Saturday, October 12, 2013

Knee Replacements - Tips on How to Prolong Their Durability


Getting the most out of a new knee replacement in regards to its longevity can consist of a number of multiple factors. The two most important that tend to cause joint loosening or failure that is widely seen is, either lack of muscular strength around the affected joint or, becoming overweight increasing the forces applied through the replacement.

Strengthening the muscles around the knee replacement prosthesis is begun immediately after surgery. The muscles involved include the quadriceps, hamstrings, and calf muscles. Though the muscular system in the leg is more complicated then listed above, these are the muscles that most people will recognize when discussed in rehabilitation.

Lack of proper muscle strength around the prosthesis causes the knee joint itself to become the structure that will support a large portion of your body weight rather then the muscles themselves. By strengthening the muscles listed above they now become the workhorse instead of the knee itself.

The quadriceps, hamstrings, and calf muscles have become weak and atrophied prior to surgery and will need concentrated work during physical therapy and after your allotted time with therapy.

Conditioning of the muscles after surgery will and should go on much longer then the time that our insurance companies or Medicare will allow for rehabilitation follow-up.

By stopping your exercise routine of consistent walking, and strength training you hinder your legs full ability and strength potential to keep the knee replacement strong and secure.

Exercises such as standing calf raises, partial mini-squats and knee flexing exercises will keep the muscles strong however, they will get accustomed to this workload and will need to be stressed further to continue to make gains in strength. This is where a sound weight training program comes into play. Our muscles no matter what your age will only get stronger if the forces applied to them is progressive and demanding enough for the muscle to grow and adapt.

Now depending on your prior level of function, you may decide that is not needed that decision will be up to you. Your age can be factor or other medical conditions can play a part regarding the intensity you put into your strengthening efforts.

I have stressed in the past that after a replacement a structured resistance training program is quite good for the replacement. Any thing other then high impact activities can be completed.

After having my knee replaced in 1999 I find that leg extensions with resistance along with hamstring curls lying in a prone position and leg presses all completed with the appropriate amount of weight does produce lasting results without complications. Standing calf raises also will increase the strength in the lower compartment of the leg and will only add to the support and durability of the knee.

The added benefit of weight training not only the surgical leg but, the entire body will add muscle in time over the body which will increase your bodies metabolism. By increasing your metabolism you burn more calories at rest which will result in a decrease of body weight.

By being overweight not by just a couple of pounds but by 10-20 pounds will greatly increase the forces that are transferred to the knee. The constant pounding just from walking will in time lead to prosthesis that will loosen. Why speed up the possibility of having a revision surgery? There are multiple factors also involved here of course however, being overweight after a joint replacement should be dealt with somehow to help prolong the life expectancy of the joint.

Dieting alone is not the answer. It is common knowledge today that after years of fad diets being promoted for a quick buck on TV, Its been advised and shown a diet with an exercise program combined lead to lasting results.

So to get the most mileage out of your new knee replacement be sure once you are cleared by your surgeon to start a resistance training program, monitor your diet by making smarter food choices and, when you follow this course of action, the weight will drop. By having a stronger, leaner body you not only look and feel good but, your knee replacement will get some added life to it as well.

The stronger the knee and surrounding muscles are, the better performance and quality of life you achieve.

What Is 50,000 Units of Vitamin D?


Vitamin D is likely to be the most popular nutritional supplement of the decade. Further studies attempting to further refine its optimal levels in the blood to reach more precise recommendations for daily dose. The fact is that the vast majority of people of all ages not getting enough of this vital vitamin.

Currently, the recommended intake of vitamin D in the U.S.A. Institute of Medicine is 200 UI per day to 50 years, 400 UI - between 50 and 70 years and 600 UI for people over 70 years. "Bearable limit", the same recommendation is 2000 IU per day for children and adults, but newer studies show tolerance and for 10,000 IU per day. People with serious vitamin d deficiency often receive prescriptions for 50 000 units vitamin d weekly until the problem is resolved. It is considering the raising of these recommended daily doses, but many experts expect changes only in the lowest values. Recommended daily intake of 1000 to 2000 units to people who are exposed to the sun, for pregnant women, nursing mothers and for people over 50 years. American Pediatric Academy recommends that breastfed infants receive additional 400 units daily of vitamin D until they are weaned, and then to drink at least a liter of vitamin D-fortified milk.

When may be overdone in obtaining supplies of vitamin D? And what are for the body 50,000 units vitamin D?

The body has a mechanism to terminate synthesis of the vitamin in the skin when it has reached optimum levels. This does not apply to cases when the vitamin is obtained by supplements and goes directly into the liver.Overdose occurs when prolonged and uncontrolled treatment with vitamin D is combined with intense sun exposure and active treatment with UV radiation. Symptoms of vitamin D overdose include nausea, vomiting, loss of appetite, constipation, general weakness, weight loss, and dangerously high levels of calcium, which can lead to the formation of kidney stones and irregular heart rhythm.There are healthy people who has received 10 000 units every day for six months without side effects. People with marked failure adopted by vitamin D 50 000 units a week while away their problems. If the amount of the vitamin is proper in your organism, then vitamin D 50,000 units can lead to the described symptoms. So it is important to consult the doctor before using this nutritional supplement.

Rheumatoid Arthritis in the Knees


Doctors have found that RA of the hands is not the only cause of worry for patients. Walking can be really painful to many of them if they are affected by RA of the knees. Researches have not been able to detect the exact causes of the disease. Nonetheless, there are certain factors which are responsible for RA in the knee.

One of the main causes for RA in the knees is if you have any precious injury. If you have hurt yourself badly in the knees previously, chances are that you will develop RA in no mean time. These wounds are obviously the ones which are grave and deep. The joints can be badly infected and you can develop this disease.

Heredity can also be responsible for this disease. If you have a defective gene, there are chances that you can have this disease since these genes can be responsible for cartilage production in your body. In these instances, you can be highly susceptible to RA.

Weight loss is a must for you if you want to get rid of this disease. If you develop too much weight in your hips, then there are chances of extra pressure on the knees, which can in turn lead to rheumatoid arthritis.

Too much crystal deposits like uric acids in the gout can lead to this disease. Excess of crystal degenerates joints and they can cause RA. Also if you overstress yourself and put constant pressure on knees, even then you might develop rheumatoid arthritis in your knee joint.

Rheumatoid arthritis of the knee is mostly seen in people who are over 50 years of age, especially, women. It can affect either one or both sides of the knee joint. Nevertheless, it mostly occurs on the inner (medial) aspect of the knee.

People who are into rigorous sports training and activities, especially those playing football, tend to develop rheumatoid arthritis in the knee. You will not be able to detect the disease since the symptoms start developing over a number of years.

Knee Anatomy

The knee joint itself is made up of the shin bone (tibia) and the thigh bone (femur). The articular cartilage is located on the surface of each of these bones. This cartilage allows flexibility to the joint. Additionally, the knee has two separate layers of cartilage which is known as menisci. This adds to the stability of our knee. Rheumatoid arthritis leads to deterioration of the knee cartilage. This causes swelling, pain and it stiffens the functionality of the knee. If the cartilage breaks, it leads to meniscal or ligament trauma.

For all you rheumatoid arthritis patients out there, it is to inform you that there is a want of a complete cure for rheumatoid arthritis. However, there are various treatments for this disease which can prevent the progress of rheumatoid arthritis. Valgus unloader braces have been found to reduce pain in few cases of medial compartment rheumatoid arthritis. It diminishes the load on that compartment. NSAID's- Non-Steroidal Anti-Inflammatory Drugs such as ibuprofen is also found to provide some temporary pain relief to your pains.

Muscle relaxants are normally detected in low doses. This can relieve you of pains which arise in your muscles. However, the most advanced process of curing the knee pain of rheumatoid arthritis is knee replacement.

Arthritis in Horses - Causes, Symptoms and Prevention


Arthritis is a very inconvenient illness not only in humans but horses as well. The pain it brings can limit movements and affect the general behavior of the animal. If you think your horse is suffering from this disease, the cause of it can be attributed to a previous injury - recent or otherwise. Heredity can also play a factor in your horse having arthritis. Whatever the causes, there are some simple but effective ways to ease the pain it brings as well as prevent it altogether.

Before anything else, however, it is essential that you understand how arthritis works. The limbs in a horse's body - like in humans - are connected by joints, which are protected by cartilage. These joints allow movement, and this is done with ease as long as there is enough liquid and cartilage in the joints to provide lubrication and protection every time the limbs move. When there's not enough joint liquid and cartilage covering the joints, what happens is direct contact between the two bones when you move, which means a lot of friction which results in pain. The most common area arthritis sufferers complain about is the knee - the body part that bears the most weight and movement. This is true with horses as well.

To make sure you give your horse the best chance of getting early treatment for arthritis, you need to be observant and catch early signs of the disease. Your horse isn't really going to come up to you and inform you that its knees are really painful, so taking note of its behavior and movements is a key.
When your horse starts to show signs of discomfort when walking or trotting, there might be a chance it has arthritis. You also need to watch out for stiffness and swelling in its joints, as well as a change in its overall behavior. Pain in any part of its body can cause an animal's temperament to change and this includes horses.

Set an appointment with your equine veterinarian as soon as you notice some of these signs in your horse. There's no harm in getting a professional opinion, and you're also improving your horse's chance of getting treatment for arthritis before the illness gets more serious.

To help avoid all these issues, however, good diet and exercise can do wonders to prevent the disease. Arthritis in horses can be avoided if you make sure your animal works out regularly as movement can help strengthen the joints and bones of the body. Proper supplements are also essential to your horse's diet. The focus of the supplements should be to improve the health of the horse's joint fluid as well as the cartilage. There are several online stores that offer great deals on supplements to prevent arthritis in horses, but make sure you first meet with your veterinarian to ensure you're getting the right supplements and doing the correct preventive measures. You don't want to start out with the best intentions only to purchase supplements online that will worsen your horse's situation.

