Dr. Atul Mishra

A stinging pain in the neck that makes you feel broken from the neck joint could be a reason to worry. It is often accompanied by an aching head or a throbbing shoulder joint. Neck pain, such as this occurs due to an injury in the area resulting from sudden back and forth movement of the neck. It is referred to as whiplash as the nature of the pain and subsequent discomfort resembles the snapping of a whip. The pain is more like a sprain, but not exactly so. This can affect athletes or even any person in general who has faced an accident in recent past. Whiplash is characterized by a tearing of ligaments and tendons that connect one bone to another.

Causes of Whiplash:

1. Sports that involve contact- Any extracurricular activity involving collisions or other forms of physical contact can cause neck injuries. Football and rugby players frequently suffer from Whiplash.

2. Road accidents- Public transport has a host of disadvantages. Reckless driving can make the tendons of your neck tear. Auto accidents cause immense strain on your neck; it can also lead to Whiplash.

3. Any kind of physical abuse- If you have gotten into a violent fight with someone your neck could suffer from a Whiplash. Instances of physical abuse where the neck is jerked or punched at can also result in neck strains. Domestic violence often leads to instances of neck strains.

Symptoms related to this condition:

1. You may or may not suffer from tinnitus. Tinnitus is a physical disorder where you hear ringing sounds. It is quite distracting.
2. Your vision might get blurry.
3. You can experience irregular sleep patterns.
4. You can find it hard to concentrate on any one thing for more than a while.
5. You can grow irritable at the drop of a hat.
6. Your memory may fail you. You might find it next to impossible to trace back a day's activity.

Some of the other direct symptoms are:

1. Your neck might turn stiff preventing you from moving it left, right, up or down.
2. Pangs of pain can be felt in and around your shoulders.
3. Your upper arms can grow numb and tender.
4. Your head can spin repeatedly or you could feel dizzy.
5. Whiplash can also result in serious fatigue.

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopause induced bone loss.

Causes of Metabolic Bone Diseases:

1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. Kidney stones are an associated complication of metabolic bone diseases.

A healthy diet is not only important for that slick waist line, but it also keeps your bones healthy. Two of the most important nutrients needed for healthy bones are Calcium and Vitamin D. Calcium helps in strengthening your bones while Vitamin D facilitates calcium absorption in the body. If the bones are not healthy, it can lead to bone disorders such as osteoporosis and rickets.

If you want to keep your bones fighting strong and healthy, here are some diet tips that you can follow:

1. Consume yoghurt: A very good breakfast option, Yoghurt contains 30% of calcium and 20% of Vitamin D as per RDA (Recommended Dietary Allowance), both being vital for healthy bones. It also contains little in terms of calories so that you don’t have to lose sleep over your waistline.
2. Milk: If you think milk is just for kids, think again. Milk is one of the best sources of protein and calcium; in fact it contains 30% of calcium as per RDA. So yes! Drop all inhibitions and drink that glass of warm milk to keep your bones healthy.
3. Cheese: Another milk based product, cheese is also rich in protein and calcium. You need to make sure that the cheese you consume is the fat free version in order to restrict calorie intake.
4. Sardines: If you are planning on getting a fish sandwich for lunch, then you are on the right track. Sardines are not only rich in Omega 3 Fatty acids, but they also contain calcium and Vitamin D is high amounts.
5. Eggs: Don’t fear the egg yolk and dispose it off. Not so fast now! Egg yolk contains Vitamin D, an essential nutrient that facilitates calcium absorption in the body. Eggs are also one of the best super foods as they are a powerhouse of various nutrients.
6. Spinach: Remember Popeye, the cartoon sailor whose muscular frame was attributed to spinach. Now let’s get down to the facts. Spinach contains calcium, fiber and iron – all very essential for your body. Consuming spinach regularly is one ‘go green’ way to keep your bones healthy.
    

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
2. Treatment for one kind of cancer can make you prone to some other kind: Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
5. Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.

The ankle, despite being one of the smaller joints, plays a crucial role as it bears the brunt of a person’s weight. Due to improper gait or injuries, the ankle often gets sprained. This can be a recurring problem in older people. Therefore, over a period of time, the ankle gets unstable and can cause chronic symptoms including pain, imbalance resulting in recurrent falls. Read on to know more about some causes, symptoms, and management techniques for ankle instability.

Causes: The ankle has ligaments which stretch to allow for ankle movement. When this ligament stretches beyond the limit, then it can tear or stretch. Therefore, sportspersons like basketball and football players, gymnasts who tend to use their ankle a lot are at a much higher risk of developing ankle instability over a period of time.

Symptoms: The most common symptom of ankle instability is when a person is unable to stand firm. This pain is worse in people wearing heels or walking on uneven ground. Patients may experience swelling, stiffness, and excruciating pain.

