It is normal and alright to feel pain in the knees occasionally after a physical activity or prolonged walking. However, it is a serious cause of concern if the pain is experienced every now and then. Not responding to your knee pain for long can lead to the extreme disability. Knee pain does not crop up in a day and it may surprise you when it first appears. 

Initially, you may notice slight pain and discomfort. If you have identified knee pain at this level, managing it is easy. You can perform different exercises to prevent pain from occurring. If the pain severe, you need to go consult a doctor, who will then help identify the real cause of pain. The following exercises, along with medications, can help you overcome knee pain and restore the mobility of the joint.

Stair Step ups: Choose a comfortable stairway. Place your hand on the wall or banister. This is to ensure that you are balanced. Your left foot should be on the taller step. Your right foot should be on the ground. Stay in this posture for a second. Now, step back, and bring left foot to the right foot. Repeat this 6 times. Reverse the legs and continue doing for 6 times. If you want to take rest between the steps, feel free to do so.
Ups and Downs: You need an armless chair that is strong. Sit on the edge but comfortably. Your arms should be at your side, relaxed and loose. Sit erect and your feet should be flat. If you feel you need balance, and then cross your arms. Start standing up. This should not be instant but deliberate, controlled, and gradual movement. Stand slowly up to the full height, and hold on for 2 seconds. Again sit down. Repeat this 5 times.
Straight Leg Raise: This can be a part of your everyday exercise regime. This is a strengthening workout that does not put too much effort on the knees. Lie down on your back. One leg should be straight on the ground and the other one should be bent. Now, slowly lift the leg that is straight, and the toes should point upward. Raise your leg up to 30 degrees, but you can start with 15 to 20 degrees in the initial stage. Repeat 15 times and perform at least 3 sets of this exercise. Keep alternating legs. This workout strengthens the knees, thigh muscles, and the ankle joints, thus offering multifold benefits.
Wall Hamstring Stretch: Hamstring muscles too can be the cause of knee pain and discomfort. To strengthen the hamstring muscles and alleviate knee pain, this exercise helps a lot. Lie down on the floor flat. Your feet should be flexed. Choose a space that is close to a wall, or a sturdy table. Your right leg should be propped on the wall or table. If you don t prefer any, a resistance band is a good alternative. When stretching, you can find your flexibility level and when you feel that you have reached the deepest point, start relaxing. Keep alternating contracting and relaxing every 5 seconds. After 10 to 15 sets, you can try the same with the left leg.
Knee Rolls: Use an exercise mat or a carpet that is cozy. Lie on your back. Bend the knees, and ensure your feet are flat. Your arms should be stretched on the sides. Look at the ceiling, and hold the knees together. In the same posture, slowly roll the knees towards the right. When you feel a gentle twitch or after 5 seconds, move to original position. Then lower the knees to the left. Hold and release. For each side, repeat 10 times.
These exercises strengthen the knees and improve the quality of life by bidding bye to the pain. Understanding that these are magic remedies that work overnight is the key to stay focused and keep going without quitting.

Exercises That Can Help Relieve Knee Pain!

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

Breaking a bone no matter how small is painful. This pain is caused both by the actual break in the bone and the damage to surrounding muscles, ligaments, nerves and other soft tissue. There are three stages of pain caused by a fracture:

Acute Pain: Pain that occurs immediately after a bone is fractured
Sub-Acute Pain: Pain experienced while the one and soft tissues heal
Chronic Pain: Pain experienced after the fracture has healed
Any kind of fracture can cause these types of pain. However, it is not essential for everyone who has had a fracture to experience all the three kinds of pain. Many people experience pain only when the fracture occurs but in few cases, a person may break a bone and not realize it. Each type of pain needs to be dealt with in a different way.

