SAKIT LUTUT? Nak rawat guna ais atau air suam?

Salam @akufisio, video kali ini saya menerangkan 1) Jika sakit lutut nak rawat guna rawatan yang sejuk ke panas? 2) Bila masa nak guna rawatan sejuk ? Bila masa pula nak guna rawatan panas? 3) Cara paling mudah nak rawat walaupun berada dirumah. Wajib tonton sampai habis. ADA PERSOALAN NAK TANYA? Comment persoalan anda dibawah, InsyaAllah saya akan bantu jawab ketika berkelapangan. Senior Physiotherapy: Muhamad Shahril Bin Senan @akufisio Video Sponsored by: https://erobarn.com/ Fb & Ig: @akufisioofficial Blog: https://akufisio.blogspot.com/ Background Music by: https://www.bensound.com/

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Home remedy Juice for Gout

Remedy Juice Vs Gout

Bismillahirahmanirahim, When i am writing the post , i was recall to share of one the Natural juice that had been use by one of my patient regarding to help him to treat and control the uric acid in his body.
its quiet interesting as this juice is easy to made and also will not harm to try as we always consume this food in our diet.
So this is the receipt i can share for the readers to try and also to seen the effect, as when i read and find in the journal ,most of the indgridents in the juice had potentially to play the role to control the uric acid in our body.

Here the receipt than we can make as home remedies juice.

The ingridents is
1 cucumber (medium size)

2 celery stems

1 sliced lemon

1 table spoon of Honey ( For sweetener)

Methods:

1. Prepare the above materials and clean them first. Make sure the celery has no dirt.
2. Cut the cucumber into smaller size
3. Cut lemon 1 slice . Remove the skin as to prevent a bitter taste. You can put the other in the refrigerator.
4. Then add a 1 tablespoon of  honey
5. Mix all and blend.
6. Ready to drink every day.( More nice if you keep it cold in refrigerator)

Effects of this Remedy in Fight Gout 
1. Cucumber = We understand that cucumbers are low in purines and high in water, they can potentially play an important role in fighting gout.

  2. Celery = Credit to researcher who are find that A study in the journal Arthritis and Rheumatism found that eating celery , Luteolin, a major component of celery, blocks the enzyme that leads to uric acid formation (Food Chemistry, Dec. 15, 2013)

 3. Lemon = Some gout patient experience a positive result after taking a lemon juice , it stimulates the formation of calcium carbonate, which neutralizes acids because its improve the body's acidity and remove it is by alkalinizing the urine.

 4. Honey =  the is a fact and research show a Honey is not a high purine food, and taking or eating it in small amounts will not trigger any gout attacks but if a person who are suffer gout it can be choose a sweetener , i believe to say a raw honey should be the choice for the gout sufferer

 As a physiotherapist i would like to say this guide is not a permanent solution for a gout problems. So make sure you improve your quality of lifestyle and make sure you keep your health well and take a medication as prescribe by the DR. wallahuaklam.

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Prevention of uric Acid (Gout)

Prevention of Uric Acid

Bismillahirahmanirahim,
In My previous Blog regarding of uric acid i was thinking to add another important info on how to prevent and control your uric acid in a safest and effective way. For our understanding prevention of uric acid can be done with diligent uric acid levels control in your blood. In the human body system are complex and intelligent but high blood glucose deposition in the blood, which can not be excreted by the kidneys, will turn into a monosodium urate crystalline which gradually attacks the joints and tissues around it to cause uric acid disease.

So we back to the simple question ,How to prevent gout disease:

• Make sure you understand on how to make your routine control of uric acid levels in the blood (especially people with risk factors for gout, men over 30)
• Try and avoid foods that contain lots of purine substances such as meat, offal, some types of nuts and vegetables
• One of the hardest way in mental for human is weight control to avoid obesity with diligent exercise
• To make sure we are maximize kidney health (drink plenty of water) to prevent complications of uric acid
• avoid alcohol and cigarettes in your life.

