Saturday, December 21, 2013

Arthritis Cream - How to Choose Effective Ones


If you or one of your family members is suffering with arthritis then you may have tried various prescriptions and oral based treatments. It has been found that one of the best ways to relieve the pain and symptoms of arthritis is by applying arthritis cream to the affected joints. It is often believed that creams and ointments are preferential in some patients as they do not cause any damage to internal organs or produce ulcers of the stomach.

There are plenty of cream based products available in the market that can help to alleviate the pain. They range from pharmaceutical to homeopathic based solutions. It is important to choose the right arthritis cream for you. The success of such treatments can vary depending on the severity and the form of arthritis that is present.

One of the longest used and most recommended products is Arnica. This is a plant of the sunflower family that commonly occurs in temperate regions. It has been successfully used to treat arthritis and similar ailments since the sixteenth century. It is now possible to purchase arthritis creams that contain high dosages of Arnica.

Another proven treatment involves the application of castor oil based creams. These are suggested to be applied to the concerned area at regular intervals to help ease the pain. Some homeopaths will advise the use of Tiger balm and similar products. Many of these balms also contain camphor, clove, and menthol.

An ingredient contained in many prescribed arthritis creams is capsaicin. This is what is known as a "hot" treatment as it creates a burning sensation when applied. The active chemical is derived from the chilli plant. It works by activating nerve cells which then in turn send signals to the brain to release endorphins.

Pharmaceutical based ointments that have proved to be successful may contain glucosamine, chondroitins, and hyaluronic acid. These are especially effective when combined with non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin.

Whichever cream is used it is always useful to fully research any possible side-effects. Certain preparations can cause reactions such as skin irritation, blistering, stinging, and in some cases inflammation. It is best to discuss any potential treatment with your GP so that you can be sure that the application is suitable for your body. It must be stated that any arthritis cream that is chosen should not be applied to areas of wounds, the eyes or the mouth.

6 Reasons to Use Craniosacral Therapy During Pregnancy


Here are 6 reasons why people recommend taking a course of Craniosacral therapy treatment during your pregnancy.

1. Ease the pain and discomfort of pregnancy

Many times women complain of tightness and stomach problems, feeling squashed by the baby growing inside them. As the body changes to accommodate the growing foetus inside the womb your body deals with new stresses and strains on both the muscles and bones.

General pain and discomfort can arise as a result and because you may want to be avoiding taking drugs to ease or deal with the pain women often find they have few options other than just living with the discomfort.

The gentle techniques used in Craniosacral therapy help to reduce these stresses and pains and helps a pregnant mother enjoy the wonderful process of pregnancy in a more relaxed and happier mood.

2. Helps the body deal with the physical changes and challenges of a growing baby.

As your new baby grows as much as the skin and womb can expand outwards there is still a lack of room in the abdomen for the rest of your organs. The stomach, liver, kidneys, intestines and other organs are fighting for space to function and move or slide around as they usually do, and this lack of space can impair the function of these organs.

Regular Craniosacral treatment helps the organs of your abdomen to adapt to their new reality, maintain good blood flow, allow organs to move correctly within the body and release fascial tensions which may develop between neighbouring organs.

This will leave a woman feeling more relaxed, less tightness, increased freedom of movement within her body and the feeling of more space inside her abdomen.

3. Treats back and other pains

Often women complain of back pain or back ache during the second half of their pregnancy as their baby gains weight. This extra pressure on the back muscles can lead to sciatic pain down the legs or severe lower back pain. Some times pain also develops in the legs and feet as a result of pregnancy.

Craniosacral therapy will help support the muscles ability to function properly, increasing blood and oxygen to them and reduce tensions in the muscles. With improved muscle tone in the lower and upper half of the back, tensions to the nerves are reduced and back and sciatic pains are relieved. Similarly, increased blood circulation in the hips and legs helps relieve pains felt in the legs and feet.

4. Helps prepare the mother's body for the process of birth

Either regular treatment of Craniosacral therapy during pregnancy or some intensive treatment during the last couple of months, can help prepare the mother's body for the birth.

By reducing tensions in the muscles of the pelvic floor, the uterus and the stomach child birth becomes an easier less physically stressful event for the mother.

5. Improves Blood flow in your body

Treatment reduces the tensions in muscles - the diaphragm and pelvic floor in particular when treating pregnant women - which can often have been placing pressure on the major arteries or veins of the body, the aorta and the vena cava. These muscle restrictions can reduce and slightly constrict the arteries reducing blood flow in the torso or legs. When the diaphragm techniques are applied to these areas, muscle tone decreases and allows for improved blood flow around the body, especially to the digestive tract and the womb. So as well feeling more energised and relaxed from CST treatment, you will be benefiting your growing baby by allowing improved blood, nutrient and oxygen flow. And a growing baby needs all the food he/she can get.

6. Supports the immune system

An amazing part of the pregnancy process is the unlimited love and giving the mother's body gives over to it's growing child. During pregnancy the mother's body diverts all of it's surplass energy and biological processes to protecting and providing the most optimal conditions for this growing baby. So much so that often the mother's immune system (which protects us from and fights disease and illness) can become less effective. CST treatment enhances and maintains a high level of energy and effectiveness for the body's defensive systems. This helps the mother deal better with the winter time, when colds, fevers and other (seasonal) illnesses are more likely to affect her.

Craniosacral Therapy is not only an excellent treatment for mothers during their pregnancy, but it is also an excellent way to help couples who are having trouble getting pregnant! Many cases of unexplained infertility in both males and females have been successfully treated using Craniosacral therapy.

The gentle techniques have helped to balance hormonal problems, improve blood flow to the reproductive organs, and help to enhance the womb's ability to support the development of the embryo.

All in all Craniosacral therapy makes for a healthier and more relaxed pregnancy and an easier birth.

Look for a Craniosacral Therapist in your area and find out how they can help you TODAY.

Corrective Fitness Solution For Low Back Pain


As a Corrective Exercise Specialist one of the most common complaints I hear from new clients is of low back pain. If you have ever suffered from low back pain then you know what I am talking about and why it is such a big complaint. Low back pain is the number one cause for sick leave than any other medical condition. (Office of Communications and Public Liaison, 2003) If you work in an office and spend most of your day sitting then this article is for you! If you are like me and have suffered or are currently suffering from things like herniated discs, compressed vertebrae or sciatic nerve pain I suggest you consult with your physician before beginning this or any exercise routine. The methods that I discuss here have helped me personally and many of my clients to alleviate low back pain and to care for it daily.

When a joint is moved into any position then one muscle is shortened (contracted) and the opposing muscle is lengthened (stretched). When these positions are held for long periods of time, the contracted muscles get tighter and stay like that, while the stretched muscle becomes weaker, thus keeping the joint in an altered position and out of neutral. Over time this can cause joint dysfunction, pain, altered movement patterns and could even lead to serious injury eventually.

The primary joint we will be discussing here is the pelvis because this is where your spine connects via muscles and connective tissues. In order to keep this as simple as possible just imagine the pelvis like a box suspended in air by four cables (representing muscles). There are a 4 major muscle groups involved in the positioning of your pelvis; the abdominal muscles and hip flexors in the front. The gluteus, hamstrings, and low back muscles in the rear. If the low back muscles and hip flexors are tightened then the pelvis shifts up in the rear. The opposite happens if the gluteus, hamstrings and abs are tightened. If all are even then the pelvis would be square.

Now that you understand how the joint and muscular systems work together, let's discuss a major contributor to low back pain. The majority of people who suffer from this problem that I've met all have one thing in common: jobs that involve hours of sitting at a desk. When sitting, the hip flexors and the low back muscles are in a shortened state. This creates a pulling of your pelvis down in the front and up in the rear, called an anterior pelvic tilt, tilting your pelvis in such a way that your butt sticks out. The lengthened muscles in this dysfunction are the abdominals, hamstrings, and gluteus. These muscles, primarily the glutes and abdominals, are constantly in a weakened state and these are the very core muscles needed to support the lower back.

The process of treating this is based on Corrective Exercise. The first step towards correcting this is to inhibit the over-active hip flexors through self-myofascial release (aka foam rolling). The second step is to lengthen them by doing a static hip flexor stretch. You can also stretch the low back by lying over a fitness ball, this is also a great way to decompress your spine after a long day of sitting.

Once you have lengthened the tight muscles, then you can begin isolated strengthening of the abdominals and glutes. Some great exercises to accomplish this are hip extensions (aka bridges), planks, and sit ups or crunches. Another great exercise for strengthening the transverse abdominals is the standing or kneeling draw-in. You should also strengthen your hamstring muscles as these contradict the pulling of the hip flexors. This last one may not seem to make sense because most people with low back pain feel like they suffer from tight hamstrings and this is true. However, the reason the hamstrings feel tight is that they are being overly stretched because of the position of the pelvis and they actually need to be strengthened to counteract the hip flexors.

By doing these exercises you can bring your pelvis back to neutral and eliminate the pressure brought upon the lower back by sitting all day. I have used these exercises on myself and many of my clients with extreme success. If you have joint pain or issues feel free to comment or email me your questions, I would love to help you live and move pain free.

Dave C Smith CES.

Myofascial Pain Syndrome Of the Low Back and Hips


Myofascial pain syndrome of the low back and hips is caused by pain producing "trigger points"(TrP) in the gluteus medius muscle. Some patients will refer this as "a pain in the butt". It is important to stress that myofascial pain syndrome can affect any muscle in the body, and in any area of the body. A common area affected can be in the upper back over the shoulder blade (scapula) area that is caused by trigger points in the trapezius muscle. The myofascial pain syndrome can even affect the side of the face, causing pain in the jaw, commonly affecting the tempero-mandibular joint TMJ).

For now we will focus on the low back and hip myofascial pain syndrome. To understand what causes the myofascial pain syndrome, we need to understand what causes it. The pain is caused by nodules (knots) causing areas of irritation in the muscle or fascia associated with the muscle. These trigger points (TrP) are areas of irritation within extremely tight bands of muscle and or fascia.

These irritations are caused by various traumas, such as engaging in sports, aerobic exercises, working out with weights and sudden falls. Another cause can be standing on one leg for extended periods of time without changing positions. This causes the muscles of the leg you are standing on to be become tired making them work harder so that they go into spasm. This spasm sets up areas of irritation that become trigger points. Another precipitant can be when the muscle becomes chilled. The chilling of a muscle can cause it to go into spasm, resulting in the same phenonemen that will result in trigger points.

One of the muscles that are very often affected in this manor is the gluteus medius. This muscle starts at the top of the ilium (hip bone) and is attached to the outside head of the thigh bone (femur). The function of this muscle is mainly to stabilize and keep the pelvis level while the individual is walking. This prevents the pelvis from dropping when raising the foot on the opposite side.

