Nature Creation ArticlesHealth, Pain, Therapy, Solution

As peo­ple get older, chronic neck and back pain becomes extremely com­mon. The back and neck pain not only affects the phys­i­cal health of these indi­vid­u­als but also their social and eco­nomic well-being. Chronic lower back pain and neck pain can dis­rupt work, rou­tine and other daily activ­i­ties. Peo­ple often choose some exer­cises for back pain. To know some exer­cises for lower back pain or chronic neck and back pain, read Exer­cise For Neck And Back Pain.

There are also cer­tain low back pain treat­ment meth­ods that you can under­take in order to han­dle the issues that may arise as a result of chronic neck and back pain. These meth­ods for reliev­ing back pain will not only help relieve the pain but also help you reduce the like­li­hood of recur­rences of this condition.

The major causes of lower back pain are strains or other injuries to the mus­cles and lig­a­ments sur­round­ing the spinal col­umn. Other rea­sons might include sports injuries or a sud­den increase in phys­i­cal activ­ity to which the indi­vid­ual is not accustomed.

Although, there is no defin­i­tive chronic neck and back pain rem­edy , still it is a highly treat­able con­di­tion. The most com­mon ther­apy used to treat back and neck pain is back pain med­ica­tion with pain-killing or anti-inflammatory properties.

Yet, there is a bet­ter solu­tion instead of tak­ing pain med­ica­tion for tem­po­rary pain relief. Nature Cre­ation is made of 9 essen­tial herbs, which can be used as wrap­per for hot or cold pain relief ther­apy. There are many sizes and designs to fit com­fort­ably to your body and ergonom­i­cally sculp­ture to wrap around the pain area. Please visit the com­pany site at http://www.naturecreation.com or call 1–888–250‑2010 to learn

Tweet This Post

If stress is not han­dled prop­erly, more seri­ous ill­nesses may result.

How Seri­ous a Threat to Your Health is Stress?

Many believe that prac­ti­cally every ill­ness has stress reac­tion as a con­tribut­ing fac­tor. Some­one who han­dles stress well just sim­ply doesn’t get sick.

How often are the times you have caught a cold or flu also been times when you were wor­ried or stressed about some­thing more than nor­mal, or even deal­ing with some kind of trauma?

This is why it is wise to remem­ber what­ever reme­dies you choose for tem­po­rary relief, there must in addi­tion be con­scious work toward releas­ing stress pat­terns and habits that keep the worry mode, or anx­i­ety in place.

Here’s some­thing to think about. Is stress dif­fer­ent today than it was a few decades ago? Con­tem­po­rary stress tends to be more per­va­sive, per­sis­tent and insid­i­ous because it stems pri­mar­ily from psy­cho­log­i­cal rather than phys­i­cal threats. It is asso­ci­ated with ingrained and imme­di­ate reac­tions over which we have no con­trol and were orig­i­nally designed to be ben­e­fi­cial such as:

* The heart rate and blood pres­sure soar to increase the flow of blood to the brain to improve deci­sion mak­ing.
* The blood sugar rises to fur­nish more fuel for energy as the result of the break­down of glyco­gen, fat and pro­tein stores.
* The blood is shunted away from the gut, where its not imme­di­ately needed for pur­poses of diges­tion. It goes to the large mus­cles of the arms and legs to pro­vide more strength in com­bat, or greater speed in get­ting away from a scene of poten­tial peril.
* Also clot­ting occurs more quickly to pre­vent blood loss from lac­er­a­tions or inter­nal hemorrhage.

These and myr­iad of other imme­di­ate and auto­matic responses have been exquis­itely honed over the lengthy course of human evo­lu­tion as life sav­ing mea­sures to facil­i­tate prim­i­tive man’s abil­ity to deal with phys­i­cal challenges.

How­ever, the nature of stress for mod­ern man is not an occa­sional con­fronta­tion with a saber-toothed tiger or a hos­tile war­rior but rather a host of emo­tional threats like get­ting stuck in traf­fic and fights or mis­un­der­stand­ings with cus­tomers, co-workers, or fam­ily mem­bers, that often occur sev­eral times a day.

Unfor­tu­nately, our bod­ies still react with these same, archaic fight or flight responses that are not only use­ful­ness but poten­tially dam­ag­ing and deadly. Repeat­edly invoked, it is not hard to see how they can con­tribute to hyper­ten­sion, strokes, heart attacks, dia­betes, ulcers, neck or low back pain and other “Dis­eases of Civ­i­liza­tion.“

Feel­ing a Bit Stressed These Days?

You’re not alone! Traf­fic jams, dead­lines, bills to pay, job changes, end­less chores and errands, rela­tion­ships, fam­ily prob­lems, it’s always some­thing and of course we are on the brink of war.

Stress is expe­ri­enced by every­one at one time or another. It requires the body to make phys­i­cal and chem­i­cal adjust­ments in order to main­tain the nec­es­sary phys­i­o­log­i­cal bal­ance for sur­vival. A rac­ing heart, a burst of energy, and mus­cle ten­sion are the body’s phys­i­cal responses to stress. When faced with dan­ger, some of the first stress reac­tions are a rise in blood pres­sure, quicker breath­ing and heart beat, and dilated pupils. Sight and hear­ing become more alert.

This reac­tion is an instinc­tive response that pro­tects us from threats to our sur­vival. Phys­i­o­log­i­cal changes are part of the “fight or flight” response, which pre­pares and ener­gizes a per­son to con­front or flee from dan­ger. After the threat has passed or a change takes place, the “alarm” signs dis­ap­pear. The body is still aroused but is adapt­ing to the change.

When you “gear up” under stress, your body begins to do more of some things and less of oth­ers. For exam­ple, blood cir­cu­la­tion increases, but diges­tion slows down or even stops. First symp­toms of these diges­tive orders may be Per­sis­tent Indi­ges­tion or Colitis.

Once the stress ends, your body goes to work to restore the bal­ance. How­ever, if stress returns too soon, your body will never have time to get back on an even keel. Even­tu­ally, this can lead to major health prob­lems. Exhaus­tion occurs, caus­ing dam­age to the person’s phys­i­cal and emo­tional well-being. If the stress is short-term, chances are good that it can be dealt with. It is long-term stress that causes the body to break down and has many real phys­i­cal effects.

Some of the dis­or­ders asso­ci­ated with stress are:

* Anx­i­ety
* High blood pres­sure
* Headaches
* Depres­sion
* Weak­ened Immune Sys­tem
* Higher Cho­les­terol Lev­els
* Sleep­less­ness
* Impo­tence
* Migraine Headaches
* Diar­rhea
* Loss of Appetite
* Increased Appetite

If stress is not han­dled prop­erly, then more seri­ous ill­nesses will result.

There is no escape from stress. You must learn how to han­dle it.

Relax­ation is often dif­fi­cult. But nec­es­sary to alle­vi­ate the stress. Nature Cre­ation (www.naturecreation.com) is one com­pany who man­u­fac­tures nat­ural herbal ther­apy packs. The prod­ucts are filled with 9 essen­tial nat­ural herbs, which the essence of scents will bring nat­ural relax­ation stim­u­la­tion to your brain. In addi­tion, the prod­ucts can also be used as hot or cold ther­apy. These are excel­lent if you have mus­cle stiff­ness, body pain, headache, cramps or awk­ward twist of your nerves.

The design of Nature Cre­ation prod­ucts are ergonom­i­cally fit com­fort­ably to the con­tour of your body. There are 18 patented shapes and sizes and five unique col­ors to choose.

Please visit the com­pany web­site to learn more of the prod­ucts and all the benefits.

Tweet This Post

There are many ways to reduce ten­sion and relax. Here are the ten stress reliev­ers I believe are most effec­tive for the amount of work and time involved. Some can be learned in the time it takes to read this page, while oth­ers take a lit­tle more prac­tice, but there’s some­thing here for everyone!

1. Breath­ing Exer­cises
Deep breath­ing is an easy stress reliever that has numer­ous ben­e­fits for the body, includ­ing oxy­genat­ing the blood, which ‘wakes up’ the brain, relax­ing mus­cles and qui­et­ing the mind. Breath­ing exer­cises are espe­cially help­ful because you can do them any­where, and they work quickly so you can de-stress in a flash. The Karate Breath­ing Med­i­ta­tion is a great exer­cise to start with, and this basic breath­ing exer­cise can be done any­where!
Also, Nature Cre­ation is offer­ing Mint Pil­low, a small pack con­tains 100% nat­ural spearmint and pep­per­mints for refresh­ing breath, sinus con­ges­tion, and relax­ation therapy.

2. Med­i­ta­tion
Med­i­ta­tion builds on deep breath­ing, and takes it a step fur­ther. When you med­i­tate, your brain enters an area of func­tion­ing that’s sim­i­lar to sleep, but car­ries some added ben­e­fits you can’t achieve as well in any other state, includ­ing the release of cer­tain hor­mones that pro­mote health. Also, the men­tal focus on noth­ing­ness keeps your mind from work­ing over­time and increas­ing your stress level. Here’s an arti­cle on dif­fer­ent types of med­i­ta­tion to help you get started.

Nature Cre­ation is offer­ing Shoul­der Wrap and Upper Body Wrap, which are designed to cre­ate warm­ness around your body, to relax and relief stiff mus­cles due to stress.

3. Guided Imagery
It takes slightly more time to prac­tice guided imagery, but this is a great way to leave your stress behind for a while and relax your body. Some find it eas­ier to prac­tice than med­i­ta­tion, as lots of us find it more doable to focus on ‘some­thing’ than on ‘noth­ing’. You can play nat­ural sounds in the back­ground as you prac­tice, to pro­mote a more immer­sive experience.

4. Visu­al­iza­tions
Build­ing on guided imagery, you can also imag­ine your­self achiev­ing goals like becom­ing health­ier and more relaxed, doing well at tasks, and han­dling con­flict in bet­ter ways. Also, visu­al­iz­ing your­self doing well on tasks you’re try­ing to mas­ter actu­ally func­tions like phys­i­cal prac­tice, so you can improve your per­for­mance through visu­al­iza­tions as well!

