Myofascial pain syndrome refers to a chronic condition that affects a person s musculoskeletal system. With this disorder, pressure on the sensitive points (known as trigger points) in the muscle induces pain in various parts of the body.

Myofascial pain syndrome mostly affects people in the age group 40-60 years.

What causes myofascial pain?

Typically, myofascial pain syndrome occurs because of repetitive muscle contraction or overuse, or due to an injury. Sensitive areas of the tight muscle fibres can develop following an injury/trauma, and ultimately lead to pain and strain throughout the muscle.

Symptoms to watch out for-

Common signs and symptoms of myofascial pain syndrome include-

  Severe pain in localized muscle areas
  Pain that worsens when you stretch or strain the affected muscle
  Muscle pain that persists for longer than usual, or worsens with time
  Painful, tender knots in the muscles that lead to severe pain when pressed
  Weakness and stiffness in the muscles
  Inflexibility or a reduced range of motion

Although muscle pain is temporary in most cases, and usually subside on its own, you should visit a doctor immediately if the pain becomes intense and severe. Otherwise, the symptoms of myofascial pain syndrome can aggravate and impede your daily routine.

What is the treatment for myofascial pain syndrome?

Treatment for myofascial pain syndrome include a range of pain management options such as the following-

  Medications
Your doctor will likely prescribe medications that include anticonvulsants, analgesics, and over-the-counter Non-steroidal Anti-inflammatory Drugs (NSAIDs). These work as painkillers and help relieve pain and reduce muscle spasms.

  Dry-needling
Dry-needling is a quicker way of getting rid of myofascial pain symptoms. The doctor inactivates the trigger points by directly inserting a needle into it. He/she will then slowly move the needle around and poke it inside and out. The initial process can be a little painful, but it certainly helps manage the pain in your muscles. Alternatively, acupuncture needles can be used for the same procedure since they are small and are less painful.

  Local injections
Local injections, also known as trigger point injections, are similar to dry-needling. The only difference is that local injections involve injecting a solution (saline/steroid/or a local anaesthetic) into the trigger points. The method yield similar results as does dry-needling.

  Therapy
Different types of therapies can be used to ease the pain associated with this chronic pain disorder.

Ultrasound therapy where sound waves are transmitted into the muscle tissues through a sound-conducting gel applied on the skin. The sound waves heat up and relax the muscles, thereby improving blood circulation and removing the scar tissues. Ultrasound therapy is also effective in reducing muscle stiffness and increasing one s mobility.
Massage therapy also is very effective in treating myofascial pain syndrome. The therapist usually uses his/her fingers or some sort of equipment to induce pressure on the various trigger points. When performed, this procedure may first aggravate the muscle pain and then release muscle tension.
Apart from these, the doctor may prescribe regular exercising or physiotherapy treatment for patients suffering from chronic muscle pain.

Myofascial pain syndrome can be managed well using the techniques mentioned above. In addition, it is very important that you stick to some sort of physical activity. Talk to your doctor and incorporate these pain management techniques to live a pain-free healthy life.

Myofascial Pain - Causes, Symptoms & Treatment Of It!

Are you prone to slipped disc problem? + the ideal way to treat it

A slipped disc, also known as a prolapsed disc or herniated disc, is the term given to the phenomenon that occurs when a cartilaginous disc found between the vertebrae in the spine becomes slightly displaced or protrudes, thereby pressing on the nerves in the adjacent areas and causing back pain.
This happens when the soft inner part of the disc, known as nucleus pulposus, bulges out through a weakness in the exterior part of the disc. A prolapsed disc usually occurs in the lower region of the spine and can be of varying sizes. There might even be the development of inflammation around the disc in some cases.

Who is likely to get affected?
Most cases of herniated disc occur in patients between the ages of 30 and 50. The number of men affected is twice as many as the number of women.
Although the root cause of this problem is not yet known, there are a number of factors that may trigger it. These factors include working at a job that requires a lot of lifting, an occupation that involves remaining in a seated position for a long time, weight-bearing sports, obesity, smoking habits and increasing age.

Effective ways of treating the problem
The different methods that are commonly used to treat the problem are:
Medications
There are many different kinds of medicines that are effective in providing relief. These include painkillers, muscles relaxants, anti-inflammatory pills, etc.

Spinal injections
A number of spinal injections are used to treat slipped discs. The injection is done at the opening where the inflamed nerve roots are found and reduces pain, swelling and irritation in the area.

Radiofrequency ablation
This procedure makes use of an electrical current produced by radio waves to reduced pain and sensitivity in the affected area.

Ozone discectomy
As opposed to the surgical removal of the prolapsed disc, this new process makes use of an ozone-oxygen mixture that is injected into the spine to treat the problem. Many international studies have proved its superiority to traditional methods and surgeries.

Those affected by this problem are advised to keep exercising and continuing with their everyday activities as best as possible.



Why You Can Get a Slipped Disc Problem?

Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

Foot pain contributes around 3-5 % of patients visiting Orthopedic OPD, with heel pain being predominant complaint. Heel pain commonly involves the underside or back of your heel. Although not a symptom of a serious condition, it s disabling as it can interfere with your routine activities.

Plantar fasciitis, Achilles tendinitis, Heel spur, Retrocalcaneal bursitis are few common conditions causing heel pain.

