Dr. Sunil V Nukapur

Shoulder impingement is a serious condition leading to severe pain in the shoulder blades of a person. Such kind of shoulder pain may affect anybody anytime. It basically affects the area of your shoulder facing stress due to any sort of overhead action. An impactful pressure on the tendons of bones constituting your shoulder gives rise to this disorder. This syndrome can affect a person who paints, swims, lifts or plays tennis on a regular basis. Once caused, persistent rendering of similar activities can worsen the case. If you are suffering from shoulder impingement syndrome, treatment under an experienced medical practitioner is indeed necessary as otherwise, you may have to suffer from tendinitis or bursitis.

Take a keen look at the symptoms of shoulder impingement

1. Disabling pain in and around the shoulders
2. Under the effect of such excruciating pain, a person has restricted use of his or her arms and neck. He or she will face difficulties in reaching to a higher position above his or head. Aiming up behind your back will also be a challenge with the existence of this syndrome.
3. There is considerable weakness in the muscles of your shoulders, preventing you from working with full vigor
4. If left unattended, shoulder impingement can worsen to cause Rotator Cuff Tear where the tendons tear into two distinctive parts.

Available modes of treatment

1. A doctor might prescribe you anti- inflammatory drugs to relieve you from excess pain. These drugs should only be taken under the close monitoring of a specialist as they might have acute side effects. You might feel nauseous or might have an upset stomach after consuming these medications.
2. Stretching your arms above your head while holding your body in an erect posture can be of great help. This stretching exercise should be tried out in a warm shower for better results.
3. Other exercises under the supervision of a physiotherapist can come to your rescue as well. You should try to move your thumb up your back to recuperate from shoulder impingement.

As you age, the cartilage cushioning your joints starts wearing down, causing the bones to rub against each other. This causes osteoarthritis, which is a type of degenerative disease caused. The rubbing of the bones causes inflammation of the joints. The joints of the arms and legs along with the lower back are most commonly affected by this condition.

Here are some common symptoms, which indicate that you are suffering from osteoarthritis:

1. Pain and tenderness: An aching back, knees, neck and hip with severe pain are some of the most common symptoms of osteoarthritis. The pain caused during the early stage of arthritis is classified into tenderness and pain. A sharper pain may be felt while moving the affected joint in a certain way. Tenderness is the discomfort experienced when the joint is pressed along with visible swelling in the affected area.
2. Joint stiffness: Joint stiffness is another early symptom of osteoarthritis. It refers to the wooden feeling, which makes a person feel slow and sluggish. The urge to rest or go to bed should be resisted. Warming up the joints with gentle exercise or moving around cause relief. It also helps in reducing the stiffness and you can continue your regular activities with more ease.
3. Abnormal sensations: When the cartilage wears down, the rubbing of the bones against each other may lead to some abnormal sensations. Grating of the joints is common in people with osteoarthritis. One may feel that their joints are cracking or clicking while moving.
4. Loss of flexibility: People who are in their early stages of osteoarthritis may face difficulty with moving the areas which are affected. This joint stiffness and pain may lead to a loss of flexibility or loss of range of motion. Range of motion refers to the extent up to which one can move his joints normally. In case you are not being able to bend your knee fully or as far as you would have done it normally, you might be experiencing osteoarthritis.

Loss of flexibility occurs slowly and gradually. A person may hurt his back unusually during a football game or may experience a stiff back in the morning after waking up. This gets more intense with time. In the later stages, you may experience joint pain even while resting.

In case you experience any symptoms of osteoarthritis, you must consult a doctor immediately. The doctor will provide you with a plan aimed at managing and getting a quicker relief from the pain caused due to osteoarthritis. Several over-the-counter medicines, braces for supporting affected joints and range of motion exercises are also effective ways of managing osteoarthritis.

A dislocated shoulder is an injury in the shoulder joint, which is the most mobile joint present in the body. A dislocated shoulder injury occurs when the upper arm bone juts out of the socket in your shoulder blade. The shoulder is capable of moving in several directions, so a shoulder dislocation can happen through either the front of your shoulder or the back of your shoulder, although most dislocations happen through the front of the shoulder.

Shoulder Dislocation Causes
Shoulder dislocations generally happen in situations involving extreme impact to the shoulders. The most common causes of dislocated shoulders include:

1. Sports injuries: Over 75% of dislocated shoulder injuries are a result of injuries sustained from sports or sports related activities. Contact sports, such as hockey and football, which require a lot of close ranged contact, as well as sports like gymnastics and skiing often cause a lot of dislocated shoulder injuries.
2. Injuries not related to sports/accidents: Hard blows to your shoulder, such as a result of a vehicle accident could be a very common reason behind shoulder dislocations.
3. Sudden fall: Any sudden impact to your shoulder which puts a lot of strain on the shoulder blade, such as falling down a ladder, or tripping on a wet surface, may also lead to shoulder dislocation injuries.