But in other facts If you already have uric acid, there are some uric acid treatments that focus on:

• relieve symptoms of gout
• prevent recurrent attacks by lowering uric acid levels through drugs

On the prevention action the most important fact and things you can do when a gout attack occurs, as a form of uric acid prevention:

1. is to make sure you see your doctor if an attack of gout strikes as you can get pain medication that has been prescribed for you by the Dr.
2. The easiest and cheap way is Rest. The best thing you should do when an attack of invading gout is to be on your mattress.
3. Cover the ice cubes on areas of pain / swelling to reduce pain due to joint inflammation.
4. when you have an acute pain make sure you Letting the pain / swelling area open. In patients with acute uric acid, even touched light objects such as cloth will cause tremendous pain.
5. Mind control and stable emotional is one of the best for you to be patient in the face of pain that is attacking you. 
6. Most common case the pain lasts only a few days, so be patient and do not forget to take prescribed medication and avoid any massage and heavy activity during attacking period.

From my experience as Physiotherapist many uric acid sufferers experience uric acid attacks within 2 years, followed by a second attack that occurs after 10 years and it was shown in some clinical experience by patient. The attacks are unpredictable, but you should immediately consult a doctor if the attacks come frequently. The faster handled, the better it can be prevent and avoid . Wallahuaklam.

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Physiotherapy and Uric Acid

Causes of Uric Acid

Bismillahirahmanirahim,         
Yesterday i have one of my uncle had came and visited me ,he had a bad of history of GOUT and today in my blog , i want to sharing some info regarding of the Uric acid. for our understand the cause of uric acid is the buildup of uric acid in the body derived from the breakdown of purine substances.The puurines are obtained from our own bodies and from food.
 Meat, beans, liver, offal is a source and rich of purine substances. For that, the more consumption of food with purine substances automatically it will increase the total purine substances in your body. When excessive consumption is taking, these uric acid deposits turn into sharp crystals of Monosodium Urates and invade the joints and surrounding tissues. Under normal conditions for the normal person the uric acid can dissolve in the blood, passing through the kidneys and out of the body in the urine.

Uric acid can form in the blood when:

1. increasing and excessive uric acid levels
2. Weak or Unhealthy kidneys that can not get rid of the amount of uric acid produced.
3. Over and high intake consumption of foods with high purine content.

In some of the case when uric acid levels in your blood are high, this is commonly called hyperuricemia. Precipitation of uric acid that can not be removed from the body by the kidneys will increase a form monosodium urate crystals in your blood or kidneys that result or causing a uric acid or kidney stones.

 A person's who had a risk factor for developing gout is when:

1. Have a history and heredity of family member with the same disease.
2. Is a man as it more attack on Male compare Female.
3. Overweight and obesity
4. Drinking too much alcohol.
5. Eat too much purine rich food.
6. It has an enzyme defect that makes it difficult for the body to break down purines.
7. Has history had an organ transplant.
8. Using some medications such as diuretics, aspirin, cyclosporine, levodopa.
9. Consume vitamin niacin intake in daily life.

So for our understanding and prevention action taken i would say many of the symptoms of uric acid can be diagnosed before it is too late, such as swelling of the big toe, fingers, and other places associated with your small or large joints.Common of the Joint pain is also one of the most frequent symptoms of uric acid. This pain is caused by inflammation due to the formation of sharp crystals of uric acid deposits that invade tissue around the joint especially when it happen it also can cause a warm and redness colour on affected joint. Although not all people with high uric acid levels in the blood suffer from gout, one way to protect the joints and prevent gout disease is to reduce purine-rich foods and exercise regular control of your uric acid levels. wallahuaklam.

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Kebaikan Bioflavonoid melawan Radang sendi

Bioflavonoid vs Radang (Inflamasi)

Bioflavonoid boleh dijumpai di dalam Black Ginger

Bismillahirahmanirahim , agak lama juga saya tidak update blog kesihatan saya ini , jika di ikutkan kesibukan harian didalam rutin harian saya ianya agak mencabar bagi penghujung tahun 2017 ini.
dalam entry saya kali ini ada beberapa pekara yang amat menarik perhatian saya mengenai satu bahan yang dikenali sebagai Bioflavonoid, Sebagai ahli fisioterapi saya gemar membaca kajian kajian perubatan yang dilakukan sama ada dari segi perubatan moden dan juga perubatan alternatif , ini kerana saya suka kongsikan ilmu ini kepada masyarakat dan juga umum.

