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What can you take to help your nerves regenerate?

What can you take to help your nerves regenerate?

Benfotiamine

Improves Thiamine (Vitamin B1) Deficiency: Benfotiamine is a synthetic form of vitamin B1 (thiamine) that is better absorbed by the body. It helps transform food into energy and is important in nerve function.
Reduces Diabetic Complications: As vitamin B1 is important in glucose metabolism it may help reduce symptoms of diabetic neuropathy. It can also decrease the symptoms of insulin resistance as it protects nerve and vascular cells from damage due to high blood sugar.
Supports Cognitive Health: Evidence shows it may increase cognitive function and decrease levels of beta-amyloid – a protein associated with Alzheimer’s disease.

Alpha Lipoic Acid (ALA)

Acetyl-L-Carnitine

Methylcobalamin (Vitamin B12)

Supports Nerve Health: Methylcobalamin is a form of vitamin B12 that is important in maintaining healthy nerve cells and red blood cells.
Improves Cognitive Function: It has been linked to improved cognitive function and may help reduce the risk of neurodegenerative diseases.
Boosts Energy Levels: Vitamin B12 is essential for energy production and can help combat fatigue.

Coenzyme Q10 (CoQ10)

Benefits: Supports mitochondrial function and energy production, which is crucial for nerve health.

Gamma-Linolenic Acid (GLA)

Benefits: An omega-6 fatty acid that can help decrease inflammation and support nerve health.

N-Acetyl Cysteine (NAC)

Benefits: Acts as an antioxidant and supports the production of glutathione, which helps protect nerve cells from oxidative stress.

Magnesium

Benefits: Helps regulate nerve function and reduce symptoms of neuropathy.

Vitamin D

Benefits: Supports overall nerve health and may help reduce pain and inflammation associated with nerve damage.

Curcumin

Benefits: The active compound in turmeric, curcumin has anti-inflammatory and antioxidant properties that can support nerve health.

Omega-3 Fatty Acids

Benefits: Found in fish oil, these fatty acids support nerve cell membrane health and reduce inflammation.

These ingredients work together to support nerve health, reduce oxidative stress, and improve overall metabolic and cognitive function.

References

Balakumar, P., et al. (2016). Benfotiamine attenuates hyperglycemia-mediated vascular endothelial dysfunction: Role of oxidative stress. Pharmacological Research, 105, 198-204. https://doi.org/10.1016/j.phrs.2016.01.021

Biewenga, G. P., et al. (2017). The role of lipoic acid in the treatment of diabetic polyneuropathy. Current Diabetes Reports, 17(9), 79. https://doi.org/10.1007/s11892-017-0904-8

Gibson, G. E., et al. (2016). Abnormal thiamine-dependent processes in Alzheimer’s Disease. Lessons from diabetes. Molecular and Cellular Neuroscience, 77, 47-54. https://doi.org/10.1016/j.mcn.2016.01.005

Gorąca, A., et al. (2011). Lipoic acid – biological activity and therapeutic potential. Pharmacological Reports, 63(4), 849-858. https://doi.org/10.1016/S1734-1140(11)70698-1

Malaguarnera, M. (2012). Carnitine derivatives: clinical usefulness. Current Opinion in Gastroenterology, 28(2), 166-176. https://doi.org/10.1097/MOG.0b013e32834e7b4b

Obeid, R. (2013). Vitamin B12 in health and disease: Deficiency and its prevention. Nutrition Reviews, 71(2), 110-122. https://doi.org/10.1111/nure.12001

Sima, A. A., et al. (2014). Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy. Diabetes Care, 37(1), 89-94. https://doi.org/10.2337/dc13-1380

Smith, A. D., et al. (2018). Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One, 13(9), e12244. https://doi.org/10.1371/journal.pone.012244

Stabler, S. P. (2013). Vitamin B12 deficiency. New England Journal of Medicine, 368(2), 149-160. https://doi.org/10.1056/NEJMcp1113996

