Erosive Osteoarthritis

Erosive arthritis affects multiple small joints of the hand. Patients who have never had a trauma or injury and do not have any history of metabolic or inflammatory condition are the ones who are diagnosed with erosive osteoarthritis which is classified as primary osteoarthritis. X-ray of the affected joint is the most effective test for the diagnosis of this condition.

Erosive osteoarthritis is the most prevalent form of osteoarthritis. Though the disease is not uncommon in men and women, but particularly people in their sixties are the most susceptible to this condition. It is believed that it often occurs mostly due to genetic traits. It usually occurs in women after their menopause but no clear relation with the level of hormones in the patient and the onset of the disease has been established as yet.

In the early stages of the disease, the treatment usually aims at reducing the enormous amount of pain caused by the various conditions brought forth by the disease. Attempts are also made towards reducing the load felt by the joints. Using walking sticks and weight loss programs are common methods for doing the same. Mobilization of the joints, through prescribed exercises is also a part of the treatment at this stage.

In the intermediate stage of the disease is osteotomy, which is a surgical operation where a bone is cut to lengthen, shorten or change its alignment. This operation is usually performed for younger patients.

In the later stages of the disease, the incessant pain requires drastic methods of treatment. In such a case, Arthroplasty is performed on patients over the age of 60. It is a surgical process in which a malformed or degenerated bone is either replaced or reconstructed. However, this operation is not suitable for treatment of younger patients as the demands placed on the affected bones physically are much greater and many a times, the surgery is only a temporary remedy.

Another Nightmare

The still quietness soothed my mind and body as I washed the last of the lunch dishes. Both boys napped, for once without a fuss. My husband had gone back to work immediately after eating. My daughter mingled with other first graders in the school a block away. I could finish the dishes and read a few pages in that new book, finally. The shrill call of the phone interrupted my thoughts of escaping into the fantasy world of romance and excitement. Wiping my hands on a towel, I reached for the receiver. The conversation shattered all thoughts of reading.

"Vivian, would you please pick up my kids when you get Rene?" Marge, a friend whose husband had died on the job, asked.

"Sure, any special reason?" I blithely asked.

"I don't want them to find my body." Her voice seemed so lifeless.

"Your body?" What language was she speaking?

"I can't take any more. I have the pills ready. I just don't want the kids to walk in and find me."

I grasped the telephone receiver so tightly my fingers turned white. My mind at first refused to believe what I heard. Marge had retreated from life since the death of her husband two months earlier, trying to escape her grief. But I refused to accept the solution my friend chose.

"Wait, Marge, I don't understand. You can't... I mean you... your kids... Why?" I stuttered in shock. I knew first-hand how devastating the death of someone loved could be. Why hadn't I seen her considering such a solution?

The nearly monotone voice, not like Marge's at all, answered, "There's nothing left. I can't stand this... this endless pain. Everyone says I'll adapt, that I'll manage, that Rob would want me to go on with my life." A sigh breathed across the line. "But I can't. I just can't. They don't know. You don't know."

"But.. but your children. How can you do this to them? They've lost their father... aren't even used to his being gone. How do you think... oh, my, how will they survive losing their mother, too? Especially..."

"Don't you think I've thought of that over and over and over?" the mechanical voice continued. "I'm not any good to them like I am. They'll be better off without me. Now, will you please pick them up after school?"

"On one condition."

"What? That I talk with a therapist or some holier-than-me preacher?" Marge sneered, changing the thou to me, but with emotion in her voice for the first time.

"No," I sighed, "but if you want me to face your three children, I must be able to say I tried every way I could to change your mind. Facing me is the least you can do."

"I can't. I won't." Again no emotion sounded in her voice.

"Marge, you owe me this much. You're asking more than... I don't know if I can..." I could feel tears trying to choke me. "You can at least talk to me, let me talk to you for, what, ten minutes. What harm can that do? Are you afraid I'll talk you out of killing yourself?" Panic and fear caused me to lose all concern about hurting her feelings. I could live with her anger and hurt, as long as she lived.

"Then come on over." The disgust and anger in her voice sounded better than the nothingness of before.

"I... I can't leave. The boys are asleep, and I don't want them..."

