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 abdomen pain can originate from a range of medical issues. In some cases, the pain disappears just like the way it came, in some cases, it takes longer medical treatment to cure the pain. Once the origin and the root cause of the pain are diagnosed, there are plenty of medical options to cure the pain. In this piece, we will briefly touch upon the causes of lower abdomen pain:

Appendicitis: This is one of the most common causes of lower abdomen pain. It typically originates from the right side of the stomach and soon diverges into the other side as well. The pain can become unbearable in a matter of hours.
Pelvic inflammatory disease: This is an infection that is caused in the reproductive system of a woman. This is often characterized by vaginal discharge, fever, weakness, intercourse related pain and pain in the lower abdomen.
Miscarriage: In case there is a loss of fetus on or before the twentieth week, the mishap is termed as miscarriage. It results in acute pain in the lower abdomen pain, vaginal bleeding, back pain, fluid expulsion from the vagina etc.
Fibroids: This is a growth in the uterus that is often non-cancerous and is commonly characterized by symptoms such as heavy periods, constipation, pain in the legs and back area, pain in the lower abdomen area, frequent urination etc.
Cancer: A cancerous growth in the lower abdomen area can lead to very sharp pain in the back and surrounding area. The pain is dull in nature and slowly spreads to other areas in a short interval of time.
Cholecystitis: This is a disorder that results in swelling of the gallbladder area. It results in a sharp pain in the lower abdomen area. A doctor needs to be immediately consulted if a person is suffering from this disease.
Intestinal obstruction: When the lower bowl gets blocked due to the contents of the lower intestine, a person can feel a sharp pain in the lower abdomen area.
Salpingitis: When a woman faces stiff pain in the lower abdomen area due to an inflammation of the fallopian tube, Salpingitis is the culprit behind it. This is a sexual disease and needs a doctor s consultation to get rid of it.
PMS: A woman can face throbbing pain in the lower abdomen area during her monthly periods. Other symptoms include cramps, weakness, fatigue etc.
Endometriosis: When there is an extension of the uterus tissue just outside the wall of the uterus, it leads to symptoms such as lower abdomen pain, cramps etc.
Polycystic ovarian syndrome: This is a disorder of the hormone and can lead to symptoms such as heavy periods, a growth of facial hair accompanied with sharp pain the lower abdomen area.

Pain In Lower Abdomen - What Could Be The Causes?

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?

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

Vaginismus is a condition characterized by significant pain in the vagina generally during sexual intercourse. This pain occurs on penetration due to the contraction of the vaginal muscles.

Causes

The exact cause of Vaginismus is not exactly known to the doctors. But some researchers suggests that the pain might result from severe anxiety or illogical fears before sex.

Vaginismus can be primary or secondary depending on the concerned woman s previous sexual experiences. Vaginismus can be linked to an earlier sexually painful experience, sexual trauma or psychological factors. In some cases, the pain tends to exist without any direct physical cause. The causes of the pain might vary from women to women and might occur in some cases with only one specific partner and not with others.

Sometimes the pain might stem from underlying infections or any other underlying complications.

The symptoms of Vaginismus are as follows:

Severe pain during intercourse.

Severe pain during insertion of tampons or during any medical check-ups.

The following treatments can be useful to treat Vaginismus:

If the pain arises due to anxiety or fear, counselling sessions can help you to a remedy.

If the pain arises whenever something penetrates the vaginal walls, progressive desensitization can be useful to treat the pain. The process aims to loosen the vaginal muscles so that you don t experience any pain during sexual intercourse.

Kegel exercises (at least 20 of them) can help in the initial stage to relax the vaginal muscles. After you exercise for a few days, you should try inserting one finger inside your vagina while doing the exercises. Try doing it gently and if it still hurts, try doing it with a lubricating jelly. This continuous procedure will help in the contraction of the vaginal muscles which eventually relax.

Vaginismus - Things You Should Be Aware of 

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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