How To Save Your Painful Hip From Surgery


Most people who experience pain in the hip, upper leg and buttock worry that they will need some type of hip surgery. In many cases, many patients have been told that a hip replacement is inevitable...not true. New research through clinical study has shown that most hips do not need to be replaced. In fact, with the right treatment the hip can be saved and the patient can return to normal daily activities.

The hip is a joint that is located on the upper side of your lower body. Just about the area of where the butt of the handle of the old cowboys gun would rest from his holster. Most people are under the assumption that the hip is below the lower back next to the buttocks. The hip is a ball and socket type of joint where the head of the femur that is shaped in a ball connects to the acetabulum the socket of the ilium. This joint is supported by numerous ligaments, tendons, fascia and muscles.

Many people are under the false impression that when the bone begins to degenerate to the point where it is causing pain that they have to have it replaced. Not so, because the area where you feel the pain is where the "damage ended up, not where it began." This is important to note because everyone including your doctor will continue to see the joint as the main contributor of pain and damage. As well I would agree that the patient experiences pain in the joint area I don't agree that this area is where the damage began. And if you don't properly address the area where the pain began then you will only continue to have a problem in the future.

Here is a case that came into my office that I feel is of interest to many hip patients suffering with pain. A man age 54 enters my office from referral of another parent whose son had great results with a knee problem. The man reported ongoing pain in his hip for years on and off however most recently he reported that the pain has gotten so bad it's stopping him from being able to work. When he entered my office it was apparent that he had a major weakness in his left hip area noticed by the way he was walking. He was unable to walk without severely dipping his hip which caused more pain with every step. The pain and restriction was so bad that he was unable to lift his leg high enough to put his sock on in a sitting position. He was thoroughly examined and the x-rays he brought in were reviewed and all treatments were explained to him.

His treatment consisted of relieving the distorted fascia in and around the joint area allowing for pain relief. Continued treatment consisted of reestablishing the nervous system communication to the muscles supporting the hip. What happens is that when this type of damage occurs muscles begin to shorten due to a diminished nerve or electrical flow to the muscles. When the muscles shorten they lose their ability to absorb force. When the muscles cannot properly absorb force, that force continues on to the joint. The joint and the tissue supporting it can't absorb the force so that joint then begins to aberrantly move causing inflammation in the joint. This causes pain and a signal to the brain to begin to shut things down in the area as a way of preventing further damage.

You see, the muscles of the body are designed to absorb force just like the shock absorbers of your car are designed to absorb force or impact from the road. You can imagine trying to drive in your car without shock absorbers...over time things will begin to break down in your car. The same goes for your hip, or any other joint for that matter, it will begin to breakdown over time causing degenerative joint disease, aka, arthritis. Now using the combined treatments of the MyoFascial Disruption Technique (MFDT) to return the disrupted fascia to normal a new treatment called the ARPWave is used to locate the exact area where the damage broke down to begin with.

Getting back to my patient with the hip problem we began using the ARPWave to locate where the damage was coming from and began to correct this problem. After the very first treatment the patient was able to life his leg to put his sock on. It was explained to him that he still has the degeneration in his hip but by correcting the fascial and muscular restrictions he was now able to move his leg and his hip didn't hurt. Obviously he needed continued treatment but to make a long story short, after correcting the damage area and developing a sound rehab program this man was able to return to his normal activities of living without pain and disability and without the recommended surgery.

If you are dealing with pain and disability of hip pain don't feel that surgery is the only way out. New discoveries in manual and bio-electrical treatment can not only relieve pain but in many cases save you from surgery.

Accident Health Insurance - Plan For the Emergency Room


Accident health insurance supplements are being used to cover upfront injury related expenses for the ER. Plans can be used to compliment an existing health insurance policy or just as a personal injury plan to pay for any unexpected ER visits or surgeries.

Many Americans are concerned with insuring the everyday mishaps like bodily injuries and emergency room coverage. Of course, insuring things like Cancer and Heart Attacks are important, but for younger adults and especially kids, emergency room visits are far more prevalent. Unfortunately, a trip to the emergency room isn't cheap and the healing process from a serious bodily injury can be exhausting. Damaged body parts often need to be surgically corrected and the post operation Physical Therapy sessions feel like a Sylvester Stallone Rocky Movie. I'm not going to lie, the Rocky Four soundtrack got me through my Physical Therapy workouts post ACL Knee surgery.

Health insurance for the self-employed is especially complicated when it comes to emergency room visits. To qualify for a Major Medical PPO plan one must go through underwriting and medically qualify. Assuming you get approved, you'll need to select a deductible and plan style. The most cost effective PPO policies in the individual health insurance market are the HDHP (High Deductible Health Plan) plans. Deductible is the out of pocket expense the insured has before the health insurance policy picks up the bill. PPO stands for Preferred Provider Organization and is the type of health insurance that lets you choose any doctor. Choosing any doctor isn't necessarily true, theirs a lot of gray area with "being in network or out of network" with PPO's.

Deductible options for individuals in the PPO market are $1,500, $2,500, $3,500, and $5,000. Typical family deductible options are $3,000, $5,000, $7,000, and $10,000. You'll want to choose a co-insurance of 100%. Co-insurance is the shared expense between you and the insurance company after the deductible. Most people are familiar with 80/20 % co-insurance. 100% co-insurance is popular because you won't need to understand Calculus to figure out any future hospital bills. Insurance plan picks up 100% of the bills after deductible with this option. On a side note, it's a good idea to set up a Health Savings Account. HSA's have some decent tax advantages and you can set up an account equivalent to the deductible amount. So a $10,000 HDHP can have a $10,000 health savings account attached to it. The yearly max contribution to the health savings account is determined by your HDHP deductible. Ask your CPA about health savings accounts if your self-employed.

Higher deductible health insurance plans have lower monthly premiums. However, with that high deductible comes risk of having to owe that deductible amount if you use the health insurance. A $5,000 dollar deductible hospital bill is one broken bone away. Guess how a lot of Americans end up paying that HDHP $5,000 deductible? You guessed it, in the emergency room from a accidental bodily injury.

Accident health insurance supplements have been doing a good job filling this ER gap for years. Other names used for this plan include personal accident insurance, emergency room insurance supplement, accident medical coverage, personal injury insurance plan, 24 hour accident coverage, and accident supplemental benefit plan. These plans are under marketed in my opinion, and most licensed health insurance agents are doing a disservice to their clients if they don't bring it up. I say this because so many people are shelling out a lot of money each month to insurance companies, and if they actually use the insurance could be stuck with a huge deductible bill.

Opposite the PPO health insurance industry is Guarantee Issue insurance products. Emergency room insurance supplements fall into this category and are automatic approval. Online applications have zero health questions but do need social security numbers and birth dates. This type of guarantee issue accident medical expense coverage is an indemnity. Indemnity's compensate members with a predetermined benefit amount.

Personal injury insurance plans in this category are membership based associations. The membership organization helps individuals and families in the United States gain access to discount programs and in this case, the pound for pound most practical emergency room insurance supplement I've seen so far.

Each association member can choose a benefit level of accident coverage to fit their monthly budget or to match the HDHP deductible. Plans cover the HDHP deductible giving high deductible health plans a virtual zero deductible effect. Remember, a lot of HDHP's max out deductibles from ER visits due to injuries. ER plan pays injury related expenses to pay off the PPO deductible. Again, plans only cover ER related expenses due to injury and not sickness.

Members can choose a emergency room coverage level of $2,500, $5,000, $7,500, or $10,000. Accident compensation benefits pay out per injury and have no limits on use. Typically a person will have a $100 dollar deductible per covered accident. ER policy pays up to the $2,500, $5,000, $7,500, or $10,000 per accident excluding the $100 deductible. In simple terms, you'll owe $100 dollars for any covered injury assuming the bill doesn't exceed the policy benefit max of $2,500, $5,000, $7,500, or $10,000.

Here's some figures on what the leading personal accident insurance dues are. Indemnity plan rate increases are seldom because it's an association based health insurance product.

-$24 dollars a month: $5,000 benefit individual plan.

-$29 dollars a month: $7,500 benefit individual plan.

-$36 dollars a month: $10,000 benefit individual plan.

-$35 dollars a month: $5,000 benefit family plan.

-$41 dollars a month: $7,500 benefit family plan.

-$47 dollars a month: $10,000 benefit family plan.

(family policy prices include everyone, it's the same price for a 3 person family or 12 person family)

It doesn't matter what accident health insurance plan brochure you pick up, all plan brochures EOB (Explanation Of Benefits) page say the same important benefit: Members may choose any Doctor, Hospital, or Emergency Room. Since this is accident indemnity, benefits have no restriction on health care providers to choose from. Accidents are unpredictable and so is knowing what emergency room you'll be showing up at. I can't imagine accident plans would sell if they came with some lame network provider booklet of acceptable doctors. This brand of accident coverage is 100% portable and can be used up to two months outside the United States while traveling abroad.

Accident Plan benefits at a glance:

-Hospital Emergency Care

-Doctor's fee for surgery (in and outpatient)

-Laboratory Tests.

-X-Rays and MRI's.

-Ambulance Expense.

-Registered Nurse.

-Hospital room and board.

-Operating Room Costs.

-Anesthesia.

-Prescription Drugs.

-Physical Therapy (super important post operation)

-Doctors visits (inpatient and outpatient).

-Dental treatment for injury to sound natural teeth.

-Splints, Crutches, and Casts.

Friday, October 11, 2013

Important Facts About Arthritis Knee Pain


The Multi-Disease

The "Arth" in arthritis literally means joints, while "itis"refers to "inflammation. Arthritis encompasses over 100 variants, making it a multi-disease. It can afflict people of all age ranges, including up to 300,000 children.