Thornalley, P. J., et al. (2014). Benfotiamine prevents the development of experimental diabetic nephropathy. Diabetologia, 57(5), 1030-1040. https://doi.org/10.1007/s00125-014-3183-8

Veronese, N., et al. (2018). Acetyl-L-carnitine supplementation and the treatment of depressive symptoms: A systematic review and meta-analysis. Psychosomatic Medicine, 80(2), 154-159. https://doi.org/10.1097/PSY.0000000000000546

Volvert, M. L., et al. (2013). Benfotiamine prevents peripheral neuropathy in diabetic mice. Diabetes & Metabolism, 39(6), 554-561. https://doi.org/10.1016/j.diabet.2013.09.002

Ziegler, D., et al. (2016). Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis. Diabetes Care, 39(3), 336-343. https://doi.org/10.2337/dc15-092

nerves

Understanding Tissue Healing Times:

Understanding Tissue Healing Times

When we sustain an injury, one of the first questions that come to mind is, “How long will it take to heal?” The answer depends on various factors, including the type of tissue injured, the extent of the damage, and individual health conditions. Understanding the healing process can help manage expectations and optimize recovery.

Phases of Tissue Healing

Tissue healing generally occurs in three phases:

Inflammatory Phase: This phase is the bodies immediate response to injury and typically is characterised by redness, swelling, heat, and pain. The primary goal is to prevent further damage and initiate the healing process.
Proliferative Phase: This phase starts within 24-48 hours post-injury and can last several weeks. During this time there is production of new, healthy tissue and the wound begins to close.
Remodelling Phase: This final phase can last from several months to over a year. The new tissue slowly gains strength and flexibility as the body continues to remodel and refine the new tissue.

Healing Times for Different Tissues

Different tissues in the body heal at varying rates. Here’s a breakdown of typical healing times for various tissues:

Muscle Tissue: Muscle injuries, such as strains, can take anywhere from a few weeks to several months to heal, depending on the severity. Grade one strains are where the muscle fibres have been over stretched however not torn and take between one and three weeks to heal. Grade two strains are where most fibres are torn, and they take anywhere from three weeks to three months to heal. Finally grade three strains are where all of the fibres are torn – this usually required surgery to fix and can take anywhere from four to six weeks to heal.
Tendons: Tendon injuries often require 4-6 weeks for initial healing, but full recovery – that is return to activity, can take several months due to the limited blood supply to tendons.
Ligaments: Similar to muscle gradings, ligament healing times vary based on the injury grade. A mild, grade1 sprain can take 4-10 days, grade 2 sprain in 3 weeks to six months and a grade three sprain – also called a rupture can heal in five weeks to eight months and may need surgical intervention.
Bones: Bone fractures typically heal within six to eight weeks however can take up to three months depending on their severity. Factors such as age, nutrition and type of fracture can affect healing time.
Cartilage: Cartilage injuries are particularly challenging due to the tissue’s poor blood supply. Healing can take anywhere from two months to two years.
Nerves: Nerve injuries may or may not heal. If they do they heal very slowly, at a rate of about 1-3 millimetres per day. Healing can take months to years.

Factors Influencing Healing Times

Several factors can affect how quickly tissues heal:

Age: Younger individuals generally heal faster than older adults.
Overall Health: Good nutrition, hydration, and overall health can significantly impact healing times.
Blood Supply: Tissues with a rich blood supply, like muscles, tend to heal faster than those with limited blood supply, like tendons and cartilage.
Extent of Injury: More severe injuries naturally take longer to heal.
Post Injury Care: proper care, rest recovery and rehabilitation are important to improve positive outcomes after injury.

Optimising Healing

To optimise healing, it’s essential to follow medical advice, maintain a healthy lifestyle, and be patient. Understanding the typical healing times for different tissues can help set realistic expectations and encourage a proactive approach to recovery.