Acute Pain: Acute pain reduces as the fracture heals. For this, the fractured bone must be reset in place and held together with a splint, brace or cast so as to immobilize it. In some cases, surgery may also be needed. Over the counter pain medication is often prescribed to help deal with this type of pain. The patient is also advised to rest the broken bone and avoid certain types of movement that could worsen the break. A broken bone takes a minimum of 6 to 8 weeks to heal. However, in cases of other conditions such as osteoporosis, this time period could be much longer.
Sub-Acute Pain: As the injury heals, the sub-acute pain experienced reduces. Immobilizing a broken bone to help it heal causes the muscles and soft tissues around it to stiffen and weaken thus triggering this type of pain. Physical therapy can be very helpful in dealing with this type of pain. Along with strengthening the muscles and reducing stiffness, physical therapy also helps reduce inflammation and scar tissue. Physical therapy can be provided in many ways including exercises, electrical stimulation, ultrasounds, massage etc. It is important to remember that at this stage of treatment, the more the affected limb is used, the faster it will heal. However, it is advisable to avoid putting too much pressure on the bone.
Chronic Pain: Some people may experience pain for several months and even years after a fracture has healed. This is usually caused by nerve damage or the development of scar tissue. Underlying conditions such as arthritis could also trigger this type of pain. Management of chronic pain varies from individual to individual. Treatment usually takes the form of medication, exercises and physical therapy. It is important not to avoid this type of pain and consult a doctor to ensure that it is not being caused by any other condition.

Fracture Pain - How To Deal With It?

Fibromyalgia is a medical condition that is known to affect the soft tissues and muscles of the body. As a result, there is a muscular pain and fatigue experienced throughout the body, often interfering with daily activities of the affected individual. Though the condition can affect both men and women, females are more prone to Fibromyalgia than their male counterparts.

The pain (can be acute or chronic) associated with fibromyalgia is often an outcome of a condition whereby the receptors in the brain that perceive the pain signal undergoes modification, becoming oversensitive to the pain stimuli.

The body has 18 tender points spread throughout the body. These tender points are highly sensitive and can be quite painful when pressed. Research suggests that individuals with fibromyalgia experience pain in at least 11 of these pressure points when pressed (often used in the diagnosis of fibromyalgia).

Causes of Fibromyalgia
While it may be difficult to decipher the exact trigger that results in Fibromyalgia, the condition may be an outcome of

Physical or emotional trauma, stress, anxiety, and depression
Genetic predisposition. The incidence of fibromyalgia is higher in individuals with a family history of the condition
Indulging in too much of a sedentary lifestyle (lack of physical activities and exercise) can play a pivotal role in triggering fibromyalgia
Certain health conditions and infections such as Arthritis can also give to fibromyalgia

Symptoms
While muscular and joint weakness and pain are synonymous to fibromyalgia, a person may also complain of

Sleeping disorders
There is a weakness, headache (often associated with a migraine), and fatigue (in spite of having a sound sleep and proper rest)
A person may experience Fibro Fog (a condition resulting from fibromyalgia whereby a person finds it difficult to memorize or concentrate on anything)
There may be morning stiffness along with numbness or a tingling sensation in the legs, hands, feet
Some women with fibromyalgia may experience menstrual cramps which are often painful
One may also suffer from IBS (Irritable Bowel Syndrome), Temporomandibular joint disorders

Treating Fibromyalgia with Ayurveda
According to Ayurveda, Fibromyalgia is an outcome of the vitiation of all the three doshas - Vata, Kapha, Pitta. This affects the digestion process (it weakens or slows down) with the buildup of toxins or Ama in the body. Thus, for an effective treatment, the balance between the three doshas should be restored along with the elimination of the toxins out of the body (detoxification).

The treatment often involves a concoction of herbal and Ayurvedic oil massages and oil baths, lifestyle changes, dietary modifications, meditation and yogas or pranayamas
Avoid non-vegetarian (can have lean meat though), spicy and greasy foods. Instead, supplement the diet with fresh fruits, vegetables, healthy or good fats (poly or monounsaturated fats), whole grains
Drink at least 6-8 glasses of water daily
Follow a healthy sleep routine. Mediation and Yoga will act as a catalyst, enhancing the overall treatment
Drinking alcohol or smoking tobacco or drug abuse should be avoided
A Warm Ayurvedic oil application with gentle pressure is very effective in this if done on regular basis
Stay happy and stress-free 

Fibromyalgia - Ayurvedic Ways That Can Help Resolve It!