5. Self-hypnosis
Self-hypnosis incor­po­rates some of the fea­tures of guided imagery and visu­al­iza­tions, with the added ben­e­fit of enabling you to com­mu­ni­cate directly you’re your sub­con­scious mind to enhance your abil­i­ties, more eas­ily give up bad habits, feel less pain, more effec­tively develop health­ier habits, and even find answers to ques­tions that may not be clear to your wak­ing mind! It takes some prac­tice and train­ing, but is well worth it. Learn more about using hyp­no­sis to man­age stress in your life.

6. Exer­cise
Many peo­ple exer­cise to con­trol weight and get in bet­ter phys­i­cal con­di­tion to become more healthy or phys­i­cally attrac­tive, but exer­cise and stress man­age­ment are also closely linked. Exer­cise pro­vides a dis­trac­tion from stress­ful sit­u­a­tions, as well as an out­let for frus­tra­tions, and gives you a lift via endor­phins as well. This arti­cle can tell you more about the stress man­age­ment ben­e­fits of exer­cise, and help you get more active in your daily life.

7. Pro­gres­sive Mus­cle Relax­ation
By tens­ing and relax­ing all the mus­cle groups in your body, you can relieve ten­sion and feel much more relaxed in min­utes, with no spe­cial train­ing or equip­ment. Start by tens­ing all the mus­cles in your face, hold­ing a tight gri­mace ten sec­onds, then com­pletely relax­ing for ten sec­onds. Repeat this with your neck, fol­lowed by your shoul­ders, etc. You can do this any­where, and as you prac­tice, you will find you can relax more quickly and eas­ily, reduc­ing ten­sion as quickly as it starts!

Nature Cre­ation offers vari­ety prod­ucts to help you relax and relieve mus­cle ten­sions. There are Ulti­mate Set, which con­tains the most com­pre­hen­sive pack­age to ulti­mately relax your mind and body from the head to back. There is also Full Set, which is sim­i­lar to Ulti­mate Set, but offer with smaller back belt design and non-enclosed shoul­der wrap.

8. Sex
You prob­a­bly already know that sex is a great ten­sion reliever, but have you offi­cially thought of it as a stress-relieving prac­tice? Per­haps you should. The phys­i­cal ben­e­fits of sex are numer­ous, and most of them work very well toward reliev­ing stress. Sadly, many peo­ple have less sex when their stress lev­els are high. Learn how to avoid this trap!

9. Music
Music ther­apy has shown numer­ous health ben­e­fits for peo­ple with con­di­tions rang­ing from mild (like stress) to severe (like can­cer). When deal­ing with stress, the right music can actu­ally lower your blood pres­sure, relax your body and calm your mind. Here are some sug­ges­tions of dif­fer­ent types of music to lis­ten to, and how to use music in your daily life for effec­tive stress management.

10. Yoga
Yoga is one of the old­est self-improvement prac­tices around, dat­ing back over 5 thou­sand years! It com­bines the prac­tices of sev­eral other stress man­age­ment tech­niques such as breath­ing, med­i­ta­tion, imagery and move­ment, giv­ing you a lot of ben­e­fit for the amount of time and energy required. Learn more about how to man­age stress with yoga.

Tweet This Post

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

* Arthri­tis
Arthri­tis is among the most com­mon causes of knee pain, and there are many treat­ments available.

* Lig­a­ment Injuries
Lig­a­ment injuries com­monly occur dur­ing ath­letic activ­i­ties and can cause dis­com­fort and insta­bil­ity.
o Ante­rior Cru­ci­ate Lig­a­ment (ACL) Injury
o Pos­te­rior Cru­ci­ate Lig­a­ment (PCL) Injury
o Medial Col­lat­eral Lig­a­ment (MCL) Injury

* Car­ti­lage Injuries | Menis­cal Tear
Car­ti­lage tears are seen in young and old patients alike, and are also an extremely com­mon cause of knee pain.

* Patel­lar Ten­donitis
Ten­donitis around the joint is most com­monly of the patel­lar ten­don, the large ten­don over the front of the knee.

* Chon­dro­ma­la­cia Patella
Chon­dro­ma­la­cia causes knee pain under the kneecap and is due to soft­en­ing of the

car­ti­lage. It is most com­mon in younger patients (15–35 years old).

* Dis­lo­cat­ing Kneecap
A dis­lo­cat­ing kneecap causes acute symp­toms dur­ing the dis­lo­ca­tion, but can also lead to chronic knee pain.

* Baker’s Cyst
A Baker’s cyst is swelling in the back of the joint, and is usu­ally a sign of another under­ly­ing prob­lem such as a menis­cus tear.

* Bur­si­tis
The most com­mon bursa affected around the joint is just above the kneecap. This is most com­mon in peo­ple who kneel for work, such as gar­den­ers or carpetlayers.

* Plica Syn­drome
Plica syn­drome is an uncom­mon cause of knee pain, and can be dif­fi­cult to diag­nose. The diag­no­sis is usu­ally made at the time of arthroscopy.

* Osgood-Schlatter Dis­ease
Osgood-Schlatter dis­ease is a con­di­tion seen in ado­les­cents and is due to irri­ta­tion of the growth plate just at the front of the joint.

* Osteo­chon­dri­tis Dis­se­cans
Osteo­chon­dri­tis dis­se­cans (OCD) is another con­di­tion seen in ado­les­cents due to the growth of the bone around the joint.

* Gout
Gout is an uncom­mon cause of knee pain. How­ever, in patients who have a diag­no­sis of gout, it must be con­sid­ered as a cause for new onset knee pain.

Treat­ments for Knee Pain
Treat­ment of knee pain depends entirely on the cause of the prob­lem. There­fore, it is of utmost impor­tance that you under­stand the cause of your symp­toms before embark­ing on a treat­ment pro­gram. If you are unsure of your diag­no­sis, or the sever­ity of your con­di­tion, you should seek med­ical advice before begin­ning any treat­ment plan.

Some com­mon treat­ments for knee pain are listed here. Not all of these treat­ments are appro­pri­ate for every con­di­tion, but they may be help­ful in your situation.

* Rest: The first treat­ment for most com­mon con­di­tions that cause knee pain is to rest the joint, and allow the acute inflam­ma­tion to sub­side. Often this is the only step needed to relieve knee pain. If the symp­toms are severe, crutches may be help­ful as well.

* Cold and Heat Appli­ca­tion: Nature Cre­ation Hot & Cold herbal packs are among the most com­monly used treat­ments for knee pain. So which one is the right one to use, ice or heat? And how long should the ice or heat treat­ments last? Click the fol­low­ing link: Heat or Cold, which Treat­ment is to use.

* Stretch­ing: Stretch­ing the mus­cles and ten­dons that sur­round the joint can help with some causes of knee pain. A good rou­tine should be estab­lished, and fol­low­ing some spe­cific sug­ges­tions will help you on your way.

* Phys­i­cal Ther­apy: Phys­i­cal ther­apy is an impor­tant aspect of treat­ment of almost all ortho­pe­dic con­di­tions. Phys­i­cal ther­a­pists use dif­fer­ent tech­niques to increase strength, regain mobil­ity, and help return patients to their pre-injury level of activity.

* Anti-Inflammatory Med­ica­tion: Non­s­teroidal anti-inflammatory med­ica­tions, com­monly referred to as NSAIDs, are some of the most com­monly pre­scribed med­ica­tions, espe­cially for patients with knee pain caused by prob­lems such as arthri­tis, bur­si­tis, and tendonitis.

* Cor­ti­sone injec­tions: Cor­ti­sone is a pow­er­ful med­ica­tion that treats inflam­ma­tion, and inflam­ma­tion is a com­mon prob­lem in patients with knee pain. Dis­cuss with your doc­tor the pos­si­ble ben­e­fits of a cor­ti­sone injec­tion for your condition.

Tweet This Post

Almost one in three Amer­i­cans older than age 45 reports some type of knee pain, and it’s a com­mon rea­son that peo­ple visit their doc­tors or the emer­gency room.

Knee pain may be the result of an injury, such as a rup­tured lig­a­ment or torn car­ti­lage. Or, cer­tain med­ical con­di­tions, includ­ing arthri­tis, gout and infec­tion, may be at the root of your knee pain.

Many rel­a­tively minor instances of knee pain respond well to self-care mea­sures. More-serious injuries, such as a rup­tured lig­a­ment or ten­don, may require sur­gi­cal repair.

Although every knee prob­lem can’t be pre­vented — espe­cially if you’re active — you can take cer­tain steps to reduce the risk of injury or disease.

A knee injury can affect any of the lig­a­ments, ten­dons or fluid-filled sacs (bur­sae) that sur­round your knee joint as well as the bones, car­ti­lage and lig­a­ments that form the joint itself. Because of the knee’s com­plex­ity, the num­ber of struc­tures involved, the amount of use it gets over a life­time, and the range of injuries and dis­eases that can cause knee pain, the signs and symp­toms of knee prob­lems can vary widely.