References:

Overview of Sprains and Other Soft-Tissue Injuries – Injuries and Poisoning. (n.d.). MSD Manual Consumer Version. https://www.msdmanuals.com/home/injuries-and-poisoning/sprains-and-other-soft-tissue-injuries/overview-of-sprains-and-other-soft-tissue-injuries

PT, J. T., & MPT. (2020, February 1). How Long Do Injuries Take to Heal? Thrive Physical Therapy. https://thriveptpilates.com/2020/02/how-long-do-injuries-take-to-heal/

Tissue Healing Times and Wound Healing Phases. (n.d.). Physical Therapy Web. Retrieved July 30, 2024, from https://physicaltherapyweb.com/tissue-healing-timelines/

What You Need To Know About Tissue Healing | The Prehab Guys. (2020, July 22). [𝗣]𝗥𝗲𝗵𝗮𝗯. https://theprehabguys.com/tissue-healing-timelines/

The Benefits of Pregnancy Massage

The Benefits of Pregnancy Massage:

Pregnancy is a beautiful journey, but it often comes with its share of physical and emotional challenges. One way to help alleviate some of these discomforts is through pregnancy massage, also known as prenatal massage. This specialised form of massage therapy is tailored to the unique needs of expectant mothers and offers a range of benefits supported by evidence.

Reduction in Pain and Discomfort

Pregnancy can bring about various aches and pains as the body adapts to the baby’s growth – particularly in the back, hips and legs as the mother’s centre of gravity changes and the body begins to compensate. Prenatal massage can help alleviate these discomforts by targeting specific muscle groups and using techniques such as Swedish massage, which involves gentle, long strokes and kneading.

Improved Circulation

As the body undergoes changes during pregnancy, circulation can become less efficient. This is as the amount of blood your body has is increased by 45% and the uterus can sometimes press on blood vessels decreasing the blood flow to the legs. Prenatal massage helps improve blood flow, which can reduce swelling in the hands and feet, a common issue for many pregnant women. Increasing the circulation can also help deliver nutrients and oxygen better to the mother and baby.

Reduction in Stress and Anxiety

Pregnancy can be a stressful time, and managing stress is crucial for the health of both the mother and the baby. Pregnancy massage can decrease the level of cortisone (the stress hormone) and increase happy hormones such as serotonin and dopamine. This can better overall mental health and contribute to a more positive pregnancy experience.

Better Sleep

Many pregnant women struggle with sleep disturbances due to physical discomfort and hormonal changes. Prenatal massage can promote better sleep by relaxing the muscles and calming the nervous system.

Preparation for Labor

Regular prenatal massage can help prepare the body for labour by improving muscle tone and flexibility. Some specific techniques like perineal massage can reduce the risk of tearing during delivery.

Emotional Support and Connection

The physical touch and care provided during a prenatal massage can offer emotional support and a sense of connection. This can be particularly beneficial for first-time mothers who may feel anxious about the changes they are experiencing. The nurturing environment of a massage session can provide a safe space for relaxation and emotional release.

Safety Considerations

Timing: Most experts recommend avoiding massage during the first trimester due to the higher risk of miscarriage during this period, although there is no evidence that physical therapy of any kind causes miscarriage
Qualified Therapist: It’s crucial to have the massage performed by a therapist trained in prenatal massage. They will know the appropriate techniques and positions to ensure safety and comfort.
Pressure Points: Certain pressure points, particularly around the ankles and wrists, are believed to potentially trigger contractions. A trained therapist will avoid these areas.

Potential Risks

References;

American Massage Therapy Association (AMTA). (n.d.). Pregnancy and massage. Retrieved from https://www.amtamassage.org/resources/massage-and-health/medical-treatments/pregnancy-and-massage/

Cleveland Clinic. (n.d.). Prenatal massage. Retrieved from https://health.clevelandclinic.org/prenatal-massage

FamilyEducation. (n.d.). Circulation problems during pregnancy. FamilyEducation. Retrieved August 8, 2024, from https://www.familyeducation.com/pregnancy/complications/circulation-problems

Healthline. (n.d.). Where not to massage a pregnant woman. Retrieved from https://www.healthline.com/health/pregnancy/where-not-to-massage-a-pregnant-woman

