Arthritis and Musculoskeletal Diseases

Polymyalgia Rheumatica - What Is Polymyalgia Rheumatica?

2010-07-23T05:05:00.000-07:00

Polymyalgia rheumatica is a rheumatic disorder associated with moderate-to-severe musculoskeletal pain and stiffness in the neck, shoulder, and hip area. Stiffness is most noticeable in the morning or after a period of inactivity, and typically lasts longer than 30 minutes. This disorder may develop rapidly; in some people it comes on literally overnight. But for most people, polymyalgia rheumatica develops more gradually.

The cause of polymyalgia rheumatica is not known. But it is associated with immune system problems, genetic factors, and an event, such as an infection, that triggers symptoms. The fact that polymyalgia rheumatica is rare in people under the age of 50 and becomes more common as age increases, suggests that it may be linked to the aging process.

Polymyalgia rheumatica usually resolves within 1 to several years. The symptoms of polymyalgia rheumatica are quickly controlled by treatment with corticosteroids, but symptoms return if treatment is stopped too early. Corticosteroid treatment does not appear to influence the length of the disease.

Source: Information courtesy of the National Institute of Arthritis and Muskuloskeletal and SKin Diseases (NIAMS)

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Painful Arthritis: Exercise it Away!

2010-07-07T20:53:00.000-07:00

Arthritis affect millions of people worldwide. In the US alone, according to the Centers for Disease Control and Prevention (CDC), about 46 million people have arthritis and majority of them are affected with osteoarthritis. It is estimated that by year 2030, about 67 million people will have arthritis. Because the population is getting older, that is, they live longer, it is expected that more people will be affected with arthritis in the future.

The most common type of arthritis is osteoarthritis where joint tissues are slowly broken down. The cause of the condition is unknown but it has been associated with being overweight, having injuries affecting the joints in the past, and getting older. Other common types of arthritis are rheumatoid arthritis and gouty arthritis (gout).

Currently, there is no cure for arthritis. However, treatments are available to manage pain improve quality of life.

Recent studies have shown that exercise and physical activity can help reduce pain of arthritis. In addition, performing physical activity and exercising regularly improve your heart and respiratory functions. People who exercise regularly are more able to perform tasks easily and are more flexible.

Some physical activities and exercises that older adults with arthritis can do are walking, gardening, cycling, and swimming. People who need more help may need specialized programs specifically created for their level of fitness and specific health problems. For more information about what exercises can be done by older people visit the Physical Therapy Notes Web Page.

Sources:
Physical Therapy Notes Website

Centers for Disease Control and Prevention (CDC) Website CDC Podcast Transcript

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Cold Packs or Hot Packs for Ankle Sprain

2010-01-02T18:32:00.000-08:00

Ankle sprain is a common injury that results from stretching or tearing a ligament that supports the ankle joint. A ligament is a tough fibrous band connecting bones in a joint.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), ankle sprain occur in about 25 million individuals in the United States each day.

An ankle sprain can occur because of faulty maneuver wherein the foot is turned inward as a person runs, turns, falls, or lands on the ankle after a jump.

Symptoms of ankle sprain depend on the severity of injury. Common symptoms of an ankle sprain include pain, swelling, bruising, instability, and loss of the ability to move and use the joint.

For mild ankle sprain, application of ice pack is advised. This helps to relieve pain and swelling in the involved joint. Resting and elevating the limb above the heart may help control swelling as well.

To apply the ice pack, wrap it in layers of towel before putting it over the swollen ankle. Leave it there for about 15 to 20 minutes at a time. Make sure that it is not too cold or don’t leave it there for more than 20 minutes as this can cause frostbites or cold injuries. Never attempt to apply hot packs for ankle sprains that recently occurred because this can further cause swelling.

Taking over-the-counter medications may also help relieve pain.

After swelling has subsided, hot pack application can be used. Wrap hot pack with towel and apply over the injured area for 20 minutes. If it feels too hot, add more layers of towel. It should be warm and comfortable. Heat increases circulation to the area, which helps in repair of damaged tissues.

Precaution should be observed when applying hot or cold packs for ankle injuries if you have other health conditions such as nerve problems or difficulty of sensing heat or cold. A health care provider should be consulted first.

For more severe cases of ankle sprain, immediate medical attention should be sought. if you are unsure what ankle sprain treatment to apply, don't hesitate to ask your healthcare provider.

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Knee Replacement

2009-11-26T09:34:00.000-08:00

Knee replacement is a type of joint replacement surgery wherein parts of the knee are removed and replaced with new, artificially made ones. The part of the body where a bone meets another bone is called a joint. The doctor who specializes in this surgical procedure is the orthopedic surgeon.

