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* Congenital insensitivity to pain
* Peripheral nerve injuries
* Diabetic neuropathy
* Chronic diseases of the spinal cord that lead to sensory disturbances of the limbs.

In myelomeningocele, absence of pain sensation is associated with flaccid paralysis and marked limitation of physical activity; thus, owing to associated severe osteoporosis, the bone and joint changes present a different picture.

The joints involved vary with the different etiologic conditions.

In congenital insensitivity to pain and diabetic neuropathy, the destructive changes occur primarily in the tarsal and metatarsal joints, less commonly in the ankle, and rarely in the knee.

In syringomyelia, the joints involved are those of the shoulder and elbow. In tabes dorsalis, the knee, hip, ankle, and thoracolumbar spine are frequent sites of the disease.

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This condition was described by Charcot, in 1868. He described it as a bizarre destruction of the knee joints with indolent swelling and instability in patients of tabes dorsalis. He proposed that the disease resulted from traumatization of a joint deprived of sensation.

Later Steindler classified the condition into the condition into the destructive, atrophic and hypertrophic proliferative forms.

Charcot-like changes in joints are seen in patients who have absence or depression of pain and proprioceptive sensation and who take part in extended continuous physical activity.

As a consequence their joints sustain repeated trauma.

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The menisci in the knee joint are required for

* Compensation of incongruity between the femur and tibia
* In the distribution of joint pressure
* Shock absorber, for stabilization of the knee, in provision of rotation, in spreading of synovial fluid, and in nutrition of articular cartilage.

An intact meniscus transmits 70 to 90 percent of the total load across the knee joint. Therefore, it is desirable to preserve the meniscus whenever possible.

A conservative nonoperative method of management is recommended In the treatment of discoid meniscus  if pain and functional disability are minimal.

SIlent discoid menisci  require no treatment. however, they should be kept under observation.

Conservative measures

* Immobilization of the knee
* Restriction of physical activity
* Progressive exercises for the quadriceps.

Operative Measures

If the knee locking persists their is functional disability or pain partial or complete excision of the discoid meniscus is indicated.

Diagnostic arthroscopy is carried out to know the pathologic changes and the type of discoid meniscus.

Partial resection of the discoid meniscus is preferred when it is of the complete or incomplete type with minimal tearing and slight degeneration

Excision of the entire meniscus is performed when it is of the Wrisberg type  or when it is torn and there is marked degenerations.

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Like any other dislocation acute dislocations of the glenohumeral  or shoulder joint should be reduced as quickly and gently as possible. There are many advantages of early reduction of shoulder dislocation.

* Eliminates the stretch and compression of neurovascular structures
* Reduces amount of muscle spasm that must be overcome to effect reduction
* Prevents further insult to  humeral head  and glenoid labrum

If patient reports within short time, some dislocations can be reduced without medication especially in thinly built patients. Reduction is difficult without medications if patient is very muscular , dislocation is of a long standing duration, the dislocation is locked in soft tissue.

In such cases, it is wise to use general anaesthesia .

Narcotics and muscle relaxants can be used to aid in the reduction of shoulder dislocations if appropriate.  However there is a danger of  respiratory depression after pain is relieved after reduction of the dislocated shoulder. EIther one should opt for GA or appropriate resuscitation measures should be kept ready before hand.

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Soma is used for treating discomfort associated with certain painful muscle conditions. It is usually used along with rest and physical therapy.

Soma is a skeletal muscle relaxant. It works in the brain and spinal cord to relax the muscles. It also causes drowsiness.

Rarely, some patients have experienced an unexpected reaction within minutes or hours after taking Soma. Contact your doctor or seek medical care right away if you develop severe weakness, paralysis of the arms or legs, severe dizziness, loss of coordination, vision changes (eg, loss of vision, double vision), joint pain, or mental or mood changes (eg, agitation, confusion, disorientation).

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Arthritis is one of the most common chronic diseases in the world. According to Ayurveda arthritis is primarily a vata (air) disease which is due to accumulation of toxins in the joints and is known as amavata.This can be caused by poor digestion and a weakened colon, resulting in the accumulation of undigested food and the buildup of waste matter. Poor digestion allows toxins to accumulate in the body, and problems with the colon allow the toxins to reach the joints.

