(By Dr. Sahil Gaba, Consultant, Orthopaedic and Joint Replacement, Amrita Hospital Faridabad)
Different forms of arthritis can cause pain and stiffness in the joints in the morning immediately after waking up. Classically, prolonged stiffness of more than 20-30 minutes is seen in individuals suffering from inflammatory forms of arthritis like Rheumatoid arthritis and Ankylosing Spondylitis. The most common type of arthritis, Osteoarthritis, or wear and tear-related joint disease, can also cause this problem, but generally not as severe. The more active the disease, the longer and more severe the stiffness. Treatment is generally aimed at reducing inflammation. Based on the severity, your doctor will prescribe anti-inflammatory medications, steroid tablets or injections into joints, and gentle range of motion exercises. If imaging shows severe disease or complete loss of cartilage, surgery (commonly joint replacement) will be offered.
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PAIN AND OTHER SYMPTOMS:
Pain in the knees while bending can be secondary to arthritis of the knee, meniscal tears which can be secondary to a sporting injury, muscle spasms, or inflammation on the back of the knee cap (Chondromalacia Patellae). Pain may be accompanied by other symptoms like instability of the knee, locking episodes (where the knee mechanically jams suddenly), swelling, etc.
Your surgeon will examine you and if there is any doubt regarding its cause, will order an X-ray and MRI scan. The treatment will depend on the cause and can range from medications and physiotherapy to knee injections, or surgery.
LEG CRAMPS:
Leg cramps are involuntary episodic muscle contractions lasting for a few seconds or sometimes longer. They can disturb sleep. Most importantly, it is important to consult a Physician to diagnose the underlying cause (eg. Kidney disease, diabetes mellitus, restless legs syndrome, etc). They have been linked to stress and excessive exercise as well. If no cause is found, they can be treated by stretching the involved muscles, applying heat or cold packs, walking, gentle massage or pressure, rarely pain medications may be needed. Preventive measures include proper hydration, good supportive footwear, stretching muscles before sleeping, taking multivitamins containing essential minerals, and taking a short walk before sleeping.
SCIATICA:
Sciatica is a shooting type of pain in the leg that occurs because of compression of nerves in the lower back or the hip. The compression can be due to many causes, commonly due to a prolapsed intervertebral disc, and causes irritation and inflammation in the nerve. Initial management includes rest, painkillers and muscle relaxants, nerve-soothing medications, and physiotherapy. If symptoms are prolonged or nerve compression causes weakness of muscles or problems with urination, it may need surgery. Sometimes, pain coming from a hip joint disease can be confused with sciatica. Your surgeon will need to check both your hip and spine to ascertain the cause.
TREATMENT
To advise treatment of lower back pain, the first step is to take a thorough history and perform a detailed clinical examination of the patient. This, along with imaging (generally X-rays and MRI) will guide the surgeon in choosing the correct treatment option for the patient. For the vast majority of patients, treatment begins with certain medications, lifestyle modifications improved posture, and physiotherapy to strengthen the muscles of the lower back and core.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]