Ooh, Ah, Ouch

Words: Dr Rajgopal NIDAMBOOR

Lumbago is pain in mid- and lower-back; however, it is an evocative term that does not specify a cause. Lumbago often presents with mild-to-severe pain, or discomfort, in the area of the lower back. The pain can be sudden and severe [acute], or long-standing [chronic]. The pain most often occurs in younger people, whose work involves physical effort, or continued work at the desk, computer, laptop etc., It is also quite common in people after retirement. It is impossible to identify the exact cause of such backache in a majority of cases. However, it is possible to arrive at the causative factor in about one-fourth of such cases, especially in patients who suffer from conditions like slipped disc, osteoporosis, deformation of the natural spine curvature, or scoliosis, and — more infrequently — skeletal damage due to a tumour, or infection.

Symptoms 

  • Pain across the lower part of the back; the pain may sometimes radiate into the buttocks, the back of the thigh, or the groin. Pain is usually worse on movement
  • Limited movement of the spine — the constraint is more profound while bending forwards and leaning back
  • Uptight contraction of the muscles surrounding the spine. This may cause a stiff back — a common complaint
  • When the pain is severe and accompanied by spasm, the back may slant to one side causing a postural change
  • A tingling sensation or numbness in the back or buttocks or leg may be a part of the pain syndrome in certain cases.

Warning Signs 

One should not neglect severe backache. If, for any reason, you suddenly find you are incapable of controlling your bladder or bowel movements, or when any area of the lower back or leg turns ‘frozen,’ it is best to seek the help of a medical specialist, such as a specialist orthopaedician — immediately.

Bursitis 

Bursitis, in simple terms, is the inflammation of a bursa. A bursa is a closed sac, or envelope, lined with synovial membrane. It contains fluid, usually found or formed in areas subject to friction — e.g., over an exposed or prominent part and/or where a tendon passes over a bone. A bursa usually contains little fluid. The bursa may become inflamed and get filled with fluid, following an injury and/or owing to overuse. It may also be caused on account of gout, pseudo-gout, rheumatoid arthritis, or certain infections — e.g., Staphylococcus aureus. The cause of bursitis, in most cases, is unknown, although the shoulder is most vulnerable to the disorder. In addition, the bursae in the elbows, hips, pelvis, knees, toes, and heels, may be affected by the disorder.

Symptoms 

  • Pain
  • Limited movement/s — although the restriction may depend on specific symptoms and/or the location of the inflamed bursa — e.g., when a bursa in the shoulder becomes inflamed, raising the arm out from the side of the body is painful.

Tennis Elbow 

Tennis elbow is protracted inflammation at the origin of the extensor muscles of the forearm. It is often caused as a result of abnormal strain. The condition, despite its name, is not essentially caused by playing tennis. The disorder is probably caused by the overuse of the muscles that straighten the fingers and the wrist. Pain is often intense around the said region. It may eventually radiate up the upper arm as well as down the outer side of the forearm. How is the pain caused? It is caused by minute splits in the connective tissue

that hold the muscles to the bone. When the tissue gets irritated, inflammation sets in. This causes the swelling in the area — although the inflammatory process often heals on its own. However, in a few cases, the pain may last for some years — in certain instances, for five years, or more. It is reported that tennis elbow often affects people in their forties. Women, it is observed, seem to be more frequently affected than men.

Cause & Effect 

Tennis elbow is not restricted to tennis players to reiterate a point — as the name would suggest — who regularly strain the muscles in the elbow region. It may be caused by other activities — not just sports, but work and hobbies that involve repetitive movements. The condition may be caused when the elbow is bent while holding firmly on to something — a racquet, an instrument, or computer keyboard too.

Symptoms 

  • Progressively increasing pain on the outer side of the elbow
  • Pain is strongly felt when someone presses the area
  • Bending the wrist upwards against pressure often hurts, especially around the protrusion of the bone [outer elbow]
  • Pain radiating up into the upper arm and down along the outer side of the forearm
  • Weakness in the wrist. This makes it difficult for one to perform things that require power in the hand.

