Understanding Osteoarthritis: A Comprehensive Guide to Managing Inflammation, Knee Pain, and Joint Discomfort

Introduction

Osteoarthritis (OA) is a prevalent condition that affects millions of individuals worldwide. It is characterized by inflammation, knee pain, and joint discomfort, primarily targeting the weight-bearing joints such as the knees, hips, and spine. In this comprehensive guide, we will explore the causes, symptoms, and risk factors associated with osteoarthritis. We will delve into the mechanisms of inflammation and joint degeneration, shedding light on the intricate processes that contribute to the progression of this condition. Moreover, we will discuss various management strategies, including lifestyle modifications, exercise, medication, and complementary therapies, which can alleviate pain and improve quality of life for individuals living with osteoarthritis.

I. Understanding Osteoarthritis AKA Arthritis

A. Definition and Overview of Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease that primarily affects the cartilage, the protective tissue covering the ends of bones in a joint. It is the most common form of arthritis and often occurs as a result of the natural aging process or wear and tear on the joints over time. Osteoarthritis can affect any joint in the body, but it most commonly affects weight-bearing joints such as the knees, hips, and spine.

In a healthy joint, cartilage provides a smooth surface for joint movement, allowing bones to glide against each other without friction. In osteoarthritis, the cartilage gradually breaks down and wears away, leading to joint pain, swelling and stiffness, and limited range of motion. As the condition progresses, bony outgrowths called bone spurs may develop at the edges of the affected joint.

1. B. Causes and Risk Factors

The exact causes of osteoarthritis are not fully understood, but several factors contribute to its development. Age is a significant risk factor, as the incidence of osteoarthritis increases with advancing age. Other risk factors include obesity, joint injuries or trauma, repetitive joint stress, genetic factors, and certain metabolic disorders.

Additionally, certain occupations and sports activities that involve repetitive joint movements or excessive loading can increase the risk of developing osteoarthritis. For example, athletes, construction workers, and individuals involved in heavy manual labor may be more susceptible to joint degeneration.

C. Common Symptoms and Diagnostic Methods

The symptoms of osteoarthritis can vary depending on the affected joint, but common signs include joint pain, stiffness, swelling, and a reduced range of motion. Initially, individuals may experience pain and stiffness after periods of inactivity, which often improves with movement. However, as the disease progresses, pain may become more persistent and affect daily activities.

To diagnose osteoarthritis, healthcare professionals typically consider a combination of factors. They will evaluate the individual’s medical history, perform a physical examination to assess joint tenderness, swelling, and range of motion, and may order imaging tests such as X-rays or magnetic resonance imaging (MRI) to visualize the joint structures and assess the extent of cartilage damage.

In some cases, joint fluid analysis may be conducted by extracting a small amount of fluid from the affected joint to rule out other possible causes of joint pain and inflammation.

Overall, early diagnosis is crucial for effective management of osteoarthritis. Understanding the symptoms and seeking medical evaluation can help individuals receive appropriate treatment and implement lifestyle modifications to minimize pain, maintain joint function, and improve their overall quality of life.

II. Inflammation and Osteoarthritis

A. The Role of Inflammation in Osteoarthritis

While inflammation is commonly associated with conditions such as rheumatoid arthritis, it also plays a significant role in osteoarthritis. Inflammation in osteoarthritis is considered low-grade and chronic, rather than the acute inflammation seen in injuries or infections. This chronic inflammation contributes to the progression of the disease and the associated joint damage.

In a healthy joint, inflammation is a natural response to injury or infection. It involves the release of chemicals called cytokines, which attract immune cells to the affected area, leading to redness, swelling, and pain. In osteoarthritis, the ongoing wear and tear on the joint triggers an inflammatory response, resulting in the release of pro-inflammatory cytokines, such as interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha).

B. Chronic Inflammation and its Impact on Joint Health

Chronic inflammation in osteoarthritis has detrimental effects on joint health. The pro-inflammatory cytokines released during inflammation contribute to the breakdown of cartilage, accelerating its degradation. They also stimulate the production of enzymes that further damage the cartilage matrix, leading to joint stiffness, pain, and loss of function.

Moreover, chronic inflammation in osteoarthritis triggers changes in the synovium, a thin layer of tissue that lines the joint space. The inflamed synovium produces excess synovial fluid, resulting in joint swelling and an increase in joint temperature. The altered synovium can also release more pro-inflammatory cytokines, perpetuating the inflammatory process.

In addition to cartilage damage, chronic inflammation in osteoarthritis can affect other joint structures. It can lead to the formation of bone spurs or osteophytes, as the body attempts to stabilize the joint. These bony outgrowths can further contribute to joint pain and interfere with joint movement.

C. Understanding the Inflammatory Cascade in Osteoarthritis

The inflammatory cascade in osteoarthritis involves complex interactions between various cells and molecules within the joint. The breakdown of cartilage releases fragments called damage-associated molecular patterns (DAMPs), which act as signals for the immune system. These DAMPs activate cells called macrophages and fibroblasts, triggering the release of pro-inflammatory cytokines and other mediators.

Once released, pro-inflammatory cytokines perpetuate the inflammatory response and attract more immune cells to the joint, including neutrophils and T lymphocytes. These cells further contribute to cartilage degradation through the production of enzymes, such as matrix metalloproteinases (MMPs), which break down the cartilage matrix.

Additionally, the interaction between the inflamed synovium and the joint structures perpetuates the inflammatory process. The synovial cells release more cytokines, leading to a cycle of inflammation and tissue damage.

Understanding the inflammatory cascade in osteoarthritis is essential for developing targeted therapies that can modulate inflammation and halt the progression of the disease. Researchers are exploring various strategies to target specific cytokines, enzymes, and cell types involved in the inflammatory response, aiming to reduce joint inflammation, preserve cartilage integrity, and alleviate symptoms.

In conclusion, inflammation plays a significant role in the development and progression of osteoarthritis. Chronic inflammation in the joints leads to cartilage degradation, joint damage, and associated symptoms such as pain and stiffness. Understanding the complex inflammatory cascade involved in osteoarthritis is crucial for the development of effective treatment strategies aimed at modulating inflammation and preserving joint health.

III. Knee Pain or Knee Osteoarthritis

A. Knee Anatomy and Osteoarthritis

The knee joint is a complex structure consisting of bones, cartilage, ligaments, tendons, and other tissues. It is particularly susceptible to osteoarthritis due to its weight-bearing function and the high forces it endures during daily activities. Osteoarthritis commonly affects the knee joint, leading to significant pain and functional impairment.

In osteoarthritis of the knee, the progressive breakdown of cartilage results in the bones of the joint rubbing against each other, causing pain, inflammation, and stiffness. The loss of cartilage also affects the shock-absorbing capacity of the joint, leading to increased stress on the surrounding tissues.

B. Types of Knee Pain in Osteoarthritis

Knee pain in osteoarthritis can manifest in various ways, and individuals may experience different types of pain:

1. 1. Mechanical Pain: This type of pain is often described as a deep ache within the joint. It typically worsens with weight-bearing activities or excessive joint movement. Mechanical pain is a result of the direct impact of bone-on-bone contact due to cartilage loss.
2. 2. Inflammatory Pain: Inflammation in the knee joint can cause pain characterized by swelling, warmth, and tenderness. This type of pain may be more prominent during periods of increased disease activity or after prolonged activity.
3. 3. Rest Pain: Some individuals with knee osteoarthritis may experience pain even at rest or during periods of inactivity. This may be due to the ongoing inflammation and degenerative changes within the joint.
4. 4. Referral Pain: Knee pain in osteoarthritis can sometimes radiate to other areas, such as the thigh or calf. This type of pain is known as referral pain and can be attributed to nerve compression or irritation.

C. Understanding the Mechanisms of Knee Pain

The mechanisms underlying knee pain in osteoarthritis are multifactorial and not fully understood. However, several factors contribute to the experience of pain:

1. 1. Inflammation: Chronic inflammation in the knee joint triggers the release of pro-inflammatory cytokines, which stimulate pain receptors and contribute to pain perception.
2. 2. Nerve Sensitization: Ongoing joint damage and inflammation can lead to changes in nerve sensitivity, amplifying pain signals and causing heightened pain perception.
3. 3. Synovial Irritation: Inflammation of the synovium can lead to the production of excess synovial fluid, causing swelling and stretching of joint tissues, which can contribute to pain.
4. 4. Bone Changes: As osteoarthritis progresses, bony outgrowths or bone spurs can develop, leading to increased pressure and irritation of surrounding tissues, including nerves, contributing to pain.
5. 5. Muscle Weakness and Imbalance: Osteoarthritis-related pain can cause individuals to limit their physical activity, leading to muscle weakness and imbalances. Weak muscles may be unable to adequately support the joint, leading to increased pain and instability.

Understanding the mechanisms of knee pain in osteoarthritis is essential for effective pain management strategies. Treatment approaches often focus on reducing inflammation, improving joint stability through muscle strengthening exercises, optimizing weight management, and implementing pain-relieving modalities such as heat or cold therapy, physical therapy, and medication as necessary.

By addressing the underlying causes of knee arthritis pain and implementing a multimodal approach to treatment, individuals with arthritis of the knee can find relief, improve their joint function, and enhance their overall quality of life.

IV. Managing Joint Pain in Osteoarthritis

A. Lifestyle Modifications for Joint Pain Relief

1. 1. Weight Management and its Impact on Joint Health: Maintaining a healthy weight can significantly reduce the stress placed on weight-bearing joints, such as the knees and hips. Even a modest weight loss can alleviate joint pain and slow down the progression of osteoarthritis. Adopting a balanced diet and engaging in regular physical activity can help achieve and maintain a healthy weight.
2. 2. Exercise and Physical Activity Recommendations: Regular exercise is essential for managing joint pain and maintaining joint flexibility and strength. Low-impact exercises such as walking, swimming, cycling, and tai chi are beneficial for individuals with osteoarthritis. These exercises help strengthen muscles, improve joint stability, and enhance overall joint function. It is important to consult with a healthcare professional or a physical therapist to develop an exercise program tailored to individual needs and limitations.
3. 3. Joint Protection Techniques: Implementing joint protection techniques can help minimize pain and prevent further joint damage. This includes avoiding activities that exacerbate pain or put excessive stress on the joints, using assistive devices such as braces or canes for added support, and adopting proper body mechanics during daily activities to reduce joint strain.

B. Medications and Therapies for Osteoarthritis Pain

1. 1. Over-the-Counter Pain Relievers and Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Nonprescription pain relievers such as acetaminophen and NSAIDs like ibuprofen can help reduce pain and inflammation associated with osteoarthritis. However, long-term use of NSAIDs should be monitored due to potential side effects.
2. 2. Prescription Medications for Pain Management: In cases where over-the-counter medications are insufficient, healthcare professionals may prescribe stronger pain medications or opioids to manage moderate to severe pain. These medications should be used under medical supervision and with caution due to potential side effects and dependency risks.
3. 3. Topical Analgesics and Corticosteroid Injections: Topical creams, gels, or patches containing ingredients such as capsaicin or menthol can provide localized pain relief. Corticosteroid injections directly into the affected joint may be recommended for short-term pain relief and reduction of inflammation.
4. 4. Hyaluronic Acid Injections and Platelet-Rich Plasma (PRP) Therapy: In some cases, hyaluronic acid injections or PRP therapy may be considered. Hyaluronic acid injections provide lubrication to the joint, while PRP therapy involves injecting concentrated platelets from the individual’s own blood to promote healing and reduce inflammation.

C. Complementary and Alternative Therapies for Joint Pain

1. 1. Acupuncture and Acupressure: These practices involve the stimulation of specific points on the body to alleviate pain and promote healing. Some individuals find relief from joint pain through acupuncture or acupressure sessions.
2. 2. Massage Therapy and Manual Techniques: Massage therapy can help reduce muscle tension, improve blood circulation, and provide temporary pain relief. Techniques such as deep tissue massage or myofascial release may be beneficial for individuals with osteoarthritis.
3. 3. Herbal Supplements and Dietary Modifications: Certain herbal supplements, such as glucosamine and chondroitin sulfate, have been used to manage joint pain in osteoarthritis. However, evidence for their effectiveness is mixed, and it is important to consult with a healthcare professional before starting any supplement regimen. Additionally, adopting an anti-inflammatory diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids can support joint health.

It is crucial to discuss these treatment options with healthcare professionals to determine the most appropriate and effective strategies for managing joint pain in osteoarthritis. Individualized treatment plans that combine lifestyle modifications, medication, and complementary therapies can help individuals find relief and improve their quality of life.

V. Lifestyle Changes to Support Joint Health

A. Optimal Nutrition for Osteoarthritis

1. 1. Anti-inflammatory Foods and Omega-3 Fatty Acids: A healthy diet can play a crucial role in managing osteoarthritis and supporting joint health. Incorporating anti-inflammatory foods such as fruits, vegetables, whole grains, and fatty fish rich in omega-3 fatty acids (e.g., salmon, mackerel, and sardines) can help reduce inflammation in the body. Omega-3 fatty acids have been shown to have anti-inflammatory properties and may help alleviate joint pain and stiffness.
2. 2. Foods to Avoid or Limit in Osteoarthritis: Certain foods can exacerbate inflammation and contribute to joint pain in individuals with osteoarthritis. It is advisable to limit or avoid foods high in saturated and trans fats, refined sugars, processed meats, and excessive amounts of red meat. Additionally, some individuals may find that certain trigger foods, such as nightshade vegetables (e.g., tomatoes, peppers, and eggplants), can worsen their symptoms. It is important to pay attention to individual sensitivities and make dietary choices accordingly.

B. Exercise and Physical Activity Recommendations for Joint Health

1. 1. Low-Impact Exercises for Osteoarthritis: Engaging in regular physical activity is vital for maintaining joint health and managing osteoarthritis. Low-impact exercises, such as walking, swimming, cycling, and water aerobics, are gentle on the joints while providing cardiovascular benefits. These activities help improve joint mobility, strengthen the supporting muscles, and reduce pain. It is crucial to start slowly and gradually increase the duration and intensity of exercise as tolerated.
2. 2. Strength Training and Range of Motion Exercises: Incorporating strength training exercises into the routine can help support joint stability and reduce the risk of injury. Focus on exercises that target the muscles surrounding the affected joints, such as leg lifts, squats, and resistance band exercises. Additionally, performing range of motion exercises, such as gentle stretches and joint mobilization movements, can help improve flexibility and maintain joint function.

Maintaining a balanced and nutritious diet, combined with regular exercise, forms the foundation for supporting joint health in individuals with osteoarthritis. It is important to consult with healthcare professionals, such as dietitians and physical therapists, to develop personalized nutrition and exercise plans that consider individual needs, limitations, and preferences. Implementing these lifestyle changes can contribute to better joint function, reduced pain, and improved overall well-being.

VI. Surgical Interventions for Osteoarthritis

A. When Conservative Treatments Are Insufficient

In many cases, conservative treatments such as lifestyle modifications, medication, and physical therapy are effective in managing osteoarthritis. However, when these measures fail to provide adequate relief or when the joint damage is severe, surgical intervention may be necessary. Surgical options are typically considered when the pain and functional limitations significantly impact the individual’s quality of life.

B. Common Surgical Procedures for Osteoarthritis

1. 1. Total Joint Replacement: Total joint replacement, also known as arthroplasty, is a surgical procedure in which the damaged joint surfaces are removed and replaced with prosthetic components made of metal, plastic, or ceramic. This procedure is commonly performed for hip and knee joints. Total joint replacement aims to relieve pain, restore joint function, and improve mobility.
2. 2. Partial Joint Replacement: In some cases, when the damage is limited to a specific area of the joint, a partial joint replacement may be performed. This involves replacing only the damaged portion of the joint while preserving the healthy parts. For example, a partial knee replacement involves replacing only the affected compartment of the knee joint. This procedure is appropriate for individuals with localized joint damage and can provide pain relief and improved function.
3. 3. Arthroscopy: Arthroscopy is a minimally invasive surgical procedure used for both diagnostic and therapeutic purposes. It involves inserting a small camera called an arthroscope into the joint through a small incision. Surgeons can visualize the joint structures and, if necessary, perform repairs or remove damaged tissues. Arthroscopy is commonly performed for knee and shoulder joints and can be helpful in relieving symptoms and repairing certain joint abnormalities.

It is important to note that surgical interventions carry their own risks and potential complications, and the decision to undergo surgery should be made in collaboration with healthcare professionals after a thorough evaluation of the individual’s condition, lifestyle, and preferences. Rehabilitation and physical therapy are typically an integral part of the recovery process after surgery, aimed at restoring joint function and optimizing outcomes.

Surgical interventions for osteoarthritis can provide significant pain relief, improve joint function, and enhance overall quality of life for individuals with severe joint damage. It is crucial to have open and honest discussions with healthcare professionals to understand the benefits, risks, and expectations associated with each surgical option to make informed decisions about the most appropriate course of treatment.

VII. Coping Strategies and Support for Individuals with Osteoarthritis

A. Emotional and Psychological Impact of Osteoarthritis

Living with osteoarthritis can have a significant emotional and psychological impact on individuals. Chronic pain, physical limitations, and changes in lifestyle can lead to feelings of frustration, sadness, anxiety, and even depression. It is important to acknowledge and address these emotional aspects of the condition in order to cope effectively.

B. Seeking Support from Healthcare Professionals and Support Groups

Healthcare professionals, such as rheumatologists, physical therapists, and occupational therapists, play a vital role in supporting individuals with osteoarthritis. They can provide education, guidance, and personalized treatment plans to manage symptoms and improve quality of life. Additionally, participating in support groups or connecting with others who have similar experiences can provide emotional support, practical advice, and a sense of community.

C. Managing Stress and Building Resilience

Managing stress is essential for individuals with osteoarthritis as stress can exacerbate pain and emotional distress. Engaging in stress-reducing activities such as deep breathing exercises, meditation, yoga, or engaging in hobbies can help alleviate stress. Building resilience and a positive mindset can also be beneficial. This involves focusing on strengths, setting realistic goals, practicing self-care, and maintaining a supportive network of family and friends.

It is important for individuals with osteoarthritis to prioritize their mental and emotional well-being alongside physical management. By seeking appropriate support, developing coping strategies, and maintaining a positive mindset, individuals can enhance their overall resilience and maintain a better quality of life despite the challenges of osteoarthritis.

Conclusion

Osteoarthritis is a chronic condition that significantly affects the lives of those affected. However, by understanding the mechanisms of inflammation, implementing lifestyle modifications, and seeking appropriate medical interventions, individuals can effectively manage their symptoms and improve their overall quality of life. It is important to remember that a comprehensive approach, encompassing both physical and emotional well-being, is crucial in dealing with osteoarthritis. By staying informed, adopting healthy habits, and utilizing the available resources, individuals can regain control over their joint health and lead fulfilling lives despite the challenges posed by symptoms and causes of osteoarthritis.

Causes Of Bone Pain And Treatment Options

Bone pain is a form of musculoskeletal pain that results in tenderness and discomfort felt in different bones, and joints of the body (majorly because bones come together to make a joint). Bone pain can occur in the upper body or the lower body. However, the majority of bone pain felt in the lower body commonly results from injuries such as in bone pain back of heel, bone pain big toe, and bone pain on side of foot.

The causes of bone pain vary, some are easily identified, for instance, lower leg bone pain from a road traffic accident is easily traced back to trauma. However, some causes of bone pain are secondary to disease conditions, for instance, lower back bone pain, bone pain in thigh, and bone pain in knee may be radiating pain as a result of prostate cancer metastasizing to the bones.

Therefore, for any kind of low pain especially persistent or chronic pain, it is important to always visit the health care provider to identify the underlying cause and for adequate treatment (1).

Description Of a Typical Bone Pain

The basic character of bone pain is usually described as dull aching, manifesting from the inner part of the body. On palpation, the overlying skin can appear tender and may hurt mobility.

Most times, individuals with bone pain can locate the site of the pain. In pain radiating to other parts, the initial or starting bone pain is also easily identified by the patient. For example, knee bone pain may manifest as lower leg bone pain but the patient can easily describe the initial location as the knee.

Bone pain secondary to trauma or an open bone fracture from trauma may be characterized as sharp and very severe pain with a location pinpoint to the injury site.

Other important pain features that will be of help in the treatment of patients with bone pain are:

• – The location where the bone pain is most severe
• – If the pain is recurrent or persistent
• – If the pain is associated with any particular timing of the day
• – When the pain is worse
• – Any aggravating or relieving factors
• – Any radiation of the bone pain to other parts of the body, for instance, thigh bone pain may radiate to the knee (1).

8 Causes Of Bone Pain According To Location

Bone pain in the lower body has various etiologies and risk factors. Most of the times different causes are associated with different anatomical locations, which is the best way to discuss the causes of bone pain.

Below are some of the highlighted causes:

1. Bone pain side of foot

Bone pain on side of foot also called lateral foot pain is a type of bone pain that spans through the foot side including the ankle. It may be mild or severe which can prevent one from fee moving of the lower limbs.

Some of the causes of bone pain side of foot are:

• – Cuboid syndrome

This occurs as a result of the partial dislocation of the cuboid bone, and the cuboid bone is one of the lateral bones of the foot. Hence, its manifestation is bone pain on side of foot.

Cuboid syndrome is usually secondary to vigorous sports activities for a long period without breaks in between. Putting on undersized or very tight shoes is another traceable cause of the cuboid bone’s dislocating from its original anatomical location.

Most times cuboid bone syndrome resolves on its own even before diagnosis occurs. It can however in certain instances lead to chronic bone pain on side of foot and weakness.

• – Ankle sprain

An ankle sprain occurs secondary to ligament injury of the ankle and foot. It accounts for one of the commonest causes of bone pain side of foot, amounting to 85% of recorded data. It can occur with or without a fracture or a dislocation.

• – Bunions

Bunions are a common defect of the bone characterized by internal rotation of the big toe towards the direction of the four other toes. This results in the majority of the body weight bearing to the lateral foot during standing or while walking consequently, this manifests as bone pain on side of foot (2).

2. Lower leg bone pain

Pain in the lower leg is characterized by bone pain below the knee joint. The affected bones include the tibia, the fibula, and the bones of the foot. Lower leg bone pain is caused by the following:

• – Fracture

A fracture which is a break in the continuity of a bone can affect almost all bones of the body including, the tibia, fibula, and bones of the foot. Fracture is the commonest cause of lower leg bone pain.

• – Cancer

Lower leg bone pain from cancer usually occurs as a result of a direct cancer of the bone affecting the lower leg, called osteosarcoma. It can also result from a distant cancer metastasizing to the lower leg bones as in prostate cancer.

• – Trauma

Direct trauma to the bone either from a fall or from a blunt injury usually results in acute, and intense lower leg bone pain (3).

3. Thigh bone pain

Thigh bone pain commonly manifests from any injury or condition that affects the femur bone, this is because the femur bone is the single long bone located in the thigh.

The following are some of the causes of thigh bone pain:

• – Osteomyelitis

Osteomyelitis of the thigh bone is a bone infection that affects the thigh bone. This is mostly a bacterial infection caused by the microorganism Staphylococcus aureus. Osteomyelitis of the long bone is either from a local infection or arising from a distant infection in the body or ongoing septicemia in the body.

As soon as thigh bone pain starts to manifest, it is best to visit the hospital immediately for diagnosis and adequate treatment. The best treatment for osteomyelitis if diagnosed early is the use of antibiotics but in chronic osteomyelitis, surgery may be indicated.

• – Patellofemoral pain syndrome

Patellofemoral pain syndrome is a common cause of bone pain in thigh, especially in women and in athletes. It mostly occurs from joint overuse in sport training causing wear and tear of the cartilage located under the kneecap.

The clinical manifestation often includes bone pain in thigh, and pain at the anterior part of the knee joint, especially when in a squatting position or prolonged sitting. The pain however is described by the patient to be a chronic dull aching pain.

• – Fracture

The femur is the bone of the thigh commonly fractured in trauma. Bone pain in thigh is usually described as aching, and severe and some patients give it a severity score of 10/10 when describing the thigh bone pain (4,5).

4. Bone pain on top of foot

Bone pain on top of foot is one of the complaints of foot pain in the clinic. Studies have revealed that the majority of the time, bone pain on top of foot occurs as a result of injury, use, and wear from friction from undersized tight shoes.

The following are highlighted causes of bone pain on top of foot:

• – Stress fracture

A stress fracture is one of the commonest and most recorded causes of bone pain on top of foot. It occurs as a result of a fracture to the metatarsal bone from overuse and pressure. This is commonly seen among military men in training.

• – Deformity of toe

A deformity of a bone either from a congenital or an acquired deformity will also cause bone pain on top of foot. A congenital deformity of the big toe, or an acquired deformity from fracture secondary to trauma will lead to bone pain big toe as well as bone pain on top of foot.

• – Tarsal coalitions

In tarsal coalitions, there is an abnormally formed connection between the tarsal bones. The tarsal bones consist of the bones located at the heel of the foot, ankle, and arch. When this coalition occurs between bones, it manifests as recurrent and moderately severe bone pain on top of foot, and it is commonly seen in children (6).

5. Bone pain tibia

Tibia and fibula are the two major bones located in the leg below the knee joint. The tibia makes up the shin of the leg and of the lower leg bones, it is commonly fractured. The bone pain tibia is commonly called the shin splint.

The following are some of the risk factors for bone pain tibia or a shin splint:

• – Runners who continuously run on a rough or uneven track, or those who suddenly increase speed.
• – Dancers
• – Bone pain tibia is also seen in individuals with flat feet or high arches. This prevents the bones and the muscles from protecting the leg from impact.
• – Military men who stand or walk for a long time. Other professionals who will have to walk for a long time are also prone to having bone pain tibia.
• – Unsupportive foot wears during daily exercise
• – Nutrient deficiency as seen in vitamin D also predispose an individual to shin lifts.
• – Underlying bone disease such as osteoporosis or osteopenia (7).

6. Knee bone pain

The knee is made up of the bones coming together ( femur, tibia, alongside patella bone), the ligaments, tendons, and cartilage. Whenever there is a problem with any of these components that make up the knee joint, it can manifest as bone pain in knee. Also, direct trauma or infection to any of the bony components will cause knee bone pain.

The following are some of the causes of knee bone pain:

• – Osteoarthritis

Osteoarthritis is one of the commonest causes of knee bone pain, especially in adults. It is an inflammatory disease of the knee joint that results from wear and tear of the knee joint. When this occurs, patients complain of a dull aching pain from inside, it can also be warm to touch alongside a red discoloration of the overlying skin,

• – Patella fracture

The Patella’s bone is a small circular bone that is sited directly in front of the knee joint. Direct trauma to the knee joint can result in a fracture of the patella bone. A fall on the knee will also result in a fracture of the patella bone. When a patella fracture occurs, it results in bone pain in knee.

