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?

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?

The knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

Osteoporosis is a condition which usually results due to a decrease in bone density. In this condition, the bones become weak and brittle. Fractures are a common result of osteoporosis. Usually, symptoms or signs do not show up until the condition progresses to its advanced stages.

Since osteoporosis is usually irreversible and incurable, preventing the fractures is considered to be extremely important.

Who is at risk of osteoporosis?
All men and women have some risk of developing 'thinning' of the bones (osteoporosis) as they become older, particularly over the age of 60. As mentioned above, women are more at risk than men. The following situations may also lead to excessive bone loss and so increase your risk of developing osteoporosis. If you:

Are a woman who had the menopause before 45 years of age
Have already had a bone fracture after a minor fall or bump
Have a strong family history of osteoporosis.
Have a body mass index (BMI) of 19 or less (that is, you are very underweight)
Have irregular periods
Have taken, or are taking, a steroid medicine (such as prednisolone) for three months or more
Are a smoker
Have an alcohol intake of more than four units per day
Lack calcium and/or vitamin D (due to a poor diet and/or little exposure to sunlight).
Are mostly inactive
Ways To Treat Osteporosis

Osteoporosis in women can be treated using Hormone Replacement Therapy (HRT). The therapy makes use of either a combination of progestin and oestrogen or simply, oestrogen. However, it is possible that certain combinations have side-effects that might give rise to other medical conditions. Therefore, proper consultation with an orthopedist is an essential pre-requisite so that the condition of osteoporosis as well the side effects may be addressed before proceeding with Hormone Replacement Therapy.

There are a number of medications that can be used which have long-term effects on osteoporosis. However, the schedule for intake of these medicines should be followed diligently. Failing to adhere to the schedule could lead to serious complications. For example, the intake of Risedronate medications (prevent bone loss) should be scheduled once every month, failing which can cause ulcers in the food pipe. Raloxifene has effects which are similar to oestrogen but does not exhibit any serious side effects. Teriparatide can be used to treat osteoporosis in people who have a high risk of suffering from bone fractures.

Don't rely entirely on medication as the only treatment for your osteoporosis. These practices also are important:

Exercise. Weight-bearing physical activity and exercises that improve balance and posture can strengthen bones and reduce the chance of a fracture. The more active and fit you are as you age, the less likely you are to fall and break a bone.
Good nutrition. Eat a healthy diet and make certain that you're getting enough calcium and vitamin D. Being underweight or losing a lot of weight unintentionally is associated with poorer bone health and a higher risk of fracture   even if you're taking a bisphosphonate.
Quit smoking. Smoking cigarettes speed up bone loss.
Limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

How To Cure Osteoporosis?

Spinal cord is a very important part of your body as it renders support to your body.  It also gives your body a good posture and thus maintaining a healthy spine is very essential. An unfit spinal cord can lead to various complicated problems. The following are five must do exercises in order to maintain a healthy spine:

    Exercising your core muscles can help you to maintain a fit spine. Your core muscles refer to the muscles of your lower back and your abdominal muscles. These muscles give support to your spine. So exercising them can give you a healthy spine.
    Walking regularly can also give you a healthy spine. It is suitable for people of all age groups. Daily walking can help you to recover from various spinal illnesses as well such as spinal stenosis.
    Swimming is also a good exercise for maintaing a fit spinal cord. Swimming helps to exercise all back muscles and thus, gives you a healthy spinal cord.
    Lying down straight with your face down on an even and firm surface for about twenty minutes can help you to get a healthy spine and also a good body posture.
    Cycling can also help you achieve a healthy spine. While cycling, all your back muscles and the muscles of the lower part of your body are engaged in physical activity. If the muscles of your lower back are strong, then it can help you to keep your spine fit.

Other than these exercises, stretching your limbs and other stretching exercises are also beneficial for a healthy spine. But it is highly recommended for you to consult a doctor before doing any exercise in order to be guided in the proper manner and avoid further complications.


Want a Fit Spine: 5 Must Do Exercises

Injuries are an inherent part of sports. All athletes have sustained some injury or another during the span of their careers. No matter which sport you play, be it football, hockey, tennis or cricket, whether you are representing your country or your college, you are likely to get hurt at some time. An injury has the potential to end careers and ruin dreams. That is because the injury takes a toll not just on the body but the mind as well. It instils confusion and hesitation and sometimes after an especially traumatic accident, athletes find it difficult to return to practice because they are crippled by a sense of fear.

That is why along with treatment or surgery, a sportsperson also needs to undergo rehabilitation therapy.

Why Psychological Rehabilitation is Important? 

After suffering a serious injury that almost jeopardized their career, athletes suffer a wide range of psychological and physical challenges, which makes them retreat from the outside world. These are problems they would not be able to cope with unless they opt for rehabilitation programmes.

  It helps them accept that getting back to the game will be a mammoth task 

  Inspires in them the confidence to keep trying 

  Deal with the pain 

  Go about their practice sessions with as little discomfort as possible 

  Overcome feelings of fear or despair 

  Cope with depression 

  Prevents the person from sinking into a state of self-pity which hinders recovery 

  Look at the injury not as something that might put an end to their career but as a mere impediment in the path to success 

Psychological rehabilitation adopts a wholesome and expansive approach to healing the athlete. It takes into account several factors in chalking out a course to recovery that is individualistic   

  The personality- the toughness, determination, will power of the athlete, ability to deal with anxiety

  Medical history- past injuries or illnesses 

  Resources of coping- the athletes  support system, a network of friends and family, management of stress, treatment and medicines etc 

Psychological rehabilitation also takes into account the individual s response to therapy to ensure that it is as effective as possible. These are   

  Cognitive appraisal - Monitors a person s growth or decline in self-esteem or worth as well as confidence. The aim of rehabilitation is to restore the person s faith in his/her capabilities 

  Behavioural response - This ensures that the individual s behaviour shows traces of denial or avoidance because negativity will only delay recovery 

  Emotional response - The profile of Mood States (POMS) is utilized to analyze or gauge the person s emotional reaction to therapy. It is supposed to uplift the athlete mood and deal alleviate feelings of despair or hopelessness. Medicines and physiotherapy become more successful in treating a sports injury when coupled with psychological rehabilitation. 

Athletic Injuries - How Effective Is Psychological Rehabilitation As A Line Of Treatment?

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