Fibromyalgia: Signs, Symptoms and Home Remedies

FIBROMYALGIA

Fibromyalgia is a painful condition often associated with illness or injury. It mainly affects the muscles. The affected muscles become sore and tender to the touch. Exposure to damp and cold are frequent causes, but any injury to joints or muscles may bring in this condition. It begins suddenly, and the pain usually feels worse when the muscles are used.

People with this condition cannot sleep at night due to pain. Their muscles begin to ache at night and their sleep is disturbed on account of pain.

Normally, when people sleep, they enter the stage-four sleep, which produces deep relaxation, and their muscles naturally turn off. But people with fibromyalgia don't enter stage-four sleep. As a result, their muscles don't rest properly and they ache.

Most common symptoms of fibromyalgia are pain, tenderness of the muscles, extreme fatigue and general weakness.

HOME REMEDIES FOR FIBROMYALGIA

• Bog bean works as an anti-inflammatory, eating this herb or taking the herb in a supplement form can help in combating pain. 
• Ginger is also known for its properties in fighting joint pain and stiffness.
•  Take two teaspoons of lemon juice and a teaspoon of honey in a cup of warm water twice daily. It is highly effective for the treatment of pain. This is one of the best home remedies for fibromyalgia. 
• Half teaspoon of turmeric powder taken with warm water twice a day is also beneficial in curing Fibromyalgia 
• Drinking alfalfa tea twice daily is also helpful for the treatment of joint pains.
• Radish juice mixed with sugar is also helpful to fight with muscle pains.
•  Drinking 15 grams of fresh bathu juice daily with an empty stomach without adding any salt or sugar to it helps in reducing the symptoms of fibromyalgia. 
• A cup of papaya seed tea taken six or seven times daily for two or three weeks gives relief in the joint pains. 
• Eat porridge of 2 teaspoonfuls of winter cherry with ghee and molasses with an empty stomach for 15 days. This is very effective home remedy for Fibromyalgia. 
• A tablespoon of fruit pectin in a small glass of cranberry juice taken every morning gives relief. A person suffering from pain should eliminate sugar, white flour, macaroni, pie, cake, and sweet drinks from diet. 
• For fibromyalgia treatment, drink consisting of four raw finely sliced beets soaked in a quart of berry wine for one day. Drink one small glass of this liquid before meals, three times a day. 
• Dissolve 4 teaspoons of blackstrap molasses in one quart of cranberry juice and drink one glass everyday. This is also very effective home remedy for Fibromyalgia. 
• Two parts pure olive oil and one part kerosene makes a wonderful solution to be applied on the affected muscles. 
• For fibromyalgia treatment, add one-tablespoon cod liver oil to the juice of one orange, and drink before going to bed. 
• Rubbing the aching joints with hot vinegar before going to bed also gives relief to the pain. 
• Mix 2 tablespoons mullein, 3 of granulated slippery elm bark, one of lobelia, 1-teaspoon cayenne. Use boiling water to make paste. Spread on cloth and place on swollen joints. This is one of the useful home remedies for fibromyalgia. 
• Bake one or two egg- plants. Mash and fry in about 2 tablespoons of castor oil. Spices like cumin, coriander, turmeric, garlic and salt can be added while frying. Take once daily for two to three months for relief. 
• Another herb known as Guggulu is very helpful in curing muscle pains. If available, eat half a teaspoon twice a day after meals with warm water. ·Paste of 1 teaspoon red chilies and fresh ginger mixed in half a cup of sesame oil and strain. Gently rub this oil on the affected muscles. Camphor, wintergreen and cinnamon oils are also beneficial for external application. 
• A vegetable-juice fast significantly reduces pain for many patients with fibromyalgia. Carrot juice, celery juice, cabbage juice, or tomato juice can be used Application of hot packs and ice packs for 10 minutes also provides relief from joint pains. 
• A combination of burdock, slippery elm, sheep sorrel and Turkish rhubarb was shown good results in improving fibromyalgia.
•  Soak Spiegel seeds in water, make a paste and apply it on the joints for quick relief from pain. 
• Omega 3 fatty acids reduce inflammation of joints. Omega-3 fatty acids can be found in salmon, sardines, other oily fish, walnuts, flax, soy, olive oil, nuts, and avocados. 
• Pine-bark and grape-seed extracts are natural anti-inflammatory that help to ease pain Topical applications of cayenne (capsicum) powder mixed with wintergreen oil can help relieve muscle pain.
•  Dandelion reduces frequency and intensity of pain and strengthens the connective tissue. Take 1 tbsp. Juice or 1-cup tea twice daily for four to six weeks. This is one of the best home remedies for fibromyalgia.
•  Willow bark has anti-inflammatory properties and works as a painkiller.  

FIBROMYALGIA :

 A Description

The word fibromyalgia comes from three Latin words, fibro ("fibrous tissue"), my ("muscle tissue"), and algia ("pain"). It is a chronic condition characterized by musculoskeletal pain and many tender points, particularly in the neck, spine, shoulders, and hips. It is called a syndrome rather than a disease, because not everyone's symptomsare the same. 

