Rotator cuff is the name given to four muscles and their tendons, which keep your arms in your shoulder sockets, allowing you to lift your arms and do day-to-day stuff like combing your hair, cutting vegetables etc.

The shoulder joint is a very important joint of the body and this is why any tear that happens in the rotator cuff can be devastating.

Causes

Tears can happen in rotator cuff due to a number of factors like injury and degeneration due to age. Tears that happen due to an injury to the shoulder are called acute. Degenerative tears are tears that happen due to degeneration of the tendon over time.

Common causes of degeneration are lack of proper blood circulation, which impedes the rotator cuff s ability to repair itself. Repetitive stress is another cause where we stress the tendon by repeating the same shoulder motions again and again while playing games like tennis, cricket etc. and doing jobs that require us to extend our arms upwards a lot. Lifting heavy objects can also lead to tears.

Symptoms

Chronic shoulder and arm pain are good reasons for you to see your doctor. If you suffer from pain in your shoulder at rest, while sleeping on the affected shoulder or pain while lifting and lowering your arm, then there is no time to wait.

The doctor will do a physical examination by moving your arm in different directions. He may follow it up with X-rays and MRI to check how big the tear is in your rotator cuff.

Treatment

Once confirmed that you indeed have a rotator cuff tear, your doctor will start the treatment. The goal of any treatment is to reduce pain and make your shoulder joint work properly again.

Nonsurgical Treatments: 

Nonsurgical treatments include rest, using of a sling to protect the shoulder and modifying your daily activities. This means you may not be able to do activities that cause shoulder pain. Your doctor can also prescribe pain and anti-inflammatory medicines. Strengthening and physical therapy bring up the rear of this type of treatment.

What you must remember is that nonsurgical treatment relieves pain and improves function in the shoulder, but does not improve shoulder strength. The size of your tear may also increase over time.

Surgery: 

Surgery, which attaches the rotator cuff to your bone, is done if you suffer from continuous pain and symptoms over a year or so. If you have a large tear, conservative treatments will not work and surgery will have to be resorted to. 

If you have been suffering from chronic shoulder or arm pain, waiting and watching is definitely not an option. You must visit an orthopedic surgeon at the earliest. Remember, if treatment is not started soon enough, your rotator cuff tear will get larger and will require only surgery.

Rotator Cuff Tears: What Are My Options?

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?

When the median nerve that runs through the palm and forearm is twisted or squeezed, a condition called the Carpal tunnel syndrome (CTS) occurs. This carpal tunnel is a passage that is narrow and is present in the ligaments and tendons. This nerve is responsible for offering a feeling sensation to the palm, index finger, thumb, and the middle finger. A part of the ring finger too shares the same. The median nerve is compressed when the tendons are irritated. This leads to pain in the forearm and arm, palm, and wrist. Additionally, this condition can cause numbness and weakness.

How it begins? 

This condition does not occur suddenly but gradually. In the initial stage, the sufferer experiences burning, itching, and numbness in the palm. The thumb, index and the middle finger feel these symptoms. The affected individuals may notice that the hands are swollen and rendered useless. You may feel pain and numbness in one or both the hands during sleep. Slowly, the numbness and pain keeps increasing and can be felt during the day. This is why you may want to shake off hands multiple times.

Factors responsible for this condition: 

Various factors can trigger Carpal tunnel syndrome. If you have had any injury to the wrist in the past that caused swelling, you may suffer from this syndrome. For instance, a sprain or fracture can trigger a Carpal tunnel syndrome. A thyroid gland that is overactive or underactive, arthritis, and overactive pituitary gland, too, can cause this condition. If your occupation involves an excessive movement of the wrists or if your lifestyle involves excessive work stress and the use of vibrating tools, then also this syndrome may affect you. Compression of the median nerve or narrowing of the space for the median nerve are the two other reasons. Fluid retention during menopause or pregnancy can also result in Carpal tunnel syndrome.

Will you be at risk?

Women are more likely to suffer from this condition as compared to men because the carpal tunnel is smaller in the former group. The symptoms are first seen in the dominant hand. The high-risk group includes diabetics and people who suffer from other metabolic disorders. People who are working with industries that deal with manufacturing, cleaning, assembly, sewing, or poultry or fish packing mostly face this disorder.

What can you do?

Surgical and non-surgical treatment methods are available for Carpal tunnel syndrome. When you are diagnosed with Carpal tunnel syndrome, undergo the treatment as advised by the doctor. Wear a splint at nights. During days, when you see swelling or redness of the palm, apply cooling packs. Take breaks from work, if it involves pressurizing the median nerve or if there is any narrowing of the space. Chiropractic therapies, acupuncture, and yoga are known to offer relief as well.

