HEALTH: OSTEOARTHRITIS (PAIN, JOINT) ARTHRITIS

HEALTH: OSTEOARTHRITIS (JOINT PAIN) SYMPTOMS & TREATMENT Rheumatoid arthritis>>

What is Osteoarthritis?

Osteoarthritis is a form of joint disease that develops when cartilage deteriorates. Over time, the space between bones narrows and the surfaces of the bones change shape, leading eventually to friction and joint damage, producing pain. Osteoarthritis often affects more than one joint, and while it can affect any joint in the body, some joints are affected much more often than others. For example, osteoarthritis is quite common in the hip, knee, lower back, neck, and certain finger joints, but it is rare in the elbow.

Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Osteoarthritis is also known as degenerative arthritis. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common of all joint diseases, affecting over 20 million people in the United States. Because the risk of developing osteoarthritis increases with age, this form of arthritis is expected to become even more prevalent as the population of the United States grows older. Osteoarthritis occurs more frequently as we age. Before age 45, osteoarthritis occurs more frequently in males. After age 55 years, it occurs more frequently in females.

Women more often have osteoarthritis in the hands and knees. Men are more likely to have it in the hips, knees, and spine. Women are 10 times more likely to develop Heberden's nodes, a type of osteoarthritis in which hard, bony growths form on the joint nearest the fingertip. In the United States, all races appear equally affected. A higher incidence of osteoarthritis exists in the Japanese population, while South African blacks, East Indians, and Southern Chinese have lower rates.

Osteoarthritis is virtually unheard of in children and is rare in young adults. But it's common among older people. Almost everyone over age 65 has some cartilage and bone changes typical of the disorder. For this reason, osteoarthritis was long considered a natural product of aging, reflecting everyday wear and tear on cartilage.

As cartilage degenerates, patches of exposed bone appear. Just as a damaged gasket leads to metal-on-metal contact in a machine, your bones experience mechanical friction and irritation. They try to repair themselves, but the repair is disorderly. As a result, the surface thickens and osteophytes (bone spurs) form.

Once your cartilage is damaged, the resulting abnormalities can irritate surrounding soft tissues and cause inflammation and pain. People with severely damaged joints sometimes have episodes of joint swelling from synovitis (inflammation of the joint's lining); however, this inflammation tends to be much milder than in rheumatoid arthritis or other inflammatory joint diseases. The damaged cartilage, bone rubbing on bone, and the inflammation combine to make movement painful.

Health: Causes of Osteoarthritis (Joint - Pain)

Primary osteoarthritis is mostly related to aging. With aging, the water content of the cartilage increases, and the protein makeup of cartilage degenerates. Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced cases, there is a total loss of cartilage cushion between the bones of the joints. Repetitive use of the worn joints over the years can irritate and inflame the cartilage, causing joint pain and swelling. Loss of the cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility. Inflammation of the cartilage can also stimulate new bone outgrowths (spurs, also referred to as osteophytes) to form around the joints. Osteoarthritis occasionally can develop in multiple members of the same family, implying a hereditary (genetic) basis for this condition. Secondary osteoarthritis is caused by another disease or condition. Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal joints at birth (congenital abnormalities), gout, diabetes, and other hormone disorders.

Excess weight

By now, everyone has heard that carrying excess body fat can lead to problems with the heart and other organs. Here's another reason to slim down: Overweight people are much more likely to develop osteoarthritis of the knee. These weight-bearing joints just don't hold up well under the continued strain of extra pounds — and extra pounding.

An ongoing study of people living in Framingham, Mass., found that overweight young adults were more likely to develop knee osteoarthritis in their 30s and 40s than were their slimmer counterparts. Women who were the heaviest were twice as likely as thinner women to get osteoarthritis and had three times the risk for severe knee osteoarthritis. Losing weight can reduce risk. Researchers who analyzed the Framingham data found that women who lost 11 pounds cut their risk of developing osteoarthritis of the knee by half.

Genetic factors

Consensus is growing that genetic factors likely control the manifestations and progression of osteoarthritis. Studies in identical twins — who share the same genes and thus offer insight into the relative importance of genetic and environmental factors — have shown that roughly half the risk of developing osteoarthritis can be attributed to genetic factors. Multiple genes are thought to be involved, and to complicate matters further, the genes may have different effects depending on the joint affected and whether someone is male or female.

Genetic studies of a disease like osteoarthritis are hampered by several factors. First, the sheer number of people with the disorder makes it impossible to discount the influence of external factors. Second, scientists must establish that a certain gene is present in most people with the disease, but is absent in those who are healthy.

Hormones

Osteoarthritis is common among postmenopausal women. One study found that women who were taking estrogen replacement therapy appeared to have a lower risk of developing the disease, suggesting that estrogen may have a protective effect on cartilage in much the same way that it protects bones from osteoporosis. However, these findings remain controversial: Estrogen has many, and in some cases conflicting, effects on connective tissue and bone, making the association between estrogen and arthritis difficult to sort out.

Postmenopausal women tend to have either osteoarthritis or osteoporosis, but not both. This may be because the bones of thinner people are less dense and more susceptible to osteoporosis; heavier people, who have higher bone density, are less prone to osteoporosis but more susceptible to arthritis from greater stress on joints.

Joint injury

Injury to a joint, either because of repeated use or trauma, may also cause osteoarthritis. As many athletes know, severe knee trauma disrupts the normal mechanics of joint function. Nearly all tissues heal by scarring, leaving irregularities on their surfaces. Because bones, joints, or muscles that are damaged rarely heal perfectly, joint injuries can create unusual mechanical stresses that lead to abnormal wear. People in certain occupations are prone to develop osteoarthritis in those joints subjected to the most stress. For example, osteoarthritis may affect the hips, ankles, and feet of ballet dancers, the knees of soccer players, the hips of farmers, the elbows of riveters, and the hands and wrists of pneumatic tool operators. The cause is thought to be repetitive stress leading to bone fatigue, microscopic fractures, and eventually cartilage breakdown.

Even those who are sedentary can develop occupational osteoarthritis when repetitive stress is sustained for several hours a day. Perhaps surprisingly, people who spend a lot of time using a keyboard aren't more likely to develop osteoarthritis of the hands, because typing puts very little mechanical stress on the joints.

Other diseases

Osteoarthritis can also develop in a joint damaged by a related disease, such as rheumatoid arthritis, infectious arthritis, or gout. Or osteoarthritis may develop because of hemophilia, growth abnormalities, or hereditary metabolic diseases. Hemophilia can produce osteoarthritis as a result of bleeding in the joint.

Growth abnormalities that can lead to osteoarthritis include acromegaly and slipped femoral epiphysis. Acromegaly is characterized by the irregular overgrowth of bone and cartilage due to abnormal production of growth hormone. Slipped femoral epiphysis involves displacement of the growth plate at the end of the femur, the bone that extends from hip to knee. Osteoarthritis can also arise from hereditary metabolic diseases, such as hemochromatosis (the harmful accumulation of iron in tissues).

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Also see: ARTHRITIS RHEUMATOID ARTHRITIS GOUT BURSITIS TENDONITIS
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Health: Symptoms of Osteoarthritis (Joint - Pain)

The symptoms of osteoarthritis usually develop over many years. Often, people first experience pain after engaging in strenuous activity or overusing a joint. The joint may be stiff in the morning, but after a few minutes of movement, it loosens up. Gradually, this stiffness becomes a routine part of waking up.

Cartilage is insensitive to pain, but the soft tissue in the joints is not. As more cartilage is worn away, soft tissue becomes increasingly irritated, even by slight movement. Some people have continual joint pain that interferes with sleep. Or the joint may be mildly tender, and movement may produce crepitus, a sensation of crackling or grating. In addition, gradual joint enlargement may interfere with normal mobility. Swelling may also occur as synovial tissues become irritated, or when inflammation develops. Although inflammation is not a cardinal feature of osteoarthritis, it does sometimes occur. Pain usually occurs in the affected joint, although it may extend elsewhere.