The orthopedic doctor may recommend a knee replacement if your knee is damaged because of arthritis or diseases affecting the joints or bones and trauma or injury. A damaged knee may cause pain, swelling, and stiffness. This can affect your daily activities or even bring about disability.

Knee replacement surgery is becoming more common, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). And advances in medical technology and procedure have resulted in better patient outcomes.

While knee replacement surgery is an option, depending on the cause of knee damage, your doctor may recommend other treatment approaches first such as exercise, diet, walking aids like braces and canes, physical therapy, and medicines or vitamin supplements. A joint replacement may be recommend if these treatments do not work. Your doctor will discuss with you about this treatment approach or other treatment options.

The Knee Replacement Procedure (Background)

First, the orthopedic surgical team will give you a medicine, called anesthesia, so you would not feel pain. The team will then replace the damaged parts of the joint with a prosthesis—a new joint, which can be made of plastic or metal. This may be cemented into place or not cemented. If not cemented, your bone can grow into the prosthesis. Sometimes, both methods may be used to keep the new joint in place.

The procedure may take about 2 hours or less. However, it may take longer if there are complicating factors or the joint is badly damaged. After surgery, you will then be moved to a recovery room where you will stay for about 1 to 2 hours until you are fully awake or the numbness goes away.

If there are no complications, you may be able to go home in 3 to 5 days. You and your health care team will determine how long you will stay in the hospital.

Your doctor may allow you to stand or begin walking the day of surgery, often with the aid of a walker or crutches. A physical therapist can assist you on how to properly use these devices. Temporary pain may be felt on your new joint because your muscles are still weak from not being used. Your doctor may prescribe pain medications to help with the pain, which should end in a few weeks or months. However, the pain should be decreasing after a few weeks. If the pain worsens, contact your doctor.

Physical therapy can begin the day after surgery. Your therapist will help you strengthen the muscles around the new joint and help you regain motion in the joint.

When you go home, follow your health care team’s advice about what you eat, what medications to take, and how to properly perform exercises to improve muscle strength and flexibility of the joint. Inform your doctor about prolonged pain or trouble in movement.

Related Reading: After Joint Replacement Surgery Problems

Source:
Joint Replacement and You (April 2009) http://www.niams.nih.gov/Health_Info/Joint_Replacement/default.asp. NIH Publication No. 09-5149. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Accessed: November 26, 2009

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After Joint Replacement Surgery Problems

2009-11-26T05:59:00.000-08:00

Joint replacement surgery is a medical procedure in which a damaged joint is removed and replaced with a new, man-made one. A specialist called orthopedic surgeon usually does the joint surgery. A joint is the point where two or more bones meet, such as the shoulder, hip, and knee. In some cases where only a part of the joint is damaged, the surgeon would only replace or fix that part.

Replacing a joint can help relieve pain and help a person move and feel better. However, like any other surgical procedure, potential problems can occur with joint replacement. The following are some of the problems that may occur after joint replacement surgery.

Infection

Infection can occur in the areas of the wound or around the new joint. Sometimes this can happen while in the hospital, after going home, or even years after the surgery. While minor infections are often treated with drugs, deep or major infections may require another operation to manage the infection or replace the joint.

Blood Clots

Sometimes, slowing of blood flow can cause clots—lumps of blood parts—to begin to form. Blood clots can cause pain and swelling to develop in the legs after surgery of the hip or knee. To manage this, the doctor may suggest drugs that make the blood thinner to allow easy flowing of blood. In addition, the doctor may suggest the use of special stockings, exercises, or boots to help the blood move faster. A person who has had joint replacement surgery should contact his or her doctor if swelling, redness, or pain is experienced after being discharged from the hospital.

Loosening of the new joint

Loosening of the new joint can occur, which can cause pain. If it causes too much pain or discomfort, another joint operation may be necessary.

Dislocation

Dislocation of the new joint can happen. The new joint can be displaced or get out of position. This can sometimes occur after hip or other joint replacement. Most cases of dislocated new hip joint can be corrected without undergoing another surgery. A brace may be worn for some time if dislocation occurs. Sometimes, strengthening the muscles supporting the new joint may help.

Because of advances in medical technology, the risks of problems after joint replacement surgery are much lower than in the past.

Source:
Joint Replacement and You (April 2009) http://www.niams.nih.gov/Health_Info/Joint_Replacement/default.asp. NIH Publication No. 09-5149. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Accessed: November 26, 2009

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What is Arthritis?

2009-11-04T21:54:00.000-08:00

Arthritis is a general term used for the inflammation of a joint or joints. This inflammation can cause signs or symptoms of arthritis, such as pain, swelling, redness, and heat on the joint. In some cases, the joints may become severely damaged.

