If you suffer from chronic pain of any kind, it is important for you to know that it is associated and linked with your emotions. Other than your physical activities and personal relationships getting hampered, unwanted feelings like resentment, stress and frustration are also common. These emotions and feelings are capable of making your chronic pain condition more worse. 

The Relationship between your mind and body: Your mind and body work together and cannot be separated. Your mind controls all your thoughts and also affects the way in which pain is controlled or perceived by the body. Pain and the fear of pain may lead you to avoid activities. This may reduce your physical strength and cause disruption in the functioning of your body.

Stress: Stress affects your body both physically and emotionally. It may lead to an increase in your blood pressure, breathing rate, heart rate and muscle tension may also occur. These may lead to fatigue, appetite changes and sleep disruption. Stress also causes depression, anxiety, make you dependent on drugs and make you dependent on other people.

Depression: Depression is common among chronic pain patients. Chronic pain can make cases of existing depression much more worse and the existing pain is also worsened. There are chances of developing depression from chronic pain if depression runs in your family or genes. 

Symptoms of Depression are as follows:

Feeling sad, angry, worthless and hopeless frequently
Lack of energy
Lack of interest in regular activities
Difficulty in sleeping
An increase or decrease in appetite, which may lead to major weight gain or weight loss
Difficulty with concentration
Having suicidal thoughts and thoughts about dying or harming oneself
How to Handle your Emotions during Chronic Pain: A common therapy, which people with chronic pain undertake is called Cognitive Behavioural therapy. You should seek the help of a therapist. In this therapy, you will learn about thinking in a positive way instead of drowning in negative thoughts. Your fear of pain will be reduced and you will learn how to strengthen important relationships. You will be able to develop a sense of freedom from chronic pain. 

If your chronic pain occurs due to an accident or emotional trauma, you may be assessed for post-traumatic stress disorder (PTSD) by your healthcare provider. Many patients suffering from PTSD cannot deal with their pain until the emotional stress is dealt with. If you feel depressed and cannot control your emotions, you need to consult a doctor.

Chronic Pain - Is it Linked to Our Emotions?

When somebody is diagnosed with a short term or a life-threatening disease, one of the main things they are likely to stress over is pain. Though, there are many effective medicines for pain, it is important to realize that medicines are not by any means the only treatment method for pain. For instance, radiation treatment can be very useful in treating pain from cancer and also in facilitating bone pain identified with the disease.

The term "alternative therapy" for the most part is used to describe any treatment or alternative that does not require medicinal attention. Alternate treatment includes a combination of controls, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, relaxation, biofeedback, massage, homegrown cures, aromatherapy and numerous others.

There are various non-medicinal methods for adapting to pain. They can be used all alone or as a part of a mix with medication treatments. Some of the alternatives patients have discovered include:

Massage: Many individuals discover relief from delicate back rub, and some clinics and massage parlors have trained massage specialists. A few studies have found that a back rub is extremely successful in soothing pain.
Relaxation: Guided imagery, spellbinding, breathing procedures and relaxation arts like tai chi are effective and viable, especially when a patient is experiencing debilitating pain.
Acupuncture: A few studies have found that acupuncture can be useful in calming pain for individuals with genuine ailments, for example - cancer.
Physiotherapy: In case a person has been very active before and is currently bed-ridden, even simply moving the hands and feet a little bit with proper physiotherapy movements can offer help.
Pet treatment: If you have episodes of pain that last 5, 10, or 15 minutes, attempting to discover something pleasant - like petting an animal's delicate fur can divert and help in relaxation.
Gel packs: These are basic packs that can be warmed or cooled and used to ease pain.
Chiropractic treatment: It is the most widely recognized non-surgical treatment for back pain. It is usually done by a chiropractor who will tune your nerves and other parts for pain relief. Qualified chiropractors are a rarity and hence one must be careful while dealing with them.
Diet: A few people trust that dietary fat intake and consumption of plants that contain calming operators can ease pain by restricting irritation.
Herbal treatment: The effectiveness of herbs is questionable. Do consult a doctor or a specialist since they could have a side effect of their own. Some of them can interact with the medicines you might be taking. This may cause harm to your health.
Alternative therapies to pain relief are not always harmless. As mentioned above, herbal remedies could have few side effects too. Likewise, one should always take a second opinion or consult someone before taking a decision on the kind of alternative therapy they opt for. It is better if you consult an interventional pain physician first and then follow his advice on how to follow these methods for maximal pain relief.

Using Non-medicinal Ways to Treat Pain

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

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

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

Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

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