Arthritis Treatment: Tibiofemoral Osteoarthritis, Diagnosis and Treatment

The most common presentation of osteoarthritis of the knee (OAK) is involvement of the tibiofemoral joint, the space between the femur (upper leg bone) and the tibia (the larger of the two lower leg bones.)

These are the two surface areas that contain the largest amount of hyaline cartilage inside the knee.

As mentioned earlier, hyaline cartilage is the "harder" of the two type of cartilage within the knee. Hyaline cartilage caps the ends of the long bones inside the joint while fibrocartilage, a softer more pliable cartilage is represented by the medial and lateral menisci of the knee. These are semicircular piece of cartilage that give added protection to the hyaline cartilage when it comes to shock absorption, gliding, and rotation.

Symptoms of OAK typically consist of stiffness, swelling, buildup of joint fluid, and tenderness along the joint line. Over time the ability to bend and straighten the knee will be compromised as well. While one compartment, either the medial (inside) or lateral (outside) compartment of the knee may be affected more than the other, often both compartments are affected. This causes diffuse pain.

The diagnosis can be suspected clinically by history and physical examination. It can be confirmed by positive changes seen on standing knee x-rays. Magnetic resonance imaging (MRI) is much more sensitive to changes of OAK which will consist of cartilage defects, bone edema (swelling), and fluid.

The typical treatment regimen is aimed at pain relief and maintenance of function.

If the patient is overweight, weight loss is a must. Regular exercise consisting of low impact aerobic exercise, resistance exercise, and stretching are components of a common-sense program for a patient with OAK.

Addition of non-steroidal-anti-inflammatory drugs taken either orally or given as a topical agent may also be used.

Removal of excessive joint fluid followed by Injections of glucocorticoids ("cortisone") are helpful for symptomatic relief. Glucocorticoids have a deleterious effect on articular cartilage and should be used sparingly, no more often than three times per year in a given joint.

The patient may also benefit from viscosupplement injections. These are substances consisting of hyaluronic acid which mimics the characteristics of normal joint fluid. These injections can also help provide symptomatic relief.

All injections need to be administered using ultrasound guidance to ensure accuracy.

Surgery is defined as being cartilage sparing or cartilage sacrificing. Cartilage sparing procedures involve osteotomy- removing a wedge of bone in order to line the knee joint straighter. This is used in young active adults to buy time. Cartilage sacrificing procedures refer top joint replacement. The trend recently has been for patients to get these operations done at a younger age. The downside is that these surgeries are associated with a small but real risk of severe complications including infection, blood clots, and death.

An option that is being proven to be an alternative is the use of autologous stem cells, a patient's own stem cells to help sustain and possibly regrow cartilage in an osteoarthritis knee.

(Wei N, et al. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)

Rheumatoid Arthritis: Occupational Therapy Assessment

Usually by the time the patient with rheumatoid arthritis requires or opts for surgery, there would have been quite a bit of joint damage and some degrees of subluxation or deformity of the joints. Comprehensive occupational therapy assessment would include physical, physiological, psychological, social and environmental perspectives of the patient with rheumatoid arthritis. It is often at this stage also that many of the patients would probably have stopped any form of paid employment, except for housewives who would still be doing household chores.

The things that the hand occupational therapist will be looking out for includes power, presence of deformity, any signs of subluxation, skin temperature, pain and range of motions will be assessed. Given the fact that rheumatoid arthritis has its cycles of exarcebations and remissions, it'd be good to keep an assessment mindset over at least 3 sessions to ascertain the hand and its function. It'd be good also to breakdown the assessment over 2-4 sessions depending on patient's ability to tolerate each session, as not all patients would like to keep travelling to the clinic.

The hand occupational therapist would then perform a series of checks, one of them is the informal interview. The results of the informal interview may be rather inaccurate as the patient might refer to a time prior to the onset of the disease, and since the disease is progressive they might not be very accurate as well. It'd be best to combine a variety of assessment tools eq quantitative and qualitative approach to have a more holistic idea to their hand function.

Essentially, it is best for the hand occupational therapist to perform a practical assessment task on the patient, covering the activities of daily living (ADL).

