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• Sakit dan/atau kekakuan pada lebih daripada satu sendi. Kekakuan bertambah teruk pada waktu pagi dan/atau selepas tidak aktif
• Bengkak dan/atau kelembutan pada lebih daripada satu sendi
• Simptom serupa pada kedua-dua belah badan, contohnya, di kedua-dua tangan
• Lesu
• Lemah
• Penurunan berat badan
• Demam

Ada kalanya simptom artritis reumatoid boleh menjadi lebih baik (remisi) atau lebih teruk (suar).

Tanda-tanda awal artritis reumatoid termasuk sakit atau kelembutan pada sendi-sendi kecil seperti di jari anda. Walau bagaimanapun, ia tidak jarang mengalami kesakitan pada sendi yang lebih besar seperti bahu atau lutut anda. Anda mesti mengenali tanda-tanda awal kerana rawatan awal akan membantu mengelakkan kerosakan sendi kekal.

• Gaya hidup yang tidak sihat – elakkan pengambilan alkohol
• Obesiti – beri perhatian kepada berat badan anda
• Genetik – keluarga yang ada masalah gout
• Tabiat pemakanan yang tidak sihat – pastikan anda mengamalkan pemakanan seimbang
• Stress yang tidak terkawal
• Pengambilan ubat supplement yang bermacam

• Sakit yang melampau serta mengejut, bengkak, kemerahan dan kehangatan serta kekakuan pada sendi
• Demam gred rendah
• Asid urik dalam sendi mengakibatkan sakit keterlaluan ketika kawasan yang terjejas digerakkan
• Keradangan tisu-tisu di sekeliling sendi juga mengakibatkan kulit menjadi bengkak dan sakit walaupun hanya disentuh dengan lembut
• Gout biasanya menyerang ibu jari kaki. Gout juga menjejaskan sendi-sendi lain seperti mata, kaki, tumit, lutut, pergelangan tangan, siku, jari dan tulang belakang
• Gout boleh terjadi juga pada sendi jari-jari kaki yang tidak dapat bergerak disebabkan kecederaan dahulu yang mengakibatkan peredaran darah yang buruk

• Bengkak, kemerahan, dan sakit saat disentuh
• Sulit bergerak pada bahagian yang terkena
• Rasa sakit yang memburuk dari waktu ke waktu
• Rasa sakit saat disentuh dan nyeri pada sendi
• Peradangan dan kemerahan pada sendi

• Kaum lelaki dalam lingkungan usia 30 hingga 60 tahun
• Wanita yang sudah putus haid/menopause
• Mereka yang mempunyai sejarah keluarga yang menghidapi gout
• Orang yang mengambil alkohol secara berlebihan
• Penyakit tertentu seperti leukemia
• Sering tertekan (stress)

• Organ dalaman seperti hati, paru-paru, ginjal dan otak
• Daging cincang
• Ekstrak daging, ragi dan kiub rebusan daging
• Makanan bercengkerang seperti ketam, udang dan kerang

• Asparagus, bunga kobis, cendawan dan bayam
• Kekacang
• Roti jagung dan bijirin

• Sakit belakang
• Sakit sendi tengkuk/pinggang/pinggul
• Sakit kepala/pening/migrain
• Sakit otot
• Sakit tulang punggung
• Sakit yang berpunca dari kanser
• Sakit selepas pembedahan
• Sakit disebabkan factor psikologi

Its main assets are fact pain relief and mobility restoration makes it an ideal therapy to speed up recovery and cure various indications causing acute / chronic pain. S/W is an acoustic wave which carries high energy to painful spots myoskeletal tissues with subacute, subchonic and chronic conditions.

The energy promotes regeneration reparative process of the bone, tendons and others soft tissues. S/W are characteristic by jump change in pressure, high amplitude and non periodicity.

S/W medical effects:

i. New Blood Vessel Formation

Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue. The acoustic wave creates capillary micro ruptures and as a result of these process arterioles are remodeled, stimulated to grow and new ones are formed. The new blood vessels improve blood supply and oxygenation of the treated area and support faster healing of both the tendon and the bone.

ii. Reversal of Chronic Inflammation

Chronic inflammation occurs when the inflammatory response is not completely halted. It can damage healthy tissue and results in chronic pain. Mast cells are one of the key components of the inflammatory process. Their activity may be increased by using pervasive acoustic waves. Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds first enhance the inflammatory process and in the next step help restore normal healing and regenerative processes.

iii. Stimulation of Collagen Production

The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged myoskeletal and ligamentous structures. Shockwave therapy accelerates procollagen synthesis. The therapy forces the newly created collagen fibers into a longitudinal structure which makes the newly formed tendon fibers more dense and stiff and creates a firmer structure.

iv. Dissolution of Calcified Fibroblasts

Calcium build-up is most often a result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcifications. Shockwave therapy starts the biochemical decalcification of the calcium and treats the tendon. The granular particles of calcium are then removed by the lymphatic system.

v. Dispersion of Pain Mediator

S/W intercepts the relays pain (neurotransmitter that generally associated with intense, persistent and chronic pain) messages to the central nervous which lowering the concentration of this neurotransmitter. Reduces the stimulation of afferent nociceptive fibers and thus reduces the pain.

vi. Release of Trigger Pints

Trigger points are the principal cause of pain in the back, neck, shoulder and limbs. They are associated with palpable nodules in taut bands of muscle fibers and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the waste products to build up. Waste product build-up irritates the sensory nerve endings which then causes even more contraction. This vicious cycle is referred to as “metabolic crisis”. S/W mechanism of action is that the delivered acoustic energy unblocks the calcium pump and thus reverse the metabolic crisis in the myofilaments and releases the trigger points.

Indications for S/W:

1. Jumper’s Knee
2. Painful Shoulder / Frozen Shoulder
3. Tennis / Golfer Elbow
4. Heel Spur
5. Insertional Pain
6. Chronic Tendinopathy
7. Chronic Back Pain
8. Medial Tibial Stress Syndrome
9. Calcifications / Osteophytes
10. Hip Pain
11. Plantar Fasciiatis
12. Archilles Tendonitis