Shoulder Dislocation Symptoms
Signs and symptoms of a shoulder dislocation injury include:

1. Extreme shoulder pain: Severe pain in the shoulder joint along with an inability to freely move the shoulder is a sure-fire symptom of a dislocated shoulder.
2. Visible deformation: If the shoulder joint looks contorted, twisted, or grossly out of shape, it is quite certain that the shoulder has been dislocated.
3. Soft and raw to the touch: When touched from the side, if the shoulder feels extremely mushy and you cannot feel the bone underlying it, a shoulder dislocation injury is definitely the reason behind it.
4. Numbness and weakness: A numb feeling not only in the shoulder, but all throughout the affected upper arm is usually a sign that the shoulder has been dislocated.
5. Swelling/bruising: This doesn’t always occur, especially if the dislocation is a minor one; however, severe swelling and bruising of the shoulder, especially if you have recently suffered a huge impact to it, is a guaranteed sign of a dislocated shoulder.

What is osteoporosis?

Osteoporosis is a disease concerning the bones. Decreased strength of the bones poses a risk for them to break. Osteoporosis is very common among older people, whose bones become brittle with age. The most common bones affected by this disease include the backbone, forearm bones and the hip bone. There are no such symptoms until a broken bone occurs. The bones weaken to such an extent that a break may happen in case of very minor stress. Usually, a broken bone is followed by chronic pain and the disability to perform daily activities. Surveys show that 15% of white people in their 50s and 70% of white people in their 80s are affected by osteoporosis.

What are the common causes and symptoms of osteoporosis?

1. May occur due to the lowering of the "peak bone mass index".
2. In women, bone loss increases after menopause stage due to lowering down of estrogen level.
3. Also occurs because of another disease or previous treatments. This includes alcoholism, surgical ovary removal, hyperthyroidism, anorexia or any form of kidney disorder.
4. Anti-seizure medicines, chemotherapy, selective serotonin reuptake inhibitors and taking of performance-enhancing drugs like steroid increase the bone loss rate.
5. Lack of regular exercise may lead to osteoporosis.
6. Osteoporosis is defined as a "bone density of 2.5 standard deviations below than that of a young adult".
7. Osteoporosis is hereditary in nature. People having a family history of osteoporosis are at a high risk of getting the disease.
8. More than thirty genes are linked with osteoporosis development.
9. If you have had a fracture before, you are at a risk of a repeat.
10. Early menopause in women is also responsible for osteoporosis.
11. People with a small structure and body build are at a risk of getting osteoporosis.
12. Protein and vitamin deficiency makes your bones weak and makes you vulnerable to osteoporosis.
13. Phosphoric acid present in soft drinks is another threat, which may cause the disease.
14. People suffering from malnutrition are likely to get osteoporosis.
15. Over replacement of L-Thyroxine may lead to osteoporosis.
16. Use of heparin and warfarin for a long time decreases the bone density.

How can Osteoporosis be prevented?
The best way to avoid getting osteoporosis in the future is to maintain a preventive lifestyle.

1. Exercise regularly.
2. Indulge in natural calcium sources.
3. Maintain intake of Vitamin D and Vitamin K.
4. Do not smoke and consume alcohol.
5. Don't undertake stressful physical activities.
6. Go for regular health checkups.
7. Stay fit and stay away from obesity.

Osteoporosis is a disease you must stay away from. It leaves you physically incapable and unfit. Comment here for other questions on osteoporosis. In case you have a concern or query you can always consult an expert & get answers to your questions!

Lumbago or Lower back pain is a condition that is characterized by mild to serious pain or uneasiness in the lower back region. Lower back pain is more prevalent among the youth whose work includes physical exertion or sitting for long hours and is also common in individuals belonging to the 'retirement age' because of their sedentary lifestyles. The pain might be acute (sudden and extreme) or chronic if it has been endured over a span of three months. 

The most common causes of lower back pain are: 

1. Overuse of the muscles and includes strains or sprains of soft tissues such as muscles, ligaments and vertebral compression fractures. 
2. Pressure on the roots of nerves due to conditions such as spinal canal stenosis (narrowing down of the spaces within the spine) or herniated disc (a condition of the rubbery disc present between the spine bones (vertebrae)). 
3. Osteoarthritis is a condition wherein the shock absorbers, found in the joints, progressively break down. 