The below few conditions which are prone to developing heel pain like:

Abnormal walking style (gait)/altered alignment of the foot
Obesity
Ill-fitting shoes/ badly-worn shoes
Standing, running or jumping on hard surfaces
Injury to the heel, such as stress fractures
diabetes and arthritis
The most common causes of heel pain are plantar fasciitis (bottom of the heel) and Achilles tendinitis (back of the heel).

Presenting complaints:

Pain which is usually intense in the mornings or after a long period of res,
Discomfort or swelling in the back of your heel
Skin on your heel overly warm to the touch
Burning sensation over heel
Numbness or tingling in your heel
Swelling around ankle etc
Remedies you can try:

Avoid activities that aggravate your heels, such as running, standing for long periods or walking on hard surfaces.
Ice application on your heel for 10-15 minutes at least three times a day.
Well fitting shoes.
Non-steroidal antinflammatory drugs can reduce inflammation and pain
A splint is worn at night
Flexibility exercises
Prevention of heel pain:

Wear a well-fitting & comfortable shoe
Always warm up and cool down when exercising or playing
Silicone insoles
Consult your doctor immediately if, Heel pain persists in spite of home remedies. Try these tips to put Heel pain at rest!

Heel Pain - Effective Ways To Put It At Rest!

In most cases, pain anywhere in the body can be explained as a symptom of some other problem, but sometimes, there is no reason for abdominal pain. This type of pain is known as chronic functional abdominal pain. This is a gastrointestinal disorder that cannot be explained through X-ray or laboratory findings. It can be triggered by altered sensitivity to nerve impulses in the brain and gut. People suffering from this condition are often so debilitated by the pain that it becomes the central focus of their life.

This condition cannot be cured, but with proper treatment, it can be managed so that it does not affect the quality of your life. The aim of treatment for this condition is to control the symptoms and improve functioning. When it comes to treating this condition, the patient s relationship with his or her doctor plays an important role as the condition cannot be proven through any form of testing and it has a great psychological effect on the person. Regular checkups are also a key to managing this condition effectively.

The first step towards achieving this is to identify possible emotional and situational triggers. Maintaining a journal that records these experiences can help with this. Further treatment is usually either through psychological treatment or antidepressants.

Psychological treatment is based on the understanding that the brain can block pain by diverting attention elsewhere. Nerve impulses that travel from the abdomen to the brain must pass through a type of  gate  that is controlled by nerve impulses generated by the brain. When these impulses close the gates, pain is blocked while when these gates are open, the pain can be magnified. Psychological treatment for chronic functional abdominal pain can be in the form of relaxation techniques, imagery, hypnosis and cognitive behavioral therapy. While relaxation techniques such as meditation and hypnosis help a person shift focus from the pain, cognitive behavioral therapy teaches a person how to change thoughts and perceptions in order to control the pain.

Antidepressants can also act as pain relievers. This form of medication stimulates the production of brain signals that close the  gates  of nerve transmissions. This blocks the pain but can take several weeks to be effective. Some people may experience side effects such as drowsiness and nausea and hence should never be taken without a doctor s supervision. In some cases, antidepressants may also be combined with cognitive behavioral therapy or medication to regulate bowels.

Ways to Treat Chronic Functional Abdominal Pain!

Lower back pain can be one of the most physically debilitating things that can affect you and limit your mobility. Even if the pain isn t that acute, it could still signal something deteriorating in your lower back. While oral medications, topical creams or sprays can help in reducing pain, there are other effective remedies you can try on your own. These will be handy when you have no medications at hand. One of these is the hot and cold therapy.

Heat therapy for lower back pain

Heat works well with lower back pain as it can dilate blood vessels and improve circulation within the tissue. This will help in circulation and also result in lowering the pain. Heat therapy will also loosen up other muscles in the area and help soothe sore areas which have been taking the burden along with the lower back muscles. Some of the techniques that can be applied are:

1. All day heat wraps: These are specially manufactured belts or wraps which wrap around your abdomen and keep tightness and pressure on your lower back as well as supplying heat.

2. Electric heating pads: These are mechanized heating pads which generate heat with electricity. You can place them under you back and then either sit or sleep with it positioned behind you. However, ensure that you don t keep these for too long as they could burn your skin.

3. Hot Compress with towels or hot water bags: Use a clean towel and heat it over a conductive surface and apply it on your lower back. You can also use hot water bags for the same purpose.

Cold therapy for lower back pain

Cold therapy uses the principle of constriction of blood vessels as well as slowing circulation. This will help numb the area and thus help relieve the pain. Some of the ways these can be administered are mentioned below.

1. Ice towel: In this method, soak a towel in ice cold water, wring it to dry it and then apply on your lower back. This will numb the pain without transferring the sting of the cold or damaging your skin.

2. Ice packs: Put about half a kg of ice in a plastic Ziploc bag and pour water over the ice to just about cover it. Push out the air out of the bag and then lock it. Use this ice pack with a towel to ensure that you back doesn't get wet.

3. Ice gel packs: These are ready made packs, which can be bought from medical stores and kept frozen to be used whenever you need it in order to relieve lower back pain.

Treating Lower Back Pain Using Hot and Cold Therapy

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