Banyak persoalan yang selalu ditanya kepada saya apakah sumber makanan yang boleh  membantu untuk mengatasi masalah sakit sakit sendi ini. Jika ianya dijawab dari segi perubatan ianya harus lah melalui atas nasihat doktor dan juga pakar kesihatan , tetapi pengalaman saya sebagai ahli fisioterapi ianya melibatkan dua faktor iaitu sakit pada bahagian sendi melibatkan kronik dan juga akut , pada peringkat awal sebagai contoh sakit sendi pada bahagian lutut adalah disebabkan faktor yang selalu berlaku dan dihadapi oleh masyarakat ialah Osteoporotik dan juga Osteoarthritis.

Antara soalan yang biasa saya terima dalam apa jua ceramah health talk saya ialah apakah makanan tambahan yang boleh membantu mencegah masalah sendi ini. Di dalam bacaan saya yang terbaru dan amat menarik perhatian saya ialah bioflavonoid  yang dikaji oleh Pihak MARDI , kajian ini menyatakan beberapa faktor yang positif yang boleh dikatakan membantu mencegah serta memberikan manfaat bagi pesakit yang mempunyai masalah sendi di peringkat awal antaranya

1. Bioflavonoid bersifat  Anti Oksidan.

Kajian yang dilakukan oleh pihak MARDI bioflavonoid merupakan bahan anti penuaan ,dimana ianya melindungi sel sel anda daripada radikal bebas yang boleh mengakibatkan radang pada sendi dan juga pelbagai sakit kronik yang lain.

2.Bersifat Anti Keradangan 
Bioflavonoid juga mengurangkan risiko keradangan pada bahagian salur darah yang boleh mengakibatkan bengkak serta kesakitan pada bahagian bahagian sendi.

3.Bermanfaat kepada sistem kardiovaskular.
Kesan bioflavonoid yang diambil secara berterusan atau konsistent ianya mampu membantu didalam mengurangkan penghasilan kolestrol jahat didalam badan .

4. Bersifat anti kanser .
tidak salah saya katakan kajian umum tentang bahan ini bersifat anti tumor atau anti kanser kerana bahan yang terkandung didalam bioflavonoid ini bersifat anti oksida.

5.Bermanfaat didalam membantu Mengurangkan risiko Keradangan Osteoporosis dan juga Osteoarthritis.
ini amat menarik perhatian saya kerana bioflavonoid merupakan salah satu pemakanan alternatif tambahan yang berbeza dengan supplement dimana jika diambil tubuh badan manusia akan mendapatkan manfaat dari pengambilan makanan ini ,dan jika tidak diambil badan kita tidak akan kehilangan apa apa , berbanding dengan supplement jika diambil tubuh badan akan mengalami proses kebaikan ,jika diambil dan berhenti sacara tiba tiba tubuh badan kita akan merasa kehilangan sesuatu dalam proses pembaikkan .
Dalam kenyataan diatas apa yang ingin saya tekankan bahawa bioflavonoid memberikan kesan yang baik jika ditambah di dalam pemakanan harian kita dan ianya tidak memberikan kerugian pada tubuh manusia jika ianya tidak diambil atau diberhentikan.
Dalam masalah keradangan sendi ini bioflavonoid adalah salah satu sumber alternatif yang boleh dicuba bagi mengatasi dan juga mencegah masalah sendi diperingkat awal.

