What colours should I use and why – Well within web design and any design industry colour is a very special subject, its what brings our creations to life.
Each colour has a meaning and subconsciously our brain is taking these in and processing them to determine our mood and thoughts. If your website is intended to go further than the UK and the US then you may need to do a little research on your chosen colours, this is because different colours can mean different things in the far east for example. At The Creative Den we will work with you and ask what sort of feeling you wish to portray. This publication is for people who have back pain, as well as family members, friends, and others who want to find out more about it.
Back pain is an all-too-familiar problem that can range from a dull, constant ache to a sudden, sharp pain that leaves you incapacitated. People who go out and exercise a lot after being inactive all week are more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Diet: A diet high in calories and fat, combined with an inactive lifestyle, can lead to obesity, which can put stress on the back. Heredity: Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, have a genetic component. Occupational risk factors: Having a job that requires heavy lifting, pushing, or pulling, particularly when this involves twisting or vibrating the spine, can lead to injury and back pain. Cigarette smoking: Although smoking may not directly cause back pain, it increases your risk of developing low back pain and low back pain with sciatica. It is important to understand that back pain is a symptom of a medical condition, not a diagnosis itself.
Mechanical problems: A mechanical problem is a problem with the way your spine moves or the way you feel when you move your spine in certain ways.
Injuries: Spine injuries such as sprains and fractures can cause either short-lived or chronic pain. Acquired conditions and diseases: Many medical problems can cause or contribute to back pain.
Infections and tumors: Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis, or when they involve the disks that cushion the vertebrae, which is called diskitis.
Although the causes of back pain are usually physical, emotional stress can play a role in how severe pain is and how long it lasts. One of the best things you can do to prevent back pain is to exercise regularly and keep your back muscles strong. Practicing good posture, supporting your back properly, and avoiding heavy lifting when you can may all help you prevent injury. In most cases, it is not necessary to see a doctor for back pain because pain usually goes away with or without treatment.
Many different types of doctors treat back pain, from family physicians to doctors who specialize in disorders of the nerves and musculoskeletal system.
During the medical history, your doctor will ask questions about the nature of your pain and about any health problems you and close family members have or have had. X rays: Traditional x rays use low levels of radiation to project a picture onto a piece of film (some newer x rays use electronic imaging techniques).
Magnetic resonance imaging (MRI): MRI uses a strong magnetic force instead of radiation to create an image. Computed tomography (CT) scan: A CT scan allows your doctor to see spinal structures that cannot be seen on traditional x rays. Blood tests: Although blood tests are not used generally in diagnosing the cause of back pain, your doctor may order them in some cases.
Erythrocyte sedimentation rate (also called sed rate), a measure of inflammation that may suggest infection. C-reactive protein (CRP), another blood test that is used to measure inflammation, may indicate an infection or some forms of arthritis. It is important to understand that medical tests alone may not diagnose the cause of back pain.
Chronic pain, on the other hand, may come on either quickly or slowly, and it lingers a long time. Treatment for back pain generally depends on what kind of pain you experience: acute or chronic. Acute back pain usually gets better on its own and without treatment, although you may want to try acetaminophen, aspirin, or ibuprofen to help ease the pain.
Treatment for chronic back pain falls into two basic categories: the kind that requires an operation and the kind that does not. Exercise: Although exercise is usually not advisable for acute back pain, proper exercise can help ease chronic pain and perhaps reduce the risk of it returning.
Stretching: The goal of stretching exercises, as their name suggests, is to stretch and improve the extension of muscles and other soft tissues of the back. Aerobic: Aerobic exercise is the type that gets your heart pumping faster and keeps your heart rate elevated for a while. NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that relieve pain and inflammation, both of which may play a role in some cases of back pain. All NSAIDs work similarly by blocking substances called prostaglandins that contribute to inflammation and pain. Side effects of all NSAIDs can include stomach upset and stomach ulcers, heartburn, diarrhea, and fluid retention; however, COX-2 inhibitors are designed to cause fewer stomach ulcers. Other medications: Muscle relaxants and certain antidepressants have also been prescribed for chronic back pain, but their usefulness is questionable.
Behavioral modification: Developing a healthy attitude and learning to move your body properly while you do daily activities, particularly those involving heavy lifting, pushing, or pulling, are sometimes part of the treatment plan for people with back pain. Injections: When medications and other nonsurgical treatments fail to relieve chronic back pain, doctors may recommend injections for pain relief. Nerve root blocks: If a nerve is inflamed or compressed as it passes from the spinal column between the vertebrae, an injection called a nerve root block may be used to help ease the resulting back and leg pain. Complementary and alternative treatments: When back pain becomes chronic or when medications and other conventional therapies do not relieve it, many people try complementary and alternative treatments. Spinal stenosis: Spinal stenosis is the narrowing of the spinal canal, through which the spinal cord and spinal nerves run.
Vertebral fractures: These fractures are caused by trauma to the vertebrae of the spine or by crumbling of the vertebrae resulting from osteoporosis. Microdiskectomy: As with traditional diskectomy, this procedure involves removing a herniated disk or damaged portion of a disk through an incision in the back. Laser surgery: Technological advances in recent decades have led to the use of lasers for operating on patients with herniated disks accompanied by lower back and leg pain.
