Tag: non-surgical treatment

Tennis Elbow in Adolescents

Tennis elbow is a condition in which tendon fibers that attach on epicondyle on the elbows exterior degenerates. The tendons talked about here anchor the muscles that help wrist and hand to lift. Although tennis elbow occurs mostly in patients of thirty to fifty years of age but it can happen to people of any age. Also tennis elbow affects almost fifty percent of teenagers who are in racquet sports thus the name tennis elbow. But still most of the patients who suffer with tennis elbow are people who dont play racquet sports. Majority if the times there isnt any specific injury before the symptoms start showing up. Tennis elbow can also happen to people who use their forearm muscles frequently and vigorously for day to day work and recreational activities. Ironically some patients develop the condition without any of the activity related reasons that leads to the symptoms.

The symptoms of tennis elbow include severe burning pain on the elbows exterior region. In majority of the cases this starts as a slow and mild pain gradually worsening with the passage of few weeks or sometimes months. The pain worsens when one tries to lift objects. In some cases it may pain even while lifting light objects like a book or full coffee cup. In the severest cases it can pain even at the movement of the elbow.

The diagnosis of the tennis elbow involves physician enquiring about the medical history of the teenager and a physical examination of the elbow by pressing directly on the part where bone is prominent on the elbows exterior to check if it causes any pain. The physician may also ask the teenager to lift the fingers or wrist and apply pressure to check if it causes any pain again. X-rays are never opted for diagnosis. However a MRI scan may be done to see changes in tendons at the attachment to the bone.

There are many treatment options available and in majority of the cases non-surgical treatment is given a try. The ultimate goal of the 1st phase of the treatment is pain relief. Be ready to hear from the physician to stop any activity leading to the symptoms. The doctor may also tell the teenager to apply ice to elbows exterior and he/she may also tell the teenager to take anti-inflammatory medicines for relief from pain.

The symptoms also diminished with the help of orthotics. The physician may also want to go for counterforce braces and also wrist splints which can greatly cut down symptoms by providing rest to tendons and muscles. The symptoms should show signs of recovery within 4 to 6 weeks otherwise next option would be to go for a injection called corticosteroid in the vicinity of the elbow. This greatly reduces pain and is also very safe to use. There are many side affects involved if it is overused.
Once there is a relief from pain the treatments next phase starts which involve modification of activities in order to prevent the symptoms from returning. The doctor may also prescribe the teenager to go for physical therapy which may include stretching exercises to gradually increase the strength of the affected tendons and muscles. Physical therapies have high success rates and return your elbow back to normal working again. Again non-surgical procedures are highly successful in eighty five to ninety percent patients.

Surgical procedure is considered only when patients undergo relentless pain that doesnt improve even after 6 months of non-surgical treatment. The procedure involves removal of affected tendon tissue and attaching it back to bone. The surgery is done on outpatient basis and does not need stay at the hospital. The surgery is done by making a small incision on elbows exteriors bony prominence. In recent years a surgery known as arthroscopic surgery has also been developed but no major benefits have been seen using it over the traditional method of open incision.

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YOGA AND ARTHRITIS: A REVIEW

YOGA AND ARTHRITIS: A REVIEW
Dr. Manoj Dash, BHMS, DYT,Ph.D.