Tujuan perkongsian saya ini adalah lebih untuk memberitahu manfaat serta kebaikan bioflavonoid itu , Kajian yang dilakukan oleh pihak MARDI tiada bukti kesan ketoksidan atau keracunan kepada pengambilan makanan yang mengandungi bioflavonoid ini
antara kajian yang boleh pembaca buat rujukan bagi bioflavonoid ini ialah
Journal Food Chemistry. Anti -Inflammatory effects of compounds from kaempferia parviflora and Boesenbergia pandurata. Volume 115 ,issue2,15 July 2009, Pages 534-538.

American Journal of pharmacology and Toxicology .anti -stress effects of kaempferia parviflora (2013)., 8(1):31-38.
bagi pembaca sekalian , apa yang ingin saya tekankan di dalam penulisan saya ini , bahawa ianya hanyalah sebagai salah satu alternatif yang boleh kita lakukan didalam mengatasi masalah sendi terutama sakit pada bahagian lutut dan juga anggota badan yang lain

wallahuaklam.

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Jari tangan berbunyi

Bunyi Sendi Jari

Bismillahirahmanirahim , hari ini agak sunyi sikit di tempat kerja saya , mungkin sebab Chinese New Year akan jatuh hari sabtu ini , maka ramai pesakit pantang untuk datang ke hospital terutama pesakit cina.
Dalam blog saya hari ini saya nak kongsikan tentang , letupkan Jari , ada yang panggil Retak sendi ia adalah merupakan  satu fenomena yang menarik dan kurang difahami oleh kalangan masyarakat kita sehingga menimbulkan terlalu banyak teori tentang mengapa sendi jari ini berbunyi  pop jika dibengkokkan maksimum , tetapi punca sebenar masih lagi masyarakat tidak mengetahui bagaimana ianya terhasil..

Melalui pengalaman saya sebagai ahli fisioterapi saya ingin menerangkan kepada umum tentang fenomena membunyikan sendi ini dari segi kajian perubatan membunyikan setiap sendi sendi di anggota badan terutama jari ianya tidaklah merbahaya dan memberikan kesan yang buruk tetapi jika menghasilkan letupan  sendi ini mula mendatangkan kesakitan dan juga kelemahan pada bahagian yang dibunyikan ianya haruslah diberhentikan serta merta .

Sekali lagi ingin saya katakan melalui kajian perubatan membunyikan sendi tidak merbahaya dan juga tidak memberikan apa apa manfaat kerana ianya masih belum terbukti berbahaya kepada tubuh badan manusia . Banyak teori yang terhasil tanpa kajian mendalam mengatakan bila kita selalu membunyikan sendi jari maka jari kita akan mudah terkena arthritis.Teori ini tidak benar , jika anda belajar apa itu arthritis banyak faktor faktor yang memungkinkan perkara ini terjadi. Sebab itu apa bila pesakit bertanya saya hanya memberitahu jika ianya tidak menyakitkan anda teruskan kerana ada pesakit memikirkan bila membunyikan sendi di jari mereka merasakan sesuatu kelegaan , tetapi bagi saya ianya lebih kepada perasaan pesakit itu sendiri.

Disini saya ingin ceritakan secara ringkas bagaimana bunyi itu dihasilkan di dalam sendi, Bunyi pada bahagian sendi ini adalahdisebabkan oleh tekanan yang berlawanan arah dimana ianya menarik gas nitrogen sementara ke dalam sendi, apa bila berlaku mampatan pada bahagian sendi deperti jari dibengkokan secara kuat maka gas ini akan dilepaskan dan bunyi POP terhasil.Selain itu bunyi sendi juga boleh didengar jika tendon pada sendi bergesel antara satu sama lain kerana penyesuaian kecil di laluan meluncur mereka. Ini boleh berlaku atas faktor usia dan juga diatas perubahan tindakan yang berlaku serta merta seperti dari bersila terus berdiri.

Ruang Gas yang berada pada sendi jari sebelum diletupkan dan selepas yang diambil melalui pengimejan gambar.

Saya ingin sarankan dan juga memberitahu jika bunyi sendi ini disertai dengan rasa sakit, mungkin ada asas keabnormalan struktur sendi, seperti rawan longgar atau kecederaan kepada ligament. Sesetengah pesakit  yang menghidap masalah arthritis , Gout , Bursitis dan juga Osteoarthritis bunyi yang terhasil adalah menunjukkan ketidak abnormalan pada permukaan sendi dan tisu itu sendiri , selalunya ia disertai dengan bengkak dan juga rasa sakit.