Pains are not always localized at the trigger point area. These trigger points can also cause radiating pain in surrounding tissues, or radiate into areas further from the trigger point site. Pains in the buttock, back of the thigh, the sacral area (the large triangular bone between the hips), and up into the side of the lumbar spine, are commonly affected sites.

Structural instability of the lower spine and pelvis is the foremost cause for the myofascial syndrome. When there is a tilt or rotation of the pelvis and/ or a shortness of one of the legs, will set up the weakness that that makes the individual more prone to injuries. Once being prone to this type of situation produces injuries while engaging in sports, aerobic exercise, weight lifting, running, golf, tennis, or even sitting in a slumped position. Even lying on the affected side for a length of time can be a causative factor. This causes the gluteus medius muscle to become shortened and loose it's flexibility. It is the muscles loss of flexibility that makes it more prone to injury, and set up one or more trigger points within that muscle.

The pains, once they occur can last for extended periods of time, or there can be remissions that can last from hours to days, or even longer. The patient sustaining a myofascial pain syndrome may be prone to future episodes even after the initial occurrence is resolved, especially if there is a spinal imbalance unless it is properly diagnosed and treated. A spinal imbalance can best be diagnosed and treated by a Chiropractor. The Chiropractor will not only correct the spinal instability, but will treat the primary pain symptoms so as to give the patient the needed relief from pain.

The patient must also take an active part in their treatment if they wish to lessen the pain and length of disability. Home health care by the patient will determine how soon they will be pain free and able to get back to their normal daily activities. At first they should curtail any and all strenuous sports, exercise, and the more difficult household chores, such cleaning windows, mopping floors, vacuuming, ironing, etc. Applying heat (preferably moist), 3 or 4 times daily for 20 minutes will soothe and relax the muscles. After the heat, rub in a good analgesic gel.

As the symptoms subside, the degree of activities can be increased. If, when they are increased, pain reoccurs or increases, then that particular activity should be stopped. When the individual is pain free, they then can resume their normal daily activities. At this point an exercise should be started. Exercise is the single most important component in the strengthening of the abdominal and low back muscles. Strengthening these muscles will help stabilize the back and prevent future episodes of this debilitating syndrome.

The type of exercise program must be carefully selected. A wrong type of program can reactivate the pain. A no impact exercise program would be best. and is excellent for strengthening the abdominal and back muscles. The program picked, even though it is a no impact program, it still gives you a total body workout. The exercise should permit the individual to set their own pace and set their goals higher as their muscles become stronger and their strength increases. With the increase of strength will come a more flexible physique that will enable the individual to live a vigorous and a more vital lifestyle!

Is There Really Any Connection Between Joint Pain And Alcohol Consumption?


Countless people say they often experience pain or discomfort in some of their joints after they have been drinking alcohol. They also say the level of pain they experience is proportionate to the amount of alcohol they consume. In other words, the more they drink, the worse the pain. What do medical professionals have to say about this?

If you tend to party hard, then you will no doubt be pleased to hear that there is seemingly no real evidence to suggest that alcohol consumption can cause joint pain. Countless studies have already been carried out over the years, and researchers have never yet managed to establish a direct link. However, this still does not mean alcohol can't contribute in an indirect way.

It is for example a well known fact that excessive drinking increases the risk of getting gout substantially, and of course gout can cause severe pain in some of your joints, with feet and knees being the most commonly affected joints. Gout is essentially caused by a buildup of uric acid in the body, and it often goes away after a few months, only to return again at a later stage.

Alcohol consumption is also known to cause weight gain, and this in turn can and frequently does result in joint pain. Those first few beers may not interfere with your weight, but if you are drinking regularly, your weight will definitely start creeping up gradually. In fact, this can happen so slowly that you don't even realize it until you start experiencing aches and pains in your joints. Do not forget, every extra pound you put on increases the burden on your joints.

Joint pain is also often caused by poor sleeping habits, and of course alcohol can be a major culprit in this regard. You may think you have a much better sleep if you have a few drinks first, but the truth is, you don't. Under normal circumstances, you will always move around in your sleep. You may go to sleep on your back and wake up still lying on your back, but you can be rest assured, you would have spent some time on your side or on your stomach during the night.

This natural pain prevention mechanism does not always happen if you go to sleep drunk. Also, you may fall asleep in a position which is far from being ideal, and naturally this can cause you to have painful joints when you wake up the next day.

While there might not be a direct link between joint pain and alcohol consumption, it is clear that alcohol can be a contributing factor. Drinking too much can also cause a vast amount of other health problems, so it really is best to only drink in moderation.

Friday, December 20, 2013

Piriformis Syndrome - Self Diagnosis


"Oh No!" It's the acute or chronic feeling of pain, hot or cold, numbness, weakness, "electric shocks," or strange sensations, starting near your buttocks and going down your leg. You've got sciatica, and all you know is that it can be excruciating. Sciatica may originate in your brain, your back, or where you sit, stemming from nerve problems in the back or entrapped nerves in the pelvis or buttocks. What causes the pain is just as varied and potentially confusing. The trouble is often due to a herniated disk, spinal stenosis, or piriformis syndrome--a commonly misdiagnosed compression of the sciatic nerve by the piriformis muscle. Here we are going to tell you how to self-diagnose whether you have piriformis syndrome.

If you are wondering if you have piriformis syndrome you can do a lot to diagnose yourself at home. First, is the pain worse when you are sitting down? Do you have pain, numbness, and/or weakness in the buttocks, down the back of the leg, or both? Without such pain and discomfort, you can rule out piriformis syndrome. Next, if you press on the muscle in each buttock, just above the middle of the cheek, and you have pain on one side or both sides, that is another indication that you have piriformis syndrome. Sometimes you can feel the muscle in spasm there. If you don't feel any pain, tenderness, or discomfort with this pressure, chances are you don't have the problem, though there are a few exceptions to this rule. Third is the classic "straight leg raise test". To do this, you will need someone to help you out. First, you lie flat on your back on a hard surface. Next, the person helping you, will raise your legs one at a time. As this is being done, you must let this person know at what point you feel pain and at what angle you feel it. If the angle is between 30 and 60 degrees and the pain is in the back, it often indicates irritation of nerve roots that form the sciatic nerve. Bending the knee while the leg is still raised should relieve the pain. If this does not relieve the pain then the problem is probably in the hip. If the pain is in the back of your knee and occurs at the same angle for both legs, you may have nothing more serious than tight hamstrings. If, however piriformis syndrome is present, this test should cause more pain on the side that is most affected.

Next we will explain how to perform the FAIR test at home. A simple form of this test, without an EMG machine was created by a Norwegian surgeon named Solheim and is commonly referred to as the Solheim Test. First, lie on your side on the floor, with the painful side up. Next, bring the knee of the leg on that side down to the floor, without turning over and without facing downward. A friend can do that part and the next. Now press ypur knee downward and move the ankle upward, more or less using the leg as a crank to turn the hip joint counterclockwise(to the left)and clockwise(to the right). If you feel pain you may well have Piriformis Syndrome.

There is also a test called the Paces Test, which also requires the help of a friend. Assume the same position as at the start of the Solheim Test. Raise your bent leg. Your friend should now try earnestly but not too vigorously to keep it down Once your leg is up in the air, hold it there. If you are weaker on one side than the other, that is another indication that you may be suffering from Piriformis Syndrome. If you experience any severe abnormalities while performing these tests, you may want to go see your doctor for the full version of the Fair Test with an EMG machine.

A conventional X-ray will not show piriformis syndrome, nor will any standard MRI or EMG. However, the spasm of the piriformis muscle can affect the sciatic nerve and can damage or even sever some of its fibers, and an EMG can pick up that damage.

The various types of exertion that could have caused piriformis syndrome in the first place can also make it worse, or make it begin again if it has eased up. Running on a treadmill is an example of this, as is walking up steep stairs or a hill, or heavy lifting for a long period of time.

Most of the time, people who have piriformis syndrome have it on one side, then get it on the other side as well. The pressure of the abnormally large or stiff piriformis muscle pulls the sciatic nerve taut. The recommended physical therapy for Piriformis Syndrome is two or three times per week for one to three months. We sincerely hope that this has made it easier to tell whether you have this sydrome before you spend a lot of money and time on worthless doctor visits that may not tell you any more than these simple tests will tell you. And we hope that this will help you to tell the difference between sciatica pain and the discomfort and Piriformis Syndrome.

Groin Pain With Back Pain


Back pain treatment is complicated by the fact that there are many potential causes. One of the best ways to get an accurate diagnosis is by considering all symptoms you may have.

If you experience groin pain with back pain, they are likely related. Groin pain and back pain may be caused by any of the following conditions:

Hip Bursitis: Bursa is a fluid sac in the body that allows two different body parts to move smoothly over one another. A tendon passes over the outside of the upper thigh bone on each side of the body, and a bursa rests between them to prevent painful friction. Inflamed hip bursa creates a condition known as hip bursitis. The tendon moves across the bursa and hip with each movement of the leg. If the bursa is inflamed, this motion will create pain. This pain can radiate throughout the pelvis, affecting the buttocks, groin and lower back.

Hip bursitis is only common in people who play sports that involve a lot of running and those who have had hip surgery. It may also appear in people who have fallen hard on the hip. People with hip bursitis usually have visible inflammation at the site of the bursa and feel pain when this area is touched. Hip bursitis is usually treated with anti-inflammatory medications and physical therapy.

Sacroiliac (SI) Joint Dysfunction: The SI joints can be found where the large hip bone meets the sacrum at the base of the spine on each side of the body. These joints stabilize the pelvis and, therefore, the back. They are supported by a network of strong ligaments and surrounded by a number of nerves that travel from the lower back to other parts of the body, including the groin. If the joint is hypermobile or stiff, it may become inflamed and create pelvic instability. Nerves surrounding the joint are often affected by this inflammation, causing referred pain to the back, thigh, buttocks and groin.

An SI joint can become hypermobile if one of the ligaments supporting it is overstretched or torn. This is generally treated by a combination of rest, anti-inflammatory techniques, joint stabilization with the use of a belt, and physical therapy to develop the muscles that support the joint. Stiff SI joints can be treated with chiropractic manipulation. Once SI joint function is restored, the nerves referring pain to the groin should be freed up.

Piriformis Syndrome: The piriformis muscle sits deep within the buttocks, stretching from the sacrum to the thigh bone on each side of the body. Its function is to move the leg outward to the side and rotate the leg to the side, as when your toes point outward rather than straight ahead. This muscle is in a location that rarely gets stretched and often gets tight. Runners, cyclists and people who sit for long periods at a desk or in a vehicle are susceptible to piriformis syndrome.

