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CAUSES OF ELBOW PAIN

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CAUSES OF ELBOW PAIN

The elbow joint is a hinge-joint that connects the humerus in the upper-arm (with two forearm bones, radius and ulna) at its distal end. Articular cartilage lines the ends of the bones, and ligaments support both sides of the elbow joint. This is because the elbow rests near nerves and vessels serving both the upper arm, problems with those that can mimic an “elbow issue” mentioned earlier.

TRAUMATIC

Fracture: Any fall, motor vehicle accident, or direct blow Whether dog bite or Human biting injury can be some of the mechanisms for sustaining fracture at the elbow. Commonly seen fractures include the Supra condylar fracture (common in the pediatric age group), Distal Humerus, Intercondylar, and Fracture Dislocations.

Dislocations: Dislocations commonly occur with a fall or the patient tries to avoid falling by using his hand for support. One of the most common is what happens in children called infantile subluxation or pulled elbow. This can occur when a child is swung by their arms or suddenly picked up jerkily catching the arm.

DEGENERATIVE

Tendonitis/ Tendinopathy: Lateral Epicondylitis or tennis elbow will have a pain on the lateral aspect of the elbow. The common extensor tendon is the one involved in this condition. Medial Epicondylitis/ Golfer’s elbow– Pain at the inner side of the elbow joint because here common flexor tendons are attached which leads to medial epicondylitis.

Elbow arthritis can occur as a result of mechanical wear and tear to the joint articulating surfaces or secondary to trauma. Auto immune conditions e.g. Rheumatoid arthritis Gout-which can lead to the Degeneration of the joint

Bursitis: Bursae are sac-like structures and may get packed with fluid leading to inflammation and pain. The most commonly-seen around the elbow was olecranon bursitis

INTRAARTICULAR

  • The wrong massage and improper manipulation of supracondylar fractures humerus cases is one more incidence of Myositis Ossificans/Heterotropic Ossification (this deformity mostly seen in Indian Sub-continent).
  • Intraarticular extension of loose bodies and osteophytes
  • Adhesive capsulitis

NERVE ENTRAPMENTS

  • C6 or C7 radiculopathy
  • Ulnar tunnel syndrome (ulnar nerve at the wrist) Cubital tunnel syndrome (entrapment of ulnar nerve at the elbow)
  • Ulnar or median neuropathy. Ulnar neuritis, anterior interosseous nerve entrapment there is tard Palsy of ulnar nerves

DEVELOPMENTAL

Osteochondritis dissecans: Often seen in adolescents, this condition results when a small piece of bone becomes avascular (as the cartilage and the underlying bone fragments). This causes pain on physical exertion. Most of these cases are treated conservatively.

UNCOMMON CAUSES

  • Lyme’s disease
  • Lupus
  • Herpes Zoster
  • Several pathologies may mimic medial epicondylitis, including neuropathy (eg C6 or C7 radiculopathy, cubital tunnel syndrome, ulnar/median nerve entrapment, and neuritis among others) as well ligamentous injury to the elbow joint (eg. Ulnar/Medial collateral elongation or sprain);. This also encompasses intra-articular issues (adhesive capsulitis, arthrofibrosis, loose bodies); osseous concerns (medial epicondyle avulsion fracture; osteophytes), myofascial problems like flexor or pronator strain; tendinopathy ([including lateral] epicondylitis, triceps tendonitis) synovitis valgus extension overload dermatologic considerations (eg shingles) ways things can go wrong.
  • Note: Your elbow is a joint where three bones meet — the upper arm bone (humerus), and the ulna and radius, two bones of your forearm.
  • The cartilage on the end of each bone allows bones to slide against one another without damage and also absorbs shocks. They are held in place by strong tissues known as ligaments. From there, your bones are held together by ligaments (what holds your femur up to the rest of you) and then connective tissue like fascia helps compartmentalize muscles into groups for specific functions — say palming a basketball.
  • If anything goes wrong with any of those bits, let alone all the nerves and blood vessels around that can make you hurt.

Here are some of the different ways your elbow can hurt:

One-time Injuries

  • Many injuries— and let’s hope all of them are one-off events, as in the case when you fall hard or get hit playing hockey.
  • Dislocated elbow (the bones that make up the elbow are forced out of alignment)—Caused by a sharp blow to the joint an all-too-common reason is sticking your hand out when you fall. Toddlers can also do it when you swing them by their forearms — that’s nursemaid’s elbow. Call your doctor if you think that either you or someone else, such as a child in your family, has dislocated an elbow.
  • If you break (fracture) one of the bones in your forearm just above the elbow, it is called broken bone-fractured elbow. Typically, this occurs with a sudden impact such as you would receive while playing contact sports or during an auto collision. Then again, you could move your elbow, but do not be deceived. If you are hurting, and it’s not proper it may be broken. You will require healthcare
  • Strains and sprains: These fall into the category, “Oof, I might have overdone it a bit.” Strain: when muscles are stretched or torn. A sprain refers to ligaments.
  • If you put a lot of stress on your elbow muscles, such as lifting heavy items or oversporting yourself, the result can be activated by getting a strain.
  • Injuries that cause elbow sprains are often experienced by athletes who throw, use racquets, or play contact sports.
  • In general, both are managed with RICE (Rest-Ice-Compression-Elevation) initially followed by gentle range of motion exercises and strengthening around the hip after symptoms have settled.

