Even though claims that magnetic therapy can treat diseases like cancer and multiple sclerosis are unfounded, there is some evidence that it may help relieve pain related to these chronic conditions:

1) Arthritis

In a 2004 study of 194 adults with osteoarthritis of the hip or knee, researchers found that those who wore magnetic bracelets for 12 weeks had a decrease in arthritis-associated pain. Meanwhile, a 2001 study of 64 people with rheumatoid arthritis of the knee showed that 68% of those who used magnetic therapy reported feeling better or much better after one week.

Learn about other natural solutions for osteoarthritis and rheumatoid arthritis.

2) Chronic Pelvic Pain

For a 2002 study of 32 women with chronic pelvic pain, one group of patients had active or placebo magnets applied to their abdomens for 24 hours a day. After four weeks of continuous use, those who received the active magnets reported significantly lower pain levels than at the start of the study.

3) Fibromyalgia

After six weeks of sleeping on magnetized mattress pads, 13 women with fibromyalgia reported significantly less pain, sleep disturbance, fatigue, and next-day tiredness. A control group of 12 women (who slept on non-magnetized mattresses) had smaller improvements in pain, sleep, fatigue, and tiredness. The study's authors note that improvements in both groups might have been due to use of a better mattress pad.

Rheumatology is a superspeciality which deals with problems of bones joints muscles and connectivity tissue diseases like Sle, vasculitis.
There are about 200 type of Arthritis mainly osteoarthritis, Rheumatic Arthritis, Gout etc.
Contrary to the previous belief, these problems can be accurately diagnosed and managed by the doctor skilled in Rheumatology who is known as Rheumatology

Unusual case of poly articular gout-a case report.

Abstract-
Gout is a common inflammatory arthritis caused by deposition of monosodium urate crystals in the joints. It classically affects the first metatarsophalangeal joint and less commonly other joints, such as wrists, elbows, knees and ankles.
We report the case of a 65-year-old man with tophaceous polyarticular gout, soft-tissue involvement of elbow joint with secondary infection leading to septicemia.
Key words—
Gout, monosodium urate crystals, tophi, arthropathy,Febuxostat,Colchicine
Introduction-