Although there more than a hundred types of arthritis are known, the two most common ones are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is considered the most common type of arthritis. It usually affects the large joints, such as the knees and hips. However, sometimes, the condition can occur in smaller joints like the joints in the fingers. Osteoarthritis usually comes with age as the joints lining are damaged through frequent wear-and-tear.

Rheumatoid arthritis, on the other hand, is known to be caused by the body’s immune system attacking normal joints. The condition may cause a person to feel sick or tired and may also cause fever.

Rheumatoid arthritis is one of the many autoimmune diseases. An autoimmune disease occurs when the body’s own defense (immune) system mistakenly attacks normal cells and tissues. The condition usually affects joints and bones and follows a symmetrical pattern. This means that if one knee is involved the other knee is affected also. Sometimes rheumatoid arthritis can affect other internal organs as well.

Another most common type of arthritis is gout. To learn more about the condition, visit the Gout Topic Page.

What is Uric Acid? Foods That Can Cause High Uric Acid.

2009-11-04T21:20:00.000-08:00

Uric acid is a substance that results from the breakdown of purines in the body. Purines are normal components of the body’s tissues, which are found in many foods. Uric acid is normally eliminated as a part of the urine. However, too much uric acid or high uric acid can cause it to accumulate in the blood. This condition is called hyperuricemia.

Having high uric acid in the blood may cause it to form crystals, which are deposited in joints and other tissues. When this happens, the condition is called gout. A type of arthritis, gout can be painful and debilitating.

Eating foods high in purines or foods that can cause high uric acid in the blood include animal internal organs like liver and kidneys, dried beans and peas, mushrooms, asparagus, gravies, sardines, and anchovies. Avoiding these kinds of foods may make the pain attacks of gout less severe and may reduce the risk of a person having future attacks.

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Fibromyalgia

2009-04-04T07:32:00.000-07:00

Fibromyalgia is a disorder that causes muscle pain and fatigue (feeling tired). People with fibromyalgia have “tender points” on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

People with fibromyalgia may also have other symptoms, such as:

• Trouble sleeping
• Morning stiffness
• Headaches
• Painful menstrual periods
• Tingling or numbness in hands and feet
• Problems with thinking and memory (sometimes called “fibro fog”).

What Causes Fibromyalgia?

The causes of fibromyalgia are not fully understood. However, experts believe that a number of factors are involved the development of the condition. Fibromyalgia has been linked to:

• Stressful or traumatic events, such as car accidents
• Repetitive injuries
• Illness
• Certain diseases.

Fibromyalgia can also occur on its own.

Some scientists think that a gene or genes might be involved in fibromyalgia. The genes could make a person react strongly to things that other people would not find painful.

Who Is Affected by Fibromyalgia?

Scientists estimate that fibromyalgia affects 5 million Americans 18 or older. Most people with fibromyalgia are women. However, men and children also can have the disorder. Most people are diagnosed during middle age.

People with certain other diseases may be more likely to have fibromyalgia. These diseases include:

• Rheumatoid arthritis
• Systemic lupus erythematosus (commonly called lupus)
• Ankylosing spondylitis (spinal arthritis).

Women who have a family member with fibromyalgia may be more likely to have fibromyalgia themselves.

How Is Fibromyalgia Treated?

Fibromyalgia can be hard to treat. It's important to find a doctor who is familiar with the disorder and its treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues.

Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.

In June 2007, the U.S. Food and Drug Administration approved Lyrica* (pregabalin) as the first drug to treat fibromyalgia. Doctors also treat fibromyalgia with medicines approved for other purposes. Pain medicines and antidepressants are often used in treatment. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, August 2007)

What Can I Do to Try to Feel Better?

There are many things you can do to feel better, including:

• Taking medicines as prescribed
• Getting enough sleep
• Exercising
• Eating well
• Making work changes if necessary.

Information courtesy of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a division of the National Institutes of Health (NIH)

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Gout

2009-01-28T04:47:00.000-08:00

Gout, also called gouty arthritis, is one of the most common and most painful forms of arthritis. It is more common in men than women and also, it is more common in adults than in children. Gout commonly occurs when uric acid builds up in the body. The uric acid is deposited as needle-like crystals in the joints or soft tissues.

Uric acid is a product formed when substances called purines are broken down. Purines are found in all body tissues. Purines are also found in many foods, such as liver, dried beans and peas, and anchovies.

Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated. However, uric acid can build up in the body when:

 the body increases the amount of uric acid it makes

 not enough uric acid is eliminated by the kidneys

 a person eats too many foods high in purines.

When uric acid levels in the blood increases, it is termed hyperuricemia. Most people with hyperuricemia do not always develop gout. However, gout develops when the excess uric acid forms crystals.

