Ouch, my knees pain
Your Health
DR GITA MATHAI
We often take our knees for granted. They may be hidden under clothing and seem inconspicuous but are, in fact, most important as they balance the entire weight of the body. This makes them prone to injury and malfunction at all ages.
One of the commonest symptoms of any knee problem is pain. This may be acute following a fall. It may occur as a result of an unexpected unbalanced twisting movement in a game of basketball or football. Or the knee may be affected as a result of degenerative osteoarthritis. In autoimmune diseases such as rheumatoid arthritis, generally small joints of the hands and feet are affected. At times, one or both knees may also be swollen. Conditions like gout and pseudogout — which occur when crystals are deposited in the joint space — usually affect the big toe, but again the knee may be affected.
The bones of the knee joint are cushioned by cartilage. Bits of the latter can suddenly break away and form loose bodies inside the joint space. These can get wedged during movement of the knee. There is excruciating pain, and the joint gets “stuck”. It cannot be bent or straightened.
The cartilage may also become worn down and degenerate with constant wear and tear. This exposes the bones. They then tend to grind against each other and produce pain.
Problems in areas like the spine, hip and ankle can produce a change in gait. The person may not balance properly on both feet and may limp. This puts more pressure on one knee. This too can result in pain.
The patella is a triangular bone that sits on top of the knee. Degeneration of the patella or strain of the ligaments that attach it to the bone may cause pain. This is common in children, older people and particularly women athletes.
Bacterial infections which start in other parts of the body can spread via the bloodstream and localise in the knee. This causes an acute infection with redness, pain and fever.
Knee pain can usually be tackled at home. It often disappears with 48 hours of rest. Pain and swelling can be reduced with the application of an ice pack. The pack, however, should not be applied for more than 20 minutes. Ointments containing Capsicain are often effective. They should be applied on the affected joint, followed by an ice pack. Lidnocaine (a local anaesthetic) ointment may also provide relief. Ointments are particularly effective if combined with tablets of paracetamol, ibubrufen or nalidixic acid. Compression of the joint with an “elastocrepe” bandage or a “knee cap” prevents swelling. Elevation of the foot also helps.
Accupressure and acupuncture have been shown to be effective. The first involves application of pressure to specific points around the knee while in the second, needles are inserted into them.
A doctor needs to be consulted if the joint pain is accompanied by fever, there is obvious swelling, it is impossible to bear weight on that knee, or if it cannot be flexed or extended fully.
By examining the knee thoroughly and performing some diagnostic manoeuvres, it is usually possible for the doctor to arrive at a tentative diagnosis. Blood tests may be done to rule out gout or rheumatoid arthritis. X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans and ultrasound may be needed to clinch the diagnosis.
A combination of physical therapy and medication usually provides great relief. Injections of steroids and other chemicals into the joint space may reduce inflammation and pain. If the problem persists, surgery may be required. Arthroscopy may be done to remove loose bodies and repair tears to the ligaments inside the joint. Surgery for knee replacement — complete or partial — is now common and done in many centres. There are very few contraindications. More and more older people are opting for it and enjoying productive and pain-free lives.
Some knee problems — particularly those resulting from an injury or a systemic disease — may be inevitable and require long-term treatment. The painful arthritis of old age can, however, be prevented with a few lifestyle modifications.
Obesity increases the pressure on the knees. Many years of being overweight take their toll, resulting in degenerative changes. Try to remain as close to your ideal body weight as possible.
Physical activity maintains muscle tone and helps keep the knee joint aligned. Repetitive high impact activity can cause tears in ligaments and cause pain. Runners in particular can develop pain in the ligaments around the joint. This is particularly true if physical activity is not preceded and followed by stretching and strengthening exercises. Cross training helps balance joints and reduce strain and injury. A combination of cycling, swimming, jogging or walking, and yoga is ideal.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Thursday, March 31, 2011
Sunday, March 13, 2011
fungus
Fungus on my skin
YOUR HEALTH
DR GITA MATHAI
The word fungus conjures up visions of mold and dirty, damp unhygienic surroundings. Many of us may cringe at the thought of developing a fungal infection. But these infections are common and most people suffer from several attacks during the course of a lifetime.