"All right, all right!" she interrupted. "I'll be there in a few minutes, but you won't change my mind."

As I slowly replaced the phone, I silently prayed for a way to help my troubled friend. "Suicide, oh, dear Lord, what can I do?" I whispered as I stumbled into the living room and slumped onto the sofa. "She doesn't think I know, but I do. Oh, I do."

Rubbing a hand over the cover of the family Bible resting on the corner table, my thoughts wandered back to the insanity of a year ago. Insanity was the right word because I nearly lost my mind after the baby died: the dreams every time I slept, dreams of holding the infant, caring for her; the reoccurring shock of loss every time I awoke to find my arms still empty, so achingly empty. No one seemed to understand my torment. I was locked in a never-ending nightmare, one that started a few days before Christmas as I lay in the delivery room at the hospital. I heard the baby, my Regina, cry; I saw her when the doctor laid her on my stomach for a moment; I heard him say, "We have a little one here."

A little one? What did he mean? A nurse whisked my baby out of the room, but she returned quickly, too quickly. "Only three pounds, fifteen ounces," she announced in a near whisper.

"No, no," I moaned. "Some thing's wrong with my baby."

I tried to muffle my cries, stop the tears, but everything couldn't be all right with my baby, not with her being so small. Sobs still shook my body, tears streamed down my face into the long hair pillowed around my head, when the gurney arrived back in my room. The doctor ordered a hypo before sending one of the nurses to bring my baby to me, telling her to wrap Regina in warm blankets.

To this day, I will always be thankful for that brief visit with my baby girl. I counted her tiny fingers, touched her downy cheek, examined her long lashes, listened to her whimper, watched her chew her fist. I didn't have a camera, but the picture was burned into my heart and my mind.

A few hours later, a nurse stood in my room complaining about having to work overtime because of my baby, while, in the nursery, Regina struggled and lost her fight to live.

A knock on the door brought me back to the present and to the current nightmare. After inviting Marge to sit on the sofa, I dropped into the matching armchair and leaned toward her. Our knees nearly touched, but I couldn't speak. I bit my bottom lip as tears slid down my cheeks. Finally, after wiping my face and nose on a tissue, I cleared my throat.

"Marge, I wish I could reach you, the sane, inner you. You think you're alone, but you really aren't." I shook my head slightly. How could I reach this cold, seemingly unfeeling woman? "One person can't know exactly how another feels, but we can understand to some extent. Please, Marge, let someone help you." I reached across the corner of the table, laying my hand on Marge's arm, as if touching her physically would trigger an inner response.

"What do you know about helping anyone? You have your perfect life, a husband who comes home after work." Her eyes bored into mine, anger and hate in their depths.

"Have you forgotten Regina? I suffered. Maybe I do still have Robert, but you have your children." I wiped my tears away again. "Think of them."

"Maybe you're stronger. I don't know. Maybe you didn't really feel the pain as much. If you had you couldn't sit there and tell me I . . ." Bitterness filled her words.

We argued; I pleaded; she scoffed or ignored what I said; I felt as if the battle had lasted a lifetime. In a way it had: what was left of Marge's lifetime. Exhaustion weighted my mind, any hope I had. I was losing the battle.

Pursing her lips tightly, Marge rolled her eyes as if to laugh at my efforts. "I've tried. I've listened. Nobody knows the agony, the horrible aching in my chest." When I started to speak, Marge held up a hand to silence me. "No, don't say another word. I..." The clamor of the telephone caused her to pause and glance toward the door to the kitchen where the phone hung.

"Never mind that," I told her. "Whoever is calling will call back."

"Go ahead, answer it. I need to leave, anyway. Please, remember your promise. I'll call my mother after I get back to the house and ask her to pick up the kids here, later."

"I'm not finished. You can't leave yet, please, please, don't leave yet," I begged, leaning forward in the chair as if my intensity could influence the other woman. "Wait at least until I tell the person on the phone that I'll call back. Don't leave yet, please."

"Okay, answer the phone. I guess a few minutes more won't matter."

I hurried to the kitchen to stop the jarring ring. Soon, frustration swamped me as my mother continued chattering for several minutes after I explained I couldn't talk.

"Mother, I'm sorry, but I must hang up. I really can't visit. I'm in the middle of an emergency. I can't give any details, but, please, pray that God will give me wisdom."

"Oh, I'm sorry. I didn't realize... I'll talk to you later, and I'll be praying."

When I reentered the living room, Marge looked up from a handful of multi-colored sheets of paper. The opened Bible on the table revealed more sheets of blue, pink, and green. Tears streaked the gaunt woman's face.

Pointing to the words on the top page in her hand, Marge sobbed, "You do understand. You...you really do understand. You have it.. all written right... here." Motioning toward the other sheets still on the open Bible, she continued, "Page after page. How did you... you survive the desolation?"

After a sniff, she read aloud from the sheet in her hand, "I can't stand this. I'm going crazy. I dreamed about Regina again. I held her. She snuggled in my arms. Finally they felt so right, so full. No one told me how empty arms could hurt, really hurt, matching the horrible pain in my chest." She looked into my face. "You know."

Blowing my breath in a silent whistle, I sank to the sofa beside my friend. "I had forgotten those were in the Bible."

"I, uh, I didn't mean to be nosy, but I saw colored papers sticking out, and... well, I found these."

Handing Marge several tissues, I started my story. "Those pages saved my sanity after Regina died. I was afraid to sleep. I told you how I dreamed of her being alive, caring for her, holding her. Then when I awoke, I couldn't stand the reality that she was gone." I took a tissue for myself before continuing.

"I had a new pad of that colored stationery. One night after a particularly realistic dream and devastating awakening, I started writing the dreams, the feelings of disorientation, the thought of going crazy, everything. As I finished a sheet, I placed it in the Bible. After that, every time I awoke from one of those dreams, I wrote." I sighed as I briefly paused. Taking a deep breath, I added, "Before too many weeks, the dreams came farther and farther apart, and I wrote less and less." I nodded toward the papers. "You've read some of the results of my struggle to stay sane."

Marge bowed her head and wiped her eyes again. "Now I know I'm not really alone. You put into words what I've been feeling."

"At least my experience helps you." I smiled wanly. "My mother always said God could use even the worst of things for His good if we allowed Him to. Well, I guess He gave me the idea to write so that I could cope; now, He's used those colored pages of despair to help you."

"Whew." After a time of healing tears, Marge shivered. "I, uh, I can't believe...I almost..." Stopping, she covered her face with trembling hands. "Yes, what you wrote helped, more than I can explain. Maybe later I'll even listen when you tell me about your God." Lowering her hands, she smiled a small, sad, but real smile. "Thank you." She stood and touched me on the shoulder. "I need to go home and wait for my children."

I watched her walk from my door to her car, her head lifted higher than when she had arrived. I returned to the living room, replacing the pastel pages in the Bible, gently touching some of the new tear stains.

The pages still reside in the Bible, thirty-nine years after they were written, with two photos of a tiny baby dressed in a pink gown, lying in a white casket. When I wrote through my heartbreak, searching for sanity all those years ago, I never thought the words would ever mean anything to anyone but me. I also didn't know the pain could, and would, last so long.

Knee Arthritis - What is It?

Arthritis is a common problem. The important thing to note is that there are many different types of arthritis. Some such as Rheumatoid Arthritis (also known as RA) are systematic, which means they affect organs as well the joints within the body. However, by far the most common type of arthritis is "osteoarthritis," also known as OA.

The term "osteo" means bone. So basically osteoarthritis is a condition that affects the cartilage on the ends of the bones that make up a joint within the body. In arthritis, the cartilage becomes "thin" rather than being nice and thick. Therefore, if excessive load or pressure is placed on the joint with "thin" cartilage, the possibility of pain and dysfunction is high.

So what actually causes pain in the condition of arthritis? Well, an interesting thing to note is that the "cartilage" actually lacks a nerve supply; however, structures such as the periosteum, ligaments, capsule, synovium and burse which surround the joint do. Researchers postulate that it is actually these structures that cause arthritic pain. However, the primary reason for this is the excessive load placed on the "thin" cartilage. Unfortunately, despite loads of research, the actual cause or etiology of knee osteoarthritis is still unknown.

