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Ankylosing Spondylitis

Introduction: Ankylosing Spondylitis (AS) is one of many forms of chronic inflammatory arthritis, affecting the spine, especially the joints between the vertebrae of the spine and the joints between the spine and the pelvis (sacro-iliac joints). It may also affect other joints of the body. The joints are initially inflamed and this may be followed by progressive stiffness and inflexibility. It eventually leads to the fusion of the spine, giving permanent painful stiffness of the back. It is often called bamboo spine, as the spine tends get stiff like a bamboo. This condition is more common in males as compared to females and usually occurs in individuals between 16-40 years of age.

Causes: The exact cause of Ankylosing spondylitis is not understood. It has been considered to be an autoimmune disease (like many others such as Diabetes, Rheumatoid Arthritis, Thyroiditis, etc.). Genetic factors are likely to be involved. The majority of people with Ankylosing spondylitis have a gene called HLA-B27. However, the presences of HLA-B27 (Human Leukocyte Antigen B27) is not absolutely diagnostic of Ankylosing Spondylitis. There are theories on its link with some bacterial infection as a triggering factor.

Diagnosis: Presence of HLA-B27 antigen, increased levels of CRP (C- Reactive Proteins) and ESR (Erythrocyte Sedimentation Rate) along with suggestive clinical history help in diagnosis of Ankylosing spondylitis.X ray and mri may help to diagnose the disease.

Symptoms: These include: painful stiffness of the lower back and hips which is often worse in the morning or after periods of inactivity. Over a period of time, the pain and stiffness may progress up the spine and to other joints such as hips, shoulders, knees and feet. Reduced mobility may be noted by the patient and gradually he may notice difficulty in bending the spine. In advanced stages of the condition patient may notice chronic stooping, stiff and inflexible spine, restricted expansion of the chest. Features such as loss of appetite, fatigue, weight-loss, inflammation of the eyes (iritis) and of the bowels may also be seen.

Homeopathic treatment: Homeopathic treatment helps two ways: a. Control underlying disease process b. Significant Relief in pain and stiffness Ankylosing Spondylitis (AS) being a constitutional disorder calls for a constitutional approach to its treatment. Homeopathic approach incorporates detailed study of the cases of AS inclusive of the genetic trend of the patients. The remedy prescribed after such detailed evaluation offers effective pain control as well as helps in controlling the progress of this condition. Early cases of AS can be treated with good success with homoeopathy. Cases that have advanced to a moderate extent can also be helped, especially in preventing the further progress of the disease and limiting the pain. However, severe cases can only be relieved symptomatically with homoeopathic treatment. Homeopathy is strongly suggested for Ankylosing Spondylitis, especially in the early and mid stages. Patients opting for homeopathic treatment do better than those who do not.

Related conditions: Rheumatoid Arthritis, Backache, Multiple Myeloma


Backache

Pain in the back anywhere below the ribs and up to the hips is called low back pain. It is a condition that affects over 90% of the population at one time or the other. Next to common cold, it remains the most common reason why people seek medical help. Many people who experience low back pain do not meet up with a doctor since it usually resolves on its own. They may suffer from any dull aches to sharp pains or even numbness. The pain characteristically lingers on for a day or two before it gradually subsides. In many, the pains keep recurring in varying intensities. Studies have shown that back pain is the single most reason cited by employees for taking maximum number of 'sick leaves'. Stresses and strains of daily living and overuse and misuse of the muscles of the back are the commonest causes of backache.

Why is back pain so common? The curvature of the normal spine is such that, the bony column is weakest at two points. The cervical spine (the nape of the neck) and the dorsal spine are the weakest points. The lower back bears at least one half of the body weight. Hence, these points bear the brunt of repeated stresses and strains. Every joint has an optimum position of function, departures from which increase the likelihood of strains and pains. Over time muscle strains lead to an overall imbalance in the muscle structure. There is constant strain on the muscles, bones, tendons, discs etc. The most common cause of back pain is poor posture. The real pain might be triggered by sudden lifting of weights, a sudden turn or a wrench, a fall on the back, sitting in a cramped position for a long time, horse-riding, riding a tractor etc. Occasionally, it won't be one event alone which triggers your backache. You may have been doing things improperly for a long time » standing, sitting or walking, until suddenly one simple movement might trigger your pains. These so-called last straws to the already overburdened back are some of the following: Trauma: acute or chronic unusual lifting over weight, sudden wrenches, fall,accident etc. Psychic factors like depression ' can cause lowered (poor) muscle tone and cause backache Any acute illnesses » can cause poor muscle tone Fatigue Pregnancy Obesity » causes increased lordosis General poor health Localized, focal infections Faulty structure of feet. What makes backache worse is that once the pain starts, in order to avoid stressing the painful parts, we tend to perform actions ( walk, stand, lift etc.) with the use of other muscles which are not used to moving in that pattern. This further increases the stress on the muscles

Causes of backache: Apart from the above mentioned triggers, backache can be caused by a number of other conditions. Osteoarthritis (OA): with increasing age, the joints of the backbones undergo degeneration. OA of the joints that link one vertebra to its neighboring ones (called the facet joints) causes back pains. Herniated Discs (disc prolapse): any heavy strain or increased pressure in the back can displace the round, resilient discs which act as shock absorbers for the back bones. They cushion every impact on the back such as when jogging, weight lifting, horse-riding etc. injuries, normal wear and tear, and diseases that affect the backbones can cause minor tears on the disc surfaces as well as make them bulge out from their places. Displaced discs can press on surrounding nerves and cause pain, tingling & numbness in the legs. Injuries and fractures of the vertebrae (backbone): conditions that cause nerve, bone and tissue injury can cause back pain ' vehicular accidents, fall from a bike, fall on the back compressing the structures in the back. Compression of the spinal cord itself (Spinal stenosis): the spinal cord travels through a narrow, hollow shaped bony canal called the 'spinal canal'. With aging, the lumen of this canal tends to become narrow, compressing the contents within it. Back pain is a common symptom of spinal stenosis. Deformities: often the backbone curvature is damaged secondary to other diseases. The alignment which is usually straight tends to deviate either to the sides (scoliosis) or appear bent forwards (kyphosis). Long-term mal-alignment of the vertebral column can cause tremendous stress and strain on the supportive muscles that surround it. This usually gives rise to backache. Occupational: many occupations can take a toll on your back. If your work requires long hours of standing, lifting of heavy weights or sitting in an uncomfortable position, your back will possibly suffer. Athletes are very prone to low back aches. Back pain might also originate from the nerves, spine and muscles of the back. Conditions affecting structures present in the abdomen and pelvis - (kidneys, ovaries, intestines, prostate etc.) can cause a backache. In general backache is never really serious. It is self-resolving and lasts only for some days. 70% of persons approaching a GP are better in 3 weeks while 90 % are better in 6 weeks time, irrespective of the treatment received. The less common causes of back pains include: Infections: tuberculosis and osteomyelitis are conditions that cause back pains. But, fever, body ache and other symptoms generally accompany back pains in these conditions. Bacteria and viruses can enter the spine either through direct trauma, through surgical procedures, injection treatments or spread through the blood stream. Ankylosing spondylitis: a condition which causes inflammation of the joints in the spine. Pagets disease: a disorder which affects the bones of spine, chest, skull, pelvis and legs due to abnormal bone growth. Pelvic inflammatory disease: any inflammation of the uterus, ovaries or the fallopian tubes can present with low back pains. Generally the pains are accompanied by uneasiness and fever. Pancreatitis: the pancreas when inflamed can cause sudden, severe pains in the abdomen accompanied by nausea, vomiting and fever. Occasionally, the pains radiate to the lower back also. Aortic aneurysm: the aorta is the largest artery carrying blood away from the heart. In some conditions, the walls of the aorta can become very thinned out due to overstretching. This can cause pain in the back especially if the thinned out wall ruptures. Kidney stones or urinary tract infections: Stones in the kidneys or anywhere within the urinary tract cause obstruction to normal flow of urine as well as braise the walls of the ureters (two structures which carry urine produced within the kidneys to the bladder where they are stored before being excreted), and can also cause back pains. Tumors: any abnormal growth of tissues especially in the back region. When to see my doctor? Your back pains definitely deserve medical attention in the following situations: Your pains are accompanied by persistent fever. You suddenly lose control over your bowel and bladder movements. There are additional symptoms of numbness in the feet, nausea vomiting etc. You have had a violent accident involving the back. There is redness of the skin overlying the backbones. Pain is elicited even with slight application of pressure. You have developed weakness in the legs along with or after onset of the back pains. The pains radiate below the hips to the legs. Even the slightest movement in intolerable. You have been on steroid treatment for other conditions. You have a positive medical history of a tumor in the past. You are HIV positive or have an addiction to drugs. You have lost weight in the recent past. You are above 50 years of age. You are less than 20 years and feel this is the worst back ache of your life. You have had back aches in the past, but this episode is clearly different. Your low grade pains persist for more than two weeks. In spite of resting your back, the pains do not improve significantly in one or two day's time.

How do I prevent backaches? Some simple measures can help keep back pain at bay! Learn to bend and lift objects properly. Avoid standing for long periods at a stretch. If you must stand for a long time, make sure your ears, shoulders, hips and knees are in the same straight line. If you have long hours of sitting, like a long car drive, try taking stops every one hour and walk around a bit. When sitting for long, make sure your chair has a high back and supports your back (especially the region between the ribs and hip-bones) curvature properly. You may need the help of a pillow for the same. Your chair should not be too high or too low either. Again, when sitting on a chair, make sure that both your feet touch ground completely. Your knees should extend beyond the seating provided and they should also be higher than your hips. Don't slouch when sitting. While sleeping, make sure your bed provides adequate support to your back. Very soft beds can strain your back muscles. If you are prone to back pains, then sleep on your back with your legs straight. Bending the legs at the hips increases stress on your back muscles. Exercise daily. A good exercise will improve your posture. A complete workout session should include walking/swimming aerobic activity + riding a stationary bike. Never skip your warm-up exercises, even if you do regular workouts. Manage your weight. Try maintaining your body weight within the range optimal for your age, sex, and daily routines. Have foods rich in calcium, Vitamin D, phosphorus and proteins. They both help in building and repairing bones and muscles. Wear low-heeled shoes. Avoid wearing stilettos for long periods. Quit smoking. Smoking contributes to osteoporosis. It hardens the arteries supplying blood to our bones and reduces the blood supply to other vital structures that form your backbone. Relax. Avoid stress from getting at you. Stress causes the supportive muscles of the back to go into an abnormally contracted state. Try yoga, tai chi and massages which are known to help.

Diagnosis: Backache is a symptom, causes for which are numerous. A sound clinical evaluation often suffices to trace the cause. Most physical exams will involve an examination of the following: Palpation: Your doctor will check for any sign of pain produced with application of pressure. He will also need to verify whether you have any outward signs of trauma » broken bones, brazed skin etc. your doctor will also assess your reflexes, joint stability and flexibility of the muscles around the joints. Gait: Check the way you walk. Is pain or stiffness preventing a normal gait? Stance: any abnormal posture adopted when standing Range of motion: To check if the range of motion is painless or painful, restricted and stiff. Straight leg test: this test is done to confirm the affection of the sciatic nerve as it passes through your leg. Doctors may even advice a few tests and laboratory investigations. A complete blood count along with erythrocyte sedimentation rates » this would help in tracing causes like infections. Other tests depending on presentation of symptoms may be required e.g. the test for tumor markers where malignancies are suspected. Radiographic evaluation: where the back pains are not relieved by rest or medications and where there is a history of acute trauma to the back, or other symptoms like weakness of legs or numbness, a radiographic evaluation becomes necessary. Magnetic Resonance Imaging and Computed Tomographic Scanning: both non-invasive tests that provide highly accurate results. These tests can often diagnose the presence of an illness, or herniated discs even in asymptomatic patients. MRI uses no ionizing radiation and is better at imaging soft tissue (e.g., herniated discs, tumors). CT scanning provides better imaging of cortical bone (e.g., osteoarthritis). Compared with MRI, CT scanning is less sensitive to patient movement and is also less expensive. Bone scanning: also called Bone Scintigraphy » useful when radiographs of the spine are normal but the clinical findings are suspicious for osteomyelitis, bony tumors or hidden fractures. Needle electromyography and nerve conduction studies: useful in differentiating peripheral nerve damage from disorders of single nerve roots or muscles. Treatment of Low Backache

Conventional treatment Painkillers and correction of structural deformities are the main stay of conventional approach to back pains. Pain killers: Non-Steroidal Anti-inflammatory Drugs (NSAIDs) given for two weeks usually reduce the pains. Physiotherapy: physical treatment through appropriate exercises for improving posture and muscle tone provide lasting relief. Homeopathy For Low Backache Homeopathic medicines offer excellent relief from low back pains. Homeopathic medications can relieve the spasms of the back muscles and provide effective pain relief without any side effects. Homeopathy is strongly recommended.

Related conditions: Rheumatoid Arthritis, Ankylosing Spondylitis, Cervical Spondylitis, Multiple Myeloma,tubercular spine,renal stone, menstrual disorder with backache.


Cervical Spondylitis

Introduction Cervical spondylitis is a common degenerative condition of the cervical (neck) spine that most likely is caused by age-related changes (wear and tear) in the intervertebral disks and vertebrae of the neck. Research has shown that CSM (cervical spondylotic myelopathy) is the most common cause of non-traumatic weakness in limbs and a persistent stiffness and nagging pain in the neck.