When the muscle gets tight and inflamed, it can press on the nerves surrounding it. It may compress the sciatic nerve, causing pain in the lower back and down the leg. It may also compress the pudendal nerve, which supplies the genitals, urethra and rectum. It can cause both groin and back pain.

Piriformis syndrome is best treated with physical therapy. Self-myofascial release, performed with the use of a dense foam roller, is the best way to relax the muscle and restore its normal length. Once this is done, a stretching routine can be learned to keep the muscle loose while surrounding muscles can be conditioned to prevent overworking the piriformis.

Groin and back pain management are most effective when both doctor and patient understand the underlying causes of pain. It is wise to keep a detailed record of your symptoms in case they relate to each other. Consider using a journal to document your pain experience, and share your findings with your doctor. Your own experience may give the clue that is needed to find proper treatment.

Be Aware: The 3 Main Symptoms For TMJ


TMJ, found on each side of the jaw, connects the lower jaw to the skull. TMJ moves in a rotating action and gliding action. Rotating action is related to the mouth's opening and closing action while the gliding action permits the mouth to open broader. The coordination of these two actions is necessary for talking, chewing and yawning.

Temporomandibular joint or TMJ syndrome or disorder is a medical problem in the joint. Patients experience pain in the neck, head, face and ears. Patients might encounter problems in biting, popping sounds in biting, difficulty to open the jaw, and jaw lock.

TMJ syndrome is usually caused by teeth grinding and clenching, joint degeneration, and rheumatoid arthritis. Inflammation of the joints may also be caused by habits of gum chewing, fingernail biting, dental problems, misalignment of the teeth, and previous history of fractures in the jaw. Stress and occupational tasks via the head and shoulders are likewise considered associated causes of TMJ. Likewise, the dislocation of the disc that performs as a cushion connecting the ball and the socket could cause the disorder.

Symptoms for TMJ include the following signs:


  • Headache, listed as one of the most universal symptoms for TMJ, is experienced by about 80% of patients with TMJ. Headache becomes worse when the individual tries to open and close the jaws. Headache is triggered when something very cold is sensed by the jaw like cold drinks, cold weather and cold air. Headache can augment muscle contraction in addition to facial muscle pains.

  • Ear pains are not all caused by infections. As one of the symptoms for TMJ, individuals who encounter frequent or recurring ear pain in the front of the ear or just below the ear must visit the doctor for diagnosis. About 50% of patients experience this symptom among the other symptoms for TMJ.

  • Do you hear popping sounds, grinding sounds and crunching sounds? As one age, the jaw experiences wear and tear. If you have the habits of teeth clenching and grinding or is already in the old age, consider calling for an appointment with a doctor.

Lastly, it is important to watch out for sensitivity to light, bloodshot eyes, watery eyes, blurred vision, pressure behind the eyes and pain on top of, underneath and at the back in the eyes.

When you have experienced any of these symptoms for TMJ, do not hesitate to consult your doctor. Seek medical help to avoid suffering from more than one of the symptoms for TMJ. Get medication and get treated without difficulty.

Types Of Arthritis - Three Most Common Types And Other Types Of Arthritis


Arthritis covers a broad spectrum of disease. To many, the term arthritis means pain and inflammation of the joints - but, arthritis is a much more complex medical condition. The term arthritis comes from the Latin phrase, "arth" meaning joint and "it is" meaning inflammation. There are over 100 illnesses associated with the term arthritis. Arthritis can range from something as simple as tendonitis to something as chronic as rheumatoid arthritis.

Three Most Common Types of Arthritis


  • Osteoarthritis - the most common type of arthritis. This degenerative joint disease affects over 16 million Americans. This form of arthritis is caused when the cartilage surrounding the ends of the bones begins to degenerate and the joints are no longer cushioned. This caused the joints to rub together and in severe cases, you can hear the bones grating against one another. At the onset of osteoarthritis, the symptoms are usually mild and consist of pain and stiffness of the joints. As the disease progresses, inflammation and loss of motion can occur. In some severe cases, deformity can occur if the grinding joints wear one side of the joint more than the other.


  • Rheumatoid arthritis - This is the second most common type of arthritis and the most severe. Symptoms usually begin appearing between the ages of 25 and 50 - however, children and senior citizens can experience the onset of this disease. Rheumatoid arthritis is the most common type of inflammatory arthritis. Rheumatoid arthritis is considered an autoimmune disease because factors other than wear and tear of cartilage can cause the disease and the disease can affect other organs, such as the eyes, lungs, and heart.
Rheumatoid arthritis usually affects the joints on both sides of the body - for instance, both hands will be affected, both wrists will be affected, and both legs will be affected. The most common symptoms of rheumatoid arthritis are pain, stiffness, swelling, redness of the skin, fatigue, weight loss, and low-grade fever. Not only affecting the joints, rheumatoid arthritis can give you an overall feeling of sickness. Rheumatoid arthritis can be a debilitating disease, however patients can experience periods of remission in which the symptoms disappear and they can lead a normal life.

  • Fibromyalgia - This is a type of arthritis that does not directly affect the joints. Rather, the inflammation and pain affect the muscles, ligaments, tendons, and soft tissues under the skin. Many patients have tender spots under the skin that are painful when any type of pressure is applied. The symptoms for Fibromyalgia include deep muscle pain, fatigue, sleeplessness, and depression. Symptoms may come and go, but the disease is long term and chronic.

Other Types of Arthritis


  • Anklyosing Spondylitis - a chronic, inflammatory disease that affects the spine. The common symptoms include lower back pain and stiffness that lasts for more than a period of three months, difficulty sleeping, fatigue, weight loss, and low-grade fever.


  • Gout - this disease usually affects the joints of the big toe, but can extend to the ankles, heels, knees, wrists, fingers, and elbow. The common symptoms are tenderness, pain, redness, warmth, and swelling of the affected joint.


  • Infectious Arthritis - this type of arthritis is caused by an infection, and can be caused by both bacterial and viral infections. The onset of infectious arthritis is sudden and the symptoms include swelling of the joint, soreness, warmth, leakage of tissue fluid, fever, and chills.


  • Cervical arthritis - this type of arthritis affects the upper back and can cause pain in the neck and arms. Cervical arthritis is caused when the cartilage protecting the discs that support the neck deteriorate. The most common symptom of cervical arthritis is chronic neck pain, but can include loss of balance, headaches, muscle weakness, and stiffness.


  • Juvenile Rheumatoid Arthritis - this inflammatory arthritis affects children. The most common symptoms of Juvenile Rheumatoid Arthritis are swelling, pain, and stiffness in joints. The symptoms are usually worse in children upon waking in the morning and after a nap. There is no known reason for the onset of arthritis in children and, unlike rheumatoid arthritis in adults, children sometimes outgrow the disease and the symptoms disappear.

These are just some of the many types of arthritis. In general terms, arthritis is any disease that involves inflammation - swelling and pain of the joints or muscles. If you suspect that you suffer from arthritis, you should consult your physician to determine the type of arthritis and learn what treatments are available.

Dog Joint Problems FAQs


What are some of the common joint problems in dogs?

Some of the most common joint issues in canines include; arthritis, osteoarthritis, hip dysplasia, elbow dysplasia, and patellar luxation.

• Arthritis - Inflammation of the joints.

• Osteoarthritis (Degenerative Joint Disease) - Degeneration of the cartilage around the joints, which also causes inflammation.

• Hip dysplasia - Abnormal formation and growth of the hip.

• Elbow dysplasia - Abnormal formation and growth of the elbow.

• Patellar Luxation - Dislocation of the kneecap.

Are certain dog breeds more prone to joint problems?

Although any dog breed can develop joint problems, some breeds are more prone to certain conditions because of their genes. Larger dog breeds for example, are more susceptible to developing arthritis, osteoarthritis, hip dysplasia, and elbow dysplasia. Some of these breeds include; Great Danes, Labrador Retrievers, Mastiffs, German Shepherds, and Rottweilers. Small dog breeds such as Chihuahuas, Pomeranians, Poodles, and Yorkshire Terriers are more commonly affected by patellar luxation.

How can I tell if my dog has joint problems?

Some of the first symptoms people notice with dog joint problems include; limping, difficulty going up stairs, trouble getting up, and slower running. Pain is also a sign to look out for with joint problems in canines. Owners will usually notice things such as; decreased activity, loss of appetite, discomfort, whining, and excess licking of certain areas.

What tests are necessary for diagnosis?

Radiographs and a physical exam are the primary sources used to diagnose joint problems in dogs. Veterinarians check the x-rays for signs of fractures, degeneration, deformations, and other things that can help with the diagnosis. If needed, your regular veterinarian can refer you to an orthopedic so that your dog can get further testing and treatment.

Can joint issues in dogs be treated?

There are two basic forms of treatment used for joint conditions in dogs; surgical and non-surgical. Surgical treatment can be anything from repairing a joint to replacing a joint. Non-surgical treatment on the other hand, focuses on managing pain and inflammation using medication, weight management, and physical therapy.

How can joint problems in dogs be prevented?

• Test your dog for joint problems before breeding. Canines who test positive for certain conditions such as hip dysplasia should not be bred.

• Maintain your dog at an ideal weight. This will minimize the amount of pressure placed on the joints.

• Feed your canine a well-balanced diet.

• Provide your dog with adequate exercise.

• Ask your veterinarian about supplements and vitamins for your dog.

Joint Pain? Check Out the Miracle of Glucosamine and Chondroitin


The Miracle of Glucosamine and Chondroitin

I had significant joint pain in my knees about 10 years ago. My knees hurt when I stood and hurt when I walked. They made horrific loud popping and grinding sounds. Believe it or not, I would wake up my daughter when she was a baby by walking through her room.

I did not want to take pain relievers or NSAIDs (like ibuprofen), but the pain was beginning to become unbearable. I am an OR nurse and I stand, walk, even knee at times, all day long. There is not much time to sit in an operating room. I needed relief.

As I researched this, I found out that some people were using something called Glucosamine, others combined it with Chondroitin. I read stories of these working...and you could buy them over the counter. I began to have hope that relief was in reach, and I would not have to visit a doctor to get it!

What is Glucosamine?

Glucosamine is a naturally occurring substance that is found in the body. It helps the body make the cartilage found in our joints. Glucosamine also helps our bodies keep cartilage healthy.

Glucosamine to use as a supplement is usually obtained from the hard outer covering of of shrimp, lobsters and crabs. People allergic to shellfish should discuss using this supplement with their doctor before taking it.

Glucosamine acts as a sugar in the body. Diabetics should discuss using this supplement with their doctor prior to using it.

Glucosamine is easily absorbed by the body.

