Reactive arthritis

Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body
mostly in genitals, intestines, genitals and urinary tracts.
This condition usually targets the knees, ankles and feet. Inflammation also can affect the eyes,
skin and the tube that carries urine out of the body (urethra). Previously, reactive arthritis was
sometimes called Reiter’s syndrome.
Sign and symptoms
Incubation period is 1 to 4 weeks.
Pain and stiffness- pain in joints of knee, ankles, low back, heels.
Eye – people who have this arthritis develops an eye inflammation ( conjunctivitis ).
Urinary problems: inflammation of prostate gland and cervix, discomfort during urination.
● Reactive arthritis occurs in reaction to an infection by certain bacteria. Most often, these
bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella,
Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms but can
cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If
you develop arthritis within one month of a gastrointestinal or a genital infection especially with
a discharge see a health care provider. You may have reactive arthritis.
Reactive arthritis tends to occur most often in men between ages 20 and 50. Some patients
with reactive arthritis carry a gene called HLA-B27. Patients who test positive for HLA-B27 often
have a more sudden and severe onset of symptoms. They also are more likely to have chronic
(long-lasting) symptoms. Yet, patients who are HLA-B27 negative (do not have the gene) can still
get reactive arthritis after exposure to an organism that causes it.
Patients with weakened immune systems due to AIDS and HIV can also develop reactive
There is no specific test for diagnosing reactive arthritis, but the doctor may check the urtheral
discharge for STD. Stool samples may also be tested. Blood reports shows positive for the HLAB27 genetic marker and alongwith wbc count esr increases. Patient will also have less rbc.
X rays reports shows bone loss, signs of osteoporosis , bony spurs , back joints and pelvis may
show abnormalities.
Doctor will also test for eye and UTI which can confirm the disease.
Treatment/ Medical Management
Microbial therapy is strongly recomended for 3 to 6 months for an microbial infection.
Antibiotics should be started soon without any delay. NSAIDS are the first choice of treatment.
Main goal is to reduce the symptoms and prevent complication.
Mechanical devices like orthotics, insoles can be used.
Medical management:
Goal of physiotherapy management
1) reduce inflammation
2) reduce pain
3) improve rom
4) increase cardiovascular fitness
Cryotherapy should be intiated to intiated early at acute stage to control inflammation and
swelling around the affected joints.
Electrical stimulations like TENS, IFT to ease pain . Range of motion and stretching exercises
for all joints to avoid any stiffness in the joint, strengtheing exercises will be intiated to improve
power of muscles.
Patient education – this is necessary to promote joint protection and proper body mechanics
when performing daily activities to maintain joint integrity.
Aerobic exercises should include low impact activities such as swimming, walking depending on
patient’s age and cardiovascular level.
Other advance techniques like dry needling and taping have shown great benefits in releiving
pain and stiffness.
Physiotherapy management will target the affected joint and its attachments

the right shoe

Why you need “The right Shoe” ?

Are your daily wear shoes giving you pain and health problem?

We know once upon a time people walked and worked whole day without wearing any footwear but now we have lot of options in footwear. The shoes we wear are actually central to our everyday health. Poorly designed shoes or footwear that doesn’t fit properly can cause a number of short or long term pain and health problem that effect various part of our bodies and life ,so it’s important to know and be aware what you’re putting on your feet.

The cost of wearing heel –

Some kind of pains are difficult to avoid but one that can be easily prevented is foot pain. Much of the time you can trace foot pain directly to the shoes you decide to wear. Experts say a bad shoe can create potential foot, leg, low back or general health problems and high heeled shoes and improperly fitted shoes cause health problems such as bunions ,heel pain and deformed toes as well as nerve damage. A survey found that most women also experience leg cramps and  tired of wearing shoes that hurt’s their feet. As well as high heel gives you muscle pain and spasms in calves causing Plantar fasciitis and Calcaneal spur. Long term wear of high heels can shorten the muscles in your calves and back leading to backache.

Ill-fitting and high shoes wearing can cause damage to your feet can create nail and fungal problems, back, joint and hip pain, calf strains.

