An Anti-Inflammatory Lifestyle And Its Benefits

Anti-inflammatory simply refers to the component of a treatment or feature of a substance that is used in the management of inflammation or to reduce swelling. Anti-inflammatory meaning anti-inflammatory drugs to a lot of people make up the majority of the analgesics available, this group of drugs helps to relieve pain by reducing the ongoing inflammatory process as opposed to the opioids that relieve pain by acting on the central nervous system to block the pathway of pain directly (1).

Osteoarthritis disease may be more common among people who do not lead an anti-inflammatory lifestyle when young and hence experience health issues in their mature years. An anti-inflammatory lifestyle also includes healthy foods, such as anti inflammatory omega 3.

Types And Examples Of Anti-inflammatory Lifestyle

Anti-inflammatory is not limited to only anti-inflammatory drugs only, other things can serve as anti-inflammatory functions. These are:

1. 1. Anti-inflammatory medicines
2. 2. Anti-inflammatory foods
3. 3. Anti-inflammatory exercises
4. 4. Anti-inflammatory supplements

1. Anti-inflammatory medicines to reduce inflammation

Anti-inflammatory meaning anti-inflammatory drugs are medications that help to reduce inflammation, they are popularly referred to as NSAIDs, meaning non-steroidal anti-inflammatory drugs, which are drugs that when taken function to help relieve pain and reduce associated edema and swelling (7).

Common examples are aspirin diclofenac and COX-2 inhibiting drugs such as celecoxib. Studies reveal that millions of people use NSAIDs daily to help relieve pain, especially headaches, swelling of body parts from inflammation, and elevated body temperature (6).

Most Common Examples Of Nsaids

There are three commonly used non-steroidal anti-inflammatory drugs. These are:

• – Aspirin: Aspirin is a commonly used NSAID that can be used solely or combined with other agents. Some brands that used it solely are Byer or St. Joseph. And brands that used them in combination such as Ascriptin, Anacin, and Excedrin (6).
• – Ibuprofen: Ibuprofen is another popular NSAID used generally, some brand examples are Motrin and Advil
• – Naproxen sodium: A popular brand of naproxen sodium is Aleve (6).

Classification Of Non-Steroidal Anti-Inflammatory Drugs

Anti-inflammatory meaning NSAIDs commonly can be classified according to their structure chemically, and their selectivity.

• – Acetylated salicylates: such as aspirin
• – Non-acetylated salicylates: examples are the salsalate and diflunisal
• – Propionic acids: examples are naproxen and ibuprofen
• – Acetic acids: common examples are diclofenac and indomethacin
• – Others are enolic acids with examples such as meloxicam, and anthranilic acids such as mefenamic acid (9).

According To Specificity

The non-steroidal anti-inflammatory drugs NSAIDs prevent the production of prostaglandins by the enzyme cyclooxygenase (COX). COX-1 and COX-2 are the two forms of COX that your body makes. The majority of the NSAIDs are not specific, this translates to the blocking of both cyclooxygenase 1 and cyclooxygenase 2 (COX-1 and COX-2). COX-1 is responsible for stomach mucosal protection, while COX-2 induces inflammation (8).

The availability of NSAIDs over the counter most of the time is dependent on their specificity, for example, in the united states, some non-specific medications can be gotten over the counter, while others will require a prescription from a doctor before they can be dispensed. Similarly, this also goes for the specific NSAIDs

The following are some examples of nonspecific NSAIDs that can be gotten over the counter in the united states,

• – Ibuprofen( motrin and advil)
• – Aspirin in highdose
• – Naproxen sodium ( brands like aleve and naprosyn) (8).

Other NSAIDs are nonspecific and cannot be dispensed in the united states unless there is a doctor’s prescription, examples of this group are:

• – Diclofenac, a branded example is zorvolex
• – Indomethacin, brand such as tivorbex
• – Diflunisal
• – Etodolac
• – Mefenamic acid, a brand such as ponstel.
• – Other common examples of prescriptive non-specific NSAIDs are ibuprofen, flurbiprofen, sulindac, and nabumetone (8).
• – Selective cyclooxygenase-2 inhibitors are a group of NSAIDs that block more of the cyclooxygenase-2 than cyclooxygenase-1. in the united states, celecoxib (Celebrex), is the only prescriptive COX-2 inhibitor available (8).

Mechanism Of Action Of Non-Steroidal Anti-Inflammatory Drugs

The primary mode of action of NSAIDs is by blocking the production and secretion of certain chemicals in the body that is responsible for the process of inflammation. Anti-inflammatory meaning NSAIDs are mostly good for the treatment of pain that occur as a result of damage to the soft tissues in the body, as in arthritis.

Additionally, NSAIDs also do part of the work of a steroid without exposing the patient to the side effects, and just as steroids are used in reducing edema and inflammations, NSAIDs also act similarly to help reduce pain and swelling in body tissues, especially around joints and muscles (6).

Indications For The Use Of Nsaids

Anti-inflammatory meaning NSAIDs are commonly used for quite a several clinical conditions, especially diseases of the joints. The following are some of the conditions that will require the use of NSAIDs:

• – Inflammation of the joint, arthritis
• – Osteoarthritis
• – Rheumatoid arthritis
• – Gout
• – Toothache
• – Backpain
• – Headache
• – Myalgia
• – Tendonitis
• – Dysmenorrhea, painful menstruation
• – Fever
• – Autoimmune diseases (6).

NSAIDs are available in different forms, they are available in form of tablets, suppositories, and tablets. Other forms in which NSAIDs are available are in sprays, creams, and liquids (7).

What Are The Side Effects Of Nsaids?

There is simply no drug without its side effects, as much as NSAIDs are very versatile in the treatment of various diseases, it also has their side effects which are quite a number. Below are some of the side effects of NSAIDs:

• – Gastric side effects: most of the side effects of NSAIDs are usually a result of the inhibition of COX-1, and COX-1 is the enzyme responsible for the inhibition of gastric mucosa protection by prostaglandins, and this damage is more severe in patients that have the previous history of peptic ulcer disease, therefore, NSAIDs which are COX-2 selective or specific will be more beneficial for this group of the patient (9).
• – Hepatic side effects: diclofenac is the medicine with the higher risk of hepatotoxicity among the drugs belonging to NSAIDs, other medicines here are not usually hepatotoxic and hospital admission on account of liver damage is not common as well
• – Renal side effects: the renal adverse effect is common among patients that have an underlying renal pathology or electrolytes imbalances, usually, NSAIDs will cause a reduction in the level of prostaglandins, and these prostaglandins are responsible for maintaining good renal hemodynamics, so when the levels are reduced in a known kidney disease, it accelerates further complications. Examples of such complications are acute kidney injury, nephrotic syndrome, and electrolyte imbalances. Others are interstitial nephritis, and renal artery stenosis (9).
• – Cardiovascular side effects: the use of NSAIDs increases the risk of cardiovascular disorders such as acute myocardial infarction, embolic events, thrombosis, and atrial flutters and fibrillations. Diclofenac has been recorded as the NSAID with the highest cardiovascular risk

Other common side effects are chest pain, abdominal discomfort, nausea, and vomiting (9).