'Spondylo' is a Greek word-meaning vertebra. Spondylitis (or Spondylosis) means changes in the vertebral joint characterized by increasing degeneration of the intervertebral disc with subsequent changes in the bones and soft tissues. Most often in people above the age of 40, the intervertebral discs get progressively dehydrated and they becomes more compressible and less elastic. Mineral deposition starts occurring in the intervertebral disc resulting in secondary changes. Although majority of individuals over 40 years of age demonstrate significant radiological evidence of the above changes, only a small percentage develop symptoms of the same. Another noteworthy point is that sometimes the degenerative changes in the cervical spine can be visible on the X-ray or in the MRI as early as in 30’s but it does not call for any treatment if the patient is not symptomatic. The above changes result in compression of the nerves leading to radiculopathy (pain, numbness, weakness and loss of reflex due to compression and irritation of spinal nerve) or compression of the spinal cord resulting in cervical spondylotic myelopathy (CSM) (commonly caused by spinal stenosis resulting in loss of movements and sensation). Both the neural and spinal cord compression will result in radiculomyelopathy.


Lumber Spondilitis (Back ache)

What is Lumber Spondilitis? Lumber Spondilitis or spondylitis is a condition where there is an inflammation of lumber (lower vertebral) spine, popularly called as Back ache. The inflammation can be mild, moderate or severe leading to a range of severity of symptoms. There is not only inflammation of the vertebra but also some amount of fusing, which gives painful stiffness.

Symptoms: The symptoms of varying degree of pain associate with stiffness. There may be restricted mobility of the back, disturbing day to day life activities. There may also be deformity of the spine over the period of time.

Related conditions: Ankylosing Spondilitis is a similar condition which is more severe and considered to be an auto-immune disease, related with HLA-B-27 gene. The stiffness associated with muscle spasm leads to stiff-spine, often compared with a bamboo spine.

Rheumatoid Arthritis: Similar condition but affects more of the multiple and often large joints such as knee, shoulder, fingers and back. Positive Rh factor is a diagnosing modality.

Homeopathic Treatment for Lumber Spondylitis: Yes, homeopathy does offer significant treatment for this condition. The treatment is targeted at relieving the inflammation and stiffness. Also, the underlying process leading to such chronic inflammation is addressed using the homeopathic medicines. However, homeopathy cannot revert but some cases may get clear the deformity also.

Related conditions: More about Backache Ankylosing Spondylitis Rheumatoid Arthritis


Osteoarthritis (OA)

Definition: Osteoarthritis is one of the types of arthritis that is caused due to degeneration and eventually loss of the cartilage of joints. Cartilage is a tissue that covers the inside of the joints and acts as a cushion between the two bones forming a joint. When the cartilage starts undergoing degeneration, the bone becomes inflamed as its protective covering is lost. This causes pain during weight bearing activities such as standing, walking,going upstairs etc. Joint structure

Causes: Osteoarthritis occurs commonly as a person ages and it is frequently seen in persons above the age of 50 years though it can also occur earlier than this. Before the age of 45 years, it is more common in males. Genetic predisposition also is one common cause for osteoarthritis. This condition usually affects the weight bearing joints such as the knees and hips; it can also affect other joints such as those of the hands, feet and the spine.

OA knees: When the osteoarthritis is due to ageing process it is known as primary osteoarthritis; when there are other conditions in the background that have triggered this disorder, it is known as Secondary osteoarthritis. Secondary osteoarthritis can be caused by any of the following: • Trauma • Joint surgery • Obesity • Congenital anomalies of the joint • Gout • Diabetes • Hormonal disorders (especially Growth hormone disorders) and curvature of the bones.

Symptoms: The common symptoms of Osteoarthritis: Heberden's nodes• Pain and stiffness of the affected joint • Swelling and warmth of the joint • Creaking of the joint • Pain is usually worse after repetitive use of the joint • Stiffness is usually worse after a long period of inactivity • Pain may occur at rest too • Limited mobility of joints • Inability to squat • Bony enlargement of small joints of fingers (called Heberden’s nodules)

Spine osteoarthritis can cause: • Neck pain and stiffness • Backache • Tingling numbness of extremities

Homeopathic treatment: Osteoarthritis is a degenerative joint disease where the pathological changes in the joint are almost irreversible. Homeopathic medicine can alleviate the pain significantly but cannot cure the disease completely. Most cases respond well as far as the long-term pain relief is concerned. Homeopathic medicines are definitely suggested for osteoarthritis, especially for early cases where the medicines can slow down the degenerative process and offer considerable pain relief and in early cases may cure completely.