Wear-and-Tear Injuries

Some injuries take time to develop as you repeat certain motions causing your elbow wear and tear. This could be playing a sport or on workplace accidents in any number of situations, from factories to officers.

  • Bursitis – Often the result of repeating the same motion, you may gain bursitis from trauma or infection as well. Bursa Bursae are small sacs filled with fluid. You have them inside of your joints to provide padding for your bones, tendons, and muscles. They also permit skin to slide over bone. But they can become inflamed and hurt. Most of the time, bursitis is treated with pain medicine and improves over a period of weeks.
  • Tennis elbow and golfer’s elbow: Both are forms of tendinopathy or tendinosis, in which the person has damage in his or her extensor/receiver tendon (what attaches that muscle to your bone) due to overuse. Although the name does imply a golfer or tennis player injury. You simply might as well be more likely to come down with them based on the armed actions necessary in those sports. The difference is that tennis elbow happens on the outside of your elbow, and golfers occur in view of within.
  • The most common is carpal tunnel syndrome, and that involves a nerve in your wrist being squeezed so it can cause some difficulty with your wrists and arm. Your elbow can have the same issues.
  • Cubital tunnel syndrome is when one of the major nerves in your arm (the ulnar nerve) becomes trapped as it passes through a tissue called the cubital tunnel, which runs along the inside part of your elbow. You might feel a burning sensation on your hand, arm, and fingers.
  • Radial Tunnel Syndrome: If you have radial tunnel syndrome, this means that the nerves associated with your arm are pinched as they cross through a small opening near the lateral part of your elbow called The Radial Tunnel. A sensation of your outside forearm and elbow burning or going numb.
  • Stress fractures: A small crack in one of your arm bones due to overuse is known as a stress fracture. So, thing occur many more frequently than in the elbow, often seen as “shinsplints” into lower extensions but a thrower (like a baseball pitcher) may have had one around an elbow. Pain is common, especially in throwing.

Diseases

  • Arthritis: Two main forms can affect your elbow, Rheumatoid arthritis and Osteoarthritis.
  • The most common type of arthritis in the elbow is rheumatoid. A condition in which your immune system attacks the body, which leads to swelling of joints is called Arthritis. Your elbow cartilage breaks down over the years and that’s how you end up with osteoarthritis- where your bones rub together, making it painful to move.
  • Osteochondritis dissecans: Occurs most often in children and adolescents, when a piece of bone along with its overlying cartilage gradually separates away from the end of the distal humerus within the elbow. A bone fragment and a bit of cartilage come off, triggering pain with exercise. The knee is most often affected, but the elbow may be involved as well.
  • Gout: Gout is a form of arthritis. What happens is that uric acid, which under normal circumstances should be excreted out of your body as a waste product, accumulates in the form of crystals inside tissues. If the buildup occurs in your elbow, it can be extremely painful.
  • Lupus: Another disease in which your immune system targets healthy parts of the body — especially your joints and organs. It most frequently involves the hands and feet, but it may affect your elbow.
  • Lyme disease: Transmitted by ticks, Lyme disease can have significant issues if left untreated. You may be diagnosed with a neurological problem such as pain in your joints or lower extremity (knee).

CAUSES OF CHRONIC NECK PAIN

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CAUSES OF CHRONIC NECK PAIN

Chronic neck Pain: Neck pain over 3 months. It can present with an endless variety of clinical manifestations from annoying occasional neck pain to devastating chronic and often disabling symptoms deleteriously affecting one’s quality of life. Cervical spondylosis is a broader term that describes conditions related to degenerative changes in the spine. It might include

Cervical osteoarthritis: Over time, the protective cartilage covering the surfaces of facet joints begins to break down and deteriorate due to wear and tear on these joint structures leading to Osteoarthritis (sometimes called degenerative arthritis) which just means “arthritis” in general terms.

Cervical herniated disc: Due to the tears, the jelly-like nucleus pulposus leaks out from the interior of the disc which suffers a lot as it is that tough outer layer known as annulus fibrosis. Inflammation proteins may trigger inflammation of the nerve root or the herniated segment can compress a nearby spinal nerve causing symptoms.

Cervical foraminal stenosis: Degenerative narrowing of the intervertebral foramen from disc involvement, ligamentous hypertrophy, and osteophytes can cause compression to a nerve root with sequelae in cervical radiculopathy.

Cervical central stenosis: The cause of myelopathy is that the spinal canal in the neck has narrowed and your cord got pinched.

Spondylosis is usually worn and torn with age but an injury could speed up this process.

  • Constitutional aspects like exposure to infection and conditions affecting the immune system that also play a significant role in causing back problems.
  • Traumatic injury due to a fall or collision can lead to an injury of the muscles, ligaments, joints, discs, or even vertebrae.
  • Frontal crash with seat belt restraints may cause whiplash — neck damage. Jetstar does any future Cervical degeneration and Instability. Force injury and falls in collisions, contact sports, or athletic events.

