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Cervical Traction Procedure
Hip Replacement Surgery
Treatment of Lumbar Radiculopathy
Spinal Fusion Surgery
Treatment of Knee replacement
Arthritis And Pain Management Treatment
Hip Resurfacing Surgery
Hip Injury Treatment
Ankle Injury Treatment
Knee Injury Treatment
Hip Pain Treatment
Ankle Pain Treatment
Knee Pain Treatment
Treatment of Joint Dislocation
Joint Mobilization Procedure
Joint Replacement Surgery
Limping Child Treatment
Meniscus Injury Treatment
Pelvic Rehabilitation Techniques
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My mother is 65 years old. She took a walking trip so that their legs and thigh got swallowed and it make her difficult to walk. As she moves her legs, she feels too pain. Even very difficult to gets down from bed. We also consult a doctor she suggested Tab enzoflam 1bd and tab Pantakind od. She is taking from last week. But no improvement. Please suggest medicine for reducing swelling and pain.
Rheumatoid arthritis is a chronic inflammatory arthritis with a prevalence of 0.5-1% in India. It is characterized by joint pain and swelling associated with morning stiffness lasting for more than 30 minutes. It generally has a slow onset - over weeks to months, though the onset can be acute also. Most common joints involved are small joints of hands and feet. Larger joints like knee and shoulder can also be involved. The incidence of RA increases with age. It is twice more common in females than in males. Early treatment is necessary to bring down the inflammation, avoid joint deformities and prevent other complications (lung, heart, vasculitis).
Predisposition to RA is multifactorial. It has a genetic component (family history of RA increases the risk). Environmental factors like smoking also play a role.
Initial symptoms start with fatigue, malaise, generalised bodyaches, low-grade fever. The onset is generally slow and eventually patient develops joint pain and swelling. Though the joint involvement is symmetrical in most cases, asymmetric onset is common (involving joints predominantly on one side).
Diagnosis is made by a physician after detailed history, clinical examination and supportive lab tests. Rheumatoid factor and anti-CCP antibody are positive in 75-80% patients with RA. They have raised inflammatory markers (ESR, CRP) during active inflammation.
RA treatment options are wide and quite effective. It starts with patient education regarding nature of the disease and the risk of complications. The need of early aggressive therapy should be emphasized. The patient should put in efforts for physiotherapy which play a very important role in muscle strength and joint mobility. Pharmacotherapy options are wide and include disease-modifying antirheumatic drugs (DMARDS). These can be conventional DMARDS like methotrexate (usually the first line drug), sulfasalazine, hydroxychloroquine, leflunomide. Failure to adequately respond to these drugs should lead your Rheumatologist to consider Biologic DMARDS (TNF antagonists, Rituximab, Abatacept, Tocilizumab). Your Rheumatologist is the best person to guide you about dose, indications, monitoring and side effects of the drugs used in RA. Treatment duration depends on patient's response but is generally long (5-10 years or lifelong).
COMPLICATIONS BEYOND JOINTS:
RA patients can have rheumatoid nodules in skin, lungs, heart and other sites. These patients are at risk of accelerated bone loss, so calcium and vitamin D intake should be optimized. Eye complications include dryness, redness (scleritis and episcleritis) and certain eye threatening complications. Lung involvement can be seen in various forms (fluid in lungs, nodules, interstitial lung disease).
These patients are at high risk of atherosclerosis (heart and blood vessel disease). They also have a tendency to have frequent infections.
NEED OF THE HOUR:
All patients with joint pains should be seen early by Rheumatologist for diagnosis and treatment. With so many treatment options, no patient should suffer from joint deformities and other complications associated with long standing, untreated RA. LEAD A HEALTHY LIFE! If you wish to discuss about any specific problem, you can consult a rheumatologist.
I have a pain in right side number since 20 to 25 days. And now I have a weakness in my both leg with lumbar pain.
My Mother aged 49 has frequent pains from her knee to her foot specially it pains more when she wakes up in the morning and this pain stays the whole day. What should she do?
I am 50 years old, with old problem of spondolysis. Now days I am getting my house painted and I find that I am getting severe pain in both my legs and I am getting tired and exhausted. What should I do.
I fell down while dancing and my knee is paining from then so I tried ice packs and pain killers but still is not perfect it is paining when I run. please help.?
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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Rheumatoid arthritis is an auto-immune disorder which causes abnormal swelling of the body joints due to a sudden attack to the joints by the immune system of the body. This disorder is fairly common in the body parts that are more frequently used such as the knees, fingers, shoulders, wrists, elbows and the hips. Although rare, this disorder can also affect the ligaments or the tendons along with kidney, lungs, eyes or the heart.
This disorder tends to be chronic. Although the exact cause of the disease is still unknown, the loss of immunity generally leads to the disorder. Thus people who are obese, regular smokers, or who have had a family history of this condition are the most vulnerable to this disorder.
The symptoms of Rheumatoid arthritis are:
- Severe pain in the joints.
- Severe pain coupled with high fever.
- Stiffening and inflammation of the joints, resulting in intense pain.
- Exhaustion, fatigue and sudden weight loss.
- The pain gets aggravated in cold weather conditions.
If rheumatoid arthritis is not treated immediately after diagnosis, it might cause further complications in the future such as lymphatic blood cancers, osteoporosis (a medical condition resulting in brittle and weak bones), blockage of the arteries and dry mouth syndrome (Xerostomia).
The treatment of rheumatoid arthritis includes:
- Prescribed dosage of non-steroidal anti-inflammatory drugs such as Ibuprofen and Naproxen, anti-rheumatoid drugs such as Methotrexate and steroidal drugs such as Prednisone help in reducing inflammation and pain. The dosage depends on the intensity of the condition.
- Performing regular exercises which will help you retain flexibility of the joints and subsequently cure rheumatoid arthritis.
- In extreme cases, the doctor might suggest surgeries such as:
- Synovectomy: A surgery that removes the damaged portion of the joint
- Joint fusion: This option will realign the joint and reduce the pain If you wish to discuss about any specific problem, you can consult a internal specialist.