Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?

The neck and shoulder have a huge range of movement and thus they are more prone to injury. The ball and socket joint at the upper arm is the shoulder and both the neck and the shoulder are made up of soft tissues, muscles and ligaments. 

Reasons behind pain Injured rotator cuffs: 

Rotator cuffs are the tendons supporting the shoulder. If they are injured it might lead to a chronic loss of the range of movement. This is more commonly known as a frozen shoulder. 

Dislocation: Dislocated disc of the neck or shoulder due to an accident would cause severe pain in the affected area. 
Fractures: Fractured collarbone or the upper arm bone may result in chronic pain. 
Tendonitis: This occurs due to the over usage of the arms or neck or strains due to over exertion like in sports. 
An unstable shoulder joint: If there is instability in the ball and socket joint of the upper arm, chances of having a chronic pain is high. Others: Degenerative arthritis, herniated disc, and even heart attacks can be the other possible causes of chronic neck and shoulder pain. 
When to go to the doctor? 

When the patient experiences a pain due to a severe blow or injury, the neck pain radiates down the legs and arms, a feeling of numbness and tingling sensation, or has a stiff neck with fever or vomiting, it is essential to seek the advice of a Doctor. 

Diagnosis for shoulder and neck pain X-ray: 

The main form of diagnosing a pain is an x-ray. It helps to reveal diseases from arthritis, tumour, slipped disc, narrowing spinal cord, fractures and spinal cord instability. 

MRI: Magnetic Resonance Imaging or simply the MRI reveals the detail of nerve-related issues along with the problems in the ligaments and tendons. 
CT scan: There may be instances when the injuries are difficult to be diagnosed. And, in the case of a fracture, a CT Scan is advised for more details. It is also an alternative to MRI. 
ECG: An Electrocardiogram is a way of diagnosis if shoulder and neck pain continues along with chest pain or shortness of breath. If there is a risk of an individual having a heart attack, then an ECG is recommended. 
Electro Diagnosis: Electromyography referred to as EMG and Nerve Conduction Velocity (NCV) are used to diagnose pain in the arm, neck, shoulder followed by a numb feeling on the affected areas. 
Treatment for chronic shoulder and neck pain 
A simple sprain on the neck and shoulder would demand a rest for a few days along with pain medication. If the pain is due to muscle spasms application of dry or moist heat may provide relief. In the case of a swelling due to injuries, a cold ice pack 4 to 8 times a day will provide immense relief. Patients might be advised a cast or sling for the shoulder pain. The soft tissues in the neck and shoulder can be treated with pain relievers taken for a few days. Muscle relaxants are also prescribed depending on the severity of the pain. Local corticosteroid injections are helpful for shoulder arthritis. Platelet rich plasma injection is another modern treatment for arthritis or tendinopathy. In some situation, radio frequency procedures are very helpful. Exercises are very effective for both neck and shoulder pain movement. Surgery might be an option if nerve roots are affected.

Chronic Shoulder & Neck Pain - Ways It Can Be Diagnosed!

A neck strain and sprain is not a serious injury. However, they can still cause significant dysfunction and pain.
Causes of Neck Strain
The anatomy of the cervical spine is such that it not only houses, but also protects the spinal cord. Along with this it supports the head and allows it for mobility and motion. But this area, which allows the spine to be flexible can also leave it vulnerable for injury.

Triggers for the onset of neck muscle strain can be:

1. Too much time spent in an uncomfortable position, such as humping over the steering wheel while driving, bending over the computer monitor, talking on the phone while placing it in the crook of the neck.

2. Sleeping on a very high or too firm pillow can lead to an uncomfortable position of the head thus leading to the strain of the neck

3. Carrying heavy objects on one side of the body

4. Any trauma that might have impacted the neck, such as an accident, whiplash or a fall that might have had a head landing

Most events of a neck muscle strain or the soft tissue sprain, such as the tendons and ligaments lead to stiff neck along with pain in shoulders. There is also pain and difficulty in moving the neck or head.

