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!

Ayurvedic treatments are mainly based on maintaining a perfect balance among the three doshas of the body, namely vata, pitta and kapha. Ayurveda has numerous healing techniques to provide individuals with proper relief from pain and one such amazing and effective pain relieving technique used in Ayurveda is called the Kizhi treatment.

What is the Kizhi Treatment?
The term Kizhi is taken from the Malayalam language and it basically is a therapy which aims at protecting as well as enhancing the health and wellness of the entire human body. However, it can also be particularly used for relieving various kinds of pains and aches in the body. In this technique, the heated oils, herbs, powders and the other prescribed items are tied into bags of muslin and then applied to the body, based on the area of pain.

Kizhi is of many other types also like Pozhikizhi and Elakizhi. Navrakizhi is specially used in case of Polio and muscle wasting.

A varied degree of pressure is applied on different body parts with a special focus on the nerve points. The nature of the ailment or the spot decides the amount of pressure to be applied using palms, fingers or heels of the hand. The entire therapy includes perspiration inducing body scrub, which is consecutively followed with a very special bath.



Kizhi - The Effective Treatment for Pain Relief!

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

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?

A menstrual cramp is something which every woman complains of for a day or two every month. Menstrual cramps are usually the pains felt in the lower abdomen, which can occur both before and during a woman's menstrual period. These cramps are caused by a hormone called prostaglandin that causes the uterine muscles to contract during menstruation. When the uterus contracts to shed its natural lining during your period it releases a hormone called prostaglandins which causes pain and inflammation. So higher the level of prostaglandins more severe the menstrual cramps.

It might be just a minor discomfort for some, but for others it can be severe. The symptoms of menstrual cramps include pain in the abdomen, pressure in the abdomen and pain in the hips, lower back, and inner thighs as well. However, if the cramps are severe you might have an upset stomach, loose stools and vomiting too.

Three out of four women experience menstrual pains and every one out of 10 women experiences severe cramps. Here are few remedies that might help in relieving the pain:

Exercise, brisk walking or any type of physical activity can help to ease your belly pain as by being physically active your body pumps more blood, which helps in releasing endorphins to counteract the prostaglandins and reduce your cramps.
Apply heat on the lower abdomen or the area where you feel the pain as it helps to relax the contracting muscles in your uterus.
Improve your diet by reducing fat and increasing vegetables. However, avoid foods that contain caffeine and salt.
Take a warm bath as it may also provide some relief.
Add ginger in your food as it helps in lowering the levels of the pain-causing prostaglandins.
Drink chamomile tea at least three times a day.
Take fish oil supplements, vitamin B1 or both.
Make sure to get enough vitamin D.
Have an orgasm as it releases endorphins which has a pain-relieving effect and helps in boosting your mood as well.
Include more dietary magnesium such as dry almonds and boiled spinach as it helps to ease the pain of cramps.
Acupuncture also has an anti-inflammatory effect.
Take a safe painkiller to reduce pain.
Birth control pills may help relieve painful cramps, but they do come with side effects which may include spotting, breast tenderness, nausea and low sex drive.
Refrain yourself from smoking and drinking alcohol.
Finally, have appropriate rest.
Note: If you still do not get any relief despite trying some of these options then you must visit your doctor to rule out more serious health issues as the menstrual cramps are sometimes caused or worsened by other conditions and any sort of medications for such cramps are to be taken after consulting a Gynaecologist.

How to Get Relief From Severe Menstrual Cramps

Vulvodynia is a condition which causes severe pain in the opening (vulva) of the vagina without any apparent reason. The pain might be chronic in nature and can go on for years. Vulvodynia might affect your emotional health in the long-term and cause anxiety, depression and disrupted sleep patterns, if not treated immediately.

Doctors are still unsure regarding the exact causes of Vulvodynia. But there are few factors, which can increase your risks of suffering from this disorder:

    If you have a sensitive skin or have any past history of previous vaginal infections, you might be susceptible to vulvodynia.
    Vulvodynia might also be caused due to past injuries around the vulva.
    Sometimes, hormonal changes might also cause Vulvodynia.
    This disorder can also occur in women who have previously suffered from recurrent instances of sexual abuse.

The symptoms of Vulvodynia can be acute or chronic in nature with the pain being confined to one particular area or around the entire region.
The treatments for Vulvodynia aim at regulation of the symptoms. The most common treatments for Vulvodynia are:

    Your doctor might prescribe a specific dosage of steroids or antidepressants to get rid of the pain. Prescribed dosage of antihistamines might help to cure the itching sensation.
    You can apply a regulated amount of  Lidocaine  ointment around the vulvar regions thirty minutes before sexual intercourse.
    You can also opt for pelvic floor therapies as they might provide relief from significant pain in the pelvic floor muscles resulting from vulvodynia.
    If the pain is centralized around a particular area, you might opt for vestibulectomy to remove the affected tissues and get rid of the pain.

Can Sensitive Skin Be the Reason Behind Pain in the Opening of Vagina

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