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!

Lower back pain can be one of the most physically debilitating things that can affect you and limit your mobility. Even if the pain isn t that acute, it could still signal something deteriorating in your lower back. While oral medications, topical creams or sprays can help in reducing pain, there are other effective remedies you can try on your own. These will be handy when you have no medications at hand. One of these is the hot and cold therapy.

Heat therapy for lower back pain

Heat works well with lower back pain as it can dilate blood vessels and improve circulation within the tissue. This will help in circulation and also result in lowering the pain. Heat therapy will also loosen up other muscles in the area and help soothe sore areas which have been taking the burden along with the lower back muscles. Some of the techniques that can be applied are:

1. All day heat wraps: These are specially manufactured belts or wraps which wrap around your abdomen and keep tightness and pressure on your lower back as well as supplying heat.

2. Electric heating pads: These are mechanized heating pads which generate heat with electricity. You can place them under you back and then either sit or sleep with it positioned behind you. However, ensure that you don t keep these for too long as they could burn your skin.

3. Hot Compress with towels or hot water bags: Use a clean towel and heat it over a conductive surface and apply it on your lower back. You can also use hot water bags for the same purpose.

Cold therapy for lower back pain

Cold therapy uses the principle of constriction of blood vessels as well as slowing circulation. This will help numb the area and thus help relieve the pain. Some of the ways these can be administered are mentioned below.

1. Ice towel: In this method, soak a towel in ice cold water, wring it to dry it and then apply on your lower back. This will numb the pain without transferring the sting of the cold or damaging your skin.

2. Ice packs: Put about half a kg of ice in a plastic Ziploc bag and pour water over the ice to just about cover it. Push out the air out of the bag and then lock it. Use this ice pack with a towel to ensure that you back doesn't get wet.

3. Ice gel packs: These are ready made packs, which can be bought from medical stores and kept frozen to be used whenever you need it in order to relieve lower back pain.

Treating Lower Back Pain Using Hot and Cold Therapy

There are many changes that take place in our face and body as we start ageing. While the face starts to show the signs of ageing earliest-in the form of wrinkles and fine lines as well as a sagging chin and neck, the effect of ageing on the body might be slightly late. The skin may sag or you may end up putting on weight in various parts of the body like upper arms, which may look unsightly and bring down your level of confidence as well. Signs of ageing can often make you shy away from living your life to the fullest. 

For the sagging upper arms, one can always get a procedure called an Arm lift. This is also called a Brachioplasty. This is a cosmetic procedure that can be conducted to tighten the skin of the arms from the elbow upwards. Let s see how this procedure works.

What does it do?

Excess fat tends to accumulate in both arms togather with weight gain. Person face laxity in this area after massive weight loss or with body ageing.
Arm Lift is a surgical procedure to tighten the skin in the arms through the removal of excess fat deposits as well as skin.
Who can opt for this surgery?

Any person who is medically fit having arm disfigurement can opt for this procedure. Patients who have signs of ageing or excessive weight gain are the best candidates for this kind of surgery. Also, it may be used by the patients who are suffering from sagging skin after losing a great deal of weight which may lead to an appearance of bat s wings on the sides.

How is this procedure conducted?

This surgical procedure is conducted by a Cosmetic Plastic Surgeon. It s a day-care procedure. The doctor begins by marking the various areas of concern having excess fat and flabby skin. Thereafter, the doctor proceeds to remove the excess skin so that the arms are tightened getting more youthful look. This is done under anaesthesia to make patient pain-free. The skin that is removed is usually shaped like an ellipse. In many cases, there may be a need to conduct a liposuction if the patient has excess fat as well. Once the excess skin has been removed, skin edges are approximated with meticulous sutures with various Plastic Surgery techniques.

Recovery usually takes 5-7 days. Person can resume routine activities from very next day. Sometimes you might be advised a pressure garment for better outcome.

Upper Arm Lift - What It Can Do?

Pain management is an issue that stares back at mankind, irrespective of the underlying health condition. Whether it is a headache or a back pain, burn or fracture, heart attack or cancer, pain is always a symptom. In some cases like migraines, cancer, etc., the pain is chronic and the patient needs to be constantly on the vigil to know when an attack will ensue. This has also put high pressure on the medical fraternity to identify ways that can provide relief to these people. Various methods have been identified, and one of them is the electrotherapy.

What is done?
A few electrical impulses are directed at the area of the pain using a hand-held device. This is similar to providing electric shocks of mild intensity to the affected area (forehead, low back, neck, etc.). What this does is stimulate the nerve endings, improves circulation and muscle strength and promotes bone growth and tissue repair. The end result of all this is overall improved functioning and pain relief. Depending on the actual condition, the sessions will have to be repeated. In some patients, the electrotherapy is used in conjunction with other therapy so that they can go about their routine exercise and pain relief.
The sessions may also have to be repeated as most often these are used in individuals with chronic pain. They are also helpful in providing relief during the acute attacks.

How does it work?
The most common form of electrotherapy is known as TENS, which stands for transcutaneous electrical nerve stimulation. The area to be treated is cleansed with spirit and then small sticky pads are applied through which the electricity is passed. A hand-held device is used, through which electrical impulses are passed to the skin, which stimulates the nerve cells to provide relief from pain. It causes a vibrating and tingling sensation in the treated area. It is believed that it blocks the nerve impulses and therefore provides pain relief. Another theory states that they promote the release of endorphins which are natural painkillers; it is also very effective in case of migraine and sciatica and neck pain where the chronic pain is coupled with acute spurts.