The buildup of uric acid can lead to:

 Sharp uric acid crystal deposits in joints, often in the big toe

 Deposits of uric acid (called tophi) that look like lumps under the skin

 Kidney stones from uric acid crystals in the kidneys.

Signs and Symptoms

Signs and symptoms of gout may include

 pain

 swelling

 redness

 stiffness in joints

For many people, the first attack occurs in the bid toe. The toe is very sore, red, warm to touch, and swollen. And often, the attack wakes a person from sleep.

Gout may also affect other joints, such as the insteps, ankles, heels, knees, elbows, wrists, and fingers.

A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within 3 to 10 days, even without treatment. The next attack may not occur for months or even years.

Diagnosis

The doctor will likely ask about your symptoms, medical history, and family history of gout. In addition, he or she will test a sample of your blood to see if uric acid levels are elevated.

To confirm a diagnosis of gout, your doctor may draw a sample of fluid from an inflamed joint to look for crystals associated with gout.

Treatment

Doctors use medicines to treat an acute attack of gout, including:

 Nonsteroidal anti-inflammatory drugs (NSAIDs)

 Corticosteroids, such as prednisone

 Colchicine, which works best when taken within the first 12 hours of an acute attack.

Sometimes doctors prescribe NSAIDs or colchicine in small daily doses to prevent future attacks. There are also medicines that lower the level of uric acid in the blood.

The doctor may also recommend losing weight, for those who are overweight; limiting alcohol consumption; and avoiding or limiting high-purine foods, which can increase uric acid levels.

For More Information About Gout Visit the:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
National Institutes of Health.
Website:http://www.niams.nih.gov

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Strain: Injury to Muscle or Tendon

2009-01-28T01:34:00.000-08:00

A strain is an injury that occurs in a muscle or tendon—the cords of tissue that connect muscle to bone. A strain may just be a simple overstretching of the muscle or tendon, or it can result from a partial or complete tear.

Causes

A strain is caused by twisting or pulling a muscle or tendon. It can occur suddenly (acute) or develop over days or weeks (chronic).

An acute strain can be caused by:

 a recent trauma or injury

 improper lifting of heavy objects

 overstressing the muscles.

Chronic strains usually occur because of overuse or moving the muscles and tendons the same way over and over.

Two common sites where strains occur are the back and hamstring muscles—the muscle located in the back of the thigh. Strains may also occur in the hand, forearm, and elbow.

Signs and Symptoms

Signs and symptoms of a strain include:

 pain

 swelling

 muscle spasms

 muscle weakness

 cramping

 limitation of motion or difficulty moving the affected part

If a muscle or tendon is torn completely, it is often very painful and disabling.

Treatment

Treatment of a strain will depend on the severity of the injury. For mild to moderate strains, doctors usually recommend:

 rest

 ice application (wrapped in towel)

 medications, such as aspirin and ibuprofen, to relieve pain.

For more severe strains, such as in the case of a torn muscle or tendon, surgery may be recommended by the doctor.

After pain and swelling subsides, doctors usually say to exercise the injured area. This is helpful in preventing stiffness and increase strength. In some cases, the doctor may refer you to a physical therapist. You may need to exercise the injured area or go to physical therapy for several weeks. Ask your doctor or physical therapist when you can start doing normal activities, including sports. Beginning too soon may result in repeated injury of the muscle.

You should see your doctor immediately if you have a painful strain. He or she will determine the right treatment for you.

For More Information About Strains Visit The:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
National Institutes of Health.
Website:http://www.niams.nih.gov

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Sprain: The injured Ligament

2009-01-25T00:50:00.000-08:00

Sprain is a common injury in a joint wherein a stretch and/or tear of ligament occurs. A ligament is a band of tissue that connects two or more bones at a joint. One or more ligaments can be injured at the same time. The severity of the injury will depend on the extent of injury (whether a tear is partial or complete) and the number of ligaments involved.

Sprains can occur in both the upper and lower parts of the body, however, the most common site is the ankle. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), more than 25,000 individuals sprain an ankle each day in the United States.

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Causes

A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position and stretches or tears the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into a baseball base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground.

Most ankle sprains occur when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump. This type of sprain is called an inversion injury. The knee is another common site for a sprain. A blow to the knee or a fall is often the cause; sudden twisting can also result in a sprain

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Signs and Symptoms of Sprain

The common signs and symptoms of a sprain include pain, swelling, bruising, instability, and loss of the ability to move and use the joint. However, these signs and symptoms can vary in intensity, depending on the severity of the sprain. In some people, sometimes they feel a pop or tear when the injury happens.

Warning Signs and Symptoms

You should seek medical attention if:

 You have severe pain and cannot put any weight on the injured joint.