People who experience pain and dysfunction of osteoarthritis should understand the basics of the disease, take pain medication if necessary, loss weight if overweight, and ensure they perform basic exercises to maintain both the strength and flexibility within the joint. It is also important to decrease load or pressure placed on the joint. Activities such as jogging & jumping place excessive load on both the knee and hip while walking places "less pressure or load" on these joints.

X rays or a film taken in weight bearing helps to define the extent of the OA. It is important to discuss any X ray findings with your GP or local medical practitioner. It is always important to rule out more serious pathology. One must also be aware that the X ray findings often do not match a patients symptoms. Ie You may look at a film and see "lots of knee osteoarthritis" but the person may not be experiencing any pain or dysfunction.

The prognosis for arthritis is a sequential progression of the disease over time. It is essential that people have knowledge and understanding of their condition in order to put strategies in place to deal with it. Many people are able to continue to live a normal life albeit with some lifestyle modifications. However, if the knee osteoarthritis disease progresses and quality of life is significantly affected, a joint replacement then becomes a viable option.

Knee Pain Relief - Can You Play Basketball With a Knee Brace? The Answer is Yes

Are you wondering if you can use a knee brace when you play basketball? The answer is: "Yes you can". Here are a couple of reasons.

1.) Knee braces were created in order for you to get added support and to help reduce your knee pain. Sometimes people can not play basketball without a knee support on at all actually. This is something to consider for yourself. - If you are currently having knee pain, or instability this issue may worsen if you continue to insult your knee joint. Even minor insults to your knee can add up, and this is easy to do when you play basketball. All the running, jumping, stopping and starting is a natural part of the game, but these movements can injure you over the long run as well.

2.) Every knee brace is not the same. This doesn't mean one is good and another is bad, but what we are trying to tell you is that there are some basic differences that you should be aware of. For example, if you have minor knee pain or a mild knee issue then you can use something that is referred to as an elastic knee brace, or knee sleeve. You may know of the best basketball player of all time using one when he played. (Initials: MJ) These knee sleeves can help you by acting as a reminder. Sometimes that is all you need when it comes to support.

Moreover, you can also use more deluxe knee braces if your pain has graduated from mild to moderate or severe. These knee braces will usually have what is called medial and lateral uprights. In addition, these uprights will be connected to a knee joint. Knee ROM (range of motion) is still allowed, but the individual will now have more support, to the point where excessive movements are limited. This can be a very good thing, and should not be considered bad by any means.

Basketball is an awesome game. Seriously. You already know this... Knee braces can be a man's new best friend when it comes to playing basketball. The stability that they help provide can greatly reduce your knee pain and help keep you out there on the court.

Simplify Your Golf Swing Today

So many golfers needlessly complicate their golf swings with all kinds of extra moves, excess swing thoughts they pick up and stuff they've heard their buddies say. Most of the time, this just adds up to more shots from the rough and having to buy more golf balls if you actually stick with the game when things are going wrong. There's a better way to play: Simplify your swing. The two tips below will help you do just that in a very short time. Check them out.

Tip #1: Use general swing thoughts that can be repeated every time you're over the ball during a round to simplify your golf swing. Thoughts like "release the wrists" or "hit down on the ball" are kryptonite to golfer's swing because they're segmental thoughts that don't focus on your overall swing. Instead, try using swing thoughts like "slow back, accelerate through", "back, and go to finish" or "1, 2 & 3". These are thoughts you can apply right away and they'll actually have a positive effect. You can say general thoughts like these to yourself during practice swings and take them right on to the tee for the real shots right after your practice swings. Using these types of techniques will create more consistency in your game almost instantly which is sure to shave off strokes and get you playing better in a matter of days.

Tip#2: Forget the upper body to simplify your golf swing. All your power, grounding and stability comes from your lower body. The pros take full advantage of their lower bodies instead of letting their upper body try to take over their swing. You can do the same by taking a bit of tension out of your upper body joints so that they don't try to chase ahead of your lower body. This doesn't mean getting all loose and wobbly with your lower body, it just means you should become aware of the true timing of the movement which is coming from your vastly more powerful lower limbs first followed by your upper body limbs second. Get in touch with your hips at the start of your downswing and follow your body through to the finish of your swing where the insides of your knees should softly kiss, not knock out teeth.

