Foot pain contributes around 3-5 % of patients visiting Orthopedic OPD, with heel pain being predominant complaint. Heel pain commonly involves the underside or back of your heel. Although not a symptom of a serious condition, it s disabling as it can interfere with your routine activities.

Plantar fasciitis, Achilles tendinitis, Heel spur, Retrocalcaneal bursitis are few common conditions causing heel pain.

The below few conditions which are prone to developing heel pain like:

Abnormal walking style (gait)/altered alignment of the foot
Obesity
Ill-fitting shoes/ badly-worn shoes
Standing, running or jumping on hard surfaces
Injury to the heel, such as stress fractures
diabetes and arthritis
The most common causes of heel pain are plantar fasciitis (bottom of the heel) and Achilles tendinitis (back of the heel).

Presenting complaints:

Pain which is usually intense in the mornings or after a long period of res,
Discomfort or swelling in the back of your heel
Skin on your heel overly warm to the touch
Burning sensation over heel
Numbness or tingling in your heel
Swelling around ankle etc
Remedies you can try:

Avoid activities that aggravate your heels, such as running, standing for long periods or walking on hard surfaces.
Ice application on your heel for 10-15 minutes at least three times a day.
Well fitting shoes.
Non-steroidal antinflammatory drugs can reduce inflammation and pain
A splint is worn at night
Flexibility exercises
Prevention of heel pain:

Wear a well-fitting & comfortable shoe
Always warm up and cool down when exercising or playing
Silicone insoles
Consult your doctor immediately if, Heel pain persists in spite of home remedies. Try these tips to put Heel pain at rest!

Heel Pain - Effective Ways To Put It At Rest!

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

Why does PAIN occur? Understand the Mechanism of Pain

Pain is an unpleasant and distressing physical sensation caused by disease or injury, which induces hurt and anxiety in those suffering from it.
There are many different manifestations of pain, ranging from short term (acute pain) to long term (chronic pain). Other classifications include pain in the internal organs (visceral pain), injured tissue (inflammatory pain), nerves (neuropathic pain), etc.

The reason for the occurrence of pain depends on the cause and kind of pain being experienced. In most cases, pain acts as a warning sign that the body has been afflicted by a disorder of some sort, which may have arisen due to internal sickness or external wounding. Acute pains are generally cured on their own through rest or simple medication. Chronic pains, on the other hand, are more complicated in nature and the treatment requires more elaborate diagnosis.

The mechanism of pain

Pain is an extremely personal and subjective experience and affects each individual to varying degrees. The pain signals, which can arise in any part of the body, travel through the spinal cord to the brain along thousands of specialized nerves and nerve fibres. In the brain, it is processed in the centres associated with anxiety, emotions, memory, appetite, etc. Signals and pain inputs are then returned from the brain to the spinal cord, which may heighten or diminish pain.

In some cases, pain may also be induced by damage to the brain and spinal cord, which happens after a stroke.
A constant barrage of pain signals may cause the cells at the end of nerve fibres to become over-sensitized. This is known as 'wind-up' and is one of the most common causes of chronic pain that occurs even though the root of the problem has been identified and treated.

The causes and effects of pain differ from case to case depending on the signals received by the brain and its interpretation. It affects the individual's day to day activities and if persistent, can also have a harmful impact on mental health and psychosis. Pain is always handled, diagnosed and treated differently in all patients by drawing out the best possible solution to the problem.





Why does PAIN occur? Understand the Mechanism of Pain

Acupuncture is a kind of therapy that combines needles with pressure and pain points in order to delicately apply pressure for pain relief. This form of physical therapy is being increasingly recognised as an efficient method of treating pain in joints, muscles, bones and even for migraine pain. So let us find out more about Acupuncture and pain management.

    Chronic or Long Term Pain: There are many ailments that cause chronic or long term pain. These include back pain, neck pain, stiffness in the joints, osteoarthritis, headache and migraine, and pain in the shoulders. All this can be treated over a long period of time with the help of simulated acupuncture which uses pointed apparatus for activating better blood circulation for overall improvement in the pain that is being experienced in the area. The use of this apparatus helps in avoiding the harmful medication that can have adverse side effects.
    Menstrual Cramps: A fine needle method at the right points can help in bringing down the symptoms of the painful condition called dysmenorrhoea during menstrual cycles. With acupuncture, the acupuncturist can administer acupoint therapy to relieve menstrual cramps. This will help in moving the qi, or life force, in a better way so that the pain will stop. 
    Acute Pain: Over use of muscles, joints and repetitive, work related movements and strain can lead to acute pain. This includes wrist pain, shoulder pain, elbow pain, back pain, lower back pain, neck pain and even leg pain. With acupuncture, the patient gets rid of the pain in close to twelve sittings.
    Pain due to Cancer Treatment: Cancer and its treatment can take a heavy toll on the body and lead to a series of complications which also includes pain. A clean needle procedure can be followed along with the chemotherapy and radiation or after it, so as to relieve the patient of the pain experienced. Also, it can be used to replace traditional chemotherapy and radiation. 
    Better Rest: When the needles or apparatus touch the pressure points and circulate the blood and life force, it actually creates a soothing effect and helps the patient sleep and get better rest. This is also a requirement for pain relief. It can bring better blood flow to the area and help in removing anxiety and stress related to pain so that there is better chance of getting rest. 