PregnancyResource.org. (n.d.). Prenatal massage. Retrieved from https://www.pregnancyresource.org/prenatal-massage/

Verywell Health. (n.d.). Pregnancy massage: Benefits, contraindications, and safety. Retrieved from https://www.verywellhealth.com/pregnancy-massage-benefits-contraindications-and-safety-5190485

WebMD. (n.d.). Pregnancy and massage. Retrieved from https://www.webmd.com/baby/pregnancy-and-massage

What to Expect. (n.d.). Prenatal massage. Retrieved from https://www.whattoexpect.com/pregnancy/pregnancy-health/prenatal-massage/

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Radiculopathy

What is radiculopathy?

Radiculopathy is described as irritation of a single nerve root that can be caused by a variety of musculoskeletal and immune factors. This is different from Myelopathy which is narrowing of the vertebra causing compression of the spinal cord.

Radiculopathy can be caused at any level of the spine however it is most common in the cervical spine (neck) and lumbar spine (low back). Radiculopathy of the neck is most common over 40 years of age however radiculopathy into your legs is generally more common irrespective of age. It can result in muscular atrophy and weakness.

What is it caused by?

Radiculopathy can be caused at the level of the spine or along the nerve pathway.

Compression of the nerve root can be caused by disc herniation (disc bulge), trauma resulting in narrowing or displacement of the spine, bone or tumour growth, diabetes, and immune disease.

A peripheral cause may be Deep Gluteal Pain Syndrome. It presents with pain on sitting, burning/cramping in the buttock and posterior thigh, radiculopathy in the lower limb and can be caused by a history of trauma.

What are the conservative treatments:

Conservative treatment includes manual therapy, such as Osteopathy, pharmaceutical pain therapy and the use of corticosteroid injections. This treatment aims to decrease inflammation around the nerve and as a result reduce pain. Results vary and some patients may have a decrease in pain and increase in function however it is only a short-term solution (Chou et. al., 2015).

What is involved in surgery:

Surgery in the case of a disc bulge includes a discectomy – that is the removal of excess disc tissue that is compressing the nerve and causing radicular symptoms. This procedure is performed as a minimally invasive surgery and typically the patient will be discharged the same or next day. Risks include recurrent disc herniation – a bulging disc at a different level of the spine, infection and bleeding. The success rate for this surgery is between 70% – 90% (Cluett, 2023)

What can we do as osteopaths?

Osteopathic treatment commonly consists of de-loading and decompressing the area. This can be done using traction, mobilisation, soft tissue and nerve flossing (Kuligowski et. al., 2021). Mobilisation was found to be effective at improving functional ability and range of motion when applied in both a rhythmic or static position (Hassan et. al., 2020).

Practitioners may decide to use manipulation in the thoracic in the treatment of cervical radiculopathy. A study by young et. al. (2019) revealed that thoracic manipulation improved pain, disability, cervical rom and deep neck flexor endurance.

A study by Langevin et. al. revealed that when combined with exercise manual therapy is effective in reducing neck radiculopathy pain and increasing functionality. This included mobilisation and facet gliding as well as strengthening of the deep stabilising muscles, muscles of the spine and muscles that would help increase range of motion that were specific to the patient (Langevin et. al., 2015). Strengthening exercise can include press ups, flexion rotation stretches, lumbar glides and pelvic tilts (Sears, 2023)

Addition of neurodynamic exercises such as sciatic nerve flossing can result in reduced nerve symptoms and mechanical sensitivity however do not appear to assist in decreasing pain (Plaza-Manzano et. al., 2020).

Sciatic Nerve Flossing Instructions:

Begin in a seated position and straighten your knee on the effected leg.
Pull your toes towards your head.
Look to the floor.
Reverse those steps until you are again in a normal seated position.
Repeat ten times.

