Pain is unpleasant suffering caused by injury or illness. Back pain may be sudden/constant, dull, severe or not responding to short rest and medication. Constant pain in back in any region of spine for more than few days to weeks needs intervention.

Pain which is intense especially at night requires urgent visit to a specialist.

Sudden onset of pain in back with or without injury needs urgent attention.

Back pain with difficulty in walking, pain while getting up from position of comfort, pain during change of posture or pain after prolonged sitting (for work) can lead to serious permanent damage, if left untreated.

Pain which travels to one or both legs may be due to pressure on the nerve/s and if left untreated for long can lead to permanent weakness or damage.

Pain associated with numbness, tingling or weakness in legs, especially below the knees, commonly called Sciatica, needs to be investigated. Various spinal ailments can lead to weakness in one or two limbs or all four limbs. There may be associated or isolated numbness (loss of sensation to touch, pain or temperature) without back pain.

Numbness, tingling or weakness may be the only symptoms without any complaint or without history of back pain.

Problems related to bladder control which may be difficulty to control, hesitancy in passing or dribbling of urine. There may be associated constipation. Loss of bowel/bladder control is caused by pressure on spinal cord &/or nerves which may be due to injury, infection, disc prolapse or tumor.

Sudden swelling and redness in back usually happens after an injury or accident but sometimes are signs of underlying severe illness.

Loss of normal shape/curvatures of spine can present with or without pain. It can lead to forward, sideways or rarely backward bending.

Unintentional weight loss, loss of appetite, evening rise of fever or disturbed sleep with associated back pain/weakness/numbness needs visit to a specialist.

When Should You See Your Doctor in Back Pain?

Do you know you can suffer from a torn bicep accidentally? A bicep is a muscle which begins from your upper arm and is attached to the shoulder via bones and to the elbows by tendons. If you do heavy lifting in the gym or somehow put excessive pressure on that area, chances are you may suffer from torn biceps.

There are two kinds of bicep tears you may encounter:

Complete Tears where the tendons are split into two parts resulting in tremendous pain.
Partial Tears result when the biceps are hurt but the tendon is not completely severed.
Among the various types of torn biceps, the muscle that is attached to the shoulder experiences the maximum number of bicep ruptures. Suddenly, the bicep tendons get detached from the bone resulting in pain and numbness. You will find a number of sportspersons suffering from this kind of torn biceps.

But why do your biceps get torn?

One of the reasons why you suffer torn biceps is a prolonged period of ignorance. If you have been putting continuous pressure on your shoulder, the biceps muscle can weaken over time. Overuse of the muscles can give rise to conditions of tendinitis (inflammation of the bone to muscle connecting tissue) and injuries in rotator cuff which, in future, might result in torn biceps.
A sudden injury like falling over your arms or hurting your shoulder can result in torn biceps.
Aging is another reason why you can have this complication. Added to this are unusually heavy tasks and overuse of shoulder which can result in this problem.
Some steroids such as Corticosteroids are directly related to the weakening of muscles and tendons.
When you suffer from torn biceps, you encounter symptoms such as:

Weakening of the elbow and the shoulder. You will find it troublesome to move your hand.
Swelling of the elbow with bruises visible on the elbow and the forearm.
You find trouble in twisting your forearm
You will experience spasms in the muscles.
You can also hear a snapping sound of the muscles.
What should you do if you face this problem?

Continuous applications of ice packs are a must. Repeat the activity 4 times a day with a duration of 20 minutes. You may need to do it for 2 or 3 days.
Avoid activities which put pressure on your hands and shoulders.
Consult a doctor immediately and get some painkillers as recommended.
If you have complete tears, you may need to undergo surgery. Talk to your doctor regarding that.

How to Treat Torn Biceps - Types, Causes, Symptoms

Osteoporosis is a skeletal disorder, which causes fragility of bones. In the absence of proper prevention and treatment modalities, osteoporosis can cause a painless progression and subsequent fractures. Such fractures (broken bones) mostly occur in the hip, spine, or wrist. As per several past data-driven studies conducted in the United States of America, 1.5 million new fractures are witnessed in people with osteoporosis every year. Of these, spine fractures are seen in 700,000; hip fractures in 300,000; wrist fractures in 250,000; and fractures of other bones in 250,000 people.