With the use of acupuncture, pain can be taken care of with the needles and various tools that come in various shapes. These tools and equipment can also use laser treatment along with the point focused treatment.

Acupuncture and Pain Management

Dysmenorrhea is a condition marked by severe menstrual cramps. This is caused due to contractions in the pelvic area during the menstrual cycle. While most women go through some degree of cramping, when the cramps become too serious and severe, it should be reported to a doctor to find out if there are any other related problems like Endometriosis, Fibroids, Adenomyosis or some infections.

Here are the ways in which this condition may be treated effectively:

Medication: One of the main ways of dealing with this condition includes taking pain relievers that must be prescribed by your doctor. Also, one can take over the counter drugs to relieve the pain. These include ibuprofen as well as aspirin and non-steroidal anti-inflammatory drugs. Acetaminophen can also help in most cases. Some women may need antibiotics to take care of pelvic infections that cause pain in the pelvic region.

Hormonal Birth Control: if your symptoms are too severe and debilitating, then the doctor can also put you on hormonal birth control treatment to bring down the pain and severity of the cramps. These are usually prescribed in the form of oral tablets which need to be consumed daily as advised by the Gynaecologist . Sometimes, some women may be unsuitable / unwilling for oral medications and in such cases, other routes for hormonal administration may be followed. This can be administered in the form of an injection. Also, you may wear the dose as a patch on the skin. A surgical procedure can also implant the same under your skin. This also comes as a flexible ring that the doctor can insert into your vagina with the help of an intrauterine device (IUD).

Surgery: In very extreme cases, the doctor may recommend surgery. This is usually conducted in case there is an underlying condition like endometriosis or fibroids, which can create severe complications for the patient as well. The doctor may also carry out surgical removal of the patient's uterus in case there are many complications.

Home remedies: One can exercise on a regular basis in a moderate manner so as to ensure that the cramps are not too severe. Also, you can use heat therapy in order to bring down the pain. This can be done by taking a hot bath and soaking in a tub of hot water. Also, you can use a heat compress so as to relieve the pain. Other dietary supplements can also be taken in order to reduce the cramps. For this purpose, one should regularly indulge in fish and flax seeds as well as other ingredients that are rich in omega three fatty acids. Also, vitamin B1 is an important ingredient that can be found in leafy green vegetables. Magnesium supplements can also be taken by the patient for such cramps.

Stress: one will need to take care of the stress levels by staying away from stressful situations and also cutting back on the consumption of alcohol. One should also avoid smoking completely. Meditation & Yoga have been known to help in relieving stress and you can practise a little bit of these on a daily basis. Also, devoting time to your hobbies and listening to good music can be a stress-buster when incorporated in your daily routine.

So eat right, exercise right, think right and have a positive attitude- That helps take care of most non-pathological cases of dysmenorrhoea.

Ways to Treat Dysmenorrhea Effectively

A pain in the neck, both in the metaphorical and the literal sense of the term can be quite discomforting. If we look at it from a medical point of view, the pain in the neck could be a serious sign of something being amiss and so, keeping in mind the causes of such a pain is just so important!

Recognizing the Type of Neck Pain

A pain in the neck can manifest itself in a variety of ways. Also, it need not also follow the textbook definition of the term. As a matter of fact, tingling, tenderness or numbness can also be significant symptoms of neck pain. Another major symptom can be having difficulty while swallowing. This could be much more crucial than just a problem with the digestive system.

Many cases that doctors come across when a patient comes to consult about a pain in the neck are regarding an issue with the spinal cord. At in certain cases, it could be related to an issue with the muscles which are located in the area.

When a person has neck pain, he or she should think back and try to remember if he or she was in an incident where the neck could have possibly been the recipient of some sort of impact. This could be a possible explanation of the pain. Also, if there is a pain in the neck after an incident, it is better not to delay a visit to the doctor as the person is likely to be uncomfortable. The neglect is this condition can also lead to the problem getting progressively worse.

In some cases, a pain in the neck can even be congenital. A very good example of this is wry neck, or torticollis. When a pain in the neck is diagnosed by the doctor, figuring out what the likely cause is quite an important thing to do and should be the first thing which is done by him or her as the various ways to treat a pain in the neck vary according to the cause of it.

The problem of neck pain is very common as two third of the population suffers from it at some point in their lives. This does not mean that it needs to affect a person's quality of life. The right precautions and proper medication can make sure that his or her neck is not on the line!

Causes of Neck Pain and Diagnosis

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