Back Pain

Back pain is a common problem that affects most people at some point in their life.

It may be triggered by bad posture while sitting or standing, bending awkwardly, or lifting incorrectly. It’s not generally caused by a serious condition. Find out more about the causes of back pain.

In most cases, back pain will improve in a few weeks or months, although some people experience long-term pain or pain that keeps coming back.

Types of back pain

Backache is most common in the lower back ('lumbago'), although it can be felt anywhere along your spine, from your neck down to your hips. Read information on neck pain and shoulder pain, which are covered separately.

Sometimes, back pain can be caused by an injury or disease, such as:

•     a slipped disc – when one of the discs in the spine is damaged and presses on the nerves

•     sciatica – irritation or compression of the sciatic nerve, which causes pain, numbness and tingling that travels down one leg

•     whiplash – neck injury caused by a sudden impact

•     frozen shoulder – inflammation around the shoulder that causes pain and stiffness

•     ankylosing spondylitis – a long-term condition that causes pain and stiffness where the spine meets the pelvis

The rest of this information will focus on back pain that doesn’t have an obvious cause. Doctors call this “non-specific back pain”.
What to do

Most cases of back pain get better on their own and you may not need to see a doctor.

If you’ve only had back pain for a few days or weeks, the following advice may help relieve your symptoms and speed up your recovery:

•     remain as active as possible and try to continue with your daily activities

•     take over-the-counter painkillers, such as paracetamol or ibuprofen if you feel you need to

•     use hot or cold compression packs – you can buy these from your local pharmacy, or a bag of frozen vegetables and a hot water bottle will work just as well

Although it can be difficult to be cheerful or optimistic if you are in pain, it’s important to stay positive because this can help you recover faster.

Treatments for long-term back pain

If you’re worried about your back or your pain hasn’t improved by around six weeks, it’s a good idea to visit your GP, who can advise you about the treatments available.

These include:

•     stronger painkillers

•     exercise classes – where you are taught specific exercises to strengthen your muscles and improve your posture

•     manual therapy, such as physiotherapy, chiropractic or osteopathy

•     acupuncture

•     counselling, such as cognitive behavioural therapy (CBT)

•     support and advice at a specialist pain clinic

Some people choose to see a therapist for manual therapy or acupuncture without seeing their GP first. If you want to do this you will usually need to pay for private treatment, which is likely to cost around £30-50 for each appointment.

Spinal surgery is usually only recommended when all else has failed.


Source : http://www.nhs.uk/conditions/Back-pain/Pages/Introduction.aspx

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Stay Safe From Arthritis Pain

Stay Safe With These Fall-prevention Guidelines

The American Geriatrics Society and the British Geriatric Society have issued updated guidelines for preventing falls in older people. It is the first such update in over 10 years.

“There is always evidence that is coming out and in area like falling, we are learning more about it every day,” says Mary Tinetti, MD, a professor of medicine at Yale University School of Medicine, New Have, Ct., and a co-chair of the panel that came up with the guidelines. “We want to make sure the guidelines are as timely and accurate as possible.”

While the guidelines, which appear in the January 2011 issue of the Journal of the American Geriatrics Society, target older patients, they apply to patients of any age with rheumatic disease involving gait.

“It relates to all of our patients who have lower extremity disorders,” says Nortin M. Hadler, MD, attending rheumatologist at UNC Hospitals and professor of medicine and microbiology/immunology at University of North Carolina at Chapel Hill.

“Gait is quite remarkable. It’s a highly integrated biological function that requires heel strike and push off of toes, knees that are supple and hips with reasonable range of motion,” says Dr. Hadler. “All of these things we take for granted, but if anyone has any impairment, they don’t take it for granted.” Dr. Hadler notes that patients with rheumatic disease also fall “less well” because they are less able to brace themselves when they do fall.

The new guidelines call for a complete risk assessment for patients who simply report difficulties with gait or balance in addition to those who have a history of falling. The assessment should include evaluation for muscle weakness, balance problems, orthostatic hypotension (a fall in blood pressure when a person stands up from a sitting or lying down position), as well as an examination of the feet and footwear, and an evaluation of both daily living skills and the use of adaptive equipment and mobility aids. Health care professionals should also ask patients about the fear of falling.

“Falls are a very serious problem and they often have a complex set of causes that can be a challenge to sort out. One of those things is that we are fearful,” says Sharon Brangman, MD, president of the American Geriatric Society. “Patients can be so fearful that it limits mobility, which sets up a vicious cycle: We are fearful, so we restrict our activities, and our muscles get weaker and so we are more likely to fall.” 

The guidelines were developed by a panel including members from previous panels, as well as experts in areas such as geriatrics, physical therapy, orthopedics, emergency medicine, occupational therapy, nursing and pharmacy. To come up with the new guidelines panelists reviewed the medical literature on fall prevention published between May 2001 and July 2009.

