Posts Tagged ‘joint’
Friday, June 10th, 2011
How are gout and pseudogout treated?
The goal of treatment for gout and CPPD is to decrease inflammation and relieve pain. Acute attacks are often treated with non-steroidal anti-inflammatory (NSAID) medication if the patient does not have other medical problems that preclude their use. Indomethacin is especially effective.
When NSAID’s are contraindicated or not effective, colchicine is often helpful. Oral or injected steroids may sometimes be used, too. Attacks of gout and pseudogout can recur. When the episodes are infrequent, an NSAID or colchicine can be used as needed for flare-ups. If the episodes occur more frequently, other types of medications are often indicated. The specific type of medication is best decided by your primary care physician and/or a rheumatologist. Patients with gout may need agents that decrease the production of uric acid, such as allopurinol.
Gout and CPPD are often effectively treated non-operatively. In addition to medications, splints or compressive wraps may be helpful to decrease swelling and lessen pain.
If the disease has eroded the joints or if tendons have been compromised, surgery may be indicated to remove the crystals and stabilize the joint.
What happens if you do not receive treatment?
The acute attacks are so painful that most people seek treatment to relieve pain. Untreated gout can be very damaging to joints and tendons.
The crystals can erode the joint to the point that it becomes unstable. Also, salt deposits on tendons just beneath the skin can cause the skin to break down and the tendons to rupture. This can lead to serious infections in addition to loss of motion.
CPPD crystals are less likely to be deposited beneath the skin, so infection is less likely. The chronic deposition of the crystal in ligaments and cartilage may lead to joint destruction. Loss of motion is common, but joint instability, as found in gout, is less frequent.
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Tuesday, June 7th, 2011
How is the diagnosis of gout and pseudogout made?
The diagnosis for either disease is made based on clinical examination, x-rays, and lab tests. You will be asked questions about your symptoms and how the disease has affected your activities. Because medications and other diseases can cause gout and CPPD, you will be asked to provide a detailed medical history and an accurate medication list. A detailed examination of your hands is important as the clinical appearance helps to clarify the type of arthritis. X-rays are also helpful.
Calcifications within the wrist in the region of a ligament called the triangular fibrocartilage complex (TFCC) are classic for CPPD. Uric acid does not show up on X-rays, but bone erosions at the end joint (DIP joint) are characteristic of gout. Over time, both disorders can show more advanced arthritic changes.
When possible, the best means to clarify the diagnosis is to obtain fluid from the joint. The fluid can be sent to the laboratory to see if it contains uric acid or calcium pyrophosphate crystals. A special microscope is needed to determine which type of crystal is present in the joint fluid. Blood tests may be ordered to check for infection as well as the uric acid level. However, uric acid levels in the blood are often normal despite an attack of gout. There is no blood test for CPPD.
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Friday, June 3rd, 2011
Both gout and pseudogout tend to present with the sudden onset of a hot, red, swollen joint. The joints are so tender that patients are reluctant to move them. Often, the affected joints appear infected.
Gout may cause crystals to form white nodules called “tophi” that are
often visible under the skin. If the skin is too swollen and stretched out, a white chalky substance may ooze from the joint. The crystals in pseudogout are usually only visible on x-ray.
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Thursday, June 2nd, 2011
Gout and pseudogout—calcium pyrophosphate deposition disease
(CPPD)—are two types of crystalline arthropathies which are disease
processes that cause sore joints because salt crystals have formed in the joint. The crystals irritate the joints and sometimes surrounding tendons, causing the body to release chemicals that make the joints swollen and red. In gout, the salt produced is monosodium urate, while in pseudogout it is calcium pyrophosphate.
Both gout and pseudogout (CPPD) can affect joints outside the hand. In gout, the first joint affected is often the big toe. In pseudogout, the joints involved tend to be large joints such as the knee or wrist. Attacks can recur.
In gout, crystals develop when patients over-produce or under-excrete
uric acid. Certain medications can cause rapid changes in uric acid level.
