Shoulder pain causes

The shoulder joint allows a wide range of motion in the arm. It is the most movable joint in your body. Muscles and tendons together known as rotator cuff allow the shoulder to move in a wide range of motions.

Rotator Cuff Muscles

Rotator cuffs are made up of four muscles and tendons that help in keeping the upper arm bone in the shoulder socket. These muscles help in a wide range of motion and stability.

Bones of the Shoulder Joint

The shoulder joint has three bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). In the shoulder blade, a rounded socket takes the head of the upper arm bone. The socket is known as the glenoid socket. Tendons and muscles (rotator cuff) keep arm bone centered in the glenoid socket.

Shoulder Pain

Shoulder pain can be temporary or may be present all the time. You can feel pain when you lift your arm above the head or move it behind or forward. You feel shoulder pain when you move your shoulder. Chronic shoulder pain requires accurate diagnosis and prompt treatment.

Shoulder Pain Causes

Tendinitis

Inflammation of the tendon (a cord that attaches muscle to bone) is known as tendinitis. It is of two types: Acute – excessive involvement in activities, sports, or works that put pressure and strain on the shoulder joint can cause acute tendinitis; Chronic tendinitis: progressive damage to the tendons due to repetitive wear and tear or arthritis and other degenerative conditions of the shoulder joint can lead to chronic tendinitis.

Bursitis

The shoulder joint has small fluid-filled sacs called Bursae. They act like shock absorbers or cushions between the bones and cartilages and soft tissues. Bursae help in reducing friction between the shoulder bone and gliding muscles.

They are present in joints throughout the body. Sometimes, overuse and excessive strain on the shoulder joint may lead to swelling and inflammation of the bursa. This may cause shoulder pain.

Both rotator cuff tendinitis and bursitis often occur together. This is the case when several tissues get involved and become painful and inflamed. When this happens, even simple day-to-day activities such as getting dressed or combing hair become difficult.

Arthritis

Osteoarthritis is the most common type of arthritis in the shoulder joint that causes inflammation and pain. It is the wear and tear type of arthritis common during middle-age years. The symptoms such as joint stiffness, pain, and swelling begin during middle age and progress gradually. The symptoms worsen over a period of time.

Other types of arthritis, in general, can be due to inflammation, an infection, rotator cuff tear, work-related injury or chronic wear and tear. People with arthritis tend to avoid shoulder movement. This will lead to stiffness and tightening of the joint with a painful limitation of motion.

Shoulder Instability

Shoulder dislocations cause instability because the upper arm bone in the shoulder socket is forced out of the socket. When the ball comes out partially out of the socket – it is known as subluxation. In a complete dislocation, the ball comes out of the socket completely. Shoulder instability results from overuse or sudden injury.

The risk of repeated dislocations increases if muscles, tendons, and ligaments are torn or turn loose. When you raise your arm above, you will feel pain and unsteadiness in your shoulder joint.

Tendon Tears

Tendons tears partially or completely due to a sudden injury, wear and tear, excessive usage, and advancing age. Long-term degenerative changes in the tendons can also result due to aging and overuse.

Fractures

Fractures commonly occur in the shoulder blade (scapula), clavicle (collarbone), and upper arm bone (humerus). In young people, fractures are often caused by sports, high-impact sports or activities, and severe blows. In elderly people, shoulder fractures result from falls. Fractures often cause severe pain, swelling, and bruising on the shoulder.

Diagnosis

Your Orthopedic doctor evaluates the cause of shoulder pain by taking into account your thorough medical history. The information about the nature of pain, the activities you do and a detailed medical history can be a valuable tool in determining the source of your pain. The doctor will look for muscle weakness, instability, deformity, swelling, or physical abnormality. Your Orthopedic doctor will also check for the range of motions and strength of your joint. Next, an X-ray, MRI, or Ct may be ordered.