A fracture separates a single solid object into two or more pieces due to pressure. In medical terms, a fracture refers to a broken bone due to some kind of external trauma. A crack in the bone, on the other hand, it does not cause a clean break in the bone, there is only a separation or discontinuity in the bone material.

A crack in the bone caused due to repeated stress is often called as 'hairline fracture'. Here are the basic differences between a crack and a fracture in the bone and how to treat them:

1. A crack or hairline fracture is rarely caused by a single injury. It is usually the result of bone fatigue, which may be caused due to repeated, concentrated stress over a long period of time and thus, it is also called as 'stress fracture'. Other bone fractures are almost always the result of sudden and severe force on the bones.

2. The skeletal system constantly remodels itself. The cells, known as 'osteoblasts' absorb calcium and secrete bone connective tissue. If a particular site is exposed to recurrent bouts of force (which are individually not impactful enough to cause a crack), over time the osteoblasts in that region malfunction and the crack appears.

Muscular exhaustion can also cause cracks in the bone. Fractures are caused due to sudden external single force trauma to the bone. Nutritional problems like deficiencies of Calcium, Phosphorus, vitamin D and excessive smoking decrease the bone mineral density and increase the chance of both cracks and fractures.

3. Symptoms of a crack are swelling, tenderness and sharp pain in the injured region and the symptoms worsen over time. A fracture has similar symptoms and might also exhibit an external physical distortion and makes it impossible to move that part of the body that where the bone is broken.

4. An MRI is often suggested for detecting the crack or crack-prone areas because an X-ray can only detect the crack after it widens somewhat or the bone starts paining because the rays cannot pass through the tiny gap in bone material. A fracture is easily detectable by an X-ray because the rays pass right through the break.

5. Complete rest for six to eight weeks is the most effective way of healing a crack. Using a walking boot in case of cracks in the leg bones in also helpful. Healing fractures require extensive medical intervention. Surgical techniques like bone grafting and the insertion of metal plates are used to reposition the broken bone.

Cracks VS Fractures

What is Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip or DDH, is a condition that affects the hip joint in newborns and young children. The hip is like a ball-and-cup, formed by the round top of the thigh bone - called the femur - and a cup-shaped socket in the pelvis. The hip joint is stable in spite of its large range of motion and is kept in place by ligaments and other soft tissue structures. The normal infant hip is not mature at birth but develops into a strong and stable joint as the child grows.

What happens in hip dysplasia?

In DDH, the hip does not develop normally as the cup and ball are either partially or completely out of alignment. DDH can vary from mild to severe depending on whether the cup is shallow, soft tissue structures are lax or a combination of all. These problems may cause the hip to become unstable, and even come out of the joint. This is known as a dislocated hip and is believed to occur in around one in 1000 infants. One or both hips can be affected. DDH isn't painful in babies and young children. Untreated DDH can result in limping in young children. This can progress to hip pain and arthritis at a later date.

How common is it?

DDH is more common in girls and first-born children. It's more likely to occur if there's a family history or if the baby was breech. Swaddling or wrapping a baby's legs too tightly can also lead to DDH. Certain traditional practices like wrapping the children, etc. are known to increase the risk, while carrying them with limbs separated apart is known to decrease the risk of dysplasia. All newborns should have both hips carefully examined by a health professional. 

Treatment options

Treatment depends on the child's age and the severity of the condition. Young babies with confirmed DDH are usually treated in a brace or harness that holds the legs apart. This helps the hip socket to deepen and the hip to become stable with growth. Regular monitoring of the hip position is necessary to ensure good outcomes. Surgery may be necessary if brace treatment is unsuccessful, or if a hip dislocation is first noticed when the child is older.

What is the long-term outlook?

Most infants who are diagnosed and treated early do not have any hip problems in later life. Earlier the diagnosis and treatment, the better the outcome, as late diagnosis often requires surgical treatment and can mean a higher likelihood of ongoing hip problems.

Developmental Dysplasia Of Hip - How Common It Is?

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