Laminectomy: When narrowing of the spine compresses the nerve roots, causing pain or affecting sensation, doctors sometimes open up the spinal column with a procedure called a laminectomy. Spinal fusion: When a slipped vertebra leads to the enlargement of adjacent facet joints, surgical treatment generally involves both laminectomy (as described above) and spinal fusion. Regardless of how spinal fusion is performed, the fused area of the spine becomes immobilized. Kyphoplasty: Much like vertebroplasty, kyphoplasty is used to relieve pain and stabilize the spine following fractures caused by osteoporosis. Intradiskal electrothermal therapy (IDET): One of the least invasive therapies for low back pain involves inserting a heating wire through a small incision in the back and into a disk. Spinal fusion: When the degenerated disk is painful, the surgeon may recommend removing it and fusing the disk to help with the pain. Disk replacement: When a disk is herniated, one alternative to a diskectomy, in which the disk is simply removed, is removing the disk and replacing it with a synthetic disk.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) supports research to better understand and treat back pain. One major focus of research in recent years has been on the relative efficacy and cost effectiveness of surgical versus nonsurgical treatment of conditions associated with low back and leg pain. Early findings from the study showed that, in general, otherwise healthy people who have surgery for one of these three conditions are likely to fare better than those who receive nonoperative care.
SPORT investigators also found that people who are reluctant to have surgery may also recover with nonoperative treatments if their conditions are not progressing and their pain is tolerable.
NIAMS-supported researchers also reviewed the scientific literature concerning low back pain and examined the costs, both direct (medications, hospitalization, outpatient visits) and indirect (lost wages, decreased productivity, care-giving expenses), of the problem and the socioeconomic factors that play in it. Socioeconomic factors (including job dissatisfaction, physically strenuous work, psychologically stressful work, low educational attainment, and Worker’s Compensation Insurance) are important risk factors for the onset of back pain and disability in general, as are smoking, obesity, older age, and issues such as anxiety and depression. Socioeconomic factors are not major risk factors for the development of radiographically apparent disk degeneration (that is, disk degeneration that can be seen on x rays). The direct costs of low-back pain vary considerably by provider specialty, patient race, and nationality. More than 80 percent of workers who report an episode of low-back pain return to work within 1 month, more than 90 percent return by 3 months, and 5 percent never return. NIH Clinical Research Trials and You was designed to help people learn more about clinical trials, why they matter, and how to participate. ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions. NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding. The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. This publication contains information about medications used to treat the health condition discussed here. Kim Kardashian spoke to PEOPLE magazine, revealing how she has lost an astounding 43 pounds after giving birth to North West in June. Kim eats about 2,000 calories a day, healthy fats and proteins that are found on the Atkins diet. Kim thought about loosing weight immediately after giving birth because of the pressure put on her while she was pregnant. Kim is now feeling more motivated than ever, as she is enrolled in Barry’s Bootcamp and Pilates Plus. Barry’s Bootcamp burns 1,000 calories in 60 minutes and combines strength training and cardio. Write your meaningful and helpful comments and get free credits on purchasing our templates. Complete matching business set includes 10 design templates in one package: PowerPoint, Word, Brochure, Business Card, Letterhead, Postcard, Newsletter, Flyer, Sale Template, and Ad Templates. This publication is for people who have osteoarthritis, their families, and others interested in learning more about the disorder. Osteoarthritis (AH-stee-oh-ar-THREYE-tis) is the most common type of arthritis and is seen especially among older people. In rheumatoid arthritis, another common form of arthritis, the immune system attacks the tissues of the joints, leading to pain, inflammation, and eventually joint damage and malformation. Osteoarthritis is by far the most common type of arthritis, and the percentage of people who have it grows higher with age. 1Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F. Although osteoarthritis becomes more common with age, younger people can develop it, usually as the result of a joint injury, a joint malformation, or a genetic defect in joint cartilage. Fortunately, most people with osteoarthritis live active, productive lives despite these limitations.
Synovium (sin-O-vee-um): A thin membrane inside the joint capsule that secretes synovial fluid. Synovial fluid: A fluid that lubricates the joint and keeps the cartilage smooth and healthy. Ligaments, tendons, and muscles: Tissues that surround the bones and joints, and allow the joints to bend and move. A Healthy Joint (Representation)In a healthy joint, the ends of bones are encased in smooth cartilage.
Collagen (KAHL-uh-jen): A family of fibrous proteins, collagens are the building blocks of skin, tendon, bone, and other connective tissues. Proteoglycans (PRO-tee-uh-GLY-kanz): Made up of proteins and sugars, strands of proteoglycans interweave with collagens and form a mesh-like tissue.
Chondrocytes (KAHN-druh-sytz): Found throughout the cartilage, chondrocytes are cells that produce cartilage and help it stay healthy as it grows. Although osteoarthritis can occur in any joint, most often it affects the hands, knees, hips, and spine (either at the neck or lower back). When osteoarthritis involves the hands, small, bony knobs may appear on the end joints (those closest to the nails) of the fingers. Spine: Osteoarthritis of the spine may show up as stiffness and pain in the neck or lower back.
About a third of people whose x rays show evidence of osteoarthritis report pain or other symptoms. If you feel hot or your skin turns red, or if your joint pain is accompanied by other symptoms such as a rash or fevers, you probably do not have osteoarthritis.
No single test can diagnose osteoarthritis; however, sometimes doctors use tests to help confirm a diagnosis or rule out other conditions that could be causing your symptoms. The doctor begins by asking you to describe the symptoms, and when and how the condition started, as well as how the symptoms have changed over time. X rays can help doctors determine the form of arthritis a person has and how much joint damage has been done.
Also known as MRI, magnetic resonance imaging provides high-resolution computerized images of internal body tissues.
Osteoarthritis is so common, especially in older people, that symptoms seemingly caused by the disease actually may be caused by other medical conditions. Most successful treatment programs involve a combination of approaches tailored to the patient’s needs, lifestyle, and health. You can use exercises to keep strong and limber, improve cardiovascular fitness, extend your joints’ range of motion, and reduce your weight. Strengthening exercises: These exercises strengthen muscles that support joints affected by arthritis. Aerobic activities: These are exercises, such as brisk walking or low-impact aerobics, that get your heart pumping and can keep your lungs and circulatory system in shape. Some people find relief from special footwear and insoles that can reduce pain and improve walking or from using canes to take pressure off painful joints. Transcutaneous electrical nerve stimulation (TENS):TENS is a technique that uses a small electronic device to direct mild electric pulses to nerve endings that lie beneath the skin in the painful area.