Self-Help 

The pain, to begin with, may be relieved by applying an ice-bag wrapped in a cloth. This is used to avoid contact with the skin. The ice-bag can be applied for 20-30 minutes, at a time and after sufficient intervals. The arm should be rested; and, any movement that causes pain should be avoided. Stretching exercises, advised by a physiotherapist, should often help.

Still’s Disease 

This disorder is a form of juvenile arthritis. It is characterised by high fever and signs of systemic [relating to a system] illness; the disease can sometimes subsist for months before the arrival of arthritis. The disease is mirrored by high spiking fevers and transient salmon-coloured rash. What actually causes the disorder is not known; some clinicians feel that the disease may be caused due to infection — with a microbe. Others feel that it could be a hypersensitive, or autoimmune, disorder.

Symptoms 

  • Extreme fatigue accompanied by high fever states [1040F, or 410C] or higher; fevers have a tendency to quickly return to normal or below normal levels
  • Pale salmon-coloured skin rash; the rash does not itch
  • Swelling of the lymph glands, enlargement of the spleen and liver and sore throat. In some patients, there may be inflammation of the lungs and the heart. There may also be occasional fluid accumulation around the lungs and heart
  • Joint pain and swelling; pain may involve multiple joints.

Ankylosing Spondylitis [AS] 

This condition refers to arthritis of the spine. It may remind you of rheumatoid arthritis too, while progressing to bony ankylosis [stiffening, or fixation, of a joint due to the disease process], along with the formation of a lip-like structure of vertebral margins. While the disorder is more common in men, it is often identified by the existence of HLA [human lymphocyte antigen] and absence of rheumatoid factor.

Pronounced ankle-low-zing spond-ill-eye-tiss, the condition causes pain and stiffness in the back with a bent posture, primarily on account of swelling and irritation of the spinal joints, or vertebrae. While the condition may eventually make the vertebrae fuse together, inflammatory upsurge in the tendons and ligaments that connect and provide support to joints may sometimes lead to pain and tenderness in the ribs, shoulder blade, hip, thigh, shin, heel, and the spine. A classical, or characteristic, feature of the disorder is the involvement of the joints at the base of the spine, where the spine joins the pelvis. The course of the disease is remarkably changeable.

Warning Signs Of AS 

  • Frequent low back pain
  • Back stiffness that lasts longer than half-an-hour in the morning, or following a long period of rest
  • Pain and tenderness, as already outlined, in the rib, shoulder blade, hips, thigh, shin, heel and along the bony projections of the spine
  • In the early stages, there may be mild fever, along with loss of appetite and general uneasiness
  • Eyes may be affected too; symptoms often include eye pain, watery discharge, redness, blurred vision, and sensitivity to bright light.

Ayurveda

Therapeutic pain management strategies that are validated and effective treatment in Ayurveda, viz., snehan, swedan, agnikarma, jalaukaavcharan, vedhankarma, lepankarma, bastikarma, help one to understand the modulation of pain in the light of modern concepts. Many other facets of vitiation vis-à-vis vata dosha and pain are also available. The management of pain itself is still under research persistently as it is a subjective parameter with different thresholds for different individuals. Our attempt is to cover the maximum aspects of pain treatment and emphasise on the probable mode of action of the chief therapeutic procedures utilised in pain treatment in Ayurveda, but as symptoms are subjective, it depends on the patient, site, extent and stage of the disease and, therefore, may not offer the most appropriate modality for pain relief. The primary aim of Ayurveda treatment is to pacify the vitiated vata dosha. Ayurveda pain management therapies are safe and natural ways that help in the management of different kinds of pain. The increase in the pain threshold and reduction of the cause of pain is a whole new [Ayurveda] approach towards pain.

  • Naikwad R et al, “A Review on Pain Management through Panchakarma,” Journal of Ayurveda and Integrated Medical Sciences, 2022;7[8]:109-115.