Inshaallah , saya harap penerangan serba ringkas ini memberikan sedikit gambaran dan juga pemahaman kepada umum agar memahami asas tubuh badan manusia ini .wallahuaklam.

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Trigger Finger problem

Trigger Finger 

Bismillahirahmanirahim , one of the common problem that will affected in either of our finger is called Trigger finger. As we understand the Trigger finger is a condition that causes stiff fingers in the same position. This disease mainly affects the layer of tissue around the fingers is called tendon. Tendons are thick fibrous tissue associated with skeletal muscle.

The Facts of Trigger Finger that we must know.

• ·         Also known as stenosing tenosynovitis
• ·         Finger that becomes 'locked' after it has been bent (flexed)
• ·         It is difficult to straighten out without pulling on it by the other hand
• ·         May hear a click when it is pulled straight
• ·         This clicking may be worse in the morning
• ·         Mild pain and/or a small swelling at the base of the affected finger
• ·         Trigger finger most commonly affects your little finger, ring finger or thumb
• ·         It is actually more common in the right hand

Causes:

A tendon is a strong tissue that attaches a muscle to a bone. In this case the tendon comes from a muscle in the forearm. It passes through the palm and attaches to the finger bone. The muscle pulling on this tendon bends (flexes) the finger towards the palm.

A tendon sheath is like a tunnel that covers and protects parts of a tendon. Normally, the tendon slides easily in and out of the sheath as you bend and straighten the finger. In trigger finger the tendon can slide out of the sheath when you bend your finger. However, it cannot easily slide back in due to the swelling. The finger then remains bent (flexed) unless you pull it straight with your other hand.

Treatment Of Trigger Finger.

Mild cases.

 Mild cases of trigger finger can be overcome with a splint, which is installed in the finger up to six weeks. Finger splint keeping the straight position during the healing process, which means that the movement of the hands will be a little limited. The aim is to provide a period of rest so that joint pain can recover and the inflammation is reduced. It also keeps the somewhat crooked fingers, when the patient is unconscious, for example asleep. Using a splint also help reduce the pain caused by trigger finger, especially early morning when the pain peaked. Once the inflammation heal, physio or Dr will recommend exercise finger to help patients restore mobility diseased joints in full. Although the condition is mild, the patient is also advised to reduce repetitive gripping motions for 3-4 weeks.

Severe cases.

In severe cases, patients have three treatment options: injectable steroid, release per cutaneous and surgical. Treatment with injected steroids are used directly on the sore tendon sheath to reduce inflammation in the section. This treatment is usually done because it is simple and caused little pain. However, this is only recommended if the patient does not suffer from diabetes. For those who have diabetes, the success rate decreased from 90% to 50%. Sometimes, the patient is injected for a second time in order to achieve the desired results.

What can we understand of the Treatment.

In some cases, patients requiring the per cutaneous release of trigger finger, a procedure in which a needle is used to remove the finger snaps. Per cutaneous release the most effective use of the index finger, middle, and sweet.

In more severe cases, surgery may be necessary, for example in rare situations. However, surgery is only used as a last resort if the finger is locked do not respond to other disposal techniques. To treat trigger finger surgery, an incision is made at the base of the fingers are sore, through the incision, orthopedic surgeons will cut the sheath that is narrow, so the tendon can be shifted back easily. This action is only performed in the operating room with a local anesthetic, but it can be done in clinic only.

The conclusion is the Trigger finger is a condition that is painful, but it need not be a permanent condition. Existing techniques for treating trigger finger to help ensure that patients do not need to live in constant pain and finger movements can normally be restored. Its Important to us to understand what is the sign and the best of treatment we can use on that situation . Wallahuaklam.