• – Dislocation

Dislocation which means displacement of the bones of a joint can affect any of the bony components of the knee joint resulting in knee bone pain. There can be dislocation of the femur or tibia from their meeting point, or dislocation of the patella, the knee cap. When this happens, it results in bone pain in knee (8).

7. Bone pain back of heel

The following are the causes of bone pain back of heel:

• – Haglund’s deformity

This deformity is also called a “pump bump”. It is a deformity of the bones at the heel leading to enlargement of these bones. In case of wear and tear from continuous pressure to the heel from undersized shoes result in irritation of the bones, and in such case manifest as bone pain back of heel.

• – Stress fracture

A stress fracture is also another commonly reported cause of bone pain back of heel. This occurs as a result of continuous stress as seen in sports, and manual labor on the heel. Stress fracture resulting in a fracture to the metatarsal bone can also result in bone pain back of heel.

• – Sever’s disease

Sever’s disease account for the commonest cause of bone pain back of heel in children and also in young adults. It occurs as a result of continuous microtrauma to the heel bone’s growth plate. The peak of this disease is seen between seven to fifteen years of age (9).

8. Bone pain big toe

The following are the common causes of bone pain big toe:

• – Sesamoiditis

Sesamoiditis refers to inflammation of the sesamoid bones. This condition commonly occurs when there is inflammation or irritation of the tendons surrounding the sesamoid bone sited after the big toe, leading to bone pain big toe. It is commonly seen in runners.

• – Fracture

A not-so-common cause of bone pain big toe is a fracture to the big toe which often result in intense pain, swelling, and deformity of the big toe (10).

Treatment For Bone Pain

There are several treatment options available for bone pain, some concerning the etiology of the bone pain. Some of the treatment options for bone pain are:

• – Analgesics

Analgesics are the first line of drugs given to patients with bone pain especially from stress, or from conditions that may be causing the pain as fractures. Pain relievers can be gotten over the counter or based on a doctor’s prescription. Examples of pain relievers commonly prescribed are ibuprofen and acetaminophen.

• – Antibiotics

In conditions such as osteomyelitis, a broad spectrum of antibiotics can be prescribed to help kill and stop the action of the invading microorganism thereby treating the infection adequately.

• – Vitamin and calcium supplements

For individuals with bone deformities from mineral or nutrient deficiency, the doctor may be prescribed a vitamin D or calcium supplement help boost the nutritional level of the patient and restore good health.

• – Cancer treatment

A commonly identified cause of bone pain lower body is cancer. Adequate and efficient treating all forms of cancer will help prevent metastasis to the bone and prevent bone pain.

• – Surgery

Surgery is not usually indicated in the treatment of bone pain, except in cases of fracture where surgery is required to reduce and restrict the broken bone to bring about bone healing. Surgery is also indicated in the cases of bone deformity from other causes not amendable to physical therapy. Surgery may also be needed to remove cancerous bone in bone cancer, osteosarcoma (11).

Summary

Bone pain or tenderness can be a concerning issue that requires prompt attention from a healthcare provider. The causes of bone pain can vary from simple injuries such as bone bruises to more complicated health issues such as infections and cancers.

Unexplained bone pain, especially when it is persistent or worsening, should be evaluated by a doctor to determine the cause of the pain. While there are a variety of possible causes related to bone pain, some common treatments include rest, over-the-counter pain medications, and physical therapy.

In some cases, more intensive medical interventions may be necessary such as surgery or prescription pain medication. Whether the cause of the pain is due to a tailbone injury, bruise, or another condition, it is important to seek medical attention as soon as possible to address any underlying health issues and begin appropriate treatment.

References:

1. 1. https://my.clevelandclinic.org/health/symptoms/24619-bone-pain
2. 2. https://www.medicalnewstoday.com/articles/321176#causes
3. 3. https://www.webmd.com/pain-management/lower-leg-pain-causes-and-treatments
4. 4. https://www.buoyhealth.com/learn/thigh-pain
5. 5. https://www.verywellhealth.com/thigh-pain-causes-treatment-4174433
6. 6. https://www.foot-pain-explored.com/pain-on-top-of-foot.html
7. 7. https://my.clevelandclinic.org/health/diseases/17467-shin-splints#:~:text=Shin+splints+occur+when+the,bone%2C+muscles+and+connective+tissues.
8. 8. https://my.clevelandclinic.org/health/symptoms/21207-knee-pain
9. 9. https://www.medicalnewstoday.com/articles/181453#causes
10. 10. https://www.medicalnewstoday.com/articles/big-toe-pain#common-causes
11. 11. https://www.healthline.com/health/bone-pain#treatments

Bone Pain: Causes, Symptoms, Types, and Various Treatments For Bone Pain

Bone pain can be a debilitating condition that affects the quality of one’s life. There are several reasons why you may feel pain in your bone. It could be due to injury, cancer, mineral deficiency, aging, or other medical conditions (1). The pain felt from the bone is different from joint pain or muscle pain because it’s present whether you move or not.

Bone pain is commonly linked to some diseases that affect the structure and function of the bone. In this article, we will discuss the causes, symptoms, treatments, and the various parts of the body where bone pain can be experienced such as shoulder bone pain, lower back bone pain, pain near the tailbone, forearm bone pain, neck bone pain, and bone pain in forearm.

What Are The Causes and Symptoms Of Bone Pain?

Bone pain can have several causes and also varying symptoms. Some of which include:

• – Osteoporosis: A condition where bones become weak and brittle due to loss of tissue, which can cause pain and fractures. It can cause severe pain in the whole body and it usually occurs when more than 12 percent of the bone mass is gone. Symptoms common to this condition include stooped posture and loss of height over time (2). Individuals with osteoporosis should be treated with calcium tablets, and activate vitamin D.
• – Osteoarthritis: A degenerative joint disease that can cause pain and stiffness in the joints, including those that connect to the bones.Generally in osteoarthritis, cartilage surrounding the surface of a joint begins to wear off due to wear and tear, causing friction between cortical bones.
• – Leukemia: This is a cancer of the bone marrow. Leukemia begins in the soft spongy tissues in the inner cavity of the bone, where blood cells are produced. Symptoms include night sweats, pale skin, unexplained weight loss, and feeling fatigued.
• – Bone cancer: Tumors that grow in or on the bones can cause localized pain and tenderness. This is because cancer can disfigure the bones’ normal structure. Other symptoms include a mass or lump under the skin, Increased bone breaks, numbness or tingling sensations (when a tumor presses against a nerve).
• – Paget’s disease: A condition that causes the bones to grow abnormally, which can lead to pain and deformities. The spine, skull, and legs are mostly affected and because it causes the body to generate new bones too quickly, making them weaker, deformed and less organized
• – Fractures: A broken bone can cause significant pain, especially if it is not properly set or allowed to heal. Symptoms include visible breaks, Swelling, visible deformities, and a grinding noise upon injury.
• – Infections: Bacterial or viral infections that affect the bones can cause pain and inflammation.
• – Osteomyelitis: A bone infection that can cause pain, fatigue, fever, and swelling. Infections sometimes reaches the bone by traveling from a near by tissue or the bloodstream. Individuals with chronic health conditions like diabetes, kidney failure are more likely to develop osteomyelitis.This infection kills bone cells (3).
• – Sickle cell disease: A genetic disorder that can cause bone pain due to a lack of oxygen to the bones.
• – Fibromyalgia: A chronic condition that can cause widespread pain, including in the bones.
• – Vitamin D deficiency: A lack of this essential vitamin can lead to bone pain and weakness. Other symptoms you may experience uncles cramps, fatigue, and sleep disturbances (5).

Types of Bone Pain

Shoulder Bone Pain

Shoulder bone pain can be caused by several factors, including injuries, overuse, and degenerative conditions. Common causes of shoulder bone pain include rotator cuff injuries, frozen shoulder, shoulder impingement, and osteoarthritis. Symptoms of shoulder bone pain can include difficulty moving the arm, aching pain in the shoulder, and stiffness.

Treatment for shoulder bone pain depends on the underlying cause. Injuries can be treated with rest, ice, compression, and elevation. Physical therapy and anti-inflammatory medications can also help. In more severe cases, surgery may be required.

Lower Back Bone Pain

Lower backbone pain is a common condition that affects millions of people worldwide. It can be caused by different factors, including bad posture, spinal stenosis, muscle strain, and herniated discs. Symptoms of lower back bone pain can include aching pain in the lower back, difficulty moving, and shooting pain down the legs.

Treatment for lower back bone pain depends on the cause. Mild cases can be treated with rest, ice, compression, and elevation. Physical therapy and chiropractic care can also help. In more severe cases, surgery may be required.

Pain Near Tailbone

Pain near the tailbone, also known as coccydynia, can be caused by several factors, including injury, poor posture, pregnancy, childbirth, and degenerative conditions. Symptoms of pain near tailbone can include aching pain in the area, difficulty sitting, and shooting pain down the legs.

Treatment for pain near tailbone depends on the actual cause. Less severe cases can be treated with ice on the site of pain, anti-inflammatory medications like steroids, and taking adequate rest. Going for physical therapy and alternative traditional medicine like chiropractic care can also be of help. In more severe cases, surgery may be required.

Forearm Bone Pain

Forearm bone pain can be caused by several factors, including overuse, injury, and degenerative conditions. Common causes of forearm bone pain include tennis elbow, golfer’s elbow, and carpal tunnel syndrome. Some of the symptoms of forearm bone pain can include having difficulty moving the arm, aching pain in the area, and weakness in the hand. Treatment for forearm bone pain depends on the cause. Mild cases can be treated with rest, ice, and anti-inflammatory medications. Physical therapy and chiropractic care can also help. In more severe cases, surgery may be required.

Neck Bone Pain

Neck bone pain can be caused by several factors, including injury, poor posture, and degenerative conditions. Common causes of neck bone pain include whiplash, herniated discs, and cervical spondylosis. Symptoms of neck bone pain can include aching pain in the area, difficulty moving the head, and shooting pain down the arms.

Treatment for neck bone pain depends on the underlying cause. Mild cases can be treated with rest, ice, and anti-inflammatory medications. Physical therapy and chiropractic care can also help. In more severe cases, surgery may be required.

Hand Bone Pain

Hand bone pain can be caused by several factors, including overuse, injury, and degenerative conditions. Common causes of hand bone pain include carpal tunnel syndrome, trigger finger, and osteoarthritis. Symptoms of hand bone pain can include aching pain in the area, difficulty moving the fingers, and weakness in the hand.

Treatment for hand bone pain depends on the underlying cause. Mild cases can be treated with rest, ice, and anti-inflammatory medications Physical therapy and occupational therapy can also help. In more severe cases, surgery may be required.

Bone Pain in Forearm

Bone pain in the forearm can be caused by several factors, including overuse, injury, and degenerative conditions. Common causes of bone pain in the forearm include fractures, sprains, and strains. Symptoms of forearm bone pain can include aching pain in the area, difficulty moving the arm, and swelling.

Treatment for bone pain in the forearm depends on the underlying cause. Mild cases can be treated with rest, ice, and anti-inflammatory medications. Physical therapy and chiropractic care can also help. In more severe cases, surgery may be required.

How Much Do Bone Density Tests Cost?

Bone density tests, also known as DXA scans, are used to measure bone density and diagnose conditions such as osteoporosis. The cost of a bone density test can vary depending on several factors, including location, type of test, and insurance coverage. According to Healthcare Bluebook, the cost of a bone density test can range from $150 to $300 without insurance. However, insurance coverage can significantly reduce the cost, with some plans covering the entire cost of the test.

Bone Pain with Leukemia

Leukemia is a type of cancer that affects the blood and bone marrow. Bone pain is a common symptom of leukemia, particularly in the long bones of the body, such as the legs and arms. The pain can be caused by the cancer cells invading the bone marrow or by the treatment of cancer (6).

Treatment for bone pain with leukemia depends on the underlying cause. In some cases, pain medications, such as opioids or non-steroidal anti-inflammatory drugs (NSAIDs), may be prescribed. Radiation therapy and chemotherapy may also be used to target the cancer cells causing the pain.

Bone Health and Vitamin D

Vitamin D is essential for bone health, as it helps the body absorb calcium, which is necessary for strong bones. A deficiency in bone health vitamin D can lead to weak bones and an increased risk of fractures.

The recommended daily intake of vitamin D for adults is 600-800 IU per day. Sources of vitamin D include egg yolks, sunlight, fatty fish,and foods such as milk.

What Are The Treatments for Bone Pain?

Treatment for bone pain depends on the underlying cause. Mild cases of bone pain can be treated with rest, ice, and over-the-counter (drugs that do not require a doctor’s prescription) pain medications, such as acetaminophen, celecoxib, or ibuprofen. Adding physical therapy and chiropractic care as advised by your physician can also help relieve pain and improve mobility.

In more severe cases, prescription pain medications may be necessary. In cases of bone cancer or other serious conditions, treatment may involve surgery, radiation therapy, or chemotherapy. Such medications may include;

1. 1. Antibiotics

If you have a bone infection, your doctor may recommend strong medicines to get rid of the infection-causing bacteria. These antibiotics can be vancomycin, clindamycin, or ciprofloxacin.

2. Pain Reliever

Although they do not treat the underlying problem, painkillers are among the most frequently recommended drugs to lessen bone pain. You can utilize non prescription medications like ibuprofen, diclofenac, or acetaminophen. For moderate to severe pain, prescription drugs like morphine or pentazocine may be utilized.

3. Dietary supplements

Osteoporosis sufferers must raise their calcium and vitamin D levels. In order to cure the mineral shortage, your doctor will prescribe nutritional supplements. The form of supplements can be liquid, pill, or chewable.

4. Cancer therapies

Cancer-related bone pain is challenging to manage. To alleviate the pain, the doctor will need to focus on and treat cancer. Surgery, radiation therapy, and chemotherapy are all frequently used cancer therapies (although chemotherapy might exacerbate bone pain). A class of drugs known as bisphosphonates aid those with metastatic bone cancer in preventing bone discomfort and destruction. Additionally, opiate painkillers may be prescribed (4).

5. Surgery

To remove bone fragments that have degenerated due to infection, surgery may be required. Resetting fractured bones and removing cancerous tumors may both need surgery. In severe cases where joints can be swapped or replaced, reconstructive surgery may be used.

Ways To Protect Yourself From Joint Pain

1. 1. Keep your body at a healthy weight.

Being overweight harms your bones in addition to your cardiovascular system. Your joint can only withstand so much pressure. Joint discomfort results from excessive body weight because it places unneeded strain on the joints. Every 500 grams of excess weight you carry, according to the Arthritis Foundation, can put an additional 2 kilograms of pressure on your weight-bearing joints. Maintain a healthy weight, if possible. By exercising daily, you shed undesirable fat, keeping your weight within the recommended BMI.

2. 2. Wear The Right Shoes.

We hardly ever think about the shoes we wear daily. When purchasing footwear, we prioritize trends over support and comfort. Another factor contributing to joint pain is the choice of footwear. Buy footwear that will protect your knees, ankles, and feet. Whenever you can, choose flat shoes instead than high heels. Inappropriate footwear can even cause back discomfort.

3. 3. Consume Healthy Foods

Consuming foods rich in vitamins, minerals, and anti-inflammatory characteristics can assist to maintain the health of your bones. Studies that take into account alliums, a food category that includes leeks, onions, garlic, and chives, can lower your risk of developing bone pain. Also, calcium supplements should be a huge part of your everyday intake.

Conclusion

Bone pain can be a debilitating condition that affects many parts of the body, including the shoulder, lower back, tailbone, forearm, neck, and hand. The causes of bone pain can vary, from injury and overuse to degenerative conditions and cancer. Treatment for bone pain depends on the underlying cause, with options ranging from rest and ice to prescription pain medications, physical therapy, and surgery. Maintaining good bone health, including getting enough vitamin D, can help prevent bone pain and reduce the risk of fractures.

References

1. 1. https://www.webmd.com/pain-management/bone-pain-what-know
2. 2. https://www.cdc.gov/arthritis/pain/index.htm
3. 3. https://en.m.wikipedia.org/wiki/Bone_pain
4. 4. https://www.medicalnewstoday.com/articles/321835
5. 5. https://www.nhs.uk/conditions/bone-cancer/symptoms/
6. 6. https://pubmed.ncbi.nlm.nih.gov/9060007/

An Overview Of The Health Benefits Of Chiropractic Care And Chiropractor For Arthritis

Chiropractors have long been recognized as a viable alternative for treating musculoskeletal conditions, including arthritis and joint pain. These medical professionals specialize in detecting and correcting misalignments in the spine, which can contribute to a wide range of physical ailments.

By manipulating and adjusting the musculoskeletal system, chiropractors aim to restore proper alignment and improve the function of the joints. Chiropractor for arthritis and joint pain is growing in popularity, as more patients seek out non-invasive, drug-free solutions to their chronic pain. With their gentle but effective techniques, chiropractic care can help patients find relief from even the most stubborn and debilitating conditions.

However, therapy sessions in a chiropractic clinic are not limited to joint treatment alone, chiropractor jaw adjustment, and chiropractor electrical stimulation among others are other tasks performed by a licensed chiropractor. Chiropractors do not take the place of medical or surgical treatment, rather they complement them (1).

Who Is a Chiropractor?

Chiropractors are licensed practitioners that help in the management of health issues involving structures of the body. Chiropractors don’t deal with medicine nor perform surgical procedures, instead, they do body alignments involving the joints, spine, and other body areas to ensure their normal anatomical position and to reduce pain. Chiropractor education is centered around the fact that good body physiology is dependent on a well-positioned structure (2).

Two major systems a chiropractor deals with are the nervous and the musculoskeletal systems. Physicians recommend visits to a chiropractor for joints, spine, or other musculoskeletal problems.

The commonest reasons people see a chiropractor for adjustment are muscle pain, back pain, neck problems, and others. Patients can also consult a chiropractor for arthritis and other general joint issues such as pains in the jaw, shoulder, and elbows (1).

Chiropractor Education And Training

A lot of questions keep coming up as to the educational background of a licensed chiropractor, the training they received, certifications, and questions such as “are chiropractors real doctors”? The answers to these questions will be best explained below.

In the united states, to become a licensed chiropractor, one must have gone through a thorough education training of four years of degree courses to obtain a doctor of chiropractic certificate or degree.

Before anyone can practice in the united states, each of the states require that such a person must have sat for the chiropractic board examination and have a passed mark to obtain the license that will enable such a person to practice.

In the real sense, chiropractor education is a continuous learning process because it never really ends as there are new evolving techniques for joint and spine adjustment, as well as technological interventions (3).

The chiropractic educational requirement includes the:

• – The full program spans four years, the first two years are meant for basic sciences courses after which the students will sit for the part1 professional board exam and one must be successful in this examination before proceeding to the next level
• – The last two of the four years are for purely clinical training and the part 2 professional board exams come shortly after of which the student must be successful to sit for the part 3 examination
• – Part 3 professional exam is mandatory for chiropractors that will make use of physiological therapeutics in the course of their practice as chiropractors.
• – Part 4 examination tests clinical and practical skills only and these include the ability to use diagnostic imaging, management of cases, and most importantly how effective one can apply the chiropractic techniques acquired so far.
• – After graduation from college, in order to become a licensed chiropractor, there is a mandatory one-year internship that should be done in an accredited clinic for that purpose (4).

Are Chiropractors Real Doctors?

Without mincing words, chiropractors are doctors, they earn a degree in doctor of chiropractic medicine. However not have a medical doctorate (M.D.). several countries including the united states will only allow a licensed chiropractor after obtaining the degree of doctor of chiropractic medicine to practice in the country.

Chiropractors do not perform the duties of a medical doctor and they are not alternatives to orthodox medicine, but they rather complement the works of medical doctors. They diagnose and manage conditions in their areas of interest but are not licensed to prescribe drugs (5).

What Does a Chiropractor Do?

A chiropractor specializes in treating musculoskeletal and spine problems such as muscle aches, joint pains, and back pains from spine misalignment. Therefore, anyone with health challenges revolving around the above areas can consult a chiropractor and the treatment is without the use of drugs or surgery.

Some of the treatment options by a chiropractor are below:

• – Adjustments: For joint pains, dislocation, arthritis, falls, and others. A chiropractor will work on joint alignment to help relieve pain and improve function.
• – Tissue therapy: The type of tissues a chiropractor works on are the soft tissues like the muscles and connective tissues. They work by helping to reduce pain and tension in these tissues thereby making the patient feel better
• – Exercises: The major type of exercise the chiropractor recommends is stretches. This type of exercise help to improve the mobility of joints.
• – Bracing: Braces are accessories used to improve stability affected by a faulty joint. With the use of braces, the chiropractor is aiming at improving joint function.
• – Referral: For every patient that visits the chiropractor for arthritis or joint diseases. One of the duties of a chiropractor is to refer patients that require the expertise of the other physician appropriately (1).

Chiropractor And Acupuncture

When discussing holistic practice in medicine, people often mistake chiropractors and acupuncture to be the same entity or practice in medicine. Although they are both noninvasive means of treating patients especially to relieve pain, they still have first-hand differences in how they operate.

The majority of their work is centered around the nervous system and the musculoskeletal system but contrary to what people believe, there are quite several distinctions between the two practices.

Unlike chiropractors limited to majorly the musculoskeletal system, acupuncture helps to promote healing in more diverse ways. Acupuncture has been traced to be useful in helping to relieve stress in infertile couples, alleviating symptoms in post-menopausal women, and treatment of addictions as in individuals who smoke.

Although both are referred to as noninvasive treatment methods, however, in acupuncture, acupuncturists are trained on how to effectively use needles along the energy lines of the body that has been believed to connect the health of a person at one point.

While chiropractic medicine is seen as complementary care for people, acupuncture is an alternative kind of treatment when individuals are trying to avoid medicine and surgery, it is a far less invasive technique that deals with even chronic pain in people.

The procedure for chiropractic medicine is less painful compared to acupuncture which requires needle insertion, and this needle insertion can be much more painful especially if it is not carried out by an expert or an experienced acupuncturist (6).

Benefits Of Choosing Chiropractor And Acupuncture As Dual Treatment Measures

Studies have revealed that using these treatment options together provides more synergistic health benefits than when they are being used isolatedly or individually.

For instance, while a chiropractor is working hard to enhance adjustment along the spine to correct subluxation in a patient, an acupuncturist is looking at how he can insert his needle at targeted areas to remove barriers causing imbalances in the body. This is how they both function to bring about their individual effects. Using them synergistically means that they are both working in their respective ways to achieve the same result of correcting subluxation in a patient and aiding healing.

Medical Conditions Chiropractor And Acupuncture Can Function Together

Both acupuncture and chiropractic medicine can work together to aid better outcomes in the individual medical condition where they are isolatedly needed. Some common examples of such conditions are:

• – Neck pain
• – Back pain
• – Migraine
• – Sciatica
• – Arthritis
• – Others are sports injury, difficulty sleeping at night, diabetes mellitus, and hypertension (7).

Chiropractor vs Massage

The majority of patients often ask to know who is better to be seen between a chiropractor and a massage therapist. Many people seem to get confused because looking at both peripherally, they have similar functions but, they are indeed different in function when studied deeply. Read further to understand what each of the does and to know if you see a chiropractor or massage first.

When To Consult a Chiropractor

One of the best times to consult a chiropractor is when you are experiencing chronic pain, especially pain starting to affect your mobility or causing gradual loss or reduction of function. Such include neck pain, lower back pain, and joint pain among others (8).

Chiropractor Or Massage First? Which Is The Best?

There have been several questions as to whether to visit a chiropractor first before going to the massage therapist or to go a body massage first before chiropractic care. There is no express answer as to which of these should be done because both are beneficial either way. Hence, it is best to discuss the pros and cons of either situation.

• – Chiropractic care before a massage

Going for a chiropractic adjustment before a massage gives the chiropractor first-hand information and the ability to have a more workable diagnosis for a physical examination of the body, thus, giving room for better chiropractic care.

After chiropractic care, the body joints, connective tissues, muscles, and the spine would have been well adjusted and aligned allowing good flexibility of the body. Therefore, going for a massage after such chiropractic care allows the body to thoroughly enjoy the massage process and absorb it better.

• – Chiropractic care after a massage

On the other hand, very stiff body muscles and structures may not have the full benefit from chiropractic care. The such body will benefit more from doing a massage first before visiting the chiropractor as the body is better relaxed for the chiropractor to also work with.

Also, individuals visiting a chiropractor for the first time are advised to go for a massage first to help relieve their anxiety about chiropractic care.

From the above points, there is no direct answer as to whether a chiropractor or massage first as both have benefits attached to them (9).

However, studies have revealed that one should go directly to a chiropractor if confused about who to see first, the reason being that chiropractors are well-trained to diagnose and refer cases to other practitioners. Hence, a chiropractor can also help to decide when it is best to see the massage therapist (8).

Benefits Of Chiropractic Care And Chiropractor For Arthritis

There are several health benefits of chiropractic care today. Below are a few of them:

• 1. Improves neck pain

Neck pain is commonly seen these days among corporate workers and this has been traced to sitting for a long duration of time in a day and frequent bending of the neck as a result of adopted poor posture. A chiropractor for joints will work effectively on adjusting and aligning joints around the neck to help relieve the pain.

A study carried out in 2012 revealed that chiropractic care for spine adjustment among over 272 adults came out to be very effective compared to when drugs are been prescribed to treat the pains within a space of three months.

• 2. Improves back pain

The majority of lower back pains felt in adults, in both genders have been traced to issues affecting the spine. Therefore a chiropractor for joint adjustment might be a good deal in these cases as a treatment measure for back pain.

Physicians in America often encourage their patients and clients to seek nonmedical means and lifestyle modification ways of improving back pain before settling for medications and surgery. Fortunately, one of the most effective means is chiropractic care. A consult with a chiropractor and acupuncture therapy are good options.

• 3. Management of osteoarthritis

Osteoarthritis has been traced to tear and wear occurring at a joint resulting in degenerative changes of the cartilage. A chiropractor for arthritis care will help in the treatment of osteoarthritis by aiding adjustments at the affected joints. Studies also reveal that good chiropractic care will help to reduce the speed of progression of arthritis in affected patients.

• 4. Management of headache

Spine alignment by chiropractors has proven to be effective in the treatment of headaches whose pain radiated to the neck. Examples of such are migraine headaches and tension headaches (10).

• 5. Jaw adjustment

The jaw is one of the head and neck structures made up of bones and joints that functions together to enable one to chew, speak, and also take part in the movement of the head. Excessive stress often manifests sometimes as jaw pain.

A chiropractor jaw adjustment works by realigning the temporomandibular joint by ensuring that the condyles are in the right places and well lined up. The main goal of the chiropractor jaw adjustment is to relieve pain in the jaw and to do this in time because of the delicate nature of the functions of the jaw (11).