Yoga is an ancient Indian science and way of life, which influences the functioning of the brain and the rest of the body. Several studies have shown that the practice of yoga has a definite role in the promotion of positive health, including mental health, characterized by improved cardio-respiratory efficiency, autonomic responses to stressors, sleep, muscular endurance, and `higher brain functions. With an increase in the incidence of stress-related ailments, related to the rapid pace of life today, yoga has been evaluated as a treatment for such disorders in several controlled trials. The disorders, which were most likely to respond to yoga, with reduced symptoms and need for medication, were bronchial asthma, non-insulin dependent diabetes mellitus, anxiety neurosis, and rheumatoid arthritis. THE CONCEPT OF HEALTH According to the World Health Organization (WHO) the state of health is defined as a state of complete physical, mental, social and spiritual well being and not merely an absence of disease or infirmity. It is clear from this definition that health and ill-health are not two discrete entities as commonly understood but health should be conceived as a continuous function indicating the state of well being.The ancient Indian science, Yoga, has its origin in the Sankhya philosophy of Indian culture, which is about 8000 years old (Nagarathna, 2001). Yoga includes a wide range of techniques (e.g., physical postures, regulated breathing, cleansing techniques, meditation, philosophical principles, and devotional sessions, surrendering to the Supreme). These techniques bring about a calm and balanced state of mind, and are expected to help the spiritual evolution of the individual. However, yoga has more pragmatic applications in medicine. In order to understand these, it is important to know the concepts of health and disease in Yoga texts. According to yoga, man is in perfect health and homeostasis at his subtle levels of existence. All diseases are classified as (i) stress-related (adhija) and (ii) not stress related, e.g., injuries (anadhija) (Vasudeva, 1937). Yoga has been considered especially useful in the management of stress related disorders by getting mastery over the excessive speed of the mind. The technique to reducing the rate of flow of thoughts with deep internal awareness is yoga. This review will describe the therapeutic applications of yoga in the management of arthritis. Physical activity is an essential part of the effective treatment of osteoarthritis (OA) and rheumatoid arthritis (RA), according to treatment guidelines published by the American College of Rheumatology (Hochberg, 1995; Newsome, 2002). In persons with arthritis, exercise is safe and does not exacerbate pain or worsen disease (Ettinger,1997; Minor,1999; O’Grady,2000;Bearne,2002). In fact, exercise may play a key role in promoting joint health (Forrest,1994) , since those who do not exercise often suffer more joint discomfort than those who do (Nordemar,1981). However, regular physical activity is especially important for people with arthritis, who often have decreased muscle strength, physical energy, and endurance (Lyngberg,1988). The psychological benefits of exercise such as stress reduction, fewer depressive symptoms, improved coping and well-being and enhanced immune functioning (Taylor,1985;Scully,1998;Fox,1999 Paluska,2000) also contribute to greater overall health.Scientific studies on yoga Yoga has been used in the management of a wide range of diverse ailments. While there is a great deal of anecdotal evidence of the benefits of yoga, to date only a handful of scientific studies have been conducted on persons with OA and RA (though several more are currently underway). The study conducted in England demonstrated that hand grip strength significantly improved following yoga in rheumatoid arthritis patients (Haslock,1994). It was subsequently proven that yoga resulted in similar benefits in rheumatoid arthritis patients in an Indian population (Dash, 2001). Studies in osteoarthritis of the hands and carpal tunnel syndrome show greater improvement in pain during activity, tenderness and finger range of motion (Garfinkel, 1994). These above studies have shown promising results with some improvement in joint health, physical functioning, and mental/emotional well-being. Perhaps most importantly, yoga has an important positive effect on quality of life. People with arthritis may also enjoy yoga more than traditional forms of exercise, and exercise enjoyment is an important predictor of adherence(Ryan,1997;Trost,2003).This is particularly important considering that, on average, 50% of sedentary individuals will drop out of exercise within 6 months (Dishman,1990).In summary, yoga can be a meaningful and enjoyable alternative to traditional forms of exercise such as aerobics or aquatic exercise with important health benefits. Yoga can play an important role in reducing stress and frustration that results from pain and disability, and increasing positive feelings and wellbeing. Drug treatments for OA and RA have improved markedly in the last few years. Despite this, arthritis cannot be cured, and even the best medications and medical care can only help a little. There is a great need for additional activities patients can do to reduce pain, disability, and take control of the overall impact arthritis may have on their lives. Thus, the evidence suggests that, when combined with a program of good medical care, yoga may provide important additional physical and psychological health benefits for arthritis patients. Finally, it has to be emphasized that while yoga has important therapeutic benefits, the practice of yoga is very important in the promotion of positive health and human potential in body, mind, and spirit (Scott, 1999).References:1.Nagarathna R. Yoga in medicine. API Text book of medicine (6th ed), 2001. 2.Vasudeva Sharma PL. Laghu yoga vasistha (in Sanskriit); Nirnaya sagar prakashan, Bombay 1937,P 684.3.Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR et al. Guidelines for the medical management of osteoarthritis. Part II. Osteoarthritis of the knee.American College of Rheumatology. Arthritis Rheum 1995; 38(11):1541-1546.4.Newsome G. Guidelines for the management of rheumatoid arthritis: 2002 update. J Am Acad Nurse Pract 2002; 14(10):432-437.5.Minor MA. Exercise in the treatment of osteoarthritis. Rheum Dis Clin North Am 1999; 25(2):397-415, viii.6.Bearne LM, Scott DL, Hurley MV. Exercise can reverse quadriceps sensorimotor dysfunction that is associated with rheumatoid arthritis without exacerbating disease activity. Rheumatology (Oxford) 2002; 41(2):157-166.7.O’Grady M, Fletcher J, Ortiz S. Therapeutic and physical fitness exercise prescription for older adults with joint disease: an evidence-based approach. Rheum Dis Clin North Am 2000; 26(3):617-646.8.Ettinger WH, Jr., Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997; 277(1):25-31.9.Forrest G, Rynes RI. Exercise for rheumatoid arthritis. Contemp Intern Med 1994; 6(11):23-28.10.Nordemar R, Ekblom B. [Effects of long-term physical therapy in rheumatoid arthritis]. Lakartidningen 1981; 78(15):1561-1564.11.Lyngberg K, Danneskiold-Samsoe B, Halskov O. The effect of physical training on patients with rheumatoid arthritis: changes in disease activity, muscle strength and aerobic capacity. A clinically controlled minimized cross-over study. Clin Exp Rheumatol 1988; 6(3):253-260.12.Paluska SA, Schwenk TL. Physical activity and mental health: current concepts. Sports Med 2000; 29(3):167-180.13.Fox KR. The influence of physical activity on mental well-being. Public Health Nutr 1999; 2(3A):411-418.14.Scully D, Kremer J, Meade MM, Graham R, Dudgeon K. Physical exercise and psychological well being: a critical review. Br J Sports Med 1998; 32(2):111-120.15.Taylor CB, Sallis JF, Needle R. The relation of physical activity and exercise to mental health. Public Health Rep 1985; 100(2):195-202.16.Haslock I, Monro R, Nagarathna R, Nagendra HR, Raghuram NV. Measuring the effects of yoga in rheumatoid arthritis. Br J Rheumatol 1994; 33(8):787-788.17.Dash M, Telles S. Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training. Indian J Physiol Pharmacol 2001; 45(3):355-360.18.Garfinkel MS, Schumacher HR, Jr., Husain A, Levy M, Reshetar RA. Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. J Rheumatol 1994; 21(12):2341-2343.19.OConnor D, Marshall S, & Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpel tunnel syndrome. Cochrane Database Syst Rev. 2003; (1): CD003219.20.Trost SG, Sallis JF, Pate RR, Freedson PS, Taylor WC, Dowda M. Evaluating a model of parental influence on youth physical activity. Am J Prev Med 2003; 25(4):277-282.21.Ryan RM, Frederick CM, Lepes D, Rubio N, Sheldon KM. Intrinsic motivation and exercise adherence. International Journal of Sports Psychology 1997; 28(4):335-354.22.Dishman R. Determinants of participation in physical activity. In: Bouchard C, Shepard R, Stephens T, Sutton J, McPherson B, editors. Exercise, Fitness, and Health. Champaign : Human Kinetics, 1990: 75-102.23.Scott AH. Wellness works: community service health promotion groups led by occupational therapy students. Am J Occup Ther. 1999; 53(6): 566-74. About the Author
I am a Doctor, doing my Ph.D.in Yoga. My topic of interest is to conduct Yoga Retreat, take class for Yoga Teacher and Medical professionals for in depth Research findings, and also Interest to conduct research in various field of yoga, both experimental and theoretical. I have been Traveling to all EUROPIAN countries.My contact: [email protected] web page:http://www.geocities.com/manojrieneke/Research.html