When osteoarthritis affects the knee, the result is pain, swelling, and stiffness of that joint. What starts out as some discomfort after a period of disuse can progress to difficulty walking, climbing, bathing, and getting in and out of bed.

Osteoarthritis of the hand often starts with stiffness and soreness of the joint at the base of the thumb, particularly in the morning. You may find it becomes harder to pinch, and your joints crackle when moved. As the condition worsens, the pain at the base of your thumb can become more of a problem, and your ability to pinch decreases even further. The entire area may seem unstable. People with osteoarthritis of the hand may eventually find it impossible to open jars, turn a key, write, or type. Many people with osteoarthritis of the hand find that, with age, their hands thicken and become stiff. Stiffness is gradually followed by pain or instability. In other people, the pain and stiffness of hand osteoarthritis may subside over time, despite marked bony enlargement typical of the disease.

Radiating pain is often the most striking feature of hip and spine osteoarthritis. When osteoarthritis affects your hip, you may feel pain in the groin or down the inside thigh, or pain may radiate to your buttocks or knee. Osteoarthritis of the cervical spine (neck) may cause pain in your shoulders and arms. In the lower spine, osteophytes may impinge on adjacent nerves and send pain radiating to your buttocks or legs.

For most people, osteoarthritis develops gradually. Pain and stiffness in affected joints may slowly worsen, but most people are able to lead normal lives.

Symptoms of osteoarthritis include: Natural Cure For Arthritis

Pain in a joint during or after use, or after a period of inactivity.

Tenderness in the joint when you apply light pressure.

Stiffness in a joint, that may be most noticeable when you wake up in the morning or after a period of inactivity.

Loss of flexibility may make it difficult to use the joint.

Grating sensation when you use the joint.

Bone spurs, which appear as hard lumps, may form around the affected joint.

Swelling in some cases.

Osteoarthritis symptoms most commonly affect the hands, hips, knees and spine. Unless you've been injured or placed unusual stress on a joint, it's uncommon for osteoarthritis symptoms to affect your jaw, shoulder, elbows, wrists or ankles.

Health: Risk factors of Osteoarthritis (Joint - Pain)

Factors that increase your risk of osteoarthritis include:

Older age. Osteoarthritis typically occurs in older adults. People under 40 rarely experience osteoarthritis.

Sex. Women are more likely to develop osteoarthritis, though it isn't clear why.

Bone deformities. Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.

Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.

Obesity. Carrying more body weight places more stress on your weight-bearing joints, such as your knees. But obesity has also been linked to an increased risk of osteoarthritis in the hands, as well.
Other diseases that affect the bones and joints. Bone and joint diseases that increase the risk of osteoarthritis include gout, rheumatoid arthritis, Paget's disease of bone and septic arthritis.

Health: Diagnosis of Osteoarthritis (Joint - Pain)

If your doctor suspects you have osteoarthritis, he or she will examine your affected joint and ask you questions about your joint pain. To better understand the cause of your pain, he or she may also recommend:

X-rays. X-ray images of your affected joint may reveal a narrowing space within a joint, which indicates that the cartilage is breaking down. An X-ray may also show bone spurs around a joint.

Blood tests. Blood tests may help rule out other causes of joint pain, such as rheumatoid arthritis.

Joint fluid analysis. Your doctor may use a long needle to draw fluid out of the affected joint. Examining and testing the fluid around your joint can determine if your pain is caused by gout or an infection.

Examining the joint with a tiny camera (arthroscopy). In some cases, your doctor may recommend arthroscopy to see inside your joint in order to determine the cause of your pain. During arthroscopy, small incisions are made around your joint and a tiny camera is inserted to see inside your joint. Your doctor watches a video screen to look for abnormalities within your joint.

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Alternative Natural Treatment For Arthritis
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Conventional Health Treatment of Osteoarthritis (Joint - Pain)

There's no known cure for osteoarthritis, but treatments can help to reduce pain and maintain joint movement so that you can go about your daily tasks. While medications and joint replacement surgery are key components of treatment for osteoarthritis, your doctor will likely recommend you try all other possible solutions before you consider those options. Eventually the pain may become severe so that medications and surgery may be necessary. Medications form the basis of treatment for osteoarthritis, but are best used in conjunction with other pain relief strategies, such as exercising to build your muscles and protecting your joints from injury or overuse.

