Showing posts with label arthritis. Show all posts
Showing posts with label arthritis. Show all posts

Wednesday, August 21, 2013

Osteoarthritis

Osteoarthritis is a degenerative joint disease, classified under mechanical degradation of joints and joints tissue. Symptoms of a person with osteoarthritis will include pain within the affected joint, stiffness, 'locking' of the knee and tenderness to the touch. When cartilage wears off due to wear and tear, the bone surfaces becomes more vulnerable to physical trauma (as the cartilages serve as 'shock absorbers'). This in turn

causes pain, and the patient will limit the movement of the joint, which causes muscle atrophy and ligamental laxity.

Treatments involves a mix of exercise therapy, lifestyle changes and modifications, and painkillers to lessen or manage the pain. If the pain experienced becomes overpowering, patients who have less risk often undergo joint replacement surgery such as hip replacement, knee replacement of the joint with osteoarthritis.

Osteoarthritis is a very common form of arthritis, and a big cause of long term impairment and disability.

Signs And Symptoms

Symptoms include pains (aching, pulling, burning) in joint and surrounding joint structures, loss of mobility and function, as well as decreased use. Sometimes movements will cause a cracking noise (known as crepitus), and accompanied by muscle spasms. Our patients also will often complain that the differences in weather e.g. moving from a cold room to a hot room or vice versa will result in a cramping ache.

OA often affects mobile and more weight bearing joints, such as the mobile hands, or the larger weight bearing hips and knees. As it progresses, the joints enlarge, becoming increasingly more painful and decreasing in mobility, as the day progresses. This distinguishes it from its related cousin,rheumatoid arthritis, that often gets better as time goes by.

In smaller joints such as the joints of the hands and fingers, Heberden's nodes can form on the end finger joint, and Bouchard's nodules can form on the joints just after the knuckles (refer to the picture by Drahreg01). They are not always painful, but they do restrict the movement of the fingers.

Causes Of Osteoarthritis

There are two types of OA classified: primary and secondary. Primary OA is the chronic degenerative disorder that is related by is not primarily caused by aging (some people in their 80+ or 90+ have no OA at all). Over time, the cartilages in our joints shrink, and becomes less resilient.

Secondary OA is caused by a variety of factors, but ends up with the same pathological results as of the primary OA. Some of the causes are listed here:
1. Joint disorders.
2. Diabetes mellitus.
3. Any/all forms of inflammatory/arthritic diseases.
4. Direct trauma.
5. Joint infections.
6. Ligamental laxity or instability.
7. Obesity.
8. Other syndromes such as marfan's syndrom and wilson's disease.

Treatments

A combination of treatment approaches and modalities for a more effective outcomes are recommended. Lifestyle changes and modification such as adopting a more active lifestyle of healthy eating, exercise and weightloss), coupled with painkillers are some of the long term solutions.
Physical therapy helps to improve function, increase strength and mobility, decrease pain and delay the need for surgery. The exercise therapy that is prescribed by physiotherapists is documented to be more effective than that of a pure pharmaceutical approach. Some of the targeting areas include balance training, gait correction re-training, and functional mobilization. Hand therapists often prescribe custom-made splints to prevent aggravation and deformities.

This article was contributed to Tab A Doctor by,
Ms Louise Yow, Physiotherapy, UrbanRehab Pte Ltd, Physiotherapy & Rehabilitation Specialists





Tuesday, July 16, 2013

What You Need to Know about Knee Pain

Knee pain is a really common pain and complaint for many people. There are several factors that can lead to pain in one’s knees, so having awareness and knowledge of their causes can lead to a more accurate diagnosis.

Knee joint

Our knee joints are made of four bones connecting – the femur (thigh bone), the tibia and fibula (the two bones of the calves) and the patella (the kneecap). The knee is divided into four compartments: medial and lateral tibiofemoral compartments, the patellofemoral compartment and the superior tibiofibular joint. Each of these compartments’ components can suffer from repetitive strain injury or disease.

What are the common injuries that cause knee pain?