Treatment

The treatment may involve lifestyle changes – mostly changes in activities and physiotherapy sessions with special flexibility and strengthening exercises. Doctors will also instruct patients to avoid overexertion or overindulgence in activities that cause shoulder pain. In most cases, restraining oneself from overuse can help prevent shoulder injury and pain. Your doctor may also prescribe inflammation and pain-relieving medications and steroid injections. However, if rest, avoiding activities that cause pain, altering activities, exercise and medications do not offer relief, then surgery may be recommended.

Meet Dr. Praharsha Mulpur to know which treatment works best for your shoulder pain. Never delay in approaching an Orthopedic doctor if you experience shoulder pain. Shoulder pain causes can be many, but nailing down the exact cause can be a bit tricky for you. Therefore, leave it to an expert.

Tennis elbow treatment in Hyderabad | Dr. Praharsha Mulpur

Lateral epicondylitis or tennis elbow is an inflammation or a painful condition of the elbow. Overuse and repeating the same motions, again and again, can damage the tendons and the forearm muscles over a period of time. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle. The tendons that join forearm muscles microtear and get inflamed due to repeated motions of the hand. These tendons are called extensors or the extensor carpi radialis brevis (ECRB). The person who develops this condition feels pain and tenderness on the outside of the elbow. This condition is commonly seen in people who play tennis or racquet sports. Surprisingly, other activities and sports that involve repeated hand movements can also put a person at risk.

What is the prominent cause of tennis elbow?

Damage to a specific forearm muscle called ECRB causes tennis elbow. This mostly happens in tennis. Microscopic tears form due to overuse and weakness in the tendons where the muscle attaches to the lateral epicondyle. This leads to pain and inflammation. When the elbow moves repeatedly, the ERCB muscle undergoes wear and tear over time. Thus, it is prone to damage.

Who are at risk of developing tennis elbow?

People who are involved in vigorous and repetitive use of the forearm and extension of the hand and wrist may develop tennis elbow.

Many people think that this condition develops only in those who play tennis. On the contrary, people who involve in recreational activities or work also develop tennis elbow. Such activities require vigorous and repetitive use of forearm muscles. People who involve in the following works more often get tennis elbow: cooking, auto works, carpentry, plumbing, butchering, and painting work. These professions require lifting weights and repetitive work that lead to injury, inflammation, and pain.

In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.

Sometimes, tennis elbow can occur due to an unknown or idiopathic cause.

Age

It is not a major risk factor as anyone can get a tennis elbow irrespective of age. However, tennis elbow is more common between ages 30 and 50 years.

Lateral Epicondylitis (Tennis Elbow) Diagnosis

Your orthopedic doctor takes into account several factors including your profession and day-to-day activities. The doctor may ask you about your symptoms, occupational risks, and other recreational activities.

You should tell your doctor about any recent injury to your elbow or the activities that are causing the symptoms. If you have a nerve injury or rheumatoid arthritis, inform your doctor.

Tennis Elbow Test

During a physical examination, your doctor may ask you to straighten your wrist and fingers by fully straightening your arm to see whether this causes pain. If you feel pain, then this may indicate that your muscles have become weak.

Tennis Elbow X-ray & MRI: Your doctor may recommend determining the extent of damage in the tendon and muscle and ruling out other injuries. Electromyography (EMG) may be ordered to rule out nerve compression and nerve injuries.

Tennis Elbow Treatment in Hyderabad at Sunshine Hospitals

Tennis Elbow Physiotherapy

Your physiotherapist may suggest exercises to strengthen your forearm muscles. To improve muscle healing, the therapist may perform, ice massage and muscle-stimulating techniques.

Your orthopedic doctor may recommend special braces to cover the back of your forearm and give steroid injections to relieve pain and inflammation if it is severe.

Shock wave therapy

Extracorporeal shock wave therapy: A device sends sound waves to the affected elbow to create microtrauma. This is done to promote the body’s natural healing process. Some experts believe this therapy to be effective, but others consider it experimental.

