Neck pain caused relief

degenerated discs, pinched nerves, arthritis and whiplash to name a few.
Most people will have a minor neck problem at one time or another. Normal body movements usually do not cause problems. However, it's not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Neck problems and resulting injuries most commonly occur during sports or recreational activities, work-related tasks, or projects around the home.
Neck pain may feel like a "kink," stiffness, or severe pain. Pain may spread to the shoulders, upper back, or arms, or it may cause a headache. Neck movement may be limited, usually more to one side than the other. Neck pain refers to pain anywhere from the area at the base of the skull into the shoulders.
The Neck includes:
Bones and joints of the cervical spine (vertebrae of the neck);Discs that separate the cervical vertebrae and absorb shock as you move;And the muscles and ligaments in the neck that hold the cervical spine together.
Neck pain may be caused by an injury to one or more of these areas, or it may have another cause.
Degenerative DiscDegenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).
The changes in the discs can result in back or neck pain as well as:
Osteoarthritis, the breakdown of the tissue (cartilage) that protects and cushions joints;
Herniated Disc, an abnormal bulge or breaking open of a spinal disc;
Spinal Stenosis, the narrowing of the spinal canal, the open space in the spine that holds the spinal cord;
These conditions may put pressure on the spinal cord and nerves, leading to pain and possibly affecting nerve function.
Causes As we age, our spinal discs break down, or degenerate, which may result in degenerative disc disease in some people. These age-related changes include:
The loss of fluid in your discs. This reduces the ability of the discs to act as shock absorbers and makes them less flexible. Loss of fluid also makes the disc thinner and narrows the distance between the vertebrae.
Tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.
These changes are more likely to occur in people who smoke cigarettes and those who do heavy physical work (such as repeated heavy lifting). People who are obese are also more likely to have symptoms of degenerative disc disease.
A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process.
As the space between the vertebrae gets smaller, there is less padding between them, and the spine becomes less stable. The body reacts to this by constructing bony growths called bone spurs (osteophytes). Bone spurs can put pressure on the spinal nerve roots or spinal cord, resulting in pain and affecting nerve function.
SymptomsDegenerative disc disease may result in back or neck pain, but this varies from person to person. Many people have no pain, while others with the same amount of disc damage have severe pain that limits their activities. Where the pain occurs depends on the location of the affected disc. An affected disc in the neck area may result in neck or arm pain, while an affected disc in the lower back may result in pain in the back, buttocks, or leg. The pain often gets worse with movements such as bending over, reaching up, or twisting.
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Pinched NerveThe term pinched nerve describes one type of damage or injury to a nerve or set of nerves. The injury may result from compression, constriction, or stretching. Symptoms include numbness, "pins and needles" or burning sensations, and pain radiating outward from the injured area. One of the most common examples of a single compressed nerve is the feeling of having a foot or hand "fall asleep." Pinched nerves can sometimes lead to other conditions such as peripheral neuropathy, carpal tunnel syndrome, and tennis elbow. The extent of such injuries may vary from minor, temporary damage to a more permanent condition. Early diagnosis is important to prevent further damage or complications. Pinched nerve is a common cause of on-the-job injury.
Is there any treatment for a pinched nerve?The most frequently recommended treatment for pinched nerve is rest for the affected area. Corticosteroids -- steroids that ease inflammation -- help alleviate pain. In some cases, surgery is recommended. Physical therapy may be recommended, and splints or collars may be used.
WhiplashWhiplash, also called neck sprain or neck strain, is injury to the neck. Whiplash is characterized by a collection of symptoms that occur following damage to the neck. In whiplash, the intervertebral joints (located between vertebrae), discs, and ligaments, cervical muscles, and nerve roots may become damaged.
Causes Whiplash is caused by an abrupt jerking motion of the head, either backward or forward, and often occurs as a result of a car accident.
Symptoms of whiplash may be delayed for 24 hours or more after the initial trauma. However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury.
Neck pain and stiffness Headaches Pain in the shoulder or between the shoulder blades Low back pain Pain or numbness in the arm and/or hand Dizziness Ringing in the ears or blurred vision Difficulty concentrating or remembering Irritability, sleep disturbances, fatigue
How Is Whiplash Diagnosed?In most cases, injuries are to soft tissues such as the disks, muscles and ligaments, and cannot be seen on standard X-rays. Specialized imaging tests, such as CT scans or magnetic resonance imaging (MRI) may be required to diagnose whiplash.
How Is Whiplash Treated?No single treatment has been scientifically proven as effective for whiplash, but pain relieving medications such as Motrin or Aleve along with gentle exercises, physical therapy traction, massage, heat, ice, injections and ultrasound all have been helpful for certain patients.
In the past, whiplash injuries were often treated with immobilization in a cervical collar. However, the current trend is to encourage early movement instead of immobilization. Ice may be applied for the first 24 hours, followed by gentle active movement.
Torticollis is caused by severe muscle contraction on one side of the neck, causing the head to be tilted to one side. The chin is usually rotated toward the opposite side of the neck. Torticollis may be present at birth (congenital) or caused by injury or disease.
Arthritis or damage to the discs of the neck can cause a pinched nerve. Neck pain caused by a pinched nerve generally affects one side of the neck and the arm on that side. Other symptoms may develop, such as numbness, tingling, or weakness in the arm or hand.

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Relieving Stress Relieves Pain

The Institute of HeartMath has focused for the past 18 years on the effects stress and emotions have on our health and quality of life. Researchers have found that the presence or absence of stress can directly impact levels of pain. For example, in the first two weeks following the Sept. 11 terrorist attacks on the World Trade Center, pain-treatment specialists were inundated with complaints of worsening pain. Calls came from patients who suffered from many types of illnesses – cancer, back problems, arthritis, diabetic neuropathy, chronic headaches and others. According to the medical director of pain management at Washington Hospital Center at the time, many patients who had been stable for years on their medication flooded the center with phone calls in those first two weeks after the attacks, saying their pain had gotten out of control. In Houston, specialists reported that pain complaints from cancer patients were up 33 percent, and in Buffalo they had doubled. Why?

"Laughter is the tonic, the relief, the surcease for pain."

—Charlie Chaplin

Your body can create chemical messengers, known as endorphins, that help manage pain naturally. The more endorphins released into your system, the less pain you experience. Although, as it now is believed, there is some endorphin secretion into the body at all times, there are periods when endorphin levels fall, particularly during times of stress, that cause aches and pains to increase. At other times, when these levels rise – exercising, listening to music or doing something as common and pleasurable as laughing – aches and pains diminish. HeartMath has received many reports over the years from people who say utilizing our scientifically researched and validated tools and technology helped decrease their pain. (Regardless of your circumstance, always consult your physician before changing your pain-management program.)

Recommended

A HeartMath TIP:

Heart Lock-In^® technique: Use the Heart Lock-In technique – an adapted version follows here – especially first thing in the morning, to increase your endorphin level and to give your body an energy boost for the day. Then try it before going to sleep at night to reduce the stress and aches and pains of the day and enjoy restful sleep.

In-depth details and a discussion about HeartMath’s Heart Lock-In technique are available in the book Transforming Anxiety: The HeartMath Solution for Overcoming Fear and Worry and Creating Serenity, by Doc Childre and Deborah Rozman.

• Shift your attention to the area of your heart and breathe slowly and deeply.
• Activate and sustain a genuine feeling of appreciation or care for someone or something in your life.
• Send these feelings of care toward yourself and others. This benefits them and especially helps recharge and balance your system.