The ADL activity assessment should include but is not limited to:

1. dressing: able to wear and take off own clothing, including undergarments and prostheses, if any
2. personal hygiene: brushing teeth, wiping/washing face, handwashing
3. toileting: ability to perform voiding activities
4. feeding: feeding and drinking during meal times
5. mobility: walking, stairs management, transfers
6. housework: cleaning, laundry, marketing, money management
7. communications: using a phone to SMS or make calls, writing, typing etc.

How Fish Oil Helps Arthritis Sufferers

Let's face it: arthritis is such a difficult condition. It is painful and uncomfortable, it is permanent, and can set it anytime. There are actually over a hundred types of arthritis, but it is generally safe to assume that arthritis is an inflammation or swelling of the joints, and causes an insurmountable amount of pain and immobility to the joints.

It has been found that omega 3 fatty acids in fish oil can provide tremendous relief from arthritis, especially if you are suffering from rheumatoid or osteoarthritis. Before we move onto finding out how these omega 3 acids help, let us familiarize ourselves with these dietary fats and the connection between omega 3 fatty acids in fish oil and arthritis.

There are actually two kinds of polyunsaturated fats that play significant roles for inflammation: omega-6 and omega-3 fatty acids. It has been found that most people, especially those who suffer from arthritis, get too much of omega-6's in their diet than omega-3's. The abundance of omega-6 has been found to be detrimental to arthritis sufferers.

You see, omega-6 fatty acids help produce inflammatory agents called eicosanoids or prostaglandins. These compounds have significant roles to play in the body and are linked to important functions, including the relaxation and contraction of smooth muscles. Getting just enough of omega-6 in the diet (sourced from vegetable oils, sweets, crackers and even junk food) can be helpful, but higher doses are not and can lead to many health problems, including the production of pro-inflammatory agents - those that enhance inflammation rather than prevent them.

Omega-3 fatty acids, on the other hand, richly found in fish oil, are also converted into eicosanoids. The interconversion happens at a much slower rate, and anti-inflammatory eicosanoids (not the "pro" ones) are involved. The chemicals released by omega-3 alleviate inflammation and stops it right at the very core.

Fish oil for arthritis: better than NSAIDs

For the longest time, NSAIDS have been the only relief available for rheumatoid arthritis sufferers. Sure, they work, but compromise health because it brings about higher risk for heart attack, stomach bleeding, among many others. Intake of NSAIDs for a prolonged period of time actually lead to more harm than good. As an alternative, fish oil supplementation does not only reduce your pain naturally, but also brings you a multitude of health benefits as well: including promotion of heart and brain health, better focus and memory, and overall better health.

Fish oil naturally stops inflammation

Omega-3 fish oil can effectively heal the pain of arthritis sufferers. Since these essential fatty acids also encourage better cardiovascular function, which means that systemic inflammation is not just reduced, you can have a shot at permanently waving your pain goodbye. For arthritis sufferers, fish oil does not only offer alleviation from the pain and the swelling, it does so naturally that there are no unwanted side effects to expect.

How To Get Rid Of A Rash - What Doctors Don't Want You to Know

Despite famous lines to the contrary, weird remedies don't always work to cure some natural conditions! William Shakespeare once claimed some benefit in the famous formula doled out as; "eye of newt, tongue of frog, wool of bat and hair of dog!" These aren't really feasible remedies to cure a rash?

There are some better homemade remedies than those and ones that do not attempt to fix the problem usually underlying a rash. After all, Shakespeare was only a poet! But what can we take away from natural home cures for common rashes? Do they really do more than just make the affected skin feel better?

For generations, humans have relied on natural remedies and old wives' tales from everything on how to prolong life to how to cure skin break-outs. While these potions are simple and cheap, these old-fashioned remedies are made from ingredients from your herb garden or pantry. Most of these ancient "cures" are more soothing than curative of these itchy maladies and none have been seen to work in the rash-sufferer's system to actually prevent further rash discomfort.

A long respected balm for irritated skin is an oatmeal poultice, which soothes as it reputedly draws out impurities and inflammation from the skin. A modern way to fashion this old-time remedy is to moisten oatmeal straight from the package and apply a thick warm glob to the affected skin for a soothing relief. The oatmeal should not be allowed to stay on the skin too long; leaving it in place could become abrasive and undo the soothing effect of the warm wet oats!

While this tried and true home remedy, warm soothing oats smeared all over your rash has a chance of making the rash feel better, in fact, it will not cure the rash nor the reason for its appearance in the first place, but many people try it when they become desperate.