Surgery for Lateral epicondylitis tennis elbow

There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. A general physician, sports medicine expert, or a physical therapist may take care if you have mild symptoms. However, in some cases, an orthopedic surgeon operates to provide the most effective relief from symptoms.

If symptoms don’t respond to non-surgical treatments for up to a few months, your orthopedic doctor may recommend surgery. An orthopedic surgeon considers several factors – such as your overall health, personal needs, and the extent of injury, and then discusses the surgical options including arthroscopic surgery. If you have been suffering from nagging symptoms for a long, then meet Dr. Praharsha Mulpur for the best Tennis elbow treatment in Hyderabad.

Plantar fasciitis treatment in Hyderabad | Dr. Praharsha Mulpur

Many people experience heel pain. One of the common causes of heel pain is plantar fasciitis. It is due to the inflammation of a thick band of tissue called the plantar fascia. This tissue connects the heel bone to the toes. It runs across the bottom of each foot.

Plantar Fasciitis Causes

Plantar Fasciitis meaning: The thick band of connective tissue that runs across the bottom of each foot is known as fascia. It connects the heel bone to the base of the toes. It works like a shock absorber by supporting the arch of the foot and absorbing the load while walking.

Repeated stress and tension exert pressure on the tissue (fascia) and cause small tears. When these small tears expand and stretch repeatedly, they get damaged further. This may lead to irritation and inflammation of the fascia. However, in a majority of the cases of plantar fasciitis, the cause either remains unknown or is poorly understood.

Plantar Fasciitis Symptoms

Plantar Fasciitis Pain: People who develop this condition experience severe pain near the heel and in the sole (bottom) of the foot. They feel the worst pain early in the morning when they wake up and take the first few steps. They also feel pain after getting up from a sitting position. Standing for a long period of time can also trigger pain. The pain slows down and becomes less severe as a person gets up and begins to move.

Plantar Fasciitis Treatment in Hyderabad

Home care and lifestyle changes such as avoiding the activities that cause pain are helpful. Many people feel better and recover from planar fasciitis after a few months of conservative approaches such as stretching, applying ice packs, and modifying their activities. Pain medicines help in relieving pain and inflammation.

Plantar Fasciitis Exercises

Taking the help from a professional physical therapist can help in managing the condition better with a faster recovery. You can learn different exercises to strengthen the Achilles tendon and plantar fascia. Exercises also help strengthen your lower leg muscles. Your therapist will also teach you the use of taping to support the bottom of your foot.

Custom-fitted arch supports (orthotics) help in the even distribution of pressure on the feet. Your Orthopedic doctor may prescribe such off-the-shelf products. Similarly, your doctor may also recommend you wear a splint. It will help in holding the Achilles tendon and plantar fascia in a lengthened position and promote stretching while you sleep. To help reduce strain and pressure on your affected foot your orthopedic doctor may recommend using crutches, canes, or boots for a brief period of time.

Plantar Fasciitis Treatment in Hyderabad (Surgery)

Your orthopedic doctor may recommend the following therapies if the above measures fail to provide any relief: Steroid injections (the use would be limited) and PRP therapy; ultrasound tissue repair and extracorporeal shock wave therapy. Surgery may be recommended only in a few failed cases of conservative treatment and also when the pain becomes chronic.

Bottom line

Many people tend to ignore plantar fasciitis. Overweight people and runners are prone to this condition although why it occurs in some people is still not understood completely. Anyway, if you have this condition, you should never ignore it as it may lead to severe heel pain. You may not be able to perform your regular activities if you develop chronic heel pain. However, if you try to avoid pain, you may tend to walk differently by making changes to your foot position. When you try to change your walking style and foot position while walking, you are at risk of developing knee, back, and hip problems.

To know more about all the possible treatment modalities and the most effective Plantar Fasciitis Treatment in Hyderabad, consult Dr. Praharshamulpur.