Benefits of Reducing Stress

• Aches and pains decrease
• Energy increases so you can do more
• Overall outlook Improves, less focus on pain
• More restful sleep at night

Recommended

Tools For De-stressing

• emWave^® Personal Stress Reliever: Regular use of this scientifically validated, hand-held stress-relief technology has proven to be a vital tool in reducing anxiety and stress, allowing your body to recharge itself and, when used with HeartMath techniques you’ll receive, to give you relief from the aches and pains of the day. The emWave^® PSR is easy to use and noninvasive. It will help you achieve heart coherence – synchronization between the heart and brain. It also teaches you to regulate your emotions and prepare for events that can trigger stress responses and to recover quickly from stressful episodes. Carry it anywhere and revitalize your mind, body and spirit anytime.
• emWave^® PC Stress Relief System:^† The emWave PC system turns your computer into a self-contained heart-rhythm-coherence monitor and manager. It let’s you see how emotions affect your heart rhythms and then teaches you how to regulate them. Then, using HeartMath techniques, you’ll easily learn to achieve heart coherence, the state in which all of your body’s systems can function at their optimum. Among the tools you’ll receive with the emWave PC is the highly acclaimed Freeze-Frame^® technique, which has been successfully used by mental health professionals, physicians, educators, corporate executives, athletes and performing artists. The emWave PC and Freeze-Frame have proven particularly effective in pain management and they currently are used in burn clinics. † Formerly known as Freeze-Framer^®.
• Transforming Stress: The HeartMath Solution for Relieving Worry, Fatigue and Tension, book by Doc Childre and Deborah Rozman. Know the warning signs of chronic stress and learn the latest research about your "intelligent heart" and its ability to help you immediately begin reducing the stress in your life. Many HeartMath clients have reported that when their stress levels decreased so did their pain. You’ll receive step-by-step instructions for HeartMath techniques that can help you live healthier with less pain.
• Transforming Depression: The HeartMath^® Solution to Feeling Overwhelmed, Sad, and Stressed, by Doc Childre and Deborah Rozman. Depression commonly goes hand in hand with those who suffer chronic pain. Transforming Depression, the fourth book in HeartMath’s Transforming Series, can help you to understand the feelings you are experiencing such as hopelessness and disinterest in activities you formerly enjoyed, among others, and then teach you powerful tools for easing your pain and overcoming those feelings, including Notice and Ease, the Power of Neutral and the Cut-Thru^® technique. With a little practice, you can lessen feelings of depression and see dramatic changes occur in your mind and body that can lead to better health and greater peace of mind.

Knee Surgery Patient Feels No Pain

The following is a brief summary of an article Dr. Raymond T. Bradley, who was familiar with HeartMath techniques such as the Heart Lock-In prior to undergoing knee surgery in 2004, wrote for the Institute of HeartMath a short time later.

Bradley had bilateral knee arthroscopic surgery on both legs as an outpatient. He prepared for the surgery by having visualization sessions with his therapist in conjunction with and complemented by daily Heart Lock-In^® sessions in the morning and evening. "My goal was to create a safe and secure place in my mind and heart in which to enter for the surgery – filled only with love (no fear) – and to be able to totally surrender myself to the surgery, whatever the outcome. … My last memory was of total peace and calm and a heart filled with unbounded love and appreciation," he said, referring to when he was wheeled into the operating room, at which time he did a final Heart Lock-In session. "The surgery went well and I awoke with no side effects: clearheaded, hungry and thirsty, and totally energized and exuberant in spirit. My body felt full only of love and appreciation – I had no pain at all!"

Chronic Low Back Pain Research Study Subject Recruitment

About the Study

We are currently enrolling patients with chronic low back pain for a study to determine how well Cymbalta (an FDA approved drug for diabetic nerve pain) works for back pain.

We are investigating how well this medication works on your pain, quality of life, and physical functioning. Additionally, we are interested in seeing where this medication works in the nervous system. We do this by taking MRI scans of your brain while on and off this medication. By comparing the scans between these conditions, we can learn how this medication works. This may lead to the development of new drugs to treat pain.

About Your Participation

• 8 study visits in our offices over approximately 13 weeks
• Physician evaluations provided at no cost
• Study medications provided at no cost
• You will be taking Cymbalta for half of the study period (6 weeks).
• You will be taking a placebo for the other half of the study period (6 weeks).
• Neither you nor your study physician will know which medication period has the active study drug versus the placebo.
• 3 fMRI scans: at the very beginning of the study and after each 6-week medication period. During the scans, you will receive a heat stimulus on your hand and back.

Benefits to Participants

• Be a part of research that may guide development of future pain medications
• Interact extensively with the research team, which includes leaders in the field of pain management
• Potential pain relief from study medication

About fMRI

• Safe and non-invasive
• No exposure to radiation

Eligibility

• Men
• Age 18-60
• Must currently have lower back pain

Compensation
Participants can earn up to $500 for their time

You can guage your eligibility for this study by completing this brief online survey.

To find out more about this study, call 650.724.0522

knee pain

Knee pain is an extremely common complaint, and there are many causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have knee pain, some common causes include:
Arthritis, Liqament Injuries

Knee Pain Location

One way to classify knee pain (and identify possible solutions) is to look at the location of the pain.

• Anterior (see chondromalacia below)
  • Reasons
    • patellar tendonitis
    • patellofemoral syndrome
  • Causes
    • pushing BIG gears - cadence too low
    • saddle too low or too far forward
    • foot too far forward on the pedal
    • crank arms too long
    • leg length discrepancy with seat set for shorter leg
  • Possible solutions
    • ride at 75 rpm or higher
    • raise seat (in small increments of less than 5mm) or move seat back
    • move cleat forward 1 to 2 mm
    • shorten crank arms by 2.5 cm
    • set seat for longer, not shorter, leg with correction for the shorter leg

Treatment of Knee Pain

Knee pain generally develops slowly over a number of days and is not an emergency. Immediate care is always available at a walk in clinics, but it is more productive to see your primary care physician or a sports medicine physician as the first step.

Dealing with yourself will be the biggest issue. Competitive athletes have a "fear of rest" - yet rest is probably the single most effective treatment. Peer pressure to continue to ride doesn't help when you are trying to do the rioght thing for yourself (and your knee).

• First Aid

  As in any musculoskeletal injury, ice, elevation, and resting the knee are all helpful.

• Rehabilitation

  Take a few days off and then begin a limited riding program - cut back mileage by 20 - 30 % and spin at a high rpm and in a low gear for a week or two. And the same goes for leg work in the gym. Remember, if you push too hard, you just get to start over again. Mild stretching before and after the ride keep the muscles loose, and icing the knee after the ride may be beneficial as well.

• Drugs

  Tylenol or NSAIDs such as motrin are a good start. Motrin can be taken up to 800 mg 3 times a day for a few days, but then drop back to the recommended dose on the bottle. If you have a history of ulcer problems or develop GI side effects, either switch to tylenol (it helps pain but is not as good an antiinflamatory) or see your physician for one of the newer Cox-2 medications (Vioxx, Celebrex) which are much easier on the stomach.

• Prevention

How you can care

People overall are experiencing knee pain, most commonly caused by arthritis, in people as young as their 30's when at one time, this was associated mainly in the elderly. Weight bearing movement, which means repeated pounding on the knee with forces up to four to five times your body weight, is the most common reason for knee stress and pain. Over the years, this takes its toll in wear and tear on the knees. Exercise is vital - and in today's society necessary - to those who wish to avoid health problems such as diabetes, heart conditions and low blood pressure to name just a few. Therefore, it is imperative to learn how to avoid injury to your knees while still getting necessary exercise in your life.