Slip-on wet floor

Falls (downsteps, off ladders)

Though neck pain often resolves with healing from an acute injury, in some cases the pain can be ongoing and persist as a chronic condition. Bad posture is the king of all bad habits that lead to neck pain. This neutral position for the cervical spine ideally should be an open chest, shoulders back, and ears aligned above your shoulders, which can become difficult to maintain because you stay slouched with your head drifting forward while sitting in front of a screen for long hours daily. This can speed up the degenerative process and may lead to neck pain.

Fibromyalgia: Fibromyalgia (fi-bro-my-al-juh) is suspected when widespread pain and tenderness are accompanied by fatigue, but fibromyalgia can be difficult to diagnose. The neck and upper back are a typical example of trigger points that manifest in patients with Fibromyalgia. The most common tender points are located in the neck and upper back.

Spondylolisthesis: This is indicated by one vertebra slipping over the top of the base vertebra. Such mechanisms may involve vertebral fracture, ligament laxity, and/or advanced disc degeneration -all causing spondylolisthesis.

Most neck pain is caused by Tumors and Infections,these are the rare causes of neck Pain.

There are also many other, less common causes of chronic neck pain like spinal tumors or infections

GOLFER’S ELBOW/MEDIAL EPICONDYLITIS

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GOLFER’S ELBOW/MEDIAL EPICONDYLITIS

Introduction

Medial epicondylitis, or more commonly known as golfer’s elbow is a tendonitis/tendinopathy of the common flexor tendon which sits on the inside part (medial) of your elbow. This is often caused by repetitive stress activities that overload the common flexor tendon Golfers account for a significant portion of sports-related cases among these, with the usual suspects being those involving an overhead throwing activity. The medial epicondyle is where the bony humeral ulnar-sided attachment for muscles of the common flexor tendon occurs.

COMMON TERMINOLOGIES

  • Medial Epicondylitis
  • Medial Epicondylalgia
  • Golfer’s elbow
  • Pitcher’s Elbow
  • Common Flexor Tendon of Elbow tendinosis/tendinopathy

ETIOPATHOGENESIS

Symptoms could be triggered by hand and arm movements (including the wrist), such as grasping, lifting, twisting, or bending. Golfer’s elbow tends to happen within people who engage in an activity where the flexor muscles are overworked which they are generally not used to or if you use your demands daily repetitive strain of the flexor muscle. The term golfer’s elbow is a bit of a misnomer as medial epicondylitis much more often occurs with other overuse activities.

The most accepted theory is that repetitive loading of the common flexor muscles causes micro-tears at the tendinous origin, triggering an inflammatory response. In chronic Tendinosis, the remodeling of the collagen fibers results in a thickening tendon as it progresses. Calcification may also occur with it.

The likely causes may be

  • Occupations demanding manual labour such as wood chopping, repairing automobiles, painting and hammering can produce repetitive load on the flexor muscles.
  • Sporting activities such as golf, weightlifting or sports involving overhead throwing actions like javelin and short put can lead to medial epicondylitis.
  • Working at a computer for long hours.
  • Cooking involving regular chopping and peeling.

PREVALENCE

Golfer’s Elbow occurs in not more than 1% of the population. Being predominantly noted in patients of 40–60 years. Its counterpart Tennis Elbow (lateral epicondylitis) is known to be very common in the community. Preponderance is equally balanced in men and women.

SYMPTOMS

The usual complaint from patients is dull aching pain on the medial/inner side of the elbow. Epicondylitis pain radiates down to the forearm and wrist from a bony prominence (medial epicondyle).

Such activities like writing and lifting which require the wrist to be bent may worsen pain. The symptoms are likely to be aggravated while making sudden jerky movements as can occur in golf or overhead throwing games, etc.

Some patients may have difficulties grabbing objects and others with more severe symptoms could even report a slight decrease in their grip strength. Rest often settles the symptoms but there may be residual achiness that does not allow for sleep either, and concerns patients with potential ulnar nerve involvement

Ulnar nerve involvement may be additional in up to 20% of patients. Symptoms often include numbness and tingling over the ulnar nerve distribution down to 5th followed by a hand condition shown secondary in weakness/stiff elbow accessed.

CLINICAL EXAMINATION

A patient may appear unwell with acute swelling, redness, and warmth; in chronic cases, this symptom complex is less often encountered. Pain is commonly elicited by palpation just anterior and distal to the medial epicondyle.

There are two parts to the clinical testing for golfer’s elbow / medial epicondylitis; an active and a passive component.