Neck muscle strain remedies

Minor strains in the tendons, ligaments and muscles of the neck usually heal within a day or two. But till the symptoms subside, there are a few self care remedies that are effective in reducing the stiffness and pain. These are:

1. Application of cold or ice packs: The cold reduces the inflammation, which in turn allows the strain to heal. This ice pack should be applied for 20 minutes interval in the first 24 hours.

2. Application of heat: Heat helps in bringing the nutrient rich blood to the affected area in order to stimulate a healing response. Moist heat as well as heat from a hot shower or bath can be used. Some people might find relief from applying heat wraps such as thermacare.

3. Over-the-counter or OTC medications: Anti-inflammatory medication, such as naproxen and ibuprofen reduces inflammation, thereby leading to the reduction in pain. Pain relieving medicines such as acetaminophen can also be taken as this reduces the perception of pain.

4. Massage of the affected area: A gentle massage in the affected area helps in stimulating the blood flow of the area which in turn helps in a quick healing.

What You Need to Know About Neck Sprains and Strains

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

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

It is normal and alright to feel pain in the knees occasionally after a physical activity or prolonged walking. However, it is a serious cause of concern if the pain is experienced every now and then. Not responding to your knee pain for long can lead to the extreme disability. Knee pain does not crop up in a day and it may surprise you when it first appears. 

Initially, you may notice slight pain and discomfort. If you have identified knee pain at this level, managing it is easy. You can perform different exercises to prevent pain from occurring. If the pain severe, you need to go consult a doctor, who will then help identify the real cause of pain. The following exercises, along with medications, can help you overcome knee pain and restore the mobility of the joint.

Stair Step ups: Choose a comfortable stairway. Place your hand on the wall or banister. This is to ensure that you are balanced. Your left foot should be on the taller step. Your right foot should be on the ground. Stay in this posture for a second. Now, step back, and bring left foot to the right foot. Repeat this 6 times. Reverse the legs and continue doing for 6 times. If you want to take rest between the steps, feel free to do so.
Ups and Downs: You need an armless chair that is strong. Sit on the edge but comfortably. Your arms should be at your side, relaxed and loose. Sit erect and your feet should be flat. If you feel you need balance, and then cross your arms. Start standing up. This should not be instant but deliberate, controlled, and gradual movement. Stand slowly up to the full height, and hold on for 2 seconds. Again sit down. Repeat this 5 times.
Straight Leg Raise: This can be a part of your everyday exercise regime. This is a strengthening workout that does not put too much effort on the knees. Lie down on your back. One leg should be straight on the ground and the other one should be bent. Now, slowly lift the leg that is straight, and the toes should point upward. Raise your leg up to 30 degrees, but you can start with 15 to 20 degrees in the initial stage. Repeat 15 times and perform at least 3 sets of this exercise. Keep alternating legs. This workout strengthens the knees, thigh muscles, and the ankle joints, thus offering multifold benefits.
Wall Hamstring Stretch: Hamstring muscles too can be the cause of knee pain and discomfort. To strengthen the hamstring muscles and alleviate knee pain, this exercise helps a lot. Lie down on the floor flat. Your feet should be flexed. Choose a space that is close to a wall, or a sturdy table. Your right leg should be propped on the wall or table. If you don t prefer any, a resistance band is a good alternative. When stretching, you can find your flexibility level and when you feel that you have reached the deepest point, start relaxing. Keep alternating contracting and relaxing every 5 seconds. After 10 to 15 sets, you can try the same with the left leg.
Knee Rolls: Use an exercise mat or a carpet that is cozy. Lie on your back. Bend the knees, and ensure your feet are flat. Your arms should be stretched on the sides. Look at the ceiling, and hold the knees together. In the same posture, slowly roll the knees towards the right. When you feel a gentle twitch or after 5 seconds, move to original position. Then lower the knees to the left. Hold and release. For each side, repeat 10 times.
These exercises strengthen the knees and improve the quality of life by bidding bye to the pain. Understanding that these are magic remedies that work overnight is the key to stay focused and keep going without quitting.

Exercises That Can Help Relieve Knee Pain!

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