These include certain blood pressure medications, diuretics, intravenous blood thinners, and a medication used for transplant patients called cyclosporin. Alcohol also increases uric acid production.
Hypothyroidism, disease, and kidney disease have also been shown to be associated with gout. Attacks of gout have been noted after injury, surgery, infection, and the use of contrast materials for x-rays.
Calcium pyrophospate disease—CPPD—has been noted in patients who have multiple injuries to a joint, though many patients will not have any injury prior to an attack. Unlike gout, CPPD is not associated with alcohol or dietary habits and is not induced by medications. It can occur with certain diseases like pneumonia, heart attacks, and strokes and may occur after an unrelated surgery. CPPD has been found in patients with problems with their thyroid or parathyroid and patients with iron overload (hemochromatosis).
Gout/CPPD in the hand, wrist and elbow:
The elbow, wrist, and small finger joints (DIP joints) are common sites for gout. CPPD is more common in the wrist.
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Monday, January 4th, 2010
Arthritis is one of the foremost common chronic diseases in the world. In line with Ayurveda arthritis is primarily a vata (air) disease that is due to accumulation of toxins in the joints and is known as amavata.This could be caused by poor digestion and a weakened colon, ensuing in the buildup of undigested food and also the buildup of waste matter. Poor digestion permits toxins to accumulate in the body, and issues with the colon permit the toxins to achieve the joints.
Symptoms:
Fever Immense pain & stiffness in affected muscles in case of chronic muscular rheumatism. Pain or tenderness in an exceedingly joint which is aggravated by any movement or activity, such as walking, getting up from a chair, writing, typing, holding an object, throwing a ball, turning a key. Excruciating pain and stiffness within the joints in case of chronic articular rheumatism.
The subsequent are some simple cures which may simply facilitate relieve you from the pain of arthritis. Attempt any of them to determine what works for you.
2 teaspoons of lemon juice and a teaspoon of honey mixed in a very cup of heat water taken twice daily is good for curing arthritis. 2 teaspoons of juice from recent leaves of bathua, drink every day on an empty stomach for 2-3 months. 0.5 a teaspoon of turmeric powder with warm water helps cure arthritis. Taking alfalfa tea twice every day makes a sensible cure. Two teaspoons of apple cider vinegar and a couple of teaspoons of honey dissolved in an exceedingly little glass of heat water taken a few times daily brings relief. Rub the aching joints with hot vinegar to urge some relief from pain. 2 elements pure olive oil and one half kerosene makes an exquisite liniment to wash afflicted joints. Add one tablespoon cod liver oil to the juice of 1 orange, whip and drink before sleeping. One raw clove of garlic each day is terribly beneficial. This clove will be fried in ghee (clarified butter) or castor oil. Take for 2 months. Guggulu is terribly useful in curing arthritis. Eat [*fr1] a teaspoon twice every day after meals with warm water. Exercise the afflicted joints during a tub filled with hot water. Drink carrot juice, cucumber juice, eat cooked vegetables and/or vegetable soups, and drink coconut water for a healthy body & massage your joints daily to cure arthritis. On an empty abdomen eat 2-three walnuts or some coconut. Avoid mental tensions that cause stress. Lose weight, if necessary, to induce shut to your ideal weight. If you weigh less, there’s less weight on your joints and less pain.
Effetive and Proven Results For – Arthcare Oil (Anti Inflammatory and Muscle Relaxant Herbal Massage Oil):
Arthcare Oil is the best natural answer for your drawback, manufactured underneath the steerage of renowned MD Ayurveda Specialist doctor. Arthcare is an anti-arthritic herbal oil that not solely offers a certain relief in rheumatic arthritis however also strengthens the bone tissues, the skeletal and therefore the neuromuscular systems, giving a comfy movements of joints and muscles. It is a robust antioxidant and increases the energy level. Arthcare penetrates the body tissue faster than any different ointment because of its strong anti-inflammatory action. It removes stiffness and improves mobility of limbs. It brings relief from backaches, muscular strains, rheumatic pains, joint pains etc. Body massage with Arthcare oil, relaxes an asthmatic person. Arthcare is scientifically proven Ayurvedic formulation containing the herbal combination of well known traditional herbs described above. Inside couple of minutes of application you will feel relaxed from pain. For Best Results Take two Arthcare Capsules twice each day and massage the affected area with Arthcare Oil two-three times a day.
Herbal Remedies:
The employment of herbs is a time-honored approach to strengthening the body and treating disease. The following are used traditionally to treat rheumatoid arthritis:
Shallaki conjointly referred to as boswellia (Boswellia serrata), comes from a tree that yields gum when its bark is peeled away. In clinical trials, promising results were observed in patients with rheumatoid arthritis, chronic colitis, Crohn’s disease. Researchers found that standardized Boswellia extract considerably reduced swelling and pain and typically reduced morning stiffness for folks with rheumatoid arthritis.
Ashvagandha (Withania somniferum) is an Asian plant of the potato family. Its roots have long been used to treat “rheumatism,” high blood pressure, immune dysfunctions, erection problems and also to ease inflammation. As a result of of all this, it’s generally referred to as the “Indian ginseng.”
Ginger (Zingiber officinale) might be among the most effective-studied of the four. Research suggests ginger root inhibits production of prostaglandins and leukotrienes, that are involved in pain and inflammation. In an uncontrolled 1992 Danish study, 56 patients who had either RA, OA or muscular discomfort took powdered ginger. All of those with musculoskeletal pain and 3-fourths of those with OA or RA reported varying degrees of pain relief and no aspect effects, even among those who took the ginger for a lot of than two years.
Herbal oils are applied to the arthritis to loosen stiff joints, restore mobility, take away pain, inflammation or swelling, nourish tissues and relieve pain. The experienced hands dipped in the pleasantly warmed oil will travel all over the body with pressure. Arthcare not solely increases blood circulation however conjointly offers a positive relief for rheumatic arthritis, spondylosis, paralysis, muscular disorder, slipped disc, asthma and tuberculosis. Brings in relief from stress, strain and tensions. It’s conjointly very smart for tonning of 1’s muscles and nerves. Get instant relief among minutes of application of oil. For a lot of info please browse at
Epsom Salt (magnesium sulfate): Magnesium has each anti-inflammatory and anti- arthritic properties and it will be absorbed through the skin. Magnesium is one in every of the most important of the essential minerals within the body, and it is commonly deficient in the Yank diet. A New England remedy for arthritis could be a hot tub of Epsom salts. The heat of the bathtub can increase circulation and reduce the swelling of arthritis.
Dosage and Directions:
Fill a tub with water as hot as you’ll stand. Add a pair of cups of Epsom salts. Bathe for thirty minutes, adding hot water as necessary to keep the temperature warm. Do that daily as often as you’d like.
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Wednesday, December 30th, 2009
Know your Pain Relief Options
The term “arthritis” refers generally to an inflammation of the joints and is typically associated with stiffness and joint pain. The different forms of arthritis vary in terms of cause, severity and potential pain relief treatments.
Management of arthritis pain depends not only upon the specific condition, but also upon your age, lifestyle, and unique response to different treatment methods.
Osteoarthritis and Rheumatoid Arthritis
The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis. Together these conditions affect approximately 40 million people in the United States alone.
* Osteoarthritis is a degenerative condition involving deterioration of the cartilage in the joints, resulting in joint pain or stiffness.
* Rheumatoid arthritis is an inflammatory disease affecting the lining of the joints. While osteoarthritis is far more common, rheumatoid arthritis is often a much more severe form of the disease.
Before assessing your arthritis pain relief options, it is important to consult with a physician to determine whether you have arthritis, and if so, which type since treatment options differ.
Common Causes of Arthritis Pain
The joint pain associated with arthritis may be caused by a variety of factors. Most commonly, arthritis pain originates from:
* Inflammation of the tendons, ligaments or lining of the joints. This inflammation may be accompanied by swelling or redness, which results in joint pain.
* Joint tissue damage, which may be related to an injury or excess pressure on the joints.
* Fatigue, which is sometimes a result of arthritis and can make the joint pain seem more intense and the condition more difficult to cope with.
Arthritis Pain Treatment Options
There are a variety of ways to treat arthritis pain and other joint pain. It’s essential to be aware that people respond differently to different treatments. An individual’s response to pain and pain relief treatments is affected by the particular disease or condition he/she suffers from, the severity of the pain, and a range of psychological and emotional factors.
Short Term Pain Relief
One of the most important considerations when evaluating arthritis pain relief treatment options is to be clear about whether you are focusing on short or long term pain relief.
For short term relief from arthritis pain, many people use hot or cold therapy, depending on the type of pain and the specific condition. Cold therapy in the form of an ice pack can sometimes provide pain relief by reducing swelling, but may not be a good option for patients with poor circulation. Heat therapy, either moist or dry, acts as a muscle relaxant, and can also provide short term pain relief.
Certain drugs can also give quick, short term relief from the joint pain associated with arthritis. Depending on the amount of inflammation, doctors will often recommend a pain relief medication such as acetaminophen or a non-steroidal anti-inflammatory drug (NSAID) like aspirin or ibuprofen.
Another non-drug alternative that provides some patients with short term relief from arthritis pain is TENS, or transcutaneous electrical nerve stimulation. A TENS unit delivers electrical pulses to nerves in the affected area. The pulses block pain messages that the nerves would normally deliver to the brain, thereby bringing pain relief to the patient.
TENS therapy may also raise the level of endorphins produced by the brain. Endorphins are substances that are produced naturally in the body and contribute to feelings of well-being and pain relief.
Long Term Pain Relief
Because both rheumatoid arthritis and osteoarthritis are chronic conditions, sufferers often need to look for long term options to deal with their joint pain.
Drugs such as NSAIDs provide some level of pain relief. In the case of rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) target the immune system and are helpful for some patients. Corticosteroids are hormones that are sometimes prescribed for treatment of the joint pain and inflammation that typically accompany arthritis.
For many people with arthritis pain, exercise and physical therapy can help reduce stiffness and joint pain. Depending on the severity of the condition, walking, swimming, and a variety of strengthening and/or aerobic activities may be helpful, not only in pain relief but also from the standpoint of improving patients’ self-confidence and psychological and emotional well-being.
Overweight people suffering from arthritis pain are frequently advised to lose weight, since additional weight places an added burden on the joints.
In a small minority of cases, medication and lifestyle changes do not provide the desired pain relief and doctors may recommend surgery. Surgical procedures can remove tissue within the joint, or else realign or replace the joint.
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Tuesday, June 9th, 2009
Fibromyalgia is a complex and multifaceted syndrome causing chronic pain. It involves both widespread myalgia (muscle pain) and localized pain in specific areas, particularly in the muscles around the joints. The musculoskeletal symptoms include pain, stiffness and tenderness. Pain commonly occurs in the neck, back, shoulders, pelvis and hands. The vast majority of the individuals affected are women.
Contrary to popular belief, it is a disorder of muscles, not of joints. Though pain is the main component of this condition, fibromyalgia may also involve fatigue, sleep disturbances and mood disturbances, such as depression and anxiety. The condition is episodic, with flare-ups that vary in intensity and come and go over time.
Although no identifying agent has been thoroughly identified at the root of the problems associated with fibromyalgia, it is generally agreed that certain body chemicals, including substance P (responsible for initiating pain signals after injuries) and serotonin (responsible for toning down the intensity of pain signals) exist in abnormal levels. This causes ordinarily nonpainful stimuli to be translated into pain (allodynia) and amplifies the pain, resulting in a lowering of the pain threshold and increase in pain sensitivity.