When it affects the spine, the condition causes back pain by stiffening the spinal joints. Symptoms of Lumbago (Low back pain) include: 

1. Stiff back 
2. Numbness in the legs 
3. Loss of weight 
4. Difficulty in urinating 
5. Sciatica, which is the pain running down the lower back to hips, legs and thighs. This occurs due to a compression by an intervertebral disc in the back, which leads to a pinched nerve. 

How to diagnose lower back pain or a slip disc?

Some methods that can be utilized for diagnosing back include Xray, CT Scans, Myelogram and MRI scans. 

Treatment options available -
Exercises along with correction of bad posture for relieving back pain are a common component of any treatment plan. Factors such as type and severity of the pain as well as the patient?s history can help in determining the type of treatment that can be administered. In most cases, the recovery time is usually six weeks without surgery. Typical treatment of back pain includes use of muscle relaxants, painkillers and physiotherapy. Surgery is suggested in severe cases. Some other treatments are discussed below: 

1. Rest: A period of rest and inactivity would help the injured tissues to recuperate and relieve back pain. However, extended periods of rest lead to weakening of muscles and hence might prolong the existing back pain. 
2. Heat and ice packs: Both heat and ice therapies are used according to the patient's preference to reduce inflammation. 
3. Medications: A large variety of prescription and over-the-counter medicines are available. Some reduce back pain caused by inflammation and others prevent the pain signals from travelling to the brain. Examples would include acetaminophen, celecoxib and diclofenac.

Arthritis is a very painful disease. It restricts you from doing a lot of the activities you would love to engage in. However, there are steps you could take to reduce the chances of it happening to you.

Here are some of them:

1. Take Omega-3 fatty acids
Research proves that the regular consumption of Omega-3 fatty acids, present in fish, result in decreased risks of rheumatoid arthritis. Omega-3 fatty acids are also found in foods such as olive oil and walnuts.

2. Take Vitamins and olive oil
Vitamins are crucial, especially A, C and D. Vitamin A can be found in carrots. Vitamin D can yet again be found in fish while Vitamin C can be found in strawberries, mangoes, pineapples and oranges. Olive oil is also useful because it contains polyphenols which reduce the chances of developing arthritis.

3. Eat ginger and broccoli
Ginger and broccoli are two of the most therapeutic foods for various reasons and the chances of getting arthritis are also proven to reduce due to these foods.

4. Avoid injury
Although this is very hard to do sometimes, avoiding injuries do reduce your chances of getting arthritis.

5. Control your weight
This is very important, especially for your knees. It has been proven by researchers at Johns Hopkins University that if you are 10 kg overweight, then 30 to 60 extra kilograms of weight fall on your knees.

6. Exercise
Strengthening your muscles around your joint decrease the pressure on the joint. If there is less pressure on the joint, then the chances of arthritis are reduced. The best way to decrease pressure on the joint and strengthen your muscles is to exercise.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Pain in two or more joints in the body is known as multiple joint pain. Pain may occur either when a joint moves or when it is at rest. Sometimes, the pain might stem from the muscles, ligaments, or tendons. Examples of such conditions include tendinitis and bursitis.

Arthritis may be associated with the pelvis or spine joints. Different disorders affect different joints and the causes and treatment options vary accordingly. There are some disorders which affect the same joint on both the sides of the body, such as both hands and the knees. In certain disorders, the pain resulting from arthritis keeps on moving from one joint to another (migratory arthritis).

Causes:

1. Most of the time, the root cause is arthritis. However, the reasons which cause arthritis are different from each other, in the way:

   • The types of joints involved.

   • The number of joints involved.

   • Whether the central area of the skeleton is involved or not.

   • Whether it is chronic arthritis (longstanding) or acute arthritis (sudden).

2. Acute arthritis which affects multiple joints can be due to:

   • Viral infections

   • A chronic disorder which was already present or any joint-related condition (such as psoriatic arthritis; occurring in combination with skin psoriasis or rheumatoid arthritis).

3. Chronic arthritis causing pain in multiple joints is most commonly due to:

   • Inflammatory disorders including psoriatic arthritis or systemic lupus erythematosus (combination of several auto-immune disorders).

   • Osteoarthritis or non-inflammatory disorder (adult joint disorder).

   • Juvenile idiopathic arthritis (children joint disorder).