Warning Indicators Of Arthritis

Watch for these warning signs of arthritis:


  • Pain

  • Swelling

  • Stiffness

  • Difficulty of joint movement

If symptoms continue over a two-week period necessitate a visit to your doctor.

Most Common Kind Of Arthritis

Of the more than 100 types of arthritis, the most common is osteoarthritis, a degenerative joint disorder which is also known as "wear-and-tear" arthritis.

This type of arthritis afflicts over 20 million people in the United States. It is usually associated with advanced age, but can also be caused by obesity and athletic injuries.

Rheumatoid Arthritis: The Autoimmune Disease

Another common type of the disease is Rheumatoid arthritis, an autoimmune disorder suffered by 2.1 million of the United States population. Rheumatoid arthritis causes the bodys' immune system to attack joint, cartilage and ligament cells, resulting in chronic inflammation which damages the joint and its surrounding areas. Apart from the systemic effects of the disease in severe cases, deformity and disability can occur.

No Known Cure

Medical science has yet to discover a cure for arthritis. The most that can be done to remedy the disease is to alleviate the accompanying pain while preventing the occurrence of deformity and debilitation. Successful management of arthritis depends on two crucial factors: early diagnosis of the disease and administering an aggressive treatment plan.

Undertaking An Aggressive Treatment Plan

During the process of diagnosing and evaluating your condition, your physician may recommend an aggressive type of treatment to manage your symptoms. While prescriptive drugs like aspirin, Tylenol or NSAIDS (non-steroidal anti-inflammatory drugs) may provide mild relief, this conservative form of pain and inflammation relief may not be enough, particularly for more severe or advanced cases of arthritis.

Aggressive treatment may involve prescribing methotrexate or Arava. These two medications fall under the classification of DMARDS (disease-modifying anti-rheumatic drugs).

Your doctor may also advise incorporating TNF blockers of biologics, a more recent class of anti rheumatic drugs, like:


  • Enbrel

  • Humira

  • Remicade

Another kind of medication, Prednisone, is also used for aggressive reduction of arthritis. At present, there are drugs currently under development to treat the disease. Meanwhile many other different remedies like exercise programs, physical therapy, surgery and other supplementary care regimens may be used as complimentary support in the management of arthritis.

Diagnosing Arthritis

If you have been suffering from arthritic symptoms for over two weeks, or suspect that you have the disease, you should schedule a visit to your doctor. You doctor will conduct a thorough examination and assess your medical history. If necessary, you will need to have x-rays and submit to laboratory tests for a more accurate and comprehensive diagnosis. Expect to undergo basic and complicated lab and x-ray checks to confirm any indications of abnormal inflammation or signs of damaged or eroded joint tissue.

Seeing A Rheumatologist

Doctors who treat arthritis and arthritis-related disorders are called Rheumatologists. Their specialty is the diagnosis, treatment and management of arthritis, and your internist or family practitioner may refer you to one.

Arthritis Fast Facts


  • In the United States, an estimated 66 million adults in 2005 reportedly suffer from arthritis and other chronic joint symptoms.

  • Of these 66 million, nearly 43 million have been medically diagnosed as arthritis.

  • The remaining 23 million continue to suffer chronic joint pain without consulting a medical professional.

  • The disease has been considered the number one cause of disability among Americans 15 years and older.

  • Arthritic sufferers are predominantly women.

How Your Hourglass Body Shape Can Bring a Man to His Knees


An hourglass signifies when time is running out. If you have been blessed when an hourglass body shape, then your time is also running out. You only have lifetime to make use of this perfectly proportioned body shape that you have been gifted.

How can you tell if you have an hourglass body shape? Measure around your bust and your hips. If they are roughly the same circumference then you are an hourglass shape and there have even been songs written about this female shape. To paraphrase the Commodores and their timeless song Brick House, you are 36-24-36 what a winning hand. Now that you know your body shape is indeed a brick house, you need to know how to you dress this body shape to maximize your... um, shall we say, assets.

Here's what to look for when shopping for items to flatter your hourglass body shape:


  • For shirts, a V-neckline shirt is going to be the most flattering for you because it gives just a hint of cleavage. A higher neckline can make your bust look larger and disproportionate to the rest of your body.

  • For cardigans, you want to look for a deep v-neckline as these are going to serve you well for many different outfits.

  • For jackets, you want to look for two buttons and again a deep V-neckline.

  • For prints, you want to aim for mid-sized prints otherwise it will overwhelm your frame.

  • For coats, look for pocket flaps on the hip as it will help emphasize your narrow waist.

  • For top lengths, if you are wearing pants you will want to hide the top part of your pants. Look for crotch length shirts.

Remember for an hourglass figure, you want to show off all of your great curves, but you don't want to add bulk or do anything to make your perfectly proportioned body look unbalanced. If you are looking for celebrities with hourglass body shapes that you can use as a style reference, look at Selma Hayek, Scarlett Johannsen, or Christina Hendricks. You can look to these celebrities to get a sense of what will work on with your body. These women are continually lusted after by men and celebrated in the press for their curves.

It a blessing not a curse to have an hourglass body shape. The men will love you and the women will envy you. To quote the Commodores yet again, "She knows she's built and knows how to please. Sure enough to knock a man to his knees." Go knock 'em dead you hourglass brick house!

Chondromalacia Patella Symptoms - Causing Your Knee Pain And Grinding?


Chondromalacia patella symptoms present as a pain felt in the front of the knee and a grating or grinding sensation when the knee is flexed. Chondromalacia patella is caused by abnormal wear on the cartilage under the kneecap (patella). This condition generally affects teens and young adults. This article will look at the distinguishing characteristics of the disorder so you can form and early medical symptom diagnosis and be better prepared for a consultation with your doctor.

Chondromalacia Patella Symptoms And Causes

Symptoms may include:

  • Pain that is felt under the kneecap (front of the knee)

  • Knee pain that increases when walking up steps or sitting with the knees bent in a cramped space for long periods ("movie sign")

  • Grating or grinding sensation when the knee is flexed or bent

  • Crunching sound (crepitus) when the knee joint is moved through a normal range of motion

  • Some cases may experience stiffness, swelling, tenderness, or buckling of the knee

Chondromalacia patella occurs most often in teenagers and young adults and is more common in females. The condition may be caused by an abnormal pull of the quadriceps muscles (thigh muscles) on the kneecap which results in the kneecap being pulled out of its normal groove and becoming irritated.

Risk factors that may increase the risk of developing chondromalacia patella include: an abnormal positioning of the kneecap; tightness or weakness of the thigh muscles; overuse from activities such as running, jumping or twisting, skiing or playing soccer; flat feet; previous injury or trauma to the kneecap.

Chondromalacia Diagnosis And Treatment

Diagnosis will be based on the observation of the aforementioned symptoms and an evaluated by a physician. The evaluation should include a physical examination complete with orthopedic tests and possibly x-rays (typically normal) or an arthroscopic examination (visual examination of the knee joint using a scope).

Treatment includes resting the involved knee. Ice and nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, naproxen, or aspirin may be used to relieve pain following activity that stresses the knee.

Physical therapy to balance the quadriceps and hamstring muscles may be helpful. Taping to realign the kneecap or wearing a brace that has an opening over the kneecap may help control the movement of the kneecap and diminish symptoms. Orthotics (specially fitted shoe inserts) may add support especially for those with flat feet.

If the conservative treatment options mentioned above do not relieve the symptoms or there are signs of arthritis developing, surgery may be an option. This may involve arthroscopic surgery (surgery using a camera inserted through a small opening).

The prognosis is good and the condition usually improves with therapy and the use of NSAIDS. If surgery is required, this is often successful.

A Stiff Knee - An Injury Might Mean Big Time Trouble! - Take Your Stability to the Next Level


Why do you think your knee is stiff? Was it due to an injury?

Many people who engage in regular sporting activities do not think much about a stiff knee injury. They simply assume that is part and parcel of leading an active lifestyle. However, this can be a very dangerous assumption to make, as a stiff knee injury can often be an indicator of something more serious.

What Causes A Stiff Knee?

Stiffness in the knee joint is usually caused by inflammation in the knee area or in the surrounding ligaments and tissues. The tissues swell up, making it difficult for the knee to bend normally, leading to a stiff knee. If your knee meniscus is injured, the damaged meniscus can also create a stiff knee sensation. Another cause could be overstrained muscles or ligaments that have been injured and have tightened up. Injured muscles and ligaments can definitely limit the degree of movement in the knee.

Don't Ignore It!

Too many people who simply ignore a stiff knee injury end up with a worsening situation. This is because a stiff knee is simply the body's way of telling you that something might be very wrong with your knee. It is vital that you pay attention to it and figure out exactly what is wrong with it before continuing with your sport of choice. (Speak with your physician about your concerns.)

Overstrained muscles and ligaments could also pose a serious problem for anyone who enjoys sports. Normally, the muscles and ligaments provide support for the knee. They do this by helping to absorb some of the impact of running or jumping, for example. This helps to prevent too much pressure being exerted on the knee. When the muscles and ligaments have been overstrained, however, they are no longer able to perform their function at a high level. This could lead to impact injuries in the knee or even cause the kneecap to be pulled or shifted out of place.

What To Do If You Have A Stiff Knee Injury

The first thing to do is to stop any strenuous activities immediately. and request information from your doctor. This includes any activity that involves running, jumping, or walking long distances. Ceasing the activity that will cause you further problems will prevent you from causing any possible further injury to your knee. You can then determine if your stiff knee injury is really just due to tired muscles or if it is due to something more serious.

The best thing to do now is to let your knee rest and recover. While you rest it, you should also seriously consider wearing a knee brace. A knee brace is an excellent device for helping to prevent further injury in the future. Currently, these supports are very light weight and affordable, and they can help prevent excessive movements that will cause you further pain or injury. If it does not go away of its own accord, however, then it is time to consider the possibility that you may have sustained a serious knee injury and to talk about this with your physician.