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Best way shoulder pain treatment

Type of shoulder pain and treatment 

Bimillahirahmanirahim,

Shoulder pain is one of the common problem in attacking around shoulder region 

and it will affected your activity and also your emotional ,today i would like to share 

the info about of this unique joint 

What is the shoulder  and anatomy around it ?

The shoulder is a complex joint made up of the humerus (upper

arm bone), scapula (shoulder blade) and clavicle (collarbone),

along with tendons, muscles and ligaments. These help us lift,

carry, throw and reach up or backward. The shoulder is the most

mobile – and least stable – joint in the body, because it is not

anchored firmly to the skeleton by surrounding muscle.

Type of injuries of shoulder 

Here i will show a common injuries is always happen around the shoulder and also the mechanism of the type of injuries ,it will give you the idea when you meet the Dr and

this explanation will help you to understand about your condition.

Rotator Cuff Injuries 

The rotator cuff comprises four muscles and cord-like tendons,

tightly enclosed within the shoulder joint. Rotator cuff injuries are

the most common causes of shoulder pain and activity restriction

at all ages.

·         Rotator cuff tendonitis. The mildest rotator cuff injury is tendonitis

(tendon inflammation). Tendonitis can develop with repetitive overhead

activities such as playing tennis, pitching, raking, shoveling or

painting. Tendonitis can also arise from joint degeneration due to

osteoarthritis. It produces pain like a toothache radiating through

the upper arm that can awaken you from sleep. Reaching overhead

or behind your back is painful.

·         Shoulder bursitis. Bursitis, which often accompanies rotator

cuff tendonitis, involves painful inflammation of one or more bursa

(fluid-filled sacs that surround our joints to provide lubrication

and protection).

·         Impingement syndrome. Swelling and inflammation of tendons and/

or bursa can place undue pressure on tendons as they pass

between the upper arm bone and the shoulder tip, called the

scapular acromion. In its cramped space, blood flow to the swollen

tendon is reduced, and it begins to fray. The resulting pain intensifies

when reaching overhead or backward. Ongoing impingement

may produce a torn rotator cuff.

·         Rotator cuff tears. A torn rotator cuff, sometimes called “pitcher’s

shoulder” or “tennis shoulder,” is the most common cause of shoulder

pain. The rotator cuff tendons can split or tear suddenly with

injury, or slowly by rubbing bone spurs. Untreated tears can weaken

the arm, inhibit its overhead elevation and visibly shrink muscles.

Pain occurs during motion and also at night

Other Common injuries at the shoulder

Labral tears

The labrum, a cartilage cuff around the socket that encircles the

head of the upper arm bone to hold it within its shallow bony

socket, can tear with injury to the shoulder. It also becomes more

brittle with age and thus susceptible to fraying. Aching in the shoulder,

“catches” in the shoulder when moved, and pain with some

activities may signal a torn labrum

Instability and dislocation

When one of the shoulder bones moves or is pushed out of place

due to injury, the shoulder becomes unstable and is at risk for

partial or complete dislocation. Recurrent dislocations cause pain

and unsteadiness when raising the arm or moving it away from the

body, and a feeling that the shoulder is “slipping out of place” when

reaching overhead.

Frozen Shoulder

Between ages 40 and 60, the joint capsule surrounding the shoulder

can shrink, making movement painful and stiff. Reluctance to

use the shoulder brings increasing stiffness, restricted motion and a

persistent, dull aching. This condition is most frequently associated

with diabetes, but in more than half the patients has no known

cause. Pain fades after several months, but the shoulder becomes

“frozen” and may take two to three years to “thaw” without treatment.

Treatment is directed at pain relief until the acute phase

passes, followed by therapy and even surgical intervention to regain

motion if it does not return spontaneously.