References:

Chou, R., Hashimoto, R., Friedly, J., Fu, R., Bougatsos, C., Dana, T., Sullivan, S.D., Jarvik, J. (2015). Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis. Annals of Interna; Medicine 162, 373-381. https://doi.org/10.7326/M15-0934

Cluett, J. (20 September, 2023). Lumbar Discectomy for a Herniated Disc. Very Well Health. Lumbar Discectomy – Spine Surgery to a Herniated Disc (verywellhealth.com)

Healthline. (23 April, 2018). Nerve Flossing Exercises to Try. Nerve Flossing: How it Works for Sciatica and Other Conditions (healthline.com)

Kuligowski, T., Skrzek, A., Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. International Journal of Environmental Research and Public Health 18. https://doi.org/10.3390/ijerph18116176

Langevin, P., Desmeules, F., Lamothe, M., Robitaille, S., Roy, J.S. (2015). Comparison of 2 Manual Therapy and Exercise Protocols for Cervical Radiculopathy: A Randomised Clinical Trial Evaluating Short-Term Effects. Journal of Orthopaedic and Sports Physical Therapy 45, 1-17. https://doi.org/10.2519/jospt.2015.5211

Plaza-Manzano, G., Cancela-Cilleruelo, I., Fernández-de-Las-Peñas, C., Cleland, J.A., Arias-Buria, J.L., Thoomes-de-Graaf, M., Ortega-Santiago, R. (2020). Effects of Adding a Neurodynamic Mobilization to Motor Control Training in Patients With Lumbar Radiculopathy Due to Disc Herniation: A Randomized Clinical Trial. American Journal of Physical Medicine and Rehabilitation 99 (2), 124-132. https://doi.org/10.1097/PHM.0000000000001295.

Sears, B. (27 May, 2023). Epidural Corticosteroid Injections for Sciatica: Epidural for nerve pain in the lower back, buttocks, and thigh. Very Well Health. Epidural Corticosteroid Injections for Sciatica (verywellhealth.com)

Young, I.A., Pozzi, F., Dunning, J., Linkonis, R., Michener, L.A. (2019). Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial. Journal of Orthopaedic and Sports Physical Therapy 49 (5), 299-309. https://www.jospt.org/doi/10.2519/jospt.2019.8150

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Shin Splints

What are Shin Splints?

Shin Splints are the common name for a condition in which the muscles on top of the shin bones – the tibia and the fibula, become tight and as a result cause pain.

It mostly occurs after an increase in activity – either frequency, length or intensity, and can last for an undetermined amount of time depending on various factors such as exercise, rest and strength.

Medial Tibial Stress Syndrome:

Medically, shin splints are referred to as Medial Tibial Stress Syndrome (MTSS). It is caused by overuse and is commonly seen in athletes and military personnel. The cause of MTSS is not known however many factors can cause it including overtraining, poor unsupportive footwear, ankle muscle imbalance, tight triceps surae muscles (calf/soleus) and your back being out of balance.

Typically MTSS presents with a diffuse (wide spread) palpable pain worse after exercise – it is more common in females than males. The pain is usually described as a dull ache that gets better with rest. One reason MTSS is so painful is due to periostitis – the inflammation of the periosteum (covering of the bone) where the muscle attaches.

Specific movements that may cause pain is knee extension – that is the straightening of the leg, as this activated the muscles affected. Inflammation of the Achilles tendon (Achilles tendonitis), the bursa on the back of the heel (retrocalcaneal bursitis), plantar fasciitis (irritation of the plantar fascia), medial arch discomfort, calf pain and cramping, iliotibial band syndrome and Osgood Schlatter’s can also occur at the same time as MTSS.

One of the risks of having MTSS repeatedly or long term is a stress fracture. Signs this has occurred is when pain occurs after activity has finished into cooldown and daily activities. Another sign is when the pain becomes less wide spread and more specific to the inside of the tibia (shin bone) and the from halfway up the shin down after exercise. Imaging such as x-ray and magnetic resonance imaging (MRI) can be used to detect other sources of pain as well as stress fractures.

Treatment:

Treatment of MTSS varies depending on therapist and sport. In the acute, short-term treatment use of compression stockings, anti-inflammatories, rest and either ice or heat depending on the varied evidence. Kinesiology taping uses tape that aims to relieve pain, facilitate proprioception, change muscle activation and correct abnormal movement patterns.

