Mosquitoes, though tiny, can wreak havoc on the human health. Malaria and dengue were common enough, but now another disease doing the rounds is chikungunya. This is a viral disease that spreads by the bites of Aedes aegypti mosquitoes. The disease lasts for 5 to 7 days and the catch is that there is no identified cure for the disease.
Symptoms of chikungunya are very non-indicative and include high temperature, rashes and multiple spots on the body, multiple joint pains, headaches, conjunctivitis and insomnia. The presence of joint pains associated with a high incidence of mosquito breeding is indicative of chikungunya. The fever usually subsides in a couple of days, but the other symptoms would persist for about a week.
Management of chikungunya includes a combination of prevention and treatment. Prevention is more important than treatment as it is easier done.
Treatment: There is no specific allopathic remedy for the treatment of chikungunya. The prescribed medicines are only for symptomatic relief, and given the intense and prolonged joint pains, the patient ends up using a lot of pain killers. There are cases where the pains may persist for up to 6 months. This is where Ayurveda comes into the picture, as there are multiple effective remedies that have been proven effective over the ages.
Ayurveda has references to something called “sandhijwara” which is “fever of the joints”. Sandhijwara is very similar to chikungunya and these remedies used for this can be very useful in treating chikungunya.
Frozen shoulder is painful inflammatory condition associated with stiffness and loss of motion in shoulder. The pain gradually grows and becomes chronic leading to restricted movement. Due to inflammatory conditions the muscles surrounding the shoulder becomes stiff. Frozen shoulder has vague triggers, which usually surfaces as a complication commonly in people with diabetes, thyroid disorders, heart disease, and Parkinson's disease and people with chronic rheumatism or arthritis. The general approach towards frozen shoulder is prescription of painkillers, anti-inflammatory and physical therapy to restore the ROM.
What is the suffering
As the chronicity advances the movement of the shoulder is severely restricted, with progressive loss of both active and passive range of motion. The condition is sometimes caused by injury, leading to lack of use due to pain, but can also arise spontaneously with no obvious trigger (idiopathic frozen shoulder). Rheumatic disease progression and recent shoulder surgery can also cause a pattern of pain and limitation similar to frozen shoulder. Intermittent periods of use may cause inflammation.
In frozen shoulder, the synovial fluid becomes scarce resulting in diminished joint lubrication between the head of humerus (Upper arm bone) and the socket of the scapula. Due to friction as precipitating factor, the shoulder capsule swells, thickens and tightens due to stiffness of ligamentous bands of scar tissue. As a result, the joint movement becomes stiff.
How to know
First sign of a frozen shoulder is that the joint becomes so tight and stiff that it is nearly impossible to carry out simple movements, such as raising the arm. The movement that is most severely inhibited is abduction and external rotation of the shoulder. Lots of tests are done clinically to assess the frozen shoulder. One of the best test is “Scratch Test” and 2nd is the Lateral external rotation.
People complain that the stiffness and pain worsen at night or the pain is worse during morning. Pain due to frozen shoulder is usually dull or aching. It can be worsened with attempted motion. A therapist or practitioner may suspect the patient has a frozen shoulder if a physical examination reveals limited shoulder movement. XRay of rhe shoulder or an MRI scan may confirm the diagnosis, though its mostly diagnosed clinically.
The frozen shoulder, according to the chronicity is categorised into stages.
Stage one: "freezing" or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses range of motion.
Stage two: "frozen" or adhesive stage is marked by a slow improvement in pain but the stiffness increases. This stage generally lasts from four to nine months.
Stage three: "thawing" or recovery, when shoulder motion slowly returns toward normal. This generally lasts from 5 to 26 months.
What to Do
Frozen shoulder makes the person so disable that he cannot work without pain. Management of the frozen shoulder is focused on restoring joint movement and reducing shoulder pain, involving medications, physical therapy and /or surgical intervention. Treatment may continue for months, there is no strong evidence to favour any particular approach. Medications frequently used include NSAIDs and corticosteroids. Alternative medicines like homeopathy, ayurveda also gives great results. Alternative measures like physical therapy, exercise therapy, yoga have good impact in increasing the range of motion.