Medicine For Swelling of Legs

Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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It is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy this should be due to the sciatic nerve compression in the right side probably close to your l5 vertebrae. It can also be due to the strain on the left leg, try wearing mcr chappals which would help you to get relieved from pain. Rheumatoid arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy rehabilitation treatment technique - rest and splinting - compression gloves - assistive devices and adaptive equipment - massage therapy - therapeutic exercise - patient education assistive devices and adaptive equipment occupational therapy improves functional ability in patients with ra. Occupational therapy interventions such as assistive devices and adaptive equipments have beneficial effects on joint protection and energy conservation in arthritic patients. Assistive devices are used in order to reduce functional deficits, to diminish pain, and to keep patients' independence and self-efficiency. Loading over the hip joint may be reduced by 50% by holding a cane. In fact, most of these instruments are originally designed for patients with neurologic deficits; therefore, certain adaptations may be needed for them to be used in patients with arthritis. Elevated toilet seats, widened gripping handles, arrangements related with bathrooms, etc. Might all facilitate the daily life. The procedures needed to increase compliance of the patient with the environment and to increase functional independence are +mainly determined by the occupational therapist. Massage therapy that improves flexibility, enhances a feeling of connection with other treatment modalities, improves general well being, and can help to diminish swelling of inflamed joints. Massage is found to be effective on depression, anxiety, mood, and pain. Therapeutic exercise every joint should be moved in the rom at least once per day in order to prevent contracture. In the case of acutely inflamed joints, isometric exercises provide adequate muscle tone without exacerbation of clinical disease activity. Moderate contractures should be held for 6 seconds and repeated 5–10 times each day. Dynamic exercise therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (ra). Finally, in chronic stage with inactive arthritis, conditioning exercises such as swimming, walking, and cycling with adequate resting periods are recommended. They increase muscle endurance and aerobic capacity and improve functions of the patient in general, and they also make the patient feel better. It might be due to lack of blood circulation which is the reason for you to have scrotum pain / back pain. You have to do basic aerobic exercises for you to become fit and also to maintain the blood circulation and tone. Patient education in patients with ra, sociopsychological factors affecting the disease process such as poor social relations, disturbance of communication with the environment, and unhappiness and depression at work are commonly encountered. The treatment of rheumatic diseases should provide education and information to their patients about their condition and the various physical therapy and rehabilitative options that are available to improve their quality of life. Passive treatments for rheumatoid arthritis •cold therapy reduces circulation, which ultimately decreases swelling. For example, a cold compress may be placed on the painful area. •cold therapy in acute phase •dosage 10-20mints/1-2 times a day. •heat therapy eases muscle tension and gets blood to flow more quickly to the painful area. For example, a moist, warm cloth may be used to promote circulation. •heat therapy in chronic phase •dosage 20-30mints/1-2 times a day. •hydrotherapy involves reducing your ra-related pain and other symptoms with water. With hydrotherapy, you will be submerged in warm water to relieve your symptoms. •massage can help reduce muscle tension and promote good circulation. It's also a fantastic way to help you manage stress (especially important for people with rheumatoid arthritis). •transcutaneous electrical nerve stimulation (tens) works by blocking pain signals from getting to your spinal cord. It also helps decrease muscle spasms. •tens short term pain relief (6 to 18 hrs) •ultrasound creates warmth using sound waves, whichenchanes circulation and decreases joint pain, inflammation, and stiffness. Exercise for acute phase: •preformed exercise at least once a day. •general assisted movement through normal range (joint mobilisation). •isometric-“static movements” helps to maintain muscle tone without increasing inflammation. Exercise for the chronic phase: •can progress the above exercise to include use of light resistance. •postural/core stability exercises. •swimming/walking/cycling to maintain cardiovascular fitness. •gentle stretch for areas that become tight, such as knees &calves. Regular exercises: •maintaing muscle strength is important for joint stability & preventing injury. •muscles can become weak following reduced activity. •pain signals from yours nerves and swelling can both inhibits muscles. •muscle length can be affected by prolonged positions immobilization and tightness can limit daily activities. Alternative therapies: •thi chi. •musical therapy. •yoga therapy. •relaxation techniques. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Symptoms of arthritis symptoms of osteoarthritis may include joint pain and progressive stiffness that develops gradually. Symptoms of may include painful swelling, inflammation, and stiffness in the fingers, arms, legs, and wrists occurring in the same joints on both sides of the body, especially upon waking up in the morning. Knee arthritis can be painful and debilitating. For osteoarthritis (oa) of the knee, self-care early on can often help significantly. It is important to stretch and strengthen the surrounding leg muscles to provide more support and reduce stresses around the joint. The following best bet exercises will help you get started on your path to feeling stronger, more flexible and more active. Remember: exercise should not be painful – if you experience pain, discontinue and consult with your physician. Advice: 1.must take adequate rest 2.apply hot water with mild heat with cotton towel 3.avoid cross leg sitting and long time standing 4. Put the small size chair under the ankle during sitting in the chair for leg elevation 5.do the exercise given below 2 times per day 1.quadriceps setting exercise helps to strengthen the quadriceps muscle (the big muscle on the front of the thigh), an important stabilizer of the knee. Lie on your back with the leg you want to exercise straight. Place a small rolled towel underneath the knee. Slowly tighten the muscle on top of the thigh (quadriceps) and push the back of the knee down into the rolled towel. Hold contraction for 5 seconds and then slowly release, resting 5 seconds between each contraction. Perform 3 sets of 10 repetitions, 1 time daily. 2.straight leg raise also helps to strengthen the quadriceps muscle. Lie on your back with the leg you want to exercise straight. The other knee should be bent to support your lower back. Tighten the muscle on the top of your thigh and lift to the level of your other knee. Slowly lower. Perform 3 sets of 10 repetitions, 1 time daily. Knee pain •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. •muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. •knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain. •legs becoming numb and also pain is there when the patient walks for 10-15 minutes?•it looks like you are anaemic. If you feel that the legs are becoming numb then keep your legs warm which is important, probably you can wear mcr chappals inside the house/ socks inside the house. Put a door mat when ever you sit so that you will feel comfortable. Also pour warm water in the legs which would help you to get better circulation. •knee pain. If you are overweight, losing weight will also help to reduce pressure on your knee. Knee pain this is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened .•don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, includingback pain it looks like you are anaemic. If you have back pain after you sit for long hours then it is due to your haemoglobin levels as it is important to check that. Anaemia always leads to the symptoms of being tired and also having back / leg pain though there may not be any pathological reasons for back pain. It looks like you are anaemic. And also you have to check with your vitamin and calcium, if the bones are weak then automatically the pain gets triggered more as there is less severity of the painbe strengthened 1.resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. 2•standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone •stretching exercises. Regular, steady stretching exercises can reduce muscle spasm and help lengthen the muscle-tendon unit. Don't bounce during your stretch. 3•strengthening exercises. Weak thigh muscles contribute to the strain on your patellar tendon. Exercises that involve lowering your leg very slowly after extending it can be particularly helpful, as can exercises that strengthen all of the leg muscles in combination, such as a leg press.•this is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened. 