The most common joint disorders are:

1. Fibromyalgia (widespread tenderness and pain in the muscles)

2. Bursitis (inflammation of the joint cushions) or tendinitis (inflammation of the tissues which connect the bone to the muscle)

3. Polymyalgia rheumatica (stiffness and muscle pain, primarily in the shoulders)

Warning Signs Include:

1. Swelling and redness of the joints.

2. Fever, chills or sweat.

3. Chest pain or severe cough.

4. Abdominal pain.

Treatment Methods:

1. Drugs and medications are needed to treat autoimmune disorders. The autoimmune response of the immune system is suppressed with the help of these drugs. These medications include immunosuppressive medications, pain relievers and anti-inflammatory medicines.

2. Non-steroidal anti-inflammatory drugs (NSAIDs) help in reducing inflammation.

3. A sling or splint bag immobilizes the joint, which relieves the pain.

4. The application of heat with a heating pad will lessen the pain to a great extent.

5. Cold application with ice cubes wrapped in a cloth will provide relief.

Consult an orthopaedic doctor to know you type of multiple joint pain and an accurate treatment for it.

It is not that very easy to get complete recovery after spinal surgery and for that you have to rely on different caring tips. Your surgeon can help you in this regard and can provide you a checklist containing different essential caring tips. You should follow those tips sincerely so that unwanted side-effects can be easily avoided. 

Few caring tips after a spine surgery:

1. Consumption of adequate amount of proteins: If the protein content is increased in your diet, then quickest recovery can be definitely expected. Muscle collagen can be strengthened and healed with the regular intake of the necessary amounts of protein. In fact, infectious conditions can be effectively dealt with by protein intake. 
2. Getting adequate rest: proper rest is needed and you should have enough sleep for getting complete recovery. If your body needs some more sleep than the standard one, then you should go for the same. Your mood, memory and body will get refreshed and rejuvenated by taking proper sleep at night. In fact, you can also get rid of pains and other side-effects after surgery by taking rest. 
3. Taking nutritional supplements: There are a few essential nutrients that are needed after the surgical procedure, and they are vitamin D, vitamin C, Omega-3 fatty-acids, magnesium and others. These nutritional elements are now available in the form of supplements and are readily available in the stores. Though these supplements are completely organic, but still you should start taking the same when doctors permit you. These supplements help in collagen healing and thus speedy recovery can be gained by taking them in a consistent manner. Muscle heath can be effectively protected by consuming these supplements. 
4. Acute hydration: Hydration is highly needed especially after spinal surgery so that toxin accumulation can be prevented. If you want to get proper hydration, then nothing can be a better option than drinking lots of water. In fact, spinal surgeons also recommend the same for avoiding surgical complications. Tea, coffee and sodas need to be completely replaced with water. Your system can be thoroughly cleaned by draining out toxins. 
5. Eliminating refined sugars from diet: Refined flour and sugary products are to be completely curtailed from regular diet; otherwise you might face severe complications. Your blood-sugar level needs to be regulated. If your immunity system gets suppressed, then you will be in great trouble and hence sugar should not be included in your diet at all.

In case you have a concern or query you can always consult an expert & get answers to your questions!

What is a strain?
A strain is a muscular injury caused due to poor posture or any physical activity that exerts a lot of pressure on the muscle. It is nothing, but a torn muscle or tissue connected to a bone. A strain can occur in any muscle of the body, but it most commonly occurs in the lower back, neck, shoulder, and hamstring, which is the muscle behind your thi gh.

What is pain?
A pain is an extreme sensation of discomfort or distress that might be caused due to external stimulus. In a nutshell, it’s an unpleasant sensory or emotional experience.

One can differentiate between a pain and a strain through the following ways

1. Symptoms: One of the major symptoms of a strain is acute pain. Simultaneously, the torn muscle will be sore; it will be discoloured and swollen. Movement will be limited in that part of the body and the patient will get a ‘knotted-up’ feeling because muscular injury weakens or stiffens the muscle. Another major symptom of strain includes muscular spasm. Pain on the other hand is a state of physical and sensory discomfort caused due to an external stimulus. The affected area will not have the aforementioned symptoms and is not limited to muscular injury.
2. Length of time: One of the key ways to differentiate between a muscle strain and pain is the amount of time the symptoms persist. Normal pain lingers for about three days and is reduced with medication. In case of muscular strain, the pain lasts longer because the injury is internal. The muscles are sore and stiff and remain weak until treated.
3. Type of distress: The feeling of pain usually persists irrespective of the fact that the patient is at rest or is not moving; while in a muscular strain, the patient is not distressed at rest but experiences major discomfort when trying to use or move the affected part of the body.

The sensation of pain usually worsens with activity. On the other hand a muscular strain is treated with muscular exercises such as stretching. If the patient doesn’t use the affected muscle for a long period of time, it tends to worsen. In case you have a concern or query you can always consult an expert & get answers to your questions!