Exercise is essential in today's society where technology and modern conveniences no longer require much physical exertion in many instances. As a result, society as a whole has become too sedentary. Being sedentary is more dangerous than smoking a pack of cigarettes a day and overall, the risk is even greater in those who do not exercise. The key is to not take your knee for granted and learn how to do exercises properly. Poor positioning of an exercise can do extensive damage to your knees. Always give special attention to the description of any specific exercise to avoid misalignment and strain to your knees. Proper exercise for the knee is imperative - get this manual, complete with pictures and quick, easy to understand procedures.

Tips:
1. Stay strong -- this is what the manual will teach you how to do using the quadriceps muscles to ease stress on the knee joint.
2. Mix up your exercise routines i.e., practice cross training, which implements a variety of activities.
3. Stay active.
4. Avoid risky activities, especially if you have had a previous knee injury.
5. Lose weight because excess weight accelerates existing osteoarthritis due to extra pressure on the knees. Example: If you lose just two pounds, the knee senses less force and "thinks" you have lost ten pounds!
6. Always wear good, quality shoes. Walking and running shoes should be changed after 500 miles of use, or in six to nine months.
7. Learn proper techniques (as previously mentioned) in all your exercises and activities.
8. If you have pre-existing knee problems, seek a professional for a customized workout most beneficial to your specific needs.
9. Add activities and new exercises cautiously. Be sure a movement is gentle on the knee.
10. Rest. Sometimes rest is the best thing we can do for our knees. Judge this by the way your knee is feeling. If you've been participating in regular exercise for some time, give it a rest for a day.

Please note: If you have any serious knee conditions, consult a medical professional immediately. This manual is for those experiencing annoying, every day knee pain commonly caused by typical, daily activities -- or lack of activity.

Weight Loss

Introduction

The number of people in the United States who are overweight has increased over the last two decades. Current estimates are that approximately two thirdsof adults and one quarter of children and teenagers in the United States are overweight. Obesity is a primary causal factor in a wide range of serious diseases including heart disease, stroke, and some types of cancer. It also tends to raise your blood pressure and cholesterol levels, and makes you more likely to develop diabetes. Hence, obesity is one of the most significant and preventable causes of death and disability among adults.

The number of calories you eat and the number of calories you use each day control your body weight. So to lose weight, you need to take in fewer calories than you use. You can do this by becoming more physically active, by eating less or both. Your weight loss program should also help you make changes that you can maintain for the rest of your life.

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Are You Overweight?

The most common way to decide if you are overweight is to determine your Body Mass Index (BMI). The BMI looks at how much you should weigh based on your height. It is a relative comparison of the proportion of fat versus lean in your body.

You can determine your BMI by using the following formula:

1.Divide your weight (in pounds) by your height (in inches) squared

2.Multiply the results of Step 1 by 705.

For example, if you are 5'3'' (63 inches) and weigh 138 pounds, the equation looks like this:

BMI=(138/(63x63)) x705=24.5

Your BMI should be somewhere in the 19 to 25 range. A BMI of 25 to 29.9 is considered overweight and a BMI over 30 is considered obese. If you are in doubt as to whether or not you are overweight, see your doctor.

If you decide that you need to lose weight, where should you start? First, you should concentrate on eating a healthy diet. Consider what you are eating. To lose weight while remaining healthy, you should try to lose only about 1/2 to 1 pound a week. One pound equals 3,500 calories. So if you cut out or exercise off 500 calories per day, you will lose about a pound a week. Losing weight will be easier if you combine exercise with diet management and good nutrition.

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Nutrition

A good diet has a structure known as the food pyramid. The idea behind the food pyramid is not necessarily to exclude any particular food, but to eat more of the healthy foods, and less of the unhealthy, fattening foods. You should eat more of the foods at the bottom, largest layer of the pyramid.

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Grain Group - breads, cereals, rices, pastas and other foods made from grain. They provide B vitamins, iron, carbohydrates and some proteins. Six or more daily servings are recommended.
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Fruit and Vegetable Group - Most vitamins, minerals, and fiber can be found in this group. Three to five servings of vegetables and two to four servings of fruit should be eaten every day.

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Dairy and Meat Group - This group contains foods with a lot of protein. Some foods are milk, cheese, poultry, fish and eggs, as well as nuts and beans. In addition to protein, these foods have calcium, iron, phosphorus, B vitamins and zinc. Two to three servings from each group are recommended daily.

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Fats, Oils and Sweets Group - The foods in this group provide calories, but little nutritional benefit. They include salad dressing, butter, margarine, sugar, sodas and candy. The American Heart Association recommends that no more than 30% of calories come from fats per day.

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The American Dietetic Association lists several warning signs to look for in a diet that signals bad nutritional advice:

* Recommendations that promise a quick fix
* Dire warnings of dangers from a single product or regimen
* Claims that sound too good to be true
* Simplistic conclusions drawn from a complex study
* Recommendations based on a single study
* Dramatic statements that are refuted by reputable scientific organizations
* Lists of "good" and "bad" foods
* Recommendations made to help sell a product
* Recommendations based on studies published without peer review
* Recommendations from studies that ignore differences among individuals or groups

Remember that variety is the spice of life! Eating a variety of foods helps provide vitamins, minerals and fiber all of which may help reduce chronic disease risk. You don’t need to give up favorite foods when trying to maintain or lose weight, but you may need to eat less of it less often.

Some tips on eating well and losing weight:

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Choose low fat, and low calorie foods. Eat grilled fish instead of fried fish; instead of french fries, have a baked potato (without all of the butter and sour cream).

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Try to limit your serving size and actually measure out the portions of food you are going to eat. It is very easy to overestimate how much you are eating. Keep measuring cups and spoons at the ready.
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Eat a variety of foods for maximum nutritional benefit.
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If you want to be able to eat more food while losing weight, the answer is EXERCISE.

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Exercise

Regular physical activity will not only help you to lose weight, but you will look and feel better. Exercise will lower your blood pressure and cholesterol, it can reduce your risk of having a heart attack and will temporarily suppress your appetite! Any activity that is done for at least 30 minutes on most days will help. You should try to exercise aerobically, meaning hard enough to make your heart pound a little and make you breathe heavier. If you are so out of breath that you can't comfortably talk to someone, you are exercising too hard. Slow down! To burn the maximum amount of fat, you should exercise at a lower intensity for a longer period of time. Check out the Health Authority web site on Fitness for more information.

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Summary

Exercise and eating well, when combined, are the most effective means of losing and maintaining weight. To get you on your way to losing weight, try using these strategies:

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Monitor your weight and food intake. Depending on your personality, you may prefer to weigh yourself every week as opposed to every day. Use measuring cups to measure out food portions since it is very easy to overestimate amounts of food. Keep a record of what you eat and how many calories you have consumed each day.
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Plan your meals ahead of time and have small, healthy snacks if necessary so that you don’t become so hungry that you overeat. A healthy snack is something like a piece of fruit or a handful of raisins or nuts.
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Try to focus on your internal hunger signals instead of external stimuli telling you to eat. Don't eat if you are not hungry, even if that is the time you normally would eat. You can resist cravings for foods in between meals by doing something to take your mind of eating. Try taking a walk or doing something active to distract yourself until the craving passes.
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Try to avoid high-risk situations where you would tend to overeat. When you feel tired, lonely, bored, depressed or anxious, you are more likely to eat when you are not hungry.
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Try waiting 10 minutes if you have eaten your meal and you are still hungry. Give your mealtime to "catch up with you". Cravings for snacks may also pass if you tell yourself to wait 10 minutes or so before you give in.

