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Ailmemts & Remedies

Baker’s cyst

Alternative Names:  Popliteal cyst; Bulge-knee

Definition:
Like all joints, the knee needs lubrication to function properly. This lubricant is a jelly-like substance called  synovial (si-NO-vee-ul)  fluid.A Baker’s cyst is a fluid-filled cyst that causes a bulge and a feeling of tightness behind your knee. The pain can get worse when you fully flex or extend your knee or when you’re active.

Although a Baker’s cyst may cause swelling and make you uncomfortable, treating the probable underlying problem usually provides relief.

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When the knee’s damaged, more synovial fluid is produced. Under pressure, this fluid stretches the lining of the joint, called the joint capsule, out into the back of the knee. This causes a bulge, known as a Baker’s cyst.

Herniation of the joint capsule is responsible for most Baker’s cysts in adults.

The most common cause of damage that triggers the process is arthritis, usually osteoarthritis. Other types of knee injury, such as tears to the cartilage, may also be responsible.

It is named after the surgeon who first described it, Dr. William Morrant Baker (1838–1896).This is not a “true” cyst, as an open communication with the synovial sac is often maintained.

Symptoms:
In some cases, a Baker’s cyst causes no pain, and you may not even notice it. If you do experience signs and symptoms, you may notice:

*Swelling behind your knee, and sometimes in your leg
*Knee pain
*Stiffness
*Texture similar to a balloon filled with water

A large cyst may cause some discomfort or stiffness, but there are often no symptoms. There may be a painless or painful swelling behind the knee.

The cyst may feel like a water-filled balloon. Sometimes, the cyst may break open (rupture), causing pain, swelling, and bruising on the back of the knee and calf.

It is important to know whether pain or swelling is caused by a Baker’s cyst or a blood clot. A blood clot (deep venous thrombosis) can also cause pain, swelling, and bruising on the back of the knee and calf. A blood clot may be dangerous and requires immediate medical attention.

Causes:
Synovial fluid circulates throughout your knee and passes in and out of various tissue pouches (bursae) throughout your knee. A valve-like system exists between your knee joint and the bursa on the back of your knee (popliteal bursa). This regulates the amount of synovial fluid going in and out of the bursa.

But sometimes the knee produces too much synovial fluid, resulting in buildup of fluid in the bursa and what is called a Baker’s cyst. This can be caused by:

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•A tear in the meniscal cartilage of the knee……
•Knee arthritis (in older adults)
•Rheumatoid arthritis
•Other knee problems

Diagnosis:
During a physical exam, the doctor will look for a soft mass in the back of the knee. If the cyst is small, comparing the affected knee to the normal knee can be helpful. There may be limitation in range of motion caused by pain or by the size of the cyst. In some cases there will be signs and symptoms of a meniscal tear.

Transillumination, or shining a light through the cyst, can show that the growth is fluid filled.

If the mass grows quickly, or you have night pain, severe pain, or fever, you will need more tests to make sure you do not have other types of tumors.

X-rays will not show the cyst or a meniscal tear, but they will show other problems that may be present, including arthritis.

Ultrasound  and or MRIs can help the health care provider see the cyst and look for any meniscal injury.
Treatment:
Baker’s cysts usually require no treatment unless they are symptomatic. Often rest and leg elevation are all that is needed. If necessary, the cyst can be aspirated to reduce its size, then injected with a corticosteroid to reduce inflammation. Surgical excision is reserved for cysts that cause a great amount of discomfort to the patient. A ruptured cyst is treated with rest, leg elevation, and injection of a corticosteroid into the knee. Recently, prolotherapy has shown encouraging results as an effective way to treat Baker’s cysts and other types of musculoskeletal conditions.

Baker’s cysts in children, unlike in older people, nearly always disappear with time, and rarely require excision.

Cryotherapy:
Ice pack therapy may sometimes be effective way of controlling the pain caused by Baker’s cyst. Ice must not be applied directly onto the skin but be separated by a thin cloth. Alternatively, cooling packs may be used, but the total application time for any product is for no more than 15 minutes at a time.