Knee braces can really help someone in your position with improved knee stability and a reduction in pain. It is very important to consider a support now, because if you do not then in the future you might look back with regrets. This conservative treatment method could help you avoid an invasive surgical procedure in the future.

Are You Weary to the Bone With Grief?


If you are, you're not alone. The stress of grief is debilitating and it's experienced by many after the loss of a loved one. Grief has the capacity to bring us to our knees physically as well as emotionally. We can feel totally exhausted, knackered, wiped out and depleted. How about spent, fatigued, and crippled with tiredness? There are many more descriptions of the bone crushing weariness that grief and loss leaves in its wake.

It can take us off-guard, this crippling weariness and physical struggle. Every little thing becomes a major feat and a major test of endurance. When you consider what has happened though, it's not surprising. Yet often we do indeed find it most surprising!

This is some or most of what has come before:

Days, weeks, months or years of care-giving.

Days, weeks, months or years of watching a loved one struggle.

An unexpected call or knock at the door telling you of something horrific and unbelievable.

Having to make life and death decisions often at a moment's notice.

Unexpected travel and associated costs.

Surrounded by happy faces in the maternity ward.

Organising a funeral service when you're numb with pain.

Government bureaucracy.

Financial worries.

Unpaid leave or pending unemployment.

Expectations.

The feeling of being so alone and unsupported.

Dealing with the missing and the longing every single moment.

Crying day and night.

Grief triggers.

The paper jungle.

Worrying about everyone else.

And the list goes on. You could add to it I'm sure but it's revealing isn't it?

All of the above is stressful beyond measure. It tests you to the limits of what you ever believed you were capable of enduring and more! Dealing with the emotional fallout of those experiences can be utterly exhausting. It takes over your body and you can feel it creep into the very marrow of your bones.

Then on top of all that you have to find some resources within yourself to keep on keeping on with the routine of daily living. Anna from Pleasant View Schoolhouse writes, "Grief is exhausting. It is the difficulty of existing in two worlds at a time." Amidst the intense pain of dealing with your grief you have to keep a home running, talk with people, get back to work, be alone for the first time in years and much, much more.

Often having this awareness about where you have come from and what you are dealing with on a daily basis is enough for you to take pause. It is enough for you to recognise your great strength in living after loss and it is enough for you to say to yourself, "No wonder I feel tired!"

With that awareness of your circumstances, it may then become easier to accept the need for more rest, for gentleness to yourself, for time out from demanding schedules and a focus on self-nurturing and the restoration of your aching body and hurting heart.

Interview With By Dr Thienna Ho, Author of Unlocking the Mystery of Skin Color


Dr. Thienna Ho was born in Saigon, Vietnam, in April of 1968, just three months after Viet Cong Forces attacked that city during the infamous Tet Offensive. Eleven years later, her family fled communist Vietnam in a 50-foot wooden boat carrying 285 passengers. During their harrowing ocean voyage to Indonesia, this vessel was attacked five times by pirates. Less than a year later, Dr. Thienna's family immigrated to the United States and settled in San Francisco. She went on to earn a number of academic degrees, including a BA in Economics, a BS in Microbiology, a Graduate Certificate in Genetic Engineering, an MA in Business Administration, and a Ph.D. in Scientific Nutrition. She also has performed significant additional study in the fields of chemistry, biology, and molecular biology.

Dr. Thienna is the founder of THIENNA, INC. She is the World Leading Authority on Human Skin Color. After seven years of independent scientific research, Dr. Thienna solved one of the most enduring mysteries on earth that had intrigued scientists for centuries-the causes for the variation in human skin color! She is here to talk about that work and her new book "Unlocking the Mystery of Skin Color."

Tyler: Welcome, Thienna. I have to admit I'm very curious to talk to you because you claim in your book that people have the ability to change or control the color of their skin. To begin, will you tell us how you first discovered this possibility?

Thienna: Thank you for having me here today. It is a treat. Tyler, this question is a very emotional one for me to answer as my mother just passed away last year and I want you and everyone to know how much I love her regardless of what I am about to say. I must admit I am very embarrassed to say this, but I was envious of my mother and siblings for having been born with beautiful light complexions, and I was the only child born with dark skin in the family. Since I was about four years old, I already knew that neighbors and friends always praised them for their beautiful fair skin but not mine. I learned at an early age from my family that my dark skin looked "dirty and unclean"-because my skin tone was so uneven that I counted at least seven distinct shades and the skin on my elbows, knees, feet, and ankles was embarrassingly alligator-like, rough, thick and dark ashen gray in color. I actually hated my skin. Every time, I looked at my mother, I longed to have her beautiful fair skin.

During my adult years here in the U.S., I tried every skin product under the sun to lighten and even out my total body complexion, but these products only darkened my skin color even more! When I was studying microbiology at San Francisco State University as an undergraduate student and genetic engineering as a graduate student, I was disappointed to discover that scientific research had not reached the stage that would help me to alter my skin color. I was so frustrated that I made it my mission to learn everything I could about the science of the human skin so that I could solve my own skin problems and eventually help others who had the same problems that I did and this was how I solved the mystery of human skin color.

Many people are skeptical that I was born dark. I must say I had to have a problem to solve a problem and to passionately see the world the way I see. People said, "Vietnamese people are not dark" and if I were dark it was because I must be hanging out in the sun! And when I moved here, the weather is colder so I would naturally get lighter or get back to my natural color. Well, this did not apply to my case. See the photos in my book and on my website http://thienna.com/thiennaphotos.html of when I was 12 years old and a photo taken with my brother when I was 18 years old. There was not much of a difference in my skin color after six years of living in the U.S. and I did not expose myself to the sun. Even when I was 30 years old, my skin color was the same from avoiding the sun.

In my book, I will prove to you that genetic heritage, solar radiation, and how close you live to the equator, do not have as important an influence on the development of skin color as we previously believed. You will learn that not all people native to the equator are jet black and not all people native to the Polar Regions are exactly white. Thus, living under a sun-deprived environment will not guarantee the development of light skin. You can cover your body up all you want and avoid the sun; you will still be dark unless you know my method!

Tyler: And what is the secret, Thienna? How does a person change his or her skin color?

Thienna: One of the most important factors in the determination of skin color and one that is commonly overlooked is the amount of sulfur in your skin. When skin of any color has less sulfur available for its use, it develops a darker shade. When skin of any color has plentiful supplies of sulfur available for its use, it develops a lighter shade. Thus, by changing the amount of sulfur in the pigment-producing layer of your skin, you can change your skin color!

What I must point out here is we need sulfur to survive. Sulfur is a natural mineral that is as fundamental to life as water and salt are. It is the eighth most abundant chemical element in all life forms and the third most abundant mineral in your body. You cannot live without it. Sulfur is found in every cell in your body. Your body needs sulfur to create skin, hair, nails, muscles, bones, and teeth. Without sulfur, your body cannot regulate its blood sugar or transmit messages from one nerve cell to another. Your body also requires sulfur to digest, absorb fat, and to excrete cholesterol. Therefore, factors in your lifestyle and diet do affect the amount of sulfur that your body uses.

In my book, I teach people how to enrich their diet with sulfur-rich foods and how to adopt behavior patterns that will maintain high sulfur levels in the body in order to lighten one's skin color or to maintain a flawless complexion.

Tyler: Thienna, I admit I've never heard sulfur discussed when we talk about minerals and vitamins and our body's makeup. Why haven't we heard more about sulfur in the past? What is an example of a sulfur-rich food?

Thienna: Sulfur is not extensively studied in human nutrition. It is solely required by your body to neutralize and eliminate toxins to keep you HEALTHY! Your survival depends, I believe, strictly on how well you combat poisons/toxins before they damage your tissues which could potentially lead to chronic illnesses or cancers and what not. It is one of the most overlooked essential nutrients for our body. Why we have not heard of it? Haha... That is a great question. Example of a sulfur-rich food is cabbage.

Tyler: You said a person's distance from the equator doesn't make a difference in their skin color. Are the diets of certain people, such as Europeans, more full of sulfur than those of people in Africa? Is geography in any way responsible for skin color?

Thienna: Diet and lifestyle of the Europeans play a good part in the development of their skin color but more importantly the secret is in the book. There is a loophole that helps them save more sulfur for the body.

Geography is not at all responsible for the outcome of skin color. Take for instance, 2 population groups: one lives at 4,500 feet above sea level and the other at 8,000 feet above sea level where every 1,000 feet, there is a 6% increase in the intensity of UV radiation. You would assume that the group that lives at 8,500 feet would have darker skin but this is not the case. As a matter of fact, the group who lives at 8,500 feet has white skin and the group who lives at 4,500 feet above sea level has brown skin. I am referring to the cases in my book-the Hotan and the Hunzakuts. These are not isolated incidences. There is no lack of variation in human skin color no matter where you look. To sum up, as long as the sulfur intake outweighs the toxin intake, light skin development is favored regardless and visa versa.

Tyler: Thienna, how radical of a color change is possible? Can a South African be made to look like someone from Finland or vice-versa?

Thienna: From my own research and feedback from people who have been practicing my Natural Fairskin Method for the past 2 years, people got many shades lighter, like myself. For example, they can go from a brown to a light brown, a dark olive to a light olive and light olive to the light range in a period of 12 to 18 months. As for me, I have been practicing my method for 7 years; I was able to go from a dark olive to the light range. As of today, I cannot say that my Natural Method can make a South African to look like someone from Finland or vice-versa because people are still testing the method and only time will tell.

Tyler: What sort of evidence is there that this change is possible?

Thienna: There are many intriguing scientific evidences in my book, which show you that skin color is not fixed and the skin lightening process could be a very recent phenomenon (recent would mean a few thousand years). Take for instance, recent genetic research showing that the ancestors of modern Germanic people did not have light skin. Visual evidence left by artists 10,000 years ago from caves in France show men with dark brown skin hunted light brown deers. Other fascinating evidence can be seen in recent research of short lived creatures! Believe it or not, research showed that even a single nutrient can affect the color development of the furs or coats of animals! You have to wait and read my Nature's Proof from my book. It will knock your sock off!

