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

Hot and Cold therapy is one of the most popular home remedies for any kind of joint pain or muscle sprain. In some cases applying heat therapy and cold therapy alternatively, can help relieve the pain while for others only one form of therapy is necessary. To understand what to use when, one should first understand the effect of heat and cooling on the body.

Applying a heat pack or immersing the affected limb in hot water improves blood circulation and makes the muscles more flexible. Thus, it can help relax a muscle and fasten the healing of damaged tissues. On the other hand, cold therapy or cryotherapy reduces blood flow to the affected site. This helps relieve inflammation and pain caused by it. It can also make the area feel numb by reducing nerve activity temporarily.

Types of Heat Therapy
Heat therapy can be categorized as dry heat and moist heat. Dry heat involves using saunas or dry heating packs to relieve pain. This is also known as conducted heat therapy. As the name suggests, moist heat involves the use of steamed towels, hot baths and moist heating packs. This is also known as convection heat therapy. Moist heat is usually considered more effective than dry heat.

Types of Cold Therapy
Cold therapy may be applied to a part of the body or to the entire body. This includes ice packs, coolant sprays, ice baths, ice massages and whole body, cold therapy chambers.

How to use heat and cold therapy?
The sooner heat and cold therapy is given to a person, the faster they will recover from their pains. Heat therapy can be given to a person for extended periods of time but when giving cold therapy, a person should not be exposed to a cold pack or ice bath for more than 10-15 minutes. Care should also be taken no to apply ice or a frozen pack directly on the skin as it can damage the skin and nerves.

When not to use Heat Therapy?
If the injury site is swollen or bruised, cold therapy is better than heat therapy. Heat therapy should also not be applied to an open wound. People suffering from conditions such as diabetes, dermatitis, deep vein thrombosis, vascular diseases and multiple sclerosis should also avoid heat therapy as these conditions can increase the risk of burns and other such complications. Pregnant women should also consult a doctor before using a hot tub or sauna.

When not to use Cold Therapy?
Cold therapy is avoidable for treating stiff joints and muscles. People suffering from poor circulation and sensory disorders should also avoid using cold therapy without a doctor s supervision. 

Hot & Cold Therapy - How It Can Treat Pain?

Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot. This can be a painful condition. Let us look at the ways in which it may be cured.

Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.

Flat Foot Pain - Ways It Can Be Treated!

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?

What you must know about body ache


Affecting your entire body, body ache is usually an indicator of a condition that requires your attention for the pain to stop or a reaction of your body's immune system to an infection. Understanding the symptoms and the cause of the pain is the first step towards getting the right treatment for your problem.
The causes of body ache can be any one of these:
  an increase in your body's lactic acid as a result of overused muscles (that you normally experience when you perform strenuous exercises) leads to body aches that are not severe but temporary in nature.
  temporary body aches can also occur if you suffer from flu caused by the influenza virus and other medical conditions like fever and viral infections, among others.
  a cause of body aches can be the presence of a serious condition such as Lyme disease or pneumonia that brings about major infection affecting your entire body.
  inflammation of body cells or damage to your body's nervous system in the form of chronic ailments like autoimmune diseases and psychiatric problems can also cause pains and aches to develop all over the body.

What can you do to manage it?
There are simple ways that you can employ to relieve your body aches based on the root cause and these are:

  if the cause of your body ache is the flu, the best way to alleviate your condition is to take a hot bath. The hot water works by eliminating the body pains you may be suffering from. Even a gentle massage can soothe the ache affecting your entire body.
  for body aches that are caused due to overused muscle, you need to apply ice packs for 2-3 weeks on the affected area to bring down the inflammation. Even the application of a heating pad can help in relieving body aches brought on by muscle soreness.
  shoulder and neck pains can be easily prevented by performing simple exercises from time to time such as shoulder shrugs or head turns. Also, the practice of using wrist and forearm rests can reduce your chances of getting shoulder and neck aches.
  reducing your stress levels can also help in effectively lowering the instances of body ache. From sleeping on time to meditating for about 20 minutes a day can help in lowering stress.

In case, you do not get relief from any of the suggested ways, you need to consult a qualified doctor who will guide you on the right treatment course. 

If you would like to consult with me privately, please click on 'consult'
Related Tip: Why does PAIN occur? Understand the Mechanism of Pain

Body Ache? Here's What You Must Know about Body 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!

Don't wait any longer, manage your Hand Pain online with a Lybrate doctor today

Consult for Hand Pain - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES