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Back, Hip & Shoulder Pain

Back pain is often a common symptom of many disease conditions and the back pain may range from simple or dull pain to sudden and sharp pain. If the pain persists for few days, it is acute pain whereas if continues for more than 3 months, it is considered as chronic pain. In most cases, back pain may resolve without any treatment however if persists for more than 3 days, medical intervention is necessary.

Back pain may be a common symptom in various conditions such as appendicitis, aneurysms, kidney diseases, kidney and bladder infections, ovarian disorders, pregnancy, nerve root syndromes such as sciatica, herniated discs, spinal stenosis, musculoskeletal problems, osteomyelitis, spondylitis, tumors, spine injuries, fractures, and many more.

Back pain can be alleviated with rest and RICE (Rest, Ice, Compression, and elevation) treatment, pain relievers, nonsteroidal anti-inflammatory drugs, corticosteroids, and physical therapy. However certain conditions causing severe pain may require surgical treatment. Treating underlying conditions offer the relief from back pain.

One of the common causes for back pain is low back strain. Low back strain or lumbar strain occurs when the muscle or the tendon in the lower back gets stretched or torn. It is caused by lifting heavy objects or overload, sitting or standing for a longer time, direct blow over the area, or sports such as basketball, baseball, or golf that involve sudden twisting of lower back can also lead to strain.

The risk factors such as excess low back curvature, weak abdominal muscles, and forwardly tilted pelvis can increase the risk of this injury.
The common symptoms include low back pain that radiates down to the buttocks; inflammation of the soft tissues that surround the muscles; stiffness in the low back; restricted movements; inability to maintain correct posture; muscle spasms; and pain which continues for a longer period.

Your doctor will perform a physical examination and take a brief medical history to diagnose your child's condition. Other additional tests such as X-ray and MRI scan may be required to confirm the injury and provide necessary treatment.

The conservative treatment methods include:

  • Rest: Your child should take complete rest for 1-3 days, as more damage could result from putting pressure on the back. Prolonged bed rest should also be avoided as it leads to loss of muscle strength and makes the muscles stiff which will aggravate pain and discomfort. Hence bed rest should not be continued for more than 48 hours.
  • Ice packs can be applied to the injury which will help to diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
  • Braces or belt might be used to support the back while the healing happens.
  • Medications that may be prescribed include nonsteroidal anti-inflammatory drugs to reduce pain and inflammation. Other medicines such as muscle relaxants control muscle spasms. These medicines often cause sedation; therefore, consult your doctor to discuss about the type of muscle relaxants for your child.
  • Your doctor may also suggest a rehabilitation program for your child. It consists of stretching and strengthening exercises, pelvic traction, gentle massages, and ice or heat therapy to improve your child's condition. It helps to control the pain, strengthen the abdominal muscles, and also speeds up the recovery which allows your child to return to the weight-bearing activities.

Some of the preventive measures which can help prevent back strain in children include:

  • Doing warm up exercises before the start of any physical activity or sports and taking short breaks in between the activity.
  • Ensure that your child uses correct lifting techniques such as squatting to lift a heavy object.
  • Ensure that your child maintains a proper posture while sitting and standing.
  • If your child is overweight or obese, it can strain the back muscles. Hence it is advised that your child lose some weight and maintain a healthy diet.
  • Encourage your child to exercise everyday as it improves spine stability and also prevents extra stress on your child's back.

Hip Pain

Hip pain, one of the common symptoms patients complain of, may not always be felt precisely over the hip joint. Pain may be felt in and around the hip joint and the cause for pain is multifactorial. The exact position of your hip pain suggests the probable cause or underlying condition causing pain. Pain felt inside the hip joint or your groin area is more likely to be because of the problems within the hip joint. Likewise, the pain felt on the outer side of your hip, upper thigh or buttocks may be a result of the problems of the muscles, ligaments, tendons and soft tissues surrounding the hip joint. However certain disease conditions affecting other parts of your body such as lower back or knees also cause hip pain.

The main cause of sudden pain in the hip is an injury resulting in fracture of the hip bone. Hip fractures are common in the elderly individuals because the bones wear out as age advances. Other causes of hip pain may be arthritis, bursitis, infection, low back pain, osteonecrosis of the hip, sprains or strains and tendinitis resulting from repetitive use. Your doctor will evaluate the condition based on the medical history, physical examination of the hip and thigh region, and diagnostic tests including X-rays and other scans.

Self-care and pain relieving anti-inflammatory medications offer symptomatic relief. However the exact cause for the pain needs to be addressed. Practicing certain measures can avoid aggravation of pain and also improve the quality of life. Avoiding physical activities that may worsen the pain, stretching the quadriceps and hamstring muscles, performing warm up exercises before actual exercise regimen improve the condition. Applying ice packs over the region of pain for about 15 minutes three to four times daily reduces both pain and swelling. But if you have an injury with severe hip pain and swelling, talk to your orthopaedic surgeon immediately for better treatment outcomes.

Shoulder Pain

Pain in the shoulder suggests a shoulder injury and shoulder injuries are more common in athletes participating in sports such as swimming, tennis, pitching, and weightlifting. The injuries are caused due to the over usage or repetitive motion of the arms.

In addition to pain, shoulder injuries also cause stiffness, restricted movements, difficulty in performing routine activities, and popping sensation.

Some of the common shoulder injuries that cause pain and restrict the movement of shoulders include sprains and strains, dislocations, tendinitis, bursitis, rotator cuff injury, fractures, and arthritis.

  • Sprains and strains: A sprain is stretching or tearing of ligaments (tissues that connect adjacent bones in a joint). It is a common injury and usually occurs when you fall or suddenly twist. A strain is stretching or tearing of muscle or tendon (tissues that connect muscle to bone). It is common in people participating in sports. Strains are usually caused by twisting or pulling of the tendons.
  • Dislocations: A shoulder dislocation is an injury that occurs when the ends of the bone is forced out of its position. It is often caused by a fall or direct blow to the joint while playing contact sport.
  • Tendinitis: It is a inflammation of a tendon, a tissue that connect muscles to bone. It occurs as a result of injury or overuse.
  • Bursitis: It is an inflammation of fluid filled sac called bursa that protects and cushions your joints. Bursitis can be caused by chronic overuse, injury, arthritis, gout, or infection.
  • Rotator cuff injury: The rotator cuff consists of tendons and muscles that hold the bones of the shoulder joint together. Rotator cuff muscles allow you to move your arm up and down. Rotator cuff injuries often cause a decreased range of motion.
  • Fractures: A fracture is a break in the bone that commonly occurs as a result of injury, such as a fall or a direct blow to the shoulder.
  • Arthritis: Osteoarthritis is the most common type of shoulder arthritis, characterized by progressive wearing away of the cartilage of the joint.

Early treatment is necessary to prevent serious shoulder injuries. The immediate mode of treatment recommended for shoulder injuries is rest, ice, compression and elevation (RICE). Your doctor may also prescribe anti-inflammatory medications to help reduce the swelling and pain.

Your doctor may recommend certain exercises to strengthen shoulder muscles and to regain shoulder movement based on the type and severity of injury of following a surgical correction of shoulder injury to regain the strength to the muscles in shoulder.

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