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?

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

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?

International Childhood Cancer Day is celebrated annually on 15 February to raise awareness and to express support for children and adolescents with cancer, survivors and their families.

Why is Cancer the biggest Threat to the YOUNG in India?

There are fewer Indians who have successfully battled Cancer and have emerged successful. Yuvraj Singh, the legendary cricketer, who was diagnosed with a rare cancer at 29, survived due to an early detection. Cancer cases in India are not as many as they are in the developed world. However, due to late detection the survival rate in the country is far worse. Particularly, we are losing our youth to Cancer. Most tobacco (pan masala) related cancers and child cancers go undetected until very late.

Few cancers like cervical cancer and breast cancer which affect women of any age, are curable, however, due to lack of awareness and timely screening, many Indian women succumb to these cancers. The most common sites for cancer among men are lung, prostate, colon, rectum, stomach and liver while that among women are breast, colon, rectum, lung, cervix and stomach.

In proportion to our population, we lack the right infrastructure nationwide. esp in the northern and north eastern region, there is a dearth of good cancer facilities, where radiation, care or treatment can be given. Not even one third of cancer patients are alive beyond 5 years after their diagnosis in India, and about 71% of cancer deaths occur in patients in their prime productive years   between the ages of 30 to 69 years.

 Most Indians believe that cancer is generally incurable and that it should be kept secret from neighbors and family.  -  Dr Paul Goss, MD, Harvard University.

All these factors have contributed to a very high mortality rate. No wonder Cancer is dreaded in the country. Investment, infrastructure, lifestyles as well as mindsets need to change if we were to contain the Cancer mortality rate. While you need to watch out for early signs of cancer, here are the lifestyle changes every individual esp. all youth must adopt to avoid cancer.

Avoid Tobacco - both smoking and chewing.

Reduce alcohol intake - Save your organs from deteriorating.

Limit UV ray exposure from the sun - Keeps your skin safe.

Maintain a healthy diet - Include foods rich in Vitamins, minerals and fiber which nourish your body and build immunity.

Increase your level of fitness - Maintain a good bodyweight. Additional flab invites a host of troubles, that includes variety of cancers.

Seeking regular medical checkup or screening - This is the only way to prevent and get detected early on.

International Childhood Cancer Day - Why Cancer Is A Threat For Young?

Stitches or sutures act as a closure for either surface wounds or deep wounds. Procedure to close a deep wound comprises of sewing the two edges and applying stitches under the skin surface.

Catagories of sutures

    Non-absorbable stitches: Such stitches are applied in case of skin wounds or internal wounds. Such stitches get healed quickly and are easy to remove. Non-absorbable stitches are made of natural fibers or synthetic threads like nylon polypropylene. As the name suggests, these stitches are either permanent or persist for a long time.
    Absorbable stitches: Such stitches are applied on layers, which have the property of healing quickly. They are very firm during the initial days. Then they start getting dissolved in the body.

Precautions taken by medical team before applying stitches to prevent infection

    Careful checking of nose for occurrence of germs before the start of operation.
    Skin must be cleansed prior to surgery.
    Sanitizing hands prior conducting the surgery.
    Usage of germ free gloves and sterile clothes while applying sutures.
    Prescribing antibiotics to the patients who may fear high risk of infection.

Precautions to be taken by patient to prevent infection

    Take a bath prior to surgery.
    Avoid using razor at the surgical site. The same can be carried out by using clippers by the surgery team itself.
    Keep all your jewellery aside before the operation starts. Do not apply nail polish.
    It is advised to cover up the wound. Try to keep the adjacent areas germ free. This is a crucial step in avoiding infection.
    Visit your doctor at once on finding redness around the wound.

When to see the doctor
Pain up to a certain threshold is normal. In case pain gets unbearable, the scene can be alarming. It may be an indication of infection. Taking immediate remedial steps is necessary to avoid infection or any other side effects post the surgery. On meeting with any of the following signs, it is better to consult doctor at once.

    If the skin around the wound gets swollen.
    If you detect redness around the wound.
    If the pain becomes unbearable.
    If the wound starts developing pus.
    If your body temperature increases abnormally or if you have fever.
    If you observe red streaks around the wound.
    If in case a stitch gets opened up and the edges of the suture start widening. This is the most alarming sign. In case a suture gets opened, you must immediately seek a remedy.

Ask your doctor for the precautions you can take to avoid experiencing any of the above signs. If you come across such alarming symptoms, rush to the nearest hospital and get the appropriate treatment.

Pain in Stiches - When You Should See Your Doctor?

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