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

Nerve compression is a condition caused by direct pressure on a nerve. It occurs when a nerve is squeezed or compacted. It is also known as compression neuropathy or entrapment neuropathy. 

It typically occurs at a single location. Nerves in the torso, limbs, and extremities may be affected. Common symptoms include pain, numbness, and muscle weakness at the site of the nerve.

Nerve compression syndrome is also known as:

nerve entrapment syndrome
compression neuropathy
entrapment neuropathy
trapped nerve
Types

Mentioned below are few of the most common types of nerve compression syndromes:

Carpal tunnel syndrome
Cubital tunnel syndrome
Suprascapular nerve compression syndrome
Guyon s canal syndrome
Meralgia paresthetica
Radial nerve compression syndrome
Causes

Prolonged or repeated external force, such as sitting with one's arm over the back of a chair (radial nerve), frequently resting one's elbows on a table (ulnar nerve), or an ill-fitting cast or brace on the leg (peroneal nerve).
Accidents such as sprains, fractures, and broken bones can also cause nerve compression syndrome
Diabetes
Autoimmune disorders, such as rheumatoid arthritis
Thyroid dysfunction
High blood pressure
Tumors and cysts
Pregnancy or menopause
Obesity
Neural disorders
Signs and Symptoms

Pain in the area of compressions, such as the neck or lower back
Radiating pain, such as sciatica or radicular pain
Numbness or tingling
Pins and needles or a burning sensation
Weakness
Symptoms worsen when you try specific movements, such as turning your head or straining your neck
Management

Lifestyle changes: Avoiding movements that cause pain.  Changing job duties may relieve symptoms. Losing weight can improve symptoms if obesity is the cause of nerve compression syndrome,
Physical therapy: Flexibility, strength, and range of motion in the affected area can be improved by working with a physical therapist. Physical therapy can also relieve symptoms, such as pain and numbness.
Medication: Drugs commonly prescribed to manage symptoms caused by nerve compression syndrome include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and aspirin. Corticosteroids, such as dexamethasone, are injected directly around the nerve.
Prosthetic devices: In few cases of nerve compression syndrome, a doctor or physical therapist may advise a splint or a brace to help avoid putting pressure on the nerve.
Surgery: The surgical procedure required depends on the type of nerve compression syndrome, the degree of compression, and the nerves and structures affected. Surgery also depends on several factors, which include the duration of the symptoms, the severity of symptoms, and any other underlying health conditions you might have. 
Home remedies: The following home remedies may stop or ameliorate symptoms of nerve compression syndrome:
Stop activities that cause pain
Apply icing on the affected area for 10 15 minutes
Taking regular breaks when doing repetitive tasks
Applying topical creams, such as menthol
Elevating the affected area
Keeping the affected area warmPerforming stretches and exercises to improve strength and flexibility
Using relaxation exercises

Pinched Nerve (Compressed Nerve) - How Can It Be Managed?

Why does PAIN occur? Understand the Mechanism of Pain

Pain is an unpleasant and distressing physical sensation caused by disease or injury, which induces hurt and anxiety in those suffering from it.
There are many different manifestations of pain, ranging from short term (acute pain) to long term (chronic pain). Other classifications include pain in the internal organs (visceral pain), injured tissue (inflammatory pain), nerves (neuropathic pain), etc.

The reason for the occurrence of pain depends on the cause and kind of pain being experienced. In most cases, pain acts as a warning sign that the body has been afflicted by a disorder of some sort, which may have arisen due to internal sickness or external wounding. Acute pains are generally cured on their own through rest or simple medication. Chronic pains, on the other hand, are more complicated in nature and the treatment requires more elaborate diagnosis.

The mechanism of pain

Pain is an extremely personal and subjective experience and affects each individual to varying degrees. The pain signals, which can arise in any part of the body, travel through the spinal cord to the brain along thousands of specialized nerves and nerve fibres. In the brain, it is processed in the centres associated with anxiety, emotions, memory, appetite, etc. Signals and pain inputs are then returned from the brain to the spinal cord, which may heighten or diminish pain.

In some cases, pain may also be induced by damage to the brain and spinal cord, which happens after a stroke.
A constant barrage of pain signals may cause the cells at the end of nerve fibres to become over-sensitized. This is known as 'wind-up' and is one of the most common causes of chronic pain that occurs even though the root of the problem has been identified and treated.

The causes and effects of pain differ from case to case depending on the signals received by the brain and its interpretation. It affects the individual's day to day activities and if persistent, can also have a harmful impact on mental health and psychosis. Pain is always handled, diagnosed and treated differently in all patients by drawing out the best possible solution to the problem.





Why does PAIN occur? Understand the Mechanism of Pain

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?

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

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

Sequences of serious, jolting or shooting pain that might generate as an electric shock
Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.
How does Radiofrequency Ablation treat Trigeminal Neuralgia?

Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
It also occurs as a result of ageing or multiple sclerosis
A disorder that damages the myelin sheath protecting the nerves can trigger pain
Sometimes pain occurs from tumors, which compresses the trigeminal nerves
Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain
Triggers-

Shaving
Touching your face
Eating and drinking
Putting on makeup
Brushing
Washing your face
Symptoms-

The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation

The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain
How Effective is Radio-frequency Ablation?

The pain is cured almost in 98% of the patients. 50% of patients report a recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

In case you have a concern or query you can always consult a specialist & get answers to your questions!

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

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

Consult for Neuropathic Pain - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES