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

It is important for you to know about degenerative disc disease (DDD) and spondylosis. Spondylosis is an umbrella term for spine pain, which occurs because of degenerative conditions. Spondylosis refers to several conditions. They include spinal stenosis, which is the abnormal narrowing of the spinal canal, leading to leg pain, degeneration due to DDD and degenerative arthritis or osteoarthritis involving the spine. It may also include cervical osteoarthritis or neck arthritis.


About spondylosis
Spondylosis is a common condition, which is age related. The joints and discs present in the neck are specifically affected as a result of this condition. It commonly develops on account of the wear and tear of the cartilage and bones present in the neck. This condition, in spite of being common, worsens with age. In many patients, symptoms are not observed externally, but pain and muscle spasms are experienced. 


Many people with spondylosis do not undertake treatment in spite of suffering from the symptoms and pain. In case the symptoms are prevalent over a long time and tend to worsen, you have several modes of treatment to choose from. They may include medicines, corticosteroid injections, physical therapy and even surgery in some extreme cases. 


How does DDD or spondylosis occur? 
DDD is a spinal condition. It is caused due to the breakdown of the intervertebral discs. With ageing, the spine starts to show signs of wearing and tearing. This happens on account of the discs drying out and shrinking. All these age-related changes are responsible for arthritis, spinal stenosis and disc herniation. Because of these factors, pressure is likely to fall on your nerves and spinal cords, which may further cause back pain. DDD or spondylosis also develops on account of these factors.


Treatment for DDD and spondylosis
There are various modes of treatment, which are available for you to choose from in order to get relief from the symptoms and pain associated with DDD or spondylosis. You may be prescribed typical painkiller medications, such as non- steroidal anti-inflammatory drugs or NSAIDS, muscle relaxants, epidural injections, ultrasound and massage, oral steroids, transcutaneous electrical nerve stimulation (TENS) and many more. Every mode of treatment has got its own benefits, but has its limitations as well.


If you experience any symptoms of DDD or spondylosis, you must consult a doctor immediately. Your pain management physician or doctor will be able to diagnose your condition properly and will determine the mode of treatment which will suit you best.

Degenerative Disc Disease (DDD) and Spondylosis - How You Can Get it Treated?

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

A hand fracture is a condition characterized by broken bones of the hand. The bones in the hand include the bones that are present in the fingers and the wrists. A fracture of the hand tends to occur when you bend or twist your hand in the wrong manner. It may also be caused by injuries related to sports and falls.

Symptoms
Symptoms of swelling and pain are the most common of them all. The range of motion for the affected hand will be reduced as well. The knuckle bone may appear to have been sunken in. Most obviously, it will be difficult in carrying out regular tasks which need the hands.

Therapies
The initial treatment for a hand fracture will be focused on reducing the pain. Pain relieving medications such as ibuprofen will be administered which provides relief from the pain. The next step will be to keep the affected hand immobilized so as not to hamper the recovery process. Once stability is restored, therapeutically relevant exercises are prescribed to help normalize the regular hand movements.

The following exercises are relevant in case of a hand fracture:

Wringing a towel: This is an exercise wherein you wring a towel to improve flexibility and strength in the hand. Simply grab a towel and twist it in both directions; imagine wringing water from the towel.
Rolls of the wrist: Wrist rolls aim to increase the ROM (range of motion) in your wrists and the hands. Hold the hand steady and rotate your wrists both clockwise and anticlockwise. You can also hold a light weight in your hand to make it more challenging.
Prayer stretch: A prayer stretch is another exercise that can help boost your wrist flexibility. You start by positioning the palms together like in a prayer, then hold up the elbows while pushing the hands against each other. You should feel a stretch in your wrists and hands.
Grasping: This is a technique wherein you grasp objects to improve your grip strength. Try gripping objects such as tennis ball or stress balls to get your gripping ability up to normal levels.


4 Effective Therapies Post Hand Fracture!

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?

Human bones are continuously being removed and formed, which is necessary for its proper maintenance. However, in certain cases, especially with aging, some bones and joints will be worn down to an extent where the body will not be able to reform them. This is especially true in the case of hips, which may become worn due to age or other problems within the body. 

Hip replacement surgery 
When this happens, a hip replacement surgery can be performed to replace the original joints with a prosthesis or artificial hip, which is usually made out of metal or a specially formed composite material or even a combination of the two. Along with other parts, it replaces the natural hip with an artificial hip to restore mobility and other related functions.

Benefits of hip replacement surgery:
1. Lessening hip pain: This is one of the major factors as well as symptoms of requiring hip replacement surgery. Due to the grinding down of the bones, even the slightest movement causes pain and after the surgery and the recovery period, the pain is lessened.

2. Correction of bone deformity: When the bones grind down and are abnormally reformed, deformities may occur reducing mobility. Artificial hips will ensure that deformities are corrected and resulting problems are thus eliminated.

3. Return to normal activities: This is possibly one of the primary advantages of this surgery, although it entails a long recovery period. However, most patients can get back to their normal activities and are able to resume a pain free life.

4. Ability to have painless sleep: Many people who suffer from hip displacements or bone deformities are not able to sleep properly due to pain. After the surgery and the recovery period, they can return to normal functions and habits, thus are able to sleep properly.

5.  Leg strength increase: Many patients tend to have an increase in their leg strength as one side of the hip tends to become very weak due to bone problems before surgery. After surgery and recovery, the same side tends to have an increased strength due to the implant.

6. In most cases a lifelong solution to hip problems: As the hip replacement prosthesis is made out of metal and if the operation is successful, it usually tends to last till the end of a person's life and this area usually doesn't tend to have problems again.

Benefits of Hip Replacement Surgery

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