Symptoms:

* Fever
* Immense pain & stiffness in affected muscles in case of chronic muscular rheumatism.
* Pain or tenderness in a joint which is aggravated by any movement or activity, such as walking, getting up from a chair, writing, typing, holding an object, throwing a ball, turning a key.
* Excruciating pain and stiffness in the joints in case of chronic articular rheumatism.

Home Remedies

The following are a few simple cures that might just help relieve you from the pain of arthritis. Try any of them to see what works for you.

* Two teaspoons of lemon juice and a teaspoon of honey mixed in a cup of warm water taken twice a day is good for curing arthritis.
* Two teaspoons of juice from fresh leaves of bathua, drink every day on an empty stomach for 2-3 months.
* Half a teaspoon of turmeric powder with warm water helps cure arthritis.
* Taking alfalfa tea twice a day makes a good cure.
* Two teaspoons of apple cider vinegar and 2 teaspoons of honey dissolved in a small glass of warm water taken once or twice a day brings relief.
* Rub the aching joints with hot vinegar to get some relief from pain.
* Two parts pure olive oil and one part kerosene makes a wonderful liniment to bathe afflicted joints.
* Add one tablespoon cod liver oil to the juice of one orange, whip and drink before sleeping.
* One raw clove of garlic every day is very beneficial. This clove can be fried in ghee (clarified butter) or castor oil. Take for 2 months.
* Guggulu is very helpful in curing arthritis. Eat half a teaspoon twice a day after meals with warm water.
* Exercise the afflicted joints in a tub full of hot water.
* Drink carrot juice, cucumber juice, eat cooked vegetables and/or vegetable soups, and drink coconut water for a healthy body & massage your joints daily to cure arthritis.
* On an empty stomach eat 2-3 walnuts or some coconut.
* Avoid mental tensions that lead to stress.
* Lose weight, if necessary, to get close to your ideal weight. If you weigh less, there is less weight on your joints and less pain.

Effetive and Proven Results For - Arthcare Oil (Anti Inflammatory and Muscle Relaxant Herbal Massage Oil):

Arthcare Oil is the best natural solution for your problem, manufactured under the guidance of renowned MD Ayurveda Specialist doctor. Arthcare is an anti-arthritic herbal oil which not only gives a sure relief in rheumatic arthritis but also strengthens the bone tissues, the skeletal and the neuromuscular systems, giving a comfortable movements of joints and muscles. It is a powerful antioxidant and increases the energy level. Arthcare penetrates the body tissue faster than any other ointment because of its strong anti-inflammatory action. It removes stiffness and improves mobility of limbs. It brings relief from backaches, muscular strains, rheumatic pains, joint pains etc. Body massage with Arthcare oil, relaxes an asthmatic person. Arthcare is scientifically proven Ayurvedic formulation containing the herbal combination of well known traditional herbs described above. Within few minutes of application you will feel relaxed from pain. For Best Results Take 2 Arthcare Capsules twice a day and massage the affected area with Arthcare Oil 2-3 times a day.

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Muscle relaxants that address back pain are available as prescription and over-the-counter medications (OTC). Over-the-counter muscle relaxant medications include Robaxin® (methocarbamol), Robaxacet® (methocarbamol and acetaminophen) and Robaxisal® (methocarbamol and ASA). Prescription medications include Soma® (carisoprodol), Flexeril® (cyclobenzaprine) and Valium® (diazepam). Soma is typically prescribed on a short-term basis and may be habit-forming, particularly if used with alcohol or other drugs that affect the mind. Flexeril may be used on a longer term basis. This drug may impair mental and physical function and can lead to urinary retention in men with enlarged prostates.

Valium is usually restricted to one to two weeks of use. Due to this drug’s habit-forming potential, and its propensity to alter the sleep cycle, it is not prescribed for the long-term. Since valium is a depressant, it can worsen the depression often associated with chronic back pain.

Treatment for back pain usually involves strengthening the back through special exercises and adjusting the lifestyle to avoid the stressors (physical and mental) that have contributed towards the injury.

In the case of persistent, debilitating back pain, prescription or over-the-counter analgesics (painkillers) and muscle relaxants may be used. Surgery is considered a last resort for continuing, debilitating back pain.