Medication:
Medications bought at pharmacies may be used to help soothe pain. Painkillers with paracetamol, a.k.a. Tylenol(c) (acetaminophen), or with the additional anti-inflammatory action (such as ibuprofen or naproxen), may be used. Stronger non-steroidal anti-inflammatory drugs may be required by prescription from one’s general practitioner.

Heat:
Heat is also a commonly used. The application of a heating pad on a low setting for 10–20 minutes may relieve some pain, but only if instructions are followed carefully.

Bracing:

A knee brace can offer support giving the feel of stability in the joint. If only support is necessary, a simple elastic bandage is recommended; however, braces compress the back of the knee, where it is most tender, and can cause pain.

Rest and specific exercise:
Many activities can put strain on the knee, and cause pain in the case of Baker’s cyst. Avoiding activities such as squatting, kneeling, heavy lifting, climbing, and even running can help prevent pain. Despite this, some exercises can help relieve pain, and a physiotherapist may instruct on stretching and strengthening the quadriceps and/or the patellar ligament.
Prognosis: A Baker’s cyst will not cause any long-term harm, but it can be annoying and painful. The symptoms of Baker’s cysts usually come and go.Long-term disability is rare. Most people improve with time or arthroscopic surgery.

Possible Complications:
Complications are unusual, but may include:

•Long-term pain and swelling
•Complications from related injuries, like meniscal tears

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/bakerscyst1.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/001222.htm
http://www.mayoclinic.com/health/bakers-cyst/DS00448
http://en.wikipedia.org/wiki/Baker’s_cyst

http://www.healthcentral.com/osteoarthritis/h/tai-chi-and-arthritis-of-the-hip.html

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Joints are constantly used during a lifetime of activity. Worn out cells are efficiently replaced. If the rate of repair falls below the rate of damage, painful degenerative osteoarthritis sets in. This generally occurs earlier in overweight individuals, smokers and those with complicating medical illnesses such as diabetes.

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Around 75 per cent of the population over the age of 65 has X-ray evidence of osteoarthritis in the hips or knees. Such people may complain of stiffness, especially after a period of inactivity. There may be difficulty in standing up, stepping and walking. The gait may be waddling and abnormal. There may be dull ache or a sharp, stabbing radiating pain. The knees may be obviously deformed and bent. Balance becomes a problem and frequent falls may occur.

Lifestyle modifications are required for the management of osteoarthritis, and this may include cessation of smoking, treatment of underlying diseases and weight loss.

A common misconception is that exercise will “wear out” an osteoarthritic joint. Low-impact exercises such as walking and cycling are actually beneficial. Physiotherapists can teach effective quadriceps-strengthening exercises (for the knees) and hip motion exercises. These increase flexibility. Strengthening the muscles surrounding an affected joint helps to hold the bones in place, reduces pain and maintains mobility. Exercises must be performed every day for them to be effective. If discontinued, accrued benefit disappears in three days. Patients who participate in exercise programmes have less pain and depression and improve faster than those who rely on medications alone.

Topical application of creams and ointments containing capsaicin (an extract of green pepper), applied four times daily, provide excellent pain relief.

Many patients with osteoarthritis of the hip and knee are more comfortable if they wear slippers with good shock-absorbing properties.

Canes are an excellent aid when held on the unaffected side of the body. For maximum effectiveness, the top of the cane’s handle should reach the patient’s wrist crease (when the patient is standing with arms straight down). Such canes can reduce hip and knee weight bearing by 20 to 30 per cent.

If the person is still incapacitated, medications can be used. In older individuals, dosage has to be carefully monitored to prevent kidney or liver damage.

Paracetamol is the probably the safest drug. It provides excellent pain relief. Non Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibubrufen or diclofenac can be used for a short time. The “Cox” group, which includes celecoxib, is also effective.

Anecdotal evidence suggests that “food supplements” such as glucosamine sulphate and chondroitin sulphate are safe and effective in patients with osteoarthritis. Actual studies, however, have not demonstrated any proven benefit.