Don't become desperate! I will actually tell you how to get rid of a rash!

Since a rash is most likely the skin's honest response to something the body does not like, merely rubbing a potion on it, no matter how natural and well-respected that something is, will not cure the rash, as it originates from the body's response to something that makes its immune system fight to heal itself.

Occasionally, the effect of too little sleep will cause a rash-like apparition under the sleep-deprived eyes. This can be made more comfortable by the application of moist tea bags over the eyelids and skin beneath the eyes. This also works on some individuals as a way to remedy bags under the eyes, also a manifestation of too little sleep.

Rashes are a usual reaction to something the body is unhappy with; some medically trained personnel believe this extends to accumulated wastes building up in the body and advocate root-based body cleansers known to make the body sweat.

Examples of this are burdock root, yarrow root, sarsaparilla root, red clover root, and Polk root. While these natural compounds are readily available at natural foods stores and seem to have no toxic effects on the body, they also have no demonstrated preventative effects on various rashes. The reality is that most 'wives tales' are exactly that, and very ineffective.

The best way to simply remedy or prevent an itchy rash is to avoid substances that you have an allergy to. This is not always possible as new allergies can pop up in the body without any warning.

Staying away from items known to cause an allergic reaction or that make you feel strange and out of sorts is one easy way to begin to identify items that you may be sensitive to, without waiting for them to give you a rash!

What Are Different Types of Arthritis?

While there are over a 100 distinct types of arthritis, there are common ones from which majority of people suffer.

The most common type of arthritis is osteoarthritis, which is a degenerative joint disorder that usually results from the natural decline of the body from old age. Other common causes of osteoarthritis are events that cause trauma to the joints, or the infection of a joint. The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates that one out of eight Americans aged 25 years and older suffer from osteoarthritis. The spread of the age group of people who suffer from osteoarthritis is attributed to the fact that it is caused both by injury and old age.

With osteoarthritis, pain results from the inflammation of the joints because of the wearing out of the cartilage, which cushions and protects joints. In the absence or lessening of this protective cartilage, pain results from simple and usual movements like walking, standing, or any activity that causes the joints to bear weight. As a result of the pain, many people who suffer from osteoarthritis lessen their physical activity, causing further degeneration of their muscles and ligaments.

While people who suffer from osteoarthritis feel general joint stiffness and joint pain, only a third of them complain from excessive pain and inflammation around the joints. The progression of osteoarthritis also vary greatly among people, with some acquiring osteoarthritis suddenly and some developing it gradually. The joints most usually affected with osteoarthritis are fingers, the neck, the lower back, the knees, and the hips.

Rheumatoid and psoriatic arthritis occurs when the body attacks itself. These two types of arthritis are generally classified as auto-immune diseases precisely because it is caused by this bodily mechanism. Rheumatoid arthritis is a painful inflammatory systemic disease that can eventually lead to a loss of mobility because of excessive pain and joint destruction. It also can affect adjacent organs like the skin, blood vessels, lungs, heart, and even muscles. A good 60% of patients who suffer from rheumatoid arthritis lose their mobility and capacity to work some ten years after their initial diagnosis.

Another common form of arthritis is gout or metabolic arthritis. In this congenital disease, the uric acid metabolism breaks down, causing the deposition of uric acid crystals in the joints. The deposit of uric acid crystals in the joints causes an inflammatory reaction as uric acid concentration in the bloodstream rises. Because the uric acid crystal deposits continue to accrue in the joints, these eventually erupt out into the skin that discharge white, chalk-like material. Gout usually attacks the big foot first, but may attack a number of other joints like the heel, the ankle, the wrist, the instep, knee, elbows, and even the spine.

Is Pernol the Product That Will Eliminate Pain and Ease the Suffering From Arthritis?

Is living in pain destroying your normal lifestyle? Arthritis and Joint Pain are a debilitative disease which cause misery and frustration to your every day life. Pernol is described as "The arthritis miracle from the sea", that will eliminate joint pain, aid joint lubrication and ease your suffering, to enable you to regain your mobility and quality of life once more.

