Articles on shoulder pain

Shoulder Pain - What You Should Know!

Dr. Shekhar Srivastav, Orthopedist
1. How common is the Shoulder problem seen in general population?The most movable joint in the body, the shoulder, is also one of the most potentially unstable joints. As a result, it is the site of many common problems. They include sprains, strains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures, and arthritis.2. What are the common problems seen in the Shoulder Joint? In younger people, the problem is usually trauma related and it can be a feeling of instability or repeated dislocations which can cause pain and prevent the person from pursuing his profession or sporting activity. The shoulder joint frequently comes out of its socket which causes acute pain to the patient and requires medical help to put it back.In older people, the problems are due to degenerative tears of tendons (Rotator Cuff tears) or bony overgrowth (Impingement), Frozen Shoulder or Arthritis which causes pain on movement or even at rest. The pain can sometimes be so severe that it even disturbs the sleep of the patient.3. What are different treatment modalities for Shoulder Problem?The treatment varies according to the problem affecting the shoulder joint. In minor injuries, Sprains, Tendinitis or most cases of Frozen shoulder, the treatment is usually medicines and exercises explained by the Doctor.Problems such as Repeated Shoulder Dislocations or Complete Tendon ruptures require repair which can be done Arthroscopically (Minimally invasive Keyhole Technique).Severe Arthritis of the Shoulder joint requires Shoulder Replacement which gives excellent results.4. How effective are Shoulder Surgeries?Though most of the problems of the shoulder joint can be managed with medicines and exercises, some problems can be tackled only by surgery. Previously, surgeries were done using open technique which frequently led to stiffness & pain later on. But now newer techniques have emerged where joint is accessed by small keyhole incisions (Arthroscopy) through which most of the problems can be tackled. This has revolutionized the understanding and management of shoulder problems.5. What are the advantages of Arthroscopic surgery of Shoulder over open surgery?Arthroscopic surgery is a Technique where the surgeon makes very small holes through which a camera and instruments are inserted into the joint to see the problem and repair it (Fig).Arthroscopy causes minimal blood loss as compared to open surgery. As it is done through only tiny keyhole cuts as compared to open surgery where the whole joint has to be opened, the recovery is much faster. This results in less pain and stiffness, fewer complications, decreased length of hospitalization. The small incisions are closed by single stitch and most of patients are discharged next day of surgery and have faster recovery times.6. Is there a treatment for severe arthritis of the shoulder too?In severe arthritis of the Shoulder joint, where the cartilage is totally destroyed and medicines & exercises have failed, Replacement of the Shoulder joint gives excellent results both in terms of pain relief as well as functions. Now newer implants (Reverse Shoulder) have also come which can restore the Shoulder function even in elderly patients where all the tendons have been ruptured.

Acupuncture for Neck, Back & Shoulder Pain

Dr. Gurudatta H K, Yoga and Naturopathy
Neck & shoulder pains are one of the commonest problems for which a GP is consulted across the world. Based on epidemiological  studies; at any given time about 10% of the population suffer from it!!Back pain is one of the most universal of all the diseases affecting practically everyone at sometime or another in one's life across the globe. About 80% of the population suffer from back pain at some point of their lifetime!!The possible common causes of back pain in today's lifestyle are -Lack of exerciseIncorrect postureLong hours of sittingStressOver weightBad dietary habitsImproper exercise without proper guidanceSpasms of back muscles and soft tissuesDisc prolapseDegeneration of joints & bonesOsteoporosisThe effective solutions for the above problems is prevention by -Regular & consistent exerciseAppropriate postureWeight managementHealthy dietary habitsStress managementAppropriate pain medication & Surgery in severe casesPhysiotherapyAcupunctureTCM (Traditional Chinese Medicine) & Acupuncture give us  more natural and long term solutions for the management of back pain. They not only work to relieve the symptoms of back pain but also address the root cause of the disease. In a study conducted at a Swedish Hospital, doctors concluded that acupuncture provides a long term relief along with improvements in physical activity levels, quality of sleep and diminished use of pain medication.It is understood that, according to TCM & Acupuncture there are energy channels called 'meridians' through which 'Qi'  or 'Prana' flows. Excessive stagnation or deficiency in the 'qi' or 'prana' leads to ill health and then to disease when not taken care of at the right time.According to TCM & Acupuncture it is understood that there are 3 most important factors which contribute for neck, back & shoulder pain. They are -Invasion of ColdInvasion of WindLeading to DampnessWhen all three factors are combined, they  lead to accumulation of heat in the channels causing pains, numbness or tingling.Deficiency of 'Qi'Acupuncture through the insertion of needles on the meridians on specific acu-points along the meridians, helps to restore deficiency, expels wind, scatters cold and resolves dampness. At the same time, it will also help to nourish blood.The result of a study published in Clinical Journal of Pain gives us sufficient proof that Acupuncture is quite safe and effective method of treatment in the management of low back pain.Action Mechanism of Acupuncture therapy²Scientific research into the mechanism of action of acupuncture began around 1950 when an important pharmacological study was published by a group at Peking University.They demonstrated that an induction time of 15 to 20 minutes is required for the development of an analgesic effect and proposed the participation of chemical substances in the analgesic actions of acupuncture [4]. Endogenous opioid peptides (EOPs) were considered major candidates for a role in acupuncture’s action.Along with acupuncture, yoga therapy and/or  therapeutic massage could also be recommended by the practitioner for effective management of the complaints.To prevent and sustain the benefits of Acupuncture, it is recommended to -Practice a correct sitting posture, when sitting for long hoursRegular exercise practice like yoga, tai chi orany other recommended exercise by the practitioner. Check out cervical spondylosis exercisePrevent going out in cold weathers without adequate clothing.Avoid strenuous & jerky movements.Stress management.More and more people are finding relief for both acute & chronic back pain through TCM& Acupuncture. Several research studies have proved this, time and again.¹Carlsson C, Sj˜lund B.Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clinical Journal of Pain 2001;17(4):296-305²Research Group of Acupuncture Anesthesia: Effect of acupuncture on pain threshold of human skin. Chin Med J 1973, 3: 151–158.Pomeranz B, Chiu D:Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sci 1976, 19:1757–1762.

Low Back Pain: What All You Must Know

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
Back pain is a problem which is very often faced by all the human beings at least once in their lifetime. This pain, if not taken seriously can turn into a deadly disease which can put your life at stake.Some important facts about back painLow back pain is the most common musculoskeletal complaint, with potentially devastating consequences.90% of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first. Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.The incidence of back pain is highest between the ages of 35 and 55.Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.Early interventional treatments in back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.Newer Developments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts.Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.Must visit Interventional pain and spine specialist :-If you have moderate to severe low back pain that lasts more than a couple of Days;If you have back or leg symptoms that have gotten worse; If your symptoms have not gone away after 2 weeks of home treatment; Or, if improved symptoms flare up again.A physical examination by pain specialist and possibly an imaging (x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.Physical Therapy: TENS, UltrasoundHeat and Cryotherapy:These Modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain. They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition.Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain. Facet joint injections: An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radiofrequency otomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3rd of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus, reducing the volume and lessening the pressure on nerves.Intradiscal Electrothermoplasty (IDET) This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc. These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Quick tips to a healthier backFollowing any period of prolonged inactivity, begin a program of regular low-impact exercises. Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.Yoga can also help stretch and strengthen muscles and improve postureAlways stretch before exercise or other strenuous physical activity. Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced. At home or work, make sure your work surface is at a comfortable height for you. Sit in a chair with good lumbar support and proper position and height for the task.Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books. Wear comfortable, low-heeled shoes. Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed. Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Frozen Shoulder

Anshul Parashar, Physiotherapist
Frozen shoulder, or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. Adhesive capsulitis is common but poorly understood. It was first described by Duplay1in 1872 as a ‘peri-arthritis scapulo-humerale’ and in 1934, Codman first used the term ‘frozen shoulder. Frozen shoulder most commonly affects patients between the ages of 40 to 60 years old, and it is twice as common in women than in men.It can be bilateral, especially in patients  with diabetes. Although it is generally considered self-limiting.No one really understands why some people develop a frozen shoulder. For some reason, the shoulder joint becomes stiff and scarred. The shoulder joint allows more motion than any other joint in the body. When a patient develops a frozen shoulder, the capsule that surrounds the shoulder joint becomes contracted. The patients form bands of scar tissue called adhesions. The contraction of the capsule and the formation of the adhesions cause the frozen shoulder to become stiff and cause movement to become painful.Several systemic conditions such as heart disease and Parkinson's disease have also been associated with an increased risk of developing a frozen shoulder.CausesThe exact underlying cause has not yet been identified but it has been seen that there has been some underlying history of trauma at the shoulder or a weak musculature around shoulder girdle which couldn’t have been able to survive under load sharing.Sign and symptomsShoulder pain; usually a dull aching pain at restLimited movement of the shoulderDifficulty with activities of daily livingPain when trying to sleep on the affected shoulderTreatmentSurgical treatmentWhere pain and stiffness are present, options include manipulation under anaesthesia (MUA), arthroscopic and open release of contractures and hydrodilatation.Nonsurgical treatmentPain control can be achieved with anti-inflammatory medications. These can include pills taken by mouth, such as ibuprofen, or by injection, such as corticosteroids.Physiotherapy treatmentExercise therapy:Shoulder muscles stretchingShoulder mobilisationMyo fascial release techniquesManual therapy ( MWM, Hold-relax )ElectrotherapyMoist heat therapyUltrasoundTens/ IFT as requiredLASERSome studies say that electrotherapy is not more beneficial in frozen shoulderSelf exercises for the patientPulleyShoulder wheelCodman,s exercisesTowel stretchArmpit stretchFinger walk on the wallPrecautions to be maintained as well.

Myths and Facts About Low Back Pain

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
· Low back pain is the most common musculoskeletal complaint, with potentially devastating consequences.· 90%of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first.· Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.· The incidence of back pain is highest between the ages of 35 and 55.· Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.· The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.· People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.· Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.· Early interventional treatments in Back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.· Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.· Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.NewerDevelopments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.· If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .· Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.· If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.· Must visit Interventional pain and spine specialist :-· if you have moderate to severe low back pain that lasts more than a couple of days;· if you have back or leg symptoms that have gotten worse;· if your symptoms have not gone away after 2 weeks of home treatment;· or if improved symptoms flare up again.·  A physical examination by pain specialist and possibly an imaging(x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.· Physical Therapy: TENS, Ultrasound, Heat and Cryotherapy:o These modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain.o They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition. Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.Facet joint injections:An injection used to determine if the facet joints are the source of pain.These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radio frequency Neurotomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus reducing the volume and lessening the pressure on nerves.These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Following any period of prolonged inactivity, begin a program of regular low-impact exercises:· Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.· Yoga can also help stretch and strengthen muscles and improve posture· Always stretch before exercise or other strenuous physical activity.· Don’t slouch when standing or sitting.When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.· At home or work, make sure your work surface is at a comfortable height for you.· Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for along period of time, rest your feet on a low stool or a stack of books.· Wear comfortable, low-heeled shoes.· Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.· Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.· Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body.Do not twist when lifting.· Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles.· If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Pain Management: Why Is It Important

Dr. G P Dureja, Spine and Pain Specialist
Most of the people suffer from different kinds of pain because of various reasons. Most of the people also tend to ignore it and move on. It is not advisable to ignore pain because you don’t know if that is casual or something serious to pay attention to. Avoiding pain will only make it worse, so it is essential to manage and treat pain. What is pain management? As the name suggests, managing your pain in a way that either it is treated or relieved, is pain management. It is also a branch in medicine called Pain Medicine, which involves in-depth procedures and techniques to ease out the pain. What are the types of pain?Majorly pain can be classified into two types, acute and chronic. Any pain that is short lived or short lasting comes under acute pain while, any pain that is long lasting or forever, comes under chronic pain. Chronic pain generally is the pain that lasts for 3 or more months. Based on, where, in the body, the pain is present, there are further three types. Somatic This type of pain is more like an exterior pain. Caused generally by the activation of receptors on the body surface or musculoskeletal tissues, it can be treated with proper rest and medication. Surgical pain comes under this type. Visceral Internal pain caused due to damage to the organs or tissues is known as visceral pain. This is not localized to just one body part. It might pain in different organs or body parts. Neuropathic Pain related to the spinal cord or peripheral nerves is called neuropathic pain. It generally occurs at the level or below the level of injury. How can you manage pain?Managing acute pain is easier than chronic. You can involve in a healthy lifestyle and physiotherapy but for advanced management and care, there are pain hospitals that manage pain well. These healthcare facilities are established especially to diagnose and manage chronic pain. What are the kinds of pain that can be treated?Various kinds of chronic pain can be treated in pain hospitals such as cancer pain, back pain, knee pain, neck pain, arthritis, fibromyalgia, migraine, etc. What are the treatments available? There are various treatment procedures that are involved in treating pain. These can be simple and complex both. It truly depends on upon the kind of pain you are suffering from. Some pain needs just lifestyle modification and counseling to be treated while the others require more complex treatments. Treatments like X-Ray guided injections, intrathecal pump implants, radiation therapy, Botox therapy and Platelet rich plasma therapy are some from a several more. These treatments can be very effective when performed by experts.

What a Pain! Managing Pains Associated With Ageing

Dr. Vishwas Virmani, Physiotherapist
Ageing is a part of growing up and one cannot stop growing. But one can certainly manage the pains that grow with time. Arthritis, particularly osteoarthritis, back pain, frozen shoulders etc are common pains associated with aging.Ignorance is NOT alwaysbliss! Flexibility and stiffness could be quite a challenge especially aftercrossing 60. Most often, we ignore stiffness and joint pains thinking they aretemporary and will cure by itself without medical help.Here is a list of some chronic pain conditions that mostsenior citizens face: ●  Joint pain & stiffness: Osteoarthritis and rheumatoid arthritis can be possible reasons for your suffering as you grow older. Senior citizens suffering with this condition complain of morning stiffness in fingers, knees and other joints.●  Lower back pain: Do you face pain that often starts from your neck and then crawls down to your lower back? This pain grows common with age and is called degenerative disc disease.Degenerative disc diseases generally start during forties and might go worse after sixties.●  Another reason of lower back pain could be bone spurs. These are calcified growths along the spine,neck, knees and feet. This too increases with age.●  Frozen shoulder: This excruciating pain arises when connecting tissues around the shoulder joint thicken. This could be a result of arthritis or prolonged shoulder immobilization.How to manage pain?●   Exercising regularly will help you manage pain. Your doctor may also suggest physiotherapy in order to improve flexibility and reduce joint pain.●   If it is a muscle pain then muscle relaxants for the back and neck could also give you relief.●   Inflammation may also accompany joint pains, with the help of non steroidal pain relief medicines both inflammation and joint pains could be managed. But make sure you suggest a good doctor first.

Killing Your Back Pain Is Easier Than You Think!

Dr. Vishwas Virmani, Physiotherapist
Perhaps you have an old injury that you ignored and is now bothering you. Or maybe you slept in an odd position and woke up to feeling really uncomfortable and uneasy. Whatever might be the reason for your back pain, this is one problem that is hard to easily get rid of. However, there are relief therapies to reduce your back pain, which, eventually completely cure your back pain. These are:Cold therapyEven with all the high tech medical options available, a simple ice or cold pack application can still be one of the more effective, proven methods to treat a sore back or neck. Ice is typically most effective if it is applied soon after an injury occurs, or after any activity that causes pain or stiffness.Ice can also be very helpful in alleviating postoperative pain and discomfort. While any form of applying cold to the injured area - such as a bag of ice wrapped in a towel or a commercial ice pack - should be helpful, combining massage therapy with ice application is a nice alternative for pain relief.Heat therapyWhile the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain.In addition, heat therapy—such as heating pads, heat wraps, hot baths, warm gel packs, etc.—is both inexpensive and easy to do. Some patients find more pain relief with heat (either moist heat or dry heat) and others with ice. You can also try alternating the 2 therapies.Note: If you still do not see any changes in your condition, check with your doctor.

Back Pain – What You Should Know

Dr. Vishwas Virmani, Physiotherapist
Ow! My aching back! Most of us have stuttered these words at one time or another. Worldwide back pain affects 4 out of 5 people at some point in life. It is one of the top ten high burden diseases and is largely responsible for decreased quality of life and disability in young adults.  Back Pain SymptomsBack pain can range from a dull nagging ache to sudden debilitating pain. It can affect anyone at any age, but becomes more common as you grow older. People, who are overweight, lead a sedentary lifestyle, under extreme psychological stress and smokers have been found to be at a higher risk for back pain. Some of the common symptoms that occur with back pain include stiffness, trouble flexing your back, difficulty with range of motion, sharp shooting pain, pain radiating down the legs and numbness in the legs or groin.Common CausesBack pain that develops abruptly, often after some activity, is known as acute pain. If your pain lasts for more than three months, it is known as chronic pain. Most causes of acute back pain are related to the muscles and/or ligaments, widely known as strains. Back strains usually result from activities such as heavy lifting, overuse, abrupt movement and poor postures. Chronic pains may be associated with infections, trauma, spinal deformities and problems with the discs, nerves and bones.Understanding the root cause of your back pain is key to preventing it from worsening or recurring. A better resolution of this problem can be achieved when you learn more and start identifying the factors that trigger your pain.10 Tips to Beat Back PainMost episodes of back pain resolve within a few days on its own. Sadly, for some people it can return and can be the most frustrating and bothersome problem to manage. Here are few tips that you can try to minimise your discomfort and prevent the back pain from becoming a long-term issue.Ice the area – Keep ice on the area for the first one or two days. Ice helps slow down inflammation that occurs after an injury. You may switch to heat after two days. Do not place heat or ice directly on your skin and do not keep it for more than 20 minutes at a time.Be active  – Continue your normal activities such as walking and mild exercises, but don’t overdo it. Avoid sitting at a place for more than half an hour, get up and do some mild stretching.Make your workstation ergonomic – Use chairs that have proper back support. Avoid hunching forward often and keep both your feet firmly planted on the floor.Maintain good posture – Avoid stooping or bending over from your waist when lifting heavy objects. Lift with bent knees.Wear footwear with low heels – High heels threaten good posture and put more pressure on the lower spine.De-stress – Anxiety, stress and depression can worsen back pain. Engage in activities that keep you happy.Get enough sleep – Inadequate sleep can aggravate your back pain. Sleep plays a major role in healing your body and mind. Sleep on a mattress that provides good back support. Keep a pillow between your knees if sleeping on your sides. If sleeping on your back, keep a pillow under your knees. These measures help maintain neutral spine position.Quit smoking – Smokers are at a greater risk of developing bone problems that worsen back discomfort.Exercise – Once your back pain has subsided, perform exercises to strengthen your back muscles.Shed some weight – Being overweight can put excess pressure on your spine. Losing weight can help relieve your back pain.There is often no single solution for back pain. You may need to explore and find out what works best for you, which often involves a process of trial and error.It is advised that you consult a qualified doctor if your back pain does not subside within 72 hours. Depending on your type of back pain, your doctor may recommend blood tests and/or imaging studies to identify the root cause of your pain. Depending on your specific condition, treatment options can include oral medications, injections or surgery. You may also choose complementary therapies such as exercises, massage, yoga, biofeedback, acupuncture, physiotherapy and chiropractic treatments that may offer some relief.