Fractures

Shoulder fractures are usually caused by trauma: a fall while

skiing, a collision during football, a car accident. A fracture of the

“ball” at the top of the arm bone or its socket, or of the collarbone,

can disable the shoulder. Bruising, pain and swelling, and pain or

a deformed appearance can indicate a shoulder fracture. Most

fractures are effectively treated by immobilizing the arm in a sling

until the bone fragments “knit together,” which takes about six

weeks. All fractures should be assessed; some require surgery

Arthritis

Osteoarthritis is the wearing down of cartilage that allows bones to

glide smoothly within the joints, and can occur with aging, trauma or

overuse injury. The bones in the shoulder begin to rub against each

other, and growths called bone spurs can develop. Stiffness, swelling,

pain and reduced range of motion can occur, along with a “catching”

sensation in the joint.

Rheumatoid arthritis, a disorder of the immune

system, produces chronic, painful inflammation of the joint’s lining,

and eventual joint deterioration. Severe osteoarthritis or rheumatoid

arthritis in the shoulder may necessitate joint replacement.

Other causes

Less common causes of shoulder pain include infection

(osteomyelitis), soft-tissue or bone tumors and nerve problems.

A shoulder specialist can help pinpoint the reason. When

shoulder pain is intense, it’s important to seek help promptly.

What is the necessary action you need to take for managing this shoulder problem ?

Evaluating shoulder pain

Your doctor will thoroughly examine your shoulder, take your health

history and order imaging. X-rays detail bone changes from arthritis

and fractures. Magnetic resonance imaging (MRI) reveals soft-tissue

injuries. Computed tomography shows 3-D images of bony abnormalities

and tendon problems. Advanced centers will offer techniques such

as ultra-fast, high-resolution CT to reveal the source of shoulder pain,

and single-sequence MRI to confirm rotator cuff injuries.

Management and shoulder therapy

Conservative care

Rest, ice and heat are essential. Fortunately, most shoulder problems

do not require surgery, and respond to a directed physical therapy

exercise program and anti-inflammatory medication.

Rest

When your shoulder hurts, it’s important to rest it, and refrain from

reaching upward, carrying heavy objects and using heavy shoulder

bags. Pain and inflammation will not subside if repetitive activities

such as vacuuming, raking or car-washing continue to stress the sore

shoulder. Keeping your elbow below shoulder-level is important. To

prevent frozen shoulder after an injury, however, early movement is

important

Ice and heat

Icing the shoulder with cold packs (or bags of frozen peas or corn)

when pain is severe reduces inflammation and swelling, and the

discomfort they cause. Taking hot showers and doing recommended

stretches first thing in the morning also help

Physical therapy

Orthopaedic specialists prescribe physical therapy to help you

recover from shoulder injury. Physical therapists tailor range-of-motion

exercises to increase flexibility in the shoulder. They will also show

you strengthening exercises that help prevent muscle shrinkage, and

good body mechanics to help you avoid shoulder strain. Ultrasound

or massage may be used for bursitis. In frozen shoulder, anesthesiologists

can perform a nerve block to allow for more aggressive physical

therapy.

Anti-inflammatory medications

Non-steroidal anti-inflammatory (NSAID) medication can be purchased

over the counter to relieve shoulder pain. If aspirin, ibuprofen (Advil®),

naproxen (Aleve®) and acetaminophen (Tylenol®) do not provide adequate

relief, prescription-strength NSAIDs can be prescribed.

    

Injections

When other treatments don’t help severe shoulder pain, cortisone (corticosteroid)

injections may temporarily help to “settle down” inflamed

tissues within the cramped joint, reducing pain. However, cortisone is

a potent drug, and potential side effects should be discussed with your

physician.

Surgical options

When shoulder problems do not respond to any conservative care,

your orthopaedic specialist may recommend surgery. Options range

from minimally invasive arthroscopic surgery to total shoulder replacement.

Arthroscopic Surgery

In arthroscopic surgery, only a few small incisions are required,

making recovery quicker and less painful. A viewing camera is inserted

through one incision, and slender telescopic instruments are inserted

through others. This allows surgeons to inspect and repair labral

tears and rotator cuff tears, and remove spurs and bony growths to

allow inflamed, cramped tendons to move more freely. They can also

remove thickened, inflamed bursa and bone to create space around

the rotator cuff and relieve painful impingement (arthroscopic decompression),

and can cut through tight sections of the joint capsule to

release a frozen shoulder.