For the active component, the patient should resist wrist flexion with the arm in extension and supination. For Passive Component Wrist Extension with Elbow in Extension. If these provocative maneuvers produce pain, the golfer’s elbow should feature highly in the clinical differential diagnosis. Clinical assessment must incorporate ruling out ulnar neuropathy

There may be erythema, swelling, or warmth on the exam in acute cases; chronic events have less chance of revealing any abnormalities. Localization tenderness will be at the site or 5-10 mm distal and anterior from it in an area close to the conjoined tendon if not combining both groups

The golfer elbow test / medial epicondylitis test has a passive and an active component. The patient actively resists wrist flexion while the arm is in extension and supination. The passive element involves being in wrist extension with the elbow extended. A positive test is one in which the patient describes pain with this maneuver.

However, the difference is that Tinel‘s test should be used to evaluate for ulnar neuropathy and stress particularly applied to the ulnar collateral ligament in a throwing athlete.

INVESTIGATION

A diligent history and physical exam are typically highly suggestive of the diagnosis, but imaging studies such as musculoskeletal ultrasound or MRI of the elbow may be performed to confirm the findings.

TREATMENT

For most cases of golfer’s elbow, conservative management is recommended. It means: to enforce that constraint as far as possible, particularly within the constraints of an individual’s vocation. Medical management consists of anti-inflammatory medications. Use ice or cold packs when inflammation is at its worst. Modalities like Ultrasound, shock waves, and electrical stimulation have been tried. When it comes to physical therapy, eccentric exercises are key. Right Stretching and strengthening certainly is an integral part of the rehabilitation process. Other patients will be recommended with night splints.

Anti-Inflammatory injection: If a patient is in pain, Corticosteroids can be injected blindly or under image guidance at the inflamed site to take inflammation down so that they may start with their rehabilitation. To avoid such setbacks repeat steroid injections in the same area should be prevented.

Quadriceps Tendonitis

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Quadriceps Tendonitis

Introduction

Our body generally loads over the knee which is a major weight-bearing joint so it takes lots of stress as we age. Decades of stress on the joint can induce overutilization. This then causes stress, friction, and swelling of the quadriceps tendon and sometimes results in a torn tendon. This can present as an aching sensation over the knee and possibly includes swelling and reduced function of your quadriceps muscles. Causes For Quadriceps Tendonitis This overuse injury is commonly associated with sports that require constant bending and straightening of the knee such as running.

Relevant Anatomy

The quadriceps mechanism is the tendon from where the big muscle of the thigh, called as quadriceps converges. The patella is smack bang in the middle of that, it has within this a tendon that extends inferiorly from the patella and goes further down until inserts into the tibia on something known as a tubercle. The tendon is the remainder of the quadriceps mechanism in addition to the patella. Anatomically the tendon is referred to functionally as one but it consists of two different structures with an upper half, which corresponds to quadriceps tendon insertion on the patella, and a lower portion –the remaining part attaching to tibial tubercle–which corresponds to the real patellar attachment (patellar ligament), also known in first cell line anterior knee pain.

The quadriceps contracts, causing the knee to straighten. Both the leg bone(tibia) and thigh femur of the figure can act as levers with one articulating end (the transverse axis or pivot point). During the walking there are forces of up to 2-3 times body weight (foot and ankle joint reaction) with p a marathon runner which may climb up to around>5X’s this while completing running.

Causes

  • A cause for Quadriceps tendonitis, an overuse injury can be intrinsic or extrinsic.
  • Extrinsic- These are factors like using the wrong footwear, Following appropriate training protocols, and most importantly constant playing in training on hard unforgiving surfaces such as cement. Quadriceps tendonitis also can be affected by overtraining (either too long or too hard) and sudden changes in the level of training.
  • Predisposing factors are classified into Intrinsic are host specific factors like age, flexibility, and joint laxity. Some specific host characteristics predispose an individual area following:
  • Foot, ankle, and leg malalignment.
  • Flat foot (pes plants),
  • Patellar maltracking
  • Rotation of tibia
  • Leg length discrepancy
  • Obesity

Symptoms

Where patients usually feel the pain at the lowest part of their thigh a few cm above their kneecap. Pain at and around the tendon attachment, aggravated further by movements of the knee joint.

Sometimes the presentation may have swelling in the lower end of the thigh, Swelling is very tender to touch in some cases. Morning stiffness or symptoms on waking up from rest and prolonged immobility, as well after exercise.

Diagnosis

It is a clinical examination done after the thorough history taking. Usually, tenderness is elicited with palpation of quadriceps tendon insertion. An assessment of the knee is made with a view to a range of movements, detecting for laxity and integrity in their axial (AP/PA), coronal or sagittal planes. Intrinsic and extrinsic factors (i.e., sudden changes in training habits) affecting the knee should be ruled out by the clinician [9]. Proper alignment with the knee, foot, and ankle is also reviewed. In the case of quadriceps tendon rupture with gap can be felt at the insertion site. Weakness in the extensor mechanism is often synonymous with a dysfunction of the quadriceps.

An X-ray of the knee can demonstrate fractures or calcific deposits in the quadriceps muscle but this will not pick up soft tissue injuries. Tears, tendonitis, and tendinosis are diagnosed with high-definition Ultrasound and MRI. The utility of ultrasound even extends to the guidance for Regenerative treatments such as Platelet Rich Plasma and Prolotherapy.

