Learn about arthritis and how it can affect you

Learn about arthritis and how it can affect you
Dr Leong Y.H

‘Rheumatism’ is a traditional and non-specific term used in the East and West to refer to a variety of conditions affecting the bones, joints, skin, heart, kidneys, lungs. This term is rapidly falling out of favour in the West today because modern medical science has discovered that most of these conditions have different aetiologies (causes) requiring very different treatments.
You can say that it’s a word mainly used in Chinese (& traditional) societies; it’s also used by a minority of Westerners into homeopathic and alternative medicine. The only common characteristics among these conditions are: 1) they cause long-term chronic pain, and 2) they are very difficult to treat.
‘Arthritis’ is a broad term refers to inflammation of the joints, but doesn’t say anything about the cause. Includes conditions like osteoarthritis, rheumatoid arthritis, psoriatic arthritis, infective arthritis, gouty arthritis, etc.
Generally, I’d divide arthritis into 2 big groups:
1) Osteoarthritis (OA)
This is primarily a ‘wear and tear’ condition affecting older people. Arises from overuse (e.g. marathon runners), previous injuries (football players), overweight, heredity.
A lot of older Asian women get OA of the knees while the Americans and Europeans get it in the hips. The pain is more mechanical than inflammatory. So you get pain in the later part of the day after a lot of walking and climbing stairs.
Because it’s mainly a mechanical problem, treatment with painkillers is only a temporary solution. Long-term lifestyle changes are more important – reduce weight, mobility and muscle-strengthening exercises, reduce all kinds of weight-bearing activities (walking, jumping, running, carrying heavy objects). In severe cases, surgery may be warranted.

2) Inflammatory (‘Rheumatic’) Arthritis
This group comprises the various types of arthritis which are mainly inflammatory , not mechanical, in nature. They usually result from an auto-immune condition, which causes the body’s immune system to go haywire and attack the joints and other parts of the body. E.g. rheumatoid arthritis (RA), SLE (skin, kidneys, joints, brain), psoriasis (skin, joints), ankylosing spondylitis (back, heart), gout (joints, skin, kidneys), rheumatic heart disease/fever (joints, heart, skin). All these conditions require different forms of treatment.
I’ll talk a bit about RA, the commonest condition in this group. Unlike OA, RA can occur at any age and is usually hereditary (we now have a test for the RA factor in the blood). Pain is usually in the early morning, worse when it’s cold, and gets better with activity and use. That means an RA sufferer suffers from morning stiffness and pain, but gets better in the afternoon when it’s warmer and when he has moved around a bit.
Treatment, unlike OA, is mainly through drugs – painkillers, anti-inflammatory drugs like steroids, cytotoxic drugs like sulfasalazine and MTX.
In Asia, treatment is mainly through accupuncture, medicated plasters and ointments. With the vast arsenals of drugs and non-drugs alternative treatments available today, RA can be controlled very well and the sufferer can actually lead a very active life. Many OA sufferers on the other hand may eventually require surgery since we don’t have very effective drugs for OA. About the Author
Dr Leong is a Western trained doctor with a keen interest in Chinese medical treatment. He contributes articles to http://www.quick-pain-relief.com. This article may be republished provided acknowledgement is made of the author and the original website.

Scoliosis in Adolescents

Normally, a spine when viewed from rear should appear straight but if the spine is lateral or curved or sideways or rotated then it is affected by scoliosis. It gives an appearance as if the person has leaned to a side. According to Scoliosis Research Society the definition of scoliosis is the curving of the spine at an angle greater than 10 degrees on an x-ray. Scoliosis is a kind of spinal deformity and shouldnt be confused to poor posture. Usually there are 4 common kinds of patterns of curves experienced in Scoliosis which are: Thoracic wherein the right side has ninety percent curves, lumbar wherein left side has seventy percent curves, thoracolumbar wherein right side has eighty percent curves and double major where both right and left sides have curves.

