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?

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!

Body pain and Physiotherapy

Physiotherapy is an effective way to reduce various kinds of body pains. Physiotherapy includes massages, exercises, and heat treatments to relieve pain. This treatment is often recommended as the first option to treat back and neck pain. Physiotherapy is also used to rehabilitate patients after surgery. Different kinds of exercises included in this treatment are also useful to treat sports injuries.  Here are some steps that you can take to relieve your body pain incorporating physiotherapy.

Get appropriate help

It is important to properly diagnose your condition before going for physical therapy. Seek help from a professional and if he/she recommends physiotherapy then only opt for the treatment.

Reduce your severe pain before exercising

If you are in immense pain, work to alleviate the pain before engaging in exercises. Cold/ hot therapy, massage, manual manipulation are some of the methods that can slowly reduce the pain. These are all part of physical therapy.

Exercise

Exercising has numerous health benefits including relieving back pain. As you age, your back tends to get weaker; it is important to workout to prevent future backaches. Stretching, strengthening and low- impact aerobics are ideal for this issue.

You can also try water therapy as water has a therapeutic effect on pain and makes your movements much easier than on land.

Observe your body's reaction to physical therapy

When you have just had a back or neck pain episode and try physical therapy you will feel some initial discomfort, it is expected. After you acclimatize yourself with the routine all kinds of pain will gradually diminish. The initial pain due to physiotherapy is caused because your muscles are stiff and they are being stretched the way they are not used to. However if the pain gradually increases you are probably not right for that particular kind of physical therapy.



Body pain and Physiotherapy

Conventional medicine treats pain with the help of medications; by either blocking the transmission of pain signals in the body or by correcting the underlying problems caused by the pain in the first place. However, traditional and alternative forms of medicine such as acupuncture manage pain issues within the body through the means of redirecting disrupted energy flows. One of the very few forms of alternative treatments used in conjunction with conventional treatments, acupuncture is seen as a mercurial rise in popularity in the past few decades.


What is acupuncture?
Acupuncture dates back to ancient China, about 2500 years ago. It has been widely practiced there for a number of millennia, not only pain relief, but also for treating many ailments. Acupuncture isn t just considered a form of therapy, but a holistic form of medicine. Acupuncture works on the principle of the flow of energy within the body, also known as  Qi , in traditional Chinese medicine. Acupuncture strives to correct the disruptions in  Qi  that may cause pain by manipulating over 2000 of the specific pressure points within the body with the help of specially created needles.


Where is acupuncture effective?
Acupuncture is very effective in treating a host of ailments, especially in relieving the associated pain. Some of the areas where acupuncture has proven its effectiveness are:
1. Treating nausea and vomiting caused due to chemotherapy treatment for cancer patients
2.  Very useful in treating post-operative pain caused due to dental procedures
3.  Rehabilitating patients who have suffered strokes
4.  Fibromyalgia (musculo-skeletal pain with fatigue accompanied by sleep and memory issues) 
5.  Effective in combating withdrawal symptoms caused due to addiction
6.  Pain from menstrual cramps
7.  Tennis elbow
8.  Osteoarthritis (a type of arthritis caused due to the erosion of tissues present at the ends of one s bones)
9.  Pain of the lower vertebrae within the spinal column
10. Asthma


How does acupuncture work within the body?
According to modern medicine, the specific pressure points utilized by acupuncture within the body help in releasing chemicals that can block or at least reduce pain. It encourages the flow of chemicals from the brain, which act as nerve and pain blockers. It also helps stimulate the muscles and nerve endings, which can lessen inflammation and thus help in reducing pain.

Acupuncture - Why Should You Use it to Combat Pain?

Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

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