Some of the more com­mon knee injuries and their signs and symp­toms include the following:

Lig­a­ment injuries. Your knee con­tains four lig­a­ments — tough bands of tis­sue that con­nect your thigh­bone (femur) to your lower leg bones (tibia and fibula). You have two col­lat­eral lig­a­ments — one on the inside (medial col­lat­eral lig­a­ment) and one on the out­side (lat­eral col­lat­eral lig­a­ment) of each knee. The other two lig­a­ments are inside your knee and cross each other as they stretch diag­o­nally from the bot­tom of your thigh­bone to the top of your shin­bone (tibia). The pos­te­rior cru­ci­ate lig­a­ment (PCL) con­nects to the back of your shin­bone, and the ante­rior cru­ci­ate lig­a­ment (ACL) con­nects near the front of your shin­bone. A tear in one of these lig­a­ments, which may be caused by a fall or con­tact trauma, is likely to cause:

* Imme­di­ate pain that wors­ens when you try to walk or bend your knee
* A pop­ping sound
* An inabil­ity to bear weight on the injured knee
* A feel­ing that the knee might buckle or give way

Ten­don injuries (ten­dini­tis). Ten­dini­tis is irri­ta­tion and inflam­ma­tion of one or more ten­dons — the thick, fibrous cords that attach mus­cles to bones. Ath­letes, such as espe­cially run­ners, skiers and cyclists, are prone to develop inflam­ma­tion in the patel­lar ten­don, which con­nects the quadri­ceps mus­cle on the front of the thigh to the larger lower leg bone (tibia). If your knee pain is caused by ten­dini­tis, some of the signs and symp­toms include:

* Pain, in one or both knees
* Swelling in the front of the knee or just below the kneecap
* Wors­en­ing pain when you jump, run, squat or climb stairs
* An inabil­ity to com­pletely extend or straighten your knee

Menis­cus injuries. The menis­cus is a C-shaped piece of car­ti­lage that curves within your knee joint. Menis­cus injuries involve tears in the car­ti­lage, which can occur in var­i­ous places and con­fig­u­ra­tions. Signs and symp­toms of this type of injury include:

* Pain
* Mild to mod­er­ate swelling that occurs slowly, as long as 24 to 36 hours after the injury
* An inabil­ity to straighten the knee com­pletely; the knee may feel locked in place

Bur­si­tis. Some knee injuries cause inflam­ma­tion in the bur­sae, the small sacs of fluid that cush­ion the out­side of your knee joint so that ten­dons and lig­a­ments glide smoothly over the joint. Bur­si­tis can lead to:

* Warmth
* Swelling
* Red­ness
* Pain, even at rest
* Aching or stiff­ness when you walk
* Con­sid­er­able pain when you kneel or go up and down stairs
* Fever, pain and swelling if the bursa located over your kneecap bone (prepatel­lar bursa) becomes infected

Loose body. Some­times injury or degen­er­a­tion of bone or car­ti­lage can cause a piece of bone or car­ti­lage to break off and float in the joint space. This may not cre­ate any prob­lems unless the loose body inter­feres with knee joint move­ment — the effect is some­thing like a pen­cil caught in a door hinge — lead­ing to pain and a locked joint.

Dis­lo­cated kneecap. This occurs when the tri­an­gu­lar bone (patella) that cov­ers the front of your knee slips out of place, usu­ally to the out­side of your knee. You’ll be able to see the dis­lo­ca­tion, and your kneecap is likely to move exces­sively from side to side. Signs and symp­toms of a dis­lo­cated kneecap include:

* Intense pain
* Swelling
* Dif­fi­culty walk­ing or straight­en­ing your knee

Osgood-Schlatter dis­ease. Pri­mar­ily affect­ing ath­letic teens and pre­teens, this overuse syn­drome causes:

* Pain, usu­ally worse with activ­ity, espe­cially run­ning and jump­ing
* Swelling
* Ten­der­ness at the bony promi­nence (tib­ial tuberos­ity) just below the kneecap

The dis­com­fort can last a few months and may con­tinue to recur until your teen or pre­teen stops growing.

Ili­otib­ial band syn­drome. This occurs when the lig­a­ment that extends from the out­side of your pelvic bone to the out­side of your tibia (ili­otib­ial band) becomes so tight that it rubs against the outer por­tion of your femur. Dis­tance run­ners are espe­cially sus­cep­ti­ble to ili­otib­ial band syn­drome, which gen­er­ally causes:

* A sharp, burn­ing pain on the outer side of the knee that usu­ally begins after longer dis­tance runs
* Pain that ini­tially goes away with rest from run­ning, but in time may per­sist when you walk or go up and down stairs

With this type of knee injury, there usu­ally isn’t swelling and you’ll likely have nor­mal range of motion.

Hyper­ex­tended knee. In this injury, your knee extends beyond its nor­mally straight­ened posi­tion so that it bends back on itself. Some­times the dam­age is rel­a­tively minor, with pain and swelling when you try to extend your knee. But a hyper­ex­tended knee may also lead to a par­tial or com­plete lig­a­ment tear, espe­cially in your ACL.

Sep­tic arthri­tis. Some­times your knee joint can become infected, lead­ing to swelling, pain and red­ness. There’s usu­ally no trauma before the onset of pain. Sep­tic arthri­tis often occurs with a fever.

Rheuma­toid arthri­tis. The most debil­i­tat­ing of the more than 100 types of arthri­tis, rheuma­toid arthri­tis can affect almost any joint in your body, includ­ing your knees. Com­mon signs and symp­toms of rheuma­toid arthri­tis include:

* Pain
* Swelling
* Aching and stiff­ness, espe­cially when you get up in the morn­ing or after peri­ods of inac­tiv­ity
* Loss of motion in your knees and even­tu­ally defor­mity of the knee joints
* Some­times, a low-grade fever and a gen­eral sense of not feel­ing well (malaise)

Although rheuma­toid arthri­tis is a chronic dis­ease, it tends to vary in sever­ity and may even come and go. Peri­ods of increased dis­ease activ­ity — called flare-ups or flares — often alter­nate with peri­ods of remission.

Osteoarthri­tis. Some­times called degen­er­a­tive arthri­tis, this is the most com­mon type of arthri­tis. It’s a wear-and-tear con­di­tion that occurs when the car­ti­lage in your knee dete­ri­o­rates with use and age. Osteoarthri­tis usu­ally devel­ops grad­u­ally and tends to cause:

* Vary­ing degrees of pain, espe­cially when you stand or walk
* Swelling
* Stiff­ness, espe­cially in the morn­ing and after you’ve been active
* Creak­ing or pop­ping sounds
* A loss of flex­i­bil­ity in your knee joints

Gout and pseudo­gout. Gout, a type of arthri­tis, is likely to cause:

* Red­ness.
* Swelling.
* Intense knee pain that comes on sud­denly — often at night — and with­out warn­ing. The pain typ­i­cally lasts five to 10 days and then stops. The dis­com­fort sub­sides grad­u­ally over one to two weeks, leav­ing your knee joints appar­ently nor­mal and pain-free.

Another con­di­tion, pseudo­gout (chon­dro­cal­ci­nosis), which mainly occurs in older adults, can cause:

* Severe inflam­ma­tion
* Inter­mit­tent attacks of sud­den pain and swelling in large joints, espe­cially the knees

Chon­dro­ma­la­cia of the patella, or patellofemoral pain. This is a gen­eral term that refers to pain aris­ing between your patella and the under­ly­ing thigh­bone (femur). It’s com­mon in young adults, espe­cially those who have a slight mis­align­ment of the kneecap; in ath­letes; and in older adults, who usu­ally develop the con­di­tion as a result of arthri­tis of the kneecap. Chon­dro­ma­la­cia of the patella causes:

* Pain and ten­der­ness in the front of your knee that’s worse when you sit for long peri­ods, when you get up from a chair, and when you climb or descend stairs.
* A grat­ing or grind­ing sen­sa­tion may be present when you extend your knee.

When to see a doc­tor
If you have new knee pain that isn’t severe or dis­abling, a good rule of thumb is to try treat­ing it your­self first. This includes rest­ing, icing and ele­vat­ing the affected knee, and some­times using non­s­teroidal anti-inflammatory drugs to reduce pain and inflam­ma­tion. If you don’t notice any improve­ment in three to seven days, see your doc­tor or a spe­cial­ist in sports med­i­cine or orthopedics.

Some types of knee pain require more imme­di­ate med­ical care. Call your doc­tor if you:

* Can’t bear weight on your knee
* Have marked knee swelling
* See an obvi­ous defor­mity in your leg or knee
* Have wor­ri­some pain
* Have a fever, in addi­tion to red­ness, pain and swelling in your knee, which may indi­cate an infection

In the sim­plest terms, a joint occurs wher­ever two bones come together. But that def­i­n­i­tion doesn’t begin to con­vey the com­plex­ity of joints, which pro­vide your body with flex­i­bil­ity, sup­port and a wide range of motion.

You have four types of joints: fixed, pivot, ball-and-socket and hinge. Your knees are hinge joints, which, as the name sug­gests, work much like the hinge of a door, allow­ing the joint to move back­ward and for­ward. Your knees are the largest and heav­i­est hinge joints in your body. They’re also the most com­plex. In addi­tion to bend­ing and straight­en­ing, they twist and rotate. This makes them espe­cially vul­ner­a­ble to dam­age, which is why they sus­tain more injuries on aver­age than do other joints.

A closer look at your knees
Your knee joint is essen­tially four bones held together by lig­a­ments. Your thigh­bone (femur) makes up the top part of the joint, and two lower leg bones, the tibia and the fibula, com­prise the lower part. The fourth bone, the patella, slides in a groove on the end of the femur.

Lig­a­ments are large bands of tis­sue that con­nect bones to one another. In the knee joint, four main lig­a­ments link the femur to the tibia and help sta­bi­lize your knee as it moves through its arc of motion. These include the col­lat­eral lig­a­ments along the inner (medial) and outer (lat­eral) sides of your knee and the ante­rior cru­ci­ate lig­a­ment (ACL) and pos­te­rior cru­ci­ate lig­a­ment (PCL), which cross each other as they stretch diag­o­nally from the bot­tom of your thigh­bone to the top of your shinbone.

Other struc­tures in your knee include:

* Ten­dons. These fibrous bands of tis­sue con­nect mus­cles to bones. Your knee has two impor­tant ten­dons, which make it pos­si­ble for you to straighten or extend your leg: the quadri­ceps ten­don, which con­nects the long quadri­ceps mus­cle on the front of your thigh to the patella, and the patel­lar ten­don, which con­nects the patella to the tibia.
* Menis­cus. This C-shaped car­ti­lage, which curves around the inside and out­side of your knee, cush­ions your knee joint.
* Bur­sae. A num­ber of these fluid-filled sacs sur­round your knee. They help cush­ion your knee joint so that lig­a­ments and ten­dons slide across it smoothly.

Nor­mally, all of these struc­tures work together smoothly. But injury and dis­ease can dis­rupt this bal­ance, result­ing in pain, mus­cle weak­ness and decreased function.