Gout is a common disorder of uric acid metabolism, characterized by recurrent episodes of inflammatory arthritis, tophaceous soft tissue deposits of monosodium urate crystals, uric acid renal calculi and chronic nephropathy. We report the case of a 65-year-old man suffering from tophaceous polyarticular gout and soft-tissue involvement, presenting with ulcerated tophi overlying the left elbow. We also emphasize the disabling effects of the untreated hyperuremic arthropathy.
Case presentation
A 65-year old man with a long-standing history of tophaceous gout and several recurrent episodes of arthritis during the past five years presented with a large, painful, ulcerated tophus located on the left elbow joint to the emergency department. He tried a course of non-steroidal anti-inflammatory drugs (NSAIDs) without improvement.
On physical examination he had a mild fever of 37.8°C. A grayish, voluminous and ulcerated nodule containing chalky material was located on the left elbow. Further examination revealed multiple other tophi overlying the 4th and 5th PIP joints (proximal interphalangeal joint) of his right hand and the first interphalangeal joints of his left hand(Figure 1). Other joints involved were wrists, elbows, ankles, interphalangeal and metatarsophalangeal joints of the feet and heels. Many joints were also deformed. The first metatarsophalangeal joint of his left foot was totally nonfunctional.
Laboratory workup revealed leukocytosis (11.000/mm3), elevated C-reactive protein (60.21 mg/dl) and elevated serum uric acid (11 mg/dl) and normal serum creatinine (0.9mg/dl). Radiographs of the hands showed showing soft tissue swelling and destruction of both wrist, left IP thumb, right 4th and 5th PIP joints, calcified tophi seen in right 2nd MCP joint(meta carpo phalangeal joint)(Figure 2). A culture from the ulcerated tophus was positive for staphylococcus aureus (Methicillin sensitive). Two days after admission, the tophus burst releasing a viscous, chalk-like material. Polarized microscopy confirmed presence of needle shaped monosodium urate crystals (Figure 3).
Antibiotic treatment with IV Ciprofloxacin (1000 mg/day) and intravenous administration of NSAIDs (Diclofenac 100 mg/day) was initiated.
A surgical debridement with lavage of the joint was performed. Debridement was also performed on the minor ulcers. Five days after admission treatment with Febuxostat (80 mg/day) along with Colchicine 0.5mg twice daily was initiated. The patient improved clinically and was discharged two days later. Six months after treatment, he remains symptom free.
Discussion:
Gout is the most common inflammatory arthropathy, reported to affect 2.13% of the population of the United States of America in 2009 [1]. Older age, male sex, postmenopausal state and black race are related to a higher risk for development of the disease [2]. Elevation of uric acid levels above the saturation point for urate crystal formation (6.8 mg/dl) usually results from an impaired renal uric acid excretion and although necessary, it is not sufficient to cause gout. Hyperuricemia and gout can be attributed to uric acid elevating drugs, genetic polymorphisms in genes controlling renal urate transport and predisposing dietary factors, such as consumption of red meat, seafood, alcohol and fructose containing soft beverages [3]. Other conditions associated with the disease include insulin resistance, obesity, hypertension, renal insufficiency, congestive heart failure, and organ transplantation [2].
Over time, poorly controlled gout may progress to a chronic phase, characterized by polyarticular attacks, painful symptoms between acute flares and monosodium urate crystal deposition (tophi) in soft tissues or joints [2]. Tophi are typically found on the helix of the ears, on fingers, toes, wrists and knees, on the olecranon bursae, on the Achilles tendons and also rarely on the sclerae, subconjuctivally, [4] and on the cardiac valves [5]. They can cause pain and dysfunction and are rarely associated with ulcerations [6], bone fractures [7], tendon and ligament rupture [8], carpal tunnel [9] and other nerve compression syndromes [10]. Differential diagnosis for subcutaneous or articular nodules includes septic arthritis, synovial cysts, nodal osteoarthritis, rheumatoid arthritis, sarcoidosis, lymphoma or neoplasms [11]. Synovial fluid or tophus aspiration permits diagnosis through demonstration of negatively birefringent monosodium urate crystals [2].
Treatment options for acute gouty attacks include dietary and lifestyle modifications, NSAIDs, colchicine, oral or topical steroids and corticotropin (ACTH). Interleukin-1 (IL-1) antagonists, such as anakinra, a human recombinant IL-1 receptor antagonist and canakinumab, a monoclonal antibody against IL-1β, have also shown promising results in the treatment of refractory cases or cases intolerant to classical therapy [2]. Even without treatment acute attacks usually resolve spontaneously within seven to 10 days. Normalizing hyperuricemia is of cardinal significance for the control of recurrent attacks and for the regression of tophi. This is achieved with drugs, which either favor uric acid excretion (probenecid), convert uric acid into soluble allantoin (pegloticase), or inhibit uric acid production (allopurinol, febuxostat) [2].
Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain and joint destruction [11]. The main indication for surgery in patients with tophaceous gout is sepsis or infection of ulcerated tophi, followed by mechanical problems, confirmation of diagnosis and pain control [12]. Removal of tophaceous deposits from the hands can be achieved through tenosynovectomy for heavily infiltrated tendons, through a soft-tissue shaving technique for heavy skin infiltration with ulceration and draining fissures [13], or through more complex surgical approaches involving large skin incisions and excision of the tophi [14]. A hydrosurgery system applying a highly pressurized saline stream has also been used with good results for the debridement of tophi [15]. In the early stages, surgical arthroplasty can be carried out, but simple enucleation of the tophi may lead to complications such as skin necrosis, tendon and joint exposures [11]. Amputation is always a valid option for untreatable and infected ulcerations [16].
Conclusion
Secondary infection of tophaceous gout are not uncommon can lead to septicemia. Surgical treatment is required for such cases along with medical therapy.