• 6. Maintaining good posture

Can chiropractors help with posture? Yes, they can. Good chiropractic care is suitable for readjustment in certain kinds of posture. Examples of such are scoliosis, kyphosis, unleveled pelvis, and high shoulder (12).

Good chiropractic care will help to improve poor posture especially posture affiliated with neck pain and traceable to sitting for a long period each day. And a regular visit to a chiropractor for posture correction is not limited to just correcting the posture, it also helps to improve the quality of life (10).

• 7. Management of sciatica

Sciatica is medical terminology describing the pain felt as a result of pinching of the sciatic nerve. The sciatic nerve took its course from the lower back down to the legs, hence a pinch to the nerve will manifest as pain along its course of travel.

Can chiropractor make sciatica worse? This is a controversial question as there have been several studies looking to encourage or cancel the use of chiropractic care in the management of a patient with sciatica.

A study done in 2015 encouraged the use of chiropractic care in all back pains including sciatica and such patients were found to have more relief with no harm done to them compared to when they visit only a physician.

The study further revealed that chiropractic care didn’t cause the pain to progress or worsen than it, which supported that chiropractic care does not make sciatica worse if done rightly, especially on the recommendation of a physician. (13,14).

• 8. Improves pinched nerves

A pinched nerve occurs when there is nerve compression by tissues surrounding the nerve such as vertebrae and soft tissues compressing on nerves around the spine. An inflamed soft tissue can also cause direct compression on its supplying nerves.

Can chiropractor fix pinched nerve? Yes, a chiropractor can fix a pinched nerve through manual adjustment and alignment of the surrounding bones, joints, and tissues compressing on the nerve. Although spine surgery can help in some cases that is with a high likelihood of side effects than chiropractic care. Hence, it is best to consult a chiropractor to fix a pinched nerve (15).

• 9. Chiropractor electrical stimulation

Chiropractor electrical nerve stimulation is otherwise referred to as E-stim. E-stim is a muscle stimulation method that works on the muscle and surrounding soft tissues to help accelerate recovery processes, especially from pain, inflammatory processes, and poor muscle tone.

The chiropractor electrical stimulation sends electric signals to nerve endings at injury sites, causing them to be stimulated and enhancing the free flow of blood to the site which is necessary for the healing of tissues to take place (16).

Summary

Chiropractors are licensed healthcare professionals who specialize in the musculoskeletal system, primarily the spinal column. They offer a non-invasive and holistic approach to addressing various ailments, including rheumatoid arthritis and various other type of arthritis. These forms of arthritis are characterized by inflammation, stiffness, and pain, primarily in the joints.

By realigning the spinal column and ensuring proper nervous system function, chiropractors can help reduce inflammation and relieve arthritis symptoms. Moreover, their way of treating patients is safe and natural, unlike medications, which may have side effects.

The chiropractic treatment for arthritis involves not only spinal adjustments but also adjusting other joints affected by the disease. This approach helps to minimize the progression of the disease and helps improve joint mobility. A visit to the chiropractor for joints is best done at the onset of arthritis symptoms to prevent the disease from becoming more advanced. Overall, a chiropractor for arthritis is a valuable resource for managing the disease and improving one’s quality of life.

References:

1. 1. https://my.clevelandclinic.org/health/treatments/21033-chiropractic-adjustment
2. 2. https://www.healthgrades.com/right-care/chiropractic-care/8-things-that-can-be-treated-by-a-chiropractor
3. 3. https://www.webmd.com/a-to-z-guides/what-is-chiropractor
4. 4. https://www.spine-health.com/treatment/chiropractic/chiropractor-educational-requirements
5. 5. https://www.bridgeport.edu/news/are-chiropractors-doctors/#:~:text=Yes%2C+chiropractors+are+doctors+of,diagnose+and+treat+musculoskeletal+conditions.
6. 6. https://www.drtimerickson.com/the-benefits-of-using-chiropractic-and-acupuncture-together/#:~:text=Both+chiropractic+and+acupuncture+work,which+leads+to+optimum+health.
7. 7. https://www.westtexaschiropractic.com/chiropractic-vs-acupuncture/
8. 8. https://www.movementhealth.ca/chiropractor-vs-massage-therapist-which-is-better/
9. 9. https://equilibriummassagetherapy.ca/chiropractor-and-massage/
10. 10. https://www.healthline.com/health/chiropractic-benefits#10-benefits
11. 11. https://debolechiro.com/blog/chiropractic-jaw-realignment/#:~:text=A+jaw+realignment+refers+to,up+correctly+with+one+another.
12. 12. https://thetaylordocs.com/can-a-chiropractor-help-improve-my-posture/#:~:text=A+chiropractor+can+help+you,the+body+is+functioning+optimally.
13. 13. https://stanleychiro.com/can-a-chiropractor-make-sciatica-worse/
14. 14. https://www.healthline.com/health/back-pain/chiropractor-for-sciatica#chiropractic-and-sciatica
15. 15. https://tristateclinic.com/2021/03/10/what-causes-a-pinched-nerve-how-chiropractic-can-help/#:~:text=A+chiropractor+can+use+adjustments,otherwise+lead+to+side+effects.
16. 16. https://chirohealthkc.com/chiropractic-care-and-e-stim-treatment-when-is-it-right-for-you/

Muscle Pain: General Overview, Causes Of Muscle Pain And Treatment

Muscle pain medically referred to as myalgia, often manifest as a sign of an ongoing medical condition, illness, infection, or even a mild injury. Muscle pain can be generalized, that is muscle pain all over body, and it can be localized to only certain parts of the body, for instance, muscle pain back of thigh from prolonged standing. All over the world, everyone must have experienced muscle pain at one time or the other, although based on different etiologies (1).

Muscle pain is not age specific, therefore, it can be seen in children, adolescents, adults, and the elderly. Most times, muscle pain and aches are not to be worried about and the doctor will only recommend rest or mild analgesics because the pain will resolve spontaneously.

However, in some instances, muscle pain may be a manifestation of certain diseases such as muscle pain behind knee which can be a symptom or a radiating pain from lumbar spondylosis, or osteoarthritis of the spine (2). There are various causes of muscle pain ranging from muscle soreness, strain, medication, and poor diet. Muscle pain causes a disruption in your daily activities both at home and work. This article discusses causes of muscle pain in different parts of the body and their treatment.

What Are The Possible Causes Of Muscle Pain?

The causes of muscle pain vary, muscle pain which can be localized or generalized has different causes responsible for each. This section will focus on discussing the general causes of muscle pain. These are:

• – Muscle strain

Muscle sprain results mostly from injuries or muscle overuse, and it is the commonest cause of muscle pain. A muscle tissue can get strained after a stressful exercise or a sudden unexpected movement across a joint, this is commonly referred to as pulled muscle in layman’s terminology.

Muscle strain is simply defined as pain resulting from an injury affecting the tendons. That is, tissue connecting muscles to bone, or injury affecting the muscles directly. This can either be minor or major. When it is a major muscle strain, it causes the muscle to tear apart. Muscle pain from overuse or strain can also be complicated by swelling or edema (3).

• – Nutritional deficit

Muscle pain can also result from a poor diet. Insufficient nutrients in diet manifest in so many ways, and one of the clinical signs can be muscle pain and generalized body weakness. Vitamin D is one of the important nutrients the body needs to grow and function well, especially the musculoskeletal system.

Vitamin D is responsible for calcium absorption, so a deficiency of vitamin D in the body can also lead to a low level of calcium termed hypocalcemia, which in turn can affect the muscles, bones, and even internal organs. What causes muscle pain in the legs at times is traceable to vitamin D deficiency.

• – Dehydration

Dehydration occurs due to inadequate fluids in the body, which can occur from inadequate water intake, vomiting, diarrhea, working under the sun, and lots more. Drinking an adequate volume of water is required to enable the body to function appropriately. Muscle pain from dehydration results when there are inadequate fluids in the body to nourish the muscular tissues.

It is important to be conscious of adequate fluid intake daily, and medical experts however recommend intake of six to eight glasses of water daily, and this should be the least for manual laborers that work under the sun (2).

• – Inadequate flow of blood

People who frequently complain of muscle pain back of thigh, or muscle pain in the arms may be experiencing what is called intermittent claudication. This results from the low flow of blood to the distal parts of the body, from arteriosclerosis. Initially, it may be occurring on exertion but as time goes on, it can also occur at rest as the condition worsens and insufficient blood is reaching the muscles.

• – Chronic fatigue syndrome

Chronic fatigue syndrome is a progressive chronic tiredness occurring for a long period, unexplained by any other cause. However, adequate rest makes it better over time.

Muscle pain all over body, muscle pain behind knee, and muscle pain back of thigh are all traceable to chronic fatigue syndrome. There is no definitive treatment for chronic fatigue syndrome, it can however be treated symptomatically (4).

• – Bad posture

Poor body posture is another cause of chronic muscle pain. This entails poor sleeping posture, poor standing posture, and poor sitting posture all contribute to muscle pain. Muscle pain from bad posture often is localized muscle pain.

