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

When you experience any kind of bone and joint pain, you may be wondering what the best remedy might be to get relief. Some people ignore the pain, and it worsens, while others take over-the-counter medicines. However, the best remedy for bone and joint pain is to visit a pain management specialist. The field of pain management has evolved over the last twenty years. Nowadays, there are dedicated pain management specialists who are experts in treating bone and joint pain.

Here are 3 reasons to consult a pain management specialist for bone and joint pain:
1. Pain management specialists are trained especially for understanding any kind of bone or joint pain. They undergo special training based on bone and joint pain management and thus know how best to recognize and treat such pains.

2. Pain management specialists have a multidisciplinary approach towards treating bone and joint pain. The aim of pain management is to provide overall treatment and pain management specialists know about the best ways to take care of joint and bone pains. Pain management involves interventional procedures, psychological therapies, medication management and physical therapies. Pain management specialists also provide you with lifestyle modification remedies and assign you exercise schedules and diet plans. Alternative medicines like acupuncture and massage therapies are also provided by pain management specialists.

3. Pain management specialists cooperate with you and come up with the best solution for your bone and joint pain. Pain is such an aspect, which has no fixed cure and the remedy varies from person to person and depends on the nature and severity of the pain. Thus everyone should receive a personalized treatment, which is most suitable to cure the pain that has occurred to them. Pain management specialists work with patients, discuss a lot and come up with the best treatment procedure, which would complement the patient. For example, a neurostimulation device can be prescribed to a patient who suffers from complex regional pain syndrome and did not have success with other treatment procedures. In many patients with a shattered spinal disc, pain management specialists prescribe injections, which work effectively to give relief and treat the condition.

A pain management specialist can make the best assessments on bone and joint pain. Being trained especially in bone and joint pain management, you can bank upon pain management specialists to receive the best treatment for your bone or joint pain.

3 Reasons to See a Pain Management Specialist for Bone and Joint Pain

There are many changes that take place in our face and body as we start ageing. While the face starts to show the signs of ageing earliest-in the form of wrinkles and fine lines as well as a sagging chin and neck, the effect of ageing on the body might be slightly late. The skin may sag or you may end up putting on weight in various parts of the body like upper arms, which may look unsightly and bring down your level of confidence as well. Signs of ageing can often make you shy away from living your life to the fullest. 

For the sagging upper arms, one can always get a procedure called an Arm lift. This is also called a Brachioplasty. This is a cosmetic procedure that can be conducted to tighten the skin of the arms from the elbow upwards. Let s see how this procedure works.

What does it do?

Excess fat tends to accumulate in both arms togather with weight gain. Person face laxity in this area after massive weight loss or with body ageing.
Arm Lift is a surgical procedure to tighten the skin in the arms through the removal of excess fat deposits as well as skin.
Who can opt for this surgery?

Any person who is medically fit having arm disfigurement can opt for this procedure. Patients who have signs of ageing or excessive weight gain are the best candidates for this kind of surgery. Also, it may be used by the patients who are suffering from sagging skin after losing a great deal of weight which may lead to an appearance of bat s wings on the sides.

How is this procedure conducted?

This surgical procedure is conducted by a Cosmetic Plastic Surgeon. It s a day-care procedure. The doctor begins by marking the various areas of concern having excess fat and flabby skin. Thereafter, the doctor proceeds to remove the excess skin so that the arms are tightened getting more youthful look. This is done under anaesthesia to make patient pain-free. The skin that is removed is usually shaped like an ellipse. In many cases, there may be a need to conduct a liposuction if the patient has excess fat as well. Once the excess skin has been removed, skin edges are approximated with meticulous sutures with various Plastic Surgery techniques.

Recovery usually takes 5-7 days. Person can resume routine activities from very next day. Sometimes you might be advised a pressure garment for better outcome.

Upper Arm Lift - What It Can Do?

