POST STROKE JOINT PAIN/ COMPLEX REGIONAL PAIN SYNDROME (CRPS)
Post Stroke Joint Pain is a condition which may accompany an injury or stroke and may cause peripheral chronic pain in the shoulder joints, arm or leg. The condition develops continuous throbbing pain and is sensitive to touch, changes in skin temperature, color and texture with joint stiffness, swelling and damage affecting the movement ability of the affected part.
The main causes for post stroke joint pain is either central or peripheral in origin. Conventional treatment methods take in a combination of therapies including medications, therapies and nerve stimulations to strengthen the range of motion of the affected body parts ad joints.
Complex regional pain syndrome (CRPS) is a complex neurological syndrome that causes intense pain after a trauma or injury to the peripheral nerve in any part of the body. The condition occurs in any part where there is a peripheral nerve running from the spine to the body extremities including arms, hands, legs and feet. The doctor diagnoses the symptoms and tailor treatment plan to reduce pain and inflammation. This includes medications, nerve stimulations and physical therapy to improve range of motion of the affected body part.
HYPERMOBILITY/ EHLERS-DANLOS SYNDROME WITH ARTHRALGIA/ RECURRENT DISLOCATION OF PATELLA
It is a condition affecting the connective tissues present in joints and blood vessel walls. They are inherited disorders that damages or alters the strength and elasticity to the underlying connective tissues in the body resulting in stretchy, fragile skin and overly flexible joints. The exact cause of the condition is unknown and is inherited from the parents. The doctor checks for extremely loose joints, ability to hyperextend elbows and knees, touch floor with palm of hands, fragile skin, and a family history of EDS syndrome to diagnosis the condition.
Comprehensive Dextrose Prolotherapy for Hypermobility/ Ehlers-Danlos syndrome with Arthralgia/ Recurrent Dislocation of Patella
Prolotherapy is an almost painless injection technique under local anesthesia where very thin needles are used to inject high concentrations of dextrose solution (sugar similar to glucose) in to loose and damaged ligaments, tendon and muscle attachments around the involved joint. Prolotherapy works by increasing the glucose concentration in the fluid outside the cells. This results in movement of fluid from inside the cells to the outside of the cells thereby shrinking the cells and causing temporary cell damage (hyperosmolar damage). As the cells are temporarily damaged, they release many biosignals to the body which results in stimulation of the immune system of the body to accelerate the inflammatory process locally resulting in increased local blood circulation, fibroblast (fibrous cell) proliferation, ligament regeneration, tightening and repair. Prolotherapy is an effective non surgical treatment method used successfully in many joint conditions, and in Dr Tejaz John’s experience it can prove to be helpful in patients with recurrent dislocation of patella/ EDS. This treatment method has the ability to strengthen the existing intact, but weakened, ligamentous and tendinous structures in the joint and near the knee cap.
Patient Benefits of Comprehensive Dextrose Prolotherapy
To know more about Prolotherapy for Hypermobility/ Ehlers-Danlos syndrome with Arthralgia/ Recurrent Dislocation of Patella book an appointment now.
ALTERNATE TREATMENTS FOR POST STROKE JOINT PAIN (PERIPHERAL)/ CRPS AT BETH YEHUWDAH ARTHRITIS CENTRE, PULLAD AND DAYSTAR CLINIC , ALAPPUZHA
Neural & Soft Tissue Infilteration Therapy (NESTIT)
Low Dose Steroid Infilteration/ Neural & Soft Tissue Infilteration Therapy (NESTIT): Steroid tablets and injections of the group Corticosteroids, (which are very different from Anabolic steroids misused by some athletes) have been repeatedly proven medically for the last 70 years in the successful treatment of inflammatory conditions due to its potent anti-inflammatory effect. Though corticosteroids are very effective in reducing inflammation, they carry numerous potential side effects, which are undesirable. To circumvent this problem, and in order to utilize the potent anti-inflammatory effects of steroid injections, at the same time taking appropriate measures to considerably lower its side-effects, Dr Tejaz Koshy John in 2010 while working as an Orthopaedician in his private clinic in Guyana, South America developed NESTIT. NESTIT stands for (Juxta) Neural and Soft Tissue Infilteration Therapy. It consists of injecting small amounts of diluted anti inflammatory steroid solution indirectly near (juxta) nerve CCPs- (chronic constricting points) in the lower back/ hip/ neck/ shoulder regions, in order to reduce juxtaneural and perineural inflammation, as well as in certain soft tissue sites including but not limited to trigger points (painful muscle “knots”)/ myofascial syndrome and/or enthesitis (inflammation of soft tissue-bone junctions) and/or sites of nerve inflammation (neuritis/ radiculitis) and/or bursitis (inflammation of fluid filled cushions called bursa) and/or additional sites causing pain referrals (referred pain) to distant sites; in order to obtain a reduction in inflammation and pain in the concerned joint/ region/ limb. It is preferably given for those patients who have Rheumatoid Arthritis, Inflammatory Arthritis, Synovitis, Inflammatory Low Back Pain, Spondyloarthropathy & Nerve and Nerve root irritation. It is not a substitute for DMARDS (Disease modifying anti rheumatoid drugs), however when given with low dose DMARDS, in Dr Tejaz John’s clinical experience it may result in significant reduction of local inflammation, pain and improvement of joint function in most cases, also indirectly reducing side effects of high dose DMARDS.
In Dr Tejaz John’s clinical experience, the patient benefits of Low Dose Steroid Infilteration/ Neural & Soft Tissue Infilteration Therapy (NESTIT) treatment are:
At Beth Yehuwdah Arthritis Centre, Pullad and Daystar Clinic, Alappuzha we provide a variety of options for patients suffering from Post Stroke Joint Pain/ CRPS. To know more about treatment plans and treatment cost, book an appointment now from one of the best joint pain treatment center in Kerala.Authored by Dr TEJAZ KOSHY JOHN
MBBS, MS Ortho (Christian Medical College, Ludhiana), Joint Replacement Fellowship (HOSMAT Hospital, Bangalore), Orthopaedic Trauma Fellowship (Hebrew University Hospital, Jerusalem, Israel)Read More