Rheumatoid Arthritis
Painful, stiff joints are the primary symptoms of rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease resulting in chronic inflammation of the joints. More than one joint is usually affected. Women are more predisposed to contracting rheumatoid arthritis. It usually sets in when a person is between 40 - 60 years. The exact reason for the autoimmune system attack is not known. This condition is heriditary and can be brought about by environmental and hormonal factors. Tissues around the joint become inflamed in a rheumatoid arthritic condition. During an attack of rheumatoid arthritis, symptoms such as fatigue, lack of appetite, low grade fever and joint stiffness are noticed. The symptoms are most notable in the morning or after long periods of inactivity. These attacks come and go.
Rheumatoid arthritis is a progressive disease that can lead to joint destruction and functional disability. Multiple joints including small joints of the hands and wrist are often affected. Rheumatoid arthritis can be extremely debilitating, thereby making simple chores painful. In fact, rheumatoid arthritis can even affect the salivary glands, tear glands and heart and lungs.
A rheumatologist will diagnose the condition based on blood test, x-rays and physical examination. The joints are examined for inflammation and deformity and presence of rheumatoid nodules. In persons suffering from rheumatoid arthritis, blood antibodies such as citrulline are noticed. Arthrocentesis or extraction of joint fluid is also conducted. There is no known cure for rhematoid arthritis. Medication is prescribed to relieve joint inflammation and prevention deformation of the joints. First-line drugs like corticosteroids or aspirin are used to reduce pain and inflammation whereas second-line drugs such as methotrexate and hydroxychloroquine are prescribed for preventing progressive joint destruction. An exercise regimen may need to be followed for preventing work disability and strenghtening the joints.
Carpal tunnel syndrome
CTS) is a condition that affects the hand and the wrist. It can result from injury to the wrist - dislocated or broken wrist bones or sprains. Carpal Tunnel Syndrome can also be caused by diabetes, rheumatoid arthritis or thyroid disease. Those who are at increased risk are computer users, violinists, golfers, meat packers, assembly line workers, hair stylists and mechanics since they perform the same hand movements repeatedly.
The median nerve controls some of the muscles that move the thumb. It also provides sensations of temperature, pain and touch from the hand to the brain as well as sweating of the hand. CTS results when the tunnel walls are compressed, thereby putting pressure on the nerve. Carpal tunnel syndrome is particularly associated with tasks that involve:
Repeated wrist movement
Awkward hand positions
Strong gripping
Stress on the palm
Use of vibrating tools
Lubrication is essential for the normal and smooth functioning of the tendons. With excessive or repetitive activity on the carpal tunnel, the lubrication system may malfunction. It may not produce enough fluid or it may produce a fluid with poor lubricating qualities. This failure creates friction between the tendon and its sheath causing inflammation and swelling of the tendon area.
The swelling squeezes the median nerve in the wrist or carpal tunnel. Repeated episodes of inflammation cause fibrous tissue to form. The fibrous tissue thickens the tendon sheath and hinders tendon movement. This makes moving of the wrist or the hand painful.
Symptoms of this condition usually start gradually - frequent burning, tingling, pins and needles or itching and numbness in the palm of the hand and the fingers especially the thumb and the index and middle fingers. In time, these symptoms can spread to the arm and shoulder. They tend to worsen at night or first thing in the morning since many people sleep with flexed wrists.
Carpal tunnel syndrome can affect one or both hands and the severity of the symptoms can vary. The hand muscles may become weakened, making it difficult to grip objects. It can also result in permanent loss of feeling. Fine finger movements, such as writing, may become increasingly difficult. In extreme cases patients might feel tingling during the day and the muscles at the base of the thumb may waste away. In some chronic cases people are unable to tell between hot and cold by touch.
Carpal tunnel exercises should be done by individuals who perform hand-intensive jobs. These exercises should be performed at the start of each workday and during a break. It reduces the amount of pressure on the median nerve in the carpal tunnel and prevents injury. A few important exercises for avoiding the carpal tunnel syndrome are discussed below:
- The most important thing to do is to get up from your desk and move around every 1/2 hour
- Extend and stretch both wrists and fingers acutely as if they are in a handstand position
- Straighten both wrists and relax fingers
- Make a tight fist with both hands and bend both wrists down.
- Take your arms out to the sides with the palms facing down. Extend your fingers and stretch through the elbows. On exhaling, rotate your shoulders back and bring the palms facing up.
Rheumatism
Rheumatism is a term used to refer to a host of disorders dealing with the joints and connective tissues. Major rheumatic disorders include Osteoarthritis, Ankylosing spondylitis, bursitis, Rheumatoid arthritis and neck pain. Rheumatism can affect adults and adolescents. Rheumatic disorders cause chronic pain and are not easy to treat. Painkillers are prescribed to alleviate the pain associated with rheumatism. Other associated symptoms are stiffness of affected joints, soreness and worsening of pain in conditions of humidity and rains. There might be periods of relief and then flare ups called rheumatic attack. The affected joints become red and swell up and turn red and warm. Usually movement increases the pain.
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