Acupuncture: When conventional medical treatment doesn't provide sufficient pain relief, people are more likely to try complementary and alternative therapies to treat osteoarthritis. Nutritional supplements, such as glucosamine and chondroitin sulfate have been reported to improve symptoms in some people with osteoarthritis, as have certain vitamins. Because some medications can interact with one another and certain health conditions put you at increased risk of drug side effects, it's important to discuss your medication and health history with your doctor before you start taking any new medication, and to see your doctor regularly while you are taking medication. Over-the-counter pain relievers: Oral pain medications, such as acetaminophen, are often a first-line approach to relieve pain in people with osteoarthritis. NSAIDs (nonsteroidal anti-inflammatory drugs): A large class of medications useful against both pain and inflammation, (NSAIDs)4 are staples in arthritis treatment. Some NSAIDs are available over the counter, while more than a dozen others, including a subclass called COX-2 inhibitors, are available only with a prescription. All NSAIDs can have significant side effects, and for unknown reasons, some people seem to respond better to one NSAID than another. Certain health problems and lifestyle habits can increase the risk of side effects from NSAIDs.
There are measures you can take to help reduce the risk of side effects associated with NSAIDs. Mild narcotic painkillers containing analgesics such as codeine or hydrocodone are often effective against osteoarthritis pain. Corticosteroids: Corticosteroids are powerful anti- inflammatory hormones made naturally in the body or man-made for use as medicine. Hyaluronic acid substitutes: Sometimes called viscosupplements, hyaluronic acid substitutes are designed to replace a normal component of the joint involved in joint lubrication and nutrition. Because most medicines used to treat osteoarthritis have side effects, it's important to learn as much as possible about the medications you take, even the ones available without a prescription. Removal of loose pieces of bone and cartilage from the joint if they are causing symptoms of buckling or locking (arthroscopic debridement).
Joint replacement advances in recent years have included the ability, in some cases, to replace only the damaged part of the knee joint, leaving undamaged parts of the joint intact, and the ability to perform hip replacement through much smaller incisions than previously possible. The decision to use surgery depends on several factors, including the patienta€™s age, occupation, level of disability, pain intensity, and the degree to which arthritis interferes with his or her lifestyle.
Primary care physicians: Doctors who treat patients before they are referred to other specialists in the health care system. Rheumatologists: Doctors who specialize in treating arthritis and related conditions that affect joints, muscles, and bones. Orthopaedists: Surgeons who specialize in the treatment of, and surgery for, bone and joint diseases. Physical therapists: Health professionals who work with patients to improve joint function.
Occupational therapists: Health professionals who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy. Dietitians: Health professionals who teach ways to use a good diet to improve health and maintain a healthy weight. Nurse educators: Nurses who specialize in helping patients understand their overall condition and implement their treatment plans. Physiatrists (rehabilitation specialists): Medical doctors who help patients make the most of their physical potential. Licensed acupuncture therapists: Health professionals who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.
Psychologists: Health professionals who seek to help patients cope with difficulties in the home and workplace resulting from their medical conditions. Social workers: Professionals who assist patients with social challenges caused by disability, unemployment, financial hardships, home health care, and other needs resulting from their medical conditions.
Massage therapists: Health professionals who press, rub, and otherwise manipulate the muscles and other soft tissues of the body.
Although health care professionals can prescribe or recommend treatments to help you manage your arthritis, the real key to living well with the disease is you.
Living well and enjoying good health despite arthritis requires an everyday lifelong commitment. These programs teach people about osteoarthritis, its treatments, exercise and relaxation, patient and health care provider communication, and problem solving.
You should start each exercise session with an adequate warm-up and begin exercising slowly.
Before beginning any type of exercise program, consult your doctor or physical therapist to learn which exercises are appropriate for you and how to do them correctly, because doing the wrong exercise or exercising improperly can cause problems. People with osteoarthritis should do different kinds of exercise for different benefits to the body. The leading role in osteoarthritis research is played by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health (NIH).
One of the major areas of focus of osteoarthritis research in recent years has been the potential role of inflammation in the disease. If these findings about the complementa€™s role hold true in people, blocking a part of the complement system may be an effective treatment for early osteoarthritis.


In 2004, the NIAMS and other institutes and offices of the NIH began recruiting participants for the Osteoarthritis Initiative (OAI). This groundbreaking study is expected to advance our understanding of how modifiable and non-modifiable risk factors are linked to development and worsening of knee osteoarthritis.
Two separate NIAMS-supported studies revealed that mechanical stress can affect the release of osteoarthritis biomarkers. A recently discovered method to detect and monitor cartilage changes could eventually enable doctors to diagnose osteoarthritis long before traditional x rays would show damage. Other NIAMS-supported researchers are combining a technique called microcomputed tomography (microCT), which yields high-resolution, three-dimensional x-ray images, with an x-ray-absorbing contrast agent to image the distribution of proteoglycans in the laboratory.
Researchers supported by the NIAMS have shown that teriparatide, a form of human parathyroid hormone that triggers new bone formation and is approved to treat osteoporosis, can restore cartilage in a mouse model of injury-induced osteoarthritis of the knee. In recent years, the nutritional supplement pair glucosamine and chondroitin has shown some potential for reducing the pain of osteoarthritis, though no conclusive proof has emerged to date. The researchers noted that there is promising potential for the use of massage therapy for osteoarthritis of the knee and that future, larger trials should use this dose as a standard. Other NIAMS-supported scientists are researching a way to patch damaged cartilage that will allow new cartilage to grow in and repair the damage. Osteoarthritis in all its various forms appears to have a strong but complex genetic connection. When patients understand and feel that they have some control over their chronic disease, the course of their disease is often improved.