What is Chondroitin?

Chondroitin is another substance that occurs naturally in our bodies. Chondroitin helps cartilage absorb fluid to keep it healthy. It may block enzymes made by our bodies that break down healthy cartilage. The building blocks of of new cartilage are made when chondroitin works with glucosamine.

Chondroitin is usually obtained from shark or beef cartilage, although it can also be manufactured synthetically. I remember reading years ago that the naturally occurring chondroitin was easier for your body to absorb.

What is Cartilage?

Cartilage is the tough layer that cushions the bones in our joints. It grows on the ends of the bones to cushion and allow smooth movement of bone over each other. (There are other types of cartilage,,,but that is a discussion for an other day.)

Our cartilage breaks down as we age. It starts to wear away, no longer giving the cushion and support to the bones in the joint. This occurs mainly in the knees, hips and ankles, but can occur in any joint. This condition is called osteoarthritis, or degenerative joint disease.

The main symptoms are pain, stiffness, swelling and decreased motion. The cartilage lining the bones is now a torn, uneven mess, instead of the smooth covering it was. The bones no longer glide over each other smoothly. In some spots the cartilage may be worn away so much that the bones rub against each other.

Back to My Story

Now that the boring facts are out of the way, we will get back to my story.

Once I found out the facts of glucosamine and chondroitin, I bought some and started taking it. I initially took the recommended dose of 1500mg of glucosamine with 1200mg of chondroitin split into 3 doses.

After the first month, my knees were starting to feel better. I started taking the pills only twice a day getting 1000mg of glucosamine and 800mg of chondroitin daily. I continued to improve.

I asked one of the orthopedic surgeons I worked with what he thought of glucosamine/chondroitin. He said that some of his patient took it, but it only worked for a few. He personally thought it was akin to voodoo. He told me not to get my hopes up.

After the third month, I cut back to once a day. I now took 500mg of glucosamine and 400mg of chondroitin daily. Most of the supplements will advise you to take 3 times daily for the first three months. After three months, you can take it 1 to 3 times daily, depending on how well it was working.

Obviously it was working very well for me. I had less than half the pain I had been experiencing previously. I still had some cracking, popping and grinding, but without the pain it didn't bother me as much.

I took it daily for 2 to 3 years. Then due to some financial difficulties, I stopped buying it. I never went back on because I no longer had pain. My joints no longer made the noise they had previously. Actually I had pretty much forgotten about taking them...until the results of the GAIT study showed up in my e-mail.

GAIT Study-What Is It and What Were the Results?

The acronym "GAIT" stands for Glucosamine/Chondroitin Arthritis Intervention Trial. It was performed by the University of Utah, School of Medicine and funded by 2 parts of the National Institutes of Health. There were 16 study centers throughout the country with 1583 participants. 78% of participants had mild pain and 22% had moderate to severe pain.

This study was a double-blind study, meaning neither the participant nor the researcher knew what was being taken. Participants were given one of 5 choices: Glucosamine alone; Chondroitin alone; Glucosamine with chondroitin; Celecoxib (a prescription drug to relieve the pain of osteoarthritis); or a Placebo. Their choice was randomly generated.

The study was to test, over a 6 month period, how well glucosamine and chondroitin worked to reduce pain in a large number of people with osteoarthritis.

The study cost just over 12.5 million dollars to complete.

The results were surprising. Most of the people with mild pain did not experience pain relief from the glucosamine/chondroitin. However, the individuals with moderate to severe pain experienced significant pain relief using the glucosamine/chondroitin.

What Does This Mean For Us?

While I read the study, it began to occur to me that my hips have been hurting lately. My knees are making those noises again. Bending down is slower than ever, and standing up can hurt.

I remembered my love of glucosamine and chondroitin and thought it was time to get some more! So, I am back on it. I hope it works as well as last time. I have been off since 2001. I'm not quite as bad as I was when I first took it, but close.

The researchers say that they need to do more studies on larger populations. They also were not able to prove significant cartilage re-growth. What ever they say, I know in my heart that mix of glucosamine and chondroitin did something pretty significant to my joints. It proved itself to me years ago!

Referred Pain From The Lumbar Spine


A Pain deep in the cheeks of your bottom can be referred from the lower back. There does not necessarily have to be pain in the lower back as well for pain to be referred into the buttocks.

What are the symptoms of pain referred from the back?

An aching in the buttocks that is difficult to pinpoint.

The slump test may reproduce buttock pain which is eased when the neck is relaxed back (extended).

Areas of the lumbar spine may be tender and have poor mobility.

Tight gluteal muscles and other muscles of the buttocks.

What can I do?

See a Physical Therapist who can identify the problems in the lower spine.

Begin an exercise programme that will stretch and strengthen the muscles supporting the lumbar spine.

Stretch the gluteal muscles and hip rotator muscles.

What can a Physical Therapist professional do?

Manipulate and mobilize the segments of the lumbar spine. This is a good way of assessing whether the lumbar spine is a cause of buttock pain. If it is then symptoms will be relieved.

Deep tissue sports massage techniques can be applied to the lower back and buttocks to release muscle tension, particularly in chronic conditions.

Acupuncture or dry needling can also help reduce chronic tension in muscles.

What other injuries are related or similar?

Piriformis syndrome

Sciatica

Sacroiliac joint pain.

What is the Sacroiliac joint ?

The Sacroiliac Joints are located at the bottom of the back. You have one either side of the spine. The Sacroiliac joints help make up the rear part of the pelvic girdle and sit between the sacrum and the ilia.

There are torsional or twisting forces applied to the pelvic girdle when the lower limbs are moved. These limbs act like long levers and without the sacroiliac joints and the pubic symphysis (at the front of the pelvis) which allow movement, the pelvis would very likely be subject to a fracture.

These joints can often get stuck or in some cases one half of the pelvis can glide forwards or backwards, which is often referred to as a twisted pelvis. When this occurs it often irritates the Iliolumbar ligament which results in Inflammation. This is usually indicated by tenderness around the bony lumps which you can feel if you place your thumbs either side of your lower back.

Inflammation of the sacroiliac joints and associated ligaments are very common, especially following pregnancy where the hormone relaxing is released and this results in the relaxation of ligaments in preparation for childbirth. In most cases the causes of sacroiliitis are mechanical, however there may be other medical inflammatory conditions present such as Ankylosing Spondylitis as well as others which will need attention.

Symptoms include:

Pain located either to the left or right of your lower back. The pain can range from an ache to a sharp pain which can restrict movement.

The pain may radiate out into your buttocks and low back and will often radiate to the front into the groin. Occasionally it is responsible for pain in the testicles among males.

Occasionally there may be referred pain into the lower limb which can be mistaken for sciatica.
Classic symptoms are difficulty turning over in bed, struggling to put on shoes and socks and pain getting your legs in and out of the car.

Stiffness in the lower back when getting up after sitting for long periods and when getting up from bed in the morning.

Aching to one side of your lower back when driving long distances.

Specific assessment tests:

The Stork test - to assess weather the sacroiliac joint is moving correctly.

Leg length difference measurements - both straight leg and bent leg assessments.

Ilia rotation - this assesses weather the ilia is rotated on one side creating imbalance.

What can a Physical Therapist or GP do?

Use diagnostic tests to discover the cause of the problem.

Eliminate medical diseases such as Ankylosing Spondylitis.

Treat the cause as well as the symptoms.

Prescribe anti-inflammatory medication (e.g. ibuprofen) and rest.

Use electrotherapy equipment to treat affected tissues.

If indicated and safe to do, level the pelvis via manipulation.

Articulate sacroiliac joint and restore normal function.

Sports massage will help relieve any soft tissue tension in the area.

Use injection therapy.

Advise Ice and cold therapy to reduce inflammation.

What are the similar or related injuries and conditions?

Ankylosing Spondylitis

Myofascial pain

Low back pain

Coping with Sciatica

Sciatica is a pain that starts in the back and radiates down one of the legs. It is quite a common complaint and is sciatica is caused by pressure on the sciatic nerve which runs down into the leg. The medical term is acute nerve root compression. The cause of pressure can be varied from a Slipped (Prolapsed) disk to muscle tension (Piriformis syndrome) or something less common such as a tumors, bony growths and infections.

A prolapsed disc or slipped disc as it is sometimes known is not simply a disc that has 'slipped' out of place. Intervertibral discs separate the bones of the spine (or vertebrae) and their function is to act as shock absorbers or cushioning for the spine and allow movement.

They quite happily allow flexion and extension (bending forwards and backwards), lateral flexion (sideways movement) and twisting. However a combination of the two can put excess stress on the spine and damage the discs. This is particularly common in people who may lift heavy objects and twist with them for example unloading heavy boxes off the back of a lorry.

The intervertebral discs are filled with a soft liquid in the middle called nucleus pullouts and when a disc prolapses this liquid squeezes out and puts pressure on the spinal cord compressing the nerve routes and causing pain.

Depending on where the sciatic nerve is pinched will determine where you feel the pain which can radiate to the front of the knee or right down the back of the leg to the foot. The L5-S1 disc is the disc most commonly damaged and the L4-L5 disc the next most commonly damaged.

Sciatica Symptoms

Acute low back pain.

Pain radiating down the leg. This pain may be sharp and accompanied by pins and needles and / or numbness.

Pain is often triggered by a minor movement such bending over to pick something up.

Pain may be worse by sitting, lifting, coughing or sneezing.

Pain is usually relieved by lying down, often on one side.

Pain is often better in the morning after a nights rest.

Scoliosis or an S shaped or bent spine as seen from behind is often present with the patient bending away from the side of pain.

There may be muscle spasm in the lower back.

Tenderness in the lower back when pressing in.

Pain on the straight leg raise test which is not apparent when just stretching the hamstring only.

Sciatica treatment

A Short Rest in bed if necessary in a position that is comfortable.

A doctor may prescribe NSAID's (non steroidal anti inflammatory drugs) such as ibuprofen. Should always be taken under the direction of a doctor and do not if the patient has asthma.

Apply heat or a hot bath may help to relieve muscle spasm.

Use a heat retainer or back brace can provide support in the early stages.

See a sports injury specialist or doctor.

Begin extension exercises as soon as pain allows.

What can a Physical Therapist or GP do?

Determine the cause of the sciatic pain.

Prescribe anti-inflammatory medication e.g. ibuprofen or muscle relaxants.

Use sports massage techniques to relax tight muscles.

Gently apply mobilization techniques to the spine.

Use traction or advise on the use of and Inversion Table.

Apply electrical stimulation in the form of a Tens machine or Interferential.

Apply ultrasound treatment.

Operate on a slipped disk if neurological signs (nerve related symptoms) continue or worsen.

