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Posted by Tressa on February 27th, 2021

I am 34, a paediatric physiotherapist and have been battling endometriosis, diagnosed through a laparoscopy three years ago. The surgeon found several adhesions in the pelvic region and around the bowel and bladder. These were removed by laser but I still suffer a lot of pain which is only partly relieved by acupuncture and co-codamol. My husband and I are trying for a baby, but I have had two early miscarriages and haven't been able to conceive for the past l6 months. I would be so grateful for any advice on the pain and how to conceive.

Answer:

In recent years endometriosis has become major problem for women in the West and urban societies worldwide. My belief is that stress plays a major role in its genesis, though this is difficult to prove.

The endometrium, or inner lining of the womb (endo- inside, metrium- uterus), is soft and jelly-like in consistency and full of blood vessels. Sometimes, for reasons we don't know, it starts to migrate and lodge in other tissues such as the gut walls, ovaries or the ligaments that suspend the womb. The main symptoms of endometriosis are pain (mainly before the period), bleeding (because this is natural for the endometrium) and disturbed cycles (longer or shorter periods).

Massage is one of the most powerful therapeutic tools for many conditions, so I have spent a lot of time prodding and feeling patients, abdomens. This has led me to discover that a lot of abdominal pain actually originates in the walls of the abdomen.

First an anatomy lesson: there are straight muscles running from the centre of the ribcage to the pubic bone and two sets of oblique muscles crisscrossing the abdomen from the ribcage to the top of the hip bone and the ribcage to the top of the pubic bone. (Strengthening these muscles is the basis of exercise systems such as Pilates.) However, this leaves some areas which are not covered by muscle - I have called these 'Dr Ali's abdominal points'. The lower ones, which lie about three or four fingers either side of the belly button and about four fingers below, are most relevant to the pain of endometriosis. Prod these areas with your index finger and a sharp pain will guide you to the exact location.

If some of the tissue of the endometrium gets lodged on the gut walls, it clings, like a cobweb on your sleeve. This is what forms the adhesions. Now if you get gas in the intestines that causes bloating, the gut walls are pulled in different directions causing pain. The situation gets worse if the gas becomes trapped: in an effort to release it, the gut starts contracting and expanding in spasms, causing colicky pain. If abdominal gas and pelvic congestion build up, the sensitive lining of the abdomen (called the peritoneum) reacts by trying to herniate, or penetrate these weak points that I have mentioned above. This causes excruciating pain. Massage is very effective. Gently rub and stroke the affected lower abdominal point with peppermint balm or cream when the pains strikes.

Also massage both lower abdominal points twice daily for two or three days just before your period, or when pain starts. Also massage your neck and shoulder area and the base of your skull, to improve blood flow to the pituitary gland: this controls your hormonal activity and thus your ability to conceive. Your partner can help with this.

How to ease the pain of endometriosis

Control abdominal gases:If you are constipated, take Isapgol psyllium husks as directed on the label, and Herbolax: one tablet after your evening meal for two months; eat papaya, spinach and prunes and drink about two litres of still water daily. Also avoid discretchemshop.com/product/buy-co-codamol-30-500mg-online/ yeast containing and gas-producing foods such as beer, fizzy water, mushrooms, vinegar, chickpeas, beans, high-fibre cereals, radishes, sugar and preserved products. Help self-healing by boosting your body's energy with Indian ginseng, Ashwaganda: take one or two daily for four months.

Also take zinc tablets: one 15mg tablet daily (preferably in the evening) for one month, then alternate days for three months. For relaxation, take one tablet of the Ayurvedic remedy Mentat at bedtime for two months. Help heal your womb with specific yoga exercises: you can find them in book Therapeutic Yoga. Beneficial poses are the cobra, abdominal pump, boat and child.

This article gives the reader a basic knowledge of the knee structure. Points covered will be different ligaments and cartilage that interact to enable correct function of the knee. The treatment and causes of housemaids knee (bursitis) will also be described. Pharmaceuticals can be used to reduce pain and inflammation. These can range from the fairly mild paracetamol to the strong opoids such as morphine. Herbal remedies tend to work on inflammation. The reduction of inflammation itself can often reduce pain levels. This article aims to help the reader suffering knee problems to be able to make considered choices in their treatment.

Basic Structure Of The Knee.

The knee consists of four bones, namely the femur, tibia, the fibula and the patella. The knee joint is located between the femur and tibia and is traditionally classed as a hinge joint, having movement in only plane. This means that the knee only bends or straightens. However, it is also classed as a ellipsoid joint because it does allow a small amount rotation of the lower leg. The patella (kneecap) is situated at the front of the knee. The femur has two ellipsoid surfaces and joins the fibia with the menisci (commonly known as cartilage) between. The fibula does not directly move with the femur but works on the lateral (outer) side of the tibia. There thirteen ligaments attached around the knee. These are patellar, patellar retinaculum, oblique popiliteal, arcuate popiteal, medial collateral, lateral collateral, anterior cruciate, posterior cruciate, coronary (2), transverse, and meniscofemoral (2). It is not in the remit of this article to describe in detail the function of all of these ligaments.

Housemaids Knee', A Common Cause Of Knee Pain.

Housemaids knee is a common name given to Bursitis. This occurs in the subcutaneous prepatellar bursa. This can, as the common name suggests, be caused by prolonged work performed on the knees. This type of bursitis can affect roofers, carpet layers, miners, plumbers amongst other groups who kneel for long periods. Bursitis may also cause another condition of slow accumulation of fluid in the knee commonly called 'water on the knee'.

Another cause of a swollen knee can be caused following an injury. If the swelling appears immediately after the injury the swelling is often an accumulation of blood within the joint called 'hemarthrosis'.

Treatment For Housemaids Knee Using Pharmaceutical Drugs.

There are many pain relief and anti-inflammatory medicines readily available. In this article some general ones will be described.

Paracetamol: Also called Acetaminophen. Paracetamol relieves pain and fever in adults and children. Its pain relief (analgesic) and fever relief (antipyretic) effects are similar to those of aspirin and it works in a similar way. Unlike aspirin, however, increasing the dose does not result in clinically useful anti-inflammatory activity. Paracetamol is therefore not of value for reducing inflammation in the treatment of bursitis (housemaids knee). The recommended adult single dose of paracetamol is two standard 500 mg tablets. Although paracetamol is widely available it should be treated with respect. An overdose to a healthy person of taking 30 tablets at once will result in liver damage and possible death.

Co-Codamol. Co-codamol contains a combination of two pain-killing ingredients paracetamol and codeine. It is used to stop pain. The amount of codeine in the combination determines the strength of the preparation. There are three different strengths of co-codamol available. Codeine/Paracetamol 8/500mg, 12.8/500mg, and 30/500mg. Common side effects are feeling sick, dry mouth and constipation amongst others.

Codeine Phosphate. Codeine phosphate is a pain killer. It comes in 3 tablet sizes, 15mg, 30mg, and 60mg. Common side effects include skin rash or itchy skin, difficulty breathing, increased sweating, redness or flushed face, constipation, feeling or being sick, dry mouth, a slow or fast heart rate, palpitations, low blood pressure, low blood pressure on standing, pain and difficulty in passing urine and a less frequent need to do so, dizziness, and blurred vision amongst others.

Ibuprofen. Ibuprofen is in the group of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body. Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as bursitis (housemaids knee). Common side effects are an increase in asthma symptoms, increased risk of stomach ulcers, and damage to the intestines amongst others.

NaproxenNaproxen is a NSAID. It is used to reduce pain and inflammation in many conditions including knee pain. Common side effects include ringing in the ears, headaches, dizziness, drowsiness, heartburn, and constipation amongst others.

Voltarol. Also called Diclofenac Sodium is a NSAID. Voltarol is available in tablet form and a gel that is rubbed into the affected area. Voltarol is used in the treatment of many conditions including acute musculo-skeletal disorders such as periarthritis (for example frozen shoulder), tendinitis, tenosynovitis, bursitis. Some common side effects include nausea, constipation, vomiting, indigestion, loss of appetite, headache, dizziness, skin rashes, drowsiness, depression, insomnia, fluid retention and ringing in the ears amongst others.

Treatment Of Housemaids Knee using Natural Methods.

Chondroitin Sulfate: Chondroitin Sulfate is also naturally