Treatment options for mild case osteoarthritis
For mild osteoarthritis pain that is bothersome, but not enough to have a great impact on your daily activities, your doctor may recommend that you:

Rest. If you're experiencing pain or inflammation in your joint, rest it for 12 to 24 hours. Find activities that don't require you to use your joint repetitively. Try taking a 10-minute break every hour.
Exercise. With your doctor's approval, get regular exercise when you feel up to it. Stick to gentle exercises, such as walking, biking or swimming. Exercise can increase your endurance and strengthen the muscles around your joint, making your joint more stable. Avoid exercising tender, injured or swollen joints. If you feel new joint pain, stop. New pain that lasts more than two hours after you exercise probably means you've overdone it.
Lose weight. Being overweight or obese increases the stress on your weight-bearing joints, such as your knees and your hips. Even a small amount of weight loss can relieve some pressure and reduce your pain. Aim to lose 1 or 2 pounds a week, at most. Talk to your doctor about healthy ways to lose weight. Most people combine changes in their diet with increased exercise.
Use heat and cold to manage pain. Both heat and cold can relieve pain in your joint. Heat also relieves stiffness and cold can relieve muscle spasms. Soothe your painful joint with heat using a heating pad, hot water bottle or warm bath. Heat should be warm, not hot. Apply heat for 20 minutes several times a day. Cool the pain in your joint with cold treatments, such as with ice packs. You can use cold treatments several times a day, but don't use cold treatments if you have poor circulation or numbness.
Work with a physical therapist. Ask your doctor for a referral to a physical therapist. The physical therapist can work with you to create an individualized exercise plan that will strengthen the muscles around your joint, increase your range of motion in your joint and reduce your pain.
Find ways to avoid stressing your joints. Find ways to go about your day without stressing your joints. An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint. For instance, a toothbrush with a large grip could make brushing your teeth easier if you have finger osteoarthritis. A special seat in your shower could help relieve the pain of standing if you have knee osteoarthritis.
Apply over-the-counter pain creams. Creams and gels available at the drugstore may provide temporary relief from osteoarthritis pain. Some creams numb the pain by creating a hot or cool sensation. Other creams contain medications, such as aspirin-like compounds, that are absorbed into your skin. Read the label so you know what you're using. Pain creams work best on joints that are close the surface of your skin, such as your knees and fingers.
Try braces or shoe inserts. Consider trying special splints, braces, shoe inserts or other medical devices that can help reduce your pain. These devices can immobilize or support your joint to help you keep pressure off it.
Take a chronic pain class. The Arthritis Foundation and some medical centers have classes for people with osteoarthritis or chronic pain. Ask your doctor about classes in your area or check with the Arthritis Foundation. These classes teach skills that help you manage your osteoarthritis pain. And you'll meet other people with osteoarthritis and learn their tips for reducing joint pain or coping with your pain.

Treatment options for moderate case osteoarthritis
Osteoarthritis pain that persists despite initial treatment may require medications in addition to initial treatment options. Don't assume that taking a medication is all you need. In order to get the most from your treatment, continue exercising when possible and resting when you need to. If you're overweight, continue working to lose weight.

Medications that may be useful for moderate arthritis include:

Acetaminophen. Acetaminophen (Tylenol, others) can relieve pain, but doesn't reduce inflammation. It has been shown to be effective for people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dosage of acetaminophen can cause liver damage, especially if you consume three or more alcoholic drinks a day. Ask your doctor for guidance on limiting or abstaining from alcohol if you take acetaminophen regularly. Acetaminophen can also affect other medications you may be taking, so be sure to inform your doctor if you're taking it.
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve). Stronger versions of these NSAIDs and others are available by prescription. NSAIDs have risks of side effects that increase when used at high dosages for long-term treatment. Side effects may include ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage. Consuming alcohol or taking corticosteroids while using NSAIDs also increases your risk of gastrointestinal bleeding.
Tramadol. Tramadol (Ultram) is a centrally acting analgesic that's available by prescription. Tramadol has no anti-inflammatory effect, but can provide effective pain relief with fewer side effects - such as stomach ulcers and bleeding - than those of NSAIDs. However, tramadol may cause nausea and constipation. It's generally used for short-term treatment of acute flare-ups. Your doctor may recommend using tramadol in combination with acetaminophen to increase pain relief.