After the acute painful phase

Restore pain free movement to the back through mobilization and stretching techniques.

Ensure posture and correct lifting techniques are learned and maintained.

Strengthen the core stabilizing muscles of the spine.

Thursday, December 19, 2013

CCL Knee Surgery and Rehabilitation


A dog's cranial cruciate ligament (CCL), similar to the ACL ligament in humans, when torn may need repaired by an orthopedic surgeon. The following information relates to recent experiences with the tightrope technique of repair.

Our 4 year old Doberman tore her CCL running up and down a steep hill at top speeds and quickly coming to a stop and turning to run back in the other direction. The first signs of a problem were slight limping. She appeared as if she hurt a muscle in her leg and needed to rest it. After a day or two of not running, she no longer exhibited any symptoms. As the summer went on, the limping happened more frequently. We took her to a vet that x-rayed her hips to see if dysplasia was the issue. Her left side showed a slight irregularity in the hip joint so the prognosis was the pain was coming from that and she was given some pain medicine and put on joint supplements. The instructions were to let her run and use her joints just like when a human has a sore joint it is better to utilize the joint to keep it strong. Unfortunately the more she ran, the more problems she exhibited. Upon taking her to a different vet, they began looking at her knees and that the problem might lie there noticing a slight bulge next to her knee joint. We were then sent to a surgeon specializing in this area. Upon testing, they were immediately aware it was related to her CCL and we were presented with the surgery options.

We selected a relatively new procedure called a tightrope. This is less evasive than the metal bone plate implant with teeth like claws that go into the bone and requires part of the bone be cut. The tightrope wraps around the joint, through a small hole in the bone, and is tied in a knot. The knot does not protrude through the skin as it is tucked under the muscle. The main incision along the knee is approximately 6" in length with another small incision on the inside of the knee of 2", both held in place with staples.

After surgery, there is a long 8 week rehabilitation time. For the first 2 weeks an e-collar is required in order for the dog not to lick the incision to eliminate possible infection. The surgeon stated that if the incision becomes infected, it could get inside the leg and once that happens, it would adhere to the implant and there would be no way to get rid of it and the implant would have to be removed and replaced. Also for the first 2 weeks, the dog needs to be confined to a small area that has solid footing. The risk of slipping needs to be eliminated due to if the dog slips and falls prior to complete healing, the implant could be damaged. Also, they are not to go up and down stairs during this time as well. When it's time to go outside, the dog must be on a lead and during the first 2 weeks a sling is utilized. The sling is placed under the dog's belly and held with straps along with the lead. The sling is not used to pick up the dog and not allow them to utilize their repaired knee, but instead is in place to be a source to prevent them from falling allowing you to catch them should they slip.

The instructions for the entire 8 weeks is that your dog cannot go outside by themselves off lead. After the initial 2 weeks, they can be let into other areas of the home to walk around with you. However, there are still issues with slipping and falling which should be addressed. Consider laying down throw rugs if you have wood or tile floors to prevent slipping. Even though your dog may appear to be feeling better, she is still not completely healed so we need to be cautious and attempt to eliminate possible hazards.

After 2 weeks, we took her back to the surgeon to have the staples removed. At this time, the rehabilitation begins. For the first week after staple removal, we were instructed the dog can be taken on one 15-minute walk a day. The next week the walk is to be increased to one 20-minute walk a day. The next week and the remaining time the walks are increased to two walks per day of 15-20 minutes each. It is recommended if there are any hills along the path, it would be good to allow them to walk up and down those to help build strength. There are also exercises you can do with the affected leg to assist with range of motion. A physical therapist can also be used and one of the techniques they may utilize is a water treadmill.

The most difficult part of this process is the dog cannot rationalize the situation and that being kept in one room of the home with limited access is good for them. Even just into the recovery, my dog wanted to play, was anxious to be let out of the living room, and was bored. Even though she appeared healed, there was evidence she was not fully utilizing her repaired leg. The majority of her weight for several weeks was on three legs. This was evident by her "tapping" her repaired leg. When standing, she would tap her foot on the floor thereby not placing full weight on it. The surgeon stated this is common and that over time with rehabilitation, she would gain the strength back and be back to normal placing equal weight on all four legs.

The above information is what I experienced following the procedure which might provide some insight if you are considering the surgery for your dog. However, for specific medical details, advice from your veterinarian or a specialist is critical.

The Basics Of Osteoarthritis and How The Disease Affects Your Bones


Known as degenerative joint disease, osteoarthritis is one of the most common forms of arthritis. It is defined by the loss of cartilage, a material found in the joints. Cartilage functions as a natural buffer between the bones, preventing them from making contact with one another whenever a person moves. With osteoarthritis, this material erodes to the point that the bones rub together. Moving the joint causes the patient to experience pain, the severity of which depends on the extent of the erosion.

Osteoarthritis can affect cartilage throughout the body, but is most commonly found in hips, knees, lower spine, feet, and hands. The disease is incurable and progressive; the loss of cartilage increases with time.

We'll provide an overview of the disease below, beginning with its symptoms. We'll explain how it is diagnosed, and describe some of the treatments that can be given to reduce the patient's discomfort.

Symptoms Caused By Osteoarthritis

Symptoms may not be noticeable until the condition reaches a moderate or advanced stage. Even though the buffer between the bones begins to erode, there may be little to no pain in the beginning. Over time, however, the loss of cartilage becomes significant, which can cause several symptoms. The most common among them is joint pain. The patient may experience soreness in the joint during, and after, moving it.

The joint will also become increasingly stiff as time passes. Stiffness will be most pronounced immediately after waking, and lasts until the joint regains flexibility.

Many patients experience bone spurs (osteophytes), which are small lumps that develop along the margins of the joint. The lumps are hard, and indicate increasing damage to the surface of the bones.

What Causes Osteoarthritis?

There are a number of contributing factors to the disease, including age. Older people are more susceptible to it than their younger counterparts. To understand the reason, it is important to be familiar with the change that cartilage undergoes as a person grows older.

In a young person, the makeup of cartilage includes a substantial amount of protein. With time, however, the amount of water in the material increases. This causes the cartilage to become more vulnerable to erosion as the bones of the joint rub against it. By the time the patient has reached an advanced age, the buffer may have completely deteriorated.

Other factors that play a role in the development of osteoarthritis include obesity, trauma to the joint, and genetic predisposition. But age, by far, is the main factor.

Detecting the Erosion Of Cartilage

After a physical examination, a doctor will order x-rays to examine the structure of the joint. The x-rays will display cartilage erosion as well as the formation of osteophytes. The physician will be able to determine the extent of the arthritis.

In some cases, an MRI (magnetic resonance imaging) is ordered to provide clearer details of the joint. The images will display the ligaments, soft tissues, bone, and layer of cartilage. This test is less common due to cost, but is ordered when x-rays prove inadequate.

One or more blood tests are usually performed to help rule out other conditions that may be triggering joint pain. An analysis of the synovial fluid in the joint is also done. This may reveal inflammation as well as causes of swelling.

Treatments To Help Minimize The Patient's Pain

As mentioned earlier, osteoarthritis is incurable. But there are treatment options available that can reduce the pain the patient experiences as the disease progresses. A number of medications may be given. These include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections. Physical therapy is also recommended in order to strengthen the joint.

In severe cases of the disease, surgery may be recommended. A surgeon may attempt to realign the bones to reduce pressure (called osteotomy). Or, the joint may be replaced (total arthroplasty); this is primarily done when there is substantial cartilage erosion in the hips or knees.

It's estimated that seven out of ten people over the age of 70 show signs on x-rays or MRIs of osteoarthritis. Although there is no cure for the disease, it can be treated.

Is the Pain in My Hip Coming From a Hip Problem or From My Back?


When a person has pain going into the hip area, it may not be emanating from the hip itself. The pain may actually be coming from a problem that is occurring in the low back and the resulting pain is radiating into a person's hip region. The problem may not be causing any low back pain so it can be difficult to delineate where the actual problem is coming from.

In order to treat the pain most effectively, it is necessary to figure out where the problem is emanating from. In the doctor's office a physical examination can show usually if the patient has arthritis of the hip. With hip arthritis often times range of motion of the hip is very painful and there are specific maneuvers which can show this. There are also additional physical exam maneuvers which can show a problem such as sacroiliac joint arthritis. Along with this, plain x-rays raise of the hip joint will typically show moderate to severe arthritis and people have pain in the area or potentially going down into the side.

Outside of hip arthritis pain, an individual might have some other derangement inside the hip joint including a cartilage tear otherwise known as a labral tear.

If the person's pain is not coming from the hip, there's a good chance it's coming from a problem in the low back. This may be from a nerve root compression or potentially several nerve roots are being pinched such as in spinal stenosis.

Spinal stenosis may cause no pain in the lower back itself, but radiating pain going down around the hip area. So the two may be mistaken for each other, or they may actually co-exist.

An MRI of the low back can show if nerve roots are being pinched. This may explain the patient's hip pain especially if there is is no evidence of arthritis and the exam does not display pain with hip range of motion.

One way to tell the difference is to have a pain management doctor do a diagnostic injection into the hip itself. This may be done with numbing medicine along with some steroid. The numbing medicine should kick in within just a few minutes so if the patient describes there being much less pain afterwards it probably was the hip being the culprit.

If the hip injection does not help, and the needle was reasonably assured of being inside the joint, then the next step would be an epidural injection to see if the pain was coming from the low back. This is done as an outpatient procedure, and can tell very nicely if the pain relief occurs into the hip area.

So between the two diagnostic injections, pain doctors can often get a very good picture of whether or not the pain is coming from the hip by itself, the spine by itself, or a combination of the two. Then treatment efforts can be catered towards the definitive diagnosis.

Relieve Gout Pain Now Without Taking Toxic Prescription Drugs


The description of a person who suffers from gout is a male over the
age of forty years of age. In ancient times, the gout sufferer would have
been royalty. Gout has been called the "king's disease" because only
royalty could indulge in fatty food and alcohol to excess.

Gout is caused by a build up or uric acid crystals in the joint fluid.
The immune system reacts to these crystals as if to a foreign invader.
The joint, as a result, becomes inflamed and painful.

The symptoms are the sudden onset of burning pain and stiffness.
The joints swell. The common areas affected by a gout attack are
the big toes, ankle, knee, wrist and elbow.

