Musculo-skeletal Care

Services Musculo-skeletal Care
Musculo-skeletal Care

Neck Pain

What is cervical spondylosis[ neck -pain]?

Cervical spondylosis is common degenerative disorder of neck which involves changes to the bones ,joints and discs of the neck… and these changes are caused by normal wear and tear of ageing . with age disc of cervical spine dehydrate and become stiffer.
Cervical spondylosis is very common and worsens with the age .
more than 85 % people above 60 yrs of age may suffer from this disease. Most of people don’t feel any symptoms related to this problem. For some persons it can cause chronic severe pain,stiffness, vertigo.

Causes for cervical spondylosis [neck-pain]

Factors that increase risk of cervical spondylosis or neck pain includes ..

• Occupation – which put extra strain on neck like long computer work, type –writing,jewellery, checking work of teachers.
• Past Neck trauma or injury
• Smoking
• Family history
• Being over weight
• Gymnasts or other athelete
• Rupture or slipped disk

Symptoms of cervical spondylosis [neck –pain]

Most of the patient don’t feel significant symptoms if symptoms occur they vary from mild to severe and may occur gradually or suddenly.

• Stiff and painful neck.
• There will be pain along the shoulder blade which may radiate to arms and finger and this pain may increase while standing,sitting,sneezing.
• Headache that occurs in back of head travels and to forhead .
• Numbness and tingling that affects shoulder and arms.
• In some cases vertigo on turning neck may be one of the symptoms.
• Muscle weakness and spasm.
• Trouble walking or loss of balance.


• At office while sitting at work don’t felx head forward with stooped back.
• In order to avoid strain on neck Take small breaks while working on computers ,driving,watching tv.
• Do turn to one side while getting up in the morning.
• Use cervical collar in case of giddiness.
• Use seat belt while driving.
• Use towel roll under the neck while lying straight on bed.
• Last but very important –your arms should be supported in one of the three position……….

  1. Hands on table/thighs.
  2. Hands in pocket.
  3. Hands behind back with elbow straight.

• Take proper rest if there is acute attack.
• Follow regular exercise Take [ under health pprofessionals] and healthy life style .
• Use firm mattress and thin pillow.


• Don’t lift heavy objects on head or neck.
• Don’t exercise in acute attacks.
• Don’t drive for long hours take breaks.
• Avoid hanging of arms .
• Don’t bend your neck instead turn around your bosy by using your feet.
• Don’t sleep straight.
• Avoid habit of taking phone calls on one shoulder and leaning on it.

Frozen Shoulder

What is frozen shoulder[ adhesive capsulitis ] ?

Frozen shoulder is painful condition which is characterized by pain , stiffness and restricted movements in the shoulder joint. When tissue around the joint gets thicker , tighter and scar tissue is formed which makes the shoulder movements restricted and painful.
Symptoms typically begin gradually worsen over time and then resolve in few years .
Frozen shoulder commonly occurs in people between age of 40 to 60 yrs.women tends to suffer more than men.
It typically affects one shoulder joint at a time .

Causes of frozen shoulder :

1.   Shoulder injury
2.   Diabetic patients are 2-4 times more prone for this problem for unknown reasons.
3.   Immobility –prolonged immobility of shoulder joint [ fracture ,recent surgery, broken arm] are at higher risk of developing frozen shoulder joint.
4.   Hyperthyroidism
5.   Hypothyroidism
6.   Heart disease
7.   Changes in your hormones as during menopause.
8.   Parkinson’s disease

Symptoms of shoulder joint :

There will be decreased and painful movement of the shoulder joint.
Stiffness at the shoulder joint is another symptom.
Pain typically worsens at night.
There are three stages of symptoms in frozen shoulder each stage last few months :
Freezing stage [ any movement is painful and shoulders motions starts to become limited]
Frozen stage [pain is less but shoulder gets stiffer and using it becomes more difficult]
Thawing stage [ motions begins to improve]

Low-Back Pain

What is low back pain ?

Low back pain is one of the common painful condition of this universe and it affects most of the people at some point in their life it refers to the pain over the lower part of the back.
The lower part of our back bear one half of the body weight hence this point is exposed to maximum strains and stresses. And these stresses may lead to strained muscles and ligaments and muscle spasm.
Many people who have backache suffer from dull aching pain to sharp pain .it is generally triggered by bad posture while sitting or standing or lifting most of the cases there is no serious cause behind backache and many a times it resolves by its own.
Although it can be present at any age but is more common among adults aged 35 to 55 yrs.

What are the causes and risk factors for back pain

Following factors are linked to higher risk of developing back pain

•   Sedentary life style
•   Strenuous physical work or exercise [not done properly]
•   Pregnancy
•   Obesity
•   Older adults
•   Back pain is more common in females than males .
•   Depression and anxiety
•   Mentally and physically stressful job.
•   General poor health.
•   Athelets are more prone to get back pain.

Causes of low back pain

•   Mechanical causes 90% cases of low backache comes under this reason like trauma or injury to back,twisting motion ,bending improperly,lifting objets,poor postures ,long driving.
•   Structural causes
•   This includes ruptured or bulging disc each vertebra in our spine is cushioned by disks and if these discks ruptures or bulges it put pressure over the nerve which causes pain.

•   Arthritis and ankylosing sponylosis patients with these disease may get more problems with back and hip joint.

•   Osteoporosis is another reason behind chronic back pain.

•   Abnormal curvatures of spine like kyphosis ,lordosis ,scoliosis more likely to get backache.