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Dr. G.R. AgrawalDHMS (Hons.)Homeopathy Doctor

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Hi, Lybrate user, •swelling ankle indicates, muscels injury. •possibility of uric acid can't be overruled causing pain ankle and knee joint, need a test for uric acid level in blood. •monitor your weight ,and sugar level. •consult, privetly for a faster recovery, till, then take, homoeopathic medicine, underlying:@ arnica mont 30ch -5 drops, thrice. •avoid, junk food, alcohol and nicotine. •tk, care. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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If you have leg pain then you have to rule out the casues for having leg pain. First of all check your weight and your haemoglobin levels, as anaemia always leads to the symptoms of being tired and also having leg pain though there are no issues with the knee joint or back pain. Since you met with an accident probably you would've had blood loss and also you must be having mineral or calcium deficiency that is one reason to feel very rigid or stiff in that area. Hot water fermentation that would help to reduce the muscle strain. Keep ice in the area where you have pain/or where the muscle is injured.Rest avoid using your muscle for a few days, especially if movement causes an increase in pain. But too much rest can cause muscles to become weak. This can prolong the healing process. After two days, slowly begin using the affected muscle group, taking care not to overdo it. Ice apply ice immediately after injuring your muscle. This will minimize swelling. Don’t put ice directly on your skin. Use an ice pack or wrap ice in a towel. Keep the ice on your muscle for about 20 minutes. Repeat every hour on the first day. For the next several days, apply ice every four hours. Compression to reduce swelling, wrap the affected area with an elastic bandage until swelling comes down. Be careful not to wrap the area too tightly. Doing so can reduce your blood circulation. Elevation whenever possible, keep the injured muscle raised above the level of your heart. 

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Dr. DivyaMBBSGeneral Physician

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Kindly tell the current medication you are taking check your cbc plus iron profile for ruling out anemia as of your bmi is within normal range so weight is not the reason but I advised you some daily activity swelling of feet have many reasons so for further evaluation kindly contact and if possible kindly provide your spine xray. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Heel pain apply ice use an ice pack or cold compress on your foot for 10 to 15 minutes at a time. This is especially beneficial at the end of a long day or when you’ve spent a lot of time on your feet. Or, roll a frozen water bottle under your foot. This method incorporates a bit of massage, relieving tightness in the bottom of your foot. Massage. Massaging the arch of your foot helps to relieve pain and promote mobility. Use your fingers and knuckles to deeply massage your foot for 1 to 5 minutes at a time. One technique is to place both thumbs at the center line of your arch and move them to the outer edges of your feet. Inserts. Use cushion inserts in your shoes for additional support and cushioning. Inexpensive options can be purchased off the shelf. Wear supportive shoes with thicker soles and extra cushioning for additional support that can help to reduce tension in the plantar fascia. Kinesiology tape can be used to improve arch and heel support. Night splints. Many people find quick and effective results by using night splints. They can be worn while sleeping to stretch the plantar fascia. They help to keep the plantar fascia relaxed and prevent you from pointing your feet down. Exercise foot flex use your hand to pull your toes back toward your shin. Hold this position for about 30 seconds .do each side two to three times. Toe towel grab place a small towel under your foot. Curl your toes to grip the towel. Raise the front of your foot off the floor. Hold this position for a few seconds. Release the towel as you lift up your toes and spread them as far apart as possible. Heel and calf stretch to do this stretch: 1.stand facing a wall. 2.place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3.lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4.change legs and repeat. 5.do this stretch twice for both legs. Golf ball roll roll a golf baell under your right foot. Continue for up to 1 minute. Do each foot two to three times. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Stretching and strengthening exercises or use of specialized devices may provide symptom relief. These include: physical therapy. A physical therapist can instruct you in a series of exercises to stretch the plantar fascia and achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist might also teach you to apply athletic taping to support the bottom of your foot. Night splints. Your physical therapist or doctor might recommend that you wear a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and achilles tendon in a lengthened position overnight and facilitates stretching. Orthotics. Your doctor might prescribe off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly. Injections. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture. More recently, platelet-rich plasma has been used, under ultrasound guidance, to provide pain relief with less risk of tissue rupture. Lifestyle and home remediesto reduce the pain of plantar fasciitis, try these self-care tips: maintain a healthy weight. Lose weight if you're overweight or obese to minimize stress on your plantar fascia. Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency. Don't go barefoot, especially on hard surfaces. Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you're a runner, buy new shoes after about 400 to 500 miles of use. Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging. Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation. Stretch your arches. Simple home exercises can stretch your plantar fascia, achilles tendon and calf muscles. Prevention: maintain a healthy weight. Choose supportive shoes. Don't wear worn-out shoes. Heel pain apply ice use an ice pack or cold compress on your foot for 10 to 15 minutes at a time. This is especially beneficial at the end of a long day or when you’ve spent a lot of time on your feet. Or, roll a frozen water bottle under your foot. This method incorporates a bit of massage, relieving tightness in the bottom of your foot. Massage. Massaging the arch of your foot helps to relieve pain and promote mobility. Use your fingers and knuckles to deeply massage your foot for 1 to 5 minutes at a time. One technique is to place both thumbs at the center line of your arch and move them to the outer edges of your feet. Inserts. Use cushion inserts in your shoes for additional support and cushioning. Inexpensive options can be purchased off the shelf. Wear supportive shoes with thicker soles and extra cushioning for additional support that can help to reduce tension in the plantar fascia. Kinesiology tape can be used to improve arch and heel support. Night splints. Many people find quick and effective results by using night splints. They can be worn while sleeping to stretch the plantar fascia. They help to keep the plantar fascia relaxed and prevent you from pointing your feet down. Exercise foot flex use your hand to pull your toes back toward your shin. Hold this position for about 30 seconds .do each side two to three times. Toe towel grab place a small towel under your foot. Curl your toes to grip the towel. Raise the front of your foot off the floor. Hold this position for a few seconds. Release the towel as you lift up your toes and spread them as far apart as possible. Heel and calf stretch to do this stretch: 1.stand facing a wall. 2.place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3.lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4.change legs and repeat. 5.do this stretch twice for both legs. Golf ball roll roll a golf baell under your right foot. Continue for up to 1 minute. Do each foot two to three times. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Rheumatoi d arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy this should be due to the sciatic nerve compression in the right side probably close to your l5 vertebrae. It can also be due to the strain on the left leg, try wearing mcr chappals which would help you to get relieved from pain. Rheumatoid arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy rehabilitation treatment technique - rest and splinting - compression gloves - assistive devices and adaptive equipment - massage therapy - therapeutic exercise - patient education assistive devices and adaptive equipment occupational therapy improves functional ability in patients with ra. Occupational therapy interventions such as assistive devices and adaptive equipments have beneficial effects on joint protection and energy conservation in arthritic patients. Assistive devices are used in order to reduce functional deficits, to diminish pain, and to keep patients' independence and self-efficiency. Loading over the hip joint may be reduced by 50% by holding a cane. In fact, most of these instruments are originally designed for patients with neurologic deficits; therefore, certain adaptations may be needed for them to be used in patients with arthritis. Elevated toilet seats, widened gripping handles, arrangements related with bathrooms, etc. Might all facilitate the daily life. The procedures needed to increase compliance of the patient with the environment and to increase functional independence are +mainly determined by the occupational therapist. Massage therapy that improves flexibility, enhances a feeling of connection with other treatment modalities, improves general well being, and can help to diminish swelling of inflamed joints. Massage is found to be effective on depression, anxiety, mood, and pain. Therapeutic exercise every joint should be moved in the rom at least once per day in order to prevent contracture. In the case of acutely inflamed joints, isometric exercises provide adequate muscle tone without exacerbation of clinical disease activity. Moderate contractures should be held for 6 seconds and repeated 5–10 times each day. Dynamic exercise therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (ra). Finally, in chronic stage with inactive arthritis, conditioning exercises such as swimming, walking, and cycling with adequate resting periods are recommended. They increase muscle endurance and aerobic capacity and improve functions of the patient in general, and they also make the patient feel better. It might be due to lack of blood circulation which is the