I am a ra patient, I am in medication, initially I took medrol 4 mg for 15 days + mimod 25 mg for about 2 months, and continue to take folitrax 10 mg - once a week & folic acid 5 mg 2 tabs a week, it was going well, but suddenly having pain on my palm & in wrist some times, some times on left hand and some times on right hand, also having pain on my right knee, went for mri, and found medial meniscus tear-grade-2, ligament sprain & moderate join effusion. I am having pain on my hands & knee as well. Gone through lot of medications, not cured yet. Pls. Advice.

Dr. Julie Mercy J DavidPhysiotherapist25yrs exp

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Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone. Stiffness have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. ? ultrasound- which heals the damaged tissues and heals ? electric stimulation / ift- which reduces the pain ? kinesiology taping ? application of heat or ice ? soft tissue massages or knee joint mobilization 5 do?s & don?ts to reduce your knee pain. 1. Don?t take too much rest- not only your body muscles may become weaker even your joint?s pain may become worse. Take consultation from your physiotherapist to guide you with knee pain exercises which are safe for your knees & keep doing it. 2. Do exercise? exercises help in strengthening the muscles, increase flexibility & also support your knee. You can also do swimming, walking, elliptical machines & bicycles, etc. 3. Don?t avoid your weight? excess weight may increase the stress on your knee and if you have inflammatory arthritis then it may become worse. You don?t need to have ideal weight, you just need to start working to reduce the weight. 4. Rice -this process is good for joint pain caused due to minor injury or an arthritis. ? ? r (rest) ? give some rest to your knees. ? I (ice) ? massage your knees with ice to reduce swelling. ? c (compression)- start wearing compression bandage. ? e (elevation)- keep your knee elevated. 5. Don?t wear bad shoes- we actively wear shoes in our daily life for hours without noticing how it can affect your knees badly. So, if you are facing knee pain, then check your shoes first. Is it giving you good comfort? If not then change it urgently. The importance of buying braces and splints from us ? orthopaedic support braces we suggest you to wear knee brace which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone 1. Heel and calf stretch to do this stretch: 1. Stand facing a wall. 2. Place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3. Lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4. Change legs and repeat. 5. Do this stretch twice for both legs. Short arc quad / isometeric quad exercise the short arc quad exercise is a great way to really focus in on properly contracting your quadriceps muscles. Here is how you do it: lie on your back and use a yoga block or basketball to prop your knee up. Slowly straighten your bent knee until it is all the way straight. Tighten your quad muscle with your toes pointed toward the ceiling and hold it tight for five seconds. Slowly lower your leg down. Repeat for 15 repetitions. Quadriceps, isometric (strength) this exercise is for an injured right knee. Switch sides if the injury is to your left knee. 1. Sit on the floor with your right leg straight in front of you. Bend your left knee up and put your left foot flat on the floor. 2. Flex your right foot and tighten the thigh muscles of your right leg. Press the back of your right knee toward the floor. Don?t arch your back or hunch your shoulders. 3. Hold for 5 to 10 seconds. Then relax. 4. Repeat 10 times, or as instructed. 5. Do this exercise 3 times a day, or as instructed. 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. Hamstring stretch ? take a break from strenuous activities to allow the injury to heal. ? use a cane or crutches to avoiding putting your full weight on your injured leg. ? apply ice packs several times a day to relieve pain and reduce swelling. ? wrap the injured area with a compression bandage or wear compression shorts to minimize swelling. ? rest with your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling. To do this stretch: to do this stretch: 1. For this stretch, you can use a mat to add cushioning under your back. 2. Lie down on the floor or mat and straighten both legs. Or, if it?s more comfortable, you can bend both knees with your feet flat on the floor. 3. Lift one leg off the floor. 4. Place your hands behind your thigh, but below the knee, and gently pull your knee toward your chest until you feel a slight stretch. This shouldn?t be painful. 5. Hold for 30 seconds. 6. Lower and change legs. 7. Repeat 2 times on each side. Strengthening exercises 5. Half squat to do this exercise: 1. Get into a standing squat position with your feet shoulder-width apart. Place your hands on your hips or out in front of you for balance. 2. Looking straight ahead, slowly squat down about 10 inches. This is the halfway point to a full squat. 3. Pause for a few seconds, then stand up by pushing through your heels. 4. Do 2 to 3 sets of 10 repetitions. 5. Calf raises to do this exercise: 1. Stand with your feet shoulder-width apart. Position yourself next to a wall or hold on to the back of a chair for support. 2. Lift both your heels off the ground so that you?re standing on the balls of your feet. 3. Slowly lower your heels to the starting position. Control is important with this exercise for strengthening your calf muscles. 4. Do 2 to 3 sets of 10 repetitions. 6. Hamstring curl 7. Leg extensions to do this exercise: 1. Sit up tall in a chair. 2. Put your feet flat on the floor, hip-width apart. 3. Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4. Pause, then lower to the starting position. 5. Do 2 to 3 sets of 10 repetitions for each leg. 8. Straight leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning under your back. 2. Lie down on the floor with one leg bent and one leg straight out in front of you. 3. Contract the quadricep of your straight leg and slowly raise it up off the floor until it?s the same height as your bent knee. 4. Pause at the top for 5 seconds, then lower to the starting position 5. Do 2 to 3 sets of 10 repetitions for each leg. 9. Side leg raises to do this exercise: 1. Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2. Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3. Pause briefly at the top, then lower your leg. 4. Do 2 to 3 sets of 10 repetitions for each leg. 10. Prone leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning beneath you. 2. Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3. Engage your glute and hamstring muscles in your left leg and lift your leg as high as you comfortably can without causing pain. Be sure to keep your pelvic bones on the floor throughout this exercise. 4. Hold your leg in the lifted position for 5 seconds. 5. Lower your leg, rest for 2 seconds, then repeat. 6. Do 2 to 3 sets of 10 repetitions for each leg. Lifestyle and home remedies rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time. Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don't use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin. Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee. Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation. Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner.  

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