I am also a proof right here and people who have used my method can testify to this too. And whether you have used my method or not, you may have unknowingly directed the development of your own skin color to a certain degree! Some people do get lighter with age and some people get darker with age.

Tyler: You claim to have lightened your own skin. Will you tell us a little bit about this change and how much of a change you actually made?

Thienna: Well, people often thought that I was Cambodian but now they think that I am Japanese. It is definitely a visible change! I do apologize if I offended anyone with labels. I must say skin color is one of the hardest and most touchy subjects to talk about and I am always in the line of fire. I hope people will understand where I came from, why I did it, and not be judging me before they read my book. I am glad I was born into this perfect situation which has propelled me to solve one of the most puzzling scientific mysteries on earth.

Tyler: What are the most common reasons why people use this change of skin color?

Thienna: For esthetic reasons and I will leave it at that. It is the same like someone likes to have a tan.

Tyler: Thienna, without meaning to offend anyone, may I ask if people have reacted to your work as having some sort of racist agenda?

Thienna: Absolutely! They think my work is evil. As evil as the theory of evolution! As you know, science has no moral judgement. If we stray from logic, we cannot solve anything.

Tyler: That's a perfect response, Thienna. Of course, we have heard of white men who dress as black men to see if they are treated differently. In your own experiences, have people treated you differently than they used to because of your lighter skin? May I ask why you think your family even made your skin color an issue?

Thienna: Tyler, this is a very interesting question indeed. To be honest, in my own experiences, I never had any problems whatsoever with how people treated me when I had a dark complexion. People genuinely love me and I can feel their love and kindness. However, it is strange enough to say, but many women just do not like me when I am lighter. I am sure it is nothing new whether I am dark or light, there is a war among women since eons which I will not go into. As for men of color, I will not comment on this as I can only listen, learn, and provide solutions that would help us all.

Again, I love my mom greater than the ocean, the sky, and the stars altogether and I would go to the ends of the earth for her in life and in death. When she left me, she took my heart and my soul. My mom is my everything but she is not without flaws. As to my dark skin color, I truly believe it was not intentional and not directed toward me at all. But if you are growing up hearing how dark skin is dirty, eventually, you know you are dirty as well. That is as much as I want to share for now. Maybe one day I will tell my story. I must say I am proud of myself. With struggles come rewards. I would not change anything and I don't have any regrets. Although I do hold grudges through eternity. Anyway, this is the spice of life. I live, learn and see life with all its beauty and its ugliness. This is what makes life the more interesting and beautiful.

Tyler: What methods can be used for people who are aging, concerned with such signs of old age as liver spots?

Thienna: They can practice my Natural Fairskin Method and their liver spots will naturally lighten. My Natural Fairskin Method utilizes diet and lifestyle alone without the use of toxic chemicals, drugs, or steroids to undo any skin problems. Some may say...well, I do not want to get lighter than I already am. I want to emphasize that you need sulfur to keep your skin clear and vibrant. To have a therapeutic skin lightening effect, you need a lot and I mean a lot more sulfur in your diet. In a nutshell, if you have a great surplus of sulfur in the body after the body uses the sulfur for all the necessary biological processes, the sulfur can then be allocated to your skin. Skin lightening is a side effect of a high sulfur intake. This is why you can control your own skin color development depending on how much sulfur you give your body and how much you save for use by your skin. If you do not want your skin to lighten, do not eat too much sulfur! But eat enough to keep your skin nice and clear into your old age!

Tyler: What about people who have suffered from serious skin damaged from sun exposure over the years. Is there hope for them?

Thienna: Damaged skin, either from toxic chemicals, poisons generated from the body or sun-damaged skin, is very difficult to correct. However, people can use my method to undo the damage to their skin to a large degree and restore its youthful vibrancy. Using toxic chemicals to correct the damaged skin may make the situation worsen in many cases. Chemical peels and other methods such as microdermabrasion may help correct the damaged skin to some degree but people still need to change from the inside out so the underlying problems will not surface again.

Remember, what you put in your body, on your body, or what affects your body from your environment will affect the mechanism that controls your skin health and its color. It does not matter where the source comes from; in the end, toxin is toxin and the body will use sulfur to clear toxins from the body, leaving less sulfur for the skin which in turn affects your skin health.

Tyler: Having a tan and using tanning salons has been a big fad in the United States in recent years, yet we are constantly warned about skin cancer. Is there another way to tan the skin naturally?

Thienna: Yes. There is a chapter in my book about how to use diet to tan your skin naturally. There is no need to expose your skin to the dangerous UV rays! Indigenous people of the world are always darker than their modern counterparts in the developed world. You will have to read the book to see what they do to achieve their dark complexions and maintain their dark complexion for thousands of years even if they live in sun deprived environment!

Tyler: In referring to indigenous people, did you find in your research that any previous cultures had the knowledge you have found-that some ancient culture perhaps had worked out the secret of skin color?

Thienna: Definitely ancient cultures do have the wisdom and the knowledge as to how to keep their skin color light but they do not know why scientifically. For instance, to make the skin lighter, ancient Egyptian women bathed themselves in milk. The Tibetans would avoid eating butter, the South Indians would avoid drinking black tea, for the Chinese, don't eat too much soy sauce if you don't want skin of the same color, etc...

In this book, I show you the science behind "the how." Any questions that you were curious before are all in this book. Even if the answers are not written in this book, the book will speak for itself effortlessly.

I have to point out that sulfur has been used since the ancient times to treat skin ailments. What I found that was truly interesting to me was how sulfur is portrayed in Ancient Christianity. Christianity conceptualized sulfur as the fuel that produces the fire of hell and in the New Testament, Hell is called the fiery lake of burning sulfur. Sulfur was known in the ancient time as a substance that cleanses pollution and purifies the sin.

Tyler: Thienna, you also comment that the poorest countries tend to have the darkest skinned people. Why is this?

Thienna: Your body's toxin-clearing mechanisms greatly depend on sulfur... Meaning whatever you put in your body, on the molecular level, it will affect your sulfur status. Changes in your skin color are the result from changes in your environment, diet, behavior, lifestyle, culture, tradition, cooking methods and emotional and psychological factors such as stress.

I discovered that, everything else being equal, a population group exposed to relatively low levels of toxins over a long period of time will have a lighter skin color than a comparable group exposed to high levels of toxins over the same period. Toxins rob the body of sulfur, which leaves less sulfur for the skin.

This is why skin color is not uniform within a population group either. This is difficult for me to say but the wealthy, high status people often have a lighter complexion than the less wealthy people even if they share the same genetic makeup. City people are also lighter than their ethnic counterparts. This is not just my observation but skin scientists also observed this phenomenon. (I must warn people about our discussion. It could be really disturbing?.

Tyler: You promise, Thienna, to give us the answers to some intriguing questions, including why do some African-American celebrities seem to get lighter over time. I have to ask, what do you think has happened to Michael Jackson's skin color?

Thienna: Some African-American celebrities do get lighter over time because money and status take a load of stress off their body, mind, and soul. They eat and live well and also do what they passionately love. Fewer toxins bombarded their bodies. Thus, these factors naturally enhance the development of lighter skin color. When we do not have money, it does not come with just the emotional and psychological stress of everyday life but we eat cheap and malnourished foods laden with toxins. (If you listen to the latest news...foods and merchandises from cheap retail outlets are packed with poisons!-I'm not going to name names-and who are the buyers?) Our skin naturally gets darker with time and if we keep on this pattern from one generation to the next, the skin of population groups just get darker and darker overtime until it reaches equilibrium. Let me explain something very important here. Most of us are taught as a fact that the sun is one of the major contributing factors that affects how your ancestors and you develop your skin color and that is...the closer you live to the equator the darker your complexion and the closer you live to the North Pole the lighter your complexion. This is not so! Skin color is not uniform worldwide wherever you look. You can remove the sun altogether and you still evolve to have a dark complexion. Other factors mentioned above (diet, lifestyle, behavior, culture, and tradition) can have as much or greater an influence on the development of skin color than the sunrays and not to mention genetics!

As for Michael, I do not know him but I will say this... Michael would have naturally gotten lighter by many, many shades over time with his money and power. That is all I can comment on about Michael.

Tyler: I have to admit when I first heard about your book, I felt skeptical about the matter. Will you tell us a little bit about the kind of research you put into the book so we are more convinced?

Thienna: The findings presented in "Unlocking The Mystery of Skin Color" are the results of my extensive research in the fields of molecular biology, chemistry, genetics and nutrition as well as my own personal observations and experiences. I applied the strict standard of scientific method to solve my skin problems and my research is backed by over 500 reputable scientific sources. The advantage of applying the scientific method is that it is unprejudiced. My results are reproducible by anyone who wants to determine whether my results are true or false in human or even animal models. Since 2005, many people worldwide have applied my method and they got the same results as I did. I am very confident to say that I did it. I solved the mystery of skin color!

Tyler: Thienna, who has been your biggest influence?

Thienna: I have to say that my dad has the biggest influence on me. Because I was born with a dark complexion, my dad always pushed me harder than my other siblings to sharpen my mind. He provided all the vehicles for me to excel since I learned to walk-from music, sport, dance, and down to my education. He made me believe in myself-an immeasurable value that helps me excel both in work and in life.

Tyler: Thank you, Thienna, for joining me today and sharing these amazing techniques to change skin color. Before we go, will you tell us what additional information about "Unlocking the Mystery of Skin Color" readers might find at your website?

Thienna: At my website (www.thienna.com), people can find additional information about my company, what I do and of course questions and answers about the book from readers. I also provide nutritional supplements to assist individuals to obtain a healthy, clearer, and brighter complexion...that is if people cannot follow my Natural Fairskin Diet strictly, they can supplement their diet with my dietary sulfur.