Five Causes of Back Pain Arising Out of Our Lifestyle in the Current Age!

Dr. Vishwas Virmani, Physiotherapist
Ouch! The very term back pain makes you wince in discomfort! Unfortunately, back pain is becoming increasingly common. Not only is it affecting ladies after a certain age, but is surprisingly being suffered by youth and working professionals of all ages.We all want solutions to get rid of this really painful problem. After all, your back is the fundamental support system for the entire body!However, rushing to the solutions, it is utmost crucial to go to the root of the matter and understand why and what we are doing wrong so as to inflict back pain upon us!First – Wrong Posture for prolonged hours is the primary cause for Back Pain!Wrong posture is the most common cause for both, lower back and upper back pain. It is very important to be deliberately conscious of your sitting posture, your reading posture and your standing posture.You back muscles are particularly strained when they are forced to be in a wrong posture for long hours.It is amusing because we are all taught the right postures in schools in our growing up years, and yet, as ’grown ups’, we forget the basics and land ourselves in such painful physical ailments!Second – Inactivity and Lack of Exercise can cause your Back Pain to last forever!On an average, we work for anything between 8 to 12 hours in our offices on a regular basis. As a result, we end up sitting all day long barring a few coffee breaks or lunch wherein we end up stuffing our body with more food and caffeine!We come back late evening, too tired and sometimes lazy enough to go for exercise. And we are of course unable to wake up early in the morning for exercise due to working late till night or late heavy dinner. Thus forms a vicious cycle and we are stuck in it!This lack of exercise on daily basis eventually leads to weakening of the back muscles simply because the back muscles are not being ‘used’. And its obvious, that weak back muscles cannot support the whole body. Only strong muscles can. As a result, one fine day, your back starts to scream in pain!Third – Stressful anxious mind and absence of a peace within you can torment your upper back!Stress is one of the major reasons that causes upper back pain in particular.Increasingly today, people suffer from cervical attacks not only due to constant wrong posture of looking down while reading or working, but also because the mind is not at rest due to work or domestic life stresses of various nature which the body is unable to bear.If you are mentally stressed with negative emotions, undoubtedly, it will impact your body sooner or later. And one of the first body parts to suffer is the upper back region comprising of your beck, shoulders, head and upper spine.Fourth – Lack of rest and adequate hours of sleep can aggravateBack pain multifold!It is fundamental truth that if you body is not well rested resulting from a decent seven to eight hours sleep, you will be vulnerable to multiple health problems. Lack of sleep causes a drop in immunity level of the body and weakens it internally.As a result, when you push your body through the rigours of your daily routine, you back is sure to be inflicted with suffering because it has to support your whole body even though it is not well rested and feeling fresh! On the contrary, your muscles are already tense!Fifth – A protruding stomach with fat accumulated in the centre of your body is a cause of lower back pain!Fat is bad in any case. And fat, when accumulated in the lower abdomen region causing a pot belly to develop, can be even more damaging!This is because you are shifting the centre of gravity of the body towards the front thereby causing further pressure on your spine to keep your body straight! Thus, a big belly primarily caused due to our sedentary lifestyle can cause lower back pain.