References:
1.Brook RA, Forsythe A, Smeeding JE, Lawrence Edwards N. Chronic gout: epidemiology, disease progression, treatment and disease burden. Curr Med Res Opin. 2010;26:2813–2821. 2.Neogi T. Clinical practice. Gout. N Engl J Med. 2011;364:443–452.
3.Lee SJ, Terkeltaub RA, Kavanaugh A. Recent developments in diet and gout. Curr Opin Rheumatol. 2006;18:193–198.
4.Sarma P, Das D, Deka P, Deka AC. Subconjunctival urate crystals: a case report. Cornea.2010;29:830–832
5.Iacobellis G. A rare and asymptomatic case of mitral valve tophus associated with severe gouty tophaceous arthritis. J Endocrinol Invest. 2004;27:965–966.
6. Patel GK, Davies WL, Price PP, Harding KG. Ulcerated tophaceous gout. International Wound Journal. 2010;7:423–427.
7.Nguyen C, Ea HK, Palazzo E, Liote F. Tophaceous gout: an unusual cause of multiple fractures. Scand J Rheumatol. 2010;39:93–96.
8.Iwamoto T, Toki H, Ikari K, Yamanaka H, Momohara S. Multiple extensor tendon ruptures caused by tophaceous gout. Mod Rheumatol. 2010;20:210–212.
9.Ali T, Hofford R, Mohammed F, Maharaj D, Sookhoo S, van Velzen D. Tophaceous gout: a case of bilateral carpal tunnel syndrome. West Indian Med J. 1999;48:160–162.
10.Tran A, Prentice D, Chan M. Tophaceous gout of the odontoid process causing glossopharyngeal, vagus, and hypoglossal nerve palsies. Int J Rheum Dis. 2011;14:105–108. 11.Khandpur S, Minz AK, Sharma VK. Chronic tophaceous gout with severe deforming arthritis.Indian J Dermatol Venereol Leprol. 2010;76:69–71.
12.Kumar S, Gow P. A survey of indications, results and complications of surgery for tophaceous gout. N Z Med J. 2002;115:U109.
13. Lee SS, Sun IF, Lu YM, Chang KP, Lai CS, Lin SD. Surgical treatment of the chronic tophaceous deformity in upper extremities - the shaving technique. J Plast Reconstr Aesthet Surg. 2009;62:669–674.
14.Tripoli M, Falcone AR, Mossuto C, Moschella F. Different surgical approaches to treat chronic tophaceous gout in the hand: our experience. Tech Hand Up Extrem Surg. 2010;14:187–190.
15.Lee JH, Park JY, Seo JW, Oh DY, Ahn ST, Rhie JW. Surgical treatment of subcutaneous tophaceous gout. J Plast Reconstr Aesthet Surg. 2010;63:1933–1935.
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16.Ertugrul Sener E, Guzel VB, Takka S. Surgical management of tophaceous gout in the hand.Arch Orthop Trauma Surg. 2000;120:482–483.

Low back ache is one of the most common complaint in our practice. Obesity by itself may not cause back pain but if a heavy person gets back pain the suffering would be more and the response to the treatment may be sub optimal. More over the medical team may find it difficult to manage back pain in an obese person with the likes of physiotherapy or surgical treatment. Obesity compounds back pain as these people may also have problems with other joints, especially those of lower limbs as excess fat in the body contributes to the inflammation of the joints. According to the American Obesity Association, back pain is prevalent among 1/3rd of Americans who are under obese category.

What cause back pain in over weight individuals?

The extra weight in the mid segment of the body pulls the pelvis forward and strains the lower back resulting in back pain. In order to compensate for extra weight, the back bone can become tilted and stressed unevenly. As a result, over the time, the back may lose its support and an abnormal curvature of the spine may develop. Overweight also causes early wear and tear in the small joints of the spine and may enhance the rate of disc degeneration which may contribute to back ache. In addition, sciatica and symptoms of pinched nerves may result when nerves get compressed in the spaces between the bones of the lower back.

How much excess weight causes back pain ?

People who are of ‘ideal weight’ as well as people who are heavy, both suffer from back pain. Hence we cannot say what percentage of back pain is purely due to obesity as there are no established scientific studies. Those patients who carry more weight around their midsection are at greater risk of developing pain in the back.

How can you reduce risk of back pain?

“Keep your back fit and maintain a good posture”
The main emphasis of management is to “ loose weight, loose weight & loose weight” which in turn will help you and your back to become fit. A fit back and a good posture are even more important for people on desk jobs with long hours of sitting.
Analgesics and other medications help to reduce the soreness of the back which are generally used only for short durations.
Physiotherapy: Regular aerobic activities that don’t strain your back can increase strength and endurance in your lower back. Strengthen your back and abdominal muscles. Flexibility in your hips and upper legs allows for proper pelvic bone alignment, which improves back pain.
• Walking is usually helpful – start slowly on flat ground, building up to longer walks and gentle slopes.
• Swimming is an excellent exercise – do back or front crawl instead of breast-stroke which can strain your neck.
• When your back pain has settled, using an exercise bike is a good way of getting fit. Keep the saddle at correct height to keep the natural curves in your spine.
• Proper shoes also may help a little.

An effective way to get relief from the pain of arthritis is to massage the affected area with warm olive oil.