Physicians often use fibromyalgia as a classic example of a central pain state, in which the cause of the pain cannot be identified in the local pain site and most of the processes Anatomy of the spine includes the cervical spine, thoracic spine, lumbar spine and sacral region.resulting in pain occur at the level of the spinal cord and brain. However, the pain is not “imagined” or psychological. Some form of input from the pain site is required – even if it is as common as a touch, light or sound. In patients with fibromyalgia, these stimuli are misinterpreted as painful events.
Fibromyalgia is considered a benign condition. It is not degenerative or deforming, nor is it life-threatening. Though the pain may be severe and may significantly reduce quality of life, fibromyalgia causes no lasting tissue damage.
The symptoms associated with fibromyalgia may seriously affect competitive employment. Though most patients remain in the workforce, some claim disability. Doing so can be difficult, even when physicians agree that symptoms are severe enough to warrant aid.
Although fibromyalgia has been recognized by the Social Security Administration as a medically determinable impairment, a general misunderstanding and lack of education regarding it may cause many organizations and individuals to disregard the condition. The Arthritis Foundation reports that disability rates among fibromyalgia patients may be as high as 44 percent.
Fibromyalgia is the second most common disorder seen by rheumatologists and among the most common causes of widespread, chronic pain. According to the Arthritis Foundation, fibromyalgia affects an estimated 2 percent of the United States population – about 3.5 million Americans.
Men and women of all races and ages, including children and the elderly, may be affected, but fibromyalgia occurs most often in women over the age of 30. According to the American College of Rheumatology, about 80 percent to 90 percent of those affected by fibromyalgia are women.
Though uncertainty remains regarding the underlying cause, diagnosis and optimal treatment exist for fibromyalgia. Many professionals and researchers are making efforts to improve the quality of life for patients with fibromyalgia. Better ways to diagnose and treat this condition are being researched. In addition, remaining active as much as possible is a must for fibromyalgia patients.
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Saturday, June 6th, 2009
Chronic instability of the elbow leading to recurrent dislocation was thought to be rare but is increasingly being reported now. T problem with recurrent dislolocation of elbow is that the diagnosis is often difficult to make and may go unnoticed for some time. It occurs more commonly in young athletes.
Reasons for chronic recurrent dislocation are
* Joint Laxity
* Break in capsule
* Coronoid fracture
The treatment includes the repair of the defect. These patients should be rehabilitated very slowly and supination should be limited inearly stages.
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Wednesday, June 3rd, 2009
The menisci in the knee joint are required for
* Compensation of incongruity between the femur and tibia
* In the distribution of joint pressure
* Shock absorber, for stabilization of the knee, in provision of rotation, in spreading of synovial fluid, and in nutrition of articular cartilage.
An intact meniscus transmits 70 to 90 percent of the total load across the knee joint. Therefore, it is desirable to preserve the meniscus whenever possible.
A conservative nonoperative method of management is recommended In the treatment of discoid meniscus if pain and functional disability are minimal.
SIlent discoid menisci require no treatment. however, they should be kept under observation.
Conservative measures
* Immobilization of the knee
* Restriction of physical activity
* Progressive exercises for the quadriceps.
Operative Measures
If the knee locking persists their is functional disability or pain partial or complete excision of the discoid meniscus is indicated.
Diagnostic arthroscopy is carried out to know the pathologic changes and the type of discoid meniscus.
Partial resection of the discoid meniscus is preferred when it is of the complete or incomplete type with minimal tearing and slight degeneration
Excision of the entire meniscus is performed when it is of the Wrisberg type or when it is torn and there is marked degenerations.
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Monday, June 1st, 2009
Ankylosing spondylitis (AS) has a strong genetic component, but there is no known way to prevent the disease. However, patients who are aware of a family history of this disease can watch for signs and symptoms. Early detection of AS provides the best chance to treat the disease before it causes irreversible damage.
In addition, patients who are diagnosed with AS can help reduce the chance of further damage by quitting smoking. Patients with AS sometimes develop stiffness in the rib cage that reduces their ability to breathe fully. Damage to the lungs caused by smoking can worsen these symptoms. Researchers have also found smoking to be a risk factor for other forms of arthritis, including rheumatoid arthritis and osteoarthritis.
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