Some of the injuries that causes pain in our knees include the following:
  • Sprain (Ligament sprain)
  • Medial collateral ligament
  • Lateral collateral ligament
  • Anterior cruciate ligament
  • Posterior cruciate ligament
  • Tear of meniscus
  • Medial meniscus
  • Lateral meniscus
  • Strain (Muscle strain)
  • Quadriceps muscles
  • Hamstring muscles
  • Popliteal muscle
  • Patellar tendon
  • Hamstring tendon
  • Popliteal tendon
What are the common diseases that cause knee pain?

Some of the diseases of cause of knee pain include:
  • Knee osteoarthritis
  • Chondromalacia patella
  • Baker's cyst
  • Meniscal cyst
  • Discoid meniscus
  • Osgood-Schlatter disease
  • Larsen-Johansson disease
  • Knee rheumatoid arthritis
  • Osteochondritis dissecans disease
  • Synovial chondromatosis disease
  • Tumors
  • Ankylosing spondylitis
  • Reiter's syndrome
  • Tuberculosis arthritis
  • Septic arthritis (Pyogenic arthritis)
  • Osteomyelitis
  • Hemophilic arthritis
  • Gout (Gouty arthritis)
What are the common inflammations that cause knee pain?
  • Bursitis of the knee
  • Prepatellar bursitis - Housemaid's knee (most common)
  • Infrapatellar bursitis - Clergyman's knee (Superficial infrapatellar bursitis and Deep infrapatellar bursitis)
  • Semimembranosus bursitis
  • Tendinitis
  • Patellar tendinitis (Jumper's knee)
  • Hamstring tendinitis
  • Popliteal tendinitis
  • Synovitis of the knee
What are the common deformities of the knee?
  • Genu varum
  • Genu valgum
  • Genu recurvatum (Knee hyperextension)
  • Knee flexion deformity
  • Bipartite patella
Syndromes
  • Patellofemoral pain syndrome (Runner's knee)
  • Plica syndrome
  • Iliotibial band syndrome
Fractures
  • Femoral fracture
  • Tibial fracture
  • Patella fracture
Dislocations
  • Patella dislocation
  • Knee joint dislocation (Tibiofemoral joint dislocation)
Referred knee pain

Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is where if a patient has a heart attack but feels the pain in his neck, shoulders and back instead of his heart. Likewise, there can be pain that is referred to the knee that is related from another part of the body – the pain can come from one’s ankle, foot, hip joints or even lumbar spine (lower back).

Cold-induced Pain In Knees

A study in China concluded that knee pain is significantly more prevalent in people working in cold stores than in those in normal, non-cold temperature.

Another study concluded that 17% of adolescents with anterior knee pain (a common condition though mildly self-limiting) reported that their pain is associated with cold temperatures and cold weather. In the same study, the main activities that are associated with pain are sporting, stair climbing, walking and sitting. Some people also reported pain in their knees when it’s colder…and they also wear extra tights and warm pants in winter.

Cold-induce pain in the knee can also be caused by tenosynovitis of knee tendon, where exposure to cold can be either a causative or contributing factor. To add to this, there is also a known hereditary disease, which is the FCAS which is the familial cold autoinflammatory syndrome which often demonstrates pain in the knee. Cold weather may also aggravate pain in the knee which already has osteoarthritis, rheumatoid arthritis and fibromyalgia.

Pain due to immobility/lack of movements

People who are more sedentary or involved in lesser physical activity and work environment is yet another reason for developing pain in the knees. What happens is that decreased activity and movement weakens one’s knee muscles, and the lax muscles are unable to support the knee structure, causing increased bone-to-bone impact. Blood vessels may be compressed as well, causing painful conditions in the knee. As we grow older, the movement of the knee joint causes higher friction with nearby tissues and cartilages.

As age progresses the movement of the knee joint involves higher friction with adjacent tissue and cartilages.

