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

Conventional medicine treats pain with the help of medications; by either blocking the transmission of pain signals in the body or by correcting the underlying problems caused by the pain in the first place. However, traditional and alternative forms of medicine such as acupuncture manage pain issues within the body through the means of redirecting disrupted energy flows. One of the very few forms of alternative treatments used in conjunction with conventional treatments, acupuncture is seen as a mercurial rise in popularity in the past few decades.


What is acupuncture?
Acupuncture dates back to ancient China, about 2500 years ago. It has been widely practiced there for a number of millennia, not only pain relief, but also for treating many ailments. Acupuncture isn t just considered a form of therapy, but a holistic form of medicine. Acupuncture works on the principle of the flow of energy within the body, also known as  Qi , in traditional Chinese medicine. Acupuncture strives to correct the disruptions in  Qi  that may cause pain by manipulating over 2000 of the specific pressure points within the body with the help of specially created needles.


Where is acupuncture effective?
Acupuncture is very effective in treating a host of ailments, especially in relieving the associated pain. Some of the areas where acupuncture has proven its effectiveness are:
1. Treating nausea and vomiting caused due to chemotherapy treatment for cancer patients
2.  Very useful in treating post-operative pain caused due to dental procedures
3.  Rehabilitating patients who have suffered strokes
4.  Fibromyalgia (musculo-skeletal pain with fatigue accompanied by sleep and memory issues) 
5.  Effective in combating withdrawal symptoms caused due to addiction
6.  Pain from menstrual cramps
7.  Tennis elbow
8.  Osteoarthritis (a type of arthritis caused due to the erosion of tissues present at the ends of one s bones)
9.  Pain of the lower vertebrae within the spinal column
10. Asthma


How does acupuncture work within the body?
According to modern medicine, the specific pressure points utilized by acupuncture within the body help in releasing chemicals that can block or at least reduce pain. It encourages the flow of chemicals from the brain, which act as nerve and pain blockers. It also helps stimulate the muscles and nerve endings, which can lessen inflammation and thus help in reducing pain.

Acupuncture - Why Should You Use it to Combat Pain?

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

Ayurvedic treatments are mainly based on maintaining a perfect balance among the three doshas of the body, namely vata, pitta and kapha. Ayurveda has numerous healing techniques to provide individuals with proper relief from pain and one such amazing and effective pain relieving technique used in Ayurveda is called the Kizhi treatment.

What is the Kizhi Treatment?
The term Kizhi is taken from the Malayalam language and it basically is a therapy which aims at protecting as well as enhancing the health and wellness of the entire human body. However, it can also be particularly used for relieving various kinds of pains and aches in the body. In this technique, the heated oils, herbs, powders and the other prescribed items are tied into bags of muslin and then applied to the body, based on the area of pain.

Kizhi is of many other types also like Pozhikizhi and Elakizhi. Navrakizhi is specially used in case of Polio and muscle wasting.

A varied degree of pressure is applied on different body parts with a special focus on the nerve points. The nature of the ailment or the spot decides the amount of pressure to be applied using palms, fingers or heels of the hand. The entire therapy includes perspiration inducing body scrub, which is consecutively followed with a very special bath.



Kizhi - The Effective Treatment for Pain Relief!

Vulvodynia is a condition which causes severe pain in the opening (vulva) of the vagina without any apparent reason. The pain might be chronic in nature and can go on for years. Vulvodynia might affect your emotional health in the long-term and cause anxiety, depression and disrupted sleep patterns, if not treated immediately.

Doctors are still unsure regarding the exact causes of Vulvodynia. But there are few factors, which can increase your risks of suffering from this disorder:

    If you have a sensitive skin or have any past history of previous vaginal infections, you might be susceptible to vulvodynia.
    Vulvodynia might also be caused due to past injuries around the vulva.
    Sometimes, hormonal changes might also cause Vulvodynia.
    This disorder can also occur in women who have previously suffered from recurrent instances of sexual abuse.

The symptoms of Vulvodynia can be acute or chronic in nature with the pain being confined to one particular area or around the entire region.
The treatments for Vulvodynia aim at regulation of the symptoms. The most common treatments for Vulvodynia are:

    Your doctor might prescribe a specific dosage of steroids or antidepressants to get rid of the pain. Prescribed dosage of antihistamines might help to cure the itching sensation.
    You can apply a regulated amount of  Lidocaine  ointment around the vulvar regions thirty minutes before sexual intercourse.
    You can also opt for pelvic floor therapies as they might provide relief from significant pain in the pelvic floor muscles resulting from vulvodynia.
    If the pain is centralized around a particular area, you might opt for vestibulectomy to remove the affected tissues and get rid of the pain.

Can Sensitive Skin Be the Reason Behind Pain in the Opening of Vagina

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

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