After a tough workout session or a strenuous day at the office, your muscles may feel floppy and exhausted until you have given them a chance to rest. However, persistent muscle weakness with no apparent cause or explanation can be a sign of an underlying medical problem.

What causes muscle weakness?
Voluntary muscle contractions and movement are generated when the brain sends a signal through your spinal cord and nerves to the particular muscle. If there are any hindrances in the connections between them, it can result in muscle weakness. However hard you try, the muscle is such cases becomes abnormal.

Here are some common causes of muscle weakness:

Lack of Use: One of the most common causes of muscle weakness, lack of muscle fitness may occur as a result of a sedentary lifestyle. If the muscles are not used, then the fibers are partially replaced with fat.
Ageing: As we age, our muscles tend to get weaker and lose strength. Muscles become bulky and recovery times during injury are greater. However, with physical activity, it is still possible to increase the muscle power. So stay active and instill strength in your muscles.
Infections: Infections and inflammation can cause temporary muscle fatigue. Even though recovery is quick, if the infection is severe the weakness can last for some time. Without proper care, it can lead to permanent damage.
Pregnancy: During and just after pregnancy, high levels of steroid in the blood and low levels of iron can cause muscle tiredness. Lower back pain is common during pregnancy and all your muscles may feel floppy.
Chronic Diseases: With conditions of diabetes, heart disease, kidney disease and anemia, it can lead to muscle weakness by thwarting the essential blood or nutrient supply to the muscles. Also, chronic pain related ailments cause weakness.
Injuries: Injury or trauma such as sporting injuries, pulls and sprains can deter the muscles. Along with localized pain, it can also lead to muscle weakness if not taken care of properly.
Sleep Disorders: With disturbed or reduced sleep there is a general sense of tiredness that leads to fatigue in the muscles. Insomnia, anxiety, depression and other mental disorders also affect the muscles a great deal.
Conditions affecting Nerves: Conditions like Myasthenia gravis or motor neuron disease affects the nerves and thereby fail to relay signals to the muscles, leading to weakness.
Genetic disorder affecting muscles: There are also certain inherited diseases which can affect the muscles like muscular dystrophy.
Spine-related disorders: Conditions like slip disc and other disorders affect the muscles served by the irritated or compressed nerves of the spinal cord.

Muscle Weakness - 10 Common Reasons Behind It!

Breaking a bone is, needless to say, a painful experience. But, when people have their broken bone put in a cast, they tend to forget about it until it comes out. This is quite wrong! A person would want to be up and running but does not find that the hand or the leg as it has been cast up. For weeks, the person's hand or leg barely moves and also shrinks up quite a lot!

There is a lot of pain, not only due to shrinkage when a fracture occurs. The occurrence itself causes what is known as acute pain. Then, for some weeks, the sub-acute pain just seems to persist, to the person having the fracture. The reason for this is the fact that the bone and the soft tissue are in the process of healing.

Chronic pain is a worry as it does not go away even after the healing process has ended. In order to make sure that there is a quick recovery and there is no chronic pain which is experienced at all, some of the proverbial leaves need to be taken out of the book of physiotherapy.

To start with, sometime between a fortnight and a month after the injury or the bone break has taken place, the doctor will wish to see some movement in the soft tissue that has broken around the bone. The great advantage of this is that while it may be a little bit of effort and time involved, there are great benefits by the way of less pain and swelling as the blood flows as normally as is possible.

If such movements are not done, a person can have related soreness, which can be even more of a pain! An example of this would be a broken foot or ankle causing the stiffness of the knee. When a person is already in pain, adding to his or her trouble makes no sense at all, does it?

Post one month mark, the physiotherapist would want to see more functioning so that the normal levels can be attained. A person who has a fracture should not despair as if he or she is willing to stick to the schedule given by the physiotherapist and perform all the exercises that have been set out, he or she will be back at the normal level much sooner than would have been expected!

Also, getting active again will reduce the risk of a repeat injury, and that is enough justification to do so!

What To Expect When Recovering From Broken Bones?

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!

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