Your medical doctor can diagnose whether you have gout through a blood test.
Traditional treatment to help gout pain is NSAIDS to kill the pain. Allopurinol,
is an anti-inflammatory drug that inhibits the formation of uric acid. Allopurinol
has serious side effects that include:

*Skin eruptions

*Liver toxicity,

*Inflammation of the blood vessels, and

*Possible weakening of kidney function

To help gout pain without taking toxic prescription drugs, follow these medical
recommendations:

1)Exercise

Recent medical advice supports the theory of regular exercise as a pain reliever
for gout. The theory is that exercise nourishes the joint cartilage
and removes waste products. Exercise also strengthens the muscles around the joint.
Stronger muscles will support the joint. Stretching exercises maintains your range of motion.

2) Apply cold packs to inflamed swollen joint for 10-15 minutes,.

3) Put your joints gently through its full range of motion one to two times per day.

4) Drink 8-10 glasses of water per day.

Drinking sufficient amounts of water, fresh juices or herbal tea daily will relieve
gout symptoms. The fluids keep the urine diluted to help the body excrete uric acid.

Add fresh squeezed lemon juice to your water daily. Lemon juice stimulates the
formation of calcium carbonate in the body. Calcium carbonate neutralizes uric acid.

Diet Recommendations:
Eliminate these foods to help gout pain

People who have gout are unable to break down and excrete uric acid, a byproduct of
digesting certain foods. Reducing the consumption of these foods is very often successful
in reducing or eliminating gout. It is recommended that individuals who suffer from gout
eliminate these foods from the diet.

*Anchovies

*Asparagus

*Legumes

*Mushrooms

*Meat organs

*Red meat

*Shellfish

Do not take aspirin for pain relief. Aspirin can raise uric acid levels
Only use ibuprofen.

It is recommended that people who suffer from gout add these foods to their diet to
help with gout pain. Baking Soda with meals will prevent gout attacks. Baking soda will
help alkalize the body.

Take 2 grams of fish oil capsules 2x a day to reduce the chances of gout inflammation.

Eating 6-8 cherries daily will relieve the symptoms of gout.. Cherries are rich in compounds
that prevent the destruction of collagen.

Mince garlic and add it to black cherry juice for a potent remedy to relieve gout pain.

Three to six shark cartilage tablets taken used on a daily basis can make the pain go away.
Take 1000 mg of vitamin C 1,000 mg per hour at the very outset of a gout attack, then reduce to
500-3,000 mg daily for maintenance.

Vitamin C helps lower serum uric acid levels.

Get some natural, concentrated black cherry juice and drink several tablespoons daily.
You should expect relief in 48 hours.

Blueberries are high in anti-inflammatory compounds called anthocyanins, which help ease
the pain of gout.

Boil one tablespoon of Cayenne pepper in 1 cup of vinegar and 1 cup of water and dab onto
the painful joint.

Grapes are high in alkalines which lessen the acidity of uric acid and aid in its elimination
from the body.

Eating a cup of strawberries with each meal should bring quick relief. Strawberries
neutralize uric acid.

Finding alternative treatment for gout pain is important. Gout sufferers are usually prescribed
one of three types of drugs that have negative side affects. Finding a combination of natural
ways to help gout pain will be beneficial for your long term health.

Using Splenda Can Cause Painful Side Effects


So many people are using Splenda as a sugar substitute, and I joined in on that bandwagon as well. I purchased a large bag of Splenda instead of sugar and promptly began to use it as I would use sugar. It was great. It tasted just as sweet as sugar but without the calories. I could use it in my coffee, in baking, in my tea, whatever I wanted. There are cookbooks filled with recipes specifically for using Splenda instead of sugar, so it had to be safe, right? Everywhere I went there was Splenda. Then the pain started.

Living in the New Orleans area during Mardi Gras season means there will be parades. My daughter is on the dance team in high school and her school participated in three parades. As her mother, I walked with her. The distance of the parades was five miles. At the end of the first parade, I had hip joint pain. I had never had hip joint pain before. Walking in the other two parades meant the hip pain would continue. I thought once parade season ended and I would have time to recover from walking so long and the pain would simply go away. It did not.

I found that while relaxing on the sofa in the evening, I would have to change positions frequently. Getting out of the car took effort and I would have to stand up slowly and stretch out my hip. I was walking hunched over and wobbling all the time. I felt as though there was a hip replacement in my future, and I am only 43 years old.

Then one day, I went to the drugstore to pick up a prescription for my husband and was glancing through a book on the Christian book rack entitled Eat This and Live by Don Colbert, MD. In his book, Dr. Colbert listed joint pain as a side effect of using Splenda. Joint pain. That got my attention. By this time, we had gone through the whole bag of Splenda and I had not yet replaced it. Well, I begin thinking about when my pain started, it was around February which is Mardi Gras season. About a month after the Splenda was gone and we were back to using sugar, my pain disappeared. Was this a coincidence? I did not want to find out. I was just happy to not be in pain anymore.

A month later, I went to my dad's house and had a cup of coffee only to find out they had Splenda in the sugar jar, not sugar. The next day the hip pain was back and lasted approximately three days. I was convinced. Never again would I eat Splenda. It is just not worth it.

Memory Foam Dog Beds Can Help You Provide Love and Support For Your Dog


Memory foam beds are designed with your dog's comfort and health in mind. The memory foam really does have a "memory." It's designed to "give" or adapt to your dog's anatomy, providing support and comfort at key joints and muscle pressure points as he rests in it. Once your dog exits the bed, the four-inch thick foam rebounds to its original shape..

Memory foam dog beds have two benefits for your dog's quality sleep. The first is that the foam helps regulate your dog's temperature, keeping him warmer in the cold months and cooler in hot months. The second benefit is the beds are designed to be low to the ground, making it easier for elderly or injured pets to climb in and out. And these beds come with removable waterproof covers that protect the cushion beneath just in case your pet can't move fast enough to make it outside and has an "accident."

Deep Dish Dog Beds

These beds resemble a couch, and are shaped like an open-ended dish. Unlike your couch which Fido may prefer now, these 4-inch thick dog beds have a tufted bolster collar attached to one top edge. This provides security and support for your dog, since he can snuggle his backside against it. Oval fleece-lined beds have a silky smooth material, making sleep a pleasure. Round wrap-arounds create a circle that "wraps" around your dog, providing a sense of security vital to good sleep.

Dream Lounger dog beds

This memory foam dog bed is made for ultimate comfort. The fleece bedding has a water-resistant liner designed to keep the foam clean and dry, which helps prevent odor build up.

Orthopedic dog bed

Dogs give you affection, love and companionship all their lives. It's fitting that you return the favor, especially when your dog gets older. As your dog ages, he may suffer from painful degenerative joint diseases in sensitive joints when he moves or lays down. Because your dog may not be able to move fast enough to get outside, "accidents" happen, But these Orthopedic dog beds have sleeping areas covered with a highly absorbent fabric, and a removable, washable bolster.

Give your dog what he needs

Your dog gives you unconditional love all his life. Give him the same. Buy him a dog bed that he can be comfortable in and enjoy his canine power naps. He'll love you all the more for it, and may be with you a lot longer.

Wednesday, December 18, 2013

Tinnitus Headache - Causes of This Type of Tinnitus


Tinnitus and headache could have sprouted from stress and could easily be taken cared of. What is hard to manage and may require further evaluation is tinnitus with temporal headache. This condition is affects the temporal bone, which is the organ responsible for hearing, and is located just on top of the ear in the skull. Knowing the causes and evaluating it may lead the patient to have the right treatment. There may be many factors that could lead to tinnitus headache but among those are discussed here and are divided into two - the primary factors and secondary factors.

There are new discoveries of how tinnitus headache developed. This will be discussed along the article as the secondary factors. But let's go over to the primary factors from which headache might develop. First and most common is the stress. Stress affects the temporal bone structure of the skull. Relaxing and getting deep breath will relieve a person from a stress. Drinking plenty of water is necessary for those who are under stress. As medications could give relief, some medicines may have adverse side effects. Insomnia, the next factor could be easily treated with right quantity of sleep (7 hours/day).

One factor of a tinnitus headache is serious and life threatening because there is bleeding in the subarachnoid space in the brain. This is called a subarachnoid hemorrhage. It could unexpectedly occur or might be from a head injury wherein the cerebral aneurysm ruptured. This is not a common cause having only 1 out of 15,000 Americans in the survey result. Lumber puncture is a collection of cerebrospinal fluid from the sac of the lumber. Tinnitus headache may occur if it does after 12 hours from which the procedure is done.

Temporomandibular Disorder (TMD) is a new study that tinnitus headache may have aroused from this condition. But this alone is the problem but this arises from another factor called Temporomandibular Join Disorder (TMJ). Some mechanisms in the jaw joint, which is located near the ear, may bring out an ear symptom. The muscles and tendrils get their nerve impulses from those that are joined to the jaw muscles, and sometimes, a bit of mistake in the analysis of the signals may cause alteration.

A progressive study of tinnitus in relation to a temporal headache is still on going. But another consideration of how a tinnitus headache may arise is from an ototoxic medication like the antibiotics, including Aminoglycosides, Vancomycin, and Erythromycin. The chemotherapy agents and quinine is also considered to be contributors to tinnitus headache, especially for the older people. Pain and discomfort may arise in the temporal structure in the skull due to the toxicity which is present in these drugs.

Sciatica Causes and Chiropractic Treatment


Sciatica is one of the most common low back injuries seen in chiropractic offices. Sciatica presents as low back, buttock, and leg pain that can be accompanied by numbness, tingling, or burning pain. It is typically one sided but can involve both legs at once. True sciatica can have many causes but the most common result from muscular and skeletal problems in the low back and buttock. Chiropractic care offers fast, natural relief from the pain without the use of harmful prescription drugs and surgery. Tight muscles and spasms can cause the spine to misalign and put pressure on the sciatic nerve. The most common treatment for sciatica is to begin at home with ice and rest. The ice should be applied to the lower back on the side of the leg pain in intervals of 15-20 minutes with about 30 minutes between applications. If the pain does not go away within 3-4 days it is recommended that you go to see a health care professional. Further studies including x-rays, MRI's, or nerve conduction velocity testing may be required in some cases. Once it is determined that there is no serious injury or organic cause for the injury chiropractic is a natural, cost-effective form of treatment that can provide lasting relief from the back and leg pain. Chiropractic treatment usually begins with ice therapy and may include electric muscle stimulation in order to reduce swelling and muscle tension. Specific stretching is then used to loosen the muscles of the back and remove pressure from the sciatic nerve. Using gentle chiropractic adjustments, the chiropractor then realigns the spine in order to remove further tension from the nerve and allow healing and recovery. Then specific stretches and exercises are provided to the patient to be done at home along with icing in order to keep the back looses and strengthen any weak parts. In order to fully understand sciatica I will now discuss in detail the involved structures and the medical explanation behind the mechanism of injury.