Some com­mon causes of knee pain and injuries include:

* A blow to the knee, either from con­tact dur­ing sports, a fall or a car acci­dent
* Repeated stress or overuse, which may occur from play­ing sports or if your work or hobby requires doing the same activ­ity over and over again
* Sud­den turn­ing, piv­ot­ing, stop­ping, cut­ting from side to side, which hap­pens fre­quently dur­ing cer­tain sports
* Awk­ward land­ings from a fall or from jump­ing dur­ing sports, such as bas­ket­ball
* Rapidly grow­ing bones, which are espe­cially prone to injury dur­ing sports
* Degen­er­a­tion from aging

A num­ber of fac­tors can increase your risk of hav­ing knee prob­lems, including:

* Excess weight. Being over­weight or obese increases stress on your knee joints, even dur­ing ordi­nary activ­i­ties such as walk­ing or going up and down stairs. It also puts you at increased risk of osteoarthri­tis by accel­er­at­ing the break­down of joint car­ti­lage.
* Overuse. Any repet­i­tive activ­ity, from cycling a few miles every morn­ing to gar­den­ing all week­end, can fatigue the mus­cles around your joints and lead to exces­sive load­ing stress. This causes an inflam­ma­tory response that dam­ages tis­sue. If you don’t allow your body time to recover, the cycle of inflam­ma­tion and micro­dam­age con­tin­ues, putting you at increased risk of injury. It’s not repeated motion itself that’s to blame, but rather the lack of ade­quate recov­ery time. That’s why cur­rent strength train­ing guide­lines advise against work­ing the same mus­cle group on con­sec­u­tive days.
* Lack of mus­cle flex­i­bil­ity or strength. A lack of strength and flex­i­bil­ity are among the lead­ing causes of knee injuries. Tight or weak mus­cles offer less sup­port for your knee because they don’t absorb enough of the stress exerted on your knee joints.
* Lack of neu­ro­mus­cu­lar con­trol. Stud­ies have shown that some peo­ple who have abnor­mal move­ment pat­terns of the leg dur­ing activ­i­ties such as squat­ting and step­ping off a step may be pre­dis­posed to knee injury.
* Mechan­i­cal prob­lems. Cer­tain struc­tural abnor­mal­i­ties, such as hav­ing one leg shorter than the other, mis­aligned knees and even flat feet, can make you more prone to knee prob­lems.
* High-risk sports and activ­i­ties. Some sports and activ­i­ties put greater stress on your knees than do oth­ers. Alpine ski­ing with its sharp twists and turns and poten­tial for falls, basketball’s jumps and piv­ots, and the repeated pound­ing your knees take when you run or jog all increase your risk of injury.
* Pre­vi­ous injury. Hav­ing a pre­vi­ous knee injury makes it more likely that you’ll injure your knee again.
* Age. Cer­tain types of knee prob­lems are more com­mon in young peo­ple — Osgood-Schlatter dis­ease and patel­lar ten­dini­tis, for exam­ple. Oth­ers, such as osteoarthri­tis, gout and pseudo­gout, tend to affect older adults.
* Sex. For rea­sons that aren’t entirely clear, your sex may increase your risk of some types of knee injuries. Teenage girls are more likely than are boys to expe­ri­ence an ACL tear or a dis­lo­cated kneecap. Boys, on the other hand, are at greater risk of Osgood-Schlatter dis­ease and patel­lar ten­dini­tis than girls are.

Not all knee pain is seri­ous. But some knee injuries and med­ical con­di­tions, such as osteoarthri­tis, can lead to increas­ing pain, joint dam­age and even dis­abil­ity if left untreated. And hav­ing a knee injury — even a minor one — makes it more likely that you’ll have sim­i­lar injuries in the future.

Tweet This Post

What is a mammogram?

A mam­mo­gram is a safe, low-dose x-ray exam of the breasts to look for changes that are not nor­mal. The results are recorded on x-ray film or directly into a com­puter for a doc­tor called a radi­ol­o­gist to examine.

A mam­mo­gram allows the doc­tor to have a closer look for changes in breast tis­sue that can­not be felt dur­ing a breast exam. It is used for women who have no breast com­plaints and for women who have breast symp­toms, such as a change in the shape or size of a breast, a lump, nip­ple dis­charge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not can­cer and are called “benign,” but only a doc­tor can know for sure. Breast changes can also hap­pen monthly, due to your men­strual period.

What is the best method of detect­ing breast can­cer as early as possible?

A mam­mo­gram plus a clin­i­cal breast exam, an exam done by your doc­tor, is the most effec­tive way to detect breast can­cer early. Find­ing breast can­cer early greatly improves a woman’s chances for suc­cess­ful treatment.

Like any test, mam­mo­grams have both ben­e­fits and lim­i­ta­tions. For exam­ple, some can­cers can’t be found by a mam­mo­gram, but they may be found in a clin­i­cal breast exam.

Check­ing your own breasts for lumps or other changes is called a breast self-exam (BSE). Stud­ies so far have not shown that BSE alone helps reduce the num­ber of deaths from breast can­cer. BSE should not take the place of rou­tine clin­i­cal breast exams and mammograms.

If you choose to do BSE, remem­ber that breast changes can occur because of preg­nancy, aging, menopause, men­strual cycles, or from tak­ing birth con­trol pills or other hor­mones. It is nor­mal for breasts to feel a lit­tle lumpy and uneven. Also, it is com­mon for breasts to be swollen and ten­der right before or dur­ing a men­strual period. If you notice any unusual changes in your breasts, con­tact your doctor.

How is a mam­mo­gram done?

You stand in front of a spe­cial x-ray machine. The per­son who takes the x-rays, called a radi­o­logic tech­ni­cian, places your breasts, one at a time, between an x-ray plate and a plas­tic plate. These plates are attached to the mam­mo­gram machine and com­press the breasts to flat­ten them. This spreads the breast tis­sue out to obtain a clearer pic­ture. You will feel pres­sure on your breast for a few sec­onds. It may cause you some dis­com­fort; you might feel squeezed or pinched. This feel­ing only lasts for a few sec­onds, and the flat­ter your breast, the bet­ter the pic­ture. Most often, two pic­tures are taken of each breast — one from the side and one from above. A screen­ing mam­mo­gram takes about 20 min­utes from start to finish.

Are there dif­fer­ent types of mammograms?

• Screen­ing mam­mo­grams are done for women who have no symp­toms of breast can­cer. It usu­ally involves two x-rays of each breast. Screen­ing mam­mo­grams can detect lumps or tumors that can­not be felt. They can also find micro­cal­ci­fi­ca­tions (my-kro-kal-si-fi-KAY-shuns) or tiny deposits of cal­cium in the breast, which some­times mean that breast can­cer is present.
• Diag­nos­tic mam­mo­grams are used to check for breast can­cer after a lump or other symp­tom or sign of breast can­cer has been found. Signs of breast can­cer may include pain, thick­ened skin on the breast, nip­ple dis­charge, or a change in breast size or shape. This type of mam­mo­gram also can be used to find out more about breast changes found on a screen­ing mam­mo­gram, or to view breast tis­sue that is hard to see on a screen­ing mam­mo­gram. A diag­nos­tic mam­mo­gram takes longer than a screen­ing mam­mo­gram because it involves more x-rays in order to obtain views of the breast from sev­eral angles. The tech­ni­cian can mag­nify a prob­lem area to make a more detailed pic­ture, which helps the doc­tor make a cor­rect diagnosis.

A dig­i­tal mam­mo­gram also uses x-ray radi­a­tion to pro­duce an image of the breast, but instead of stor­ing the image directly on film, it stores the image of the breast directly on a com­puter. This allows the recorded data to be mag­ni­fied for the doc­tor to take a closer look. Cur­rent research has not shown that dig­i­tal images are bet­ter at show­ing can­cer than x-ray film images in gen­eral. But, women with dense breasts who are pre– or per­i­menopausal, or who are younger than age 50, may ben­e­fit from hav­ing a dig­i­tal rather than a film mam­mo­gram. Dig­i­tal mam­mog­ra­phy may offer these benefits:

• Long-distance con­sults with other doc­tors may be eas­ier because the images can be shared by computer.
• Slight dif­fer­ences between nor­mal and abnor­mal tis­sues may be eas­ily noted.
• The num­ber of follow-up tests needed may be fewer.
• Fewer repeat images may be needed, reduc­ing expo­sure to radiation.

How often should I get a mammogram?

• Women 40 years and older should get a mam­mo­gram every 1–2 years.
• Women who have had breast can­cer or other breast prob­lems or who have a fam­ily his­tory of breast can­cer might need to start get­ting mam­mo­grams before age 40, or they might need to get them more often. Talk to your doc­tor about when to start and how often you should have a mammogram.

What can mam­mo­grams show?

The radi­ol­o­gist will look at your x-rays for breast changes that do not look nor­mal and for dif­fer­ences in each breast. He or she will com­pare your past mam­mo­grams with your most recent one to check for changes. The doc­tor will also look for lumps and calcifications.

• Lump or mass. The size, shape, and edges of a lump some­times can give doc­tors infor­ma­tion about whether or not it may be can­cer. On a mam­mo­gram, a growth that is benign often looks smooth and round with a clear, defined edge. Breast can­cer often has a jagged out­line and an irreg­u­lar shape.
• Cal­ci­fi­ca­tion. A cal­ci­fi­ca­tion is a deposit of the min­eral cal­cium in the breast tis­sue. Cal­ci­fi­ca­tions appear as small white spots on a mam­mo­gram. There are two types:
  • Macro­cal­ci­fi­ca­tions are large cal­cium deposits often caused by aging. These usu­ally are not a sign of cancer.
  • Micro­cal­ci­fi­ca­tions are tiny specks of cal­cium that may be found in an area of rapidly divid­ing cells.

If cal­ci­fi­ca­tions are grouped together in a cer­tain way, it may be a sign of can­cer. Depend­ing on how many cal­cium specks you have, how big they are, and what they look like, your doc­tor may sug­gest that you have other tests. Cal­cium in the diet does not cre­ate cal­cium deposits, or cal­ci­fi­ca­tions, in the breast.

What if my screen­ing mam­mo­gram shows a problem?