So what is it? The main active ingredient is a patented, highly purified 99% stabilised pharmaceutical grade oil, extracted from the Green Lipped Mussels (Perna canaliculus) which are exclusive to the New Zealand coastline along the South Island. It is a unique chronic joint pain and inflammation product new which completely alleviates inflammation, eliminating swelling, pain, joint stiffness, lack of mobility, irritation and the wearing down of cartilage.

For generations the native coastal Maori population of New Zealand has consumed raw Greenlipped Mussels as a primary part of their diet. Coastal dwelling Maoris, who regularly consumed the Green Lipped Mussel as part of their diet, suffered from practically no arthritis when compared to their inland dwelling relatives or other New Zealanders of European origin.

The Green Lipped Mussel possesses rich Omega-3 essential fatty acids which are unique to its species. The presence of this source of essential fatty acids provides the mussel with potent anti-inflammatory activity. This can be passed on to consumers when the mussel or its concentrated pure oil is as the mussel acts as a unique filtration system extracting crucial and essential nutrients that have shown to provide phenomenal pain relief, aid joint lubrication and act as powerful anti-inflammation agents.

The main active ingredient of Pernol is a patented, highly purified 99% stabilised pharmaceutical grade oil, extracted from the Green Lipped Mussels ( Perna canaliculus ) which are exclusive to the New Zealand coastline along Marlborough Sounds area of the South Island. This unique chronic joint pain and inflammation formulation can alleviate inflammation, eliminate swelling, pain, joint stiffness, lack of mobility, irritation and the wearing down of cartilage.

A key component in combating and relieving arthritis pain and inflammation is the Concentrated Natural Oil Blend of Salmon Oil, Fish Oil, Evening Primrose Oil, Lemon Oil and Celery Seed Oil. This blend, combines with and aids the 99% Green Lipped Mussel Oil Extract, to provide the crucial natural oil blend to ensure optimum joint lubrication and overall joint health.

So is there any medical proof? Clinical test studies carried out in The Queen Elizabeth Hospital and the University of Adelaide in Australia using concentrated extracts of Green Lipped Mussel Oil have shown positive results in relieving arthritic conditions by inhibition of the principal human inflammatory pathway known as "the lipoxygenase pathway". Both rheumatoid and osteoarthritis patients showed a significant improvement with 79% of rheumatoid patients and 80% of osteoarthritic patients benefitting significantly from taking concentrated Green Lipped Mussel Oil Extract.

There are no known side effects or interactions with any other form of medication. Due to its unique anti-inflammatory action on the respiratory airways, it is also fantastic for Asthma sufferers.

Discover The Most Common Causes of Joint Aches

As we get older, many of us start to wake up with joint aches and pains we never had before.

Although you may still consider yourself young, such as late 30's or early 40's, the truth is that most causes of joint aches and pains is arthritis.

This isn't to say that you have arthritis...but you could be in the early stages of developing it.

You may be overweight or you may not be. The onset of arthritis can be from an old injury....especially if you played sports in your younger years.

If you are a few pounds too heavy, this can make the situation worse.

Of course, there are several types of arthritis. There is rheumatoid arthritis and there is osteoarthritis as two examples. The causes of joint aches will depend on which type of arthritis you may have or may be developing, if indeed arthritis is at the cause of your aches.

If you notice your joint aches happen frequently in the morning, upon first rising, then osteoarthritis could be your problem.

The Root Causes of Joint Aches

Regardless if it's rheumatoid arthritis or osteoarthritis, both types are characterized by inflammation of the joints. This inflammation causes joint aches because of the swelling and stiffness created.

As such, regardless of what the causes of your joint aches happen to be, there is a really good chance that you should look into anti-inflammatory substances to counter the inflammatory cascade transpiring within your body.

One of the best anti-inflammatories is fish oil. Fish oils are a natural substance that can not only help alleviate inflammation, but they have a myriad of other health benefits, such as improving cardiovascular and brain functioning.

Other good sources of anti-inflammatory foods include rich, leafy green vegetables. Think spinach.

If you live in the United States, you've probably never heard of a substance known as the New Zealand green lipped mussel. In New Zealand it is rather famous for its anti-inflammatory properties and is used to counter joint stiffness, aches, and pains. Like fish oil, the green lipped mussel is rich in omega 3's.

In summary, the root causes of joint aches are usually inflammation that can mean the onset of some type of arthritic condition. Increasing your dietary intake of natural anti-inflammatory substances may help counter these aches and also may improve your overall health.