JointVibes: by Dr Markandaiya Acharya

A 68-year-old grandmother. Let us call her Kamala. She is not a real patient of mine, but her story is very common. Six months ago she slipped and fractured her spine. The bone healed. The X-ray now looks "fine". But Kamala has changed. She no longer goes to the temple alone. She avoids the market. She sits at home, worried she will fall again, and she has stopped enjoying her grandchildren's visits. Her daughter asks me: "Doctor, the fracture has healed. Why is she still not herself?" Because osteoporosis affects the mind as well as the bones . Fear, low mood and loss of independence after a fracture are real, and they deserve treatment just as much as the bone does. The cycle after a fragility fracture: fear of falling leads to less activity, weaker muscles and bones, and a higher risk of another fall Fracture Fear of falling, low mood Less activity Weaker muscles and bones Break the cycle: treat bone, mood and movement together Afte...

Walk into any home in Odisha and you will find at least one tube of pain-relief gel or balm on the shelf. People rub it on aching knees, stiff necks and sprained ankles. But do these creams actually work? Which one should you choose? And are they completely safe? As an orthopaedic surgeon, I get these questions every week. Here is an evidence-based guide to topical pain relief: what works, for which pain, and how to use it properly. Where pain-relief gels work best (knee and hand arthritis, sprains and strains) and where they help less (hip, back, nerve pain, widespread pain) Gels help most Gels help less ✓ Knee arthritis ✓ Hand and finger arthritis ✓ Sprains and strains ✓ Tendon pain near the skin ✗ Hip joint (too deep) ✗ Long-standing back pain ✗ Nerve pain, sciatica ✗ Pain all over the body Joint close to the surface Deep or widespread pain Pain-relief gels work best on joints and tendons close to the skin. Illustration: JointVibes. What is topical pain relief? ...

A 36-year-old school teacher. Let us call her Pragyan. She is not a real patient of mine, but her story is common. For about three months her fingers have been stiff every morning. It takes her nearly an hour to loosen them enough to hold a pen. Her wrists are puffy. Lately both feet hurt when she gets out of bed. She has been taking painkillers from the medical store and rubbing oil on her hands. She asks: "Doctor, is this just body pain, or something serious?" Morning stiffness lasting more than half an hour, with swelling of the small joints of both hands, is a pattern doctors take seriously. It can be early rheumatoid arthritis (RA) . And with RA, the first few months matter more than most people realise. Joints usually affected in rheumatoid arthritis (wrist, knuckles and middle finger joints, on both hands) compared with osteoarthritis (end finger joints and thumb base) Rheumatoid arthritis Wrist, knuckles, middle finger joints; both hands;...