With narcotic painkillers having various side effects, techniques like electrotherapy are gaining popularity. A small catch also is that it does not work for everybody and in most people with back pain, fibromyalgia, and migraines, requires repeat sessions for relief. The cost of each session also needs to be considered against the extent of relief achieved. However, for those whom it works, it is a very good technique for chronic pain control.

Electrotherapy - How It Can Help In Managing Pain?

The Anterior cruciate ligament (ACL) is an important ligament that gives stability to the knees. An injury to this ligament can result in a host of complications and discomfort. Children or adults who are into sports such as gymnastics, volleyball, tennis, basketball, soccer, football, often injure this ligament. As per various studies and surveys, ACL injury is more likely to affect female athletes as compared to their male counterparts.

Depending on the severity and extent of the damage, an Anterior Cruciate Ligament Injury may be ranked on a grade of 3.

Grade 1 sprains indicate a mild injury or stretching of the ligament, seldom affecting the stability of the knees.
Grade 2 sprains are indicative of a partial ligament tear (the ligament loosen up). The damage is still under control.
Grade 3 sprains are extensive and severe, indicating a complete ligament tear (the ligament often breaks in two pieces). With a complete ligament tear, the stability of the knee is also affected (the knee becomes highly unstable).
What causes Anterior Cruciate Ligament (ACL) Injury?
While a host of sports activities mentioned above increases the risk of the injury, a person may also suffer a partial or a complete anterior cruciate ligament tear under the following situations.

A jump down a ladder, a tree, or a wall. An incorrect jump or a landing may be equally responsible for the ligament tear.
A collision or a hit, especially on the knee (while playing football).
Slowing down suddenly while still in running motion. A person suddenly stopping or missing a step can also injure the ligament.
Symptoms associated with ACL injury

An excruciating pain (especially in the back and outside of the knee) is often seen in people with a complete ligament tear (the movement is yet not affected). However, within a few hours, there may a swelling around the knee, indicating the severity of the injury with internal bleeding within the knee joints.
There may be restricted knee movement. The knee also feels unstable, further limiting the movement.
Sometimes a pop in the knee can be heard just at the time of the ACL injury.
Prolonged ACL injury left unattended can result in a painful complication such as knee osteoarthritis.
Diagnosis
To diagnose the extent of the damage, the doctor may suggest

Physical examination, including a quick brief about the case history.
Imaging tests such as X-rays and MRI can go a long way to analyze the ligament injury.
In the case of extensive swelling of the knees, the doctor may carry out an arthroscopy to have a closer look inside of the knee.
An accurate and timely diagnosis is important to avoid the aggravation of the injury. In the case of swelling and knee pain, consult a doctor, and get yourself thoroughly examined.

Anterior Cruciate Ligament Injury- Causes, Symptoms, and Diagnosis

In preparation for the possibility of conception, a woman's body undergoes the menstrual cycle every month which culminates into the periods. This is a normal process which all women of reproductive age go through every month. However, in certain cases, the periods can be really painful where you may suffer from menstrual cramps or could be generally in much pain. This condition is known as Dysmenorrhea.

What exactly is Dysmenorrhea
As mentioned above, Dysmenorrhea is a disorder that many women got through while having their periods where they may suffer from painful cramps. The pain usually occurs in the pelvis area along with the lower abdomen and it may also be accompanied by other symptoms.

Some symptoms of Dysmenorrhea
Some of the symptoms of Dysmenorrhea could be any combination of the following factors
I. Very painful menstrual cramps accompanied by lower back pain
II. Diarrhea and nausea along with the cramps
III. Pain in the inner thighs, lower back and hips
IV. Being hypersensitive to light, loud sounds, specific smells and touch
V. Being fatigued all the time, even causing you to faint

Causes of Dysmenorrhea
Dysmenorrhea is usually caused by the contraction of the Uterus. While the uterus does contract a little even in normal periods, during Dysmenorrhea the contractions tend to be a little too much. Due to this the uterus presses against the blood vessels and organs within the vicinity causing oxygen loss to them. This causes elevated levels of pain and discomfort.

Some of the underlying causes which may result in Dysmenorrhea are:
1. Narrowing of the cervix - Also known as stenosis, the lower part of the uterus which is the cervix may become narrow due to scarring and cause Dysmenorrhea.
2. Endometriosis - This is where the uterine lining is found outside the uterus, especially in the pelvic cavity and thus may cause painful cramps.
3. Inflammatory pelvic diseases - This is when a bacterial infection in the pelvic area can spread to multiple organs, including the uterus and thus may cause painful menstrual cramps.
4. Tumors - Tumors or fibroids which are unwanted growths on the inside of the uterus may also trigger Dysmenorrhea.

What to do if you are suffering from Dysmenorrhea
Below are some of the basic steps which you can take to ease pain from Dysmenorrhea
1. Avoid smoking and abstain from alcohol
2. Ample rest during periods
3. Keep the body dehydrated
4. Don't consume foods high in salt
5. Don't drink coffee or any caffeine rich foods
6. Lower back massages and hot water bag treatments to relieve pain
If severe pain still persists for long or if dysmenorrhea occurs repeatedly, then you should consult a doctor first rather than trying to resolve the problem yourself.


All about Dysmenorrhea

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