Losing weight should be viewed as a long term goal rather than a short term fix. Remember that you didn't gain weight overnight, and you won't lose it overnight either. If after several months of eating right and exercising, you still are not losing weight, you may decide to see your doctor. Most people are capable of losing weight on their own, without medical intervention.

Kidney Pain

Pain caused by the kidneys is typically felt in the flank area, which is in the back, just at the lower edge of the ribs on either side of the spine. Pain caused by the kidneys tends to be sharp, severe and occur in waves.
What Isn't Kidney Pain
It is rare for the kidneys to cause dull, aching pain. People sometimes equate back pain with kidney pain, but dull aching pain in the back -- especially the lower back or the middle of the back -- is usually due to muscles, ligaments, or even vertebrae and disks in the spinal column. Musculoskeletal pain typically gets worse with movement, and is relieved by heat or massage.
Common Causes of Kidney Pain

Kidney Stones
Cause of Pain: The pain caused by kidney stones occurs when a stone becomes lodged in the ureter, the slender tube that connects the kidney with the bladder. Urine flow is then blocked, which causes urine to back up into the kidney. The kidney then swells and enlarges, stretching the pain-sensitive capsule, or thin covering around it.
What to expect: The pain caused by kidney stones is referred to as "colic," meaning that it comes on in waves as opposed to being a steady continuous pain. Pain from kidney stones is described as being almost as severe as that of childbirth. Patients with renal colic usually find it very difficult to hold still, and are in constant motion, pacing and writhing. Often the pain is so severe that it causes nausea and vomiting.
Although the pain starts in the right or left flank area, it may move as the stone travels down the ureter. The pain may move around the side of the trunk to the lower part of the abdomen in the front and even travel down to the groin.

Degenerative Disc Disease

What is Degenerative Disc Disease ?

is one of the most common causes of low back pain, and also one of the most misunderstood. Many patients diagnosed with low back pain caused by degenerative disc disease are left wondering exactly what this diagnosis means for them.

Degeneration of the intervertebral disc, often called "degenerative disc disease" (DDD) of the spine, is a condition that can be painful and can greatly affect the quality of one's life. While disc degeneration is a normal part of aging and for most people is not a problem, for certain individuals a degenerated disc can cause severe constant chronic pain.

Causes

Trauma, such as a simple lifting accident, is the most common cause of disc degeneration. After trauma, the discs in the spine dehydrate and lose their ability to act as shock absorbers between the vertebrae. There is minimal blood supply to the discs, so they lack the ability to heal or repair themselves.

Symptoms

With symptomatic degenerative disc disease, chronic low back pain sometimes radiates to the hips, or there is pain in the buttocks or thighs while walking; sporadic tingling or weakness through the knees may also be evident. Similar pain may be felt or may increase while sitting, bending, lifting, and twisting. Chronic neck pain can also be caused in the upper spine, with pain radiating to the shoulders, arms and hands.

Treatment of Degenerative Disc Disease

Primary management for DDD is non-operative and includes nonsteroidal anti-inflammatory medications (NSAIDs) and exercise programs to strengthen abdominal and spinal musculature, improve aerobic fitness, and reduce lumbar lordosis (swayback).

Surgical intervention is an option when nonoperative medical management fails to adequately relieve the intolerable pain during activities of daily living which is individual-specific. It should also be considered in patients with initial signs and symptoms of progressive neurologic deterioration, specifically numbness or muscle weakness.

Classical surgical treatment for DDD which has failed nonoperative management is a spine fusion. However, advances in disc replacement technologies have made this technique a viable option for many individuals. Early investigations have demonstrated lumbar disc replacements have had outcomes equivalent to spine fusion. Not all individuals with DDD are good candidates for disc replacement surgery. Concomitant spinal deformity (scoliosis, kyphosis), history of spinal infection, posterior spinal arthritis, and multilevel disc disease are relative or absolute contraindications.

For those individuals who are not candidates for lumbar disc replacement, lumbar spine fusions have had good short-term and long-term outcomes. Fusion involve creating a solid bony connection between two or more vertebrae anteriorly, posteriorly, or both.

In a spine fusion procedure, the surgeon joins two or more adjacent vertebrae. Bone taken from other parts of the body, usually the pelvis just above the hip joint, is placed across the vertebrae. Plugs of bone shaped like hockey pucks or cages made of metal or plastic are used between the vertebrae anteriorly. Posteriorly the bone is ground up into small pieces and laid down over the spine. The vertebrae and bone graft grow together as healing progresses, eventually forming a single unit without motion across them.

If the spine is in overall good position, spinal implants may not be necessary. So while not all spinal fusions require implants, many patients whose spines are weakened by injury or disease or whose deformities must be corrected are treated with internal fixation or spinal implants. If the spine needs to be placed and maintained in a new position, spinal implants will typically be necessary. The implants can include rods, screws, and hooks to fixate and stabilize the spine. Various types of implants are used depending on the problem that required the fusion, the patient's age, and the surgeon’s judgment. These implants are usually left implanted indefinitely to minimize the possible loss of spinal alignment. The development of a spine fusion may take up to one year during which time physical activity may be limited and a spine brace may be recommended.

Fusion surgery is inherently more complicated, more painful, and riskier than procedures such as discectomy and laminectomy. There is no consensus in the medical community as to the appropriate indications for fusion surgery.

Lung Diseases

When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.

The term lung disease refers to many disorders affecting the lungs, such as

Asthma

Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that you are allergic to or find irritating. When your airways react, they get narrower and your lungs get less air. This can cause wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night.
When your asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that your vital organs do not get enough oxygen. People can die from severe asthma attacks.
Asthma is treated with two kinds of medicines: quick-relief medicines to stop asthma symptoms and long-term control medicines to prevent symptoms.

COPD (Chronic Obstructive Pulmonary Disease)
Chronic Obstructive Pulmonary Disease (COPD) makes it hard for you to breathe. Coughing up mucus is often the first sign of COPD. Chronic bronchitis and emphysema are common COPDs.
Your airways branch out inside your lungs like an upside-down tree. At the end of each branch are small, balloon-like air sacs. In healthy people, both the airways and air sacs are springy and elastic. When you breathe in, each air sac fills with air like a small balloon. The balloon deflates when you exhale. In COPD, your airways and air sacs lose their shape and become floppy, like a stretched-out rubber band.
Cigarette smoking is the most common cause of COPD. Breathing in other kinds of irritants, like pollution, dust or chemicals, may also cause or contribute to COPD. Quitting smoking is the best way to avoid developing COPD.
Treatment can make you more comfortable, but there is no cure.

Flu
Also called: Grippe, Influenza
Flu is a respiratory infection caused by a number of viruses. The viruses pass through the air and enter your body through your nose or mouth. Between 5% and 20% of people in the U.S. get the flu each year. The flu can be serious or even deadly for elderly people, newborn babies and people with certain chronic illnesses.
Symptoms of the flu come on suddenly and are worse than those of the common cold. They may include
Body or muscle aches
Chills
Cough
Fever
Headache
Sore throat

Modern Pain management Technique

Pain is a massive problem in our society, in fact it is estimated that at any given time, around one third of the population are in pain. Pain of any type is the most frequent reason for physician consultation. It is a major symptom in many medical conditions, significantly interfering with quality of life and general functioning.

Management is therefore an extremely important part of health care because people forced to continue living with extreme pain often become depressed and have poor treatment outcomes.
Some types of pain are still not really understood with as many as a third of cases having unknown origins.