In majority of the cases, as high as eight to eighty five percent, the cause of the deformity is unknown, this is also known as idiopathic scoliosis. It is observed that females have scoliosis more commonly than males. According to some established facts 3 to 5 children per 1000 has chances of developing spinal curves which is a number big enough requiring medical treatment. There are three types of scoliosis that can develop in children namely congenital, neuromuscular and idiopathic. Congenital scoliosis is seen in 1 out every 1,000 births which is caused due to vertebraes failure in normal formation, vertebrae is absent, vertebrae is formed partially and vertebrae is not separated. Neuromuscular scoliosis is linked with various neurological conditions and particularly in children who dont walk like cerebral palsy, muscular dystrophy, spina bifida, tumors in spinal cord, paralytic conditions and neurofibromatosis. The cause of third type of scoliosis called Idiopathic scoliosis is still unknown. It is further divided into infantile, juvenile and adolescent scoliosis. Infantile scoliosis occurs up to the age of 3 years from birth wherein the vertebrae curve is towards left and is more frequently observed in boys. The curve takes normal shape with the growth of child. Juvenile scoliosis is common in children of age three to nine. Adolescent scoliosis is common in kids of age ten to eighteen and this is also the most common form of scoliosis occurring more in girls than boys.

The other possible causes of the deformity include hereditary reasons, different lengths of legs, injuries, infections and tumors. There are numerous symptoms attributed to scoliosis which can vary from individual to individual. The symptoms are: Difference in heights of the shoulders, off-centered head, difference in the height or position of the hip, difference in the position or height of shoulder blade, different arm lengths in straight standing position and lastly different height back sides when the body is bent forward. Other symptoms include leg pain, back pain and change in bladder and bowel habits do not belong to the symptoms of idiopathic scoliosis and require medical checkup by a doctor. The symptoms may be similar to other problems related to spinal cord or other deformities or could result from an infection or injury and consulting a doctor is the best bet in this situation who may conduct diagnosis to know what exactly it is.

The diagnosis of scoliosis requires thorough medical history of the teenager, diagnostic tests and also physical examination. The doctor asks for entire prenatal history, birth history and also would want to know if anyone in the family has scoliosis. The doctor may also ask for the milestones related with the development of the teenager since some kinds of scoliosis are known to be related to neuromuscular disorders. The delay in development may need additional medical evaluation. Doctor may also prescribe x-ray, CT scan and MRI scan of the back to measure the degree of curvature in the spinal. There are various treatments available for scoliosis which is decided by the physician depending on teenagers age, medical history and health in general. The method of treatment also depends on the extent to which disease has reached. The tolerance of the teenager to certain medicines, therapies and procedures are also taken into consideration. Expectations and opinion of the parents or teenager is also the criteria in deciding the type of treatment. The main aim of the treatment is stop the curve from progressing and avert deformity. The treatments include observation and repetitive examinations, bracing and surgery to correct the defect.

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What is Sports Medicine?

Sports medicine is a sub specialty of the medical field that is somewhat confusing to some people. Because of the fact that sports is not medicine, it is a bit of a misleading term however the term is intended to represent the doctors and other medical staff who are in the practice of treating and diagnosing athletes and sports related injuries.

The professionals who are actively involved in the sports medicine field ranges from standard doctors, physical therapists, surgeons, and even athletic trainers and other similar careers. Sports tend to be a highly competitive field, and as such most emphasis is placed upon speedy as well as complete recoveries from any injuries. This could mean that an injury that would take normally 3 months to heal can be reduced to only 2 months using the appropriate sports medicine techniques under a qualified doctors care.

Most doctors who practice sports medicine treat athletes both professional, amateur and often children for the various injuries that occur while playing any sport imaginable. The human body is designed to quickly heal following most injuries if an appropriate treatment is followed, and sports medicine is intended to speed the recovery process as much as possible. Many sports medicine doctors are also actively involved in giving athletes preventive care as well which is designed to reduce the occurrence of many common injuries.

Doctors who are interested in sports medicine come from a wide range of fields including cardiology, orthopedic surgery, biomechanics and even pulmonology just to name a few. The exact specialty of the doctor is often quite focused while the majority of patients are all involved in sports in one capacity or another. The roll of the doctor is often to work with the athlete to adjust training procedures to reduce the risk of injury while increasing the skill level of the athlete as much as safely possible.

There are some sports medicine doctors who are specializing in treating female athletes while others will treat both female as well as male athletes. Deciding upon the best sports medicine doctor for your needs can involve meeting several doctors before finding someone whom you are comfortable with. Many athletes develop a close relationship with their doctor so that the best possible athletic results are achievable.