Prevention techniques: 

To prevent Carpal tunnel syndrome, always ensure you stay in the right posture. Use a fingerless glove as this keeps the wrist and palm warm. Take frequent breaks from the task that you are performing, especially the ones that require too much of the wrist movement. Job demands should be considered, however, rotating tasks with colleagues can provide an excellent relief. If your doctor feels that surgery is the only option left to provide relief, then you need to go for the same. With the two options of open release surgery or endoscopic surgery, you can expect symptoms to be relieved as soon as the procedure is conducted. 

Things You Need To Know About Carpal Tunnel Syndrome! 

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?


A fracture separates a single solid object into two or more pieces due to pressure. In medical terms, a fracture refers to a broken bone due to some kind of external trauma. A crack in the bone, on the other hand, it does not cause a clean break in the bone, there is only a separation or discontinuity in the bone material.

A crack in the bone caused due to repeated stress is often called as 'hairline fracture'. Here are the basic differences between a crack and a fracture in the bone and how to treat them:

1. A crack or hairline fracture is rarely caused by a single injury. It is usually the result of bone fatigue, which may be caused due to repeated, concentrated stress over a long period of time and thus, it is also called as 'stress fracture'. Other bone fractures are almost always the result of sudden and severe force on the bones.

2. The skeletal system constantly remodels itself. The cells, known as 'osteoblasts' absorb calcium and secrete bone connective tissue. If a particular site is exposed to recurrent bouts of force (which are individually not impactful enough to cause a crack), over time the osteoblasts in that region malfunction and the crack appears.

Muscular exhaustion can also cause cracks in the bone. Fractures are caused due to sudden external single force trauma to the bone. Nutritional problems like deficiencies of Calcium, Phosphorus, vitamin D and excessive smoking decrease the bone mineral density and increase the chance of both cracks and fractures.

3. Symptoms of a crack are swelling, tenderness and sharp pain in the injured region and the symptoms worsen over time. A fracture has similar symptoms and might also exhibit an external physical distortion and makes it impossible to move that part of the body that where the bone is broken.

4. An MRI is often suggested for detecting the crack or crack-prone areas because an X-ray can only detect the crack after it widens somewhat or the bone starts paining because the rays cannot pass through the tiny gap in bone material. A fracture is easily detectable by an X-ray because the rays pass right through the break.

5. Complete rest for six to eight weeks is the most effective way of healing a crack. Using a walking boot in case of cracks in the leg bones in also helpful. Healing fractures require extensive medical intervention. Surgical techniques like bone grafting and the insertion of metal plates are used to reposition the broken bone.

Cracks VS Fractures

Exercising and sports activities are necessary evils in your life. While they keep your body fit, you are also exposed to injuries at the same time. Of all the injuries, muscle strains are the most common ones. These might look very ordinary or minor, but remember there is an intense pain attached to it. So much so that you might even feel suicidal at times. Poor conditioning, over exertion and a faulty warm up session, can lead to muscle sprain. Strains are very common in certain regions like lower back, neck, shoulder and hamstring muscle (at the back of the thigh).

Don t need medical treatment
In most cases, muscle strains don t need medical treatment. But it is important to provide the right supplies and rest to the victim. For treating a muscle sprain, you will need ice, plastic bag, towel, compression bandage, pillows and over-the-counter painkillers. You may also need certain devices to assist you, depending upon the area that has been affected. These devices include crutches, slings, braces and wheelchairs. These devices help in stabilising the affected area (especially the muscle there.)

RICE Method
As per the data by American Academy of Orthopaedic Surgeons (AAOS), the most effective way to treat muscle sprains is by following the Rice method. The word rice stands for- rest, ice, compression, and elevation. The patient must take adequate amount of rest and not undertake physical activities. He or she must give proper time for healing of the injury or wound, prior to resuming back regular activities. If the sprain is chronic, take total bed rest. It is often advised to apply ice compression to the affected area for about 8 to 10 times a day. Try to compress your muscle by putting mild pressure to avoid swelling or any kind of inflammation. For this, it is best to tie up a bandage around the affected part. It is generally advised to elevate the injured part above the heart to avoid or reduce the swelling of the area. Sometimes, physical therapy is also needed to treat the sprains.

Risks of strain treatment
There are certain risk factors associated with muscle strain treatment. It is bad to take too many painkillers as they can affect other organs like kidneys, gut and heart. You should also avoid applying the ice pack directly on the skin for a prolonged period. Also, if you undertake a surgery to fix muscle strain, you are at the risk of suffering bleeding, developing blood clots, infection, pain and stiffness.

Muscle Sprain - How It Can Be Treated?

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