In babies, small curd-like white patches can form in the mouth. These are difficult to remove. If scraped off, a raw red area is exposed. This is commonly called “thrush” and is caused by a fungal specie called candida. It may occur if the child is bottle fed, uses a pacifier or has recently had a course of antibiotics. It may make the child irritable while feeding.
Oral thrush may occur in adults too if they have ill-fitting dentures, suffer from diabetes, have had a course of antibiotics, consumed steroids, are on anti-cancer drugs, are smokers, or are immuno compromised as a result of medicines or HIV infection.
In adults as well as children, oral thrush can be treated with applications of anti-fungal medication like clotrimazole two or three times a day. Dentures must be cleaned regularly. Feeding bottles and artificial nipples should ideally not be used. If thrush has occurred, they must be rinsed with a solution of equal parts of vinegar and water and air dried prior to sterilisation.
Candida and some bacteria like lactobacillus normally live in perfect harmony in the vagina. The lactobacillus produces acid, which prevents the overgrowth of candida. If this balance is disrupted, candida can overgrow, resulting in infection. Imbalance occurs as a result of diabetes, pregnancy, hormonal tablets, antibiotics, steroids or immuno suppression. Frequent douching or using “feminine hygiene sprays” may also lead to infection. Vaginal fungal infections owing to candida affect almost all women. It causes redness, an uncontrollable itch and an odourless white discharge.
Treatment involves the application of creams or insertion of vaginal tablets for one, three or six days. Sometimes oral medicines have to be taken. The bacteria-fungus balance in the vagina can be restored by eating lactobacillus. This is found in homemade curd. A tablespoon a day usually restores the balance.
Men can develop candida infection on the foreskin, especially if they are diabetic. The skin is itchy and may develop fissures. Topical anti-fungal creams work well.
Men are also prone to developing “jock itch” (or dhobi’s itch), an infection of the groin area where the skin is usually warm and moist. Infection is precipitated by wearing tight undergarments, or not changing sweaty exercise clothes promptly. Treatment involves bathing regularly, wearing loose-fitting clothes and application of anti-fungal creams.
The warm moist areas between the toes may also develop a fungal infection called Tinea pedis or athlete’s foot. It causes itching, burning, cracking and at times blisters. It occurs with wearing damp socks and tight airless shoes, especially of a non-porous material like plastic.
To prevent Tinea pedis, the feet need to be aired and socks changed regularly. Once infection has developed, the feet should be soaked in equal quantities of water and vinegar for 10 minutes a day. After wiping them dry, an anti-fungal cream needs to be applied. The infection may take two to four weeks to clear up.
The warm and moist areas of the inner thighs, genitalia, armpits, under the breasts, and waist may also develop fungal infection and become red, itchy, oozy and sore. This is common in overweight individuals and those with diabetes. Treatment is by bathing regularly and keeping the area dry. Talcum powder aggravates the problem. Instead, the area should be patted dry after a bath and a combination of a “diaper rash” cream containing zinc oxide and an anti-fungal medication must be applied.
Toe nails and fingernails can also get infected by fungus. The nail then hurts, breaks easily and becomes discoloured. This occurs if the nails are constantly exposed to moisture or are immersed in water, if non-absorbent socks or shoes are used, or if the person has diabetes. Treatment is with applications and medications for one and a half to six months. Soaking the feet in a solution of one part vinegar and two parts water for 10 minutes daily and then applying Vicks VapoRub has anecdotally been shown to be effective.
The outer layers of the skin can develop scaly white patches of Tinea versicolor infection. Moist climates, sweating, humidity and hormonal changes have been blamed for this. The infection responds well to Selinium sulphide (Selsun) or Ketoconazole (Nizral) shampoo.
Ringworm causes round, hairless patches on the scalp and skin. They are contagious and spread by contact with infected humans or animals. Medicines have to be taken for six weeks. Topical agents are not effective.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
The word fungus conjures up visions of mold and dirty, damp unhygienic surroundings. Many of us may cringe at the thought of developing a fungal infection. But these infections are common and most people suffer from several attacks during the course of a lifetime.