Tyler: Thank you, Thienna, for the fascinating information. I wish you lots of luck in your continued research.

Thursday, October 10, 2013

Arthritis Treatment: Complications of Stem Cell Arthritis Treatment


There has been an explosion of interest in the possible remedial effects of mesenchymal stem cells (SCs) on osteoarthritis. In fact, in the November 2011 issue of the journal, Arthroscopy, there were two articles on mesenchymal SCs and three articles on the use of enhanced platelet rich plasma.

In addition, descriptions of mesenchymal SCs being used with various matrices for osteoarthritis are coming out of the rheumatology literature as well.

In fact, the use of materials such as mesenchymal SCs and platelet rich plasma has spawned an entire specialty, regenerative medicine.

With each new article, there is more and more evidence that SCs and associated growth factors can help the body to heal connective tissue disorders.

In previous articles I've discussed the science, the rationale, the various types of stem cells, and the variety of techniques used to perform a stem cell procedure.

With this article, I will highlight some of the dangers.

As with any new area of medicine, there are specific concerns that need to be addressed.

SC treatment is no different. The obvious first concern is infection. Since administration of stem cells involves an invasive set of procedures, it is important to realize that infection is a potential problem.

Special care to ensure the technique is performed in a sterile environment, preferably a surgical center, is advisable. Strict adherence to sterile preparation, as with any other operative procedure, is imperative.

The administration of perioperative antibiotics should be considered.

Another possible problem- less so with autologous (a patient's own) SCs, but definitely with donor or induced pluripotential SCs, is rejection. The SCs are viewed as a foreign protein by the host when considering a donor or an induced pluripotential source. The use of anti-rejection therapy is a consideration but should be administered with the utmost caution. Anti-rejection drugs carry their own set of issues.

Dove-tailing with rejection is the possibility of graft versus host reaction. This can be a complication of any organ transplant and SCs coming from any source other than the recipient can be the cause of this.

Another potential problem with SCs is the development of malignancy. The danger is probably less with autologous SCs than it is with other types. Malignancy has been reported with the use of embryonic SCs on at least two occasions in the literature.

Transmission of genetic disorders is also a danger, particularly with donor SCs. Despite careful screening, this remains a very real problem.

In summary, SC science and clinical application is an exciting new area for both research scientists as well as clinicians. Special precautions need to be taken in order to ensure, this new technology is administered in both a safe as well as effective manner.

Five Risks of Wearing High Heels Revealed


Over the years, high heeled shoes continue to be a popular fashion trend. So popular, it is causing some women to surgically alter their feet in order to fit into them. Even without this, there are health risks associated with wearing high heels.

1. A high heeled shoe forces the posture into an unnatural position that significantly stresses the joints. The spine, which in flat shoes is reasonably straight, forms more of an 'S' shape with the chest and lower back pushing forward and the hips pushed back. The height of the heel also changes the amount of weight on the forefoot. A 1-inch heel will increase the pressure by 22%; a 2-inch heel by 57%; and a 3-inch heel by 76%. This increased pressure puts the forefoot at risk for injuries such as stress fractures, bunions, and hammertoes.

2. Knee pain is common when high heels are involved. The heel height causes increased strain on the knee joint and associated tendons. The quadriceps muscle group in the front of the thigh works harder, increasing pressure on the kneecap by up to 26%. This can ultimately increase the incidence of osteoarthritis of the knee and quadriceps tendinitis.

3. When the heel is constantly elevated, the calf muscle and Achilles tendon can contract and shorten. Wearing high heels habitually can result in a woman no longer able to tolerate a flat shoe. On occasion, this can even require surgery to lengthen the Achilles tendon. Most often, however, this will increase the chances of Achilles tendinitis or shin splints.

4. The changes in posture and overall imbalance will lead to instability when walking and a resulting risk of ankle sprains. High heels, especially stilettos, will lead to instability and a major increase in ankle sprains result. An ankle sprain is caused from the twisting of the ankle and results in a tear of the ligaments that connect the foot and leg bones and stabilize the ankle. When the heel is balancing on a narrow stiletto heel, if the heel shifts outward slightly a sudden twist may occur to sprain these ligaments. Swelling, bruising and pain will result. At worst, it is possible for the ankle to fracture, a ligament can pull a piece of bone off, or even a bone in the foot can break due to the pull of a tendon.

5. High heels are enjoyed by most women because they are "cute." They are narrow and are contoured to make the foot look slender. The tight fit of many heels will force the toes to conform to its shape. The added pressure on the toes can exacerbate bunions and hammertoes. The pressure of the shoe itself can cause corns to form. Furthermore. The compression of the metatarsal bones can cause pressure on the nerves that run between them. A Morton's neuroma, which is a growth and inflammation of the nerve, can form due to the pressure. Remember, a shoe is meant to fit the foot, not squeeze it relentlessly.

While the overall percentage of women wearing high heels daily has decreased, the percentage reporting physical problems from wearing them has increased. This is likely due to the newer styles that have been introduced. Some have no choice but to wear the shoes for work, however comfort is a priority. Pain should not be a price for style. Be sure to always wear a shoe that is right for your foot. Of course, if the pain continues, be sure and visit your podiatrist.

British Seaside Holidays in the 1950s


The typical seaside holiday in Britain in the 1950s was quite different from those enjoyed today. Admittedly, there was the same desire to lounge on the beaches, paddle in the sea and enjoy the amusements as there is today, but the the past half century has seen huge changes in tastes and expectations.

A far bigger percentage of Britons enjoyed their holidays in their home country than they do today. In the 1950s cheap international flights had not been introduced and the big holiday resorts of the Mediterranean and beyond - magnets for modern sun-seeking Britons - had not been developed.

For their summer holidays the British tended to visit the resorts in their own area, such as Blackpool for northerners and Brighton for people living in the south. A trip to Torquay in the south west for someone living in Yorkshire would have been seen as exotic.

Staying in a hotel or holiday park, now very popular with holidaymakers in Great Britain, would have been unknown, especially to working class families in the 1950s. Holiday lodgings were far more austere.

Hotels were only affordable for the well off, so most families stayed in bed and breakfasts, which folklore tells us were owned by strict unsmiling landladies. Caravan parks were available, but very unlike the luxury holiday parks of today. Washing and toilet facilities were basic and communal. Caravans were nothing like the modern static caravan complete with mod cons.

They were cramped, tiny, and lacked a WC. And as for the modern log cabin, the most you could expect in the 1950s was a small prefabricated chalet, with only marginally better facilities than the caravans of the period.

The British seaside holiday of the 1950s was very much a communal affair. Families travelled, along with other families, to the seaside on coaches or trains. A good example of the communal aspect of the British holiday of the period were the holiday camps, Butlins and Pontins being the most famous.

The holiday camp, aimed at catering for working class families, had been introduced before the second world war, but were still tremendously popular during the 1950s. While families stayed in in their own on-site chalets, the rest of the holiday was communal. They ate together in large halls, silly competitions such as knock knees contests were held, and the British of the time absolutely loved it.

British seaside holidays of the 1950s may amaze the Britons of today. Sophisticated they may not have been, but they still gave great enjoyment to millions.

Stopping Your Dog From Jumping Up


Many dogs jump up when greeting their owners, friends and other pets, but in many cases this is not behavior that should be encouraged. You, as the dog's owner, may not mind, but guests may well be annoyed, frightened or simply worried about hygiene issues of having a dog's face close to their own.

Some trainers have advocated kneeing a dog in the chest to stop it from jumping up. I DO NOT advise this - it may hurt the dog or your knees and it will almost certainly not cure the behavior. We need to look at the reason the dog responds and tackle the problem from its root.

The behavior usually begins with a trigger, such as a knock at the door or a doorbell ringing. The dog will be immediately alert and ready for a visitor - he thinks that it is his job to welcome a guest, to check a stranger, to keep the pack and the territory safe. This is where the problems begins, because it should be the owner who has the responsibility of welcoming, checking and maintaining safety, not the dog.

So, when the trigger occurs, put your dog away in another room. You have effectively controlled your dog's behavior and can now welcome your guest in your own way. You will have raised your status in the pack and reduced your dog's, showing him that you are in control of who enters the house and in what manner they are greeted. You will also have saved your guest from being jumped on!

When your dog is allowed through to see your guest, do this in a controlled manner and don't allow him to jump up. As soon as his behavior is anything less than acceptable, banish him to another room. He will soon realise that he must follow your rules if he wants to stay with you and the guest.

If your dog jumps up at you yourself when you come back home, there are two strategies for dealing with this. The first is to ignore your dog for a good five or ten minutes when you the enter the house. Don't look at him, don't speak to him and don't react if he does something to get your attention. Just turn away and ignore even bad behavior. He will be very confused at first, especially if you're in the habit of making a big fuss of him on entering the house, but after five to ten minutes he will settle down and maybe even lay down quietly. Then you can call him to you, praise him and give him a little treat.

If your dog jumps up at you, it's because he has been rewarded in some way for this behavior. Even being told off or shouted at can seem to be a reward to a dog that's desperate for attention. So when he jumps up, hold his front paws and keep him standing up on his back legs. Don't let him down and stretch him upwards a little. He will wriggle and want to get down, even mouth your hands to make you let go of his paws. Let go and reward him when he is back on the ground where he belongs.

If he jumps up again, go through the same procedure until he learns that jumping up produces a situation he doesn't find rewarding. You must be firm, kind and consistent to ensure that the message is being received loud and clear.

A Single Exercise For Power to Help in Football!


The best exercises for football have to include big core lifts that integrate multiple joints in the lift in order to integrate more than one muscle group to be effective. Forget about single joint lifts if you are wanting to develop all the desired traits of football consisting of explosiveness, power, speed, size, and total body strength. There is only room for what matters if you intend on being competitive. This is why I am glad to introduce to you the overhead kettlebell swing!

