling and redness in back usually happens after an injury or accident but sometimes are signs of underlying severe illness.

Loss of normal shape/curvatures of spine can present with or without pain. It can lead to forward, sideways or rarely backward bending.

Unintentional weight loss, loss of appetite, evening rise of fever or disturbed sleep with associated back pain/weakness/numbness needs visit to a specialist.

When Should You See Your Doctor in Back Pain?

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