 Flip flops: Flat shoes with little or no arch support cause fallen arches, can be extremely painful and makes walking difficult and tiring for prolonged periods and on uneven surfaces such as hilly areas. One may also get inflamed and worn fascia at the bottom of the foot (plantar fasciitis) which can be debilitating for the patient as well as flats without arch support can cause lower back and ankle pain due to the flopping gait.

Ballet flats: Ballet flat shoes that are too tight across the toes and bell of the foot increase the pressure on the toenails and nail beds as the toes and nails themselves have no room for movement , the nails are often encouraged to bend and curl inwards. If the nail pierces the skin, an infection can occur. In particularly severe cases, this infection can lead to amputation.

Thigh high shoes: When it comes to foot pain, thigh high boots can cause some of the same foot health issue as shoes with stiletto heels, depending on their heel height and they present the additional risk of causing leg issues if the boots are too tight. Tight non stretchable thigh high boots can put pressure on the peroneal nerve in the knee and cause burning and tingling.

Take care of your feet:

It’s easy to take our feet for granted. They’re just there, handling with a lot of challenges, from being stiffened into high heels and elevated to heights to perspiration inside sweaty socks or tight nylon pantyhose.

While suffering those indignities, our feet take hundreds of tons of force impact just during an average day of walking.

You don’t need an expensive spa treatment to take care of your feet. Spending just a few minutes a day on foot care and choosing the right shoes can keep you free of problem that may lead to pain and even disability.

Make point to wash your feet with a washcloth carefully and regularly. Be sure to dry your feet completely, including between the toes. This can lessen problems such as athlete’s foot, odour, bacteria and fungus.

For soaking your feet, forget the Epsom salts as they’re too drying and are of least medical benefit. Instead, just use warm water and a little liquid soap containing skin softeners. Moisturize your feet after washing during winter months, you may need to moisturize several times a day. Nothing fancy is needed just basic lotions and creams are fine.

Pre-habilitation, What’s that?

Pre-habilitation – A lateral thinking towards prevention of injuries

Rehabilitation of athletic injuries such as ligament and muscle injuries is common at present which takes longer period of time to get recovered and require great deal of patience throughout, ultimately leading to longer period out of play. On the other hand it is already known that tissue damage had been done.

Why not prevent injuries before it happen? There is a need of awareness and education among sporty and general exerciser individuals about pre-habilitation and its importance.

So what it actually is?

Pre-habilitation is a exercise program set for an individual knowing his/her weak links in body which can cause injury in near future. Pre-habilitation works on decreasing risk of injury, focuses on strength, flexibility & neuromuscular control of the areas vulnerable to injuries. This will also minimize the resting time or out of completion period due to injury and its recovery.

Pre-habilitation is sports specific and individual body based approach means it’s not common for all. Strengthening, flexibility, proprioception and agility exercises can reduce risk of injuries and also can help to enhance performance.

As according to American journal of Sports medicine , agility drills reduced ACL injuries among female soccer players by 88%.

Science behind Pre-habilitation –

Continuous training while having bio-mechanical fault can lead to injury, it becomes necessity to have a bio-mechanical approach towards athlete assessment. Pre-habilitation focuses on the regimes which will counter these faults. Biomechanical assessment follows functional activities to reach to weaker links in the body and the structures to be worked on. As for example pronation distortion syndrome can cause stress on ACL or PFPs over a period of time. Pre-habilitation works upon correcting the faulty mechanics thus reducing injury risks.

Beneficiaries of Pre-habilitation –

Elite athletes, occasional exercisers, gym going individuals & also those who are not regular exercisers are vulnerable to get injury , can benefit by pre-habilitation. Individuals having past injury can also have pre-habilitation program for themselves in order to prevent recurrence of same injury or other associated with it.

Why to get treated or rehabilitated after injury or any musculoskeletal pain when we can prevent it as it is rightly said “prevention is better than cure”.

Right choice of professional for pre-habilitation –

Physiotherapist is best choice when it comes to rehabilitation after injury similarly in prehabilitation physiotherapist is right selection. Biomechanical analysis is key for pre-habilitation for exercise planning and for that who can be better than physiotherapist.

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