Fibromyalgia afflicts between three and six million Americans, women more often than men. It often occurs in more than one member of a family, which suggests it may be an inherited disorder. Other possible causes include a virus or an injury that affects the central nervous system. Symptoms may be triggered or exacerbated by stress, anxiety, depression, poor sleep habits, or a change in the weather. For many years, fibromyalgia was thought to be a psychosomatic disorder because no one could find a definitive cause of the pain.

Signs and Symptoms

•  Chronic, widespread pain that lasts three months or more, with no clear cause, combined with tenderness in at least 11 of 18 well-defined tender point sites on the body
•  Pains, aches, and stiffness in several muscle groups, joints, and in all four quadrants of the body
•  Pain that moves from one part of the body to another, most commonly felt in the neck, chest, arms, legs, hips, and back
•  Pain that may be variously characterized as deep aching, radiating, gnawing, shooting, or burning
•  Body aches and stiffness upon awakening
•  Headaches and jaw pain
•  Disturbed sleep patterns
•  Fatigue
•  Anxiety
•  Depression
•  Digestive system difficulties, as in swallowing, alternating diarrhea and constipation, or recurring abdominal pain
•  Numbness or tingling in parts of the body
•  Increased sensitivity to bright lights, noise, odors, and various foods
•  Alternating feelings of hot and cold

Conventional Medical Treatment

Diagnosis is frustrating, because fibromyalgia mimics the symptoms of other diseases, such as Lyme disease, rheumatoid arthritis, hypothyroidism, or low-back degenerative disease. Diagnosis usually comes after these and other conditions have been investigated and dismissed. There is no known way to prevent fibromyalgia, and the symptoms can come and go, often lasting for months or years. However, the disorder leaves no permanent damage, and in most cases it eventually does subside.

A doctor may prescribe a combination of muscle relaxers, anti-inflammatory, and antidepressant drugs. The antidepressants amitriptyline (Elavil) or cyclbenzaprine hydrochloride (Flexeril) are beneficial in relieving some symptoms, but can have side effects, including weight gain, urinary retention, and morning grogginess. Other muscle relaxers and antidepressants are occasionally prescribed.

The treatment for fibromyalgia also includes a combination of healthy diet, exercise, and rest. Stationary biking, low-impact aerobics, swimming, and walking may help alleviate symptoms; slowly work up to 60 minutes of exercise 3 or 4 times per week. Warm up and cool down the muscles gradually before and after exercise, and avoid exercises that can cause joint pain. Proper sleep is also important. Experts recommend eating a wide variety of fruits and vegetables because these foods provide trace elements and minerals that help muscles. High-fiber foods help the digestive system perform its functions. Massage and physical therapy (with heat) may bring some short-term relief.

Complementary and Alternative Treatments

Nutrition and Supplementation   

When it comes to fibromyalgia, it seems more important to avoid certain food than to include particular foods in your diet. Eliminate meat, dairy products, and all other foods high in saturated fats; these fats interfere with circulation and increase pain. Likewisee avoid fried and processed foods, shellfish, whith bread, and pasta. Eliminate sugar products from your diet, as sugar in any form disturbs sleep and promotes fatigue. Avoid caffeine and alcohol as well. If you have been consuming these foods on a regular basis, you will go through a short with-drawal period where your symptoms may worsen once you eliminate them from your menu. Before long, however, you will notice improvement.

Center your diet around raw foods and fresh juices. Eat lots of vegetables, fruits, whole grains, nuts and seeds, skinless turkey or chicken, and deep-water fish. These foods provide nutrients that help energize and build immunity. It is important to flush out toxins, so drink steam distilled water and herbal teas. Eat four or five small meals daily so your body is supplied with a steady intake of proteins and carbohydrates necessary for muscle function.

Malabsorption problems are common in fibromyalgia, so all nutrients are needed in amounts greater than normal. A daily plan would include:

Most Important

•  Coenzyme (75 mg)-improves oxygenation of tissues
•  Lecithin (as directed on label)-energizes and improves circulation
•  Malic acid and magnesium (as directed on label)-assist in energy production in many cells
•  Proteolytic enzymes (as directed on label, 6 times daily)-improves the absorption of foods, especially protein
•  Vitamin A (25,000 IU for 1 month, reduce to 10,000 IU; not to exceed 8000 IU if you are pregnant)-protects the body's cells; use the emulsion form
•  Vitamin E (800 IU for 1 month, then reduce to 400 IU)-enhances immune function; use the emulsion form
•  Vitamin C with bioflavonoids (5000 to 10,000 mg)-energizes; use buffered form
•  A prodophilus formula (as directed on label)-supports intestinal function

Also Recommended

•  Vitamin B complex (as prescribed by a doctor)-energizes and increases normal brain function; injections are best
•  Free-form amino acid complex (as directed on label)-supplies protein necessary for repair and building of muscle tissue
•  Magnesium glycinate (1000 mg)-a deficiency is common in people with fibromyalgia
•  Calcium citrate or calcium lactate (2000 mg)-balances with magnesium
•  Potassium (99 mg)-aids in muscle function
•  Selenium (200 mcg) -an antioxidant
•  Zinc (50 mg, not to exceed 100 mg total from all supplements)-helps the immune system function properly
•  Melatonin (as directed on label, 2 hours or less before bedtime)-promotes sleep
•  Vanadyl sulfate (as directed on label)-protects muscles and reduces fatigue
•  L-glutamine (2 g)-supports immune system functioning.
•  Live cell therapy supplement (as directed on label) (thymus, adrenal, liver, and pancreas)-Supports glandular functions Consult your healthcare provider regarding the duration of treatment.)

Herbal Therapy

•  Since fibromyalgia presents a variety of stressing, even incapacitating, symptoms and discomforts, more than one herb is necessary for relief. try a combination of the following herbal remedies:
•  To boost blood circulation, alertness, and the immune system, use astragalus, echinacea, and ginkgo. You might also try these teas: burdock root, dandelion, and red clover. To make the teas, steep 1 to 3 teaspoons dried herb or root in 1 cup boiling water for 5 to 15 minutes; strain. Drink several cups daily. You also can brew a blend of the herbs.
•  For relief from muscular pain, use a topical application of 1 part cayenne powder and 3 parts wintergreen oil. You also can try cayenne (in capsule form) and flaxseed oil (as directed on the label, three times daily).
•  Sip skullcap or valerian root tea to improve sleep. To make the skullcap tea, steep 2 teaspoons dried leaves in 1 cup boiling water for 10 to 15 minutes; strain. To prepare the valerian tea, steep 2 teaspoons dried, chopped root in 1 cup boiling water for 8 to 12 hours; strain. Both skullcap and valerian are available in tincture form. Be aware that these herbs can cause drowsiness and should not be used to excess.
•  Grape seed extract helps to protect muscles from free radical damage. Use as directed on the product label.

Traditional Chinese Medicine

Acupuncture  

Most of the symptoms and side effects associated with fibromyalgia can be treated with acupuncture. The acupoints to be manipulated will, of course, depend entirely on the symptoms presented by the individual.

Chinese Herbal Therapy 

There are numerous Chinese herbs that can be used to treat fibromyalgia-related symptoms. Consult the entry for each specific ailment ("Headache," "PMS," etc.) for detailed information or recommended herbs.

 Formulas often used for fibromyalgia muscle pain are Corydalis Formula, Ginseng and Tang Gui Ten, Ginseng and Atractylodes, Peony and Licorice, and Tian Qi and Eucommia.

  

Reference:

Eating Well for Optimum Health by Andrew Weil.

Clifford R. Anderson, M.D. : Your Guide To Health. Second edition.

The best alternative medicine: what works? What does not? Kenneth R. Pelletier. Simon & Schuster Fireside.

Green pharmacy herbal handbook: Your comprehensive reference to the best herbs for healing. James Duke. Rodale, 2000.

IMPACTED WISDOM TEETH

Symptoms, Causes, Risk Factors, Tests & Diagnosis, Complications,Treatments & Drugs and Coping & Support for

IMPACTED WISDOM TEETH - Akal Dant

Definition

Wisdom teeth that become impacted can cause a variety of problems, from nuisance pain to serious dental disorders. Impacted wisdom teeth often must be surgically removed.

Wisdom teeth are your third molars that are way in the back of your mouth. You usually have four wisdom teeth, one in each corner of your mouth - two on top, two on bottom. Wisdom teeth are the last of your teeth to come in, or erupt through the gums. They normally emerge between ages 17 and 25.

Wisdom teeth often aren't able to emerge normally and instead become impacted, or trapped within your jaw. Understanding more about impacted wisdom teeth can help you decide how and when to treat them and how to prevent related complications.

Symptoms

You may never experience problems with your wisdom teeth. They may emerge normally and be trouble-free for the rest of your life. Or, you may have impacted wisdom teeth but remain blissfully unaware, since they don't always cause signs and symptoms.

Common signs and symptoms of impacted wisdom teeth include:

• Pain or tenderness around your gums
  
• Swelling around your jaw
  
• Red or swollen gums around the impacted tooth
  
• Jaw pain
  
• Bad breath
  
• Unpleasant taste when biting down on or near the area
  
• Prolonged headache or jaw ache

Causes

Early humans needed wisdom teeth and larger jaws to handle a tougher diet. Today's humans typically have smaller jaws and little use for wisdom teeth. That often means problems as your wisdom teeth begin to emerge. Having pesky wisdom teeth surgically extracted seems almost a rite of passage for teens and young adults.

Wisdom teeth develop like your other teeth. But they take the longest to develop and are the last teeth to emerge. Any tooth can become impacted. Because wisdom teeth must fight for space with teeth that have already emerged, they're the teeth most likely to become impacted.

At about age 9, the crown of a wisdom tooth begins to form in a small sac inside your jaw. Over time, the tooth grows and the roots become more firmly planted in the jawbone. By your early 20s, the crown of a wisdom tooth should fully emerge from your gum. By your 40s, the roots of your wisdom teeth are solidly planted within the dense bone of the jaw.

But wisdom teeth often don't follow this normal development pattern. Today's smaller jaws simply may not have room for this last set of molars to grow properly. So the wisdom teeth may become impacted.

The cramped wisdom teeth struggle for a path to grow and emerge. They grow at various angles in the jaw, sometimes even horizontally. Sometimes, a wisdom tooth partially emerges through the gums. Other times, it remains completely hidden.

Risk factors

Having a small jawbone may make you more prone to having impacted wisdom teeth. But otherwise, there are no particular biological or environmental risk factors that make you more likely than someone else to have impacted wisdom teeth.

When to seek medical advice

If you notice pain or swelling in your mouth, teeth, gums or jaw, contact your dentist right away. Also contact your dentist if you notice any changes in your teeth, such as shifting of position, discoloration or changes in sensitivity.

Tests and diagnosis

Your dentist can evaluate your teeth and mouth to determine if you have impacted wisdom teeth or if another condition is causing your problems. Such evaluations typically include:

• Your dental and medical history
  
• A dental exam
  
• Dental X-rays

Complications

Impacted wisdom teeth that aren't removed can cause numerous problems. These problems include:

• Gum disease. Bacteria and food can become trapped under a flap of gum that can grow over wisdom teeth, creating infections. Gum disease may be initially mild (gingivitis) or progress to a more severe form (periodontitis) .

• Crowding. A wisdom tooth can push on other teeth, damaging them or moving them out of position.

• Decay. Because they're hard to reach, wisdom teeth may not get fully cleaned during brushing, making them vulnerable to decay and cavities.
• 
  Cysts. The crown of a wisdom tooth grows in a sac. If the sac remains in the jawbone, it can fill with fluid, forming a cyst that can damage the jawbone, teeth and nerves. Very rarely a tumor, usually benign, also may develop, which may require removal of tissue and bone.

Treatments and drugs

Impacted wisdom teeth don't always need to be surgically removed. You have two main treatment options, depending on the severity of your situation and other factors. They are:

• Conservative treatment
  
• Surgical extraction

Conservative treatment

If impacted widsom teeth aren't causing problems, you and your dentist may choose to simply monitor them. People who can't have their teeth removed because of certain health problems such as a bleeding disorder also need to choose conservative treatment.

Under guidance from your dentist or oral surgeon, you may be able to care for your impacted wisdom teeth and minor problems using mouthwashes, saltwater rinses and over-the-counter pain relievers. If complications arise or worsen, surgery might become an option.

Surgical extraction

Experts agree that when an impacted wisdom tooth causes complications, it should be extracted to prevent further problems.

Some experts say that impacted wisdom teeth should always be removed, even if they aren't causing problems. The belief is that the impacted tooth will eventually cause problems, and that it's better to remove it when someone is younger and more likely to recover faster from surgery. This is why many teenagers or young adults have their wisdom teeth extracted even before the teeth start causing problems. In addition, if a child might require braces, his or her dentist may recommend extraction of the wisdom teeth first.

There's no scientific evidence to recommend for or against extracting impacted wisdom teeth in adults or adolescents if the teeth aren't causing complications. You and your dentist can evaluate your situation to see which treatment option is best for you or your child.

Extracting an impacted wisdom tooth

Extraction of impacted wisdom teeth often can be done in your dentist's office with local anesthesia. However, if the tooth is deeply impacted or if the extraction may be difficult, your dentist may suggest that you consult with an oral surgeon. Sometimes extractions are done in the hospital. You may need general anesthesia for more complicated extractions.

To reach the impacted tooth, an incision is made in your gum. The incision creates a flap of gum, which can be peeled back to expose the impacted tooth and jawbone.

An impacted wisdom tooth that has partially emerged may be removed with forceps. But if the tooth is fully impacted or if the roots reach deep into the jawbone, the tooth may have to be broken into pieces for removal. In more severe cases, portions of jawbone may be removed.

You may need stitches to close the gap in your gum. The socket where your tooth was located is packed with gauze to control bleeding and to help a clot form, which promotes healing.

Care after surgery

Your dentist or oral surgeon gives you specific instructions about caring for your mouth after extraction of an impacted wisdom tooth. Here are general tips about care after oral surgery:

• Activity. Plan to rest for the remainder of the day after surgery. Limit strenuous physical activities. If you are a smoker, don't smoke for at least the first 24 hours after surgery, as doing this may disrupt the blood clot in the socket.

• Diet. Drink lots of clear liquids and eat only soft foods for the first 12 hours. If you had several teeth removed, stick to a diet of soft foods for the first few days. Don't use straws, as doing so can dislodge the clot that forms in the tooth socket. Avoid hard or crunchy foods, such as popcorn, for two weeks after surgery.
• 
  Pain management. If your pain is severe you may need a prescription pain medication during the first few days after surgery. Or you may find that you can manage your pain with over-the-counter pain relievers. Applying ice packs — a bag of frozen peas or corn works nicely — also may help control pain, as well as swelling.

• Bleeding. Some oozing of blood is normal for the first day after removal of your impacted wisdom tooth. Swallow blood-tinged saliva instead of spitting it out, to avoid dislodging the socket clot. Get instructions from your dentist or surgeon about replacing the gauze packing. Remember that when blood mixes with saliva, the amount of blood loss can look worse than it actually is.

• Swelling and bruising. Swelling of your cheeks and jaw is normal after surgery. You can use ice packs to help control swelling. Swelling normally begins to subside by the third day. Some dentists give an injection of a steroid during the surgery to help minimize swelling. Swelling may make it a bit difficult to open your mouth fully, but this normally improves on its own. You may also have some bruising around your jaw or upper neck.