By working together with training coaches and other athletic professionals doctors in the sports medicine field are able to help athletes achieve the best possible results performance wise, while still maintaining healthy standards in terms of overall health. Achieving spectacular sports results is often meaningless if the athlete is always injured in the process, or if the overall health is neglected and the athlete is unable to continue in their chosen sport.

As you can imagine, the number of athletes who only work with a single sports medicine doctor are very slim. Most athletes work with a team of doctors that comprise of various sub-specialties such as surgical, dietary, cardiogologist and anything else that may be needed. Each doctor is responsible for helping the athlete, and this helps to ensure that each doctor is well trained in their specialty. Using a single doctor as opposed to the entire team can greatly limit the options that you have for treatment.

However, while an entire team is generally used to treat patients in sports medicine, there is usually a general care doctor who is given the task of heading the team and sending each patient to the specific additional doctors that they need to see based upon their individual needs. This helps to avoid confusion, chaos and other problems from occurring. Over all sports medicine is a fascinating and very necessary field that most can agree is quite helpful for athletes.

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Heat-Related Illnesses in Teens

Heat related illnesses are caused due to prolonged exposure to heat and also humidity without any reprieve and due to inadequate intake of fluids. Kids and teens adjust to the variations in heat compared to adults who adapt more quickly. However the heat production is high in them when compared to adults but sweat relatively less. Sweating is the natural action of the body and cooling mechanism to counter heat. Kids and teens often ignore these facts and do not hydrate themselves enough while playing, participating in sports and exercises.

Kids and teens with health problems that are chronic or those who are on certain prescription could be more susceptible to heat related problems. Overweight adolescents or those who wear heavy clothing in times of exertion also suffer heat related illnesses. Heat related illnesses are basically classified into three types. They are: Heat cramps, heat stroke and heat exhaustion.

Heat cramps are the mildest of all heat related injuries and constitute aching muscle cramps and also spasms that occur during intense exercising and also after intense exercising and also sweating in high heat. The symptoms of heat cramps include cramps that are painful in the legs. Flushed and moist skin is also symptoms of heat cramps. The symptoms could also include mild fever generally below 102 degree Fahrenheit. Teens suffering from heat cramps should move to a cool place and take adequate rest. Remove any excessive clothing and wear or put cool clothing on skin or cool skin using air conditioner or fan. Sports drinks which are cool and which contains sugars and salts can also be taken. Stretching out cramped muscles slowly and steadily also helps reduce heat cramps.

On the other hand hear exhaustion is more serious and severe compared to heat cramps and occur due to heavy loss of salt and water from the body. Extreme heat conditions, inadequate fluid intake and excessive sweating results in this conditions. Also, heat exhaustion occurs as a result of inability of the body to maintain the body temperature below the normal which can deteriorate further and also result in a heat stroke which is even worse. The symptoms of heat exhaustion are: muscle cramps, moist skin, pale skin, nausea, fever above 102 degree Fahrenheit, diarrhea, vomiting, fatigue, headache, weakness, anxiety and faint feeling. Teens suffering from heat exhaustion should stay in cool surrounding and take enough rest. Removing excessive clothing, putting on cool clothes and sitting in fan or air conditioning also helps the situation. Intake of cold sports drinks which contains salts and sugars are also advisable. If a teen doesnt show any signs of improvement even after taking all these measures a physician should be consulted immediately.

Heat stroke is the severest condition of all heat related illnesses. In this condition the body gets overwhelmed with excessive heat and the efficiency of the system that regulates body heat goes down considerably which can result in a serious emergency requiring immediate medical care. The symptoms of heat stroke include dry and warm skin, very high fever generally above 104 degree Fahrenheit, increased heart rate, appetite loss, nausea, headache, vomiting, fatigue, agitation, confusion, stupor, seizures, coma and possible death. A teenager experiencing symptoms of heat stroke should stay in a cool place and have adequate rest. Heat stroke is a serious condition and emergency attention should be sought by calling 911. In the meanwhile the affected teenager should be made free of excessive clothing and should be worn with cool clothes and also put cool water on the skin to lower the temperature. Placing ice bags in armpits also helps. Make the teenager drink cool drinks if the teenager is alert.

Heat strokes are very much preventable if certain precautions are taken like drinking adequate water during hot days, avoiding alcoholic and caffeine drinks, wearing light clothes, exercising in cooler time of the day, wearing sunglasses and hat, using umbrella on a hot day, applying sun cream with a spf of at least 15 etc.

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