Care after knee replacement surgery | Dr. Praharsha Mulpur

Knee replacement surgery provides relief from severe pain with improved mobility and better quality of life. In a majority of the cases, knee replacements are expected to last for more than 15 years. However, you must take care of your new knee joint.

After the procedure

Your hospital stay depends on your individual case and requirements. Many patients leave the hospital the same or very next day. Doctors prescribe medications to help control pain. Your doctor will advice you to wear support to prevent swelling and clotting. A physiotherapist will assist you in improving your activity levels and show you the exercises for your new knee. You will continue the exercises at your home or a centre, once you leave the hospital.

What else can you do?

Make your home a safer place to dwell and make it easier to recovery. Take care of the following:

Ensure safety handrails in your bathroom

To avoid climbing stairs, have a living space on ground floor.

Use a stable well-cushioned and firm chair with a comfortable back support.

Have a stable chair in the bathroom for shower.

Remove loose surfaces, cords and rugs.

What to Expect after a knee replacement?

You can resume the following activities after three to six weeks after knee replacement: most common daily activities, light housekeeping and shopping. As far as driving is concerned, you can drive a car if you can sit comfortably in the car and if you have good muscle control to operate clutch, accelerator and brakes – and if you have stopped taking narcotic pain medications.

You can get on with your normal routine activities after complete recovery. In addition, you can also engage in low-impact activities – such as biking, golfing, swimming and walking.

You should avoid the following activities:

Jumping, contact sports, tennis, skiing, jogging and other contact and high-impact exercises and sports. Talk to your Orthopedic surgeon regarding any limitations that you may have in your case. If you have any more concerns regarding the care after knee replacement surgery, meet Dr. Praharsha. Learn Why Robotic Knee Replacement is a better option… 

What is Rheumatoid arthritis?

It is an autoimmune disorder that causes inflammation in the joints. It occurs when your body’s own immune system attacks cells and tissues in the joints. The condition is often associated with painful swelling in the joints – which eventually causes bone erosion and joint deformity.

Can rheumatoid arthritis affect other organs?

Yes, it is a chronic inflammatory disorder that can affect your skin, blood vessels, heart, lungs, eyes, and other body systems.

What are the symptoms of rheumatoid arthritis?

The signs and symptoms associated with rheumatoid arthritis include:

• Joint stiffness
• Loss of appetite, fever, and fatigue
• Swollen joints that are warm and tender to touch
• Bone erosion in the joints with swelling and slight deformity
• First RA affects the smaller joints – fingers, hands, toes, and feet.
• The progressive disease affects – the elbows, ankles, knees, wrists, shoulders, and hips.
• Rheumatoid arthritis may also affect blood vessels, heart, lungs, kidneys, eyes, and skin
• People who have this condition may experience alternate periods of flares and remission. Symptoms may vary in severity with swelling and pain that may disappear and then reappear.
• As the disease progresses, joints deform and shift out of place.

What are the causes?

Rheumatoid arthritis (RA) is an autoimmune disorder wherein your immune system attacks your body’s own cells and tissues in the joints. The normal function of our immune system is to protect our body from diseases and infection. In the case of RA, the reverse happens. Doctors don’t have any clue as to what starts this process. Your genes and environmental factors may trigger the disease.

What are the risk factors for rheumatoid arthritis?

 Women are at increased risk of rheumatoid arthritis especially if they have a family history of the disease. The disease can strike at any age but commonly occurs in middle-aged women. Compared to men women are at increased risk. The other risk factors include excess body weight and smoking.

What are the complications associated with rheumatoid arthritis?

 The complications associated with rheumatoid arthritis include the following:

  Proneness to infections increases

  Lean mass to fat proportion is high in people who have RA

  Rheumatoid nodules form around elbows

  Sjogren’s syndrome develops – eyes and mouth become dry

  The risk of osteoporosis increases

   The risk of heart disease, lungs problems, and kidney issues increase

When to See a doctor?

Make an appointment with your doctor if you feel weakness, stiffness, and swelling in your joints with pain and discomfort.