2. Foods for Anti-Inflammatory Lifestyle

Anti-inflammatories are not limited to just medicines, anti-inflammatory food is also very important, with adequate consumption of the right anti-inflammatory foods, the immune system gets adequate stimulation to fight against any pathogenic microorganisms when they come in contact with the body. Anti-inflammatory foods are also very important to combat severe inflammation that persists for a long time even without a foreign pathogen.

Some of the non-communicable diseases, such as diabetes mellitus, cancer, and heart diseases, that affect the body system have been linked to chronic inflammation, and all of these are controllable with diet. Hence, another reason why anti-inflammatory foods are very important (2).

Several epidemiological studies have revealed that processed foods may lead to obesity and promote inflammation in the body. Examples of these inflammatory foods are red meat, processed and fried foods. An anti-inflammatory diet contains plant-based foods, such as fruits and vegetables and omega-3 fatty acids. A good example of such diet is Mediterranean diet that also contains omega-3 and turmeric.

Examples Of Anti-Inflammatory Foods

Studies reveal that some foods can help to alter inflammatory processes, especially chronic inflammation. Below are examples of some anti-inflammatory foods available:

1. 1. Fatty fish

Fatty fish is one of the most commonest and good sources of protein and fatty acids, especially the long-chain fatty acids such as anti-inflammatory omega 3 fatty acids, eicosapentaenoic acid, and another fatty acid component in fatty fish is docosahexaenoic acid. It is good that the anti-inflammatory omega3 fatty acid is a component of almost all kinds of fish but some fatty fish contain it the most examples of such are:

• – Sardines
• – Herring
• – Mackerel
• – Others are salmon and anchovies (11).

Anti-inflammatory omega 3 is a form of healthy fat seen in food that helps to build the body and also help to maintain an overall health. One of the best benefits of anti-inflammatory omega 3 is in the treatment and prevention of inflammation (4) and cardiovascular disease. Aside from the inflammation function, they also help to keep the body organs in good shape and set the immune system on alert to help fight invading pathogens (5).

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), helps to prevent and alter chronic inflammatory processes that can lead to further complications such as diabetes mellitus, chronic kidney diseases, and metabolic syndrome. When these fats are consumed, they are broken down by the body into smaller components called resolvins and protectins, and they function basically as anti-inflammatory substances (3).

Studies reveal that individuals that consume the anti-inflammatory omega 3 fatty acids, salmon fish, and docosahexaenoic acid have the health benefit of reduction in their inflammatory markers levels such as CRP (C-reactive protein), and ESR (erythrocyte sedimentation rate) in addition to reduced risk of cardiovascular disease(11).

2. 2. Berries

Berries are fruits that are rich in minerals, vitamins, and fibers. There are different kinds of fibers such as strawberry, blueberry, blackberry, and lots more. Berries are rich in antioxidants named anthocyanins, and one unique advantage of anthocyanin is that it contains compounds that perform anti-inflammatory functions. Studies have revealed that individuals that eat blueberries have high production of natural killer cells (NK cells) compared to others not consume the powder (11).

Other anti-inflammatory foods are:

• – Fruits
• – Green vegetables
• – Nuts (like walnut)
• – Whole grain meals
• – Tomatoes (12).

3. Exercises for Anti-Inflammatory Lifestyle

Just like medicine and food, anti-inflammatories also include exercises in relieving the symptoms of inflammation. Especially inflammation that affects the joints and muscles, and studies reveal that regular exercise is one of the main components of altering the inflammation process, in cases of joint inflammations like osteoarthritis, anti-inflammatory meaning NSAIDs are sometimes combined with exercises as prescribed by the physician and physical therapist to prevent stiffness of the joints. The following are examples of the best exercise to tackle inflammation:

• – Walking

As easy as it sounds, walking is one of the easiest ways to tackle inflammation, especially inflammation affecting the joints. and the easiest way to exercise the body as well. Walking as low as a twenty-minute walk a day can lower inflammatory processes, a simple walk outside the house or walk around the garden will do a lot to benefit the body and inflammatory sites (13).

• – Strength training

Strength training is one of the key exercises to protect the body against inflammation, it is majorly an anti-inflammatory serving as a prophylaxis. Either heavy or light weight lifting, it does a lot of good to the body to slow down inflammatory processes, it is associated with the release of cytokines and growth hormones as well as reducing the risk of the body to chronic inflammation predisposed chronic diseases such as hypertensive heart diseases, diabetes mellitus, and cancers (14).

• – Yoga

Yoga is more than just body motion exercise and impressing the viewers, studies have revealed a lot of benefits that can be gotten from yoga exercise. Apart from its fitness benefits, yoga has been found to confer anti-inflammatory benefits, it can help to reduce chronic inflammatory processes that predispose individuals to chronic diseases such as heart diseases, rheumatoid arthritis, and metabolic disorders.

Yoga instructors reveal that breathing in and out during yoga exercises helps to send a signal to the parasympathetic nervous system of the brain which in turn helps to control stress and down-regulate ongoing inflammatory processes in the body. It is therefore good to practice yoga for these benefits and also to calm the body (14).

4. Supplements to fight Inflammation

Anti-inflammatory meaning actions against inflammation are not limited to medicines, exercises, and foods alone, there are tested and trusted supplements that are recommended to help combat inflammatory processes in the body. The following are the best supplements for inflammation, especially inflammations affecting the joints of the body:

• – Glucosamine

Glucosamine has been identified as one of the best anti-inflammatory supplements against joint inflammation. They help to keep the joint cartilage healthy and reduce the pain experienced during arthritis of the joint. Glucosamine is also more important in the elderly because the level tends to decrease as one grows old.

• – Omega 3 fatty acids

Anti-inflammatory omega 3 fatty acids supplements have been shown to contain substances that help to decrease the production and secretion of inflammatory chemicals, especially in rheumatoid arthritis.

• – Green tea

Studies have revealed that green tea is made up of substances that perform anti-inflammatory function in helping to combat inflammation as well as joint pain in inflammations of the knee. Green tea also contains anti-oxidant properties (10).