Other research shows that patient education and social support is a low-cost, effective way to decrease pain and reduce the amount of medicine patients use.
Walking can result in better functioning, and the more you walk, the farther you will be able to walk. Research has shown that losing extra weight can help people who already have osteoarthritis. Special thanks also go to the patients who reviewed this publication and provided valuable input. Within web design particularly, the colour of your website should represent your companies brand and the colour your company follows, along with the feeling you want to portray when your customers visit your site as well as the age group of your potential customers.
The publication describes causes, diagnosis, and treatments, and research efforts to learn more about back pain, many of which are supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the U.S. Studies show that low-impact aerobic exercise is good for the disks that cushion the vertebrae, the individual bones that make up the spine. These include various forms of arthritis, such as osteoarthritis and rheumatoid arthritis, and cancers elsewhere in the body that may spread to the spine.
An inactive job or a desk job may also lead to or contribute to pain, especially if you have poor posture or sit all day in an uncomfortable chair. Perhaps the most common mechanical cause of back pain is a condition called intervertebral disk degeneration, which simply means that the disks located between the vertebrae of the spine are breaking down with age. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Stress can affect the body in many ways, including causing back muscles to become tense and painful. However, a trip to the doctor is probably a good idea if you have numbness or tingling, if your pain is severe and doesn’t improve with medication and rest, or if you have pain after a fall or an injury. However, depending on what the history and exam show, your doctor may order medical tests to help find the cause. Unlike an x ray, which shows only bony structures, an MRI scan produces clear pictures of soft tissues, too, such as ligaments, tendons, and blood vessels. A computer creates a three-dimensional image from a series of two-dimensional pictures that it takes of your back.
The presence of inflammation may also suggest some forms of arthritis or, in rare cases, a tumor. Often, MRI scans of the spine show some type of abnormality, even in people without symptoms. Perhaps the best advice is to go about your usual activities as much as you can with the assurance that the problem will clear up. Heat dilates the blood vessels, both improving the supply of oxygen that the blood takes to the back and reducing muscle spasms. Many doctors think that strengthening the muscles of the abdomen will reduce the load on the spine. They may minimize radiating pain, which is pain you can feel in other parts of the body besides where it originates. For fitness, it is important to get at least 30 minutes of aerobic (also called cardiovascular) exercise three times a week. They include over-thecounter acetaminophen and aspirin, as well as prescription narcotics, such as oxycodone with acetaminophen or hydrocodone with acetaminophen. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious.
If the cause of back pain is an inflammatory form of arthritis, medications used to treat that specific form of arthritis may be helpful against the pain. The rationale behind traction is to pull the vertebrae apart to allow a bulging disk to slip back into place. Other behavior changes that might help pain include adopting healthy habits, such as exercise, relaxation, and regular sleep, and dropping bad habits, such as smoking and eating poorly.
The injection contains a steroid medication or anesthetic and is administered to the affected part of the nerve. Although such therapies won’t cure diseases or repair the injuries that cause pain, some people find them useful for managing or relieving pain. If you are in constant pain or if pain reoccurs frequently and interferes with your ability to sleep, to function at your job, or to perform daily activities, you may be a candidate for surgery. People in the first group have chronic low back pain and sciatica, and they are often diagnosed with a herniated disk, spinal stenosis, spondylolisthesis, or vertebral fractures with nerve involvement.
As the spine tries to stabilize itself, the joints between the slipped vertebra and adjacent vertebrae can become enlarged, pinching nerves as they exit the spinal column.
This causes mostly mechanical back pain, but it may also put pressure on the nerves, creating leg pain. The herniated disk is then removed through the incision, which may extend two or more inches. The difference is that the incision is much smaller and the doctor uses a magnifying microscope or lenses to locate the disk through the incision.
During this procedure, the surgeon inserts a needle in the disk that delivers a few bursts of laser energy to vaporize the tissue in the disk. In a laminectomy, the doctor makes a large incision down the affected area of the spine and removes the lamina and any bone spurs, which are overgrowths of bone that may have formed in the spinal canal as the result of osteoarthritis. In spinal fusion, two or more vertebrae are joined together using bone grafts, screws, and rods to stop slippage of the affected vertebrae.
An electrical current is then passed through the wire to strengthen the collagen fibers that hold the disk together. This fusion can be done through the abdomen, a procedure known as anterior lumbar interbody fusion, or through the back, called posterior fusion.
Replacing the damaged one with an artificial one restores disk height and movement between the vertebrae. A multi-year multicenter study called the Spine Patient Outcomes Research Trial (SPORT) compared the most commonly used standard surgical and nonsurgical treatments for patients with the three most common diagnoses for which spine surgery is performed: intervertebral disk herniation, spinal stenosis, and degenerative spondylisthesis.
And, importantly, delaying or avoiding surgery does not cause additional damage in most cases. By the time a worker has been out of work for 6 months, the likelihood of ever returning to work drops to 50 percent. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from actual clinical trial volunteers, explanations from researchers, and links to how to search for a trial or enroll in a research-matching program. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences. A form of arthritis that affects the spine, the sacroiliac joints, and sometimes the hips and shoulders.
A condition in which the nerves that control the bowels and bladder are pinched as they leave the spine. A treatment for herniated disks in which a wire is inserted into the disk through a small incision in the back.
A disease in which the cartilage that cushions the ends of the bones at the joints wears away, leading to pain, stiffness, and bony overgrowths, called spurs. A disease that occurs when the body’s immune system attacks the tissue that lines the joints, leading to joint pain, inflammation, instability, and misshapen joints. A condition in which the spine curves to one side as a result of congenital malformations, neuromuscular disorders, injury, infection, or tumors. The surgical joining of two or more vertebrae together, usually with bone grafts and hardware. The narrowing of the spinal canal (through which the spinal cord runs), often by the overgrowth of bone caused by osteoarthritis of the spine. Tissue rejection occurs when a person’s immune system attacks donor tissue, such as donor bone tissue used for spinal fusion surgery.