Long term orthotics (inserts) and supportive shoes can be used to try and correct the posture of the foot. Increasing the supination (weight on the outside of the foot), strength of the inverter/evertor muscles and releasing the muscles on the bottom of the foot can also be helpful. Supplements such as vitamin D, calcium for bone health/density and magnesium for muscle fatigue should be taken long term as preventatives.

Manual therapy, such as osteopathy can be beneficial in both the short and long term phases of shin splints/MTSS. Through various techniques such as soft tissue, myofascial release, mobilisation and manipulation treatment is aimed at decreasing muscle tension, improving joint mobility and releasing the fascia of the foot and lower leg.

References

Bhusari, N. and Deshmukh, M. Shin splint: a review. Cereus, 15 (1), e33905. https://doi.org/10.7759/cureus.33905

Guo, S., Lui, P. (2022). Efficacy of Kinesiology taping on the management of shin splints: a systematic review. The physician and sports medicine 50 (5), 369-377. https://doi.org/10.1080/00913847.2021.1949253

Schulze, C. Finze, S., Bader, R., Lison, A. (2014). Treatment of medial tibial stress syndrome according to the fascial distortion model: a prospective case control study. The Scientific World Journal, 790626. https://doi.org/10.1155/2014/790626

Yüksel, O., Ozgürbüz, C., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Ertat, A. (2011). Inversion/eversion strength dysbalance in patients with medial tibial stress syndrome. Journal of sports science & medicine 10 (4), 737-742. Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome – PubMed (nih.gov)

Ozgürbüz, C., Yüksel, O., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Karamizrak, O. (2011). Tibial bone density in athletes with medial tibial stress syndrome: a controlled study. Journal of sports science & medicine 10 (4), 743-747. Tibial bone density in athletes with medial tibial stress syndrome: a controlled study – PubMed (nih.gov)

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Ankylosing Spondylitis

What is Ankylosing spondylitis?

Ankylosing spondylitis is an autoimmune condition where inflammation occurs first in the sacroiliac, intervertebral and intercostal joints. From there inflammation also occurs in joint cartilage causing degeneration, ossification (making bone) and then joint fusion.

Patients are more likely to develop ankylosing spondylitis if a family member has the disease due to the hereditary nature of the condition.

It is more likely to occur in the Caucasian population, males more than females and between the ages of 20-40 years. It typically presents as a sudden onset of low back pain that lasts for three months or more. The stiffness is worse after periods of inactivity, improved through the day, and is helped with heat. Pain and grinding can occur in the spine alongside muscle weakness and balancing issues.

You may also develop associated issues such as tendonitis, fasciitis and dactylitis. Sometimes patients may also present with eye issues such as uveitis and iridocyclitis – inflammation of the eye. This can present with sudden eye pain, redness, light sensitivity and decreased vision.

Assessment:

When you come in for your appointment your osteopath will assess different regions of your body and spine including your neck, back, pelvis and hips.

We may send you for a blood test looking for HLAB27 and an increased level of inflammatory factors interleukin 12, 17 and tumour necrosis factor which can be an indication of a genetic disposition for ankylosing spondylitis. X-ray’s may also be ordered to confirm the presence of the disease.

To be diagnosed with ankylosing spondylitis you may need to have a combination of the below;

Inflammatory pain and morning stiffness in the low back for a minimum of three months. This should improve with exercise and is not relieved by rest.
Limitation of range of motion in the lumbar spine in rotation, flexion/extension and side bending
Decreased chest examination.
Sacroiliitis identified on X-ray that is between grades two and four.
Decreased joint space, calcification of ligaments, squaring of the vertebrae and joint fusion.

Medical Treatment:

Corticosteroids can be beneficial in a short course and long term non-steroidal anti-inflammatory drugs and disease-modifying anti-rheumatic drugs can assist in preserving quality of life.

