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

28th July is considered to be World Hepatitis Day. Viral hepatitis can invade the human body in a variety of ways, but it is in your hands to prevent this infection from intruding your body and mess with your health. Hepatitis is a disease that takes a toll on the human liver. There are 5 different types of hepatitis from Hepatitis A to E, but there are ways you can take to prevent yourself against the same, such as:

Know how the Hepatitis spread: On the basis of the different types of Hepatitis, there are two main ways by which hepatitis gets its way from one person to another, contact with infected blood and body fluid as well as contact with the infected stool. It is important to note here that Hepatitis A and E are carried through the faeces of the affected individual. Also, a person may get infected with Hepatitis A and E even if you consume contaminated food and water. Hepatitis B, C along with D can also spread through the infected blood. 
Get the proper immunization: There are vaccines available all across the world to prevent spreading Hepatitis A and B. But it is crucial to point here that it is not possible to prevent Hepatitis C and D and sometimes Hepatitis E as well. But the Hepatitis C can be cured when the patient has received effective anti-viral medications. There are no vaccinations for Hepatitis D but the virus causing this infection requires Hepatitis B for survival. Therefore, getting vaccinated against Hepatitis B will help prevent the disease from affecting you.
Get the right precautions while travelling: When travelling, no one can tell whether you will get access to clean and purified water. Water contaminated with impurities can lead to Hepatitis A as well as E. You should take proper precautions and immunizations in the first place. If you are going to a place that doesn t have access to clean water, you should steer clear from ice cubes, running tap water, cut fruits and raw vegetables which may have been cleaned in the water with impurities.
By being aware and taking necessary precaution, getting affected by hepatitis can be prevented.

World Hepatitis Day - How You Can Prevent Yourself?

Are you feeling lightheaded, unbalanced or woozy lately? Are you having strange sensations in the ears and eyes? These indicate that you are suffering from dizziness, a condition affecting the body s sensory organs. It can cause fainting at times as well. It is not a disease, but a symptom of several disorders. Dizziness is caused by inner ear disturbances, effects of medication, motion sickness and underlying health conditions, such as poor blood circulation, infections or injuries.

Test and diagnosis
If you feel dizzy for a prolonged period of time or if the dizziness occurs and reoccurs, a special treatment is required. This is because dizziness may make you prone to several risks in everyday life. Several tests are carried out to find out the cause of the dizziness. If a stroke is suspected, an MRI scan or CT scan is carried out. A physical examination is undertaken in which the way you walk and balance are observed and the nerves of the central nervous system are checked. Hearing and balance tests may also be required, which are as follows:

Eye movement testing in which the path of the eyes is observed while tracking an object in motion. An eye motion test may be given where cold and warm water is placed in the ear canal.
Head movement tests are carried out when benign paroxysmal positional vertigo is suspected.
Treatment
Treatment of dizziness includes medicines, therapies and balance exercises.

Medicines

Water pills are prescribed when a patient has Meniere s disease, which helps in reducing dizziness.
Antihistamines provide temporary relief from dizziness.
Therapy

Head position maneuvers: A technique known as canalith repositioning helps in resolving dizziness quickly. It can be performed by a doctor, therapist or audiologist. The position of the head is maneuvered in the process.
Balance therapy: Several exercises help in making the body s balance system lesser sensitive to motion. This technique, known as vestibular rehabilitation, is used for people suffering from dizziness due to inner ear conditions.
Psychotherapy: This therapy may be used for patients who experience dizziness because of anxiety disorders.
Use of antibiotics: An antibiotic by the name of gentamicin may be injected in the inner ear for disabling the balance function. The unaffected ear performs that function.
Other procedures: A procedure known as labyrinthectomy may be used for disabling the vestibular labyrinth in the affected ear.
If you experience dizziness continuously, it is important for you to visit an ENT specialist. An ENT specialist deals with problems related to the ear, nose and throat and will be able to provide you with the best diagnosis and treatment for dizziness.

Dizziness - Can it be a Sign of Ear Disturbance?

Cirrhosis is a severe problem of the liver, wherein the liver stops functioning properly due to long-term damage caused by its exposure to toxic substances like alcohol or viral infections. Every time the liver gets affected, it tries to repair itself through the body s natural healing process. Now, due to this continuous healing process, scar tissue gets formed. With the progress of cirrhosis, resulting in the formation of more and more scar tissue, the liver becomes unable to function properly. 

What are the symptoms of Cirrhosis?
Usually, cirrhosis doesn t have signs or symptoms till the time when extensive liver damage has occurred. In those cases, the signs and symptoms which occur include:

One could sense discolouration in the eyes and skin, giving a clear indication of jaundice.
Excess fluid might get accumulated in your abdomen, resulting in utter discomfort.
One may not feel like having any food due to loss of appetite.
You might have uneasiness and discomfort in your upper stomach, provoking you to vomit.
There can be noticeable swelling in your legs, which make it difficult for you to walk properly.
Drowsiness and slurred speech could also be associated as symptoms of cirrhosis.
There might be redness in the palms of one s hands.
So we see that there are numerous signs and symptoms which you could come across, giving a clear indication of the problem of cirrhosis.

Causes which lead to cirrhosis
There are various kinds of diseases and conditions, which can damage the liver and lead to cirrhosis. Some of the most common causes are:

Chronic alcohol abuse over a long period of time can cause severe damage to the liver, hence resulting in cirrhosis.
The virus out of chronic hepatitis B and C attacks the liver and gradually lead to the formation of scar tissue, thereby resulting in Cirrhosis.
Accumulated fat in the liver due to the intake of an unhealthy diet.
Other possible causes can include:

The genetic digestive disorder is another serious cause behind the occurrence of cirrhosis.
Autoimmune hepatitis, where liver disease is caused by one s body s immune system.
Iron is an important part of haemoglobin as it carries oxygen from our lungs to other parts of our body. The problem arises when too much iron gets accumulated in the system, which can poison organs like liver, heart and pancreas. Presence of too much iron in the liver cause cirrhosis.
Poor formation of bile ducts.
Treatment
Treatment mainly depends on the underlying cause and extent of your liver damage. Some of the treatment options which doctors would adopt are:

People should stop drinking immediately if the cirrhosis has been caused due to alcohol consumption.
As one of the reasons for cirrhosis in non-alcoholic persons is obesity, so making a conscious attempt to lose weight is must if they want to get rid of this problem. Loss of weight and keeping blood sugar under check would gradually make the liver healthy.
Damage to liver cells caused by hepatitis B or C can be healed through the specific treatment of these viruses.

Liver Cirrhosis - Possible Factors That Can Lead To It!

One of the most debilitating conditions that anyone can experience is migraine. They can severely limit you by affecting your personal and professional life as you are in constant pain. Migraine can manifest in a type of headache with intense pain, an acute sensitivity to light, vomiting and nausea. Often described as a severe throbbing pain in the head, it may stop you from completing regular daily tasks and may delay or postpone your work.

How can migraines be treated?
The exact cause for these debilitating migraine pain hasn't been pointed out yet, but certain triggers such as stress, hormonal changes in the menstrual cycle, sun exposure, bright or flashing lights, among many others have been identified. The first line of defense for you would be to understand and identify what your triggers are. Once that is done, you can try and avoid them. If these still trigger a migraine or are about to trigger one, you can immediately take medications or steps to control it or at least lessen the pain to go through your day. Some of the options you can employ to this effect are mentioned below.

Medications to prevent a migraine attack: The medications mentioned here are specialized treatments and can only be taken after a consultation with a doctor. If you are deemed as a candidate for preventative medication for migraines, then either one or a combination of drugs from the following may be prescribed to you.
Valproate and Topiramate are anti-seizure medications which can be used to prevent migraines.
Propranolol, a type of beta blocker and used for cardio vascular problems, has proven to be very effective in preventing migraines.
Onabotulinumtoxin A or a type of Botox, has shown a lot of promise in preventing migraines and is being slowly rolled out as a proper drug as a treatment option.
Certain antidepressants have also shown to be quite effective in reducing the symptoms of migraines as well.
Medications to relieve pain: Some of the go to medications that help relieve your pain from migraine are mentioned below. Although some of them are OTC (over the counter) drugs, it is best advised that you consult with your doctor for medications which suit you better. The side effects of these medications can be bad and thus, it is not advised to continue them in the long run and to find other means to control pain from migraines. Some of the medications to relieve pain temporarily are:
Triptan is a drug used to treat severe migraines
Caffeine along with Ergotamine can also help dull the pain and deal with it.
Ibuprofen and aspirin and Acetaminophen are common pain killers that you can use
Codeine, which contains opioids are also used to treat this problem.
Metoclopramide and chlorpromazine are two examples of anti-nausea medications as vomiting along with nausea may frequently accompany your migraine.
Always remember that these medications can have strong side effects if not taken properly, therefore do not just pop a pill, consult your physician first and know which one should you take and how frequently. 

Severe Headache - Can it Be Migraine?

In today s stressful environment, more and more people are being diagnosed with psychological disorders such as insomnia and depression. Neither of the two are things which people feel lucky to possess. However, it is interesting to note that there is a link between the two conditions. Also, the problems are a lot more common than a person is likely to first think; 80% of depressed people suffer from chronic insomnia!

For a long time until recently, many people were of the opinion that most depressed people were insomniac. But that is not really correct. The two issues do overlap to a large extent, but they are different from each other. Again, that does not mean one cannot affect the other.

When a person has depression, one of the main things that he or she can experience is a lack of pleasure from the activities and happenings which occur in his or her daily life. Similarly, when a person does not get enough sleep or even just cannot sleep, he or she is quite likely to display a tendency to worry. Often, worrying sets the stage for depression to develop in the person. In fact, doctors have observed that people who do not sleep enough are more likely to undergo treatment for depression than the others.

Recent findings have concluded that when a person sleeps better, the case of depression also shows an uptick. In addition to this, the habit of sleeping well can also go quite a long way to make sure that a person does not relapse into depression. According to some sleep therapies, people who suffer from lack of sleep are advised to follow a systematic routine of getting to bed and getting out of bed. Activities including reading in bed or watching TV after going to bed must be avoided. While there are various means to help a person sleep better, the choice as to which one would suit a person in the best possible way is only best decided by the person s personal doctor. What is for sure is the fact that a person can effectively sleep to a better life!

So, it can be said that if a person wants to cure his/her depression and enjoy life being peppy, napping away is not such a bad idea after all. Having said that, everything is good only up to a certain limit!

Insomnia and Depression - Is There A Link Between Them?

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