These two tips will simplify your golf swing almost instantly. They're the kinds of golf tips that can actually be used by any golfer right away. Though they sound simple, they're very effective when you run into a tough shot or find your swing slipping away a bit.

For more great golf tips and more like these ones that will help make your golf swing simple and practical so you can start shooting better every time you play, check out my site Better Golf Secrets. All the best and keep on swinging.

Cheers,
Ty Cooper

How to Have a Successful Total Knee Replacement Recovery

One of the most common joint replacement surgeries is the total knee replacement (TKR) or total knee arthroplasty (TKA). Despite the numerous surgeries performed each year many individuals are ill prepared regarding the total knee replacement recovery process. Below we will discuss some of the issues involved in recovering and rehabilitating from this orthopedic surgery.

1. Preoperative Physical Conditioning

Knee replacement recovery actually begins well before the surgery takes place. Here's why. Successful knee replacement recovery will depend on many different factors but some include the age of the patient, the number of commodities and the general condition of the individual prior to surgery. Patients who are in better physical shape and overall condition tend to have an easier time with the rehab program.

Many orthopedic doctors will recommend a patient lose weight and/or strengthen the muscles of the involved leg to better prepare the knee joint for surgery and postoperative rehab.

2. Pain

I won't sugar coat this one. Other than shoulder replacement, the total knee replacements are among the most painful orthopedic surgeries that are done. I have rehabilitated many joints in my career and this one gets frequent complaints regarding the level and duration of pain through the rehab phase. The good news is that your doctor will prescribe pain medications if indicated and there are special therapy treatments to help reduce pain as well. Once you can get through the initial week or two of total knee replacement recovery it gets significantly better.

3. Early Postoperative Rehabilitation

It is crucial to start the total knee replacement recovery as soon as the physician indicates. Early rehabilitation will reduce joint stiffness, swelling, improve overall circulation in the extremity, speed up weight bearing activities and reduce pain. Most patients will have a continuous passive motion (CPM) device placed on the surgical knee within hours of the operation. This mechanical device will provide automatic passive range of motion to the knee while the patient is lying in bed.

4. Progressive and Continuous Rehab

Some of the goals for total knee replacement recovery is to walk down the hallway with a crutch or walker, climb a short set of stairs, fully straighten their knees, bend the knee to approximately 90° or greater, and perform home exercises independently. If the patient is unable to reach these goals within three to six days, further aggressive rehab is needed and they may be sent to a rehabilitation center for a week or two or longer depending on their medical and social needs.

Ultimately the goal of replacement recovery is to return the patient to their prior level of function and living environment. Most total knee replacement surgeries have a high success rate when combined with early, progressive rehab intervention.

High Tibial Osteotomy Procedure

An 'osteotomy' is an operation where a bone is cut and re-positioned. The 'tibia' is the shin bone. In a high tibial osteotomy the bone of the upper tibia is cut and repositioned. Knee osteotomy is commonly used to realign your knee structure if you have arthritic damage on only one side of your knee. The goal is to shift your body weight off the damaged area to the other side of your knee, where the cartilage is still healthy.

Osteotomy is a procedure in which the surgeon removes or adds a wedge of bone below or above your damaged knee joint. The decision whether to create a wedge above or below the knee joint depends on which area of the knee is most damaged with arthritis, causing either a bowlegged or knock-kneed deformity.

The procedure is done under general anesthesia. Exact size of the bone wedge will be map out by surgeons either using an X-ray, CT scan, or 3D computer modeling. A four- to five-inch incision is made down the front and outside of your knee, starting below the kneecap and extending below the top of your shinbone. Guide wires are drilled into the top of your shinbone (tibia plateau) from the outside (lateral side) of your knee. The wires usually outline a triangle form in your shinbone.

A standard oscillating saw is run along the guide wires, removing most of the bone wedge from underneath the outside of your knee, below the healthy cartilage. The cartilage surface on the top of the outside (lateral side) of your shinbone is left intact.

The top of your shinbone is then lowered on the outside and attached with surgical staples or screws, depending on the size of the wedge that was removed. Most patients remain in the hospital for two to four days following an osteotomy.

Most patients will have significant improvement.