When you experience any kind of bone and joint pain, you may be wondering what the best remedy might be to get relief. Some people ignore the pain, and it worsens, while others take over-the-counter medicines. However, the best remedy for bone and joint pain is to visit a pain management specialist. The field of pain management has evolved over the last twenty years. Nowadays, there are dedicated pain management specialists who are experts in treating bone and joint pain.

Here are 3 reasons to consult a pain management specialist for bone and joint pain:
1. Pain management specialists are trained especially for understanding any kind of bone or joint pain. They undergo special training based on bone and joint pain management and thus know how best to recognize and treat such pains.

2. Pain management specialists have a multidisciplinary approach towards treating bone and joint pain. The aim of pain management is to provide overall treatment and pain management specialists know about the best ways to take care of joint and bone pains. Pain management involves interventional procedures, psychological therapies, medication management and physical therapies. Pain management specialists also provide you with lifestyle modification remedies and assign you exercise schedules and diet plans. Alternative medicines like acupuncture and massage therapies are also provided by pain management specialists.

3. Pain management specialists cooperate with you and come up with the best solution for your bone and joint pain. Pain is such an aspect, which has no fixed cure and the remedy varies from person to person and depends on the nature and severity of the pain. Thus everyone should receive a personalized treatment, which is most suitable to cure the pain that has occurred to them. Pain management specialists work with patients, discuss a lot and come up with the best treatment procedure, which would complement the patient. For example, a neurostimulation device can be prescribed to a patient who suffers from complex regional pain syndrome and did not have success with other treatment procedures. In many patients with a shattered spinal disc, pain management specialists prescribe injections, which work effectively to give relief and treat the condition.

A pain management specialist can make the best assessments on bone and joint pain. Being trained especially in bone and joint pain management, you can bank upon pain management specialists to receive the best treatment for your bone or joint pain.

3 Reasons to See a Pain Management Specialist for Bone and Joint Pain

Leg bypass surgery is needed when the patient suffers from peripheral artery disease. PAD is a very common condition in elderly people, where the rate of flow of blood to the limbs (in this case, the legs) is reduced due to narrowing of the blood vessels.

Causes and risk factors-

The narrowing of the blood vessels occurs due to excess calcium accumulation and fat deposits in the walls of the arteries. The following are the risk factors of PAD-

  Age (60 years and above)
  Smoking
  Diabetes

The condition may be life-long or can last for years.

Symptoms that indicate you might need a leg bypass surgery-

The following are the signs and symptoms of PAD, which suggest you should consider having a leg bypass surgery-

  Pain in the legs, especially when walking
  Pain in the buttocks
  A sore on a foot/leg that does not seem to heal
  Thinning of the skin on the legs
  Loss of hair on the legs
  Tingling, weakness, or numbness in the legs
  One or both the feet/legs may feel cold
  The feet or legs may appear bluish, pale, or dark reddish in colour

You should get yourself checked by a specialist in the initial stage, or else the condition may get worse and affect your day-to-day activities.

Vascular surgery for PAD in the legs:

Vascular surgery is a surgical sub-specialty, which manages vascular system disorders- disorders of the veins, arteries, and lymphatic circulation- by surgical reconstructions, minimally invasive procedures, and medical therapies.

The most commonly used surgical procedure is the leg bypass surgery. The surgery aims to reroute the supply of blood around an obstructed artery in one of the legs.

How is leg bypass surgery performed?

The surgeon performs leg bypass surgery using a graft (usually made of plastic tube) to bypass or replace the blocked portion of the artery. On some occasions, the graft may be a vein or blood vessel taken from the patient s body (usually, the other leg).

During the surgery, the surgeon will first administer anaesthesia so that you are not able to feel pain or discomfort. He/she will make an incision over the portion of the blocked artery. After carefully removing the skin tissues, the surgeon will place clamps on each side of the narrowed artery and sew the grafts in place. The surgeon will ensure that the flow of blood in your lower extremity (legs) is good. An arteriogram (an X-ray of the arteries/blood vessels) is recommended to make sure that the graft is working fine after the leg bypass surgery.

For most people, leg bypass surgery helps improve the flow of blood in the arteries. The prognosis is better if underlying medical conditions like diabetes are controlled.

Leg Bypass - Treating It Through Vascular Surgery!

Sciatica, which is pain along the huge sciatic nerve that runs through the lower back to the back of each leg, can bring about serious, weakening pain. The term sciatica depicts indications of leg pain along with potential shivering, weakness, or numbness that starts in the lower back and goes through the butt cheek and down the vast sciatic nerve in the back of every leg. However, here are some top ways to get pain relief from sciatica:

1. Chiropractic/manual control
Spinal adjustment and manual control performed by properly trained health experts, for example, chiropractors and osteopathic doctors, are centered around giving better spinal cord alignment. These are intended to address various basic conditions, which can bring about sciatic nerve pain.

2. Acupuncture
This practice is based on the goal of achieving or keeping up the strength through an open stream of energy by certain pathways in the body. Hair-thin needles (which are generally not felt) are embedded into the skin, close to the zone of pain.

3. Subjective behavior therapy
This treatment for taking control and evolving self-defeating behaviors can be useful in overseeing sciatica pain, especially in the short term. Sessions with an advisor might be face-to-face or on the web.