A minimally invasive surgical procedure that involves injecting a cement-like mixture into a fractured vertebra to relieve pain and stabilize the spine. When this publication was developed, we included the most up-to-date (accurate) information available.
It’s a lot of hard work, but Kim still admits she has insecurities — read the interview below!
She had just given birth to her sweet daughter, and she already felt a lot of pressure to lose the weight,” a friend told the magazine. The publication describes osteoarthritis and its symptoms and contains information about diagnosis and treatment, as well as research efforts supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the U.S. Unlike some other forms of arthritis, such as rheumatoid arthritis, osteoarthritis affects only joint function. It typically begins at a younger age than osteoarthritis, causes swelling and redness in joints, and may make people feel sick, tired, and feverish. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. The most commonly affected joints are those at the ends of the fingers (closest to the nail), thumbs, neck, lower back, knees, and hips. With a few exceptions (in the skull and pelvis, for example), joints are designed to allow movement between the bones and to absorb shock from movements like walking or repetitive motions.
Muscles are bundles of specialized cells that, when stimulated by nerves, either relax or contract to produce movement. Sometimes, however, they release substances called enzymes that destroy collagen and other proteins.
If your mother or grandmother has or had osteoarthritis in their hands, youa€™re at greater-than-average risk of having it too. Symptoms of knee osteoarthritis include stiffness, swelling, and pain, which make it hard to walk, climb, and get in and out of chairs and bathtubs. As with knee osteoarthritis, symptoms of hip osteoarthritis include pain and stiffness of the joint itself. In some cases, arthritis-related changes in the spine can cause pressure on the nerves where they exit the spinal column, resulting in weakness, tingling, or numbness of the arms and legs.
For those who experience steady or intermittent pain, it is typically aggravated by activity and relieved by rest.
The doctor will also ask about any other medical problems you and close family members have and about any medications you are taking. The doctor will also examine bothersome joints and observe your ability to walk, bend, and carry out activities of daily living. X rays of the affected joint can show such things as cartilage loss, bone damage, and bone spurs. This procedure uses a strong magnet that passes a force through the body to create these images. He or she may also order a joint aspiration, which involves drawing fluid from the joint through a needle and examining the fluid under a microscope. The doctor will try to find out what is causing the symptoms by ruling out other disorders and identifying conditions that may make the symptoms worse. Exercise can improve mood and outlook, decrease pain, increase flexibility, strengthen the heart and improve blood flow, maintain weight, and promote general physical fitness.
They can be performed with weights or with exercise bands, inexpensive devices that add resistance. Weight loss can reduce stress on weight-bearing joints, limit further injury, increase mobility, and reduce the risk of associated health problems.
Some people have found pain relief using acupuncture, a practice in which fine needles are inserted by a licensed acupuncture therapist at specific points on the skin. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial.
Doctors consider a number of factors when choosing medicines for their patients with osteoarthritis.
By working together, you and your doctor can find the medication that best relieves your pain with the least risk of side effects. These include a history of peptic ulcers or digestive tract bleeding, use of oral corticosteroids or anticoagulants (blood thinners), smoking, and alcohol use.
These include taking medications with food and avoiding stomach irritants such as alcohol, tobacco, and caffeine. But because of concerns about the potential for physical and psychological dependence on these drugs, doctors generally reserve them for short-term use. Depending on the particular product your doctor prescribes, it will be given in a series of three to five injections. They include topical pain-relieving creams, rubs, and sprays, which are applied directly to the skin over painful joints. After surgery and rehabilitation, the patient usually feels less pain and swelling and can move more easily. Research shows that people with osteoarthritis who take part in their own care report less pain and make fewer doctor visits. Get educated: To live well with osteoarthritis, it pays to learn as much as you can about the disease. Research has shown that people who participate in these programs are more likely to have positive outcomes. A health care professional can also advise you on how to warm up safely and when to avoid exercising a joint affected by arthritis. Eat well: Though no specific diet will necessarily make your arthritis better, eating right and controlling your weight can help by minimizing stress on the weight-bearing joints such as the knees and the joints of the feet.
Keep a positive attitude: Perhaps the best thing you can do for your health is to keep a positive attitude. One NIAMS-supported study found that a pathway called the complement system, which is a major component of the innate immune system, is critical to the development of osteoarthritis. They found the mice developed a disease characteristic of human osteoarthritis following injury to the stabilizing ligament of the knee joint.
The OAI is a public-private partnership that brings together new resources and a commitment to help identify biomarkers of disease for osteoarthritis. Such findings may, in turn, lead to improved strategies for prevention of disease and identification of novel treatment targets, which could result in prevention of later-life disability in individuals with knee osteoarthritis. The first study, on the role of mechanical stress on biomarker release from normal cartilage, showed that mechanical stress in the ranges experienced from normal to intense physical activity increased the turnover of cartilage and the release of biomarkers from the tissue and varied with the amount of applied stress.
It could also allow clinicians the opportunity to monitor the impact of therapeutic interventions very early in the disease process. By detecting proteoglycan content and distribution, the technique reveals information about both the thickness and composition of cartilage, both of which are important factors for monitoring the progression and treatment of osteoarthritis.
In a British study of several hundred people with mild-to-moderate osteoarthritis of the knee, those treated with risedronate, a member of a class of drugs called bisphosphonates, showed a clear trend toward reduced symptoms and improved joint structure. Both of these nutrients are found in shark cartilage, the shells of shellfish, and pig ears and noses, and are components of normal cartilage. The trial found that the combination of glucosamine and chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants.
