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!

Hot and Cold therapy is one of the most popular home remedies for any kind of joint pain or muscle sprain. In some cases applying heat therapy and cold therapy alternatively, can help relieve the pain while for others only one form of therapy is necessary. To understand what to use when, one should first understand the effect of heat and cooling on the body.

Applying a heat pack or immersing the affected limb in hot water improves blood circulation and makes the muscles more flexible. Thus, it can help relax a muscle and fasten the healing of damaged tissues. On the other hand, cold therapy or cryotherapy reduces blood flow to the affected site. This helps relieve inflammation and pain caused by it. It can also make the area feel numb by reducing nerve activity temporarily.

Types of Heat Therapy
Heat therapy can be categorized as dry heat and moist heat. Dry heat involves using saunas or dry heating packs to relieve pain. This is also known as conducted heat therapy. As the name suggests, moist heat involves the use of steamed towels, hot baths and moist heating packs. This is also known as convection heat therapy. Moist heat is usually considered more effective than dry heat.

Types of Cold Therapy
Cold therapy may be applied to a part of the body or to the entire body. This includes ice packs, coolant sprays, ice baths, ice massages and whole body, cold therapy chambers.

How to use heat and cold therapy?
The sooner heat and cold therapy is given to a person, the faster they will recover from their pains. Heat therapy can be given to a person for extended periods of time but when giving cold therapy, a person should not be exposed to a cold pack or ice bath for more than 10-15 minutes. Care should also be taken no to apply ice or a frozen pack directly on the skin as it can damage the skin and nerves.

When not to use Heat Therapy?
If the injury site is swollen or bruised, cold therapy is better than heat therapy. Heat therapy should also not be applied to an open wound. People suffering from conditions such as diabetes, dermatitis, deep vein thrombosis, vascular diseases and multiple sclerosis should also avoid heat therapy as these conditions can increase the risk of burns and other such complications. Pregnant women should also consult a doctor before using a hot tub or sauna.

When not to use Cold Therapy?
Cold therapy is avoidable for treating stiff joints and muscles. People suffering from poor circulation and sensory disorders should also avoid using cold therapy without a doctor s supervision. 

Hot & Cold Therapy - How It Can Treat Pain?

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

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?

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

Our body is composed of many elements that carry out emotional and physical functions that are usually in sync with one another. It is important for these organs and other elements to be in sync for good health. All nerves are connected to the brain and are responsible for sending important signals throughout your body. Therefore, even one pressed nerve may send you warning signals such as pain to the body. It is advisable not to overlook these signals. Damage from a pressed nerve might be minor or extreme. It might bring about persistent and chronic issues. Therefore, the sooner you get a treatment for nerve compression, the more relieving experience you will have. In a few cases, you cannot reverse the damage caused by a pressed nerve. However, treatment does relieve you from the pain in most cases.

Nerves are the most vulnerable at spots in your body where they go through narrow spaces and have very less tissue to protect them. These are the places they are more likely to get pinched. A number of the causes may include:

If the nerve is pressed between tissues, for example, your tendon, ligament or bone.
Nerve compression in your neck or arm may likewise bring pain in zones, for example, your elbow, hand, wrist or fingers.
Aggravation or weight on a nerve root leaving the spine may bring about neck or low back pain.
In case a disc tears, it is known as a herniated circle that can put weight on a spinal nerve.
Some of the common symptoms of pinched nerves are:

Pain in the region of pressure, for example, the neck or low back
Transmitting pain, for example, sciatica or radicular pain
Numbness
Tingling
Blazing sensation
Weakness
To what extent you are affected depends from individual to individual. Treatment fluctuates, based upon the seriousness and reason for the pinched nerve. You may find that you benefit from just resting the affected area and by maintaining distance from any exercises that may cause you harm. If side effects endure or torment is serious, it is best to see your specialist. You may require one or more types of treatment to contract swollen tissue around the nerve.

Treatment may include:

NSAIDs - Non steroidal inflammation mitigating drugs (NSAIDs, for example, headache medicine, ibuprofen, or naproxen may diminish swelling).
Oral corticosteroids - These are utilized to lessen swelling and agony.
Opiates - These are utilized for brief periods to lessen extreme pain.
Steroid infusions - These infusions may diminish swelling and allow the affected nerves to recover.
Exercise based recuperation - This will extend and reinforce muscles.
Brace - A prop or delicate neckline limits movement and permits muscles to rest for brief periods.
Interventional Pain Procedures: They are the most cost effective and non invasive methods for pain relief as recommended by the WHO. Your pain will be taken care of by the interventional pain physician or the pain specialist.
Surgery - Surgery might be required for more serious issues that do not react to different sorts of treatment.

What to Do When You Have a Pinched Nerve?

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