Aspirin - Acetylsalicylic Acid
Developed by German chemist Felix Hoffmann in 1897, acetylsalicylic acid or Aspirin as it is popularly known is a safe and effective treatment for many an ailment ranging from moderate fever to swelling or even blood clotting. This over-the-counter medication is probably one of the widest selling drugs.
Aspirin is used to treat headache, migraine, muscular pain, neuralgia and sore throat. Aspirin or acetylsalicylic acid has anti-coagulant properties as well as analgesic and antipyretic properties. This drug is a NSAID - non steroidal anti inflammatory drug. Prostaglandins - a family of chemicals are produced within the body's cells by the enzyme cyclo oxygenase (COX). Further there are 2 kinds of COX enzymes - COX 1 and COX 2 which produce prostaglandins which in turn promote pain, inflammation and fever. Nonsteroidal anti inflammatory drugs - NSAIDS act by blocking the COX enzymes and reduce prostaglandins thereby reducing the pain, fever and inflammation. In this process of reducing the prostaglandins, NSAIDS promote bleeding and may contribute to stomach ulcers. Aspirin is an unique NSAID in the sense that it inhibits clotting of blood for prolonged period - up to 4 to 7 days. It is used to reduce temperature and is commonly recommended for pain relief as in the case of dental pain. Aspirin works as a pain reliever by working on the sensitivity of the nerves both at the site of the pain as well as the central nervous system. FDA has approved the use of aspirin in the following conditions:
Heart conditions : The FDA has approved the use of aspirin to reduce the risk of fatality in the event of a heart attack. Aspirin taken during a suspected heart attack can also lessen the damaging effects of the heart attack. Persons who have already suffered a heart attack or unstable angina are put on a course of aspirin to reduce the risk of another heart attack. Aspirin is also recommended for use in people who have suffered transient ischemic attack (TIA or mini-stroke). FDA has endorsed the use of low dose aspirin (75 and 325 mg) for lowering the risk of heart attack and strokes. Aspirin helps in improving blood flow through narrowed blood vessels.
Side Effects of Aspirin: Side effects from aspirin are relatively rare. If you are prone to heartburn or indigestion, ensure that you take aspirin after food. Some people experience rashes or vomiting or stomach pain. Rarely are side effects such as ringing in the ears, dizziness or mental confusion noticed. In such a case, consult a doctor immediately.
Contraindications: Aspirin must not be taken on an empty stomach. Persons suffering from peptic ulcer must consult the doctor for the recommended dosage. Aspirin must not be taken along with alcohol. Aspirin and other salicylates should not be taken during the last 3 months of pregnancy or while breast-feeding. It is essential to keep the doctor informed if you are allergic to aspirin If you are taking medications for high blood pressure, diabetes or any anticoagulants, you must inform your physician before he prescribes aspirin.
Rheumatologist
Rheumatologist is a specialist who specializes in the diagnosis and treatment of arthritis and diseases of the joint, bones, and muscles. Rheumatologists complete medical school, complete another three years training in internal medicine and thereafter complete another three years in rheumatology training.
Modern techniques in the field of rheumatology
Treatment for rheumatology has seen a drastic change for the past few years, modern techniques used in the field of rheumatology include
- Using non-steroidal anti-inflammatory drugs (NSAID).
- Disease-modifying anti-rheumatic drugs (DMAR) are also prescribed along with NSAID to treat severe conditions of rheumatology.
- Early treatment helps in pain management and easy recovery from pain.
Chondromalacia
Chondromalacia can be defined as the degeneration of the cartilage in the knees. A chondromalacia patella is the softening of the cartilage underneath the patella or kneecap. Generally it is described as a pain beneath or the sides of the kneecap. Chondromalacia is often called Patellofemoral stress syndrome. When softening occurs, the cartilage breaks down causing irregularities along the under surface of the kneecap. Chondromalacia is caused by muscle imbalance like weak quadriceps and strong hamstrings. Excessive pronation as is the case when an arch collapses too much thereby causing the knee cap to twist sideways can also be a source for chondromalacia.
Chondromalacia occurs when the articular cartilage breaks down due to wear and tear process in the body. The patella cartilage is one of the earliest places in the body where cartilage breakdown can occur. This leads to degenerative arthritis or osteoarthritis in the knee joint. Chondromalacia also occurs frequently due to overuse and related trauma. Referred to as runner's knee, chondromalacia occurs in part time athletes and in professional sports person who trains more than usual. Due to overuse cartilage tear occurs and the knee starts giving way. Nagging injuries is also a common cause of chondromalacia in sports persons. Symptoms of Chondromalacia include pain in front of the knee around the kneecap as well as deep-seated pain in the back of the knee. There may be pain on squatting or kneeling. The knees might be tender and there may be swelling around the knee joints. In severe cases of chondromalacia a grating or grinding sensation of the bone are heard when the knee is extended.
After ascertaining the clinical history and a physical examination, the physician orders for x-ray of the knee. Even if the x rays are normal, a special x ray view of the patella view or 'sunrise' view shows the patella displacement or tilted laterally and the muscle (vastus lateralis) looks too tight or over powering.
In most cases of chondromalacia, exercises with or without formal physical therapy are enough to correct the problem. Physicians prescribe physical therapy if the pain persists. Icing an injured body part is an important part of the acute treatment process for Chondromalacia. A physician prescribes NSAID for chondromalacia to reduce pain and swelling. Sports medicine therapists often prescribe knee brace for patients who want to stay active in sports. This brace is known as a patella stabilizing brace. If the pain worsens, surgical treatment is suggested. Arthroscopic surgery is a common orthopedic procedure for diagnosing and treating chondromalacia.
- Trauma and abnormal stress to the knee should be avoided.
- The leg muscles, especially the quadriceps and hamstrings should be maintained strong and flexible.
- Participation in sports and strenuous activities should be limited until the pain has gone away. Activities that increase the knee pain such as knee bends, should be avoided until the pain improves.
- Girls may develop this problem of chondromalacia patellae depending on the morphology. Tall and knock-kneed teenagers are more prone to develop chondromalacia especially if they have tightness of lateral muscles.
Bibliography / Reference
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