Treatment options for severe osteoarthritis
If you've tried other treatments but are still experiencing severe pain and disability, you and your doctor can discuss other treatments including:

Stronger painkillers. Prescription pain pills, such as codeine and propoxyphene (Darvon), may provide relief from more severe osteoarthritis pain. These stronger medications carry a risk of dependence, though that risk is thought to be small in people who have severe pain. Side effects may include nausea, constipation and sleepiness.
Cortisone shots. Injections of corticosteroid medications may relieve pain in your joint. During this procedure your doctor numbs the area around your joint and then inserts a needle into the space within your joint and injects medication. It isn't clear how or why corticosteroid injections work in people with osteoarthritis. Your doctor may limit the number of injections you can have each year, since too many corticosteroid injections may cause joint damage.
Visco-supplementation. Injections of hyaluronic acid derivatives (Hyalgan, Synvisc) may offer pain relief by providing some cushioning in your knee. These treatments are made of rooster combs and are similar to a component normally found in your joint fluid. Visco-supplementation is only approved for knee osteoarthritis, though researchers are studying its use in other joints. Injections are typically given weekly over several weeks. Pain relief may last for a few months. Possible risks include infection, swelling and joint pain. People who are sensitive to birds, feathers or eggs shouldn't undergo visco-supplementation treatments.

Surgery for osteoarthritis
Surgery is generally reserved for severe osteoarthritis that isn't relieved by other treatments. You may consider surgery if your osteoarthritis makes it very difficult to go about your daily tasks. Surgical treatments include:

Joint replacement. In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal devices called prostheses. The hip and knee joints are the most commonly replaced joints. But today implants can replace your shoulder, elbow, finger or ankle joints. How long your new joint will last depends on how you use it. Some knee and hip joints can last 20 years. Joint replacement surgery can help you resume an active, pain-free lifestyle. In smaller hand joints, it can also improve appearance and comfort and may improve your joint's mobility. Joint replacement surgery carries a small risk of infection and bleeding. Artificial joints can wear or come loose, and may need to eventually be replaced.
Cleaning up the area around the joint (debridement). Your surgeon may recommend removing loose pieces of cartilage and bone from around your joint to relieve your pain. Debridement is most useful if you're experiencing a locking sensation from a torn cartilage or loose debris in your knee joint. Debridement is typically done arthroscopically, meaning only small incisions are made in your body. A tiny video camera is inserted through the incision to allow your surgeon to see inside your joint. The surgeon uses special surgical tools to clean out any debris pieces from your joint.
Realigning bones. Surgery to realign bones may relieve pain. These types of procedures are typically used when joint replacement surgery isn't an option, such as in younger people with osteoarthritis. During a procedure called an osteotomy, the surgeon cuts across the bone either above or below the knee to realign the leg. Osteotomy can reduce knee pain by transferring the force of the joint away from the worn-out part of the knee.
Fusing bones. Surgeons also can permanently fuse bones in a joint (arthrodesis) to increase stability and reduce pain. The fused joint, such as an ankle, can then bear weight without pain, but has no flexibility. Arthrodesis may be an option if you experience severe pain in your joint, but can't undergo joint replacement surgery.

Health: Steps and care in slowing the progression of osteoarthritis (Joint - Pain)

Osteoarthritis is a disease that progresses slowly over many years. If you've already been diagnosed with osteoarthritis, you can take steps to slow its progression and reduce your discomfort. These measures are most effective if you begin them in the earlier stages of your condition. But no matter how far your osteoarthritis has progressed, you can benefit from the following.