For example, a recent study found that a 60-minute a€?dosea€? of Swedish massage therapy delivered once a week for pain caused by osteoarthritis of the knee was both optimal and practical, establishing a standard for use in future research.
Furthermore, they suggest that more definitive research is needed on massage for osteoarthritis of the knee, in terms of efficacy, how it may work in the body, and its cost effectiveness for patients.
One recent study showed that although supplements of vitamin K appear to have no effect on osteoarthritis in most people, for people who are deficient in vitamin K, supplements could have a significant effect. Unless the tear is repaired, the knee can become unstable, resulting in damage to the joint surfaces and the eventual development of knee osteoarthritis. Using a unique weaving machine of their own design, the researchers have created a three-dimensional fabric scaffold patch. One NIAMS-supported study found that improvement can be made in the self-management of osteoarthritis when spouses provide help. One NIAMS-funded project involves developing and testing an interactive website by which health professionals and patients could communicate concerning appointments and treatment instructions, thus giving patients a greater role in and control of their care.
Researchers are studying exercise in greater detail and finding out just how to use it in treating or preventing osteoarthritis. Moreover, overweight or obese people who do not have osteoarthritis may reduce their risk of developing the disease by losing weight. A balanced, comprehensive approach is still the key to staying active and healthy with the disease. A procedure involving a small incision that removes loose pieces of bone and cartilage from the joint. Small, bony knobs associated with osteoarthritis of the hand that can occur on the middle joints of the fingers. A naturally existing substance in joint cartilage that is believed to draw fluid into the cartilage. Powerful anti-inflammatory hormones made naturally in the body or man-made for use as medicine. A relatively new class of nonsteroidal anti-inflammatory drugs (NSAIDs) that are formulated to relieve pain and inflammation. A substance that occurs naturally in the body, providing the building blocks to make and repair cartilage. Small, bony knobs associated with osteoarthritis of the hand that can occur on the joints of the fingers closest to the nail. A substance that gives healthy joint fluid its viscous (slippery) property and that may be reduced in people with osteoarthritis.
A procedure in which the damaged cartilage surfaces are replaced while the rest of the joint is left intact.
Bundles of specialized cells that contract and relax to produce movement when stimulated by nerves. A class of medications available over the counter or with a prescription that ease pain and inflammation.
A procedure that involves cutting and realigning bone, to shift the weight from a damaged and painful bone surface to a healthier one.
A form of arthritis in which the immune system attacks the tissues of the joints, leading to pain, inflammation, and eventually joint damage and malformation. A fluid secreted by the synovium that lubricates the joint and keeps the cartilage smooth and healthy.


A technique that uses a small electronic device to direct mild electric pulses to nerve endings that lie beneath the skin in a painful area. A procedure in which low-level radiation is passed through the body to produce a picture called a radiograph. From here we will get your feedback and work closely with you to produce the website you and your company requires. Although osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae.
Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.
Exercises that increase balance and strength can decrease your risk of falling and injuring your back or breaking bones. To keep your spine strong, as with all bones, you need to get enough calcium and vitamin D every day. Your doctor may order an x ray if he or she suspects that you have a fracture or osteoarthritis or that your spine is not aligned properly. Your doctor may order an MRI scan if he or she suspects a problem such as an infection, tumor, inflammation, or pressure on a nerve. Your doctor may order a CT scan to look for problems including herniated disks, tumors, or spinal stenosis. In these cases, it may be comforting to know that most back pain gets better whether or not you find out what is causing it. Getting up and moving around can help ease stiffness, relieve pain, and have you back doing your regular activities sooner. One word of caution: If your back pain is caused by a herniated disk, check with your doctor before performing flexion exercises because they may increase pressure within the disk, making the problem worse. Examples of extension exercises are leg lifting and raising the trunk, each exercise performed while lying prone. Aerobic exercises work the large muscles of the body and include brisk walking, jogging, and swimming.
Aspirin and acetaminophen are the most commonly used analgesics; narcotics should only be used for a short time for severe pain or pain after surgery.
More than a dozen others, including a subclass of NSAIDs called COX-2 inhibitors, are available only with a prescription. Many other drugs cannot be taken when a patient is being treated with NSAIDs, because NSAIDs alter the way the body uses or eliminates these other drugs.
Some people experience pain relief while in traction, but that relief is usually temporary.
People in the second group are those with only predominant low back pain (without leg pain). Compression of the nerves caused by spinal stenosis can lead not only to pain, but also to numbness in the legs and the loss of bladder or bowel control. The smaller incision may reduce pain and the disruption of tissues, and it reduces the size of the surgical scar.
The procedure is major surgery that requires a short hospital stay and physical therapy afterwards to help regain strength and mobility. With donor bone, there is a slight risk of disease transmission or tissue rejection, which happens when your immune system attacks the donor tissue. In the first step, the doctor inserts a balloon device to help restore the height and shape of the spine. Fusion for low back pain or any spinal surgeries should only be done as a last resort, and the patient should be fully informed of risks.
And by the time a worker has been out of work for 1 year, the likelihood of ever returning to work drops to 25 percent. Chronic pain may come about suddenly or gradually; it generally lasts for 3 months or longer. A diskectomy can be performed in a number of different ways, such as through a large incision in the spine or through newer, less invasive procedures using magnifying microscopes, x rays, small tools, and lasers. The sacroiliac joints are often affected by types of arthritis referred to as spondyloarthropathies.
The NIAMS Information Clearinghouse is a public service sponsored by the Institute that provides health information and information sources. Osteoarthritis mostly affects cartilage (KAR-til-uj), the hard but slippery tissue that covers the ends of bones where they meet to form a joint.
Also, the joint involvement of rheumatoid arthritis is symmetrical; that is, if one joint is affected, the same joint on the opposite side of the body is usually similarly affected.