Treatment

CONSERVATIVE TREATMENT

The first Effective Treatment employed would involve Rest, Ice, Elevation and anti-inflammatory Drugs.

The answer to that is relative rest… followed by some very gradual increase of activities which will enforce the physiology behind recovery. However, immobilization is the first thing to be done for a patient who has pain at rest with a splint or brace. Relative rest → a detail of the resting-to-recovery process varying in intensity according to symptoms. If the pain is at rest, then full immobilization is strict. brace or splint will be for a short duration of time. Progressive activity as such is permitted only when it will not cause a return of the resting pain.

Rehabilitation is not complete without physical therapy. Ice massage, local ultrasound application, and electrical stimulation are all modalities that help to keep the pain and inflammation under control. Stretching and strengthening are the means by which we correct those imbalances of muscle dominance. Eccentric Muscle strengthening is useful in cases where the primary cause of pain is excessive eccentric muscle loading during weight-bearing closed-chain kinetic activities. (Open Chain- foot is free from ground)

SURGICAL INTERVENTION

Rehabilitation is not complete without physical therapy. Ice massage, local ultrasound application, and electrical stimulation are all modalities that help to keep the pain and inflammation under control. Stretching and strengthening are the means by which we correct those imbalances of muscle dominance. Eccentric Muscle strengthening is useful in cases where the primary cause of pain is excessive eccentric muscle loading during weight-bearing closed-chain kinetic activities. (Open Chain- foot is free from ground)

Tennis Elbow/Lateral Epicondylitis Explained

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Tennis Elbow/Lateral Epicondylitis Explained

Tennis elbow, also known as lateral epicondylitis causes tenderness and pain in the outer side of the elbow. The common extensor origin is the part of the elbow where all the extensor muscles of the forearm originate on the humerus (bone) It involves the tendon of the Extensor Carpi Radialis Brevis most commonly. Degenerative changes are most widely identified where the tendon attaches to bone. The attachment is weakened, which as you can imagine results in more tension in the area since it breaks up the tendon from the bone. Tennis and many activities that require repeated gripping, grasping, or lifting movements are common offenders of tennis elbow progression. Most of the time in the age group 30-50, is commonly seen and there is no gender preponderance.

Why Does Tennis Elbow Occur?

Everything that might overload the extensor tendons of the forearm, notably when our palm gets into a position facing down, can promote micro tears and inflammation seen in Lateral epicondylitis/tennis elbow.

Such types of activities include

Repeated gripping or holding activities idiopathically driven two-wheeler riding, playing tennis, carrying and pushing heavy objects
Activities like typing words of tools on a daily basis cause the extensor muscle to a repetitive load. is a painful condition that occurs when the tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm.
Direct trauma or blow to the elbow can bring about inflammation of a tendon resulting in degeneration as well.

Symptoms

Bothering outer elbow symptoms, most notably. The lateral epicondyle is the bony point of tenderness. Pain increases with activities such as gripping, pushing, and grasping Pain may be experienced localized to the lateral epicondyle, but some patients could have pain radiating down to the forearm.

Diagnosis

These types of injuries are usually very suggestive history and clinical examination but can be confirmed by imaging (Ultrasound or MRI elbow).

Treatment

Had I wanted to take the more conservative approach, I could have only stopped or substantially slowed doing simple tasks like typing or gripping. Anti-inflammatory medications may be prescribed for patients. Tennis Elbow Splints/Braces: These braces can help take some of the strain off the elbow extensors. Manual massage, ice massage, or modalities like Ultrasound in physical therapy have been used to provide symptomatic relief of lateral epicondylitis. Taping the painful elbow can be another approach used in addition to these.

Tennis Elbow Exercise Protocol

Stretching and strengthening the muscle groups involved are essential to any rehabilitation program. Exercises broadly include

  • Forearm extensor
  • stretch
  • The muscular eccentric Extensors of the Wrist
  • Wrist Extension Isometric Strengthening
  • Isotonic Wrist Extensor Strengthening

Anti-Inflammatory injection- Corticosteroids can be blindly injected over the inflammation or image-guided using an imaging modality (eg. Multidetector CT scanner/X-ray) to restain the inflammation so that the patient can take rehabilitation). Steroid injections should not be given in the same area back-to-back

PRP and Phototherapy

This is a very good treatment with Ultrasound-guided platelet-rich plasma with Prolotherapy) as it works to heal the damaged tendon. So, 2-3 sittings of PRP with prolotherapy along wed regular exercises have been quite effective in controlling the troublesome symptoms of tennis elbow.

Stem Cells: Stem Cell injection has been attempted in a few chronic cases into the damaged tendon.

Surgery- Arthroscopic: (or) open surgery for removal of the degenerated tendon in chronic, resistant cases not responding to non-operative means.

Forearm extensor stretch

Keep your arm straight and bend the elbow slightly.
Now just curl your fingers and the other hand over your knuckles. Pull the affected arm hand and wrist gently further inward until you can feel a small stretch along your arm. You want to make certain that there is some pressure from the pull in your arm, but you should not be pulling so hard that the pull hurts.