Homeopathy

Pain management has been called ‘the leading edge’ of complementary and alternative medicine [CAM] modalities for integration into conventional healthcare in the United States. New pain-management guidelines from the American College of Physicians and the American Pain Society recommend a wide range of CAM modalities, instead of opioids for chronic low-back pain — but the recommended CAM modalities do not include homeopathy. In contrast, the American Pain Management Association’s textbook, Weiner’s Pain Management, has a detailed chapter on homeopathic treatment of pain syndromes. In a large-scale study in France, where national health insurance covers homeopathic as well as conventional primary care doctors, the former prescribed fewer opioids [and half as many nonsteroidal anti-inflammatory drugs (NSAIDs)] for musculoskeletal disorders, while providing better results in terms of pain reduction and quality of life. Further, there is some evidence to suggest that homeopathy can work faster than conventional pain medications, or reduce the need for them, without the danger of dependence, or withdrawal symptoms. There is also research to suggest that homeopathy can work better than placebo in reducing pain, for example from endometriosis, joint pain and stiffness, and haemorrhoids. For those in the throes of withdrawal, homeopathic medicines can minimise suffering and help to ensure a successful rehabilitation outcome.

  • Burke Lennihan, “Homeopathy for Pain Management,” Alternative & Complementary Therapies, Vol 23, No 5, October 2017.

Nutrition 

There are a host of natural and effective natural sea supplemental treatments to alleviate arthritis, bursitis, tennis elbow, AS, and arthritic pain. The most popular is the New Zealand green-lipped mussel extract. The product is not only unique and safe, but also efficacious.

Research at the University of Auckland Department of Medicine has been augmented by studies at independent clinical laboratories, besides pharmaceutical companies. Results have been uniform — that the extract is effective as an anti-inflammatory — while other studies have so far ruled out the possibility of adverse side-effects on foetal development when the extract is taken during pregnancy just as well.

There is yet another facet which needs to be highlighted. Conventional wisdom would have us believe that scientific studies, under controlled or laboratory conditions, hold the key to prove the effectiveness or otherwise of a product. Yet, the fact remains that real advance often emerges from patients who suffer from disorders that don’t always seem to respond to conventional treatment. These individuals are actually the real experts — their testimonies indicate results and also inform us how a certain preparation has helped them, and why it could help others, and reduce their suffering. The best part is — their reports are not solicited; they are voluntary, genuine expressions. They don’t carry a price tag, promotional or ‘modelling’ fee.

Interestingly, several testimonies have also been presented by medical professionals, from time to time, who have found their own medications not being useful in the treatment of arthritis and other disorders — over a period of time.

This has a palpable advantage — the benefit of providing clinical information from the point-of-view of medical expertise and monitoring clinical outcomes. Such reports carry a genuine intention and purpose too — as to how mussel extract offers freedom from pain, not miraculously, but gradually and progressively. In addition, such outcomes have also been supplemented with reports of relief from arthritic pain and disability that some pets have obtained when owners gave them the product. This has had a healthy, extra effect — several pet owners often report that mussel extract has led to revival of fur growth and hair in places which were earlier showing bald patches. Veterinarians, who have used mussel extract, testify the several benefits of the product — most notably in cats and old dogs afflicted by arthritis. The daily dosage for animals is 17mg per kg of their body weight. The product is available in the form of tablets, or specially made treats and also powder. Results often emerge within a week following use, or after 10-12 days of use.

Dr RAJGOPAL NIDAMBOOR, PhD, is a wellness physician-writer-editor, independent researcher, critic, columnist, author and publisher. His published work includes hundreds of newspaper, magazine, web articles, essays, meditations, columns, and critiques on a host of subjects, eight books on natural health, two coffee table tomes and an encyclopaedic treatise on Indian philosophy. He is Chief Wellness Officer, Docco360 — a mobile health application/platform connecting patients with Ayurveda, homeopathic and Unani physicians, and nutrition therapists, among others, from the comfort of their home — and, Editor-in-Chief, ThinkWellness360.

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