Before age 45, more men than women have osteoarthritis; after age 45, it is more common in women. In some people, osteoarthritis is relatively mild and interferes little with day-to-day life; in others, it causes significant pain and disability. Similar knobs, called Boucharda€™s (boo-SHARDZ) nodes, can appear on the middle joints of the fingers. Accurate answers to these questions can help the doctor make a diagnosis and understand the impact the disease has on your life.
But there often is a big difference between the severity of osteoarthritis as shown by the x ray and the degree of pain and disability you feel. Joint fluid samples could reveal bacteria, indicating joint pain is caused by an infection or uric acid crystals, indicating gout. The severity of symptoms in osteoarthritis can be influenced greatly by your attitude, anxiety, depression, and daily activity level. These can involve exercise, weight control, rest and relief from stress on joints, pain relief techniques, medications, surgery, and complementary and alternative therapies.
Splints should be used only for limited periods of time because joints and muscles need to be exercised to prevent stiffness and weakness. In some cases, cold packs (bags of ice or frozen vegetables wrapped in a towel), which reduce inflammation, can relieve pain or numb the sore area.
It seems to work by blocking pain messages to the brain and by modifying pain perception. However, arthritis-stressed joints are sensitive, so the therapist must be familiar with the problems of the disease.
Scientists think the needles stimulate the release of natural, pain-relieving chemicals produced by the nervous system. These include the intensity of pain, potential side effects of the medication, your medical history (other health problems you have or are at risk for), and other medications you are taking. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.
In some cases, it may help to take another medication along with an NSAID to coat the stomach or block stomach acids.
Tramadol carries risks that don’t exist with acetaminophen and NSAIDs, including the potential for addiction.
This is a short-term measure, generally not recommended for more than two to four treatments per year. They contain ingredients that work in one of three different ways: (1) by stimulating the nerve endings to distract the brain's attention from the joint pain, (2) by depleting the amount of a neurotransmitter called substance P that sends pain messages to the brain, or (3) by blocking chemicals called prostaglandins that cause pain and inflammation. Primary care physicians also handle other medical problems and coordinate the care you receive from other physicians and health care providers.
Three kinds of programs help people understand osteoarthritis, learn self-care, and improve their good-health attitude. If arthritis makes it difficult to participate in favorite activities, ask an occupational therapist about new ways to do them.
People must decide to make the most of things when faced with the challenges of osteoarthritis. Through analyses of joint tissue and joint fluid from individuals with osteoarthritis, researchers found that expression and activation of complement is abnormally high in people with osteoarthritis. When the scientists genetically engineered those mice to lack part of the complement systema€™s, however, they did not develop osteoarthritis. The partnership is designed to stimulate the development of tools and identify targets to combat the disease. This suggests that mechanical stress regulates turnover of molecules in the cartilage extracellular matrix. The new noninvasive method uses an adaptation of established MRI techniques to separately visualize proteoglycans (molecular building blocks of cartilage) from water molecules in cartilage.
However, a subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements.
This trial, funded by NCCAM, builds on an earlier pilot study of massage for knee osteoarthritis pain, which had promising results but provided no data to determine whether the dose was optimal. In the study, participants who had insufficient levels of vitamin K at baseline but achieved sufficient concentrations at followup had almost 50 percent less joint space narrowing (a sign of cartilage damage) in their hands. Traditionally, repair has involved replacing the ligament with ligament or tendon graft, but NIAMS-funded research shows that filling the tear with a collagen- and platelet-rich gel material may enable it to heal, making a graft unnecessary. For example, scientists have identified a mutation (a gene defect) affecting collagen, an important part of cartilage, in patients with an inherited kind of osteoarthritis that starts at an early age. The intervention that was tested used spouse-assisted coping skills training and exercise training to improve physical fitness, pain coping, and self-efficacy in patients with osteoarthritis of the knee. People with osteoarthritis should combine exercise, relaxation, education, social support, and medications in their treatment strategies. Primarily used for pain relief, acupuncture may be a helpful component of an osteoarthritis treatment plan for some people.
Doctors believe they may one day be able to use biomarkers for diagnosing osteoarthritis before it causes noticeable joint damage and for monitoring the progression of the disease and its responsiveness to treatment. Chondrocytes are cells that produce cartilage, are found throughout cartilage, and help it stay healthy as it grows.
Chondroitin is often taken in supplement form along with glucosamine as a treatment for osteoarthritis.
Corticosteroids may be injected into the affected joints to temporarily reduce inflammation and relieve pain.
For some people with osteoarthritis of the knee, replacing hyaluronic acid with injections of agents referred to as viscosupplements is useful for increasing lubrication, reducing pain, and improving function. It is characterized by the breakdown of joint cartilage, leading to pain, stiffness, and disability.
It typically begins at a younger age than osteoarthritis does, causes swelling and redness in joints, and may make people feel sick, tired, and feverish. X rays of joints affected by osteoarthritis can show such things as cartilage loss, bone damage, and bone spurs. If you have further questions after reading this publication, you may wish to discuss them with your doctor. Less commonly, back pain may be caused by more severe injuries that result from accidents or falls. These nutrients help prevent osteoporosis, which is responsible for a lot of the bone fractures that lead to back pain. Cold may reduce inflammation by decreasing the size of blood vessels and the flow of blood to the area. The theory behind these exercises is that they open up the spinal canal in places and develop muscles that support the spine. For back problems, you should avoid exercise that requires twisting or vigorous forward flexion, such as aerobic dancing and rowing, because these actions may raise pressure in the disks and actually do more harm than good.
People with muscular back pain or arthritis pain that is not relieved by medications may find topical analgesics helpful. These are people with diskogenic low back pain (degenerative disk disease), in which disks wear with age.
Patients may have difficulty walking any distance and may have severe pain in their legs along with numbness and tingling.