• Cleaning your mouth. The day after surgery, rinse your mouth gently with warm salt water at least six times a day. Mix 1/2 teaspoon (2.5 milliliters) of table salt in 8 ounces (237 milliliters) of water. Brush your teeth, but be very gentle in the area around your surgery.

Complications of extraction

Recovery after the removal of impacted wisdom teeth is usually quick and without problem. However, complications can arise. Your dentist or surgeon will advise you about signs and symptoms to watch for, such as fever and increasing pain.

Other complications can include:

• Numbness, usually temporary, of your teeth, gums, tongue and chin
  
• Dry socket when the socket clot dislodges, exposing underlying bone
  
• Infection from bacteria or trapped food particles
  
• Sinus problems if teeth near the sinuses were removed
  
• Weakening of the jawbone from bone removal or damage

Coping and support

A visit to the dentist may cause so much anxiety that you can't get yourself to go, despite the pain you're experiencing. The thought of having a tooth extracted may be overwhelming. But if you're having problems related to an impacted wisdom tooth, delaying care could lead to serious and permanent problems.

Make sure you have a dentist who is sympathetic and willing to help relieve your fears. Talk to your dentist about your concerns. Don't be embarrassed about your anxiety — it's common, especially when you must have a dental procedure that can be uncomfortable.

Many dentists offer ways to ease your anxiety, such as listening to music or watching videos. You may be able to bring along a supportive family member or friend. You can also learn relaxation techniques, such as deep breathing and imagery. If you have severe anxiety, talk to your doctor about medications that may help. And of course, you may be able to opt for full sedation during the procedure itself, so you're unconscious through it all.

WRIST PAIN

Symptoms, Causes, Risk Factors, Tests and diagnosis , Complications, Treatments and drugs AND Prevention

Definition

Chopping vegetables, angling for trout, falling during an athletic activity — there's practically no end to the ways you can hurt your wrists. In fact, hand pain and wrist pain are among the most common musculoskeletal complaints that doctors see.

The causes of wrist pain can range from repetitive stress injuries to sprains, fractures and diseases such as arthritis. Because so many factors can lead to wrist pain, and because the wrist is a complex structure, diagnosing the exact cause of long-standing wrist pain can be difficult.

For most people, wrist pain can be diagnosed and treated. The type of care depends on the cause and severity of the wrist pain.

Symptoms

The signs and symptoms of wrist pain vary by the type of wrist pain you have.

Ligament sprains and tears

A sprain is an injury to a ligament — the fibrous tissue that connects bones. Ligaments are composed of a number of individual fibers, and the degree of injury depends on how many of the fibers are damaged and whether they're completely torn or just pulled apart. A mild sprain will generally cause minor discomfort and swelling, whereas a severe injury or complete tear can lead to:

• Significant pain and swelling that becomes worse with use
  
• Bruising
  
• Inability to use your wrist normally
  
• A painful popping or clicking

Tendinitis

Tendons are thick, fibrous cords that attach muscles to bone. Tendinitis, which occurs when tendons become inflamed or irritated, can cause the following symptoms just outside the affected joint:

• Pain
  
• Mild swelling

Though tendinitis is most common in your shoulders, elbows and knees, it can also affect your hips and wrists.

Fractures

Because the bones in the wrist are small and intricately arranged, they're prone to fractures. Though a broken wrist bone is usually quite painful, it's possible to have a fracture and not realize it. In addition to pain, symptoms may include:

• Swelling
  
• Discolored skin
  
• Limited ability to move your wrist
  
• A deformed or crooked wrist, sometimes with the bone protruding through the skin

Repetitive strain injuries

Any repetitive motion can stress and inflame your joints or worsen an existing injury, especially when done forcefully and for long periods of time without rest. Such motions can range from assembly line work to hitting a golf or tennis ball or typing on a computer. Repetitive strain injuries cause the following symptoms in muscles, joints, tendons and nerves:

• Pain
  
• Inflammation
  
• Dysfunction (sometimes)

Carpal tunnel syndrome

One of the most highly publicized wrist injuries, carpal tunnel syndrome occurs when the median nerve is compressed as it passes through a narrow passageway (carpal tunnel) in your wrist. Symptoms may include:

• Tingling or numbness in your hand or fingers, especially when you're holding a cup, driving a car or reading a newspaper
  
• Pain radiating or extending from your wrist up your arm to your shoulder or down into your palm or fingers, particularly after forceful or repetitive use
  
• A sense of weakness in your hands and a tendency to drop objects
  
• Chronic loss of feeling in some fingers in advanced cases

Osteoarthritis

Osteoarthritis is the breakdown of cartilage that cushions the bones in your joints. Over time, the loss of cartilage can cause:

• Joint pain, swelling and stiffness
  
• Limited motion and weakness in your wrist joint

Rheumatoid arthritis

Unlike osteoarthritis, rheumatoid arthritis is a systemic disease that can cause problems throughout your body. It usually starts in small joints in your hand and wrist, leading to:

• Joint pain and swelling
  
• Loss of motion and strength in the affected joint
  
• Joint deformity
  
• Fatigue and a general feeling of being unwell

Causes

Your wrist is a complex joint made up of eight small bones (carpal bones) arranged in two rows between the bones in your forearm (radius and ulna) and the metacarpal bones in your hand. Tough bands of ligament connect the carpal bones to each other and to the forearm bones and metacarpals. Damage to your ligaments, bones or the cartilage that cushions your joints can cause pain and affect your ability to use your wrist and hand.