Arthroscopic surgery can be combined with standard “open” surgery

when a larger incision is required to properly view and repair a more

complex problem, or with forcible stretching of a tight joint capsule

under anesthesia to free up frozen shoulder.

Rotator cuff surgery

Torn rotator cuffs do not heal by themselves and require surgery when

pain persists. Repairing the torn muscle and tendon, and removing

bone spurs restores comfort and function to the shoulder after several

months of healing.

Surgery for shoulder fractures

Severe osteoarthritis or rheumatoid arthritis can cause painful, debilitating

shoulder deformity. In these cases, or when trauma crushes the

“ball” of the shoulder joint, then shoulder replacement surgery can relieve

pain and improve quality of life. Any damaged cartilage or bone in

the shoulder’s ball and socket are removed, and replaced with a metal

“ball” and a plastic “socket.” This artificial shoulder always relieves

pain and usually improves motion, strength and function.

Recovery from surgery

Physical therapy is essential to regaining your range of motion and

strength, which relieves pain. Your therapist and surgeon will prescribe exercises that

will tailor to your needs. Your therapist will ensure

that you perform your exercises correctly, give you advice on body

mechanics so that you avoid straining your shoulder, and check your

progress wallahuaklam...

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GOUT problems in adult

What Is Gout

History

·         Historically known as ‘disease of the kings’

·         Gout dates back to 2,600 BC when Egyptians noticed gouty arthritis of the big toe.

·         Hippocrates (400BC) commented on gout.

·         Alfred Baring Garrod (1848) noticed that gout was due to excess uric acid in blood

Introduction

·         Gout is a medical condition that presents with recurrent attacks of acute inflammatory arthritis.

·         Gout is a medical condition that usually presents with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint).

·         Gout affects the joints which appear red, swollen, tender and hot.

·         Gout usually affects the big toe first but can affect any joint in the body

Causes

·         12% of gout is attributed to dietary causes.

·         Gout is linked with the consumption of food high in purines like alcohol, sugar, meat and seafood

·         Gout presents as a complication of other medical conditions like hypertension and diabetes.

·         Gout may also occur as a result of kidney failure.

·         Gout is caused by a build up of uric acid in the body.

·         Uric acid is a waste product produced by a body’s metabolism.

·         People who kidneys do not excrete uric acid properly, or too much uric acid can have high levels of uric acid in their blood which forms crystals in the joints.

·         Crystals cause the joints to become inflamed and painful.

Who suffers?

·         Gout affects 4 times the amount of men than women. 1% of men in the UK will be affected by gout.

·         Gout usually affects men between the ages of 40 and 60 and women between the ages of 60 and 80.

·         Occurrence of gout is high among African Americans, Pacific Islanders and Maori.

Diagnosis

·         A blood test can measure the amount of urate in the blood.

·         Fluid can be removed from the joint with a needle.

·         X ray may rule out other conditions.

Prevention

·         Avoid food high in purines like red meat, seafood (mackerel and herrings), vegetables (Asaparagus) and food which contain a yeast extract (Marmite/Quorn).

·         Exercise helps decrease levels of uric acid in blood.

·         Allopurinol will help to lower your uric acid levels by disrupting the enzyme that is responsible for converting purines into uric acid.

Management

·         Ice applied for 20-30mins/day decreases pain.

·         NSAIDs reduce the level of pain and inflammation. (Diclofenac+Naproxen)

·         Colchicine helps reduce the level of Uric acid in the blood

·         Corticosteroids can also be used in more severe cases of gout

Gout Complications

·         Frequent and recurring attacks of gout may eventually damage joints permanently.

·         Small white lumps of crystal called Tophi form underneath the skin.

·         10-25% of people with gout have kidney stones which are crystals that collect in the urinary tract causing pain and UTI’s

Physiotherapy and Gout

·         Physiotherapists can help reduce joint stiffness and improve muscle tone through exercise.

·         Acupuncture

·         Laser Therapy

·         Coping Strategies (RICE)

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