References:

1. 1. https://en.wikipedia.org/wiki/Anti-inflammatory
2. 2. https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
3. 3. https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00122/full#:~:text=Omega%2D3+polyunsaturated+fatty+acids+(n%2D3+PUFAs),are+collectively+named+specialized+pro%2D
4. 4. https://www.healthline.com/nutrition/17-health-benefits-of-omega-3
5. 5. https://www.webmd.com/healthy-aging/omega-3-fatty-acids-fact-sheet
6. 6. https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids
7. 7. https://www.healthdirect.gov.au/anti-inflammatory-medicines
8. 8. https://www.healthline.com/health/pain-relief/otc-anti-inflammatories#uses
9. 9. https://www.ncbi.nlm.nih.gov/books/NBK547742/#:~:text=NSAIDs+are+typically+divided+into,meloxicam%2C+piroxicam)+anthranilic+acids+(
10. 10. https://www.webmd.com/arthritis/arthritis-guide#:~:text=Some+people+use+supplements+to,just+a+few+of+them.&text=Glucosamine+has+been+touted+as,the+cartilage+in+joints+healthy.
11. 11. https://www.healthline.com/nutrition/13-anti-inflammatory-foods#TOC_TITLE_HDR_4
12. 12. https://www.webmd.com/diet/anti-inflammatory-diet-road-to-good-health
13. 13. https://www.eatingwell.com/article/7677835/5-exercises-you-can-do-at-home-to-reduce-inflammation/
14. 14. https://www.realsimple.com/anti-inflammatory-exercise-6754728

Causes, Symptoms, Risk-Factors and Treatments For Rheumatoid Arthritis Pain

Rheumatoid arthritis is a type of autoimmune disease in which the body’s immune system is attacking normal body tissues, particularly tissues that line the joint bilaterally. Rheumatoid arthritis is not limited to the joints alone, it can also affect some other systems of the body.

Studies have revealed that the actual cause of this autoimmune disease is not known yet, however, there are treatment options available for its management both medical treatment and lifestyle changes (1).

What Is Rheumatoid Arthritis?

Rheumatoid arthritis is defined as a chronic inflammatory autoimmune disease characterized by symmetrical migratory polyarthritis that usually affects the hands and the feet. It is a systemic disease and usually leads to inflammation of the synovial membrane causing synovitis.

Rheumatoid arthritis can affect any joint so long the joint is lined by a synovial membrane. Being a systemic disease, it can affect other organs and systems of the body such as the heart, the eyes, and the skin. The flare usually more when it is affecting individuals with a family history or genetic susceptibility (2).

What’s Rheumatoid Factor?

Rheumatoid arthritis cannot be discussed without mentioning the rheumatoid factor. A rheumatoid factor test is a blood test usually carried out to determine the amount of rheumatoid factor present in the body.

An individual with an autoimmune disease will demonstrate a high level of rheumatoid factor in their bloodstream which does not automatically mean rheumatoid arthritis, a patient with another autoimmune disease such as Sjogren’s syndrome will also have elevated rheumatoid factor (3).

The Normal Joint Physiology

To understand what is happening in a joint with rheumatoid arthritis, it is also important to understand how normal joint works and what in a normal joint gets affected by rheumatoid arthritis.

The position where two or more bones meet is referred to as a joint. The presence of joints in the body permits us to move in different directions either laterally, medially, internally rotation or externally rotation, the knee joint for instance is one of the physiologically important joints in the body because it helps to bear the weight of the body, and it helps to stand properly.

The distal part of each bone is covered by cartilage, a tissue made up of smooth surfaces that help to keep the joints in place, and also permits movement without friction. In between the joint is the synovium which contains the synovial fluid, a thick slippery fluid that protects the joint. There is also the presence of tendons that helps to attach the bones to the muscles (4).

Pathophysiology Of Rheumatoid Arthritis

The pathophysiology of rheumatoid arthritis is still been studied according to researchers as it is currently not understood. In the presence of genetic susceptibility, the presence of a trigger such as infection or smoking will lead to an autoimmune reaction.

This autoimmune reaction will furthermore manifest as inflammation of the synovium and other joint tissues with other systemic manifestations.

Before full-blown rheumatoid arthritis occurs, there is a pre-rheumatoid phase of the disease that gradually progresses in different phases to actual and active rheumatoid arthritis.

In conclusion, chronic inflammation and hypertrophy of the synovium will lead to tissue destruction as well as the cartilage, ligaments, tendons, and vascular structures. Although the articular structures above are the primary areas of attack by rheumatoid arthritis, rheumatoid arthritis also affects other tissues (2).

Comparison Between Rheumatoid Arthritis And Other Articular Diseases

Rheumatoid arthritis should be compared with other articular diseases such as osteoarthritis and lupus for better understanding.

• – Rheumatoid arthritis vs lupus

Rheumatoid arthritis and lupus are commonly confused or misdiagnosed one for one because of their similarity in clinical manifestations. Rheumatoid arthritis and lupus are both types of autoimmune diseases in that they result from the body’s immune system attacking its normal cells.

The clinical features of rheumatoid arthritis and lupus often mimic each other. Symptoms like pain, joint stiffness, and swelling are not severe in patients with lupus and they occur slowly.

However, to differentiate lupus from rheumatoid arthritis, there are certain symptoms patients manifest that are specific to lupus alone, such as the butterfly rash also called malar rash, ulcers, skin rashes, low white blood cell count, and others.

Interestingly, both rheumatoid arthritis and lupus have no cure but they can be managed symptomatically for patient tolerance (5).

• – Rheumatoid arthritis vs osteoarthritis hand

A lot of studies have been ongoing comparing the manifestations of rheumatoid arthritis and osteoarthritis in the hand joints. Rheumatoid arthritis is a chronic autoimmune disease while osteoarthritis is an articular disease of wear and tear that occur as a result of joint overuse.

Studies have revealed that the metacarpophalangeal joint of the big finger in the hand is commonly affected in patients with rheumatoid arthritis. These patients are commonly present with swelling and stiffness of the joint.

In rheumatoid arthritis of the hand, distal interphalangeal joints of the hand and toes are usually spared. When rheumatoid arthritis is the joint junction between the ulnar and radius bone it usually manifests as wrist pain and tenderness. Rheumatoid arthritis has a predisposition to affecting the small joints first.

Unlike rheumatoid arthritis, osteoarthritis has an initial target for the big joints of the body. When the hand is affected, the index finger and the thumb are commonly affected. To studies, a patient who complains about osteoarthritis in the hand mostly complains of the affectation in their dominant hand (6).