Related condition: Rheumatoid Arthritis


Polymyositis

Polymyositis is a chronic and difficult disease conditions calling for long-term planning treatment. As the name suggests, it is poly=many, myco=muscles, sitis=inflammation. That is, a disease condition where many muscles get inflamed. It is similar to another condition called dermatomyositis, where skin is also involved.

Symptoms of Polymyositis: Females are affected more than men. Usually, it starts after around 18 years. Patients present with muscular weakness in the legs, spreading to upper limbs and then eventually to entire body. There is a sense of tiredness or fatigue, due to muscle involvement. Patients also complain of painful body movement due to inflammation of muscles. Increasing difficulty in getting up, running, climbing staircase, and eventually day to day activities, forms a major symptom of this disease. Polymyositis is a progressive condition, where more and more groups of muscles tend to get involved, leading to restricted mobility and increasing painfulness. It does not have a tendency to go into natural remission, as recoded in the cases at Life force. Polymyositis is not a common disease, fortunately.

Causes of Polymyositis: The exact cause behind Polymyositis is not yet known. However, it falls in the category of auto-immune disease. It is also suspected to have some genetic links. Certain infections such as virus, parasites (protozoa), Lyme disease, etc. might trigger Polymyositis.

How is Polymyositis diagnosed? Clinical diagnosis supported by one or more of the following investigations would help to confirm the diagnosis of Polymyositis: High blood levels certain enzyme called CPK (Creatine Phospho-Kinase) Muscle biopsy Electromyogram

Treatment of Polymyositis: a. Conventional treatment: There is hardly any treatment except the use of cortisone and immunosuppressive medicines used conventionally. Also, physiotherapy and such supportive measures are useful. b. Homeopathic treatment for Polymyositis: Experience suggests that homeopathy has reasonably good treatment to offer for Polymyositis, which works at two levels: 1. Controls further progress of disease 2. Improves the symptoms of pain, fatigue and mobility Homeopathy may not cure the Polymyositis but even if improvement as stated above is considered significant for a disease such as this. Homeopathy is strongly suggested for Polymyositis.

Related diseases: Guillain Barré Syndrome, Myasthenia Gravis


Rheumatoid Arthritis

Definition: Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. This condition can also affect the tissues surrounding the joints as well as other organs of the body. RA is a chronic condition and it tends to last for many years though there are periods in between when the patient is without any symptom. RA is a progressive condition and over a period of time, it causes joint destruction and functional disability.

Causes: Scientists largely believe that the tendency to develop rheumatoid arthritis may be genetically inherited. It is also suspected that certain infections or factors in the environment might trigger the immune system to attack the body's own tissues (Autoimmune response), resulting in inflammation. In any case, the autoimmune response causes chronic inflammation of the joints, that later progresses to joint destruction. Stress can act a predisposing factor as well as a trigger to induce acute episodes of the condition. The disease is three times more common in women as compared to men. It afflicts people of all races equally. The disease can begin at any age, but peak incidence is seen between 40 to 60 years of age.

Symptoms: The course of RA varies from patient to patient. There are stages when the disease is active and this is called a ‘Flare-up’. In between the flare-ups are episodes when the patient is absolutely free from symptoms, such periods are called ‘Remissions’. • Common symptoms during the active stage of RA are as follows: • Joint swelling, redness and tenderness • Joint stiffness • Limited range of motion of joints • Deformities of hands and feet (at later stages) • Muscular pains • Fever • Loss of appetite • Usually multiple joints are affected at one time (polyarthritis) • Symmetrical affection of joints is common • Small joints of hands and feet; elbows, ankles are commonly involved • Skin redness or inflammation • Round, painless nodules under the skin • Inflammation of the lung (pleurisy) • Swollen glands • Anemia

Diagnosis of RA: Following are the common tests done to diagnose RA: • RA (Rheumatoid Arthritis) factor • X-ray of the joint • ESR • C-Reactive proteins (CRP) • CBC

Homeopathic treatment: RA being a constitutional disease that is auto immune in nature, calls for constitutional medication. Homeopathy offers excellent treatment for the cases of RA, especially for those who have not developed joint deformities. The pain control is very effective with homeopathy and this is without any side effects whatsoever. The treatment can also have a role to play in controlling the progress of the condition to some extent and in delaying the onset of complications. Homeopathy is very strongly suggested for all cases of Rheumatoid Arthritis.

Related Condition: Ankylosing Spondylitis, Psoriatic Arthritis, Adverse effects of Methotraxate

 

 

 

 

 

 

 

 

 

 



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