Common causes of wrist injury and pain include:

• Ligament sprains and tears. Most ligament sprains or tears result from the kind of high-impact injuries that happen when you fall forward onto your outstretched hand. They can also occur when you push a heavy object or brace yourself against the car dashboard during a sudden stop or collision. The ligament that's most often torn is the scapholunate ligament, which connects the scaphoid bone, on the thumb side of your wrist, to the neighboring lunate bone.

• Cartilage tears. The triangular fibrocartilage complex (TFCC) is a small piece of cartilage and ligaments on the small-finger side of your wrist, just below the ulna. The TFCC can tear when you fall on your outstretched hand, swing a bat or racket, or twist your wrist sharply.

• Fractures. The bones in your wrist can break for many reasons, but they're most likely to fracture when you land on your outstretched hand in an accident; fall from a roof or ladder; are in a car collision; or receive a direct blow to your wrist. But the same injury may not break the same bone in every person. For instance, teens tend to have growth plate fractures — a break in a part of the bone that's still growing — whereas adults who fall the same way might break the scaphoid bone on the thumb side of the wrist.

• Repetitive strain injuries. Any activity that involves a repetitive motion — from hitting a tennis ball or bowing a cello to driving cross-country — can inflame the joints in your wrist, especially when you perform the movement for hours on end without a break.

• Carpal tunnel syndrome. Carpal tunnel syndrome develops when there's increased pressure on the median nerve, which passes through the carpal tunnel, a passageway in your wrist. Studies have failed to pinpoint the exact cause of carpal tunnel syndrome, though they have ruled out the commonly held notion that typing on a computer is to blame. Several studies have found no relationship between using a computer up to seven hours a day and a risk of carpal tunnel.

• Osteoarthritis. In osteoarthritis, the problem lies in the cartilage that cushions the ends of bones in your joints. Over time, the cartilage deteriorates and its smooth surface roughens. If the cartilage wears down completely, you may be left with bone rubbing on bone — damaging the ends of the bones and causing pain in the joint. Arthritis that affects the metacarpal-carpal joint in the thumb is particularly common.

• Rheumatoid arthritis. Some researchers suspect that rheumatoid arthritis is triggered by an infection — possibly a virus or bacterium — in people with an inherited susceptibility. Although the disease itself is not inherited, certain genes that create an increased susceptibility are. People who have inherited these genes won't necessarily develop rheumatoid arthritis. But they may have more of a tendency to do so than others. The severity of their disease may also depend on the genes inherited. Some researchers also believe that hormones may be involved in the development of rheumatoid arthritis.

• Kienbock's disease. Like all living tissues, your bones require a constant supply of blood for nourishment. In Kienbock's disease, the blood supply to the lunate bone is cut off, and the bone slowly dies. The exact cause isn't known, though it may begin with a fall or a series of injuries to the hand or wrist. Kienbock's is often overlooked because its initial symptoms resemble those of a ligament strain. Untreated Kienbock's can lead to arthritis and disability.

• Other diseases. Most wrist pain comes from arthritis or an injury to your wrist joint, but certain systemic diseases can also affect the bones and tissues in your wrist. These include diabetes, gout, Paget's disease, leukemia, scleroderma and lupus erythematosus.

Risk factors

You're a candidate for wrist pain whether you're very sedentary, very active or fall somewhere in between. Still, certain factors can make you more prone to wrist problems, including:

• Certain sports. Professional and amateur athletes of all sorts — basketball, football, hockey and tennis players, pitchers, and golfers — are prone to wrist injuries. But wrist problems are also showing up in more children and teens, especially those who snowboard, rollerblade and skateboard. According to some estimates, nearly 80 percent of young gymnasts have chronic wrist pain.

• Age. Older adults are more likely to have osteoporosis, which makes bones brittle and more susceptible to fractures, than younger people are. They're also more likely to fall and to develop arthritis.

• Repetitive work. Almost any activity that involves your hands and wrists — even knitting and cutting hair — if performed forcefully enough and often enough can lead to disabling wrist pain.

• Pregnancy. Some women develop carpal tunnel in the second and third trimesters of pregnancy because of hormonal changes. Shifts in the balance of estrogen and progesterone cause the body to retain more fluid, which increases swelling in the carpal tunnel.

When to seek medical advice

Not all wrist pain requires medical care. Minor strains, for instance, usually respond to ice, rest and over-the-counter anti-inflammatory medications. But if pain and swelling last longer than a few days or become worse, see your doctor. Delays in diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.

Get emergency care if your pain is severe, your wrist looks misshapen or bone protrudes through your skin. An exposed bone can lead to a life-threatening infection if not treated promptly.

Tests and diagnosis

Some wrist injuries can be diagnosed with a medical history and careful examination of the painful area. For example, your doctor can often detect an injury to a ligament simply by examining your hand. Ligament injuries don't always show up on imaging tests.

In other cases, though, you may need further tests. These may include X-rays, sometimes using a contrast material (arthrogram) , or more detailed images from a computerized tomography (CT) scan or magnetic resonance imaging (MRI). If the results are still inconclusive, your doctor may perform an arthroscopy, a procedure used both to diagnose and treat joint problems.