 The injured area looks crooked or has lumps and bumps (other than swelling) that you do not see on the uninjured joint.

 You cannot move the injured joint.

 You cannot walk more than four steps without significant pain.

 Your limb buckles or gives way when you try to use the joint.

 You have numbness in any part of the injured area.

 You see redness or red streaks spreading out from the injury.

 You injure an area that has been injured several times before.

 You have pain, swelling, or redness over a bony part of your foot.

 You are in doubt about the seriousness of the injury or how to care for it.

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Classification of Sprain According to Severity

Sprain may be mild, moderate, or severe.

Mild (Grade I) Sprain

In general, a mild sprain is caused by overstretching or slight tearing of the ligaments with no joint instability. A person with a mild sprain usually experiences minimal pain, swelling, and little or no loss of functional ability. Bruising is absent or slight, and the person is usually able to put weight on the affected joint.

Moderate (Grade II) Sprain

A grade II or moderate sprain is caused by further, but still incomplete, tearing of the ligament and is characterized by bruising, moderate pain, and swelling. A person with a moderate sprain usually has more difficulty putting weight on the affected joint and experiences some loss of function. An x ray may be needed to help the doctor determine if a fracture is causing the pain and swelling. Magnetic resonance imaging is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament, or can be recommended to rule out other injuries.

Severe (Grade III) Sprain

A sprain is classified as severe or grade III when the ligament is completely torn or ruptured. Pain, swelling, and bruising are usually severe, and the patient is unable to put weight on the joint. An x ray is usually taken to rule out a broken bone.

When diagnosing any sprain, the provider will ask the patient to explain how the injury happened. He or she will examine the affected area and check its stability and its ability to move and bear weight.

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Treatment

There are two stages of treatment for sprains.

The primary goal during the first stage is to reduce swelling and pain. At this stage, health care providers usually advise patients to follow a formula of protection, rest, ice, compression, elevation, and medications (PRICEMs) for the first 24 to 48 hours after the injury.

Protection. The injured area should be protected from further injury.

Rest. Reduce regular exercise or activities of daily living as needed. Your health care provider may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.

Ice. Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes.

Compression. Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your provider for advice on which one to use, and how tight to safely apply the bandage.

Elevation. If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.

Medications. Over-the-counter or prescription nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen may also be recommended by the doctor to help decrease pain and inflammation.

For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied. This often occurs after the initial swelling has subsided. Severe sprains may require surgery to repair the torn ligaments. An orthopaedic surgeon usually performs the surgery.

It is important that moderate and severe sprains be evaluated by a health care provider to allow prompt, appropriate treatment to begin. The list of Warning Signs and Symptoms should alert people to consult their provider. However, a person who has any concerns about the seriousness of a sprain or strain should always contact a provider for advice.

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Begin Rehabilitation

The second stage of treating a sprain is rehabilitation. The overall goal of rehabilitation is to improve the condition of the injured area and restore its function. The health care provider will prescribe an exercise program designed to prevent stiffness, improve range of motion, and restore the joint's normal flexibility and strength. Some patients may need physical therapy during this stage. When the acute pain and swelling have diminished, the provider will instruct the patient to do a series of exercises several times a day. These are very important because they help reduce swelling, prevent stiffness, and restore normal, pain-free range of motion. The provider can recommend many different types of exercises, depending on the injury. A patient with an injured knee or foot will work on weight-bearing and balancing exercises. The duration of the program depends on the extent of the injury, but the regimen commonly lasts for several weeks.

Another goal of rehabilitation is to increase strength and regain flexibility. Depending on the patient's rate of recovery, this process begins about the second week after the injury. The provider will instruct the patient to do a series of exercises designed to meet these goals. During this phase of rehabilitation, patients progress to more demanding exercises as pain decreases and function improves.

The final goal is the return to full daily activities, including sports when appropriate. Patients must work closely with their health care provider or physical therapist to determine their readiness to return to full activity. Sometimes people are tempted to resume full activity or play sports despite pain or muscle soreness. Returning to full activity before regaining normal range of motion, flexibility, and strength increases the chance of reinjury and may lead to a chronic problem.

The amount of rehabilitation and the time needed for full recovery after a sprain depends on the severity of the injury and individual rates of healing. For example, a mild ankle sprain may require up to 3 to 6 weeks of rehabilitation; a moderate sprain could require 2 to 3 months. With a severe sprain, it can take up to 8 to 12 months to return to full activities. Extra care should be taken to avoid reinjury.

Source: Adapted from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) of the National Institutes of Health.

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Acute or Chronic Back Pain?

2009-01-19T19:25:00.000-08:00

The Difference Between Acute and Chronic Back Pain.