In most cases the sciatic nerve is being affected by a number of structures within the lower back and pelvic region. The sciatic nerve is the largest nerve in the body measuring 2 cm across at its origin and is formed from the sacral plexus by the ventral rami of L4-S3. It leaves the pelvis through the greater sciatic foramen, travels beneath the anterior portion of the piriformis muscle, passes behind the sacrospinal ligament, and then descends along the posterior aspect of the thigh behind the quadratus femoris muscle to supply the skin of the posterior and lateral portion of the leg and foot as well as motor to the muscles of the posterior thigh, leg, and foot. The sciatic nerve has two main divisions: The tibial nerve and the common peroneal (fibular) nerve. The tibial nerve descends through the popliteal fossa and divides at the flexor retinaculum into the medial and lateral plantar nerves. Its main function is to supply motor innervation to the posterior muscles of the knee joint and leg. The common peroneal nerve descends with the medial aspect of the biceps femoris, and passes over the posterior aspect of the fibular head where it divides into the superficial (lateral compartment of the leg), and deep (anterior compartment) peroneal nerves. The relationship between the sciatic nerve and the piriformis muscle is very important, especially in this case. Normally the sciatic nerve passes inferior to the piriformis muscle as it leaves the inferior portion of the greater sciatic foramen, but in an estimated 12.2% of the population it divides before it enters the gluteal region and the common peroneal division passes directly through the piriformis muscle. In 0.5% of the population it divides early and the common peroneal division crosses the piriformis superiorly. The piriformis muscle itself helps to stabilize the femoral head in the acetabulum and externally rotates the extended thigh and abducts the flexed thigh. It travels from the anterior surface of the sacrum and sacrotuberous ligament to the superior portion of the greater trochanter of the femur. It is innervated by branches of the ventral rami of S1 and S2 and receives no innervation from the sciatic nerve.

Sciatica is defined as sharp pain in the leg along the course of the sciatic nerve caused by irritation, compression, or trauma to the sciatic nerve or its roots. Many factors can lead to the irritation of the sciatic nerve, resulting in low back and leg pain. Mechanical aspects of nerve compression play a large role in sciatica cases. The sciatic nerve can be slowly compressed and deformed from factors such as the multiple disc bulges, disc herniations, degenerative changes such as discogenic spondylosis, facet arthrosis, stenosis, and osteophytosis, and then peripherally at the piriformis muscle. When compression occurs either centrally or peripherally it impairs neural function due to compromise of the vascular supply. When it comes to any nerve compression in the body, the first structures to be compressed are within the venous system causing blood stasis. Venous stasis leads to capillary stasis which then changes the microcirculation to the nervous tissue. This decrease in neural tissue perfusion causes hypoxia or a decrease in oxygen. Without sufficient levels of oxygen the cells can no longer produce the energy rich molecule ATP via oxidative phosphorylation. Without ATP, important Na+/K+ pumps within the neural membrane can no longer maintain the needed ionic gradient across the membrane. This results in the leakage of Na+ into the cell and alteration of the resting membrane potential (RMP) of the nerve. Normally this RMP is -70 mV. During normal depolarization, the threshold for nerve firing is around -55 mV. Once the ionic charge within the nerve reaches this threshold the nerve will fire. The leakage of Na+ into the cell brings the RMP near threshold. This results in a hypersensitized nerve that needs very little input to fire. This is the cause of the associated numbness and paraesthesia in the areas of the sciatic nerve. Pain is also perceived much easier in this state. If the pressure on the nerve is not relieved, chronic hypoperfusion and hypoxia will result in neural death. In cases which involve arthritis, the patient may have advanced osteoarthritic changes throughout the lumbar spine. In the early phases of degenerative joint disease dehydration of the intervertebral disc causes thinning and approximation of bony structures. Damage often begins within the inner portion of the disc which as no innervation and thus goes undetected. As time goes on and compressive forces deform the inner nucleus, shearing and rotational forces cause tears and weakening of annular fibers. The annulus of the disc is highly innervated by the sinuvertebral nerve and can cause a great deal of diffuse low back pain. This weakening can cause disc bulging and herniation into the extradural space and can put compressive and chemical forces into neural structures including the cord and the nerve roots of the sciatic nerve. This will manifest as sharp pain along the nerve route and cause antalgia. If the inner disc materials fully protrude out in later stages of disease it can cause increasing pain and tenderness. This is due to the water attractive properties of glycosamino glycans once out of the contained space of the disc. This hydrophilic swelling will place more pressure on the neural structures. As disc degeneration continues and the bony structures of the vertebral column come in contact with one another, a reflex hypertrophy takes place to protect the surfaces. This is seen in subchondral sclerosis of the vertebral bodies often resulting in space occupying osteophytes protruding into the neural canal. Apophyseal joint arthrosis occurs at the posterior aspect of the neural canals and in Irene's case, hypertrophy of the ligamentum flavum occurs. Together, all these degenerative changes produce stenosis in the canal and place extradural compressive forces on the nerve roots of the sciatic nerve. Stenosis can result in one or two sided sciatica. If centralized, bilateral leg pain is more common.

As the sciatic nerve leaves the greater sciatic foramen it can also be compressed as it transverses the piriformis muscle in the gluteal region. Sciatica cases such as these are referred to as piriformis syndrome sciatica, which is very common. Spasm or hypertonicity of the piriformis will compress the sciatic nerve. These peripheral nerve entrapment syndromes usually occur as the nerve passes beneath or through muscles or fibrous tissues. These nerve compression symptoms usually develop gradually with pain and paraesthesia being the most common complaints. Weakness can be seen later in chronic settings although in cases of older individuals this may be hard to detect. These are just a few of the most common causes of sciatica but any severe case should be evaluated by a health care professional if symptoms remain the same or worsen after initial ice and rest routines.

What Is The Best Way To Relieve Joint Pain Naturally?


Joint pain happens when the cartilage and muscles close to the bone joints suffer from wear and tear, and it leads to rubbing of bones against each other causing pain. Inflammation may also happen if the bones are not getting adequate amount of nutrition and it loses the plane surface structure and the poor blood flow to the bones may also lead to inflammation and pain in the joints. Women suffer three times more than men from pain in the joint (mostly due to osteoarthritis) - the condition which is caused due to poor intake of nutrition required for healthy bones.

The way to relieve pain in the popular method of treatment is to take anti inflammatory medications which help in relieving pain immediately but these over-the-counter medicines, generally, have side effects and the dose of these medicines varies depending on the amount of pain you are suffering. It may be more for patients suffering regularly from the pain and as you start taking this way to relieve joint pain, you get dependent on it for relieving pain and find it difficult to live without these medicines.

Surgery is another way to relieve pain but surgery does not guarantee prevention from pain. A joint replacement surgery is done by an expert doctor to remove the damaged tissues but as the person ages the pain may reappear after some years. Surgery is very expensive way to relieve joint pain and you will have to take leave from your everyday work for go for it.

One of the safe and effective ways to relieve pain is natural remedy - Rumoxil capsule and oil- which is a traditional tried and tested remedy. Rumoxil capsule and oil helps to improve blood flow to the joint to improve the health of the bone. The herbal way to relieve joint pain - Rumoxil capsule and oil contains plant based substances which are needed to improve the flow of nutrition to the joints and to prevent degradation of the bones. The herbal way to relieve joint pain tries to eliminate the roots cause of joint pain, and it also contains herbs which have the properties to reduce symptoms of pain and inflammation.

The herbal way to relieve pain - Rumoxil capsule and oil provides a complete solution which include nutrition to improve the condition of joints and the oil which should be massaged on the joints to relieve pain. The oil helps to reduce pain as the pressure applied on the joint by the massage of oil helps to soothe the tissues which are injured and it also helps to reduce the irritation to the nerves caused by broken damaged tissues. Rumoxil capsule and oil not only helps to reduce joint pain in the legs but it can be used for different types of inflammation and swelling in the bones and joints. It is effective way to relieve joint pain caused by sciatica and arthritis, and the oils can be massaged two to three times in a day to completely improve the condition.

Boswellia Serrata - Natural Remedies For Arthritis to Relieve Pain


Boswellia or the extract of salai guggal is a standardized powder extract of the gum of the Boswellia tree which contains a mixture of Boswellic acids. Boswellic acids are very effective in the problem related to osteoarthritis, rheumatoid arthritis, soft tissue rheumatism and also in the low back pain as it is an anti-arthritic and anti-inflammatory agent.

In comparison to the other standard drug of choice for rheumatic disorders the extract of boswellia is more beneficial as it is less toxic and also more potent. The different benefits of boswellia includes increased mobility, reduction in joint swelling, steroid sparing action, less morning stiffness and improved grip strength. It is very helpful in improving the general quality of life for both the problem of rheumatoid arthritis and osteoarthritis.

The Latin name of Boswellia Serrata is Shallaki Guggal. Shalaki is an anti-inflammatory and anti-arthritic extract in Ayurveda. It is very helpful in treating the problem of arthritis as the therapeutic action of shallaki extract includes decrease of joint restoration, swellings and also improvement in the supply of blood to the joints which is inflamed, increased the mobility, increase relief in pain and amelioration of morning stiffness.

This ayurvedic extract is also used to improve lower the elevated serum transaminase levels, alleviate the general weakness, appetite and debility. Shallaki reduces the erythrocyte sedimentation rates and synovial fluid leucocyte count. Shallaki is very effective in rheumatoid arthritis as it is very effective in shrinking inflamed tissues which is mediated through a vascular phenomenon. Shallalki is very helpful in improving blood supply to the joints and also restores the integrity of blood vessels.

Usually the health practitioner recommends 1-2 capsules twice a day after the meal. Some of the important health benefits of this herb are -

1. The main cause behind each pain is vata, so shallaki is very helpful in relieving pain.

2. It is very effective in curbing any type of pain and swelling as it works as anti-inflammatory substance due to the presence of boswellic acid.

3. It is very popular and effective for arthritic problems like rheumatoid arthritis, osteoarthritis, gout, skeletal muscle pain and also joint pains.

4. Shallaki is also popular in the treatment for cancer as it contains anti cancerous properties.

5. It is very effective in healing wound. It is commonly used as wound healer herb.

6. Boswellia Serrata works effectively in eliminating any foul odor.

Arthroscopic Elbow Surgery: Diagnosis and Treatment


Elbow arthroscopy involves the use of fiber optics and a tiny camera for the diagnosis and treatment of many elbow conditions. With this procedure, small incisions are made around the elbow joint to allow the camera to show a magnified picture on a TV monitor in the operating room. When the surgery is done to treat a diseased or injured joint, the orthopedic specialist inserts tiny surgical instruments through the incisions to make the necessary repair.