“The main thing is that these guidelines were developed by a panel of experts who scoured the literature and scientific information to find guidelines based in science,” says Dr. Brangman. “We knew things anecdotally, but these guidelines have evidence behind them.”

Within the new guidelines are recommendations for intervention that include:

•     an exercise component that combines balance and strength training, such as tai chi or physical therapy.

•     cataract surgery when needed (but only in conjunction with other interventions).

•     medication reduction or withdrawal, especially drugs that affect the central nervous system, such as sleep medications and antidepressants.

•     appropriate management of heart rate and rhythm abnormalities, and orthostatic hypotension.

•     a daily 800 IU vitamin D supplement.

“The new guidelines are not all doctor-oriented,” says Dr. Brangman. “They have practical pieces that people can carry out on own: finding safer shoes, removing clutter in your home, clearing off stairs and installing handrails in bathrooms and on steps.”

But the interventions must be followed. “It really made a difference in how carefully all the interventions were carried out,” says Dr. Tinetti. “It’s important not just to say that something needed to be done, but to do it.”

More Information : http://www.arthritis.org/living-with-arthritis/pain-management/joint-protection/fall-prevention-guidelines.php

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Arthritis Mistakes

6 Rheumatoid Arthritis Mistakes to Avoid

 

 

You do your best to live a full, active life with rheumatoid arthritis (RA). But do you recognize any of these common missteps? If they sound familiar, it’s not too late to get back on track.

1. Not Seeing a Rheumatologist

Your regular doctor may have diagnosed your RA. It’s still a good idea to see a specialist, too.

Rheumatologists are doctors who are experts in treating RA and other types of arthritis. A rheumatologist will have the most training in the medicines that treat RA and in finding the right ones for you. If you don’t have one, ask your primary care doctor for a referral.

2. Too Much Couch Time

You need rest, just not too much.

When you have joint pain and fatigue, it's hard to get up and get moving. But regular exercise is key for your health. Too much idle time makes pain, fatigue, and stiffness worse.

When your RA flares, slow down but don’t stop. Do gentle flexibility exercises, like yoga and tai chi. You may also be able to do some exercises in a warm pool, but take it easy.

When you feel better, step up your activity. Add strength training (you can use weight machines at a gym, handheld weights, resistance bands, or your own body weight) to strengthen the muscles around your joints. You should also do cardio for your heart, bones, and mood.

Talk to your rheumatologist, or a physical or occupational therapist, about the best exercises for you. Walking can be a good exercise for people with RA. It’s low-impact, and you can do it anywhere for free. Swimming and water aerobics are also good choices.

3. Canceling Doctor Appointments

When you feel good, do you stop seeing your doctor? You need those regular checkups to keep feeling good and to keep your treatment on track.

During regular visits, your rheumatologist will check on how you’re doing, how well your treatment is going, whether you have any side effects, and tweak your treatment, if needed.

In addition to seeing your doctor, you also may need lab tests or X-rays now and then. Make sure you keep those appointments, too.

4. Not Taking All Your Medications

If your doctor prescribed more than one RA medicine, there’s a good reason for that. One of those drugs may ease your pain, and the other helps to stop joint damage.

If you’re not sure what your drugs do or why you need them, ask your doctor. Also tell her if side effects or costs are problems. She can help you look for solutions, whether it’s another drug or help with costs, so you can keep up with your treatment.

5. Skipping Medication When You Feel Good

You may be tempted to skip your medications on days when you’re feeling better. Don’t do that.

Missing a dose could cause the pain to return, and it may be harder to get relief later. Your RA could also worsen.

Some drugs need to stay in your bloodstream at specific levels in order to be effective. If you skip them too often, blood levels of the medication will drop and you could end up with a flare of your RA. You might forget a dose once in a while, and that's OK. Just take it as soon as you remember (but don't take a double dose).

6. Overlooking Your Mood

RA can be painful and challenging. It’s normal to feel sad about that at times. But if you start to feel depressed -- for instance, your blue feelings don’t lift, and you don’t enjoy the things you used to like -- tell your doctor so you can get treated and feel better.

Your doctor can refer you to a counselor for “talk therapy” and prescribe antidepressants if needed. You may also want to join a support group for people with RA, such as those offered by the Arthritis Foundation. Ask your doctor for more information.


Source : http://www.webmd.com/rheumatoid-arthritis/biologics-15/mistakes-with-ra

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Arthritis - 10 Things You Should ?

Rheumatoid arthritis is a chronic, potentially disabling type of arthritis. If you have been diagnosed with the disease or you have signs and symptoms pointing to rheumatoid arthritis, you should know these 10 basic facts.

1 - Rheumatoid arthritis is an autoimmune inflammatory type of arthritis.