Back pain is a common medical condition that may range from a dull, constant ache to a sudden, sharp pain. Sometimes back pain can occur suddenly, which result from an accident, a fall or lifting too heavy objects. On the other hand, the condition may develop slowly that results from age-related changes to the back-bone or spine.

Acute back pain, the most common type of back pain, is a pain that hits you suddenly. The condition, for example, can result from falls (e.g. falling from a ladder); sports-related (e.g. being tackled on the football field); or lifting too heavy objects. Back pain is classified as acute when pain does not last for more than 6 weeks.

Chronic back pain, on the other hand, may occur quickly or slowly. However, the pain stays for a long time. Generally, back pain lasting for more than 3 months is considered chronic. Chronic back pain is less common than acute back pain.

Source: Adapted from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Web URL: http://www.niams.nih.gov

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Bursitis

2009-01-14T03:48:00.000-08:00

Bursitis is a common condition that involves inflammation of the soft tissue in a joint. Most often, bursitis occurs in the shoulder, elbow, wrist, hip, knee, or ankle.

A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts: muscles, tendons, or skin. Bursae are found throughout the body. Bursitis occurs when a bursa becomes inflamed (redness and increased fluid in the bursa).

Overuse or direct trauma to a joint commonly causes bursitis. Bursitis may occur at the knee or elbow; for example, from kneeling or leaning on the elbows longer than usual on a hard surface. The condition occurs more often as a person grows older.

The condition is more common in people who perform activities that require repetitive motions or place stress on joints, such as carpenters, gardeners, musicians, and athletes.

Diagnosis

Diagnosis of bursitis begins with a medical history and physical examination. The patient will describe the pain and circumstances in which pain occurs. The location and onset of pain, whether it varies in severity throughout the day, and the factors that relieve or aggravate the pain are all important diagnostic clues. X rays do not show bursae, but may be helpful in ruling out problems in the bone or arthritis. The doctor may also recommend magnetic resonance imaging (MRI). MRIs detect both bone and soft tissues like muscles, tendons and their coverings (sheaths), and bursae.

To rule out infection, the doctor may remove and test fluid from the inflamed area.

Treatment of Bursitis

Treatment focuses on healing the injured bursa. The first step in treating the condition is to reduce pain and inflammation. This can be achieved through rest, compression, elevation, and anti-inflammatory medicines such as aspirin, naproxen, or ibuprofen. Ice may also be used in acute injuries, however, most cases of bursitis are considered chronic, and ice may not be helpful. When ice is needed, an ice pack can be applied to the affected area for 15-20 minutes every 4-6 hours for 3-5 days. Longer use of ice and a stretching program may be recommended by a health care provider.

Activity involving the affected joint is also restricted to encourage healing and prevent further injury.
Other protective devices, such as foot orthoses for the ankle and foot or splints for the knee or hand, may temporarily reduce stress to the affected bursa and facilitate quicker healing times, while allowing general activity levels to continue as usual.

The doctor or therapist may use ultrasound (gentle sound-wave vibrations) to warm deep tissues and improve blood flow. Iontophoresis may also be used. This involves using an electrical current to push a corticosteroid medication through the skin directly over the inflamed bursa. Gentle stretching and strengthening exercises are added gradually. Massage of the soft tissue may be helpful. These may be preceded or followed by use of an ice pack. The type of exercises recommended may vary depending on the location of the affected bursa.

If there is no improvement, the doctor may inject a corticosteroid medicine into the area surrounding the inflamed bursa. While corticosteroid injections are a common treatment, they must be used with caution because they may lead to weakening or rupture of a tendon—the tissue that attaches a muscle to a bone. If there is still no improvement after 6-12 months, the doctor may perform either arthroscopic or open surgery to repair damage and relieve pressure on the bursae.

If the bursitis is caused by an infection, the doctor will prescribe antibiotics.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases (April 2007). Available at: http://www.niams.nih.gov/Health%5FInfo/Bursitis/default.asp. Retrieved: January 14, 2009

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Osteoarthritis

2009-01-12T17:11:00.001-08:00

Osteoarthritis, sometimes called degenerative joint disease or osteoarthrosis, is the most common type of arthritis. It commonly affects older people, although the condition may also occur in the younger age. People with osteoarthritis usually experience pain in their joints, which causes some limitations in movement. However, this type of arthritis does not affect other organs.

Normally, a layer of cartilage covers the end of a bone in a joint. The place where two bones meet is called a joint. The cartilage, clinically called articular cartilage, is a hard but slippery tissue that allows bones to glide over one another. In addition, the cartilage also helps absorb energy from the shock that occurs upon movement of a joint.