Eccentric Lean-to Fist with the Wrist Extensors

  • Gently place your affected arm on a table with the hand hanging free over the edge.
  • Use the other hand to raise the hand of the affected arm into elevation. Maintain this grip with your hand as you release the hand assisting.
  • Gently encourage the hand of your affected arm to return to neutral (hanging). They then lower the weight back down in a slow manner which is referred to as “controlled release” or an “eccentric muscle contraction”.
Isometric wrist extensor strengthening
  • Place your affected arm on a flat surface with your wrist extended beyond the edge of the table.
  • Apply downward pressure on the hand of the affected arm with one of your hands while keeping the wrist out straight.
Wrist Extensor Isotonic Strength

Place the arm of those affected face down on a table or in your lap, and let your hand hang over the edge.
Lift and lower your hand by bending the wrist.
These are the joints at which the muscle attaches to the bone via tendons. In this condition, the involved muscle, the Extensor Carpi Radialis Brevis, is an important wrist extensor for maintaining the stability of the wrist.

Cause

Tennis elbow, on the other hand, is when you damage some of the muscles in your forearms that aid you in extending your wrist and fingers. Excess or repeated stress to the tissue can cause small tears in the tendons that connect on the outside of the elbow.
Tennis elbow can develop if any activity is played on the upper limb in pronation performed by turning the arms face down. These activities include:

  • Similar jobs are performed several times:​ Typing, using tools, etc.
  • Activities that require prolonged gripping, such as riding a motorcycle or bicycle, working with vibrating tools, and pushing or carrying heavy loads.
  • Trauma: A direct blow to the elbow can cause the tendon to swell, which may trigger degeneration. A rapid force or activity also could harm the tendon.
Who gets it?

Most people with this condition are between ages 30 and 50, although it can occur in those younger and older, as well as in both men and women.

Signs and Symptoms

Patients historically seek medical attention for pain. Pain over the lateral (outside) aspect of the elbow, over an area of bone called the lateral epicondyle. And this area gets sore when you touch it. Any activity which overloads the tendon, such as gripping or lifting, will cause pain. Pain with activity usually starts at the elbow and may travel to the hand down the forearm. Sometimes, pain can occur with any elbow motion. Tennis elbow pain may develop gradually or can occur suddenly. Symptoms can include

Care at home Home care Management of tennis elbow
  • Adjusting activity and rest: In the short term, the FFWZ as a condition should be reduced – Rather, the recommendation is to limit that aggravating activity; not total rest.
  • Medicine: Anti-inflammatory medicine might help control the pain.
  • Brace: wearing a tennis elbow brace, which is worn around your forearm muscle and just below the elbow will decrease tension on the tendon making it easy to heal.
  • Taping: Tape your elbow to provide support to the soft tissues. You may want to consult a physical or occupational therapist on how to tape your elbow.
  • Apply ice-icing the knee multiple times per day helps reduce pain.
  • Ice pack application: Hold the ice pack up to your skin with a towel. Apply the ice pack to the painful area for 15–20 minutes. Every five minutes, check your skin to make sure you are not damaging it.
  • Ice massage: Apply an ice pack, and massage around the elbow area for about 5 mins as a loop process [14].
  • Manual massage:  A good massage is known to help improve blood circulation, reduce sensitivity, and relieve pain in the bladder. Learn how to massage from a physical or occupational therapist.
Exercises

This May Help Stretching and Strengthening for Tennis Elbow Exercising helps to keep the muscles strong so that they can support you as your body recovers. For many people, this relief from pain starts almost immediately after exercise.

Neck Muscle Sprain

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Neck Muscle Sprain

The neck, muscle, and sprain are so regular among individuals now. A neck muscle sprain can aggravate it or in the worst case worsen it. A neck sprain occurs when there is a stretch in the muscle or ligament of the neck. That would be the typical thing like a bump into something, or going that extra little bit when you should have stopped twisting for example; or some sort of accident. Therefore, there are many causes of neck muscle sprain. If a sprain is mild it will heal without treatment in days to weeks. This is a stark, real pain—hard or tougher or excruciating; it hurts. Getting medical intervention right away will prevent the condition from becoming severe.

Consulting with the best neck specialist doctor will help you get the best treatment process.

When should you see a doctor for treatment?

Usually, the strain triggered by a neck sprain will take days or weeks to heal. People often feel that during neck muscle sprain, they cannot even move side to side, it also occurs when it is extremely painful. Thus consulting the right doctor and getting proper treatment can make the recovery rate high.

Neck Muscle Sprain Diagnosis

Your condition will be accessed by an expert neck specialist doctor. A physical examination may be in order if your doctor wishes to observe how you move, stand, and sit. Neck Specialist Center has reputed advanced facilities, resources, and tests to identify a genuine solution for the ailment.

Cure for Neck Muscle Sprain

When you visit the neck pain clinic, they use some effective techniques to treat neck muscle sprain. Once a precise cause is identified for the neck muscle sprain, your neck pain doctor will employ the best method to treat your disorder in a risk-free manner.