Here are some of the things we do know about pain:

* It is constant for about 20% of people.
* Back pain is the most common pain.
* Most chronic sufferers have had pain for at least 3 years.
* As can be expected, the incidence increases with advancing age.
* Women report suffering more often than men.
* Only 70% of sufferers look for professional help.

Pain Management

Modern management programs should be multidisciplinary combining the input of Medical practitioners, Acupuncturists, Physiotherapists, Chiropractors, Clinical psychologists and Occupational therapists, amongst others.

1. Narcotics are often prescribed for severe pain, but narcotics carry with them a potential for side effects and addiction, so patients and caregivers must weigh the level of pain against these dangers in the management process.

2. Numerous studies have found that certain complementary therapies are effective in management.

3. Massage therapy can hasten pain relief, soothe stiff sore muscles, and reduce inflammation and swelling.

4. Psychological pain management teaches people skills to cope with with their condition. Research has shown that having realistic, helpful thoughts is an important part of management.

5. Natural pain relief is a sought after alternative to medication and drugs based on chemicals and other synthetic medication. Herbs have been used for centuries for pain relief, but many have not undergone extensive study. Some allergic reactions might occur with some patients using natural relief, but these can be easily controlled or prevented by doing a skin test before using the natural pain relief.

6. One of the pain management modalities are trigger point injections and nerve blocks utilizing long acting anesthetics and small doses of steroids.

7. NSAID medication will not only relieve pain, but also reduce fever and inflammation. However there are real disadvantages associated with the long term use of these drugs.

8. Aspirins, Paracetamol, Ibuprofen are other common remedies used for the relief of acute pain.

9. Morphine is the major active substance in opium and a very potent pain relief medication. Morphine will act directly on the central nervous system and is commonly used as a medication for acute and severe pain caused by surgery or major trauma. Morphine is also used as a pain relief medication for moderate and severe chronic pain, such as caused by cancer.

10. TENS machines give short term pain relief to many people. These machines are fairly cumbersome but at least they do not have side effects.

11. Finally there is a new modality which has just been released on to the market and that is the rather unique pain patch which combines nano technology with crystals activated by body heat to produce an energy wave. The waves are transmitted to the origin of the pain where they produce an acupuncture effect which relieves pain. There are reports of pain of 40 year duration being relieved instantly.

Liver Pain

Liver pain can be caused by a wide variety of ailments. The pain is felt in the upper-right quadrant, usually underneath the rib cage. Liver pain location may vary slightly, and in some cases can be felt in conjunction with back pain. It can be sharp, but typically is felt as a dull ache. Liver pain and abdominal pain in general are sometimes confused with each other. For reference purposes on this site, all upper-right abdominal pain is considered as potential liver pain. A doctor or medical professional may be able to determine the difference between particular types of pain in the abdomen, and whether they are related to the liver itself.

Is It Really Liver Pain?

Liver pain is on the right side, mostly right under the rib cage, and up. There can be free fluid around the liver in the abdominal cavity which will produce pain in the right shoulder. It probably hurts to breathe in, or cough. Sometimes people describe the feeling as a swollen full feeling or cramping under the rib cage.
Liver pain symptoms are often dismissed because it is a general belief that organs don't hurt. If you are experiencing any of these sensations, don't give up, and don't think you are making it up. Liver Pain can be real. Rheumatologists, nephrologists, family practitioners, all have been known to dismiss liver pain as patient complainings.
Sometimes it feels like your liver just doesn't fit under your rib cage. One person described it as feeling like a brick was tucked under their right rib. Sometimes the feeling is connected to a pain in the back as well.
Pain caused from a swollen liver is not necessarily sharp. Most of the time 'liver pain' is just a dull ache. Sometimes the sensation is wrongly attributed to fibromyaliga.
The cause of Liver Pain may be more easily identified by identifying other symptoms, such as fatigue, itching, swollen testes, difficulties breathing, eating problems, or even shoulder pain.
There can be many reasons for liver pain. Blood and urine tests help to identify problems in the liver, but don't rule out the effects of barrage of pollutants and toxic substances in today's environment. While the liver was designed to detoxify and rid the body of foreign chemicals, it may not be equipped to handle the barrage of pollutants and toxic substances in today's environment. So, while you are checking for possible causes of the pain associated with the liver, it would be a good idea to check your body for chemical overload as well.
Individual reaction to toxic overload can vary greatly. The most common symptom associated with toxic overload is fatigue. Other symptoms include headache, muscle and joint pain, irritability, depression, mental confusion, gastrointestinal and/or cardiovascular irregularities, flu-like symptoms or allergicreactions including hives, stuffy or runny nose, sneezing and coughing which is not usually associated with liver pain, but can actually be the cause.

Causes Of Liver Pain Symptoms

There are various instances when you have felt a pain in your abdominal region, which has been different from the pain that you usually feel. Basically these are often pains caused in the liver, which can be dangerous and should not be ignored. There are instances when patients have been diagnosed with hepatitis and they expect to feel pain over the liver. There are many people with chronic hepatitis who don't experience abdominal pain or discomfort over the liver. There are also some people who do not actually experience pain but sense a vague fullness of the liver. But the patients who have been reporting these symptoms to the doctor are usually informed that the liver itself does not typically cause pain or discomfort. Any kind of abdominal pain and pain over the liver, which is also known as right upper quadrant pain, is due to liver disease that may have many causes. It should be kept in mind that this type of pain should not automatically be attributed to a liver disorder. Hence these pains should be investigated and the abdominal and right upper quadrant pain is rarely due to chronic liver disease. The area where the right upper quadrant pain occurs is usually due to the liver and takes place in the acute stages of liver disease. There are often instances of these pains taking place due to inflammation of the liver that lasts less than six months. This can also be due to a flare up of a chronic liver disease which leads to acute inflammation, irritation or even the distention of the liver's surface. It should be remembered that apart from these, the liver is rarely tender. Then there are also various other cause of these pains and this can be due to Gallstones, which are stones that form in the gallbladder. This is a pear-shaped organ below the liver and its main function is to store and concentrate bile. These stones can occur in individuals with liver diseases and those with cirrhosis are quite prone to it. There are also various other risk factors for gallstones and these include female gender, obesity, multiple pregnancies, rapid weight loss, etc. The typical pain from gallstones in the right upper quadrant results in discomfort. This usually lasts from a half hour to six hours and this pain is severe and always recurs. It should be kept in mind that this pain often radiates to the shoulder or back and thus leads to nausea and vomiting. Remember that the diagnosis of gallstones is typically through obtaining an abdominal sonogram and thus the people with symptomatic gallstones require surgical removal of the entire gallbladder, instead of just the gallstones, which is known as a cholecystectomy, and is performed using a laparoscope. But it should be remembered that liver pain is caused due to various kinds of health problems and it is best to consult a doctor to understand the symptoms and the causes of these pains. Any delay here could be fatal and can lead to additional liver problems for you including liver cancer.

Abdominal Pain

Definition:

Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
Alternative Names:Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Acute abdomen.

Considerations:

There are many organs in the abdomen. Pain in the abdomen can originate from any one of them, including:
Organs related to digestion -- the end of the esophagus, the stomach, the small and large intestines, the liver, the gallbladder, and the pancreas.
The aorta -- a large blood vessel that runs straight down the inside of the abdomen
The appendix -- an organ in the lower right abdomen that no longer serves much function
The kidneys -- two bean shaped organs that lie deep within the abdominal cavity
The spleen -- an organ involved in blood maintenance and infection control
However, the pain may start from somewhere else -- like your chest or pelvic area. You may also have a generalized infection, such as the flu or strep throat, that affects many parts of your body.
The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or the cramping of viral gastroenteritis. On the other hand, relatively mild pain or no pain may be present with life-threatening conditions, such as cancer of the colon or early appendicitis.