Osteoarthritis occurs when the layer of cartilage covering the bone ends in a joint breaks down and eventually wears away. As a result, the bones under the cartilage rubs together, causing

 pain
 swelling
 and limitations or loss of motion of the joint.

Persistent, rubbing of the bone ends may cause loss of the joint’s normal shape. Osteophytes or bone spurs — small deposits of bone — may grow on the edges of the joint. Some bits of bone or cartilage may also break off and float inside the joint space, which may cause more pain and damage.

Signs and Symptoms

In general, osteoarthritis often develops slowly and may get worst over time. Signs and symptoms of osteoarthritis may include:

 Pain in a joint

 Tenderness

 Stiffness in a joint after getting out of bed or sitting for prolonged periods

 Sensation of grating in the joint upon movement

 Swelling in one or more joints

Although osteoarthritis can occur in any joint, it commonly affects the hands, knees, hips, and the spine (either at the neck or lower back).

Diagnosis:

In addition to knowing about your signs and symptoms and other information about your medical and family history, your doctor may also perform physical examination and may request other diagnostic tests and procedures.

Although no single test can diagnose osteoarthritis, diagnostic test and procedures may be recommended by your doctor to confirm the diagnosis and rule out other health problems or conditions.

Tests may include;

 X rays

 Magnetic resonance imaging

 Blood tests

Your doctor can provide you with more information about diagnostic tests and procedures performed in the diagnosis of osteoarthritis.

Treatment

The goals of treatment for osteoarthritis include:

 Control of pain

 Improvement of joint function

 Achieve or maintain normal body weight

 Achieve a healthy lifestyle.

No single treatment approach is effective in treating osteoarthritis. Most programs for the treatment of osteoarthritis include treatment procedures tailored to the patient’s needs, lifestyle, and health. And most of these programs include ways to manage pain and improve function. Treatment programs may include the following:

 exercise

 weight control

 rest and relief from stress on joints

 pain relief techniques

 surgery, and

 complementary and alternative therapies.

Treatment approaches may differ from person to person. Your doctor or health care provider can provide you with more information about the treatments available for managing osteoarthritis.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a division of the National Institutes of Health.

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Types of Arthritis

2008-12-26T06:09:00.000-08:00

Although there more than 100 types of rheumatic disease, some of the common types include the following:

Osteoarthritis

Osteoarthritis is the most common type of arthritis, which according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), affects an estimated 27 million adults in the United States. Osteoarthritis affects both the cartilage-the tissue that cushions the ends of bones within the joint-and the underlying bone. In osteoarthritis, there is damage to the cartilage, which begins to fray and may wear away entirely. There is also damage to the bond stock of the joint. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints such as the knees and hips.

Rheumatoid Arthritis

This inflammatory disease of the immune system targets first the synovium, or lining of the joint, resulting in pain, stiffness, swelling, joint damage, and loss of function of the joints. Inflammation most often affects joints of the hands and feet and tends to be symmetrical (occurring equally on both sides of the body). This symmetry helps distinguish rheumatoid arthritis from other forms of the disease. About 0.6 percent of the U.S. population (about 1.3 million people) has rheumatoid arthritis.

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis is the most common form of arthritis in children. This disease causes pain, stiffness, swelling, and loss of function of the joints. This condition may be associated with rashes or fevers and may affect various parts of the body.

Fibromyalgia

Fibromyalgia is a type of chronic disorder, which causes pain throughout the tissues that support and move the bones and joints. Pain, stiffness, and localized tender points occur in the muscles and tendons, particularly those of the neck, spine, shoulders, and hips. Patients also may experience fatigue and sleep disturbances. Fibromyalia affects millions of adults in the United States.

Systemic lupus erythematosus

Systemic lupus erythematosus (SLE), also called lupus, is an autoimmune disease in which the immune system mistakenly attacks the body’s own healthy cells and tissues. This can result in inflammation of and damage to the joints, skin, kidneys, heart, lungs, blood vessels, and brain. By conservative estimates, lupus affects about 150,000 people.

Scleroderma

Also known as systemic sclerosis, scleroderma literally means “hard skin.” The disease affects the skin, blood vessels, and joints. It may also affect vital organs, such as the lungs and kidneys. In scleroderma, there is an abnormal and excessive production of collagen (a fiber-like protein) in the skin and internal organs.

Spondyloarthropathies

This group of rheumatic diseases principally affects the spine. One common form – ankylosing spondylitis – also may affect the hips, shoulders, and knees. The tendons and ligaments around the bones and joints become inflamed, resulting in pain and stiffness. Ankylosing spondylitis tends to affect people in late adolescence or early adulthood. Reactive arthritis, sometimes called Reiter’s syndrome, is another spondyloarthropathy. It develops after an infection involving the lower urinary tract, bowel, or other organ. It is commonly associated with eye problems, skin rashes, and mouth sores.