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Your back is an intricate structure composed of bones, muscles, ligaments, tendons and disks — the cartilage-like pads that act as cushions between the segments of your spine. Back pain can arise from problems with any of these component parts. In some people, no specific cause for their back pain can be found.

Back Pain Strains

Back pain most often occurs from strained muscles and ligaments, from improper or heavy lifting, or after a sudden awkward movement. Sometimes a muscle spasm can cause back pain.

Back Pain Structural problems

In some cases, back pain may be caused by structural problems, such as:

* Bulging or ruptured disks. Disks act as cushions between the vertebrae in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve. But many people who have bulging or herniated disks experience no pain from the condition.
* Sciatica. If a bulging or herniated disk presses on the main nerve that travels down your leg, it can cause sciatica — sharp, shooting pain through the buttock and back of the leg.
* Arthritis. The joints most commonly affected by osteoarthritis are the hips, hands, knees and lower back. In some cases arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
* Skeletal irregularities. Back pain can occur if your spine curves in an abnormal way. If the natural curves in your spine become exaggerated, your upper back may look abnormally rounded or your lower back may arch excessively. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain.
* Osteoporosis. Compression fractures of your spine’s vertebrae can occur if your bones become porous and brittle.

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We try to do everything in this 21 century — filling our lives with a dozen of activities that tax our bodies and emotions. Multi-tasking is the norm with organizing busy schedules at work, for family and for our social life has become a daily task.

To stay and go on running in the rat race, you must be prepared to endure aches and pains all over your body as well as the lumps and swelling — sure signs of overwork and stress.

Another cause of lower back pain for runners is the thought that running is about going forward, okay of course it is, but it doesnt require you to push forward to do it. Running is really about passing a force into the ground and using the hip, inflamed knee and ankle joints to translate that into a forward motion.

Stiff and swollen joints make it difficult to do any bending. Pain in the knees are usually worse in the morning or after a long period of inactivity. Knee joints are often affected by arthritis.

Muscle pain can be caused by many conditions. The most commo is a “ strain” where the muscle is stretched beyond its maximum length resulting in injury. Muscle pain is most frequently related to tension or muscle injury any physically-demanding work. When muscle pain last beyond the expected healing time, it is then best to consult your doctor.

Every now and then you might be having muscle cramps and if you are working for quite some time and it also involves some heavy work that you might be experiencing a sensation of your muscles making you so tired and there is a decreased in your muscular performance. The underlying cause of muscle fatigue can fall into two categories: central and local.

Regular exercise can help restore proper muscle tone. A good physical therapist can teach you stretching, aerobic exercises to feel a lot better. You can also do it yourself by cycling, swimming and walking. Warm up before you do any kind oe exercising. Do some stretching. Drink lots of fluids before and after exercising. You can overcome muscle fatigue by dieting, getting adequate rest and taking supplements or nutritional stimulants such as caffeine. If you work in the same position most of the day like sitting in front of the computer, get up and do some stretching at least every hour.

Taking some acetaminophen, aspirin or other non-steroidal anti-inflammatory drugs (Cyclobenzaprine, Soma) can also be helpful in pain relief. Workouts in the gym to strengthen the back and shoulders can help restore a good balance.

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What Is Rheumatoid Arthritis?

Rheumatoid arthritis, or RA, is a systemic inflammatory disease that causes pain, stiffness, swelling and loss of motion in the joints. It is an autoimmune disease – one of many in which, for unknown reasons, a person’s immune system attacks his or her own body tissues. In RA, the immune system attacks the synovium, which is the tissue that lines the joints, causing inflammation in and overgrowth of this tissue.

How Do I Know If I Have RA?

The symptoms of RA vary from person to person and can mimic those of other inflammatory joint conditions, sometimes making the diagnosis difficult. Common RA symptoms include:

* Tender, warm, swollen and stiff joints, often first noticed in the hands and feet and usually symmetrical, e.g., both wrists are affected at the same time.
* Stiffness and pain that are usually worse after waking in the morning and last at least an hour before improving, which occurs with use and motion.
* Symptoms like tiredness, low-grade fever, weight loss and a general feeling of malaise that may develop even before the onset of joint symptoms.
* Systemic effects on other parts of the body such as the tear and salivary glands, lungs, heart and blood vessels.
* Soft lumps called rheumatoid nodules that range in size from a pea to a walnut, which occur in 20 to 30 percent of people with RA.