Eat a healthy diet. A healthy diet emphasizing fruit, vegetables and whole grains can help you control your weight and maintain your overall health, allowing you to deal better with your arthritis. However, there's no special diet effective for treating arthritis. It hasn't been proved that eating any particular food will make your joint pain or inflammation better or worse.
Take your medications as recommended. By taking medications regularly instead of waiting for pain to build, you will lessen the overall intensity of your discomfort.
Use assistive devices. Assistive devices can make it easier to go about your day without stressing your painful joint. A cane may take weight off your knee or hip as you walk. Gripping and grabbing tools may make it easier to work in the kitchen if you have osteoarthritis in your fingers. Your doctor or occupational therapist may have ideas about what sorts of assistive devices may be helpful to you. Catalogs and medical supply stores may also be places to look for ideas.
Avoid grasping actions that strain your finger joints. For example, instead of a clutch-style purse, select one with a shoulder strap. Use hot water to loosen a jar lid and pressure from your palm to open it, or use a jar opener. Don't twist or use your joints forcefully.
Spread the weight of an object over several joints. Use both hands, for example, to lift a heavy pan. Try using a walking stick or cane.
Maintain good posture. Poor posture causes uneven weight distribution and may strain ligaments and muscles. The easiest way to improve your posture is by walking. The faster you walk, the harder your muscles must work to keep you upright. Some people find that swimming also helps improve their posture.
Use your strongest muscles and favor large joints. Don't push open a heavy glass door. Lean into it. To pick up an object, bend your knees and squat while keeping your back straight.
Choose appropriate footwear. Wearing comfortable cushioned shoes that properly support your weight is especially important if you have arthritis in your weight-bearing joints or back.
Stay active. For people with osteoarthritis, regular exercise has been shown to reduce pain and stiffness and to improve balance. Exercise helps people perform such basic activities as walking. It also helps build or maintain muscle tone, which is necessary for joint stability.
There are three types of exercise beneficial for someone coping with osteoarthritis. Range-of-motion exercises can maintain or improve flexibility. Strengthening exercises with weights can build muscles to support affected joints. And aerobic exercises can help improve endurance and prevent weight gain.

One study that compared walking and weight training suggests that exercise may help prevent disability. People with knee osteoarthritis who exercised regularly were less likely to need help with daily activities such as getting out of bed, bathing, using the toilet, or getting dressed. The improvements most likely reflected a general improvement in health and functioning, rather than a change in the arthritis itself. The reported improvements were nonetheless substantial.

Try to work your way up to 30 minutes of aerobic exercise — slow walking, biking, or swimming — at least four times a week. Add in some resistance or weight-training exercises three times a week.
Protect your joints. When exercising, protect yourself from joint injury. For example, if you have osteoarthritis of the hip, knee, foot, or ankle, don't run, especially on roads. Walking is a much gentler form of exercise, although it, too, puts full, weight-bearing stress on some joints. Other good alternatives are non-impact aerobic activities such as swimming or biking. Invest in a good pair of exercise shoes, which will absorb some of the impact. Avoid repetitive, weight-bearing motion. If you can't avoid such joint stress altogether, take frequent breaks. Remember to bend your knees when lifting heavy objects. Use the largest, strongest joint to complete a task. For example, open a jar with the palm of your hand instead of with your fingers
Control your weight. Osteoarthritis and excess pounds often go hand in hand. For one thing, arthritis promotes inactivity. For another, it affects older people, who tend to be less active. But studies have shown that weight loss reduces osteoarthritis pain. It does so by taking some of the pressure off your joints, especially the weight-bearing joints such as the knees and hips. Losing weight also allows greater ease of movement.

Exercise is the first step toward weight loss. A healthy, well-balanced diet is another. Concentrate on replacing empty calories from desserts and junk food with nutrition-packed calories from whole grains, lean proteins, and fruits and vegetables. Also be sure to control portion sizes. Most experts now agree that virtually any diet program is effective for losing weight when it encourages people to reduce their calorie intake and increase calories burned. Whatever diet strategy you choose, the bottom line is that to lose weight, you have to consume fewer calories than you burn.

Osteoarthritis pain may flare from time to time. In order to prevent and cope with these flares in pain and stiffness, try those self-care techniques.

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Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.

Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services

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