Osteopathic Treatment:

Osteopathic treatment is unable to cure ankylosing spondylitis, however it aims to improve quality of life and activities of daily living. This is through a holistic approach that focuses on the local biomechanical changes as well as the greater impact on muscles and posture.

Treatment focuses on mobilisation of joints, ligament and soft tissue techniques and decreasing swelling. There has been evidence that suggests significant improvement in pain and quality of life when combined with physical strengthening focusing on weightlifting, resistance training and core stability.

Typically, due to the progression of ankylosing spondylitis no manipulation is used as it poses significant risk of damage to soft tissue and joint structures.

Needling:

Use of needling through the modalities of acupuncture or dry needling has been shown to be effective.

Needling can have a pain-relieving affect and assist in immune function. In addition, the meridian theory followed in acupuncture believes that needling points related to the kidney can have a benefit in alleviating spinal pain, improving spinal function and reduce the levels of tumour necrosis factor and inflammatory factors.

Specific needling/acupuncture points that can be used to decrease pain include KD3/6, LV8, ST36, GB34, BL11/23/29/52/40

Referencing:

Ebrahimiadib, N., Berijani, S., Ghahari, M., & Golsoorat Pahlaviani, F. (2021). Ankylosing Spondylitis. Journal of Ophthalmic and Vision Research, 16(3). https://doi.org/10.18502/jovr.v16i3.9440

Seiler, M., Vermeylen, B., Poortmans, B., Feipel, V., & Dugailly, P.-M. (2020). Effects of non-manipulative osteopathic management in addition to physical therapy and rehabilitation on clinical outcomes of ankylosing spondylitis patients: A preliminary randomized clinical trial. Journal of Bodywork and Movement Therapies, 24(4), 51–56. https://doi.org/10.1016/j.jbmt.2020.06.028

Xuan, Y., Huang, H., Huang, Y., Liu, D., Hu, X., & Geng, L. (2020). The Efficacy and Safety of Simple-Needling Therapy for Treating Ankylosing Spondylitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine, 2020, 1–10. https://doi.org/10.1155/2020/4276380

Zhang, Y., & Song, A. (2022). Clinical research progress of acupuncture therapy in the treatment of ankylosing spondylitis. Medical Theory and Hypothesis, 5(2), 4. https://doi.org/10.53388/tmrth202206004

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Baker’s Cyst

What are Baker’s Cysts:

Also called popliteal cysts, baker’s cysts occur behind the knee in the popliteal fossa and are fluid filled sacs. They are predominantly asymptomatic and usually discovered during imaging for another unrelated condition.

Symptoms associated with these cysts include knee pain, tightness, and discomfort. Pain worsens with increased activity and decreases range of motion. Inflammation is most visible when the knee is at full extension and least visible at 45 degree flexion.

Lower limb swelling can occur due to the cyst’s impingement of blood vessels and in some cases may present the same as deep vein thrombosis. If the cyst bursts it can cause inflammation/swelling, sharp knee/calf pain and a sensation of water running down the calf. When the cyst busts it can cause nerve entrapment, blood vessel blockage and compartment syndrome.

It is typically diagnosed through physical examination and imaging such as plain radiography, ultrasound and MRI.

Causes:

The knee is a synovial joint where a capsule of synovial fluid cushions between the two bones. Bakers’ cysts can occur when this synovial fluid accumulates and moves between muscle attachments to the knee. This is due to the pressure gradient between the knee joint capsule and fossa moving fluid flow into the fossa.

While more common in adults they can also occur in children. However rather than being caused by a co-morbidity they typically occur when the knee joint capsule herniates.

Commonly occurring in patients aged 35 to 70 years of age or in children 4 to 7 years of age.

Inflammation of the semimembranosus (hamstring) bursa can also cause fluid build up in addition to arthritis, meniscus damage and other degenerative conditions.

Risk factors:

Patients that have a history of trauma to the knee cartilage and meniscus are at greater risk of developing a baker’s cyst. In addition, they commonly occur when patients have degenerative conditions such as arthritis.