Management: Ankle instability is an acute problem but the recovery time is limited too, so the symptoms disappear over a period of time. However, in some people, especially sportspersons, it may lead to a chronic condition which needs immediate attention. Few remedies for getting relief from ankle pain are mentioned below:

1. Ice: For pain relief, icing the ankle is an excellent option. Applying a cold pack for about 10 to 15 minutes about 2 to 4 times per day is an effective way to relieve the pain, stiffness, and swelling.
2. Rest: Ligament injuries often heal on their own, and sportspersons may be advised to stay off of the game for about a week or two, to give it time for self-repair.
3. Compresses: Using an elastic wrap or compression ice wrap for a few hours can help in relieving ankle instability.
4. Pain killers: Non-steroidal anti-inflammatory drugs like ibuprofen can help in reducing both the inflammation and pain from the ankle injury.
5. Exercise: Increasing the strength and flexibility of the ankle via exercise is a great way to reduce chances of further sprain. Rotating the ankles, standing on one leg, etc., are some effective ways to do this.
6. Surgery: If none of the above-mentioned remedies work, a surgery may be required which is only in severe and/or chronic cases.

Ankle instability is quite common but is equally easy to manage.

Muscle contusion is a condition that is characterized by bruising in the muscles. It generally tends to occur in athletes who play a lot of contact sports. Repetitive blows in any part of the body may cause damage to the underlying muscle tissues. These blows may lead to internal bleeding, resulting in blood clot formation. The most common site where it occurs are the quadriceps.

The various causes of this condition are:

1. Direct repetitive blows to a part of the muscle in contact sports such as football
2. If you fall on a hard surface 
3. It may also occur if the muscle comes in contact real hard with sports equipment like soccer balls

The symptoms of a muscle contusion are:

1. You may experience swelling of the muscle
2. Excessive pain
3. Decrease in range of motion in the concerned body part
4. It may lead to leaking of blood vessels
5. You may also experience hematoma where a lump is formed over the affected spot
6. Symptoms of broken bones, dislocations and fractures may also occur

Complications: This disorder may also lead to various complications such as compartment syndrome, which leads to compression of blood vessels resulting in pain. 

Treatment: The basic treatment for this condition is the RICE protocol which is rest, ice, compression and elevation. You should rest the muscle, then apply ice to the affected area to reduce the pain. You can also take NSAIDs (non steroidal anti-inflammatory drugs) to reduce the pain. In severe cases, the doctor may drain the lump surgically.

It is advisable to not return to your normal sports routine in order to allow the muscle to recover. If you carry on with your regular routine, it may result in further complications like the formation of scar tissue. You may undergo various stretching exercises to relieve the pain and make a gradual return to your normal sporting activities.

Your shoulder is one of the most overused joints in the body and thus is at a higher risk of contracting an injury. Shoulder pain may lead to mobility issues where moving your arms may become extremely difficult. The shoulder consists of three parts, viz. the shoulder blade, collarbone and the upper arm bone. Shoulder pain may result from an injury to any of these areas.

The various causes of shoulder pain are:

1. Impingement: Impingement of the shoulder muscle occurs when the top of the shoulder impinges on the rotator cuff muscles. This condition can lead to severe pain in the shoulder.
2. Bursitis: Bursa is a fluid filled sac that cushions the bones and help in preventing friction. Bursitis is a disorder that results in inflammation of the bursa, thus resulting in shoulder pain.
3. Tendinitis: Tendinitis is a condition that is characterized by gradual wear and tear of the tendon. Usually the rotator cuff tendons in the shoulder are affected by this condition.
4. Instability of the shoulder: Shoulder instability is a disorder of the shoulder wherein the upper arm bone dislocates from its socket. This can cause excessive pain in the shoulder.
5. Fractures: A fracture in the bones of the shoulder results in excruciating shoulder pain.
6. Arthritis: Arthritis is a disorder that leads to inflammation in the joints, thus resulting in pain and impaired movement of the joint.

Treatment
The treatment for shoulder pain consists of medications and physiotherapy. You may also be asked to discontinue any strenuous activity that requires shoulder movement. Medications such as NSAIDs are prescribed to help in controlling the pain. Various stretches of the shoulder are also recommended to improve shoulder flexibility and mobility.

Tips
Do exercises such as the overhead press with light weights to improve your shoulder strength. Also make sure to include certain external rotation exercises to strengthen the rotator cuff muscles.

If you are thinking that runner’s knee pain can ony happen to runners or sportsmen, then you are wrong. It can happen to anyone who spends time in doing things that involve bending the knees. It can happen due to activities like walking, biking and jumping. It refers to an aching pain around the kneecap. In medical terms, it is also called patellofemoral pain syndrome.

It doesn’t refer to a particular injury. It is an umbrella term to refer to any pain that happens during knee problems. Here are some of the reasons responsible for runner’s kneecap:

1. High stress exercises, such as lunges or plyometrics
2. Direct hit in the knee.
3. If any of the bones are out of their correct position.
4. Hypermobile feet and fallen arches or overpronation can cause joint pain as they change the way you walk.
5. Weak or unbalanced thigh muscles.

What Are the Symptoms of runner's knee?

1. You can feel the pain in front, behind, or around the kneecap
2. Pain is felt when you walk, squat, kneel, run, or get up from a chair
3. Pain is felt when you walk downstairs
4. Swelling around your knee or a grinding feeling inside the joint

Diagnosis:
It can be diagnosed through physical examination and might require X-rays, MRIs, or CT scans.