Causes Of Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune disease that occurs as a result of the body’s immune system affecting its normal cells. However, the specific etiology of rheumatoid arthritis is not yet known.

In rheumatoid arthritis, inflammatory cells are sent by the immune system to the joint lining and other systemic areas of the body. The antibodies released caused the disintegration of the synovial cells and consequently led to inflammation. There is a release of chemical substances that will lead to the destruction of the cartilage, tendons, and ligaments.

If rheumatoid arthritis is not managed thoroughly early, it can lead to total joint destruction and misalignment of the joint (7).

Risk Factors Of Rheumatoid Arthritis

The following factors will increase the risk of predisposition to rheumatoid arthritis:

• – Age: anyone at any age is at risk of rheumatoid arthritis irrespective of the age of the individual. But commonly, it is commoner in the middle age group.
• – Sex: rheumatoid is more commoner in women than in the male gender.
• – Family history: family history is another strong risk factor for developing autoimmune disease. The presence of rheumatoid arthritis in any member of the family, especially the first-degree relatives is a risk factor for developing rheumatoid arthritis.
• – Smoking: Smoking cigarette increases the likelihood of developing rheumatoid arthritis, especially in people that are genetically predisposed to RA. Smoking also causes poor prognosis in such patients.
• – Obesity: being overweight or obese increases the risk of rheumatoid arthritis. Obesity is an associated high-risk factor for articular diseases (8).
• – Diet: excessive consumption of a diet rich in sugar, sodium, and red meat increases the risk of rheumatoid arthritis. Iron has also been traceable to the development of rheumatoid arthritis.
• – Early exposure: early exposure to triggers such as smoking in nursing mothers makes their children passive smokers, according to the center for disease control (CDC), such early exposure increases the risk of rheumatoid arthritis (7).

Joints Commonly Affected By Rheumatoid Arthritis

The following joints of the body are commonly affected in patients with rheumatoid arthritis and the patient can feel pain in the following areas:

• – Hands
• – Fingers
• – Toes
• – Feet
• – Elbow
• – Others are wrists, knees, and ankles (1).

Other areas of the body aside from joints affected by rheumatoid arthritis are:

• – Heart
• – Lungs
• – Eyes
• – Skin
• – Others are kidneys, vascular tissues, and salivary glands (8).

Rheumatoid Arthritis Elbow

Just as in other joints of the body, rheumatoid arthritis elbow joint will lead to the progressive and slow destruction of the joint tissues. In certain individuals, rheumatoid arthritis elbow manifests as a bulge-like swelling around the elbow due to the chronic effect of the inflammation on the joint.

When the first joint to be affected is the elbow, then the pain will start from the elbow joint progressively affecting other joints of the body such as the toes, hands, hip, and knee joint.

When the diagnosis is picked early, it will lead to rapid inflammation of the elbow joint tissues such as the synovium and the bursa causing synovitis and bursitis, which occurs when the fluid pads in the joints get inflamed. Continuous and uncontrolled edema from inflammation can cause the nerves around the joint to be compressed (9).

Symptoms Of Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disease, hence, common symptoms seen in the patients are the signs of inflammation and pains around the joint.

The symptoms reach the peak when the patient has flares and they subside or fade off in the time of remission when the patient is currently not under any attack.

Symptoms are commonly affected in joints of the wrists, hands, toes, and knee joints. Also, other tissues of the body can be affected such as the heart, the skin, the lungs, and the eyes (7).

The following are the main symptoms commonly manifested by patients with rheumatoid arthritis:

• – Joint pain
• – Edema of the joint
• – Joint redness
• – Differential warmth of the affected joint
• – Joint stiffness is worse after waking up from bed and can last for up to 30 minutes.
• – Joint/bone deviation, is commonly recorded in the ulnar bone. Rheumatoid arthritis ulnar deviation is characterized by the bending of fingers to the lateral side facing the pinky finger and the wrist towards the thumb.

Other symptoms experienced by people with rheumatoid arthritis are:

• – Fatigues, demonstrated by extreme tiredness and generalized body weakness
• – Anorexia, lack of appetite
• – Weight loss
• – Hyperpyrexia, a very high fever
• – Excessive sweating
• – Eye dryness, usually from inflammation
• – Chest pain
• – Rheumatoid nodules, this is a form of lump usually seen under the skin of the affected joints. Although not always painful, some patients elicit tenderness on palpation of the nodules.
• – Most often than not, when rheumatoid arthritis occurs, it is usually bilaterally more than just one part of the body, although not all the time (4).

Diagnosis Of Rheumatoid Arthritis

As much treatment is important in making a patient with rheumatoid arthritis feel better, it is also important to make a good diagnosis that will guide the treatment. A specialized physician called a rheumatologist is often in charge of caring for patients with rheumatoid arthritis.

Diagnosis entails a detailed medical history, examination, laboratory, and imaging studies.

• – Medical history: A detailed history of the joint symptoms is very important when it started if it is recurrent, the level of severity of the pain, what the patient has done to get relieved the pain, and if there is a family history of similar symptoms in the family or a family history of rheumatoid arthritis.
• – Examination: On examination, the doctor can notice swelling around the joint, the presence of differential warmth or redness, difficulty moving the limbs, and tenderness of the joint on palpation.
• – Blood tests: blood tests are usually done to check for antibodies, infectious agents, and the presence of rheumatoid factor to further ascertain the diagnosis. The following blood tests are done:

1. a) Rheumatoid factor: rheumatoid factor is commonly seen in a patient with rheumatoid arthritis and other autoimmune diseases. Another type of antibody commonly seen is a cyclic citrullinated peptide in the majority of patients with rheumatoid arthritis.
2. b) ESR (Erythrocyte sedimentation rate): ESR is usually done to confirm the presence of an ongoing inflammatory process. C-reactive protein can also be done alongside ESR still for the same purpose.

• – Imaging studies: this includes an x-ray, CT scan, or MRI. These tests are usually done to check the bones, joints, and surrounding soft tissues. Erosion is the major usually checked for. Rheumatoid arthritis x ray hand will show the affected small joints, and how bad it is and can also help to know when the treatment is winning (10).

7 Treatments For Rheumatoid Arthritis Pain

The treatments for rheumatoid arthritis symptoms include the use of medication and lifestyle changes. People with RA have the option to first try diet and lifestyle changes to reduce pain and rheumatoid arthritis symptoms at their own. If pain relief is not experienced, they may want to see a licensed physician for prescription medicines that may help reduce pain and stiffness associated with joint damage.