Other causes of pain in the knees
  • Ligamentous laxity
  • Fat pad impingement
  • Knee effusion
  • Deep vein thrombosis
  • Peripheral vascular disease
Implications for Physiotherapy and Deep Tissue Release / Sports Massage Therapy

It’s important that an accurate diagnosis is made for all knee-related pain and injuries, and physiotherapy and deep tissue release therapy to start as soon as possible. Treatment techniques may include specific strengthening to correct muscle imbalance, soft tissue massage, joint mobilization and ultrasound therapy. Other electrotherapy procedures such as heat therapy may also be used to accelerate healing and provide pain relief.


This article was contributed to Tab A Doctor by,

Ms Louise Yow, Hon. in Physiotherapy
Urbanrehab Pte Ltd
22 Malacca Street, Royal Brother Building,
#03-03 (RB Capital Building), Singapore 048980

Thursday, March 28, 2013

Knees and Arthritis

Knee Oesteoarthritis
"I couldn't even sleep at night because of the pain in my knees," said Sally, sharing about her osteoarthritis of the knees at AAOS.org. As a hostess in a restaurant and an active person who loved biking, tennis, walking, gardening and traveling, Sally found that her osteoarthritis had a negative impact on her life.

Sally's condition affected both knees, making it impossible for her to walk, especially up and down the stairs. The constant pain left her hunched over and limping. No longer able to exercise, she gained weight and her overall health began to deteriorate.

Osteoarthritis (OA) is a degenerative joint disease often found in the hands, knees, hips, feet and spine, according to the AAOS article. It is one of the most common forms of arthritis and occurs when the cartilage that cushions the ends of the bones breaks down, resulting in a bone-on-bone contact and significant pain, loss of movement and deformity. Besides physical limitations, OA can also cause financial strain to the sufferer as treatments can be expensive, and for some patients with this condition, they may no longer be able to work.

Symptoms
Common symptoms of OA according to an article at Pain-Research.org:

  • Joint pain and swelling
  • Early morning stiffness
  • Warmth around a joint
  • Redness of the skin around a joint
  • Reduced ability to move the joint
  • Unexplained weight loss, fever, or weakness that occurs with joint pain

Diagnosis
Diagnosing arthritis according to the Pain Research article includes:

A physical examination may show fluid being collected around the joint known as effusion, and the affected joints may indicate limited range of motion, being painful or difficult to move in some directions. In certain forms of arthritis, for example rheumatoid arthritis, the joints may become deformed if the disease continues for too long without treatment.

Diagnostic tests vary depending on the suspected cause, and may include blood or urine tests, as well as joint X-rays. In septic arthritis or inflammation of a joint due to a bacterial or fungal infection, fluid may be removed from the joint with a needle and examined for the presence of infection.

Medication and Treatment
Many over-the-counter medications include common anti-inflammatory drugs like:

  • Aspirin
  • Ibuprofen
  • Naproxen

Such drugs may be used to effectively control pain and inflammation in arthritis, as described in another article at Pain-Research.org. However, these drugs need to be used with care as they have possible side effects of causing damage to the stomach lining and the kidneys.

Glucosamine and chondroitin which are known to provide naturally-occurring nutrient for forming the building blocks of cartilage may be recommended. These are available at health food stores or supermarkets without a prescription. Early studies indicate that these compounds are quite safe and may improve symptoms relating to arthritis.

Injections of liquid cortisone directly into the joint may temporarily help to relieve pain and swelling. However, it should be noted that repeated frequent injections into the same joint can damage the joint and have undesirable side effects.

If nonsurgical treatment fails to give relief, a surgery for arthritis by an orthopedist may be considered. This is the advice given in an article on arthritis treatments at Pain-Research.org. The orthopedist and patient will choose the type of surgery by taking into account the type of arthritis, its severity, and the patient's physical condition.

Surgical procedures include:

  • Removal of the diseased or damaged joint lining
  • Realignment of the joints
  • Total joint replacement
  • Fusion of the bone ends of a joint to prevent joint motion and relieve joint pain

For professional help with osteoarthritis and joint degeneration, please consult a doctor or an orthopedic specialist.

by Singapore Health



by Singapore Health