Infectious arthritis

This is a general term used to describe forms of arthritis that are caused by infectious agents, such as bacteria or viruses. Parvovirus arthritis and gonococcal arthritis are examples of infectious arthritis. Arthritis symptoms also may occur in Lyme disease, which is caused by a bacterial infection following the bite of certain ticks. In those cases of arthritis caused by bacteria, early diagnosis and treatment with antibiotics are crucial to removing the infection and minimizing damage to the joints.

Gout

This type of arthritis results from deposits of needle-like crystals of uric acid in the joints. The crystals cause episodic inflammation, swelling, and pain in the affected joint, which is often the big toe. An estimated 2.1 million Americans have gout.

Polymyalgia Rheumatica

Because this disease involves tendons, muscles, ligaments, and tissues around the joint, symptoms often include pain, aching, and morning stiffness in the shoulders, hips, neck, and lower back. It is sometimes the first sign of giant cell arteritis, a disease of the arteries characterized by headaches, inflammation, weakness, weight loss, and fever.

Polymyositis

This rheumatic disease causes inflammation and weakness in the muscles. The disease may affect the whole body and cause disability.

Psoriatic Arthritis

This form of arthritis occurs in some patients with psoriasis, a scaling skin disorder. Psoriatic arthritis often affects the joints at the ends of the fingers and toes and is accompanied by changes in the fingernails and toenails. Back pain may occur if the spine is involved.

Bursitis

This condition involves inflammation of the bursae, small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint or injury or infection of the bursae. Bursitis produces pain and tenderness and may limit the movement of nearby joints.

Tendinitis (Tendonitis)

Tendinitis is the clinical term for the inflammation of the tendon or tendons. A tendon is a tough cord of tissue, which connects a muscle to a bone. The condition may be caused by overuse, injury, or a rheumatic condition. Tendinitis produces pain and tenderness and may restrict movement of nearby joints.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Arthritis at a Glance

2008-12-24T01:14:00.000-08:00

Arthritis is the medical term for the inflammation of a joint or joints. Joints are places where two bones meet. Examples of joints include the elbow, shoulder, and knee joints.

People with arthritis may feel pain and stiffness and experience swelling of their joints, which can make movement hard and bothersome.

The term "arthritis" may often be used to refer to any condition or disorder that affect the joints. However, these disorders are included in a broader category of condition called rheumatic diseases. There are actually more than 100 types of rheumatic disease.

Many people are affected with arthritis or some kind of rheumatic disease. In the United States alone, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), there are more than 46 million people who have arthritis or other rheumatic disease. They added that by 2020 this number is expected to reach 60 million.

The different types of arthritis and rheumatic disease have different signs or symptoms. In general, however, people with arthritis experience pain and stiffness in their joints. Other common signs and symptoms of arthritis include:

swelling in one or more joints

stiffness around the joints that lasts for at least 1 hour in the early morning

constant or recurring pain or tenderness in a joint

difficulty using or moving a joint normally

warmth and redness in a joint

If you experience these signs or symptoms, you should consult your health care provider. Early diagnosis and treatment of arthritis is important to prevent further damage to the joints or to prevent complications.

Contact NasugnaM

2008-12-22T15:36:00.000-08:00

Thank you for visiting the NasugnaM Health - Arthritis Division website.

Contacting the webmaster

Please be aware that we cannot reply to email questions about your specific health problems. We recommend that you direct your questions to your medical doctor.

The information in this website is meant to serve as an aid to understand general descriptions of health conditions and other health matters and not to replace a consultation with a qualified healthcare provider. You should not use the information in this website to formulate your own treatment plan. Your healthcare provider can determine which optimal medical and dietary plan is best for you.

To report any broken links, request for health topics to be featured in our website, or other concerns about our website, you can contact the webmaster at davidkm77(@)gmail(dot)com. View information about our privacy policy.Thank you very much.

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About Nasugnam Health

2008-12-21T15:00:00.000-08:00

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Unless it is specifically stated otherwise, no additional information will be collected about you. When inquiries are emailed to us, we store the question and the email address information so that we can respond electronically. Unless otherwise required by statute, we do not identify publicly who sends questions or comments to our web site. We will not obtain information that will allow us to personally identify you when you visit our site, unless you chose to provide such information to us.

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Contacting the Webmaster

Nasugnam Health and all its divisions does not provide specific medical advice, diagnosis, or treatment. Your doctor can provide you with more information about your specific health problem or concerns.

For other concerns, you can contact the webmaster at: davidkm77 (at) gmail (dot) com.

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Published: December 22, 2008; Updated: March 18, 2009

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