reason for you to have scrotum pain / back pain. You have to do basic aerobic exercises for you to become fit and also to maintain the blood circulation and tone. Patient education in patients with ra, sociopsychological factors affecting the disease process such as poor social relations, disturbance of communication with the environment, and unhappiness and depression at work are commonly encountered. The treatment of rheumatic diseases should provide education and information to their patients about their condition and the various physical therapy and rehabilitative options that are available to improve their quality of life. Passive treatments for rheumatoid arthritis •cold therapy reduces circulation, which ultimately decreases swelling. For example, a cold compress may be placed on the painful area. •cold therapy in acute phase •dosage 10-20mints/1-2 times a day. •heat therapy eases muscle tension and gets blood to flow more quickly to the painful area. For example, a moist, warm cloth may be used to promote circulation. •heat therapy in chronic phase •dosage 20-30mints/1-2 times a day. •hydrotherapy involves reducing your ra-related pain and other symptoms with water. With hydrotherapy, you will be submerged in warm water to relieve your symptoms. •massage can help reduce muscle tension and promote good circulation. It's also a fantastic way to help you manage stress (especially important for people with rheumatoid arthritis). •transcutaneous electrical nerve stimulation (tens) works by blocking pain signals from getting to your spinal cord. It also helps decrease muscle spasms. •tens short term pain relief (6 to 18 hrs) •ultrasound creates warmth using sound waves, whichenchanes circulation and decreases joint pain, inflammation, and stiffness. Exercise for acute phase: •preformed exercise at least once a day. •general assisted movement through normal range (joint mobilisation). •isometric-“static movements” helps to maintain muscle tone without increasing inflammation. Exercise for the chronic phase: •can progress the above exercise to include use of light resistance. •postural/core stability exercises. •swimming/walking/cycling to maintain cardiovascular fitness. •gentle stretch for areas that become tight, such as knees &calves. Regular exercises: •maintaing muscle strength is important for joint stability & preventing injury. •muscles can become weak following reduced activity. •pain signals from yours nerves and swelling can both inhibits muscles. •muscle length can be affected by prolonged positions immobilization and tightness can limit daily activities. Alternative therapies: •thi chi. •musical therapy. •yoga therapy. •relaxation techniques. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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•do contrast bath ie. Take two tubs in one you can fill hot water (ie. Bearable heat) to immerse the feet in the tub and you will have good effect ie. Warmth effect. Further to that wipe with towel and immerse the feet in the cold water (ie. Ice water bath) which will help you to reduce the inflammation. Once this is done you can do some ankle movements to both the feet which will help you to boost and improve the blood circulation. As I said over the phone please use anklet which I have already sent by whats app and you can use mcrchappals which will help you to reduce the weight falling on the injured front portion of the foot. If you have the habit of using shoes then you can keep removable insoles which can be used inside the shoes and that acts like a shock absorber and which will also help to reduce and prevent the weight falling on the injured foot. This is the way to reduce the inflammation through home remedy. If the pain persists say for example after doing for 5-7 days then you have to consult physiotherapist where they will treat you with infra red radiation. But this is quite a rare treatment, if in case it is not available, let me know we can send it to you by courier. It is quite expensive but you will feel good results with that. This will help you to reduce the inflammation in the bone ie. Which is caused by the table which fell on your foot. You can thrombophob ointment to reduce the contusion and also to loosen and break the blood clot which is there in the front portion of the foot. It will also help you to change the skin colour. If the pain is too much then you can take ultracet tablet every day in the night. Keep two pillows under the ankle while sleeping on the bed which will help you to reduce the swelling. Hope you recover with this. And also please share your feed back if you become better. If you do not become better too pls let us know so that we can give some alternate solution. Please send your address so that we can send the products ie. Anklet to use it in the ankle / foot, mcrchappals for your size and also the removable foot insole. 

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Dr. Vaibhav Mohan ShingadeMBBS, DNB OrthopaedicOrthopedic Doctor

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Will need to evaluate by physical examination and diagnostic imaging like x rays/mri / blood tests. We may need to aspirate the joint if swelling is associated with pain. We need to find out the cause of pain. Do not consume painkillers for prolonged duration since it has its own side effects. Consult an orthopaedic surgeon. 

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