Common Causes:

Many different conditions can cause abdominal pain. The key is to know when you must seek medical care right away. In many cases you can simply wait, use home care remedies, and call your doctor at a later time only if the symptoms persist.

Lower Back Pain

What is low back pain?

Low back pain can affect the back anywhere below the ribs and above the legs. The lower back is the connection between the upper and lower body, and it bears most of the body’s weight. Because of these roles, it is easily injured when you lift, reach, or twist.

Almost everyone has low back pain at one time or another. The good news is that most low back pain will go away in a few weeks with some basic self-care. But if your pain is severe or lasts more than a couple of weeks, see your doctor.

Causes Of Back Pain.

Back pain can be cause due to a number of reasons and also due to various kinds of health related factors. It has been seen that some of the back pain causes are common activities that we perform in our everyday lives and these result in some of the most suffered forms of pains. It has been seen that back pain episodes usually diminish within a few weeks if caused from muscle strain. But if these forms of pain are caused due to any other internal reasons then this backache can be amongst the most difficult and frustrating problems for patients and their doctors.

It is not very easy to understand the causes of these back pains and their occurrences but this is also the key to proper treatment because back pain is sometimes difficult to treat. Thus with a better understanding of the causes of will assist patients in their recovery and the patient can avoid the reasons that cause these pains also. It has been seen that some of the most common causes of back pain are strains in the muscles which usually cause pain in the lower back of the body.

In most of the cases the patients may or may not remember the initial event that triggered their muscle spasm but most of the times these pain fade away in a few weeks time. However this pain can re-occur if the right care and caution is not taken and hence muscle strains should be treated the right way to avoid these kinds of pains. It has also been seen that a ruptured inter-vertebral disc, which is also called a herniated disc, can be another common cause of back pain.

Also along with these forms of back pains the Disco-genic back pain is thought to be a common cause of low back pain. Basically the Disco-genic back pain is the result of damage to the inter-vertabral disc, but without disc herniation and the diagnosis of disco-genic back pain may require the use of a discogram, which also helps to treat the problem of the same. The spinal stenosis causes back pain in the aging population and hence the older age group should take special care of the same.

As the people grow older the spinal canal can become constricted and this can also be a part of arthritis and other conditions. Thus if your spinal canal becomes too tight, back pain can be the result and hence you need to keep exercising at older ages to remain fit. Another common problem that affects the joints is arthritis most commonly affects joints such as the knees and fingers. But various studies have proved that arthritis can affect any joint in the body, including the small joints of the spine and cause back pain.

Another common cause of back pain is Spondylolysis, which causes back pain because adjacent vertebra becomes unstable and begins to slip. This pain happens because of degenerative changes causing loss of the normal stabilizing structures of the spinal column and this is also one of the major causes of back pain today.

Tips on Pain Relief and Prevention:

The best position for relief when your back hurts is to lie on your back on the floor with pillows under your knees, with your hips and knees bent and your feet on a chair, or just with your hips and knees bent. This takes the pressure and weight off your back.

You may need 1 to 2 days of this sort of rest for a hurt back. Resting longer than this can cause your muscles to weaken, which can slow your recovery. Even if it hurts, walk around for a few minutes every hour.

What else can I do for relief ?

Heating pads can help to relax painful muscle spasms. Use heat for 20 to 30 minutes at a time. Ice packs and massages may also give relief.

Nonprescription medicines that reduce pain or swelling include aspirin, acetaminophen (brand name: Tylenol), naproxen (brand name: Aleve), ketoprofen (brand name: Orudis), and ibuprofen (brand name: Motrin).

Brain Injury, Brain Tumors

Head pain may indicate brain tumors or a brain injury, but in the majority of cases head pain is due to non-organic causes. Organic headaches are symptoms of a physical condition. Examples of organic head pain include meningitis, aneurysm, brain tumors, brain abscesses, and brain injury.

Only one to five percent of head pain has an organic cause, but severe or persistent head pain should never be ignored. If head pain does have an organic cause the condition is often serious enough to require immediate medical attention. Seek medical help for head pain if any of the following conditions apply.

• Head pain causes loss of balance or coordination.
  
• Headache is accompanied by mental confusion or loss of consciousness.
  
• Head pain is associated with mood swings, odd behavior, or personality changes.
  
• Headache occurs following a head or brain injury.
  
• Head pain onset is sudden, intense, and severe.
  
• Muscular weakness of numbness accompanies head pain.
  
• Previous history of head pain exists.
  
• Seizures or convulsions occur.
  
• Visual problems occur with headaches.
  
• You experience difficulty speaking or slurred speech.

Causes of Head Pain

The following conditions can all cause severe head pain, and are all considered medical emergencies. While uncommon, brain tumors, aneurysms, and other organic causes of head pain are much more serious than even the most severe non-organic types of headache.

Brain Tumors and Headaches

Not all brain tumors cause head pain. Slow-growing brain tumors may only cause dull, occasional head pain that is easily mistaken for a normal headache. Over the counter painkillers often provide relief. This makes symptoms of brain tumors easy to ignore until the tumors grow large enough to cause intracranial pressure and more severe head pain.

Rapidly growing brain tumors are characterized by a sudden onset of head pain as the tumors put pressure on the skull and surrounding brain tissue. Rapid-growth brain tumors can cause progressively worsening head pain, or head pain that is aggravated by coughing, movement, and exercise.

Head pain from brain tumors is often described as deep, steady, aching, or dull, but brain tumors rarely cause throbbing headaches. The sudden development of sharp intense head pain with no previous history of headaches suggests the possibility of a brain tumor. Other symptoms of brain tumors may include:

• difficulty speaking or swallowing
• loss of mental alertness
• mental confusion
• seizures and convulsions
• sudden loss of coordination
• unusual, "weird," or inappropriate behavior
• visual problems.

Heart Block

Introduction

Heart block is a condition where the heart beats irregularly or much more slowly than normal. Sometimes, the heart may even stop for up to 20 seconds. It is caused by a delay, or disruption, of the electrical signals that control the heartbeat.

A healthy heart beats between 60-80 times a minute. A heartbeat is when the muscles of the heart contract and push blood around the body. These muscle contractions are controlled by electrical signals that travel between the heart 's upper chambers (the atria) and lower chambers (the ventricles).

If these electrical imlegumes are delayed or stopped (partial heart block), then your heart may not beat regularly. If the electrical signals are stopped completely (complete heart block), then the heart will only beat around 40 times a minute.

Heart block reduces your heart 's efficiency in pushing blood around the body. This means that your muscles and brain may not be getting enough oxygen for them to work properly.

Types of heart block

There are three different types of heart block:

• First degree heart block (the least serious) usually refers to skipped beats, or some other kind of disruption, and often does not need treatment.
  
• Second degree heart block is where some of the electrical signals do not reach your heart , causing 'drooped' beats. It can cause dizziness and sometimes a pacemaker is needed.
  
• Third degree or complete heart block (the most serious) is when the electrical signals do not travel between the upper and lower chambers of your heart . It is most common in adults with heart disease , and can have serious complications, such as heart attack , if it is not treated with a pacemaker.

Bundle branch block/AV bundle

Heart block is also known as bundle branch block or AV bundle . This is because the electrical imlegumes that control the heart 's muscle contraction pass through what is known as the 'bundle of HIS'.

This is the part of your heart where muscle fibers are divided into a right bundle and a left bundle. Together they control the heart 's contraction and, in a normal healthy heart , both contract together.

Bundle branch block is a common condition and, in most cases, there is no obvious cause. If a signal block occurs in the right side of your heart (right bundle branch block) it is not considered a serious concern. However, if the block is in the left side (left bundle branch block) it is usually associated with an increased risk of developing a heart problem, such as coronary artery disease

Causes

Heart block is caused by damage to the tissues that pass electrical signals through your heart (right and left bundle branches). This usually occurs in older people who have had a heart disease such as:

• cardiomyopathy ( disease of the heart muscle),
• coronary thrombosis (sudden blockage in your heart 's blood vessels ),
• myocarditis ( inflammation of the muscle in the wall of the heart ), or
• valvular heart disease ( disease of the heart valves ).

Sudden complete heart block (either temporary or permanent) can also happen after a heart operation, or following a heart attack .

Heart block may also be caused by problems that have been there since birth ( congenital heart block).

Treatment

The long-term treatment for heart block is to fit a pacemaker . This is a small, battery-driven device that sends out electrical signals to keep your heartbeat regular.

Modern pacemakers are very sophisticated and some can be set to produce an electrical impulse only when one is needed. Some can even tell when the heart stops beating and produces a small electric shock to restart it. (Older pacemakers used to produce the electrical signal at a constant rate and this limited a patient's physical activity.)

Pacemakers are not affected by household appliances or any mobile technology, such as mobile phones, or personal stereos. However, a magnetic resonance imaging ( MRI ) scan should not be performed as it may interfere with a person's pacemaker.

Before having a permanent pacemaker, some people might need a temporary 'pacing wire'. The pacing wire does a similar job to a pacemaker (sending electrical signals to regulate your heartbeat) but it is inserted through a vein in your chest, or groin area.

Sometimes no treatment is recommended for heart block. This may be the case when people are elderly and the symptoms are very minor, or where people have other medical conditions that would make the operation to fit a pacemaker too dangerous.

Rheumatoid arthritis

What is Rheumatoid arthritis (RA) ?

is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks the joints producing an inflammatory synovitis that often progresses to destruction of the articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue under the skin. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in its chronicity and progression.

About 1% of the world's population is afflicted by rheumatoid arthritis, women three times more often than men. Onset is most frequent between the ages of 40 and 50, but no age is immune. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility. It is diagnosed chiefly on symptoms and signs, but also with blood tests (especially a test called rheumatoid factor) and X-rays. Diagnosis and long-term management are typically performed by a rheumatologist, an expert in the diseases of joints and connective tissues.

Various treatments are available. Non-pharmacological treatment includes physical therapy and occupational therapy. Analgesia (painkillers) and anti-inflammatory drugs, as well as steroids, are used to suppress the symptoms, while disease-modifying antirheumatic drugs (DMARDs) are often required to inhibit or halt the underlying immune process and prevent long-term damage. In recent times, the newer group of biologics has increased treatment options.

The name is based on the term "rheumatic fever", an illness which includes joint pain and is derived from the Greek word rheumatos ("flowing"). The suffix -oid ("resembling") gives the translation as joint inflammation that resembles rheumatic fever. The first recognized description of rheumatoid arthritis was made in 1800 by Dr Augustin Jacob Landré-Beauvais

What is Rheumatoid arthritis ?

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks the joints producing an inflammatory synovitis that often progresses to destruction of the articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue under the skin. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in its chronicity and progression.

About 1% of the world's population is afflicted by rheumatoid arthritis, women three times more often than men. Onset is most frequent between the ages of 40 and 50, but no age is immune. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility. It is diagnosed chiefly on symptoms and signs, but also with blood tests (especially a test called rheumatoid factor) and X-rays. Diagnosis and long-term management are typically performed by a rheumatologist, an expert in the diseases of joints and connective tissues.

Various treatments are available. Non-pharmacological treatment includes physical therapy and occupational therapy. Analgesia (painkillers) and anti-inflammatory drugs, as well as steroids, are used to suppress the symptoms, while disease-modifying antirheumatic drugs (DMARDs) are often required to inhibit or halt the underlying immune process and prevent long-term damage. In recent times, the newer group of biologics has increased treatment options.

The name is based on the term "rheumatic fever", an illness which includes joint pain and is derived from the Greek word rheumatos ("flowing"). The suffix -oid ("resembling") gives the translation as joint inflammation that resembles rheumatic fever. The first recognized description of rheumatoid arthritis was made in 1800 by Dr Augustin Jacob Landré-Beauvais.

Causes of Rheumatoid arthritis ?

The cause of Rheumatoid arthritis currently is unknown. In fact , there prbably isn't an exact cause for RA researches now are debating weather RA is one disease or several different diseases with common features.

Diagnosis of Rheumatoid Arthritis?

Physicians take many factors into account when diagnosing a patient with RA symptoms: physical exam, blood tests, and imaging. But, first, the doctor will take a medical history. According to the Arthritis Foundation, the medical history will include these questions:

• Do you have joint pain in many joints?
• Does the pain occur symmetrically-that is, do the same joints on both sides of your body hurt at the same time? Or is the pain one-sided?
• Do you have stiffness in the morning?
• When is the pain most severe?
• Do you have pain in your hands, wrists and/or feet?
• If you have pain in your hands, which joints hurt the most?
• Have you ha periods of feeling weak and uncomfortable all over? Do you feel fatigued?

Causes

As with other forms of arthritis, rheumatoid arthritis involves inflammation of the joints. A membrane called the synovium lines each of your joints. When you have rheumatoid arthritis, white blood cells — whose normal job is to attack unwanted invaders such as bacteria and viruses — move from your bloodstream into your synovium. There, these blood cells appear to play an important role in causing the synovial membrane to become inflamed.

This inflammation results in the release of proteins that, over months or years, cause thickening of the synovium. These proteins also can damage cartilage, bone, tendons and ligaments. Gradually, the joint loses its shape and alignment. Eventually, it may be destroyed.

Some researchers thinks that rheumatoid arthritis is triggered by an infection — possibly a virus or bacterium — in people with an inherited susceptibility. Although the disease itself is not inherited, certain genes that create a susceptibility are. People who have inherited these genes will not necessarily develop rheumatoid arthritis. But they may have more of a tendency to do so than others. The severity of their disease may also depend on the genes inherited.

Rheumatoid arthritis symptoms, your doctor will likely conduct a physical examination and order laboratory tests to determine if you have this form of arthritis. A blood test that indicates your erythrocyte sedimentation rate ( "seed" rate) can indicate the presence of an inflammatory process in your body. People with rheumatoid arthritis tend to have abnormally high seed rates. The seed rates in those with osteoarthritis tend to be normal.

Another blood test looks for an antibody called rheumatoid factor. Four out of five persons with rheumatoid arthritis eventually have this abnormal antibody, although it may be absent early on in the disease. It's also possible to have the rheumatoid factor in your blood and not have rheumatoid arthritis.

Doctors may take X-rays of your joints to differentiate between osteoarthritis and rheumatoid arthritis. A sequence of X-rays obtained over time can show the progression of arthritis.

Treating rheumatoid arthritis typically involves using a combination of medical treatment and self-care strategies. The following self-care procedures are important elements for managing the disease.

Exercise regularly. Different types of exercise achieve different goals. Check with your doctor or physical therapist first and then begin a regular exercise program for your specific needs. If you can walk, walking is a good starter exercise. If you can't walk, try a stationary bicycle with no resistance or do hand or arm exercise. A chair exercise program may be helpful. Aquatic exercise is another option, and many health clubs with pools offer such classes. It's good to move each joint in its full range of motion every day. As you move, maintain a slow, steady rhythm. Don't jerk or bounce. Also, remember to breathe. Holding your breath can temporarily deprive your muscles of oxygen and tire them. It's also important to maintain good posture while you exercise. Avoid exercising tender, injured or severely inflamed joints. If you feel new joint pain, stop. New pain that lasts more than 2 hours after you exercise probably means you've overdone it. If pain persists for more than a few days, call your doctor.

Control your weight. Excess weight puts added stress on joints in your neck, hips, knees and feet — places where arthritis pain is commonly felt. Excess weight can also make joint surgery more difficult and risky. Eat a healthy diet. A healthy diet emphasizing fruit, vegetables and whole grains can help you control your weight and maintain your overall health, allowing you to deal better with your arthritis. However, there is no special diet that can be used to treat arthritis. It hasn't been proven that eating any particular food will make your joint pain or inflammation better or worse. Apply heat. Heat will help ease your pain, relax tense, painful muscles and increase the regional flow of blood. One of the easiest and most effective ways to apply heat is to take a hot shower or bath for 15 minutes. Other options include using a hot pack, an electric heat pad (set on its lowest setting) or a radiant heat lamp with a 250-watt reflector heat bulb to warm specific muscles and joints. If your skin has poor sensation or if you have poor circulation, don't use heat treatment.

Coping Skills The degree to which rheumatoid arthritis affects your daily activities depends in part on how well you cope with the disease. Physical and occupational therapists can help you devise strategies to cope with specific limitations you experience as the result of weakness or pain. Here are some general suggestions to help you cope:

Keep a positive attitude. With your doctor, make a plan for managing your arthritis. This will help you feel in charge of your disease. Studies show that people who take control of their treatment and actively manage their arthritis experience less pain and have less difficulty functioning. Use assertive devices. A painful knee may need a brace for support. You also might want to use a cane to take weight off the joint as you walk. The cane should be used in the hand opposite the affected joint. If your hands are affected, various helpful tools and gadgets are available to help you maintain an active lifestyle. Contact your pharmacy or health care provider for information on ordering items that may help you the most. Know your limits. Rest when you're tired. Arthritis can make you prone to fatigue and muscle weakness — a deep exhaustion that makes everything you do a great effort. A rest or short nap that doesn't interfere with nighttime sleep may help.

Avoid grasping actions that strain your finger joints. Instead of using a clutch purse, for example, select one with a shoulder strap. Use hot water to loosen a jar lid and pressure from your palm to open it, or use a jar opener. Don't twist or use your joints forcefully. Spread the weight of an object over several joints. For instance, use both hands to lift a heavy pan.

Take a break periodically to relax and stretch. Maintain good posture. Poor posture causes uneven weight distribution and may strain ligaments and muscles. The easiest way to improve your posture is by walking. Some people find that swimming also helps improve their posture. Use your strongest muscles and favor large joints. Don't push open a heavy glass door. Lean into it. To pick up an object, bend your knees and squat while keeping your back straight.

Self Care

Treating rheumatoid arthritis typically involves using a combination of medical treatment and self-care strategies. The following self-care procedures are important elements for managing the disease.

Exercise regularly. Different types of exercise achieve different goals. Check with your doctor or physical therapist first and then begin a regular exercise program for your specific needs. If you can walk, walking is a good starter exercise. If you can't walk, try a stationary bicycle with no resistance or do hand or arm exercise. A chair exercise program may be helpful. Aquatic exercise is another option, and many health clubs with pools offer such classes. It's good to move each joint in its full range of motion every day. As you move, maintain a slow, steady rhythm. Don't jerk or bounce. Also, remember to breathe. Holding your breath can temporarily deprive your muscles of oxygen and tire them. It's also important to maintain good posture while you exercise. Avoid exercising tender, injured or severely inflamed joints. If you feel new joint pain, stop. New pain that lasts more than 2 hours after you exercise probably means you've overdone it. If pain persists for more than a few days, call your doctor.

Control your weight. Excess weight puts added stress on joints in your neck, hips, knees and feet — places where arthritis pain is commonly felt. Excess weight can also make joint surgery more difficult and risky. Eat a healthy diet. A healthy diet emphasizing fruit, vegetables and whole grains can help you control your weight and maintain your overall health, allowing you to deal better with your arthritis. However, there is no special diet that can be used to treat arthritis. It hasn't been proven that eating any particular food will make your joint pain or inflammation better or worse. Apply heat. Heat will help ease your pain, relax tense, painful muscles and increase the regional flow of blood. One of the easiest and most effective ways to apply heat is to take a hot shower or bath for 15 minutes. Other options include using a hot pack, an electric heat pad (set on its lowest setting) or a radiant heat lamp with a 250-watt reflector heat bulb to warm specific muscles and joints. If your skin has poor sensation or if you have poor circulation, don't use heat treatment.

Coping Skills The degree to which rheumatoid arthritis affects your daily activities depends in part on how well you cope with the disease. Physical and occupational therapists can help you devise strategies to cope with specific limitations you experience as the result of weakness or pain. Here are some general suggestions to help you cope:

Keep a positive attitude. With your doctor, make a plan for managing your arthritis. This will help you feel in charge of your disease. Studies show that people who take control of their treatment and actively manage their arthritis experience less pain and have less difficulty functioning. Use assertive devices. A painful knee may need a brace for support. You also might want to use a cane to take weight off the joint as you walk. The cane should be used in the hand opposite the affected joint. If your hands are affected, various helpful tools and gadgets are available to help you maintain an active lifestyle. Contact your pharmacy or health care provider for information on ordering items that may help you the most. Know your limits. Rest when you're tired. Arthritis can make you prone to fatigue and muscle weakness — a deep exhaustion that makes everything you do a great effort. A rest or short nap that doesn't interfere with nighttime sleep may help.

Avoid grasping actions that strain your finger joints. Instead of using a clutch purse, for example, select one with a shoulder strap. Use hot water to loosen a jar lid and pressure from your palm to open it, or use a jar opener. Don't twist or use your joints forcefully. Spread the weight of an object over several joints. For instance, use both hands to lift a heavy pan.

Take a break periodically to relax and stretch. Maintain good posture. Poor posture causes uneven weight distribution and may strain ligaments and muscles. The easiest way to improve your posture is by walking. Some people find that swimming also helps improve their posture. Use your strongest muscles and favor large joints. Don't push open a heavy glass door. Lean into it. To pick up an object, bend your knees and squat while keeping your back straight.

Rheumatoid Arthritis Treatment

by Alan K. Matsumoto, M.D. , Joan Bathon, M.D. and Clifton O. Bingham III, M.D.

Rheumatoid arthritis is a chronic disorder for which there is no known cure. Fortunately in the last few years, a shift in strategy toward the earlier institution of disease modifying drugs and the availability of new classes of medications have greatly improved the outcomes that can be expected by most patients. The goal of treatment now aims toward achieving the lowest possible level of arthritis disease activity and remission if possible, the minimization of joint damage, and enhancing physical function and quality of life. The optimal treatment of RA requires a comprehensive program that combines medical, social, and emotional support for the patient. It is essential that the patient and the patient’s family be educated about the nature and course of the disease. Strategies are all aimed at reducing pain and discomfort, preventing deformities and loss of joint function, and maintaining a productive and active life. Inflammation must be suppressed and mechanical and structural abnormalities corrected or compensated by assistive devices. Treatment options include medications, reduction of joint stress, physical and occupational therapy.