  • Medications over the Counter: Medications that can be taken to help relieve pain and reduce swelling are prescribed.
  • DO NOT: USE HEAT AND COLD PADS On the advice of your surgeon, you should use heat or cold pads for the sore areas If there is any swelling keep it down.
  • Workouts: Doing light workouts will help in movement and increase flexibility.
    Physical Therapies: A physical therapist will be assigned for your chronic neck muscle strain which helps in reducing the inflammation and pain.

Picking the right clinic for your neck muscle sprains and spasm needs with best way to take. Many neck disorders have been treated at Alleviate Pain Clinic successfully by the seasoned and valued hands of their qualified neck pain specialist doctors. Anyone suffering from neck pain, experiencing numbness or stiffness of the neck should book an appointment with their doctor as soon as possible.

Frozen Shoulder treatment in Punjab

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Frozen Shoulder treatment in Punjab

Frozen shoulder is quite common now. Many people complain about pain & stiffness in their shoulder joints, which can even cut down on how well you can move. Folks also call it adhesive capsulitis. Your shoulder has three bones that form a ball-and-socket joint (yep, that’s what it’s called). This joint involves the upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). Together, they are known as the shoulder capsule. When someone deals with a frozen shoulder, this capsule gets thick and tight. That means less movement and more pain. Ignoring it can make things worse. It might last anywhere from 1 to 3 years or even longer.

Best treatment for Frozen Shoulder

Before starting any treatment, your specialist will ask for some tests. These tests will help figure out just how bad things are and the best way to treat it. Usually, surgery isn’t needed – which is good news! People often get back to their normal activities without going under the knife.

For Frozen Shoulder Treatment in Punjab—Book An Appointment!

Here’s how frozen shoulder can be treated

Over-the-counter Medication – Your pain specialist will prescribe meds like paracetamol or ibuprofen to ease pain and help you move your shoulder again.

Hydrodilatation – A fine needle goes into your shoulder joint with ultrasound or X-ray guidance. Then, an injection with corticosteroid, local anesthesia & sterile water is given.

Nerve Blocks – Here, the doctor gives you general anesthesia to block pain signals from your nerves through minor surgery using nerve stimulation or ultrasound.

Exercise and Physical Therapies – Easy exercises & physical therapy tailored by a therapist can strengthen your shoulder, reverse stiffness & improve motion range.

You might find relief with just one treatment or a mix of them

If you need top-notch frozen shoulder treatment in Punjab, understanding non-surgical success rates is key. A good center will have experienced pain specialists & standout physiotherapists who know how to boost movement and ease stiffness.

Amandeep Hospital is your go-to for frozen shoulder treatment in Punjab. It’s advanced & home to highly reputed doctors and physiotherapists who can help you get better fast!

Monsoon Brings Rain & Pain — How To Take Care Of Joint Pain?

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Monsoon Brings Rain & Pain — How To Take Care Of Joint Pain?

It’s monsoon time! The season brings both joy and woe. With the rains, we also get joint pains. Here’s a helpful guide to watch out for specific aches and how to take care of yourself.

Monsoon is a happy time for many. The rains are refreshing & bring greenery back to life. But, it can bring some sadness too. Along with the rain, comes joint pain. Folks with bone disorders and those older than 60 often complain during this season. But you know what? Joint pain can affect others too.

What Causes Joint Pain During Monsoon?

Studies show that people with arthritis and bone-related issues feel more pain in monsoon compared to other seasons. What’s to blame? Barometric pressure. It’s the weight of the air around us. When barometric pressure is high, it keeps your body tissues from swelling. Before it rains, this pressure drops, causing tissues to expand and create pain.

Higher humidity levels also play a part, thickening blood which increases blood pressure. This causes your body to work harder and results in dehydration. Less fluid around joints leads to pain.

How to Manage Joint Pain in Monsoon?

Exercise is key to managing joint pain in monsoon. Regular stretching and physical activities will keep such pain in check while stretching twice a day is highly recommended. Avoid sitting for long hours! If work requires you to sit for long periods, make sure you stand up & walk every half an hour or so. If your room has air conditioning, it might make the pain worse, so get moving every 30-40 minutes. Weight can also add to the pain, so work on keeping it in check. Extra weight puts more pressure on your joints, increasing the pain. Make sure your diet has vitamins and Omega-3 fatty acids. If the pain doesn’t go away after three weeks, it’s called chronic pain and you need to see a doctor. The doctor might ask for a blood test to find out what’s wrong. They may also suggest changes in diet or lifestyle, maybe even physical activities or physiotherapy.

What Can Amandeep Hospitals Do to Help Relieve Pain?

Pain management is crucial when dealing with joint pain—it’s not a common term here yet. We specialize in it with treatments like modern regenerative medicine & radiofrequency ablation to relieve pain.

Chronic Low Back Pain (CLBP)

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Chronic Low Back Pain (CLBP)

What is CLBP?