Different tests may be needed to evaluate the degree of carpal tunnel syndrome, including:

• Electromyogram. This test measures the tiny electrical discharges produced in your muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when you're at rest and when the muscle is contracted.

• Nerve conduction study. In this variation of electromyography, a small shock is passed through the median nerve to see if electrical impulses are slowed in the region of the carpal tunnel.

Complications

Wrist injuries can sometimes lead to long-term problems, including:

• Ongoing stiffness, aching, numbness or disability. You may have ongoing stiffness, pain or aching even after your injury has healed. These problems sometimes go away, but they may be permanent if your injury was severe. You may also have some deformity in your wrist or limited range of motion. Be sure to talk to your doctor about exercises that might help prevent some of these problems.

• Arthritis. Fractures that extend into the joint can cause arthritis years later. If your wrist or hand starts to hurt long after a break, see your doctor for an evaluation.

• Poor healing. Some wrist fractures — such as scaphoid fractures — may take longer to heal because of poor blood supply to this part of your body or because treatment wasn't started quickly enough. Not immobilizing the fracture properly can also delay healing. And fractures are less likely to heal if you smoke.

• Bone death. Because the scaphoid and capitate bones both have poor blood supplies, they're especially prone to avascular necrosis, which occurs when a lack of blood causes the bone to deteriorate and die.

• Nerve or blood vessel damage. Trauma to your wrist can injure adjacent nerves and blood vessels. Seek immediate care if you notice any numbness or circulation problems.

Treatments and drugs

Treatments for wrist problems vary greatly, depending on the type, location and severity of the injury, as well as on your age and overall health.

Ligament sprains and tears

Minor sprains generally heal on their own with ice, rest and anti-inflammatory medications. More severe sprains or ligament tears may need:

• Splinting. Torn ligaments may be splinted for three to six weeks to allow them time to heal.
  
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  Surgery. When the ligament is torn and the joints no longer line up, your doctor may suggest surgery to either repair the ligament or pin the bones together to improve alignment while the ligament heals.
  
  
  If a great deal of time has passed since the initial injury, the ligament may need to be replaced with a tendon graft that's usually taken from the same wrist. In cases of long-standing instability or arthritis, two or more wrist bones may be fused together to stabilize the motion between the bones and reduce pain.

Cartilage tears

You can treat some cartilage injuries yourself with rest, ice and anti-inflammatory drugs, but complete tears may need to be surgically repaired. This can usually be done using local anesthetics, small incisions and a fiberoptic scope fitted with a tiny camera and surgical instruments.

Fractures

If you have a broken wrist bone that's properly aligned, you may wear a cast for six weeks to three months or more. You'll have regular X-rays to monitor your progress. If the bone doesn't seem to be healing, your doctor may recommend wearing an electrical stimulator, which looks something like a large bracelet, to encourage the bone to heal.

Other options include:

• Screw fixation. In this procedure, a screw is inserted through the broken bone to help hold it in place. Your doctor may suggest screw fixation instead of a cast because it can lead to a faster recovery and less downtime.

• Removal of dead tissue (debridement) . If your bone doesn't heal even after casting and electrical stimulation, your doctor is likely to suggest surgery. One approach is to remove the old scar tissue between the two halves of the broken bone — a procedure called debridement — which allows the fresh surfaces to try healing again.

• Bone graft. A graft involves using bone tissue from another site in your body or a graft substitute and placing it in the fracture to stimulate healing. A metal pin or screw may be inserted to hold the graft in place. Though minimally invasive procedures can hasten healing and minimize scarring, they still pose certain risks, such as damage to nearby blood vessels.

Repetitive strain injuries

For mild to moderate symptoms of carpal tunnel syndrome and other repetitive strain injuries, your doctor may suggest:

• Wrist splinting. A splint that immobilizes your wrist while you sleep may relieve minor numbness and tingling.

• Nonsteroidal anti-inflammatory drugs (NSAIDS). Over-the-counter pain relievers such as ibuprofen (Motrin, Advil, others) and acetaminophen (Tylenol, others) may help reduce pain from repetitive strain injuries caused by inflammation.

• Corticosteroids. Your doctor may inject the carpal tunnel with cortisone to relieve the pressure on the median nerve.

When pain and numbness are more severe and splinting doesn't reduce your symptoms, surgery may be the best option. Several procedures are used, but all involve cutting the transverse carpal ligament (flexor retinaculum) that's compressing the nerve.

Surgery usually causes marked improvement, but it can take several weeks or months until you have full use of your hand and wrist, and you may have residual numbness, pain, stiffness or weakness. Be sure to discuss all possible outcomes with your doctor before your surgery.

Prevention

It's impossible to prevent the unforeseen events that often cause wrist injuries, but these basic tips may offer some protection:

• Build bone strength. Getting adequate amounts of calcium — at least 1,500 milligrams a day for adults — and vitamin D can help prevent fractures.

• Prevent falls. Falling forward onto an outstretched hand is the main cause of most wrist injuries. To help prevent falls, wear sensible shoes. Remove home hazards. Light up your living space. And install grab bars in your bathroom and handrails on your stairways, if necessary.