What's the treatment for runner's knee?

1. In most cases, runner’s knee gets better with time. However, the cause of the pain must be identified and then the treatment is done. Here’s what can be done:
2. Give rest to your knees. It is best to avoid activities that cause the pain.
3. Apply ice pack on the knees to ease the swelling. Repeat this after every 3 to 4 hours in a day and apply the pack for at least 20 minutes.
4. Use an elastic bandage or straps to wrap the knees. It gives extra support to the knees and prevents the pain.
5. Elevate the leg on a pillow at the time of lying down.
6. Take pain killers like ibuprofen or naproxen.
7. Indulge yourself in stretching exercises.

What is Osteoporosis?

Osteoporosis is a disease concerning the bones. Decreased strength of the bones poses a risk for them to break. Osteoporosis is very common among older people, whose bones become brittle with age. The most common bones affected by this disease include the backbone, forearm bones and the hip bone. There are no such symptoms until a broken bone occurs. The bones weaken to such an extent that a break may happen in case of very minor stress. Usually, a broken bone is followed by chronic pain and the disability to perform daily activities. Surveys show that 15% of white people in their 50s and 70% of white people in their 80s are affected by osteoporosis.

What are the common causes and symptoms of osteoporosis?
- May occur due to the lowering of the "peak bone mass index".
- In women, bone loss increases after menopause stage due to lowering down of estrogen level.
- Also occurs because of another disease or previous treatments. This includes alcoholism, surgical ovary removal, hyperthyroidism, anorexia or any form of kidney disorder.
- Anti-seizure medicines, chemotherapy, selective serotonin reuptake inhibitors and taking of performance-enhancing drugs like steroid increase the bone loss rate.
- Lack of regular exercise may lead to osteoporosis.
- Osteoporosis is defined as a "bone density of 2.5 standard deviations below than that of a young adult".
- Osteoporosis is hereditary in nature. People having a family history of osteoporosis are at a high risk of getting the disease.
- More than thirty genes are linked with osteoporosis development.
- If you have had a fracture before, you are at a risk of a repeat.
- Early menopause in women is also responsible for osteoporosis.
- People with a small structure and body build are at a risk of getting osteoporosis.
- Protein and vitamin deficiency makes your bones weak and makes you vulnerable to osteoporosis.
- Phosphoric acid present in soft drinks is another threat, which may cause the disease.
- People suffering from malnutrition are likely to get osteoporosis.
- Over replacement of L-Thyroxine may lead to osteoporosis.
- Use of heparin and warfarin for a long time decreases the bone density.

How can Osteoporosis be prevented?
The best way to avoid getting osteoporosis in the future is to maintain a preventive lifestyle.
- Exercise regularly.
- Indulge in natural calcium sources.
- Maintain intake of Vitamin D and Vitamin K.
- Do not smoke and consume alcohol.
- Don't undertake stressful physical activities.
- Go for regular health checkups.
- Stay fit and stay away from obesity.

Elbow pain may be caused due to a variety of reasons from injuries to fractures and ligament pulls or tears. This is most commonly experienced by people who are into sports, including those who play tennis, golf and other such sports that require intense arm movements.

So, let us look at the six most common reasons behind elbow pain:

1. Medial Epicondylitis: This condition creates pain in the inner tendon within the elbow and is usually termed as 'golfer's elbow'. It basically occurs due to the constant swinging and throwing motion that a sports person may indulge in. When these movements are repeated on a constant basis, there is wear and tear as well as acute pain in the area. Also, an injury to the wrist can cause this pain in the elbow.
2. Lateral Epicondylitis: This condition is commonly known as 'tennis elbow'. The affected area under this condition includes the outside tendons of the elbow. This is caused due to swinging, hitting, hammering and punching motions that are repeated too often. It is commonly experienced by cooks, artists, carpenters, automobile workers, and plumbers and people who use heavy tools.
3. Olecranon Bursitis: This condition is also known as 'student's elbow' and usually occurs due to constant writing and gripping motion which affects the bursae. These are small fluid filled sacs that lubricate the joints even as the protection happens. The symptoms include swelling and pain. There is also risk of infection and redness in this condition.
4. Osteoarthritis: The cartilage of the joints gets affected in this condition which is the connective tissue that exists in the joints. This condition causes wear and tear of the joints and bones which leads to pain in the various areas including the elbow. Medication and physiotherapy are good measures for treatment.
5. Fracture: Sometimes, dislocation or fracture may lead to pain in the outstretched arm or elbow. Dislocation may take place when a bone moves from its aligned spot. The symptoms will include obvious swelling and acute pain in the elbow.
6. Ligament Damage: Strains and sprains in the ligaments within the elbow joint can lead to this damaging condition. Torn or stretched ligaments are the most common outcomes in this kind of injury and damage.

To find out which reason may be the culprit behind your elbow pain, you will need to see a general physician or an orthopaedic specialist who will run you through a series of tests and examinations including X rays, MRI scans and others in order to ascertain the cause and treatment.