Chronic low back pain (CLBP sticks around in the lower back for at least 3 months. This pain is a big reason people have trouble moving and working all over the world. The number of adults with CLBP has more than doubled in the last ten years and is up fast, especially among older folks. It messes with how people can function normally & go about their daily jobs. Sunshine and rain both? Yup, it can even get worse due to stress, depression & anxiety. Because it’s so tricky, diagnosing CLBP isn’t a walk in the park and needs careful thought by doctors.

Where Does The Pain Come From?

The pain in the lower back can come from different places:

  • Discogenic Pain: This one’s pretty common. It usually stays in the lower back area. Our discs have an outer annulus fibrosis and a nucleus pulposus inside. When the disc dries out or gets messed up, this nucleus moves out through cracks. This hike in local blood flow and nerve activity causes classic discogenic pain.
  • Radicular Pain: If the pain shoots from your back to buttocks and legs (known as sciatica), it’s radicular pain. Most of the time it’s because of ectopic signals from the spine’s dorsal root or its ganglion, often due to a herniated disc. It’s more tied to nerve inflammation than just nerve squeezing. Doctors match symptoms with MRI findings to figure this out.
  • Spinal Stenosis: Over time, narrowing of central canals & side spaces can squeeze the spinal cord and nearby nerves & vessels. Causes? Could be discs pushing out, thick ligaments, overgrown bones, or even old surgery scars. Patients get clumsy legs, odd feelings, or weakness especially when standing for long periods but feel better bending forward.
  • Facet Joint: These joints help our vertebrae move together and get achy too like any load-bearing joint. The pain is mostly centered near the spine but doesn’t go past the buttocks much. Around 30% of CLBP may come from these joints with pain starting in its synovial membrane or nearby tissues.
  • Sacroiliac Joint Disease: These joints linking our spine to pelvis help us stay upright with little movement allowed. Pain shows up around the upper parts of the hips but doesn’t reach all way down like sciatica does. Sitting long or bad postures make it worse – possibly coming from arthritic bones or irritated tendons/ligaments around these joints.
  • Piriformis Syndrome: This issue feels like sciatica with pain mainly in buttocks area because the piriformis muscle irritates the sciatic nerve.

Other Causes of Pain

There are other things that can spark up low back pain too:

  • Thickened inflamed ligaments (like ALL, PLL, Interspinous ligaments)
  • Fractures
  • Myofascial pain points

It’s clear lots is going on with chronic lower back pain – making it tough on those who deal with it every day!

Back Pain Treatment — The Beginning & The End

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Back Pain Treatment — The Beginning & The End

Back pain is something a lot of grown-ups deal with – about 8 out of 10, to be exact. The reasons causing back pain vary, just like how strong the pain can be. However, solutions are pretty limited. Well, not anymore! Amandeep Hospitals has got answers. For many people, back pain gets in the way of their daily activities. Sometimes, even bending over to pick something up can be super hard. For others, carrying stuff or just sitting can feel impossible. Back pain affects nearly 8 out of 10 adults. The severity can vary depending on the person’s symptoms and how serious it is. Many folks search for answers and end up getting pricey surgeries that don’t always cure the pain. Some just give up and try to live with it.

What Causes Back Pain?

Lots of things can cause back pain – straining a muscle or ligament, getting hurt, lifting heavy stuff, sitting or lying down for too long, or even wearing a bad backpack. Causes can also include cases like a slipped disc. When that happens, treatment is crucial.

More serious causes of back pain might include:

Arthritis: Arthritis can sometimes mess with the spine, causing back pain. It leads to ‘Spinal Stenosis,’ which narrows the space around the spinal cord and causes pain.

Skeletal Irregularities: This happens when the spine curves to one side causing pain; it’s called scoliosis and usually affects people in middle age.

Slipped Disc: A slipped disc puts extra pressure on nearby nerves & muscles, leading to numbness or weakness in your arm or leg. There are over 10 million cases of slipped discs each year; it’s quite common.

Other factors include age & smoking. Smoking reduces blood flow to your lower back and stops your body from delivering the nutrients needed to keep your back healthy. It also slows down healing.

Symptoms of Back Pain

Back pain symptoms include muscle aches in your back – upper or lower – and sharp or stabbing pains along your spine, sometimes spreading downwards to your legs. Even simple tasks like bending, lifting, sitting, or standing might hurt. In severe cases, there could be numbness or a tingling feeling in your legs.

When Should You See a Doctor?

It’s time to worry if the pain doesn’t go away after resting or if you get new bowel/bladder issues; if it spreads down to one leg (or both), or if you lose weight without trying. Certainly see a doctor if back pain lasts more than 10 weeks—some form of treatment will be necessary by then.

Lots of folks try home remedies for chronic back problems like slipped discs but don’t get great results. That’s when seeing a professional who specializes in pain management becomes important.

Why Choose the Experts?

Amandeep Hospitals has several branches across Punjab. Their team specializes in offering non-surgical solutions for managing pain effectively. Over time, patients have gotten great treatment for their back pain and regained mobility! Doctors at Amandeep Hospitals use modern regenerative medicine as well as radiofrequency ablation to help people who thought they’d never find relief from their pain. The idea of managing pain optimally is quite new & aims to spread awareness across India about these advanced methods!