In babies, small curd-like white patches can form in the mouth. These are difficult to remove. If scraped off, a raw red area is exposed. This is commonly called “thrush” and is caused by a fungal specie called candida. It may occur if the child is bottle fed, uses a pacifier or has recently had a course of antibiotics. It may make the child irritable while feeding.
Oral thrush may occur in adults too if they have ill-fitting dentures, suffer from diabetes, have had a course of antibiotics, consumed steroids, are on anti-cancer drugs, are smokers, or are immuno compromised as a result of medicines or HIV infection.
In adults as well as children, oral thrush can be treated with applications of anti-fungal medication like clotrimazole two or three times a day. Dentures must be cleaned regularly. Feeding bottles and artificial nipples should ideally not be used. If thrush has occurred, they must be rinsed with a solution of equal parts of vinegar and water and air dried prior to sterilisation.
Candida and some bacteria like lactobacillus normally live in perfect harmony in the vagina. The lactobacillus produces acid, which prevents the overgrowth of candida. If this balance is disrupted, candida can overgrow, resulting in infection. Imbalance occurs as a result of diabetes, pregnancy, hormonal tablets, antibiotics, steroids or immuno suppression. Frequent douching or using “feminine hygiene sprays” may also lead to infection. Vaginal fungal infections owing to candida affect almost all women. It causes redness, an uncontrollable itch and an odourless white discharge.
Treatment involves the application of creams or insertion of vaginal tablets for one, three or six days. Sometimes oral medicines have to be taken. The bacteria-fungus balance in the vagina can be restored by eating lactobacillus. This is found in homemade curd. A tablespoon a day usually restores the balance.
Men can develop candida infection on the foreskin, especially if they are diabetic. The skin is itchy and may develop fissures. Topical anti-fungal creams work well.
Men are also prone to developing “jock itch” (or dhobi’s itch), an infection of the groin area where the skin is usually warm and moist. Infection is precipitated by wearing tight undergarments, or not changing sweaty exercise clothes promptly. Treatment involves bathing regularly, wearing loose-fitting clothes and application of anti-fungal creams.
The warm moist areas between the toes may also develop a fungal infection called Tinea pedis or athlete’s foot. It causes itching, burning, cracking and at times blisters. It occurs with wearing damp socks and tight airless shoes, especially of a non-porous material like plastic.
To prevent Tinea pedis, the feet need to be aired and socks changed regularly. Once infection has developed, the feet should be soaked in equal quantities of water and vinegar for 10 minutes a day. After wiping them dry, an anti-fungal cream needs to be applied. The infection may take two to four weeks to clear up.
The warm and moist areas of the inner thighs, genitalia, armpits, under the breasts, and waist may also develop fungal infection and become red, itchy, oozy and sore. This is common in overweight individuals and those with diabetes. Treatment is by bathing regularly and keeping the area dry. Talcum powder aggravates the problem. Instead, the area should be patted dry after a bath and a combination of a “diaper rash” cream containing zinc oxide and an anti-fungal medication must be applied.
Toe nails and fingernails can also get infected by fungus. The nail then hurts, breaks easily and becomes discoloured. This occurs if the nails are constantly exposed to moisture or are immersed in water, if non-absorbent socks or shoes are used, or if the person has diabetes. Treatment is with applications and medications for one and a half to six months. Soaking the feet in a solution of one part vinegar and two parts water for 10 minutes daily and then applying Vicks VapoRub has anecdotally been shown to be effective.
The outer layers of the skin can develop scaly white patches of Tinea versicolor infection. Moist climates, sweating, humidity and hormonal changes have been blamed for this. The infection responds well to Selinium sulphide (Selsun) or Ketoconazole (Nizral) shampoo.
Ringworm causes round, hairless patches on the scalp and skin. They are contagious and spread by contact with infected humans or animals. Medicines have to be taken for six weeks. Topical agents are not effective.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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