Medications

In the treatment of rheumatoid arthritis, the physician will use some or most of these medications in the management of the patient:

1. 1. Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are commonly used with caution and prescription in rheumatoid arthritis patients in the treatment of pain and inflammatory symptoms.
2. 2. Steroids: steroids can also be prescribed by the doctor to treat pain and reduce the symptoms felt by the patient.
3. 3. (DMARDs): DMARDs is an acronym for disease-modifying antirheumatic drugs. The drug works by reducing the disease progression of rheumatoid arthritis and they can do this by inhibiting the immune response of the body.
4. 4. Biologics: Biologics are new generational drugs often referred to as modified DMARDs. Instead of blocking the immune system of the patient like DMARDs will do, biologics work against inflammation by slowing down the systemic inflammatory reaction.

Lifestyle changes

The following lifestyle changes will help to improve the quality of life of patients with rheumatoid arthritis:

5. Exercise as recommended by an Occupational Therapist. Proper rest.

6. Anti-inflammatory diets such as foods rich in omega-3 fatty acids to reduce inflammation.

7. Hot or cold compress as prescribed by the physician, similar to occupational therapy (7).

References:

1. 1. https://my.clevelandclinic.org/health/diseases/4924-rheumatoid-arthritis
2. 2. https://emedicine.medscape.com/article/331715-clinical
3. 3. https://www.mayoclinic.org/tests-procedures/rheumatoid-factor/about/pac-20384800
4. 4. https://www.versusarthritis.org/about-arthritis/conditions/rheumatoid-arthritis/
5. 5. https://www.webmd.com/rheumatoid-arthritis/ra-lupus-difference
6. 6. https://www.medicinenet.com/rheumatoid_arthritis_vs_osteoarthritis_hands/article.htm
7. 7. https://www.healthline.com/health/rheumatoid-arthritis#diet
8. 8. https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648
9. 9. https://www.healthline.com/health/advancing-rheumatoid-arthritis/rheumatoid-arthritis-in-elbow#impact-on-elbow
10. 10. https://www.arthritis.org/diseases/rheumatoid-arthritis

Natural Treatments For Fibromyalgia

Fibromyalgia is also known as chronic general (widespread) body pain. Fibromyalgia also presents with sleep problems or insomnia, weakness, and extreme sensitivity to pain. It can also be referred to as Fibromyositis, Fibrositis, or Fibromyalgia Syndrome (FMS). Fibromyalgia is a compound term derived from a Latin word (‘fibro-’) and two Greek words (‘myo-’ and ‘algia’). ‘Fibro-’ means fibrous tissues. ‘Myo-’ means muscle and ’algia’ means pain. Thus, the term ‘Fibromyalgia’ literally means fibrous tissues and muscle pain.

Prevalence of Fibromyalgia

Centers for Disease Control and Prevention (CDC) estimates that Fibromyalgia Syndrome affects 4 million United States adults; this amount is about 2% of the adults.[1] Fibromyalgia affects more women than men. Fibromyalgia, its likely causes, and various treatments are thoroughly explained further in this article.

What are the Symptoms of Fibromyalgia?

People diagnosed with Fibromyalgia may have diverse symptoms. The most usual symptoms are;

• – Widespread pain, headache, and stiffness.
• – Sleep problems or Insomnia.
• – General body weakness (fatigue).
• – Cognitive disruptions such as Inattention, poor memory, and mental dullness.
• – Depression and anxiety.

Other symptoms include;

• – Gastrointestinal problems such as stomachache, constipation, and bloating.
• – Temporomandibular Joint Dysfunction or TMJ syndrome (Pain in the jaw joint and surrounding muscles).
• – Tingling and numbing sensations of the peripheries (the hands and feet).

How do I find out if I have Fibromyalgia?

There are no particular laboratory tests or scans to diagnose Fibromyalgia currently. If you suspect you have Fibromyalgia, you may need to see several doctors. Your doctor (based on familiar experiences) may diagnose Fibromyalgia as a result of your major symptoms along with other symptoms.

Other doctors may conclude on Fibromyalgia based on the established criteria by the American College of Rheumatology for diagnosing Fibromyalgia: pain and symptoms for over one week (based on the number of tender points among 19 parts of the body), the level of tiredness severity, cognitive problems and waking unrefreshed, symptoms lasting 3 months or more at the same level and ruling out of other health problems that may mimic pain and some other symptoms.[2]

Is there chronic pain or chronic fatigue associated with fibromyalgia? Chronic fatigue syndrome has been observed in clinical trial associated with fibromyalgia However, you may benefit more from a Rheumatologist (a doctor who specializes in musculoskeletal conditions) to reduce pain associated with fibromyalgia. Using your intensive history taking, the knowledge of all the symptoms you experience, and ruling out other related health issues, they may be able to diagnose Fibromyalgia.

What causes Fibromyalgia Pain?

The cause of Fibromyalgia is unknown. However, scientists have said that it may be a result of the unusual processing of pain signals even in the absence of pain stimuli. Usually, pain may result from known causes such as injuries and diseases.

In individuals with Fibromyalgia, however, pain does not result from direct causes but from abnormal pain signals processing. The fact that there is no direct pain cause, makes Fibromyalgia Syndrome chronic and difficult to cure. However, Fibromyalgia patients benefit from some medications and lifestyle changes (such as practicing Fibromyalgia Yoga, getting sufficient sleep, and stress management). Examples of lifestyle changes that can be adopted, as well as examples of Fibromyalgia Yoga are soon stated in this article.

The presence of certain genes occurs commonly amongst Fibromyalgia patients. Due to this, some researchers also presume that these genes may cause Fibromyalgia patients to unusually process stimuli that are not painful to others. Many other scientists are looking at possibilities of problems with how the brain and spinal cord process pain. Many researchers have linked Fibromyalgia to some illnesses, traumatic events, psychological stress, and injuries. Studies are still ongoing, however, on some other possible causes.

Is There A Fibromyalgia Treatment?

There is no cure for Fibromyalgia. However, people living with Fibromyalgia can benefit a great deal from medical and non-medical management. These may help fibromyalgia easier to live with and help to alleviate symptoms. These treatments will be explained further in this article.

What Are The Treatment Options?

Drug Treatments for Fibromyalgia Symptoms

A set of medications prescribed by doctors and rheumatologists may be beneficial for alleviating some of the symptoms of Fibromyalgia Syndrome. These include a set of medications that may provide pain relief, insomnia, cognitive dysfunctions, fatigue, and depression.

Your drugs should be taken according to your doctor’s or rheumatologist’s prescriptions. You should also report serious side effects promptly to your doctor. Inform your doctor about all the drugs you take. Fibromyalgia treatment requires the combined knowledge of several professionals including doctors, rheumatologists, therapists, and yogi. Some drugs can be beneficial to relieve your fibromyalgia symptoms.

