Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

If you suffer from chronic pain of any kind, it is important for you to know that it is associated and linked with your emotions. Other than your physical activities and personal relationships getting hampered, unwanted feelings like resentment, stress and frustration are also common. These emotions and feelings are capable of making your chronic pain condition more worse. 

The Relationship between your mind and body: Your mind and body work together and cannot be separated. Your mind controls all your thoughts and also affects the way in which pain is controlled or perceived by the body. Pain and the fear of pain may lead you to avoid activities. This may reduce your physical strength and cause disruption in the functioning of your body.

Stress: Stress affects your body both physically and emotionally. It may lead to an increase in your blood pressure, breathing rate, heart rate and muscle tension may also occur. These may lead to fatigue, appetite changes and sleep disruption. Stress also causes depression, anxiety, make you dependent on drugs and make you dependent on other people.

Depression: Depression is common among chronic pain patients. Chronic pain can make cases of existing depression much more worse and the existing pain is also worsened. There are chances of developing depression from chronic pain if depression runs in your family or genes. 

Symptoms of Depression are as follows:

Feeling sad, angry, worthless and hopeless frequently
Lack of energy
Lack of interest in regular activities
Difficulty in sleeping
An increase or decrease in appetite, which may lead to major weight gain or weight loss
Difficulty with concentration
Having suicidal thoughts and thoughts about dying or harming oneself
How to Handle your Emotions during Chronic Pain: A common therapy, which people with chronic pain undertake is called Cognitive Behavioural therapy. You should seek the help of a therapist. In this therapy, you will learn about thinking in a positive way instead of drowning in negative thoughts. Your fear of pain will be reduced and you will learn how to strengthen important relationships. You will be able to develop a sense of freedom from chronic pain. 

If your chronic pain occurs due to an accident or emotional trauma, you may be assessed for post-traumatic stress disorder (PTSD) by your healthcare provider. Many patients suffering from PTSD cannot deal with their pain until the emotional stress is dealt with. If you feel depressed and cannot control your emotions, you need to consult a doctor.

Chronic Pain - Is it Linked to Our Emotions?

How To Control Nerve Pain?
Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.
What are the common causes?
Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.
How can you control nerve pain?
Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:
Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.
Painkillers: There are painkillers available OTC which can curb nerve pain. However, painkillers such as ibuprofen, aspirin and acetaminophen do not really work well for severe pain of the nerves.
Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.
Acupuncture: This time honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.
Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.
Relaxation Techniques: In combination with the above mentioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.
Lifestyle Modifications: This one s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder.

Nerve Pain - 7 Ways You Can Control it 

Pain management is an issue that stares back at mankind, irrespective of the underlying health condition. Whether it is a headache or a back pain, burn or fracture, heart attack or cancer, pain is always a symptom. In some cases like migraines, cancer, etc., the pain is chronic and the patient needs to be constantly on the vigil to know when an attack will ensue. This has also put high pressure on the medical fraternity to identify ways that can provide relief to these people. Various methods have been identified, and one of them is the electrotherapy.

What is done?
A few electrical impulses are directed at the area of the pain using a hand-held device. This is similar to providing electric shocks of mild intensity to the affected area (forehead, low back, neck, etc.). What this does is stimulate the nerve endings, improves circulation and muscle strength and promotes bone growth and tissue repair. The end result of all this is overall improved functioning and pain relief. Depending on the actual condition, the sessions will have to be repeated. In some patients, the electrotherapy is used in conjunction with other therapy so that they can go about their routine exercise and pain relief.
The sessions may also have to be repeated as most often these are used in individuals with chronic pain. They are also helpful in providing relief during the acute attacks.

How does it work?
The most common form of electrotherapy is known as TENS, which stands for transcutaneous electrical nerve stimulation. The area to be treated is cleansed with spirit and then small sticky pads are applied through which the electricity is passed. A hand-held device is used, through which electrical impulses are passed to the skin, which stimulates the nerve cells to provide relief from pain. It causes a vibrating and tingling sensation in the treated area. It is believed that it blocks the nerve impulses and therefore provides pain relief. Another theory states that they promote the release of endorphins which are natural painkillers; it is also very effective in case of migraine and sciatica and neck pain where the chronic pain is coupled with acute spurts.

With narcotic painkillers having various side effects, techniques like electrotherapy are gaining popularity. A small catch also is that it does not work for everybody and in most people with back pain, fibromyalgia, and migraines, requires repeat sessions for relief. The cost of each session also needs to be considered against the extent of relief achieved. However, for those whom it works, it is a very good technique for chronic pain control.

Electrotherapy - How It Can Help In Managing Pain?

Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

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