How Is RA Treated?

RA patients use a combination of treatments to relieve pain, improve mobility and slow down or perhaps even stop damage to the joints. A treatment plan may include:

* Lifestyle modifications: exercise, stress reduction, healthful eating
* Medications including non-steroidal anti-inflammatory drugs (NSAIDs), steroids, disease-modifying anti-rheumatic drugs (DMARDs), and biologic therapies
* Physical therapy
* Surgery to repair damaged joints
* Alternative and complementary therapies such as acupuncture, massage or biofeedback for pain control

Sports-related activities as well as falls and other trauma can injure the cartilage within a joint and, if it is not provided sufficient time to heal, chronic pain and persistent disability can follow. These activities and incidents may increase the risk of osteoarthritis, especially if there’s impact involved or there’s the risk of injury to ligaments. Additionally, damage to the bone surface can start a biological process that results in joint degeneration. This in turn, often leads to rheumatoid arthritis or osteoarthritis.

Arthritis is often a chronic disease meaning it can affect the person afflicted over a long period of time. It cannot be cured, but it can be treated through a variety of methods and products. Learning how to manage your joint pain over the long term is an important factor in controlling the disease and maintaining a good quality of life. This is a brief overview of some of the methods that arthritis sufferers can use to alleviate many of the symptoms associated with arthritis, especially joint pain. Products, both prescription and over-the-counter, for relieving arthritic joint pain are described in Joint Pain Products.

Heat and cold

Heat and/or cold therapy is not recommended to alleviate symptoms associated with all types of arthritis and as such, the decision whether to use it or not should be discussed with your doctor or physical therapist. If your care provider determines that the use of heat and/or cold is appropriate for use on your arthritis pain, it must be determined which kind of temperature treatment should be used. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad, placed on affected joint for about 15 minutes may relieve the pain. An ice pack or bag of frozen vegetables wrapped in a towel and placed on the sore area for about 15 minutes may help to reduce swelling and stop the pain. If you have poor circulation, do not use cold packs.

Joint protection

In order to relieve the stress of everyday activity on an afflicted joint, which can exacerbate the condition and may lead to additional injury, a splint or brace can be used to allow joints to rest and keep them from being used. As with many other treatments, a medical care provider such as a physician or physical therapist can make recommendations and possibly provide you with the brace.

Massage

Massage is associated with temporarily relieving joint pain, one of the major symptoms associated with arthritis, rather than treating the underlying cause of a loss of cartilage. A massage therapist will typically lightly stroke and/or knead the muscles around the joint, which increases blood flow to the stressed area. It is important to realize that arthritic joints are very sensitive, so the massage therapist must be familiar with the disease and problems associated with the affected joints.

Exercise

Low-impact exercises such as stretching exercises, swimming, walking, low-impact aerobics, and range-of-motion exercises may reduce joint pain and stiffness while increasing joint mobility. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Weight Reduction

In addition to alleviating some symptoms, the weight loss associated with an exercise program is beneficial in relieving the extra stress that extra pounds put on weight-bearing joints such as the hips and knees. Studies have shown that overweight women who lost approximately 10 pounds substantially reduced the development of osteoarthritis in their knees. In addition, these studies suggested that if osteoarthritis has already affected one joint such as the knee or hip, weight reduction would reduce the chance of it occurring in the other knee or hip. A physical therapist or gym trainer can help plan an exercise program that will give you the most benefit with the least stress on the arthritis-stressed joints.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation uses a small devi ce that is placed near the joint afflicted with arthritis and directs mild electric pulses to nerve endings in and around the arthritic joint. It is theorized that TENS blocks the pain messages sent to the brain from the nerves and modifies the body’s perception of pain. Although TENS relieves some joint pain associated with arthritis, it doesn’t offset the joint inflammation that is associated with arthritis.

Surgery

In some extreme cases of persons with arthritis, surgery may be necessary. The surgeon may perform an operation to remove the synovium, realign the joint, or in extreme cases, replace the damaged joint with an artificial one. Total joint replacement provides not only dramatic pain relief but also significant improvement in joint motion and mobility for many people with arthritis.

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