Possible Causes of Osteoporosis

Hormonal imbalances Pregnancy
Metabolic diseases Cancer
Age beyond 60-65 years
Symptoms of Osteoporosis-Induced Compression Fractures 
Significant upper or lower back pain
Changes in posture
Difficulty with breathing and digestion 
Decreased ability to walk 
An overall decrease in the quality of life Increased tendency for fracture of adjacent vertebrae
Treatment

Compression fractures are usually managed with pain medications; narcotic pain medicines are administered for a few months until the pain decreases. Also, few available medications are known to increase the bone density. It is hoped that by building the bone density, future fractures can be prevented. Another method is immobilization of the spine with a brace that helps decrease pain from a broken vertebra; however, such braces are helpful only for the fractures of the lower back.

Role of Kyphoplasty in the Management of Osteoporosis

Kyphoplasty is a procedure that involves a new technology whereby an osteoporotic compression fracture can be treated with relief in pain, restoration of the lost bone height, and immediate stabilization of the fracture with the injection of bone cement. 

How is kyphoplasty done?

The procedure is carried out via two A  incisions on each side of the affected vertebra. The technique utilizes X-ray equipment to place working tools into the collapsed vertebra. This step is followed by an insertion of an inflatable bone tamp or expander into the fractured vertebra on each side, after which, the balloons are slowly inflated, lifting up the fractured portion of the vertebra to a more normal height. The balloons are then deflated, and cement is slowly injected. Excellent restoration of fractures, which are less than 4-6 months old and better than 90% success at reducing pain associated with the broken vertebra, is seen with kyphoplasty. 

Which patients can benefit from kyphoplasty? 

Patients with a recent vertebral compression fracture due to osteoporosis 
Patients with fractures which are less than 4 months old
Patients with fractures who are on chronic prednisone or steroids 
Complications from this procedure have been primarily related to patients who have been on blood thinner medications. 
Potential complications also include cement leaking out of the vertebra and into inappropriate areas. 

Kyphoplasty In The Management Of Osteporosis!

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

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

Breaking a bone no matter how small is painful. This pain is caused both by the actual break in the bone and the damage to surrounding muscles, ligaments, nerves and other soft tissue. There are three stages of pain caused by a fracture:

Acute Pain: Pain that occurs immediately after a bone is fractured
Sub-Acute Pain: Pain experienced while the one and soft tissues heal
Chronic Pain: Pain experienced after the fracture has healed
Any kind of fracture can cause these types of pain. However, it is not essential for everyone who has had a fracture to experience all the three kinds of pain. Many people experience pain only when the fracture occurs but in few cases, a person may break a bone and not realize it. Each type of pain needs to be dealt with in a different way.

Acute Pain: Acute pain reduces as the fracture heals. For this, the fractured bone must be reset in place and held together with a splint, brace or cast so as to immobilize it. In some cases, surgery may also be needed. Over the counter pain medication is often prescribed to help deal with this type of pain. The patient is also advised to rest the broken bone and avoid certain types of movement that could worsen the break. A broken bone takes a minimum of 6 to 8 weeks to heal. However, in cases of other conditions such as osteoporosis, this time period could be much longer.
Sub-Acute Pain: As the injury heals, the sub-acute pain experienced reduces. Immobilizing a broken bone to help it heal causes the muscles and soft tissues around it to stiffen and weaken thus triggering this type of pain. Physical therapy can be very helpful in dealing with this type of pain. Along with strengthening the muscles and reducing stiffness, physical therapy also helps reduce inflammation and scar tissue. Physical therapy can be provided in many ways including exercises, electrical stimulation, ultrasounds, massage etc. It is important to remember that at this stage of treatment, the more the affected limb is used, the faster it will heal. However, it is advisable to avoid putting too much pressure on the bone.
Chronic Pain: Some people may experience pain for several months and even years after a fracture has healed. This is usually caused by nerve damage or the development of scar tissue. Underlying conditions such as arthritis could also trigger this type of pain. Management of chronic pain varies from individual to individual. Treatment usually takes the form of medication, exercises and physical therapy. It is important not to avoid this type of pain and consult a doctor to ensure that it is not being caused by any other condition.

Fracture Pain - How To Deal With It?

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