The Food and Drug Administration (FDA) approves three medications to specifically treat Fibromyalgia. Some of them are Milnacipran (Savella), Duloxetine (Cymbalta), and Pregabalin (Lyrica). Some over-the-counter drugs may help to relieve Fibromyalgia pain such as Aspirin, Ibuprofen, and Naproxen. Some antidepressants and sleep-improving medications can also be prescribed to help relieve your insomnia, pain, and depression symptoms.

Antidepressants can also assist in reducing your sleep quality problems and emotional problems. Examples of antidepressants that are commonly used to treat Fibromyalgia include Amitriptyline (Elavil), Citalopram, Fluoxetine, and Sertraline. Sleep-improving drugs help to initiate or maintain sleep. , of sleep-improving drugs that are commonly used to treat Fibromyalgia include Neurontin (Gabapentin) and Zanaflex (Tizanidine). With experience and the help of your doctor, you may learn which drug combination benefits you most.

9 Natural Treatments for Fibromyalgia or Non-Drug Therapy

People with Fibromyalgia may benefit from natural remedies for fibromyalgia, such as lifestyle modification, therapies, and Complementary and Alternative Medicine (CAM). Studies prove that these non-drug treatments are very effective for patients with Fibromyalgia.

1. 1. Lifestyle modifications to relieve Fibromyalgia symptoms may include stress management, getting enough sleep, getting enough nutrition, and engaging in physical exercises.

1. 2. Stress management is a wide range of methods, strategies, or psychotherapies that improve quality of life by regulating your level of stress. For relieving symptoms associated with fibromyalgia, stress management involves practicing meditation, Fibromyalgia Yoga, massage therapy, and adjusting your work.
4. 

1. Fibromyalgia Yoga poses recommended by Shoosh Crotzer are Uttanasana (standing forward bend), Setu Bandha Sarvangasana (bridge pose), Bhujangasana (cobra pose), and Savasana (corpse pose).[3] You need to adjust your working hours by reducing them or switching to another work (less difficult). You will benefit highly from an Occupational Therapist, a Yogi, and Massage Therapist for pain management.

1. 3. Train yourself to have good sleep habits. This improves your quality of life. Have a specific time to sleep and don’t compromise with it. Don’t take alcohol or caffeinated substances just before sleeping as they may interfere with your sleep. Do not exercise close to bedtime; this may disrupt your sleep. Avoid midday naps as these may disturb your sleep pattern.

1. 4. Getting good and adequate nutrition helps relieve your Fibromyalgia symptoms and generally improves your quality of life. Your diet should include whole foods. Be careful with the consumption of substances that can disrupt your sleep patterns like alcohol and caffeine. Let your meals be rich in Vitamins. Take a lot of fruit. If you are deficient in Vitamin D nutrients, you may benefit from taking Vitamin D supplements. Your Vitamin D intake may improve from the early morning sun. Food substances like Cod liver oil and beef liver are very rich in Vitamin D nutrients, Avoid the intake of too much food addictives and take sufficient water.

1. 5. Engage in moderate physical exercises. This may be difficult due to your pain. You need to start with moderate exercises such as walking if exercising is difficult for you. Follow your doctor’s advice and prescribe exercises suitable for your pain and condition. Fibromyalgia patients also benefit from exercises like swimming and aerobic exercises.

People living with Fibromyalgia also benefit from therapies such as Cognitive Behavioral Therapy (CBT), support groups, and hydrotherapy.

6. 6. Cognitive Behaviors Therapy is also called Talk Therapy. It deals with understanding how your behavior and thinking patterns influence pain and some other symptoms of yours. CBT and present-moment awareness help you to learn techniques that can reduce your symptoms and relieve your pain.

6. 7. A support group is a group of other people living with Fibromyalgia. Belonging to one may uplift you and improve your quality of life. Together, you can achieve more and be dedicated to your lifestyle modifications.

6. 8. Hydrotherapy involves the use of water to relieve pain. It can also be known as a water cure. It helps to soothe the pain. Some hydrotherapy equipment includes hot tubs, whirlpool spas, hydrotherapy tanks, and pools. Doctors or physiotherapists may offer advice on hydrotherapy techniques suitable for you. Hydrotherapy can be effective for Fibromyalgia.

6. 9. Complementary and Alternative Medicine, also known as integrated medicine can also be effective for managing some of your Fibromyalgia symptoms. It is used by some medical practitioners. Examples include the use of acupuncture, massage, drinking green tea, and practicing Tai chi (also called shadowboxing).

Practicing all these non-drug treatments alongside drug treatments can be effective to relieve Fibromyalgia symptoms.

Fibromyalgia VA Rating

VA means Veterans Affairs. A VA Disability Rating is defined as a percentage that is usually assigned by The VA Rating Authorities to a Veteran with a disability, using a VA Disability Process. A 0% rating usually means your condition hardly affects you while a 100% rating means your condition has made you unable to work. A VA Disability Rating determines the quantity of VA Disability benefits provided the veterans suffer from a service-connected problem. Benefits may include monetary benefits and total medical care.

Does Fibromyalgia relate to service? Most causes of Fibromyalgia are unknown or idiopathic. However, some are related to emotional stress, physical trauma, infections, and psychological stress which may all be service-connected. The higher the VA Disability Rating, the higher the benefits for a veteran’s condition. Veterans with the same VA Disability Rating get the same amount except in cases that involve partners or children.

The VA Math is used to combine the Disability Ratings of all service-connected conditions a Veteran has. The total Disability Rating is utilized to ascertain the exact value of VA Disability Benefits the veteran will get. If your Fibromyalgia has worsened since you last applied for a VA rating, reapply and submit a new claim for a higher evaluation.

How is a Fibromyalgia VA Rating calculated?

Using the VA’s Schedule for Rating Disabilities (VASRD), the VA assigns percentages to conditions. The level of disability caused, treatment options, and extent of symptoms are the basis for the giving of rating rules by The VASRD.[4]

You may be required to provide medical records that show proof you have Fibromyalgia and proof that your Fibromyalgia is service-connected or other Statements in Support of the Claim. You may also be required to take a VA claim examination.

You are generally assigned a Fibromyalgia VA Rating based on the gravity or seriousness of your Fibromyalgia. Your Fibromyalgia must either be sustained or aggravated by your functioning or active military service. Your service duration will not be considered if the VA approves your eligibility. If you have more than one service-connected condition, the VA considers a total disability rating for you by using the VA Math to combine the VA ratings of all your conditions.

What are the Fibromyalgia VA Ratings?