If there is pain and disability despite these simple measures, affected joints can be injected with steroids or hyaluronic acid analogues.

Surgical intervention is also an option. The joint can be viewed, lavaged and debrided through an arthroscope.

Hips and knees can now be replaced. This should be considered if there is severe persistent pain, loss of motion, inability to stand or climb stairs, deformity and if all other therapies have failed. Earlier, replacement was an option reserved primarily for severely affected adults over 60 years. The artificial joints were heavy and maladroit, and the surgery was long and complicated. But now, research has converted the clumsy, original hinge joint into an engineering marvel. Lightweight biocompatible and durable materials such as plastic, titanium and stainless steel are now used. They resist corrosion, degradation and wear. Surgeons no longer need to make 12-inch incisions to replace the joints. Keyhole surgery is possible.

Replacement surgery is successful in more than 90 per cent of patients. Age is no bar to this procedure though it is marginally riskier in older people with other complicating illnesses. (Britain’s Queen Mother underwent the surgery at the age of 95, and survived for six years after that). If the surgery is performed in active, younger individuals, the replaced joint itself can get worn out after 15 or 20 years, requiring a second surgery.

Physiotherapy speeds recovery and strengthens the muscles supporting the new joint, enabling rapid mobilisation. Within a few days, sitting up or even supported walking with crutches or a walker is possible. Eventually, within a month, unsupported walking is possible.

Squatting is not possible after replacement surgery. High-impact activities such as running are better avoided but swimming, walking and cycling are possible.

Two joints should not be operated simultaneously. There should be least a month’s gap in between surgeries.

Walking is an essential function for all age groups. Effortless walking requires coordination and unhindered functioning of the bones and joints involved. Replacement surgery does this, giving patients a new lease of life.

Sources:The Telegraph (Kolkata,India)

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Ailmemts & Remedies

Knee pain

Left knee-joint from behind, showing interior ...
Image via Wikipedia

Common Causes

Knee pain usually results from overuse,but in several cases poor form during physical activity, not warming up or cooling down, or inadequate stretching. Simple causes of knee pain often clear up on their own with self care. Being overweight can put you at greater risk for knee problems.

Other Knee pain causes :-

  • Arthritis — including rheumatoid, osteoarthritis, and gout, or other connective tissue disorders like lupus.
  • Bursitis — inflammation from repeated pressure on the knee (like kneeling for long periods of time, overuse, or injury).
  • Tendinitis — a pain in the front of your knee that gets worse when going up and down stairs or inclines. Happens to runners, skiers, and cyclists.
  • Baker’s cyst — a fluid-filled swelling behind the knee that may accompany inflammation from other causes, like arthritis. If the cyst ruptures, pain in the back of your knee can travel down your calf.
  • Torn cartilage (a meniscus tear) — can cause pain on the inside or outside of the knee joint.
  • Torn ligament (ACL tear) — can cause pain and instability of the knee.
  • Strain or sprain — minor injuries to the ligaments caused by sudden or unnatural twisting.
  • Dislocation of the kneecap.
  • Infection in the joint.
  • Knee injuries — can cause bleeding into your knee, which worsens the pain.
  • Hip disorders — may cause pain that is felt in the knee. For example, iliotibial band syndrome is injury to the thick band that runs from your hip to the outside of your knee.

Less common conditions that can lead to knee pain include the following:

Home Care

Many causes of knee pain, especially those related to overuse or physical activity, respond well to self-care:

  • Rest and avoid activities that aggravate the pain, especially weight bearing activities.
  • Apply ice. First, apply it every hour for up to 15 minutes. After the first day, apply it at least 4 times per day.
  • Keep your knee elevated as much as possible to bring any swelling down.
  • Gently compress the knee by wearing an ace bandage or elastic sleeve. Either can be purchased at most pharmacies. This may reduce swelling and provide support.
  • Take acetaminophen for pain or ibuprofen for pain and swelling.
  • Sleep with a pillow underneath or between your knees

YOGA EXERCISE

Several kind of knee pain problem can be cured through yoga exercise under some Yoga Expart.