4. Massage treatment
Certain types of back rub treatments have proven to have various advantages for back pain, including expanded blood flow, muscle relaxing, and release of endorphins (the body's regular pain relievers).

5. Strengthening activities
Many activities can strengthen the spinal cord and the surrounding muscles, tendons, and ligaments. The greater part of these back exercises center around the lower back, as well as the (stomach) muscles and gluteus (butt cheek) and hip muscles.

6. Stretching
Stretching is usually prescribed to mitigate sciatic pain. Stretching for sciatica is intended to target muscles that cause pain when they are tight and unyielding. Hamstring stretch is very often an essential part of a sciatica exercise program. As part of everyday exercises, many people do not stretch these muscles, which extend out from the pelvis to the knee in the back of the thigh.

7. Low-impact aerobic activity
Some types of low-impact cardiovascular workout, for example, walking, swimming, or pool therapy, are generally parts of the recovery, as high-impact action increases the exchange of liquids and nutrients to make a better environment for healing.

8. Micro-disectomy
In situations where the sciatica pain is because of a lumbar disk herniation, a microdiscectomy is the most widely recognized surgical approach. It is an open surgery done using magnification techniques. In this surgery, just the bit of the herniated disk that is squeezing the nerve is evacuated. Whatever is left of the plate is left in place.

Top Eight Ways To Get Pain Relief From Sciatica!

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

Tennis elbow is a condition, which is characterized by the inflammation of the tendons occurring in the elbow region due to excess use of the muscle groups present in the overarm. Tennis elbow can cause a lot of distress once it occurs so it is best to perform certain exercises to strengthen the muscle groups in your overarm so that muscle strain does not occur during your physical activities. Read on more to find about all the different ways to strengthen your muscle groups to prevent tennis elbow.

1. Staying in good physical shape overall tones your body and strengthens your muscle groups, thus reducing the likelihood of tennis elbow.

2. It is also important that the physical activities, which are performed by you are done using proper technique as otherwise undue strain might cause unnecessary discomfort and pain.

3. You should try strengthening the muscles in your shoulder, arm and upper back to reduce the stress your elbow undergoes during physical activity.

4. Using a counterforce brace for activities, which include twisting or grasping of the arm can also help. The use of a counterforce brace is to distribute the pressure throughout the arm, which reduces the stress on the elbow. The brace is highly recommended for people who are likely to develop tennis elbow. One should consult a doctor before opting for a counter brace. 

However, it is not a substitute for rehab exercises. If repeated arm movements or certain physical activities are causing discomfort or pain in the elbow region, check for alternative ways of performing the task. If you have taken up tennis, cricket or golf as a sport, it is highly recommended that you take proper lessons in technique as these sports involve twisting and grasping your arm, which can cause injuries if you do not follow proper techniques. Also keep in mind to choose sports equipments which are at par with your physical fitness, flexibility and strength.

For daily activities, take a note of the activities, which involve putting stress on your elbows. In such instances follow techniques or different ways to perform the tasks, which will put minimum stress or pressure on your elbows. Also, apart from using the technique one has to stay fit, for which getting regular body health check up is very important.

How to Prevent Tennis Elbow

Bones and muscles, together known as the musculoskeletal system, are responsible for all bodily movements. The bones and muscles move in unison, as they are connected by what are known as tendons, which are thin fibrous tissue. These tendons are prone to damage and inflammation known as tendinitis (this can cause inflammation in any organ). It can occur in any bone/joint but most common in areas which are prone for repetitive use including the wrists, arms, elbows, shoulder, knees, and ankles. 

Read on to understand how it happens and how it can be managed.

Causes: Depending on the onset, tendinitis can be acute or chronic. Though it can occur in any individual, the risk increases with age, as bones lose their elasticity and can tear.

Acute is caused by a sudden injury like a fall or accident or infections
Chronic is caused by repetitive movements, poor posture, poor stretching, overuse, etc. Some common movements include carpentry, painting, golfing, tennis, gardening, lawn mowing, badminton, etc.
Symptoms: As with any inflammation, the symptoms of tendinitis would include swelling, pain, redness, and warmth. There is also a reduced range of motion of the affected joint, producing what is known as adhesive capsulitis.

Prevention: Tendinitis is preventable to some extent by avoiding repetitive work and overuse of the joint. Those who are used to a lazy week and an active weekend should definitely watch out. Sudden, excessive stress can cause tendinitis. The tendons should be subjected to limited stress and activity. With any kind of activity, if there is even a slight hint of pain or any issue, get it checked with the doctor. Continuing to do the same activity will only make it worse. Symptoms to watch for include fever, swollen and painful joints, and limited movement of the affected joint.

Management: If identified and arrested in the early stages, tendinitis can be managed conservatively. Progressive measures of treatment would include the following.

As soon as there is discomfort identified, rest the joint and stop any activity, which you think could have caused the problem. Usually, this should help the condition to subside on its own. Ice and heat therapy can also help.
If it is the ankle or the knee, keep it elevated.
Pain killers may be taken if the pain cannot be tolerated or is affecting daily routine.
After the initial week, mild exercises to strengthen the tendon can be started.
Steroid injections may be required in cases where the joint pain and swelling is significant.
As a last resort, if the above measures do not work, surgery may be recommended. This will again be followed by rest, medications, and physical therapy.

Tendinitis - Ways It Can Be Managed!

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