For instance, muscle pain right side and muscle pain left side of the body may be attributed to poor sleeping posture and a bad mattress. Muscle pain from bad posture is easily corrected by employing good posture techniques and good physiotherapy.

• – Widespread fibromyalgia

When muscle pain becomes on and off and has been ongoing for a while, it may be a pointer to a chronic illness such as fibromyalgia. It is defined by its generalized muscle pain and its weakness. It is sometimes similar to pain felt in muscle strain. Widespread fibromyalgia can radiate pain to different parts of the body such as muscle pain under shoulder blade. Fibromyalgia may also be what causes muscle pain in legs (6).

• – Inadequate sleep

Inadequate sleep, medically referred to as insomnia can cause muscle pain all over body. Adequate sleep and rest are required to nourish the body, recuperate, and be well-rested. Inadequate sleep makes one inactive and function during the day, it makes the body weak and unable to utilize the day. Sometimes, inadequate sleep may also be a pointer to an underlying medical condition (2).

• – Medications

Muscle pain, especially muscle pain all over body can also be a side effect of drugs and therapies. Some drugs will result in myositis, which is inflammation of the body’s muscles as part of its side effect. Examples of such medications and therapies are:

• – Chemotherapies
• – Radiation therapy
• – Antihypertensive drugs, such as ACE inhibitors (Angiotensin-converting enzyme inhibitors)
• – Statins (1).

• – Medical conditions

Certain medical conditions also cause muscle pain in different parts of the body. Pain in an internal organ can also mimic muscle pain in the affected side of the body. Examples of such medical conditions are:

1. a) Lupus

Lupus is an autoimmune disease that affects different systems of the body and is not limited to the musculoskeletal system alone. In lupus, the antibodies in the body meant to protect it against infectious agents begin to act against the normal body cells.

Lupus attacks the muscles and joints and cause pain in the muscles and the joints associated with it. For example, muscle pain elbow may be a clear clinical manifestation of lupus along with other pathognomonic signs (4).

1. b) Urinary tract infections

Infections that affect the urinary system from the urethra to the kidneys are referred to as urinary tract infections or UTIs. This usually occurs when pathogenic microorganisms invade the organs of the urinary system.

Urinary tract infection is more commoner in women compared to male because of the short length of the urethra which is about 4cm. When UTIs occur, it leads to muscle pain in the flanks, which can manifest as muscle pain lower left back, or muscle pain lower right back.

Without adequate and early treatment, a lower urinary tract infection, the infection ascends to the kidney and if not treated early will result in a kidney disease which can be fatal. Aside from the flank pain, people with urinary tract infections also manifest frequent urination, painful urination, and at times, hematuria, that is, blood can be seen in the urine.

1. c) Kidney disease

Kidney disease whether acute kidney disease, chronic kidney disease, polycystic kidney disease, or pyelonephritis all results in pain in the muscles which radiates to muscular pain in the affected flank side.

Some kidney diseases like kidney stones cause severe infection in the affected kidney side and upon touching, the patient is always very irritable, and the muscle aches too.

Muscle pain right side occurring from kidney stones is always very severe and can radiate to other parts of the body like the loin. Individuals who describe their pain as muscle pain lower left back or lower right back may be trying to describe flank pain and they should be given urgent medical attention for immediate treatment.

1. d) Shingles

Shingles is another medical condition that results in muscle pains. Shingles result in painful blisters and rashes along the affected part of the body. Anyone that has been infected with chicken pox in the past is also at risk of shingles infection.

Shingles are also high in those who are immunosuppressed, the elderly, and non-vaccinated children. shingles usually affect just parts of the body, so muscle pain all over body may not occur in shingles, when it affects the back, it can result in muscle pain lower right back or muscle pain lower left back (5).

1. e) Lungs cancer

Muscle pain under shoulder blade oftentimes is radiating pain from other parts of the body and is usually pain from the internal organ, the lungs. Aside from lung cancer, other pain or conditions can manifest as radiating pain presenting as muscle pain under shoulder blade, and examples of such are pericarditis and aortic dissection.

Aside from muscle pain, they have other presentations such as dizziness, difficulty in breathing, and chest pain. These clinical signs should not be ignored because they are maybe life-threatening (6).

1. f) Depression

Depression is one of the commonest mental health disorders all over the world, and it is often associated with physical clinical manifestations such as joint pain and muscle pain. Muscle pain all over body and generalized body weakness is associated with depression.

Although, the pathophysiological explanation of the condition is psychologically related but mental health experts revealed that the muscle pain felt most often than not is a result of hormonal imbalances from serotonin and norepinephrine (3).

Symptoms Of Muscle Pain

There is no particular order of symptoms associated with muscle pain. However, some of the symptoms traceable to muscle pain are associated with the underlying cause or the muscle inflammatory symptoms. Individuals with muscle pain can notice some of the following symptoms:

• – Fever, high body temperature
• – Rashes
• – Dizziness
• – Redness
• – Bite mark
• – Swelling
• – Difficulty in breathing in widespread fibromyalgia
• – Loss of function.

Some of the above signs and symptoms will need urgent medical treatment because they are emergencies, such as difficulty in breathing, dyspnea, and fever. Depending on how severe the muscle pain is, the loss of function can vary from mild to a total inability to use the muscle group affected (2).

When To Call The Doctor For Muscle Pain

A lot of people wonder which doctor for muscle pain is available to be seen for muscle pain or fibromyalgia. However, on the contrary, any trained and licensed physician can treat muscle pain adequately.

There are therefore indications and pointers as to when to visit the doctor for treatment:

• – Tick bite resulting in muscle pain
• – Redness and swelling
• – Muscle pain with rashes
• – Muscle pain induced by a drug
• – Difficulty breathing
• – Dizziness
• – Neck stiffness
• – Hyperthermia, elevated body temperature
• – Loss of function
• – Vomiting
• – Reduced urine flow rate (2).

Remedies For Systemic Muscle Pain

Irrespective of the cause of the muscle pain, the following practical steps will help to treat muscle pain and cause relief of symptoms.

• – Rest

Rest is one of the practical steps to reduce pain and inflammation without the use of medication. Resting the affected body parts helps to relieve symptoms such as pain and swelling. Also, it is advisable to elevate distal parts of the body when they are affected such as muscle pain back of thigh or muscle pain behind knee. Rest the limb and elevate it.

• – Hot and cold compress

Alternate ice and hot compress can be applied to the affected muscle parts to help relieve symptoms. Muscle pain heat or cold compress will help to improve blood flow and reduce the swelling of the affected body parts. You may want to apply ice to the aching muscles for the first 24 to 72 hours.

• – Medications

Over-the-counter medications can be used for muscle pain relief and fever. For muscle pain Tylenol or Advil, drugs can be used to relieve pain in the affected muscle groups.

Also, drugs can be prescribed based on the underlying medical condition precipitating the muscle pain. For example, muscle pain back of thigh can be traceable to intermittent claudication and should be treated accordingly.

• – Complementary therapies

Certain complementary therapies have proven to help relieve muscle pain, examples of such are massage, and acupuncture (1).

Prevention Of Muscle Pain

The following practical steps will help to prevent muscle pain

• – Adequate hydration: Drinking enough water, especially on active days will help to nourish the muscles and help ease the pain in the muscles
• – Exercise: Regularly exercising the body helps to strengthen the muscle and keep them healthy
• – Stretching of muscles
• – Eating healthy (7).

Conclusion

Muscle pain can be a common occurrence for individuals who engage in physical activity or have an underlying health condition. Muscle aches and pains can range from a dull, lingering soreness to sharp, intense pain that affects movement. Soft tissue injuries can lead to pain and inflammation, which may require blood tests to diagnose the extent of the issue. Muscle weakness can develop alongside sore muscles, which can make daily activities challenging.

Myalgia, or muscle discomfort, can be attributed to a variety of factors. It might occur from a localized injury, for instance, a sprain, or by a local infection, such as inflammatory muscle disease, or pyomyositis. It could also be the outcome of a systemic sickness or infection.

Muscle cramps are also a type of pain that can strike suddenly and cause discomfort. Understanding the type of pain a person is experiencing can help determine the best course of treatment. Rest and gentle stretching can often alleviate sore muscles, while more severe pain may require medication or physical therapy. Maintaining an active lifestyle can help prevent muscle pain, but it’s essential to listen to the body and avoid over-exertion to avoid injury.

A physician or a physical therapist can diagnose the disease by reviewing the signs, medical records, laboratory results, and imaging studies. The remedies for muscle pain varies depending on the reason and might range from lengthy rest, and medication to surgery (3).

References:

1. 1. https://my.clevelandclinic.org/health/symptoms/17669-muscle-pain
2. 2. https://www.medicalnewstoday.com/articles/322869#seeing-a-doctor
3. 3. https://www.verywellhealth.com/muscle-pain-what-you-should-know-190093
4. 4. https://www.webmd.com/pain-management/ss/slideshow-body-aches
5. 5. https://www.medicalnewstoday.com/articles/324592#causes
6. 6. https://www.injurymap.com/articles/shoulder-blade-pain
7. 7. https://www.healthline.com/health/muscle-aches#prevention

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