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I am feeling pain just below my left ankle joint & there is a bit of swelling too. It's been 15-20 days, I have used heat therapy, cold therapy & taken some pain killers, but to no effect. My question is there might b chance of hair-line fracture or swelling in that part of the bone?
For last 4/5 days I am having a dull pain on both sides of the rib cage near abdomen. Has also an urge to visit toiletore than once. Quantity of stool passed is small in quantity. Want a remedial medicinal advice.
I have several back pain what can I do? I am using calcium tablet. But pain are there what can I do. Suggest me.
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
- 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.
- 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
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'. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Spinal scoliosis is a lateral ‘S’ shaped twist through the spine which is obvious when viewed from behind. It can be congenital abnormality or caused by a shorter leg. If the scoliotic curves are relatively stable and do not involve rotation of the vertebrae, the pathology will limit itself to segmental jamming.
- If however the spine twists as well as deviates laterally, the disorder will include facet joints trouble. The facets become chronically inflamed in their taxing role of locking the spinal segments together to prevent them toppling off on other.With scoliosis the curvature usually consists of a primary curve in the lower back and a secondary curve higher up the spine.
- The upper curve develops to compensate for the lower one, throwing the spine back across the central line so ahead sits squarely on the shoulders at the top of the column, allowing the eyes to focus.When one leg is shorter, the spine usually twists one way then the other, compensating in a fairly predictable way. For example, if your right leg is shorter and your pelvis dips to the right, your spine leans initially to the right, making a lateral sweeping curve, convex to the right.
- Higher up your spine there will be another lesser curve convex to the left, to tip the spine back the other way.Lateral curves in the spine lead to trouble because the ligamentous shoring of the sides of the column is so weak. Unlike the various structures which keep it stable in the forwards-backwards direction, there is little impediment to the segments sliding sideways off one another except the disc wall itself.
- The vertebrae below the apex of the curve tend to slide one way, and those above it, the other. Rather unfortunately, the vertebrae at the peak of the apex are pinched in the middle, compressing its intervertebral disc beneath it. As the travelling vertebrae move off-centre their discs are dragged sideways. Thus the disc at the apex of the curve is flattened and the neighboring ones are tugged in opposing directions. In all cases, the disc walls bunch down and the discs stiffen. Several contiguous discs end up thinner with their vertebrae sluggish-which explains why scoliotic spines can be so worrying, with such a diffuse spread of pain.
- The pain from the jammed apical segments is always the greatest. There may be several of them, depending how many times the spine twists back and forth as it goes up. These focal points account for the wide variety of symptoms which go with scoliosis. There can be pain in the neck(sometimes including headaches), in the shoulder blade area (sometimes down the arm), pain in the back beside the waist (sometimes referred to the groin), and pain in the low back (sometimes referred into the buttock or down the leg).
- With so much pain at once, mild scoliotic patients in particular are rarely taken seriously and often wrong dismissed as malingerers.Symptoms from exaggerated spinal curves (lordotic and kyphotic low backs) usually emerge during the third decade of life as the internal make-up of the tissues changes and they become more fibrous. Pain from scoliosis, on the other hand, can come on as early as nine or ten years old and be with you for life, getting progressively worse, unless you do something about it