Best Exercise For Football!

Football is a violent game that requires the fool development of your body in most every way in order to play it. If you want to compete and survive in this game you have got to train your body for the demands that lie ahead. This is why overhead kettlebell swings are a single hard hitting exercise for you to implement into your football strength and conditioning program. By now you may have heard of the ancient kettlebell and realize that this is one hard hitting strength training device that is about the construction of total superior physical prowess.

The overhead kettlebell swing is a strength endurance lift that you can perform with this ancient device that is tremendous for helping you to develop hip power, core strength, back strength, and overall explosiveness for the purpose of football. You have to generate the power from your hips, glutes, and core in order to knock someone off of the line of scrimmage and this drill is great for helping you to do just that.

In order to pull off the overhead swing you will need the availability of a single bell of moderate resistance. Begin by standing with your feet at about shoulder width distance apart in length allowing the bell to hang at your groin while holding it with both hands. Make sure your grip is hooked around the handle of the bell by gripping it in the base of your palm and not out near the insides of your fingers. From here simply begin to engage your hips and knees in a state of constant flexion and extension in order to create the momentum to swing the bell back and forth like a pendulum. As the bell builds momentum make sure to keep your shoulders retracted, abs tight, and gradually build momentum until the bell is swinging from between your legs all the way up to above your head. This is football strength and conditioning at it's best.

If you haven't already started to implement the overhead kettlebell swing into your football strength training wokrouts then you are missing out. Take the time to learn more about this football explosiveness drill and others like it by accessing the rest of my articles on the subject for free. Remember that most any athlete can train hard, but only the champions train smart!

Innovation and Technology Give Ankle Implants Resurgence


Total knee and hip replacement implants have been used with success for years, but ankle implants have had a long history of failure. In the late '70s and early '80s the ankle implants wore out, popped out or collapsed into the bone. Ankle implant surgery disappeared, for the most part, for almost two decades, with surgeons recommending an ankle fusion for those patients with severe pain and disability due to ankle arthritis. In the earlier part of this decade, ankle implants have started to make a resurgence with the new emerging technology.

Why the failures? Early ankle replacement devices were fixed to the bone with cement. The fixation was lost with the excess shearing forces causing the bone support to fail. Compared with the hip and knee joints, the ankle joint has a much smaller surface with much greater weight to support and greater shearing forces.

An ankle fusion, the current standard of care for surgical treatment of chronic ankle pain due to arthritis, is limiting because of the lack of motion at the ankle after the procedure. The newer ankle implant devices have higher success rates than the older models. There are many two component implants on the market and currently being used, including the Inbone Total Ankle Replacement (Wright Medical Technology), Agility Total Ankle System (DePuy), the Eclipse Total Ankle Implant (Kinetikos Medical, Inc.) and the Salto-Talaris Total Ankle Prosthesis (Tornier).

Mobile bearing, three component ankle replacement systems have been under review and in clinical trials. Entering the market, but still under review, are the Buechel-Pappas Ultra Total Ankle Replacement (Endotec) and Hintegra Total Ankle Replacement (Integra). The S.T.A.R. (Small Bone Innovations, Inc) total ankle replacement system was approved by the FDA in May, 2009, for ankle joint replacement due to osteoarthritis, post-traumatic arthritis or rheumatoid arthritis. The advantage of the mobile bearing system is the third component, made of polyethylene, a medical grade plastic. This insert allows for translation and rotation and decreases excess shearing and breakdown of the polyethylene, common in the two-component systems. Excess shear and stress on the interface between the metal component and the bone can lead to implant failure.

Small Bone Innovations, Inc. (SBi) notes that the S.T.A.R. ® Ankle has been in development for 30 years and the most recent design has been implanted in over 15,200 patients around the world. There have been thirty-five peer-reviewed outcomes papers published on the S.T.A.R. ® Ankle replacement device.

In August of 2000, a U.S. IDE Trial of S.T.A.R.® was initiated to evaluate and safety and effectiveness of the device. The 2 year, prospective, multi-center controlled study evaluated 670 patients and compared the S.T.A.R. implant to joint fusion surgery. The results showed superior efficacy and safety with the S.T.A.R. ® Ankle compared to ankle fusion.

The Scandinavian Total Ankle Replacement (S.T.A.R.) system is a 3- component, mobile bearing device, approved for use without cement. The first component is designed to fit into the tibia, the bottom portion of the shin bone. The second component is designed to fit on the talus, also known as the ankle bone. The third component is called the UHMWPE Sliding Core, the mobile bearing made of medical grade plastic. The Sliding Core is designed to move between the two metal components, to simulate normal ankle joint motion.

Indications for ankle joint replacement systems include severe pain and loss of mobility and function due to post traumatic arthritis, ankle osteoarthritis and rheumatoid arthritis.

Wednesday, October 9, 2013

A Gymnastics Knee Brace - Support Your Knees - Special Report


A Gymnastics Knee Brace

How do your knees feel currently? - Are they stopping you from participating at the level you want to in gymnastics?

Introduction: The world of gymnastics is extremely impressive. We both know that a lot of time and effort go into perfecting your routines. Although it is a great experience for many people, sometimes knee pain or instability issues settle in. The stress to be your best can really be a chore when your knee is hurting you. If you have any knee problems then this free information can help you.

1.) Knee Pain or Instability While Performing

All it takes is for a quick twist of your knee to hurt some of the internal structures in and around your knee joint. It does not matter who you are... Knee problems do not care, they will come for you; even if you are careful. Sometimes it is an imperfect landing, or a repetitive stress that will wear down your knee. Either way, you will need to face your knee problems and the following information can be of great help.

2.) Treatment Methods

Everyone has choices. Sometimes, even when we do not think we do. What we are saying here is that you can choose to rest and ice your knee, maybe elevate it as well. These are all conservative methods of treatment that you can do before or after gymnastics to help douse the pain that a knee problem will bring on. These are good for before or after your gymnastics work out, but what about during the work out? - That is the reason why knee braces can be very helpful for almost any time you are moving around.

3.) Knee Braces For Support

The benefit of knee braces are that they are there with you when you are active. They can help to provide meaningful support for you while you train, or in almost any activity that requires your knees. The support can help stop excessive movements that can inflame a minor, moderate or even a severe knee injury. They help to promote healing and if you are not yet diagnosed with problem, they can help you to maintain proper knee alignment so you can avoid any future difficulties.

4.) Don't Look Back With Regrets

We want you to use the treatment method that works best for you. Just do not look back with regrets wishing you would have done more for your knee, before it got worse.

(*This is helpful information, but remember to speak to your physician regarding medical advice on your unique situation.)

8 Ways To Avoid A Knee Replacement With Knee Arthritis


Undergoing a knee replacement for knee arthritis can be a very effective quality-of-life decision. Patients are able to get back to recreational activities and a severely reduced painful lifestyle. However, a knee replacement is not without its risks. There are risks of surgery, there are risks post-operatively, and it is very important to look at the future. Knee replacements often last 10 to 15 years, at which point they may need a revision. The outcomes for revision are not nearly as successful as that from a primary surgery. So the patient may end up having future significant problems despite having an initially satisfactory result.

The answer to this is to try and avoid surgery if at all possible until it becomes truly necessary. It is in fact a quality-of-life decision and is not one that patients have to have done. Here are 8 non-surgical methods of avoiding the replacement with the arthritis.

1. Benign neglect - This treatment option is really not a very active one. From its name you can surmise that it really does involve ignoring the situation. What is meant by this is that if the knee arthritis pain is tolerable, and the patient is able to do most of the things that he or she wants to do, the most appropriate answer at that point may be to simply ignore the problem. One additional aspect to consider may be to modify one's activities. This may include switching from jogging to fast walking, or shifting from skiing to an activity that is less stressful on the joints such as swimming. Those kinds of considerations are what is meant.

2. Weight loss - Over 65% of Americans are either overweight or obese. The problem with this is that a lot of stress goes through the joint during ambulation. If that joint has arthritis, this excess weight can lead to increased pain and/or increased arthritis. Losing weight may allow the patient to see decreased joint pain from decreased stress, and an increased ability to perform activities of daily living, along with other substantial health benefits such as lower blood sugars and lowered blood pressure.

3. Physical therapy - Undergoing physical therapy may have significant benefits. Therapy can strengthen up the muscles around the knee joint, which may have the beneficial effect of unloading the pressure from the knee joint and dissipating it into the surrounding musculature. This can reduce pain.

4. Acetaminophen and NSAIDS - These medications are predominantly available without prescription and they can be extremely beneficial for alleviating the pain. They have a low risk profile, as long as patients stick to the manufacturers dosing on the box, and don't combine those medications that can have an additive effect and lead to a bleeding ulcer.

5. Knee injections - Injections into one's arthritic knee can help substantially with pain reduction. Presently the bulk of these injections consist of cortisone, which is a hefty anti-inflammatory substance, but not one that is going to alter the course of the disease. There are some newer types of medications consisting of regenerative substances, which contain components such as stem cells, hyaluronic acid, and cytokines. These may in fact alter the course of the arthritis.

6. Bracing - Treating patients with a neoprene sleeve is not going to alter the course of arthritis and research does not back up their usage. However, there are off-loading braces which have in fact been shown to take pressure off of the arthritic area of the knee joint and promote pain relief. These braces are typically custom fit after seeing your doctor, and should be worn whenever the patient is up and about when the pain would typically be felt. Utilizing this may also decrease the amount of pain and aching felt at night.

7. Narcotic medications - Opiate medications should not be used on a chronic basis. They should be utilized only for an acute type of situation where patients are having an exacerbation of their arthritis pain. Narcotic medication on a chronic basis for arthritis maintains substantial risks. These include the risk of tolerance, addiction, constipation, etc. So it should be avoided. Utilizing them for exacerbations can however be very effective.

