Headache is a common symptom of most of the neurological diseases involving the brain. Some of these caonditions can be fatal and accurate identification of the cause of headache is essential.
So if you have headache, first you should see what kind of a headache that is, because the nature of the headache differs with the type of underlying pathology.
Are you having headache for a long period (from months to years)? Does it reccurs occasionally?
Then it could be due to following causes.
The most common cause for this kind of headache is migraine. Migraine is not a serious condition and nowadays there are more successful treatments for this condition.
Glaucoma and sinusitis can also cause recurrent attacks of headache.
Does your headache aggravates when you cough, strain, sneeze, walk or lie down?
Then you could be having any of the following conditions.
Brain tumour - in this type of headache you may also have vomiting as an associated feature.
Headache which gradually rises within days to weeks
Brain Tumour
Encephalitis
Meningitis
Headache with tenderness (pain when touching) of the scalp
giant cell arteritis
Pain after injury to the head
Most of the times these kinds of headache does not indicate any serious pathological condition, but subdural haematoma should always be considered.
Single attack of severe headache
Subarachnoid haemorrhage
migraine
meningitis
Saturday, October 30, 2010
Joint Pain and Swelling? Rheumatoid Arthritis?
Today I met a patient who has had and still having multiple joint pain and swelling for more than 20 years duration. She was 44 years now and is suffering from sero positive rheumatoid arthritis since childhood. Despite her present day condition with all the pains, aches and disabilities, she was surprisingly quite happy and active.
She has first started experiencing right knee pain which was very mild initially. Then the pain has gradually increased in severity. The mild pain has been there for nearly an year, and she had not look for medical advice since it was not unbearable.
But the things began to get worse after about one year. By that time, both her knees were swollen and painful and the same kind of symptoms has started to appear in all joints in her body.
For the past 25 years the arthritis condition relapses and recurses. Her X-Ray revealed severely reduces bone densities. Her condition was kept under control by medication for about 15 years, but unfortunately her condition has started worsening recently.
Recently, her mobility has reduced due to severe hip, knee and back pain. As a result she has started to develope joint deformoties, due to lack of exercise. Therefore her doctors had decided to do a hip replacement and knee replacement. Both the surgeries were successful and now she says that she is not experiencing any pain in those replaced joints. This is good news for people who are awaiting joint replacement as a treatment method for rheumatoid arthritis.
This is a more severe form of rheumatoid arthritis. Not all the rheumatoid arthritis patients develop same kind of illness. Some people may experience only one episode of joint pain and the illness never occurs gain in their lives again.
Have you got joint pain and swelling? How to know whether it is actually rheumatoid arthritis.
People with following properties are more likely to have Rheumatoid arthritis.
She has first started experiencing right knee pain which was very mild initially. Then the pain has gradually increased in severity. The mild pain has been there for nearly an year, and she had not look for medical advice since it was not unbearable.
But the things began to get worse after about one year. By that time, both her knees were swollen and painful and the same kind of symptoms has started to appear in all joints in her body.
For the past 25 years the arthritis condition relapses and recurses. Her X-Ray revealed severely reduces bone densities. Her condition was kept under control by medication for about 15 years, but unfortunately her condition has started worsening recently.
Recently, her mobility has reduced due to severe hip, knee and back pain. As a result she has started to develope joint deformoties, due to lack of exercise. Therefore her doctors had decided to do a hip replacement and knee replacement. Both the surgeries were successful and now she says that she is not experiencing any pain in those replaced joints. This is good news for people who are awaiting joint replacement as a treatment method for rheumatoid arthritis.
This is a more severe form of rheumatoid arthritis. Not all the rheumatoid arthritis patients develop same kind of illness. Some people may experience only one episode of joint pain and the illness never occurs gain in their lives again.
Have you got joint pain and swelling? How to know whether it is actually rheumatoid arthritis.
People with following properties are more likely to have Rheumatoid arthritis.
- Female gender
- Age 30-50 years
- The following pattern of joint involvement
Gradually rising moderate joint pain. If the disease has taken several months to years, to reach its maximum condition, you are more likely to have rheumatoid arthritis.
- Symmetrical joint involvement – This means the bilateral involvement of the joint.
The peripheral joints are commonly involved (peripheral poly-arthritis)
- Stiffness of the joints - Commonly this is referred to as morning stiffness. It is the inability to move the joints after a period of rest. The small joints of the hands and feet are commonly affected.