• Use protective gear for athletic activities. Wear wrist guards for high-risk activities, such as football, snowboarding and rollerblading. If you're new to extreme sports, consider getting professional instruction, and know your limits.

• Pay attention to ergonomics. The market is flooded with devices such as ergonomic chairs, keyboards and mice that claim to take the stress off your wrists when you're at the office. Using some of these devices, taking regular breaks, keeping your wrists in a relaxed, middle position when you type, and improving your posture can make you more comfortable and help protect your wrists.

Neck Pain

Tips to Get the Kinks Out

Maybe you have a boss, or a brother-in-law, whom you describe as a pain in the neck. But when it comes to neck pain, the blame—as well as the pain—is probably resting on your shoulders.

"It's keeping your head in an awkward position—that is, pushed forward with your ears in front of your shoulders—for a long time that makes your neck hurt. "That's what many people who have neck problems are doing."

Naturally, some people—because of their occupations—are more at risk than others. "Beauticians, for example, work in a bent-over position all day long".

Regardless of your job or lifestyle, you can rid yourself of blame—and more importantly, pain—by applying a few time-tested methods, replacing bad habits with good ones, and giving your neck regular exercise. So keep your head up and your eyes open. Help is on the way.

Ice down. An ice pack or ice wrapped in a towel is a good choice when stiffness is just settling in. If your neck has been slightly injured, ice can help hold down swelling.

Heat up. After ice has reduced any inflammation, heat is a wonderful soother—be it from a heating pad or a hot shower.

Use a heat rub. These over-the-counter ointments are soothing but have no real healing effect because they don't really penetrate the skin's surface. Never use them with heating pads. At best they provide "psychological benefit."

Exercise Away Neck Pain

Yes, even your neck muscles need to be stretched and strengthened. Here are some exercises to combat stiffness and prevent problems in the future. Do each five times twice a day. Do the first three exercises for two weeks before starting the rest.

• Slowly tilt your head forward as far as possible. Then move your head backward as far as possible.
  
• Tilt your head toward your shoulder, while keeping your shoulder stationary. Straighten, then lean toward the other shoulder.
  
• Slowly turn your head from side to side as far as possible.
  
• Place your hand on one side of your head while you push toward it with your head. Hold for 5 seconds, then relax. Repeat three times. Then do the same exercise on the other side.
  
• Do basically the same exercise as above, only provide slight resistance to the front of your head while you push your head forward. Then provide slight resistance to the back of your head while you push your head backward.
  
• Hold light weights—say 3 to 5 pounds—in your hands while shrugging your shoulders. Keep your arms straight.

Take the old standby. Over-the-counter anti-inflammatories such as aspirin or ibuprofen will help reduce pain and inflammation. Take two pills three or four times a day.

Sit in a firm chair. Like the song says, the backbone is connected to the neck bone. And if you sit in a chair that doesn't give you good back support, you increase your chances of worsening existing neck problems and causing new ones.

Throw in the towel. Actually, roll a towel up and place it against the small of your back when sitting—it will better align your spine and give you additional support.

Take a break. Just as the feet need rest from constant standing, the neck needs a rest from constant sitting. Your head weighs approximately 8 pounds, and that's a lot of weight for the neck to support without much help from the rest of your body. So periodically stand up and walk around.

Keep your chin up. Keep your head level but pull your chin in as if you were making a double chin. Also avoid having your head lowered all the time when working at a desk or reading. This will prevent stressing the muscles in the back of the neck.

See eye to screen. If you work with a video display terminal all day, it's important to have it positioned at eye level. If you force yourself to look up or down hour after hour, you may cause your neck to spasm.

Reach out. And consider putting down the telephone. If you talk on the phone a lot, especially while trying to write, you've got your neck in an awkward position—an invitation to stiffness and pain.

Lift carefully. It's all too easy to forget there's a right way and a wrong way to lift heavy objects. The right way is to bend your knees and hold your spine erect while positioning the object between your feet, which should be shoulder-width apart. When you lift the object, keep it as close to your body as possible.

Sleep on a firm mattress. A lot of neck problems begin, and worsen, with poor sleeping habits. Having a firm mattress is important.

Don't fight with your pillow. Just toss it aside. "A lot of people with neck pain feel better sleeping flat—without a pillow".

MEDICAL ALERT

Whiplash needs a Doctor's Care

If you have been in an auto accident and have severe neck pain afterward, you may have whiplash and should see a doctor. In the meantime treating with ice instead of heat because heat could inflame the injured area.

As a general rule, persistent neck pain warrants professional medical evaluation. "It's extremely remote, but it's possible that neck pain could be a signal that there's a tumor on the spine".

Or get a cervical pillow. These pillows, which can be bought for a little amount, give the neck a proper support.

Don't sleep on your stomach. This is not only bad for your back, but your neck, too.

Sleep like a baby. In other words, sleep in the fetal position—on your side with your knees up toward your chest.

Wrap up. When it's cold and damp outside, you probably wear a hat. But you should cover your neck as well. The weather can aggravate neck stiffness and pain.

Relax. Just being tense can tighten the muscles in your neck and put you in pain. If you're under a lot of pressure or feel tense a lot, learning relaxation techniques, such as meditation or progressive relaxation, can help. Also, audiotapes are available to teach you how to relax.