It appears to take about the same amount of time to recuperate from a microdiskectomy as from a traditional diskectomy. Although many patients return to daily activities within 3 to 5 days after laser surgery, pain relief may not be apparent until several weeks or even months after the surgery. In recent years, a new development has eliminated those risks for some people undergoing spinal fusion: proteins called bone morphogenic proteins are being used to stimulate bone generation, eliminating the need for grafts. Spinal fusion is used as a treatment for spondylolisthesis, scoliosis, herniated disks, and spinal stenosis. It also discusses pain relief, exercise, and quality of life for people with osteoarthritis. Osteoarthritis, on the other hand, can occur in a single joint or can affect a joint on one side of the body much more severely.
It is also more likely to occur in people who are overweight and in those with jobs that stress particular joints.
You may also experience joint stiffness, particularly when you first wake up in the morning or have been in one position for a long time. Osteoarthritis of the hip may limit moving and bending, making daily activities such as dressing and putting on shoes a challenge. Also, x rays may not show early osteoarthritis damage until much cartilage loss has taken place.
The amount and form of exercise prescribed will depend on which joints are involved, how stable the joints are, and whether a joint replacement has already been done. Although pain can make it difficult to sleep, getting proper sleep is important for managing arthritis pain. If you need a splint, an occupational therapist or a doctor can help you get a properly fitted one. All NSAIDs work similarly: by blocking substances called prostaglandins that contribute to inflammation and pain. Others have porous surfaces and rely on the growth of bone into that surface (a process called biologic fixation) to hold them in place. Activities such as sports, hobbies, and volunteer work can distract your mind from your own pain and make you a happier, more well-rounded person.
The innate immune system is designed to protect the body from harmful invaders such as viruses and bacteria.
The same results were seen when the mice were treated with an agent to inhibit part of the complement system, confirming its role in the development of the disease. Biomarkers are biological clues to increased disease susceptibility, early stages of disease, the course of the disease, and the response of people with osteoarthritis to the various therapies. The second study, which examined release of cartilage-and bone-derived biomarkers in college athletes undergoing high-intensity training (rowers, cross-country runners, and swimmers) and in nonathlete controls, suggests that rowers undergo the highest bone turnover and runners the highest cartilage turnover. Although further research and refinements are needed, the researchers are hopeful this approach could one day play an important role in the management of people with osteoarthritis.
Physicians believe that preserving the patient’s own ACL (if it becomes possible) would likely better protect the mechanics of the knee. In the future, surgeons will likely be able to impregnate custom-designed scaffold with cartilage-forming stem cells (taken from a person’s own fat tissue, for example) and biochemicals that stimulate their growth, and then implant them into a patient in a single procedure. The results from the study suggest that a combination of both spouse-assisted pain coping skills training and exercise training leads to more improvements than could be achieved with either intervention alone. Meanwhile, as scientists unravel the complexities of the disease, new treatments and prevention methods should become apparent.
Rheumatoid arthritis may also affect skin tissue, the lungs, the eyes, or the blood vessels.
Other mechanical causes of back pain include spasms, muscle tension, and ruptured disks, which are also called herniated disks. An MRI scan is needed if the pain persists for longer than 3 to 6 weeks or if your doctor feels there may be a need for surgical consultation. These creams, ointments, and salves are rubbed directly onto the skin over the site of pain.
There is no scientific evidence that traction provides any long-term benefits for people with back pain.
Usually, the outcome of spine surgery is much more predictable in people with sciatica than in those with predominant low back pain. The proteins are placed in the affected area of the spine, often in collagen putty or sponges. The procedure is done under anesthesia, and in some cases it is performed on an outpatient basis. At the end is a list of key words to help you understand the terms used in this publication. Walking, swimming, and water aerobics are a few popular types of exercise for people with osteoarthritis. If you have trouble sleeping, you may find that relaxation techniques, stress reduction, and biofeedback can help, as can timing medications to provide maximum pain relief through the night. However, each NSAID is a different chemical, and each has a slightly different effect on the body. When cartilage is injured, the researchers found, the complement system is activated, leading to inflammation directed against the bodya€™s own tissues. Researchers are collecting images (x rays and MRIs), biological specimens (blood, urine, and DNA), and clinical data from 4,800 people at high risk for having osteoarthritis, as well as those at high risk for progression to severe osteoarthritis during the course of the study.
These results suggest that biomarkers can vary between individuals involved in different types of physical activities, and that the interpretation of biomarker analyses from osteoarthritis patients will need to take into account the type and extent of physical activity of the patients. The hope is that their research will lead to ways to monitor cartilage changes with good resolution and little or no invasion of the tissue, and that eventually the technique will allow pharmaceutical researchers to obtain more detailed information about the effects of new drugs and other treatment strategies for osteoarthritis.
Such developments are expected to improve the quality of life for people with osteoarthritis and their families. Because most low back pain goes away on its own, getting an MRI scan too early may sometimes create confusion for the patient and the doctor. Applying heat or cold may relieve pain, but it does not cure the cause of chronic back pain.
If back pain or your fitness level makes it impossible to exercise 30 minutes at a time, try three 10-minute sessions to start with and work up to your goal. If you have further questions after reading this, you may wish to discuss them with your doctor.
Surgeons choose the design and components of prostheses according to their patienta€™s weight, sex, age, activity level, and other medical conditions. The second type, aerobic conditioning exercises improve cardiovascular fitness, help control weight, and improve overall function. If you are not outside much, you can obtain vitamin D from your diet: nearly all milk and some other foods are fortified with this nutrient. But first, speak with your doctor or physical therapist about the safest aerobic exercise for you.
This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint. The third type, range-of-motion exercises, help reduce stiffness and maintain or increase proper joint movement and flexibility.
Most adults don’t get enough calcium and vitamin D, so talk to your doctor about how much you need per day, and consider taking a nutritional supplement or a multivitamin.



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