8. Non-narcotic medications - Medications that are non-addictive such as Tramadol can be very effective for knee pain. In addition there are modulating medications such as gabapentin that can help a lot with decreasing the pain that is coming into the arthritic knee joint from the surrounding nerve endings.

With these 8 methods of non-surgical arthritis treatment, patients may be able to either push back the need for a knee replacement or avoid it altogether. With it being a quality-of-life decision, all non-surgical options should be attempted prior to undergoing the knife.

Learn How to Treat Jumper's Knee


There are a number of reasons why a person may be experiencing knee pain, and one of those reasons could be jumper's knee. This is a degenerative condition in the patellar tendon that causes pain in the front part of the knee. This is also known as patellar tendinopathy. This condition occurs when the tendon that attaches the kneecap or patella to the shinbone (tibia) becomes stressed. Often, jumper's knee happens to those who are involved in sports involving jumping and changes in direction, such as soccer. Over time, if the tendon is strained over and over, it will develop tiny tears and cause much pain.

There are two sides to the patellar tendon, and Jumper's knee usually affects one side or the other, so one side of the knee will look normal, while the other side is often visibly swollen. Using ice packs will do much to decrease the inflammation, which will in turn help to reduce some of the pain. It is important to remember that if you have jumper's knee, don't think of it as a minor injury that does not need to be treated. Jumper's knee can be treated, but if it is not, there can be even more damage done to the knee over time. This is seen a lot in athletes who continue to be involved in sports regularly and do not take time out to give their knees a rest.

Symptoms

There are many symptoms involved with jumper's knee. For one thing, there is pain, which is usually felt after pressing the front and bottom of the kneecap. Many people find that when they have jumper's knee, they have stiffness and aching in the joint, and often pain is also felt when the knee muscles, particularly the thigh (quadriceps) muscle, are contracted.

Treatment

If you have problems with your knee, and do not want to give up doing your favorite sporting activities, there are steps you can take to reduce the risk of further injury and to help alleviate pain and swelling. A jumper's knee brace is often recommended, and one that is highly recommended is the DonJoy Cross Strap. This is unlike most knee braces because instead of covering the knee and part of the leg, it is just a single strap that is wrapped around the leg, just beneath the knee. It places just the right amount of pressure on the tendon to help ease pain, and it is extremely easy to use, making it popular with athletes. Another option would be the ProCare Surround Patella Knee Strap, which is also a strap worn just below the knee, and it has a Floam bladder, which is a unique material that helps to provide compression to the tendon. This brace can be easily customized to fit just about anyone.

For pain management, you may be interested in trying the Aircast Knee Cryo/Cuff SC, which can be filled with ice or cold water so you have a built-in cold pack, which is ideal for easing inflammation. There is also a hand bulb, so you can measure the pressure for the best compression for you.

More Complete Arthritis Supplement


People accept arthritic disease as a 'natural part of the aging process', but sometimes the pain from osteoarthritis, rheumatoid arthritis, and over 100 other forms of arthritis so intolerable, prompting people to look for effective treatment.

Prescription drugs such as VIOXX, Bextra and Celebrex (arthritic painkillers) - and many other COX-2 inhibitors widely used for arthritic treatment - have been investigated following studies into their negative cardiovascular side effects. VIOXX alone has been linked to around 140,000 cases of coronary heart disease in the US since 1999.

More and more people look for alternative solutions for arthritis pain and more and more people are buying the combination of Glucosamine, Chondroitin Sulfate and MSN, as studies have shown that Glucosamine and Chondroitin help in the repair and maintenance of cartilage.

Both inflammation and oxidative stress function are primary degenerative mechanisms in the development and progression of osteoarthritis. While researchers believe that glucosamine inhibits inflammation and stimulates cartilage cell growth and chondroitin provides cartilage with strength and resilience, specific amino acids is also need for overall impact.

Amino acids are the building blocks that make up protein. Vitamins and minerals will not perform their specific functions effectively if the necessary amino acids are not present.

Three amino acids are critical to antioxidant, anti-inflammatory functions: cysteine, glutathione, and taurine.

Cysteine influences the synthesis of the antioxidant glutathione (GSH), which plays an important role in the inflammatory response by influencing the production of phagocytes.

Taurine acts as a specific scavenger for the hypochlorite ion, a free radical. Adequate levels of taurine naturally limit the degree of inflammation. When taurine is low, the inflammatory response is enhanced, commonly resulting in oxidative stress reactions.

Other amino acid imbalances may also impact the etiology of osteoarthritis - particularly methionine metabolism. Normally, B12 and folate are necessary for the body to metabolize homocysteine to methionine, the essential amino acid the body needs to produce S-adenosylmethionine. Numerous clinical trials have shown that S-adenosylmethionine can greatly reduce degenerative damage and symptoms of osteoarthritis in some patients, including related depression.

Imbalances of amino acids may also signal key deficiencies of vitamins and minerals integral to the musculoskeletal system. Experimental studies show that impaired cartilage structure can be induced by a vitamin B6 deficiency. Vitamin B6 triggers the transformation of the amino acid homocysteine to cystathionine and then to cysteine and its urinary metabolites.

Not all amino acids are same. Amino acids can be derived from a variety of sources, including plants, meats, fish and cartilage.

For arthritis treatment, the most compatible amino acid source is animal cartilage, including porcine, borvine cartilages and young chicken keel. Joint TLC is one of such products (www.holistictlc.com) that combines chondroitin, glucosamine and essential amino acids that promotes joint health, but this combination is still rare as most still use MSN in the place of cartilage derived amino acids, as MSN, for the marketer, is less expensive.

References:

1 Bradley JD, Flusser D, Katz BP, Schumacher HR Jr, Brandt KD, Chambers MA, Zonay LJ. A randomized, double-blind, placebo controlled trial of intravenous loading with S-adenosyltmethionine (SAM) followed by oral SAM therapy in patients with knee osteoarthritis. J Rheumatol 1994;21(5):905-11.

2 Barcelo HA, Wiemeyer JC, Sagasta CL, Macias M, Barreira JC. Experimental osteoarthritis and its course when treated with S-adenosyl-L-methionine. [Spanish} Rev Clin Esp 1990;187(20:74-78.

3 Konig B. A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. Am J Med 1987;83(5A):89-94.

4 Baldessarini RJ. Neuropharmacology of S-adenosyl-L-methionine. Am J Med 1987;83(5A):95-103.

5 di Padova C. S-adenosylmethionine in the treatment of osteoarthritis. Review of the clinical studies. Am J Med 1987;83(5A):60-5.

6 Flynn MA, Irvin W, Krause G. The effect of folate and cobalamin on osteoarthritic hands. J Am Coll Nutr 1994;13(4):351-6.

7 McCarty MF. The neglect of glucosamine as a treatment for osteoarthritis--a personal perspective. Med Hypotheses 1994;42(5):323-7.

8 Masse PG, Ziv I, Cole DE, Mahuren JD, Donovan SM, Yamauchi M, Howell DS. A cartilage matrix deficiency experimentally induced by vitamin B6 deficiency. Proc Soc Exp Biol Med 1998;217(1):97-103.

Arthritis Treatment: Four Drugs That Can Cause Excruciating Aches and Pains


One area that is overlooked when it comes to arthritis are drug-induced aches and pains. Here are four categories of medicines you might want to avoid.

Statins:

Statin drugs cause a number of muscle problems. First, they can cause simple muscle aches and pains. This condition usually gets better once the drug is discontinued. The second problem statins cause is mild muscle inflammation along with weakness. The blood muscle enzyme, CPK, is mildly elevated. While this problem also gets better once the drug is stopped, it may take several months to resolve. Finally, statins can cause extreme muscle inflammation, damage leading to profound weakness. The CPK, is markedly elevated. When the muscles get this damaged, they release a protein called myoglobin into the blood. Myoglobin in large quantities can lead to kidney failure.

The risk of muscle injury is increased when a statin is used with other drugs that also affect muscles. When statins are combined with drugs like niacin or fenofibrate, the incidence of muscle damage is greatly increased.

Fluoroquinolone antibiotics:

Fluoroquinolone-induced tendon problems such as rupture, are described in the medical literature. The Achilles tendon is the commonly involved site, although other tendons can be affected. Usually, spontaneous tendon rupture happens during or shortly after a course of treatment, but symptoms can occur even months after taking these antibiotics. Whether fluoroquinolone antibiotics should be used in patients with a history of tendon problems or who have risk factors for the development of tendon ruptures basically depends on how serious the infection is and whether there are suitable alternatives.

People at the highest risk are those over the age of 60 years, people taking steroid drugs, and people who have had an organ transplant. Patients who exercise and already have tendon problems are also at risk.

Aromatase inhibitors:

A small number of women receiving estrogen-depleting treatment termed "aromatase inhibitors" will develop aches and pains. Symptoms are most prominent in the hands and can be so severe that patients ask to be taken off therapy. More than 25% of women can be affected by this syndrome which affects hands, knees, elbows, ankles, and a few other other areas.

Symptoms are usually transient and resolve when the aromatase inhibitor is discontinued.

There have been incidences reported in the literature of patients developing rheumatoid arthritis after treatment with these drugs. Therefore, assumptions regarding the cause of aches and pains with these drugs should not be made.

Symptomatic treatment with non-steroidal anti-inflammatory drugs may be helpful.

Bisphosphonates:

These drugs are used for osteoporosis treatment. Unfortunately they cause two types of pain syndromes. The first is the acute phase response which consists of fevers, chills, bone pain, muscle and joint pains that starts after initial administration of bisphosphonates. These symptoms tend to resolve within several days after discontinuation of the drug.

The second syndrome is experienced either within days of taking the bisphosphonate or it can occur after months, and even years of being on the drug. The pain is excruciating and incapacitating in many cases.
Some patients get better after stopping taking the bisphosphonate but there are others who do not.