Rheumatoid arthritis is triggered by a malfunctioning immune system (i.e. autoimmune disease). The joints are primarily affected by rheumatoid arthritis, but organs may also be involved (i.e., systemic disease).

2 - Rheumatoid arthritis patients are classified as seropositive or seronegative.

Rheumatoid factor is an immunoglobulin (antibody) which can bind to other antibodies (normal proteins found in the blood which function within the immune system). A blood test is used to detect the presence of rheumatoid factor. About 80% of adults who have rheumatoid arthritis are positive for rheumatoid factor (i.e., seropositive rheumatoid arthritis). Approximately 20% of rheumatoid arthritis patients are negative for rheumatoid factor (i.e., seronegative rheumatoid arthritis).

What Is Rheumatoid Factor?
What Is the Significance of a Positive Rheumatoid Factor?
3 - There are physical symptoms which are common to rheumatoid arthritis.

A physical examination by a rheumatologist (arthritis specialist) can detect certain signs and symptoms consistent with rheumatoid arthritis:

Early symptoms of warmth, swelling, and pain often begin in small joints of the fingers, wrists, and feet.
Affected joints are usually symmetrical (same joint on both sides of the body).
Morning stiffness lasting at least an hour or more.
Rheumatoid nodules (subcutaneous lumps) may be present.
Joint deformities caused by cartilage, tendon, and ligament damage.
Fatigue, loss of appetite, and low grade fever.
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4 - Imaging studies and blood tests, along with the physical examination, are used in combination to diagnose rheumatoid arthritis.

No two cases of rheumatoid arthritis are exactly alike and the disease course is unpredictable. Some patients experience a lot of pain, even if their x-rays don't reveal evidence of severe joint damage. Some patients have evidence of severe joint damage on x-ray but do not experience a lot of pain. Differences between patients make it necessary for rheumatologists to observe the entire clinical picture (medical history, physical exam, imaging, and blood tests) in order to formulate an accurate diagnosis.

What Is Anti-CCP?
Blood Tests to Diagnose and Monitor Rheumatoid Arthritis
Is MRI Valuable for Diagnosing Rheumatoid Arthritis?
5 - With rheumatoid arthritis, joint damage can occur early after disease onset.

Often, joint damage occurs within the first two years following the onset of rheumatoid arthritis. The possibility of early joint damage makes early diagnosis and treatment essential. It's also important for rheumatoid arthritis patients and their doctors to consider an aggressive approach to treatment rather than a conservative approach.

Is Early Diagnosis of Arthritis Important?
Is Early, Aggressive Treatment Recommended for Rheumatoid Arthritis Patients?
6 - There are 1.5 million adults in the United States with rheumatoid arthritis.

Rheumatoid arthritis is the most common form of inflammatory arthritis, but osteoarthritis, which affects 27 million Americans, is the most common type of arthritis overall. Rheumatoid arthritis usually develops between 30 and 50 years of age, but it can develop in anyone at any age.

Arthritis Prevalence Statistics Released by CDC
7 - People with rheumatoid arthritis have an increased risk of mortality or death rate compared to the general population.

Older medical literature suggests that people with rheumatoid arthritis may live 10-15 years less than their healthy counterparts. Life expectancy is influenced by many factors though, including family history, overall health, and lifestyle choices. The newest class of arthritis drugs, referred to as biologics, hopefully will offer a better prognosis.

Rheumatoid Arthritis Shortens Life Expectancy
The Correlation of Life Expectancy and Arthritis
The Effect of Rheumatoid Arthritis on Mortality
8 - There is a high risk of disability for rheumatoid arthritis patients.

According to the Centers for Disease Control and Prevention (CDC), arthritis and other rheumatic conditions are the leading cause of disability in the U.S. More than 30% of adults with doctor-diagnosed arthritis (all types) report a work limitation due to arthritis. According to Johns Hopkins, disability is higher among patients with rheumatoid arthritis, with 60% being unable to work 10 years after disease onset.

Can I Continue to Work?
Social Security Disability Income - Do You Qualify?
9 - Rheumatoid arthritis is three times more common in women than men.

The prevalence of rheumatoid arthritis in women suggests that genetics and hormones may play some role in the cause of rheumatoid arthritis. Some types of arthritis are more prevalent among men, including gout and ankylosing spondylitis, but many types of arthritis are more prevalent among women. According to the CDC, 28.3 million women and 18.2 million men report doctor-diagnosed arthritis (all types).

More About Rheumatoid Arthritis
10 - Even with physical limitations, rheumatoid arthritis patients can have a good quality of life.

Physical limitations may become disabling. The disease may challenge your emotions. Finances may be stretched by an inability to keep working. With a positive attitude, you can take action and find solutions.
source: http://arthritis.about.com/od/rheumatoidarthritis/a/rheumatoid_fact.htm

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