The Code of Federal Regulations covers the VA disability ratings for Fibromyalgia. Fibromyalgia VA Ratings can be 10%, 20%, or 40% based on the presence of symptoms requiring constant drugs (10%), the presence of symptoms that are present one-third of the time and increased by triggers (20%), or the presence of symptoms that do not cooperate with treatments (40%).[5]

Conclusion: Fibromyalgia Treatment

Fibromyalgia is said to highly impact one’s quality of life negatively. Fibromyalgia may last for a long period, possibly lifelong. However, the combination of both drug and non-drug wellness therapies has been proven to be effective in reduction in pain and improving the quality of life of persons with Fibromyalgia.

Despite the many symptoms related to it, it does not cause damage to a person’s internal organs, joints, or muscles. Fibromyalgia syndrome is also not generally considered a progressive condition except in a few cases (with triggers of Fibromyalgia flares such as emotional stress, physical stress, insufficient sleep, and hormonal imbalance). This means that the condition will not likely get worse as time goes on. The condition can improve.

Recent National Center for Complementary and Integrative Health (NCCIH)-funded studies have been investigating diverse ways that some Integrative and Complementary interventions work for Fibromyalgia.[6]

REFERENCES

1. 1. https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
2. 2. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/DiseasesConditions/Fibromyalgia
3. 3. https://www.yogajournal.com/lifestyle/health/pain-reliever/
4. 4. https://militarydisabilitymadeeasy.com/va-disability-rating.html
5. 5. https://vet.law/va-disability-claims/physical-conditions/fibromyalgia/#:~:text=The+VA+disability+ratings+for,%2C+20%25+or+10%25.&text=Some+veterans+have+more+than+one+service%2Drelated+illness+or+injury
6. 6. https://www.nccih.nih.gov/health/fibromyalgia-in-depth

Causes Of Joint Stiffness And Its Treatment

Joint stiffness occurs when there is difficulty in moving a particular joint or joints across the required number range of motions. Most times, joint stiffness does not occur isolated, it is often accompanied by painful joint symptoms or swelling of the affected joint. And depending on the specific etiology of the stiffness, such individuals can experience redness of the joint, tenderness on examination of the joint, numbness and at times, tingling sensation in the affected joint (1).

There are numerous causes of joint stiffness, it can occur as a result of a disease entity like cancer, or it can result from an inflammatory process or even an injury. Interestingly, injury to surrounding structures of a joint, such as the bursae can result in severe pain one of its manifestations can be stiffness of the affected joint, and also restricted movement (2).

Most times, joint stiffness also occurs with age in quite a several patients, in which no specific injury or disease is causing it but just a result of overuse of the joint and surrounding muscles (3).

Possible Causes Of Joint Stiffness

The following are the causes of joint stiffness:

1. 1. Rheumatoid arthritis

Generally, arthritis account for the highest percentage of the causes of joint stiffness in young adults and the elderly, studies have revealed that close to 15 million patients with arthritis are suffering from joint stiffness and pain (3).

Rheumatoid arthritis is a progressive chronic joint inflammatory disease that arises as a result of a disorder affecting the immune system causing the immune system to affect normal body cells, hence, called an autoimmune disorder.

Rheumatoid arthritis can manifest as joint stiffness hand, although it spares the distal interphalangeal joints, causing pain, stiffness, and nodule-like swelling on the affected joints, and when not corrected early, deformity occurs in long term.

Common clinical manifestations of rheumatoid arthritis are pains in the joint, stiffness, and edema in the affected joint. Although rheumatoid arthritis has no definitive treatment, it has management plans that can help relieve the symptoms, and the earlier the treatment the better to prevent complications from arising (3).

2. 2. Osteoarthritis

Joint stiffness knee most times occurs as a result of osteoarthritis, which usually occurs as a result of wear and tear of the joint when overuse of the joint occurs. In osteoarthritis, most times the affected structure is the cartilage, when this happens, it leads to bone friction and sometimes bone particles can fall off. This results in stiffness, pain, and swelling of the affected joint (4).

As the treatment for the condition becomes effective, the joint stiffness and other associated symptoms also reduce and get better. Depending on the severity of the symptoms, lifestyle management can help a lot, such as frequent exercises as medically prescribed in other to reduce the body weight being carried by the joint.

Medications to reduce pain and inflammation can also be used such as acetaminophen and other non-steroidal anti-inflammatory drugs such as ibuprofen and diclofenac. Surgery, such as joint replacement, is the last resort in chronic cases not responding to medical treatment (3).

3. 3. Circadian rhythm

Studies have revealed that joint stiffness is severe in the morning compared to other times of the day. People with rheumatoid arthritis experience severe treatment in the morning after waking up from sleep which can go as far as thirty minutes in cases with poor prognosis. Studies have also revealed that patients who have inadequate sleep experience joint pain and weakness at night and very early in the morning as in the case of arthritis (5).

4. 4. Obesity

Obesity is clinically described as an elevated BMI greater than 30kg/meter square, and when the BMI is greater than 40, it is called severe obesity. In obese patient, their joints are weakened due to the extra load of weight they are carrying at the time, they are also at risk of joint inflammation because fat adipocytes result in the secretion of certain proteins that predisposes the such patient to inflammation.

In obesity, joint stiffness knee joint disease is a common clinical manifestations. Obesity has also been identified as one of the components of metabolic syndrome that can affect tissues and organs of the body, all of which the bone is not an exclusion (5).

5. 5. Lupus

Lupus, a popular short form of systemic lupus erythematosus is an autoimmune inflammatory disease common in premenopausal women and commonly known for its effects on the body’s joints and muscles. Commonly lupus affects both small and large joints of the body which can produce joint stiffness fingers and painful joint symptoms

Common clinical manifestations of lupus when it affects joint stiffness and swelling, overall generalized body pain, and weakness which also affects the joints. Due to the complexity of the disease, lupus has no definitive treatment and complications often arise as the disease progresses (2).

6. 6. Psoriatic arthritis

Psoriatic arthritis is a joint inflammation that is often associated with a psoriatic skin disorder, and in most cases, patients with psoriatic arthritis have a family history of the disease. Joint stiffness fingers commonly occur in this disorder and patients manifest pain and swelling, and the nails start to pit.

There is also associated stiffness of the joints in the affected joints of the body such as the hands, the finger, and the knee, and it could be symmetrical or asymmetrical (4).

7. 7. Bursitis

Bursitis refers to inflammation of the bursae in the joints of the body. Bursaries are cushions in joints that contain fluids and their major function on the joints is to help prevent friction on the joints.