Because elbow arthroscopy uses smaller incisions and the joint is not open and exposed, there is minimal injury to the surrounding soft tissues. What's more, this technique allows the orthopedic surgeon to view inside the elbow joint from a variety of angles, allowing for a thorough evaluation and more appropriate treatment regimen.

What is Done Before the Procedure?

Before the surgeon performs your elbow arthroscopy, he will examine your elbow, discuss your history, and usually obtain x-rays of the joint. He may then obtain special imaging (CT scan, MRI scan) to help in diagnosis and planning. These images allow him to obtain information about the soft tissues that surround the bones. These tissues include cartilage, tendons, and ligaments. Sometimes, the bones themselves have irregularities such as spurs or extra growths that could lead to inflammation and pain. Placement of the incisions is guided by these test findings and they are an important part of your treatment plan.

What Conditions are Treated with Elbow Arthroscopy?

Elbow arthroscopy is used as a diagnostic and treatment measure for stiffness, loss of motion, and pain of the joint. Some conditions that are diagnosed include:

Adhesions - soft tissue bands that permit full motion
Injuries - fractures and torn or degenerative tissues (e.g. tennis elbow)
Contracture - problem where the tissues are contracted, limiting range of motion
Loose bodies - bone fragments and pieces of cartilage
Arthritis - a disease that involves the wearing away of cartilage that is necessary for the bones to glide smoothly against each other

How Does the Doctor Perform Elbow Arthroscopy?

Elbow arthroscopy is usually done using general anesthesia (put you to sleep). After you receive adequate anesthesia, the orthopedic specialist will create incisions known as 'portals' that allow him to gain access to the elbow joint. These portals are put in exact locations that help minimize the potential for swelling and complications. The small camera is placed through one of these incisional portals while the instruments go in others to repair and correct the condition.

The length of the procedure will vary depending on what the surgeon has to do. After the operation, the surgeon will put you in a soft bandage and splint to support your surgical site. Most patients work with our physical therapist following the procedure to regain maximum range of motion and strength of the joint. The length of your rehabilitation will depend on the extent of damage to your joint, the procedure performed, and how healthy you are going into surgery.

What are Some Reasons for Getting Elbow Arthroscopy?

Not all conditions of the elbow are treatable with arthroscopy. Some of the reasons the orthopedic specialist will perform an arthroscopic elbow surgery include:

Removing Loose Debris - The elbow joint can accumulate loose cartilage or other debris as a result of injury or arthritis. These loose bodies within the joint can cause limited range of motion, stiffness, and pain. Arthroscopic elbow surgery is a minimally invasive way to remove this difficult debris.

Removing Bone Spurs - Bone spurs can form in early stages of elbow arthritis, and these growths impede normal motion of the joint. An arthroscopic elbow procedure may be appropriate to remove the growths to eliminate pain and restore more normal motion of the elbow joint.

Thrower's Elbow - A specific elbow problem known as 'thrower's elbow' occurs in athletes such as baseball pitchers who throw a lot. Because of the tremendous forces on the elbow, a bone spur can form in the back of the joint and this leads to inflammation and pain. If nonsurgical treatments fail to relieve these symptoms, an elbow arthroscopy may be helpful to remove this growth and restore use of the joint.

Loosening the Joint Capsule - The elbow joint is notorious for stiffening as a result of surgery, injury, or other trauma to the joint. This condition is called elbow arthrofibrosis. With this condition, the elbow joint capsule may become so tight that motion is decreased and limited. Surgically loosening the joint capsule is possible in some of these patients. The advantage of an arthroscopic approach is that less scar tissue is likely to form after the procedure making the chance of regaining motion highly probable.

Assessing Cartilage Damage - Many cartilage problems are the result of osteochondritis dissecans (OCD). This leads to problems with the mobility of the elbow joint. X-rays and MRIs may not adequately show the extent of the damage, so arthroscopic surgery can be used to assess the extent of cartilage damage and determine if further treatment is necessary.

Tennis Elbow - This condition occurs when there is microscopic tearing of the tendons on the outside of the elbow joint. Many people improve without surgery, however, some do not and surgery is required. The traditional arthroscopic procedure detaches the tendon from the bone, removes the damaged tissue, followed by a repair or reattachment of the tendon.

Tuesday, December 17, 2013

Treatment of Odontogenic Infections


Odontogenic infections, primarily consisting of periodontal disease (periodontitis and gingivitis) and dental caries, are typical and have local (tooth loss) and in a few instances, systemic implications. In the United States, it's estimated that twenty-five percent of adults over age 60 have lost all of their teeth (edentulism), around half from periodontal disease and half from dental caries.

Besides inflicting pain and discomfort, odontogenic infections may extend beyond natural barriers and cause probable life-threatening complications, like infections of the deep fascial regions of the head and neck.

Periodontal infection also can be related to numerous systemic disorders. They involve fever of an unknown origin, bacteremic seeding of prosthetic devices and heart valves, low birth weight/preterm birth babies, and a higher risk of cerebrovascular events and coronary heart disease.

Careful attention to oral hygiene is the most important plan for efficient control of subgingival and supragingival plaque which, in turn, is important for the prevention of caries and periodontal disease. For people with mental or physical limitations who can't adequately undertake efficient oral hygiene procedures alone, it is important there is assistance with day-to-day oral hygiene by a care provider. More frequent visits to the dentist and the use of an electric toothbrush should be considered with such patients. Prompt restorative care and routine check-ups by a dental professional should be actively promoted.

With the realization of microbial specificity of such infections, systemic antibiotics and topical antiseptics play a vital role in the treatment and control of periodontal disease and dental caries.

The necessity for dental extractions was considerably reduced by the obtainability of improved restorative materials, like fluoride-releasing and bonding agents, and improved dental restorative care.

Dental caries- Management of dental caries along with restorative therapy (i.e. fillings) is the preferred treatment approach in multiple countries. But, restorative therapy has to be blended with preventive measures, as restorations possess brief durability and new dental caries might form in the margins of restorations if the causes of the disease persists.

Pulpitis - Inflammation of the dental pulp, or pulpitis, happens as progression of caries. The dental pulp becomes exposed, resulting in infection. The dominant and early symptom of acute pulpitis is a serious toothache which may be elicited by thermal changes, particularly cool drinks.

Irreversible pulpitis will be characterized by intense and acute pain, and is among the most common reasons for individuals requiring emergency care. Aside from tooth removal, the usual approach to relieving irreversible pulpitis pain is drilling inside the tooth, getting rid of the nerve (inflamed pulp), as well as root canal cleaning.

Acute gingivitis- This will rarely require systemic antimicrobial treatment. Chlorhexidine 0.12% oral rinse may be utilized in many instances. Exceptions involve individuals who have severe pain, rapidly advancing disease, or HIV infection where systemic treatment is indicated. Potential regimens involve metronidazole and penicillin, clindamycin, ampicillin-sulbactam, or amoxicillin-clavulanate.

Periodontitis- Because of microbial specificity within different types of periodontitis, specific kinds of serious periodontitis will be amenable to systemic antimicrobials, along with mechanical debridement (scaling & root planing). The approach has often obviated the necessity for extreme surgical periodontal tissue resection.

Efficacy of local antibiotic treatment alongside scaling and root planing in chronic periodontitis also has been assessed. Adjunctive local antibiotics were proven to substantially decrease the degree of periodontal detachment or pocket depth. Efficient agents involve 2% Arestub (minocycline spheres), 10% Atridox (doxycycline hyclate extend release liquid), as well as 25% Elyzol (metronidazole gel). The agents will release controlled portions of the antibiotic beneath the gum and are utilized alongside scaling and root planing to decrease the pocket depth in adult periodontitis.

With localized juvenile periodontitis, the systemic tetracycline treatment directed against a HACEK infection known as actinobacillus actinomycetemcomitans and blended with local periodontal therapy yielded outstanding results. Doxycycline or tetracycline administration to children 8 years of age or younger, unfortunately, may lead to staining of the permanent dentition and generally isn't advised. Moreover, tetracycline resistance amongst periodontal pathogens was increasingly apparent.

Regular systemic antimicrobials used to avoid postoperative infections after periodontal and/or oral surgery in a healthy host does remain controversial.

Suppurative odontogenic infections- The most vital treatment modality for pyogenic odontogenic infections includes surgical removal and drainage of necrotic tissue. A needle aspiration by the extra oral route may be especially useful for evacuation of pus and microbiologic sampling alike. The necessity for extraction or definitive restoration of an infected tooth, the main infection source, is usually readily apparent. Endodontic therapy using root filling and deep periodontal scaling is needed in most cases.

Antibiotic therapy- It might stop local infection spread, as well as prevent hematogenous dissemination. The antimicrobial agents are generally indicated if regional lymphadenopathy and fever are present, or if the infection has perforated the bony cortex, and spread to the surrounding soft tissue. Seriously immunocompromised individuals are especially at risk of orofacial infections spreading; empiric broad spectrum antimicrobial treatment with these individuals is warranted.

The option of certain antibiotics for the treatment of odontogenic infections is based on knowledge of the indigenous organisms colonizing the mucous membranes, gums and teeth, as well as certain periodontopathic and cariogenic pathogens related to medical disease, instead of on the results of susceptibility and culture testing.

The production of beta-lactamase amongst oral anaerobes, especially pigmented Fusobacterium spp and Prevotella spp, is highly recognized, and therapy failure with penicillin by itself was well documented. Therefore, penicillin monotherapy is no longer advised.

Ampicillin-sulbactam (three grams IV every 6 hours) offers prolonged coverage against anaerobes, involving the ones which produce beta-lactamases, and is also the therapy of choice. One alternative is penicillin G (two to four million units IV each 4-6 hours) along with metronidazole (500 milligrams IV or orally each 8 hours).

Even though metronidazole is extremely active against anaerobic gram-negative spirochetes and bacilli, it's only moderately active to anaerobic cocci and isn't active against aerobes that include streptococci. Consequently, it shouldn't be used solely in odontogenic infections except with advanced periodontitis and acute necrotizing gingivitis.

Patients who are allergic to penicillin should be treated using clindamycin (600 milligrams IV each 8 hours). Tetracycline and erythromycin aren't advised due to increasing resistance amongst a few streptococci strains and their loss of optimal anaerobic activity.

Osteomyelitis- Treatment of osteomyelitis of the jaw will be complicated by the existence of teeth and consistent oral environment exposure. Antibiotic treatment must be extended, often from weeks to months.

If available, adjuvant treatment using hyperbaric oxygen might hasten the process of healing, especially if combined with surgery, yet information that supports this is inconclusive.

Surgical management that includes closed-wound suction irrigation, decortication, saucerization, and sequestrectomy is occasionally needed. On rare occasions, in advanced cases, the whole infected jaw segment must be resected.