Morning stiffness occurs because the joint stays imobile throughout the night while you are slleeping. People who stay awake and active during night, like watchmen, may complain of evening stiffness instaed of morning stiffness.
- People with a family history of arthritic condition.
These symptoms are not highly specific for rheumatoid arthritis. The same kinds of symptoms also appear in following diseases, too.
- Postviral Arthritis
- Seronegative spondyloarthropathies
- Polymyalgia Rheumatica
- Acute Nodal Osteoarthritis
Therefore specific investigations are required to confirm th diagnosis. So, if you are suspected to have rheumatoid arthritis, your doctor will initially do the following tests.
- ESR
- CRP
Rheumatoid arthritis is a inflammatory disease of the joints. Therefore, the inflamatory markers of the body such as ESR and CRP should be elevated.
But these two tests alone are not diagnostic for rheumatoid arthritis. So if they are elevated the doctor will order a test for rheumatoid factor. This is positive in 80% of the patients with rheumatoid arthritis. A negative result does not entirely rule out rheumatoid arthritis, because they might be having sero negative rheumatoid arthritis.
Treatment available for rheumatoid arthritis
Early visit to rheumatologist is essential for the better management of the disease. Even though rheumatoid arthritis is a very concerning illness, the patient should understand that it can be managed and the patient can live a almost normal life if he/she follows the treatment schedule tightly.
25% of the patients have a chance of recovering entirely, which gives every rheumatoid arthritic patient a hope.
The management involves drug therapy and physiotherapy.
Does Acupuncture helps to relieve rheumatoid arthritis?
There are evidence that patients with rheumatoid arthritis seemed to be relieved by other intervention methods like acupuncture, and ayuruvedic methods . If you are interested, you should check on that too, but don't forget your routine medications and physiotherapy.
But these two tests alone are not diagnostic for rheumatoid arthritis. So if they are elevated the doctor will order a test for rheumatoid factor. This is positive in 80% of the patients with rheumatoid arthritis. A negative result does not entirely rule out rheumatoid arthritis, because they might be having sero negative rheumatoid arthritis.
Treatment available for rheumatoid arthritis
Early visit to rheumatologist is essential for the better management of the disease. Even though rheumatoid arthritis is a very concerning illness, the patient should understand that it can be managed and the patient can live a almost normal life if he/she follows the treatment schedule tightly.
25% of the patients have a chance of recovering entirely, which gives every rheumatoid arthritic patient a hope.
The management involves drug therapy and physiotherapy.
Does Acupuncture helps to relieve rheumatoid arthritis?
There are evidence that patients with rheumatoid arthritis seemed to be relieved by other intervention methods like acupuncture, and ayuruvedic methods . If you are interested, you should check on that too, but don't forget your routine medications and physiotherapy.
References:
Kumar and Clark's clinical Medicine Seventh Edition
Hutchison's Clinical Methods 22nd Edition
Bailey and Love's Short Practice of Surgery 25th Edition
Hip Joint Replacement
Replace your hip, and you'll be able walk just like before. This is one of the miracles achieved by the advancement of the medical and surgical practices.
Hip replacement (joint replacement) surgeries are done in increasing numbers throughout the world. This indicates the high positive outcome rates of the surgery. A total of 50 000 total hip replacements are been done in United Kingdom every year.
The prognosis of the surgery is very good and 95% of the patients are found to have a almost normal joint movements without any pain. The replaced joined may function really well even for more than 20 years.
As a result of high number of people getting their joints replaced, the number of people with failure is also increasing, but this is a relative increase, not an absolute one.
I have met with several patients who had to get their hip joints replaced due to advanced stages of rheumatoid arthritis and osteoarthritis. One of them had a her both knee and hip joints replaced and now her condition has really improved. She says that now she can walk with no pain at all.
References:
Hip replacement (joint replacement) surgeries are done in increasing numbers throughout the world. This indicates the high positive outcome rates of the surgery. A total of 50 000 total hip replacements are been done in United Kingdom every year.
The prognosis of the surgery is very good and 95% of the patients are found to have a almost normal joint movements without any pain. The replaced joined may function really well even for more than 20 years.
As a result of high number of people getting their joints replaced, the number of people with failure is also increasing, but this is a relative increase, not an absolute one.
I have met with several patients who had to get their hip joints replaced due to advanced stages of rheumatoid arthritis and osteoarthritis. One of them had a her both knee and hip joints replaced and now her condition has really improved. She says that now she can walk with no pain at all.
References:
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