When bursitis occurs, there is swelling of the bursae and this often manifests in stiffness and pain in the joints. Although any joint of the body can be affected, it also commonly affects the large joints more.

Popularly affected joints are the elbow, shoulder, and hip joints. Joint stiffness knee that results in bursitis is due to the affectation of the knee joints. Other joints affected are the ankle and the big toes. Often time bursitis is not a chronic disease, it presents as acute and temporary, and doctors commonly advise patients to rest the affected joint for a week for healing to take place.

Physical exercises can also e done to prevent stiffness or to heal the joint stiffness if there is one already, but this is based on the recommendation by the physical therapist. Non-steroidal anti-inflammatory drugs can also be used to relieve pain, and examples of such include ibuprofen, and diclofenac (2).

8. 8. Gout

Unlike the other aetiologies of joint stiffness that are often progressive and chronic, gout is an acute disease of the joint which occurs as a result of excess accumulation of uric acid in the body, hyperuricemia. It may start during sleep causing a sudden stiffness of the joint in the morning, and it is characterized by the sudden pain and tenderness of the affected joint. In most cases, the big toe of the body is commonly affected by gout, and gout can affect any joint of the body

Some studies explain that a gout is a form of arthritis and that it has a sexual predilection for men more than women, especially post-menopausal women. Unlike in lupus where it has no definitive treatment, joint stiffness in gout is treatable with the use of drug therapy, although recurrence is also possible (2).

9. 9. Bone cancer

Although it is unlikely, this can occasionally result in joint discomfort and stiffness. Joint pain and bone pain are potential side effects of bone malignancy. The most common manifestation of a bone malignancy is the swelling around the bone, and not all patients present with pain, which explains why the malignancy may have become advanced before its diagnosis.

Bone cancer is usually treatable but the treatment approach is often dependent on the cancer staging, the size and the location of the tumor, and of course, the type of cancer is also important in determining the management therapy. Common bone malignancy treatments include the use of radiotherapy, surgery, and the use of chemotherapy as well.

Recently, immunotherapy has been indicated and this includes the use of managing drugs such as pembrolizumab, to stimulate the action of the immune system against the cancer cells (2).

10. 10. Fibromyalgia

Joint and muscle discomfort, as well as issues with sleep, emotions, and cognition, are all symptoms of this chronic illness. According to researchers, the brain amplifies natural pain impulses. They don’t understand what causes it, but disease, surgery, or periods of extreme stress frequently precede it. However, it doesn’t harm the affected joints the way osteoarthritis does. Joint stiffness knee and painful joint symptoms are manifestations of fibromyalgia (4).

11. 11. Diet

Consuming dairy and meat products may contribute to the development of diseases like gout or osteoarthritis, which can cause joint stiffness. Humans are possibly more prone to joint stiffness if they consume greater amounts of these meals and fewer organic diets. According to research, adopting a vegetarian or Diet plan may aid with stiffness reduction. It may be advantageous to consume more fiber, cereals, and fruits. Others are vegetables, healthy fats, and herbs (5).

12. 12. Sleeping position

How individuals sleep during the night is frequently a factor in joint stiffness. Whenever a patient does not sleep with a good neck position and their spine aligned, they may awaken experiencing joint stiffness or soreness. For individuals who are already experiencing joint pain or stiffness in certain parts of their body, it is normally best advised if they avoid sleeping on the same body side when they go to bed at night (4).

13. 13. Injury to the joints

Patients who suffer from ligament injuries frequently feel excruciating agony. The femur, tibia, and fibula are the three bones that are connected by ligaments in a joint. They contribute to the knee joint’s stability.

The anterior, posterior, and medial cruciate ligaments, which are the three ligaments in the knee, are frequently injured in sports-related injuries. Ligamentous injuries can also occur in car accidents with strong forces.

The following characteristic is frequently seen in patients who have ligament injuries:

• – Joint pain is always really severe.
• – Painful joint symptoms causing discomfort when moving.
• – There is a crepitus-like noise inside the building.
• – Movement instability or difficulty.
• – Joint edema in the afflicted area.
• – The inside of the joint, such as the knee, is sore, producing joint stiffness knee (6).

14. 14. Fracture

Joint fractures happen when any of the bony parts of the joint experience a discontinuity, and this can make the damaged joint stiff and immobile.

After the fracture has been fixed or healed, stiffness often persists, and in some cases, physical treatment is necessary to relieve it.

Depending on the joint site affected, the stiffness of the joint can occur in different sites of the body, for example, joint stiffness hand will occur in a fracture to the bones of the hands, joint stiffness knee will occur in a knee fracture, and they all have their associated painful joint symptoms.

Therefore, it is always recommended for patients recuperating from fractures to keep all of their scheduled physiotherapy appointments to aid with the stiffness and accompanying swelling.

Treatment For Joint Pain And Stiffness

Before thinking of what to use to relieve joint stiffness, it is best to see a doctor to determine the specific cause of the stiffness and to treat it accordingly. The doctor may diagnose the etiology and recommend the appropriate treatment plan, such as physical therapy that may tackle the cause. The following are the available treatment options for joint stiffness:

1. A. Medications: Medications such as over-the-counter pain relievers can be used especially when there are associated pains, and the doctor can also prescribe specific NSAIDs depending on the severity of the pain.
2. B. Cold or hot compress: Following the RICE principle, which requires that patient should rest the affected limb, apply ice, compression, and elevation, when cold compress is applied, it helps to reduce the edema around the stiff joints while hot compress causes relaxation of the muscles and soft tissues.
3. C. Steroids: Depending on the severity of the joint issue causing the stiffness, the doctor can also prescribe steroids to help with inflammation, but this should be taken with caution because of the possible side effects.
4. D. Exercise: When necessary, exercise will be prescribed at the right time by the doctor or the physical therapist as exercise can also help to relieve stiffness.
5. E. Supplements: The use of supplements such as glucosamine and fish oil has been proven to help with joint stiffness (7).

References:

1. 1.https://www.medicinenet.com/joint_stiffness/symptoms.htmhttps://www.medicoverhospitals.in/symptoms/joint-stiffness
2. 2. https://www.medicoverhospitals.in/symptoms/joint-stiffness
3. 3. https://www.healthline.com/health/stiff-joints#traditional-treatment
4. 4. https://www.webmd.com/rheumatoid-arthritis/ss/slideshow-stiff-joints
5. 5. https://www.medicalnewstoday.com/articles/321588#causes

6. https://www.healthline.com/health/causes-of-severe-knee-pain-leading-to-knee-replacement#ligament-injuries

7. 7. https://www.orthoatlanta.com/media/what-are-stiff-joints-and-how-to-remedy-them