If you have a screen­ing test result that sug­gests can­cer, your doc­tor must find out whether it is due to can­cer or to some other cause. Your doc­tor may ask about your per­sonal and fam­ily med­ical his­tory. You may have a phys­i­cal exam. Your doc­tor also may order some of these tests:

• Diag­nos­tic mam­mo­gram, to focus on a spe­cific area of the breast
• Ultra­sound, or imag­ing test that uses a device with sound waves to cre­ate a pic­ture of your breast. The pic­tures may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac. Cysts are not can­cer. But a solid mass may be can­cer. After the test, your doc­tor can store the pic­tures on video or print them out. This exam may be used along with a mammogram.
• Mag­netic res­o­nance imag­ing (MRI), which uses a pow­er­ful mag­net linked to a com­puter. MRI makes detailed pic­tures of breast tis­sue. Your doc­tor can view these pic­tures on a mon­i­tor or print them on film. MRI may be used along with a mammogram.
• Biopsy, a test in which fluid or tis­sue is removed from your breast to help find out if there is can­cer. Your doc­tor may refer you to a sur­geon or to a doc­tor who is an expert in breast dis­ease for a biopsy.

Where can I get a high-quality mammogram?

Women can get high qual­ity mam­mo­grams in breast clin­ics, hos­pi­tal radi­ol­ogy depart­ments, mobile vans, pri­vate radi­ol­ogy offices, and doc­tors’ offices. The Food and Drug Admin­is­tra­tion (FDA) cer­ti­fies mam­mog­ra­phy facil­i­ties that meet strict qual­ity stan­dards for their x-ray machines and staff and are inspected every year. You can ask your doc­tor or the staff at the mam­mog­ra­phy cen­ter about FDA cer­ti­fi­ca­tion before mak­ing your appoint­ment. A list of FDA-certified facil­i­ties can be found on the Inter­net at: http://www.fda.gov/cdrh/mammography/certified.html.

Your doc­tor, local med­ical clinic, or local or state health depart­ment can tell you where to get no-cost or low-cost mam­mo­grams. You can also call the National Can­cer Institute’s Can­cer Infor­ma­tion Ser­vice toll free at 1–800-422‑6237 (TTY: 1–800-332‑8615). Visit them online at http://www.cancer.gov.

What if I have breast implants?

Women with breast implants should con­tinue to have mam­mo­grams. A woman who had an implant after breast can­cer surgery should ask her doc­tor whether she needs a mam­mo­gram of the recon­structed breast.

If you have breast implants, be sure to tell your mam­mog­ra­phy facil­ity that you have them when you make your appoint­ment. The tech­ni­cian and radi­ol­o­gist must be expe­ri­enced in x-raying patients with breast implants. Implants can hide some breast tis­sue, mak­ing it harder for the radi­ol­o­gist to see a prob­lem when look­ing at your mam­mo­gram. To see as much breast tis­sue as pos­si­ble, the x-ray tech­ni­cian will gen­tly lift the breast tis­sue slightly away from the implant and take extra pic­tures of the breasts.

How do I get ready for my mammogram?

First, check with the place you are hav­ing the mam­mo­gram for any spe­cial instruc­tions you may need to fol­low before you go. Here are some gen­eral guide­lines to follow:

• If you are still hav­ing men­strual peri­ods, try to avoid mak­ing your mam­mo­gram appoint­ment dur­ing the week before your period. Your breasts will be less ten­der and swollen. The mam­mo­gram will hurt less and the pic­ture will be better. 
• If you have breast implants, be sure to tell your mam­mog­ra­phy facil­ity that you have them when you make your appointment.
• Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
• Don’t wear any deodor­ant, per­fume, lotion, or pow­der under your arms or on your breasts on the day of your mam­mo­gram appoint­ment. These things can make shad­ows show up on your mammogram.
• If you have had mam­mo­grams at another facil­ity, have those x-ray films sent to the new facil­ity so that they can be com­pared to the new films.

Are there any prob­lems with mammograms?

Although they are not per­fect, mam­mo­grams are the best method to find breast changes. If your mam­mo­gram shows a breast change, some­times other tests are needed to bet­ter under­stand it. Even if the doc­tor sees some­thing on the mam­mo­gram, it does not mean it is cancer.

As with any med­ical test, mam­mo­grams have lim­its. These lim­its include:

• They are only part of a com­plete breast exam. Your doc­tor also should do a clin­i­cal breast exam. If your mam­mo­gram finds some­thing abnor­mal, your doc­tor will order other tests.
• Find­ing can­cer does not always mean sav­ing lives. Even though mam­mog­ra­phy can detect tumors that can­not be felt, find­ing a small tumor does not always mean that a woman’s life will be saved. Mam­mog­ra­phy may not help a woman with a fast grow­ing can­cer that has already spread to other parts of her body before being found.
• False neg­a­tives can hap­pen. This means every­thing may look nor­mal, but can­cer is actu­ally present. False neg­a­tives don’t hap­pen often. Younger women are more likely to have a false neg­a­tive mam­mo­gram than are older women. The dense breasts of younger women make breast can­cers harder to find in mammograms.
• False pos­i­tives can hap­pen. This is when the mam­mo­gram results look like can­cer is present, even though it is not. False pos­i­tives are more com­mon in younger women, women who have had breast biop­sies, women with a fam­ily his­tory of breast can­cer, and women who are tak­ing estro­gen, such as hor­mone replace­ment therapy.
• Mam­mo­grams (as well as den­tal x-rays and other rou­tine x-rays) use very small doses of radi­a­tion. The risk of any harm is very slight, but repeated x-rays could cause prob­lems. The ben­e­fits nearly always out­weigh the risk. Talk to your doc­tor about the need for each x-ray. Ask about shield­ing to pro­tect parts of the body that are not in the pic­ture. You should always let your doc­tor and the tech­ni­cian know if there is any chance that you are pregnant.

Tweet This Post

Arthri­tis is inflam­ma­tion of one or more joints, which results in pain, swelling, stiff­ness, and lim­ited move­ment. There are over 100 dif­fer­ent types of arthritis.

Causes, inci­dence, and risk factors

Arthri­tis involves the break­down of car­ti­lage. Car­ti­lage nor­mally pro­tects the joint, allow­ing for smooth move­ment. Car­ti­lage also absorbs shock when pres­sure is placed on the joint, like when you walk. With­out the usual amount of car­ti­lage, the bones rub together, caus­ing pain, swelling (inflam­ma­tion), and stiffness.

You may have joint inflam­ma­tion for a vari­ety of rea­sons, including:

* Bro­ken bone
* Infec­tion (usu­ally caused by bac­te­ria or viruses)
* An autoim­mune dis­ease (the body attacks itself because the immune sys­tem believes a body part is for­eign)
* Gen­eral “wear and tear” on joints

Often, the inflam­ma­tion goes away after the injury has healed, the dis­ease is treated, or the infec­tion has been cleared.

With some injuries and dis­eases, the inflam­ma­tion does not go away or destruc­tion results in long-term pain and defor­mity. When this hap­pens, you have chronic arthri­tis. Osteoarthri­tis is the most com­mon type and is more likely to occur as you age. You may feel it in any of your joints, but most com­monly in your hips, knees or fin­gers. Risk fac­tors for osteoarthri­tis include:

* Being over­weight
* Pre­vi­ously injur­ing the affected joint
* Using the affected joint in a repet­i­tive action that puts stress on the joint (base­ball play­ers, bal­let dancers, and con­struc­tion work­ers are all at risk)

Arthri­tis can occur in men and women of all ages. About 37 mil­lion peo­ple in Amer­ica have arthri­tis of some kind, which is almost 1 out of every 7 people.

Other types or cause of arthri­tis include:

* Rheuma­toid arthri­tis (in adults)
* Juve­nile rheuma­toid arthri­tis (in chil­dren)
* Sys­temic lupus ery­the­mato­sus (SLE)
* Gout
* Scle­ro­derma
* Pso­ri­atic arthri­tis
* Anky­los­ing spondyli­tis
* Reiter’s syn­drome (reac­tive arthri­tis)
* Adult Still’s dis­ease
* Viral arthri­tis
* Gono­coc­cal arthri­tis
* Other bac­te­r­ial infec­tions (non-gonococcal bac­te­r­ial arthri­tis )
* Ter­tiary Lyme dis­ease (the late stage)
* Tuber­cu­lous arthri­tis
* Fun­gal infec­tions such as blastomycosis

Symptoms

If you have arthri­tis, you may experience:

* Joint pain
* Joint swelling
* Stiff­ness, espe­cially in the morn­ing
* Warmth around a joint
* Red­ness of the skin around a joint
* Reduced abil­ity to move the joint

Signs and tests

First, your doc­tor will take a detailed med­ical his­tory to see if arthri­tis or another mus­cu­loskele­tal prob­lem is the likely cause of your symptoms.

Next, a thor­ough phys­i­cal exam­i­na­tion may show that fluid is col­lect­ing around the joint. (This is called an “effu­sion.”) The joint may be ten­der when it is gen­tly pressed, and may be warm and red (espe­cially in infec­tious arthri­tis and autoim­mune arthri­tis). It may be painful or dif­fi­cult to rotate the joints in some direc­tions. This is known as “lim­ited range-of-motion.”

In some autoim­mune forms of arthri­tis, the joints may become deformed if the dis­ease is not treated. Such joint defor­mi­ties are the hall­marks of severe, untreated rheuma­toid arthritis.

Tests vary depend­ing on the sus­pected cause. They often include blood tests and joint x-rays. To check for infec­tion and other causes of arthri­tis (like gout caused by crys­tals), joint fluid is removed from the joint with a nee­dle and exam­ined under a micro­scope. See the spe­cific types of arthri­tis for fur­ther infor­ma­tion.
Treatment

Treat­ment of arthri­tis depends on the par­tic­u­lar cause, which joints are affected, sever­ity, and how the con­di­tion affects your daily activ­i­ties. Your age and occu­pa­tion will also be taken into con­sid­er­a­tion when your doc­tor works with you to cre­ate a treat­ment plan.

If pos­si­ble, treat­ment will focus on elim­i­nat­ing the under­ly­ing cause of the arthri­tis. How­ever, the cause is NOT nec­es­sar­ily cur­able, as with osteoarthri­tis and rheuma­toid arthri­tis. Treat­ment, there­fore, aims at reduc­ing your pain and dis­com­fort and pre­vent­ing fur­ther disability.

It is pos­si­ble to greatly improve your symp­toms from osteoarthri­tis and other long-term types of arthri­tis with­out med­ica­tions. In fact, mak­ing lifestyle changes with­out med­ica­tions is prefer­able for osteoarthri­tis and other forms of joint inflam­ma­tion. If needed, med­ica­tions should be used in addi­tion to lifestyle changes.

Exer­cise for arthri­tis is nec­es­sary to main­tain healthy joints, relieve stiff­ness, reduce pain and fatigue, and improve mus­cle and bone strength. Your exer­cise pro­gram should be tai­lored to you as an indi­vid­ual. Work with a phys­i­cal ther­a­pist to design an indi­vid­u­al­ized pro­gram, which should include:

* Range of motion exer­cises for flex­i­bil­ity
* Strength train­ing for mus­cle tone
* Low-impact aer­o­bic activ­ity (also called endurance exercise)

A phys­i­cal ther­a­pist can apply heat and cold treat­ments as needed and fit you for splints or orthotic (straight­en­ing) devices to sup­port and align joints. This may be par­tic­u­larly nec­es­sary for rheuma­toid arthri­tis. Your phys­i­cal ther­a­pist may also con­sider water ther­apy, ice mas­sage, or tran­scu­ta­neous nerve stim­u­la­tion (TENS).

Rest is just as impor­tant as exer­cise. Sleep­ing 8 to 10 hours per night and tak­ing naps dur­ing the day can help you recover from a flare-up more quickly and may even help pre­vent exac­er­ba­tions. You should also:

* Avoid posi­tions or move­ments that place extra stress on your affected joints.
* Avoid hold­ing one posi­tion for too long.
* Reduce stress, which can aggra­vate your symp­toms. Try med­i­ta­tion or guided imagery. And talk to your phys­i­cal ther­a­pist about yoga or tai chi.
* Mod­ify your home to make activ­i­ties eas­ier. For exam­ple, have grab bars in the shower, the tub, and near the toilet.

Other mea­sures to try include:

* Tak­ing glu­cosamine and chon­droitin — these form the build­ing blocks of car­ti­lage, the sub­stance that lines joints. These sup­ple­ments are avail­able at health food stores or super­mar­kets. While some stud­ies show such sup­ple­ments may reduce osteoarthri­tis symp­toms, oth­ers show no ben­e­fit. How­ever, since these prod­ucts are regarded as safe, they are rea­son­able to try and many patients find their symp­toms improve.
* Eat a diet rich in vit­a­mins and min­er­als, espe­cially antiox­i­dants like vit­a­min E. These are found in fruits and veg­eta­bles. Get sele­nium from Brewer’s yeast, wheat germ, gar­lic, whole grains, sun­flower seeds, and Brazil nuts. Get omega-3 fatty acids from cold water fish (like salmon, mack­erel, and her­ring), flaxseed, rape­seed (canola) oil, soy­beans, soy­bean oil, pump­kin seeds, and wal­nuts.
* Apply cap­saicin cream (derived from hot chili pep­pers) to the skin over your painful joints. You may feel improve­ment after apply­ing the cream for 3–7 days.

MEDICATIONS

Your doc­tor will choose from a vari­ety of med­ica­tions as needed. Gen­er­ally, the first drugs to try are avail­able with­out a pre­scrip­tion. These include:

* Aceta­minophen (Tylenol) — rec­om­mended by the Amer­i­can Col­lege of Rheuma­tol­ogy and the Amer­i­can Geri­atrics Soci­ety as first-line treat­ment for osteoarthri­tis. Take up to 4 grams a day (2 extra-strength Tylenol every 6 hours). This can pro­vide sig­nif­i­cant relief of arthri­tis pain with­out many of the side effects of pre­scrip­tion drugs. DO NOT exceed the rec­om­mended doses of aceta­minophen or take the drug in com­bi­na­tion with large amounts of alco­hol. These actions may dam­age your liver.
* Aspirin, ibupro­fen, or naproxen — these non­s­teroidal anti-inflammatory (NSAID) drugs are often effec­tive in com­bat­ing arthri­tis pain. How­ever, they have many poten­tial risks, espe­cially if used for a long time. They should not be taken in any amount with­out con­sult­ing your doc­tor. Poten­tial side effects include heart attack, stroke, stom­ach ulcers, bleed­ing from the diges­tive tract, and kid­ney dam­age. In 2005, the U.S. Food and Drug Admin­is­tra­tion (FDA) asked mak­ers of NSAIDs to include a warn­ing label on their prod­uct that alerts users of an increased risk for heart attack, stroke, and gas­troin­testi­nal bleed­ing. If you have kid­ney or liver dis­ease, or a his­tory of gas­troin­testi­nal bleed­ing, you should not take these med­i­cines unless your doc­tor specif­i­cally rec­om­mends them.

Pre­scrip­tion med­i­cines include:

* Cyclooxygenase-2 (COX-2) inhibitors — These drugs block an inflammation-promoting enzyme called COX-2. This class of drugs was ini­tially believed to work as well as tra­di­tional NSAIDs, but with fewer stom­ach prob­lems. How­ever, numer­ous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and ben­e­fits of the COX-2s. Cele­coxib (Cele­brex) is still avail­able, but labeled with strong warn­ings and a rec­om­men­da­tion that it be pre­scribed at the low­est pos­si­ble dose for the short­est dura­tion pos­si­ble. Talk to your doc­tor about whether COX-2s are right for you.
* Cor­ti­cos­teroids (“steroids”) — these are med­ica­tions that sup­press the immune sys­tem and symp­toms of inflam­ma­tion. They are com­monly used in severe cases of osteoarthri­tis, and they can be given orally or by injec­tion. Steroids are used to treat autoim­mune forms of arthri­tis but should be avoided in infec­tious arthri­tis. Steroids have mul­ti­ple side effects, includ­ing upset stom­ach and gas­troin­testi­nal bleed­ing, high blood pres­sure, thin­ning of bones, cataracts, and increased infec­tions. The risks are most pro­nounced when steroids are taken for long peri­ods of time or at high doses. Close super­vi­sion by a physi­cian is essen­tial.
* Disease-modifying anti-rheumatic drugs — these have been used tra­di­tion­ally to treat rheuma­toid arthri­tis and other autoim­mune causes of arthri­tis. These drugs include gold salts, peni­cil­lamine, sul­fasalazine, and hydrox­y­chloro­quine. More recently, methotrex­ate has been shown to slow the pro­gres­sion of rheuma­toid arthri­tis and improve your qual­ity of life. Methotrex­ate itself can be highly toxic and requires fre­quent blood tests for patients on the med­ica­tion.
* Bio­log­ics– these are the most recent break­through for the treat­ment of rheuma­toid arthri­tis. Such med­ica­tions, includ­ing etan­er­cept (Enbrel), inflix­imab (Rem­i­cade) and adal­i­mumab (Humira), are admin­is­tered by injec­tion and can dra­mat­i­cally improve your qual­ity of life. Newer bio­log­ics include Oren­cia (abat­a­cept) and Rit­uxan (rit­ux­imab).
* Immuno­sup­pres­sants — these drugs, like aza­thio­prine or cyclophos­phamide, are used for seri­ous cases of rheuma­toid arthri­tis when other med­ica­tions have failed.

It is very impor­tant to take your med­ica­tions as directed by your doc­tor. If you are hav­ing dif­fi­culty doing so (for exam­ple, due to intol­er­a­ble side effects), you should talk to your doctor.

SURGERY AND OTHER APPROACHES

In some cases, surgery to rebuild the joint (arthro­plasty) or to replace the joint (such as a total knee joint replace­ment) may help main­tain a more nor­mal lifestyle. The deci­sion to per­form joint replace­ment surgery is nor­mally made when other alter­na­tives, such as lifestyle changes and med­ica­tions, are no longer effective.

Nor­mal joints con­tain a lubri­cant called syn­ovial fluid. In joints with arthri­tis, this fluid is not pro­duced in ade­quate amounts. In some cases, a doc­tor may inject the arthritic joint with a man-made ver­sion of joint fluid. The syn­thetic fluid may post­pone the need for surgery at least tem­porar­ily and improve the qual­ity of life for per­sons with arthritis.

Expec­ta­tions (prognosis)

A few arthritis-related dis­or­ders can be com­pletely cured with treat­ment. Most are chronic (long-term) con­di­tions, how­ever, and the goal of treat­ment is to con­trol the pain and min­i­mize joint dam­age. Chronic arthri­tis fre­quently goes in and out of remis­sion.
Complications

* Chronic pain
* Lifestyle restric­tions or disability

Call­ing your health care provider

Call your doc­tor if:

* Your joint pain per­sists beyond 3 days.
* You have severe unex­plained joint pain.
* The affected joint is sig­nif­i­cantly swollen.
* You have a hard time mov­ing the joint.
* Your skin around the joint is red or hot to the touch.
* You have a fever or have lost weight unintentionally.

Prevention

If arthri­tis is diag­nosed and treated early, you can pre­vent joint dam­age. Find out if you have a fam­ily his­tory of arthri­tis and share this infor­ma­tion with your doc­tor, even if you have no joint symptoms.

Osteoarthri­tis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to over­work a dam­aged or sore joint. Sim­i­larly, avoid exces­sive repet­i­tive motions.

Excess weight also increases the risk for devel­op­ing osteoarthri­tis in the knees, and pos­si­bly in the hips and hands. See the arti­cle on body mass index to learn whether your weight is healthy.

Tweet This Post

Although chest pain or pres­sure is the most com­mon symp­tom of a heart attack, heart attack vic­tims may expe­ri­ence a vari­ety of symp­toms including:

* Pain, full­ness, and/or squeez­ing sen­sa­tion of the chest

* Jaw pain, toothache, headache

* Short­ness of breath

* Nau­sea, vom­it­ing, and/or gen­eral epi­gas­tric (upper mid­dle abdomen) discomfort

* Sweating

* Heart­burn and/or indigestion

* Arm pain (more com­monly the left arm, but may be either arm)

* Upper back pain

* Gen­eral malaise (vague feel­ing of illness)

* No symp­toms (Approx­i­mately one quar­ter of all heart attacks are silent, with­out chest pain or new symp­toms. Silent heart attacks are espe­cially com­mon among patients with dia­betes mellitus.)

Even though the symp­toms of a heart attack at times can be vague and mild, it is impor­tant to remem­ber that heart attacks pro­duc­ing no symp­toms or only mild symp­toms can be just as seri­ous and life-threatening as heart attacks that cause severe chest pain. Too often patients attribute heart attack symp­toms to “indi­ges­tion,” “fatigue,” or “stress,” and con­se­quently delay seek­ing prompt med­ical atten­tion. One can­not overem­pha­size the impor­tance of seek­ing prompt med­ical atten­tion in the pres­ence of symp­toms that sug­gest a heart attack. Early diag­no­sis and treat­ment saves lives, and delays in reach­ing med­ical assis­tance can be fatal. A delay in treat­ment can lead to per­ma­nently reduced func­tion of the heart due to more exten­sive dam­age to the heart mus­cle. Death also may occur as a result of the sud­den onset of arrhyth­mias such as ven­tric­u­lar fibrillation.

Tweet This Post

A heart attack (also known as a myocar­dial infarc­tion) is the death of heart mus­cle from the sud­den block­age of a coro­nary artery by a blood clot. Coro­nary arter­ies are blood ves­sels that sup­ply the heart mus­cle with blood and oxy­gen. Block­age of a coro­nary artery deprives the heart mus­cle of blood and oxy­gen, caus­ing injury to the heart mus­cle. Injury to the heart mus­cle causes chest pain and chest pres­sure sen­sa­tion. If blood flow is not restored to the heart mus­cle within 20 to 40 min­utes, irre­versible death of the heart mus­cle will begin to occur. Mus­cle con­tin­ues to die for six to eight hours at which time the heart attack usu­ally is “com­plete.” The dead heart mus­cle is even­tu­ally replaced by scar tissue.

Approx­i­mately one mil­lion Amer­i­cans suf­fer a heart attack each year. Four hun­dred thou­sand of them die as a result of their heart attack.

What causes a heart attack?

Ath­er­o­scle­ro­sis

Ath­er­o­scle­ro­sis is a grad­ual process by which plaques (col­lec­tions) of cho­les­terol are deposited in the walls of arter­ies. Cho­les­terol plaques cause hard­en­ing of the arte­r­ial walls and nar­row­ing of the inner chan­nel (lumen) of the artery. Arter­ies that are nar­rowed by ath­er­o­scle­ro­sis can­not deliver enough blood to main­tain nor­mal func­tion of the parts of the body they sup­ply. For exam­ple, ath­er­o­scle­ro­sis of the arter­ies in the legs causes reduced blood flow to the legs. Reduced blood flow to the legs can lead to pain in the legs while walk­ing or exer­cis­ing, leg ulcers, or a delay in the heal­ing of wounds to the legs. Ath­er­o­scle­ro­sis of the arter­ies that fur­nish blood to the brain can lead to vas­cu­lar demen­tia (men­tal dete­ri­o­ra­tion due to grad­ual death of brain tis­sue over many years) or stroke (sud­den death of brain tissue).

In many peo­ple, ath­er­o­scle­ro­sis can remain silent (caus­ing no symp­toms or health prob­lems) for years or decades. Ath­er­o­scle­ro­sis can begin as early as the teenage years, but symp­toms or health prob­lems usu­ally do not arise until later in adult­hood when the arte­r­ial nar­row­ing becomes severe. Smok­ing cig­a­rettes, high blood pres­sure, ele­vated cho­les­terol, and dia­betes mel­li­tus can accel­er­ate ath­er­o­scle­ro­sis and lead to the ear­lier onset of symp­toms and com­pli­ca­tions, par­tic­u­larly in those peo­ple who have a fam­ily his­tory of early atherosclerosis.

Coro­nary ath­er­o­scle­ro­sis (or coro­nary artery dis­ease) refers to the ath­er­o­scle­ro­sis that causes hard­en­ing and nar­row­ing of the coro­nary arter­ies. Dis­eases caused by the reduced blood sup­ply to the heart mus­cle from coro­nary ath­er­o­scle­ro­sis are called coro­nary heart dis­eases (CHD). Coro­nary heart dis­eases include heart attacks, sud­den unex­pected death, chest pain (angina), abnor­mal heart rhythms, and heart fail­ure due to weak­en­ing of the heart muscle.

Ath­er­o­scle­ro­sis and angina pectoris

Angina pec­toris (also referred to as angina) is chest pain or pres­sure that occurs when the blood and oxy­gen sup­ply to the heart mus­cle can­not keep up with the needs of the mus­cle. When coro­nary arter­ies are nar­rowed by more than 50 to 70 per­cent, the arter­ies may not be able to increase the sup­ply of blood to the heart mus­cle dur­ing exer­cise or other peri­ods of high demand for oxy­gen. An insuf­fi­cient sup­ply of oxy­gen to the heart mus­cle causes angina. Angina that occurs with exer­cise or exer­tion is called exer­tional angina. In some patients, espe­cially dia­bet­ics, the pro­gres­sive decrease in blood flow to the heart may occur with­out any pain or with just short­ness of breath or unusu­ally early fatigue.

Exer­tional angina usu­ally feels like a pres­sure, heav­i­ness, squeez­ing, or aching across the chest. This pain may travel to the neck, jaw, arms, back, or even the teeth, and may be accom­pa­nied by short­ness of breath, nau­sea, or a cold sweat. Exer­tional angina typ­i­cally lasts from one to 15 min­utes and is relieved by rest or by tak­ing nitro­glyc­erin by plac­ing a tablet under the tongue. Both rest­ing and nitro­glyc­erin decrease the heart muscle’s demand for oxy­gen, thus reliev­ing angina. Exer­tional angina may be the first warn­ing sign of advanced coro­nary artery dis­ease. Chest pains that just last a few sec­onds rarely are due to coro­nary artery disease.

Angina also can occur at rest. Angina at rest more com­monly indi­cates that a coro­nary artery has nar­rowed to such a crit­i­cal degree that the heart is not receiv­ing enough oxy­gen even at rest. Angina at rest infre­quently may be due to spasm of a coro­nary artery (a con­di­tion called Prinzmetal’s or vari­ant angina). Unlike a heart attack, there is no per­ma­nent mus­cle dam­age with either exer­tional or rest angina.

Ath­er­o­scle­ro­sis and heart attack

Occa­sion­ally the sur­face of a cho­les­terol plaque in a coro­nary artery may rup­ture, and a blood clot forms on the sur­face of the plaque. The clot blocks the flow of blood through the artery and results in a heart attack (see pic­ture below). The cause of rup­ture that leads to the for­ma­tion of a clot is largely unknown, but con­tribut­ing fac­tors may include cig­a­rette smok­ing or other nico­tine expo­sure, ele­vated LDL cho­les­terol, ele­vated lev­els of blood cat­e­cholamines (adren­a­line), high blood pres­sure, and other mechan­i­cal and bio­chem­i­cal forces.

Unlike exer­tional or rest angina, heart mus­cle dies dur­ing a heart attack and loss of the mus­cle is per­ma­nent, unless blood flow can be promptly restored, usu­ally within one to six hours. While heart attacks can occur at any time, more heart attacks occur between 4:00 A.M. and 10:00 A.M. because of the higher blood lev­els of adren­a­line released from the adrenal glands dur­ing the morn­ing hours. Increased adren­a­line, as pre­vi­ously dis­cussed, may con­tribute to rup­ture of cho­les­terol plaques.

Approx­i­mately 50% of patients who develop heart attacks have warn­ing symp­toms such as exer­tional angina or rest angina prior to their heart attacks, but these symp­toms may be mild and discounted.

Tweet This Post

How is the knee designed, and what is its function?

The knee is a joint that has three com­part­ments. The thigh bone (femur) meets the large shin bone (tibia) form­ing the main knee joint. This joint has an inner (medial) and an outer (lat­eral) com­part­ment. The kneecap (patella) joins the femur to form a third com­part­ment, called the patellofemoral joint.

The knee joint is sur­rounded by a joint cap­sule with lig­a­ments strap­ping the inside and out­side of the joint (col­lat­eral lig­a­ments) as well as cross­ing within the joint (cru­ci­ate lig­a­ments). These lig­a­ments pro­vide sta­bil­ity and strength to the knee joint.

The menis­cus is a thick­ened car­ti­lage pad between the two joints formed by the femur and tibia. The menis­cus acts as a smooth sur­face for motion and absorbs the load of the body above the knee when stand­ing. The knee joint is sur­rounded by fluid-filled sacs called bur­sae, which serve as glid­ing sur­faces that reduce fric­tion of the ten­dons. Below the kneecap, there is a large ten­don (patel­lar ten­don) which attaches to the front of the tibia bone. There are large blood ves­sels pass­ing through the area behind the knee (referred to as the popliteal space). The large mus­cles of the thigh move the knee. In the front of the thigh, the quadri­ceps mus­cles extend the knee joint. In the back of the thigh, the ham­string mus­cles flex the knee. The knee also rotates slightly under guid­ance of spe­cific mus­cles of the thigh.

The knee func­tions to allow move­ment of the leg and is crit­i­cal to nor­mal walk­ing. The knee flexes nor­mally to a max­i­mum of 135 degrees and extends to 0 degrees. The bur­sae, or fluid-filled sacs, serve as glid­ing sur­faces for the ten­dons to reduce the force of fric­tion as these ten­dons move. The knee is a weight-bearing joint. Each menis­cus serves to evenly load the sur­face dur­ing weight-bearing and also aids in dis­burs­ing joint fluid for joint lubrication.

What injuries can cause knee pain, and what other symp­toms may accom­pany knee pain?

Injury can affect any of the lig­a­ments, bur­sae, or ten­dons sur­round­ing the knee joint. Injury can also affect the lig­a­ments, car­ti­lage, menisci (plural for menis­cus), and bones form­ing the joint. The com­plex­ity of the design of the knee joint and the fact that it is an active weight-bearing joint are fac­tors in mak­ing the knee one of the most com­monly injured joints.

Lig­a­ment injury

Trauma can cause injury to the lig­a­ments on the inner por­tion of the knee (medial col­lat­eral lig­a­ment), the outer por­tion of the knee (lat­eral col­lat­eral lig­a­ment), or within the knee (cru­ci­ate lig­a­ments). Injuries to these areas are noticed as imme­di­ate pain but are some­times dif­fi­cult to local­ize. Usu­ally, a col­lat­eral lig­a­ment injury is felt on the inner or outer por­tions of the knee. A col­lat­eral lig­a­ment injury is often asso­ci­ated with local ten­der­ness over the area of the lig­a­ment involved. A cru­ci­ate lig­a­ment injury is felt deep within the knee. It is some­times noticed with a “pop­ping” sen­sa­tion with the ini­tial trauma. A lig­a­ment injury to the knee is usu­ally painful at rest and may be swollen and warm. The pain is usu­ally wors­ened by bend­ing the knee, putting weight on the knee, or walk­ing. The sever­ity of the injury can vary from mild (minor stretch­ing or tear­ing of the lig­a­ment fibers, such as a low grade sprain) to severe (com­plete tear of the lig­a­ment fibers). Patients can have more than one area injured in a sin­gle trau­matic event.

Lig­a­ment injuries are ini­tially treated with ice packs and immo­bi­liza­tion, with rest and ele­va­tion. It is gen­er­ally rec­om­mended to avoid bear­ing weight on the injured joint, and crutches may be required for walk­ing. Some patients are placed in splints or braces to immo­bi­lize the joint to decrease pain and pro­mote heal­ing. Arthro­scopic or open surgery may be nec­es­sary to repair severe injuries.

Sur­gi­cal repair of lig­a­ments can involve sutur­ing alone, graft­ing, and syn­thetic graft repair. These pro­ce­dures can be done by either open knee surgery or arthro­scopic surgery (described in the sec­tion below). The deci­sion to per­form var­i­ous types of surgery depends on the level of dam­age to the lig­a­ments and the activ­ity expec­ta­tions of the patient. Many repairs can now be done arthro­scop­i­cally. How­ever, cer­tain severe injuries will require an open sur­gi­cal repair. Recon­struc­tion pro­ce­dures for cru­ci­ate lig­a­ments are increas­ingly suc­cess­ful with cur­rent sur­gi­cal techniques.

Menis­cus tears

The menis­cus can be torn with the shear­ing forces of rota­tion that are applied to the knee dur­ing sharp, rapid motions. This is espe­cially com­mon in sports requir­ing reac­tion body move­ments. There is a higher inci­dence with aging and degen­er­a­tion of the under­ly­ing car­ti­lage. More than one tear can be present in an indi­vid­ual menis­cus. The patient with a menis­cal tear may have a rapid onset of a pop­ping sen­sa­tion with a cer­tain activ­ity or move­ment of the knee. Occa­sion­ally, it is asso­ci­ated with swelling and warmth in the knee. It is often asso­ci­ated with lock­ing or an unsta­ble sen­sa­tion in the knee joint. The doc­tor can per­form cer­tain maneu­vers while exam­in­ing the knee which might pro­vide fur­ther clues to the pres­ence of a menis­cal tear.

Rou­tine X-rays, while they do not reveal a menis­cal tear, can be used to exclude other prob­lems of the knee joint. The menis­cal tear can be diag­nosed in one of three ways: arthroscopy, arthrog­ra­phy, or an MRI. Arthroscopy is a sur­gi­cal tech­nique by which a small diam­e­ter video cam­era is inserted through tiny inci­sions on the sides of the knee for the pur­poses of exam­in­ing and repair­ing inter­nal knee joint prob­lems. Tiny instru­ments can be used dur­ing arthroscopy to repair the torn meniscus.

Arthrog­ra­phy is a radi­ol­ogy tech­nique whereby a con­trast liq­uid is directly injected into the knee joint and inter­nal struc­tures of the knee joint thereby become vis­i­ble on X-ray film. An MRI scan is another radi­ol­ogy tech­nique whereby mag­netic fields and a com­puter com­bine to pro­duce two– or three-dimensional images of the inter­nal struc­tures of the body. It does not use X-rays and can give accu­rate infor­ma­tion about the inter­nal struc­tures of the knee when con­sid­er­ing a sur­gi­cal inter­ven­tion. Menis­cal tears are often vis­i­ble using an MRI scan­ner. MRI scans have largely replaced arthrog­ra­phy in diag­nos­ing menis­cal tears of the knee. Menis­cal tears are gen­er­ally repaired arthroscopically.

Ten­dini­tis

Ten­dini­tis of the knee occurs in the front of the knee below the kneecap at the patel­lar ten­don (patel­lar ten­dini­tis) or in the back of the knee at the popliteal ten­don (popliteal ten­dini­tis). Ten­dini­tis is an inflam­ma­tion of the ten­don, which is often pro­duced by a strain event, such as jump­ing. Patel­lar ten­dini­tis, there­fore, also has the name “jumper’s knee.” Ten­dini­tis is diag­nosed based on the pres­ence of pain and ten­der­ness local­ized to the ten­don. It is treated with a com­bi­na­tion of ice packs, immo­bi­liza­tion with a knee brace as needed, rest, and anti­in­flam­ma­tory med­ica­tions. Grad­u­ally, exer­cise pro­grams can reha­bil­i­tate the tis­sues in and around the involved ten­don. Cor­ti­sone injec­tions, which can be given for ten­dini­tis else­where, are gen­er­ally avoided in patel­lar ten­dini­tis because there are reports of risk of ten­don rup­ture as a result of cor­ti­cos­teroids in this area. In severe cases, surgery can be required. A rup­ture of the ten­don below or above the kneecap can occur. When it does, there may be bleed­ing within the knee joint and extreme pain with any knee move­ment. Sur­gi­cal repair of the rup­tured ten­don is often necessary.

Frac­tures

With severe knee trauma, such as motor vehi­cle acci­dents and impact trau­mas, bone break­age (frac­ture) of any of the three bones of the knee can occur. Bone frac­tures within the knee joint can be seri­ous and can require sur­gi­cal repair as well as immo­bi­liza­tion with cast­ing or other supports.

What are dis­eases and con­di­tions that can cause knee pain, and how are they treated?

Pain can occur in the knee from dis­eases or con­di­tions that involve the knee joint, the soft tis­sues and bones sur­round­ing the knee, or the nerves that sup­ply sen­sa­tion to the knee area. In fact, the knee joint is the most com­monly involved joint in rheumatic dis­eases, immune dis­eases that affect var­i­ous tis­sues of the body includ­ing the joints to cause arthritis.

Arthri­tis is inflam­ma­tion within a joint. The causes of knee joint inflam­ma­tion range from non­in­flam­ma­tory types of arthri­tis such as osteoarthri­tis, which is a degen­er­a­tion of the car­ti­lage of the knee, to inflam­ma­tory types of arthri­tis (such as rheuma­toid arthri­tis or gout). Treat­ment of the arthri­tis is directed accord­ing to the nature of the spe­cific type of arthri­tis. For more infor­ma­tion on arthri­tis, please read the fol­low­ing arti­cles: Pso­ri­atic Arthri­tis and Reac­tive Arthritis.

Swelling of the knee joint from arthri­tis can lead to a local­ized col­lec­tion of fluid accu­mu­lat­ing in a cyst behind the knee. This is referred to as a Baker cyst and is a com­mon cause of pain at the back of the knee.

Infec­tions of the bone or joint can rarely be a seri­ous cause of knee pain and have asso­ci­ated signs of infec­tion includ­ing fever, extreme heat, warmth of the joint, chills of the body, and may be asso­ci­ated with punc­ture wounds in the area around the knee.

Tumors involv­ing the joint are extremely rare. They can cause prob­lems with local pain.

The col­lat­eral lig­a­ment on the inside of the knee joint can become cal­ci­fied and is referred to as Pellegrini-Stieda syn­drome. With this con­di­tion, the knee can become inflamed and can be treated con­ser­v­a­tively with ice packs, immo­bi­liza­tion, and rest. Infre­quently, it requires a local injec­tion of corticosteroids.

Chon­dro­ma­la­cia refers to a soft­en­ing of the car­ti­lage under the kneecap (patella). It is a com­mon cause of deep knee pain and stiff­ness in younger women and can be asso­ci­ated with pain and stiff­ness after pro­longed sit­ting and climb­ing stairs or hills. While treat­ment with anti­in­flam­ma­tory med­ica­tions, ice packs, and rest can help, long-term relief is best achieved by strength­en­ing exer­cises for the quadri­ceps mus­cles of the front of the thigh.

Bur­si­tis of the knee com­monly occurs on the inside of the knee (anser­ine bur­si­tis) and the front of the kneecap (patel­lar bur­si­tis, or “housemaid’s knee”). Bur­si­tis is gen­er­ally treated with ice packs, immo­bi­liza­tion, and anti­in­flam­ma­tory med­ica­tions such as ibupro­fen (Advil, Motrin) or aspirin and may require local injec­tions of cor­ti­cos­teroids (cor­ti­sone med­ica­tion) as well as exer­cise ther­apy to develop the mus­cu­la­ture of the front of the thigh.
Knee Pain At A Glance

* The knee joint has three com­part­ments.
* Causes of knee pain include injury, degen­er­a­tion, arthri­tis, infre­quently infec­tion, and rarely bone tumors.
* Lig­a­ments within the knee (cru­ci­ate lig­a­ments) and on the inner and outer sides of the knee (col­lat­eral lig­a­ments) sta­bi­lize the joint.
* Sur­gi­cal repair of lig­a­ment injury can involve sutur­ing, graft­ing, and syn­thetic graft repair.
* Rou­tine X-rays do not reveal menis­cus tears but can be used to exclude other prob­lems of the bones and other tis­sues.
* The knee joint is the most com­monly involved joint in rheumatic dis­eases, which are immune dis­eases that affect var­i­ous tis­sues of the body, includ­ing the joints, to cause arthritis.

Tweet This Post