•   Some other less common cause for back pain can be kidney stones ,cancer of spine ,infections like tuberculosis and osteomyelitis ,pelvic inflammatiory disease.
•   Persistant pain and stiffness over the lower back…in acute cases sudden shooting pain.
•   Pain may be mild or severe that patient cant even move .
•   Some times back pain may radiate from back to buttocks,thighs,calves and toes.
•   Back pain is more while coughing and sneezing .
•   In serious cases loss of bowl and bladder control in such situations patient should seek medical advice .

Complications or when to seek medical advice

•   In case of loss of bladder or bowl control.
•   If the person is unable to move any body part.
•   If backache is with fever.
•   Severe backache with weakness ,numbness, tingling of arms and legs .

Do’s in low back pain

•    Apply ice on injured part in first 24 to 48 hrs of accident as it reduces the inflammation.
•   Always follow healthy life style and perform exercise which includes swimming and walking etc as exercise can improve your posture .
•   During office hours make sure that your chair is neither too high nor too low and feet should touch ground. You should be seated at eye level to your screen.
•   Consume food which is rich in calcium and phosphorus and proteins.
•   Always perform back exercise under health care professionals.
•   Try to sleep on your back.
•   Always lift heavy objects in a proper manner like feet apart and back straight.
•   Be careful for your posture
•   Always maintain proper weight use diet and exercise to maintain healthy weight.
•   Always keep moving if back pain is not sudden and acute our spine is meant to move .

Don’ts in low back pain

•   Avoid prolonged sitting or standing take breaks in between and do some stretching and walking.
•   Avoid smoking which can cause osteoporosis.
•   Avoid too soft and comfortable bed while sleeping your bed should support your back completely.
•   Avoid high high heels .


What is Osteoarthritis ?[OA]

OA is degenerative joint disease which causes pain, swelling reduced movement in affected joints.

OA results from damage and loss of cartilage of joints ..cartilage acts like cushion between the two bones of the joint once the cartilage is lost bones rub together and over the time this rubbing can damage the joints.

This is most common and chronic form of arthritis ..this most commonly affect knees, spine, hip

OA is caused by ageing, injury and obesity and genetic predisposition.

OA generally occurs after the age of 50 .

Causes of osteoarthritis

Apart from genetic predisposition for OA being overweight can put additional pressure over the j0ints like knee and hips and can lead to fast degeneration of cartilage .

Repeated movements and injury to the joints can lead to OA. some other factors like rheumatoid arthritis and metabolic disorder [acromegaly, hemochromatosis]

Symptoms of Osteoarthritis

• Pain ,swelling ,tenderness and stiffness of the affected joints.
• Creaking sound on bending the joints .
• Warmth of the joint.
• Pain is worse after activity or long period of inactivity.
• Limited rage of motions which goes away after movement.
• Inability to sit down or squat.
• Bony enlargement of small joints of hand [herberdens nodules]
• Neck or low Backache .
• Limping in later stages.

Complication of osteoarthritis

In later stages of OA there can be total loss of cartilage and limping of the affected joints.


What is osteoporosis ?

Osteoporosis is most common bone disease in which bone becomes weak ,porous ,brittle and more susceptibility to fracture . that is characterized by decrease of bone density. Broken hips ,wrist and spinal bones are most common fractures in osteoporosis .

It is the most common reason in elderly for fractures it is a silent disease one can not know until the person breaks his bone.

This disease is more common in women than men.

To keep bones strong eat calcium and vitamin d rich diet ,exercise and do not smoke.

Cause of osteoporosis

• Genetic predisposition –osteoporosis runs in families.
• Having certain medical condition hyper thyroidism, hyper parathyroidsm, chronic liver failure which increases inflammation in body
• Vitamin d deficiency is one of the leading cause in females for osteoporosis .
• Taking medications that leads to decrease bone density like steroids more than 3 months ,medicines for prostate and breast cancer, for seizurs .
• Hormonal changes like menopause .
• prolonged bed rest in few disease.
• Drinking large amount of alchol.
• Excessive smoking.
• Low body weight.

Symptoms of osteoporosis

• Low Backache is present along with other symptoms .
• Stooping due to collapse of vertebra .
• Frequent and easy fracture of hip, wrist, shoulder and chronic pain in later stages .

Complications of osteoporosis

• Hip fractures due to osteoporosis can casue, deep vein thrombosis pneumonia and pulmonary embolism in elderly patients .
• Osteoporosis is also responsible for high mortality rate due to complication of fracture .
• Decreased quality of life .
• Disability due to osteoporosis .

Management of osteoporosis

• Patient should always lead healthy life style and perform exercise.
• Reduce excess body weight
• To maintain vitamin d level Take proper sun light esp early morning sunlight for 15-20 minutes daily
• Always consume calcium, vitamin and minerals rich diet like milk, paneer, leafy vegetables, broccoli.
• Routine screening of bones if family history of osteoporosis and after the age of 45 yrs .

Rheumatoid Arthritis

What is rheumatoid arthritis ?[RA]

Rheumatoid arthritis is an auto immune disease and a form of chronic arthritis which causes pain ,stiffness, swelling ,deformity and loss of functions of the joints .this condition can also affect other organs of the body [skin ,lungs , heart, blood vessels].
This arthritis can involve any joints but more common in hands and wrist joints .
Females are more frequently affected the males .
It starts in middle age[20 to 40yrs ] and most common in old age .
RA can also affect body parts like lungs, eyes ,mouth besides joints.
There are periods of flare ups and remissions[symptoms free ] in this disease

Causes of rheumatoid arthritis [RA]

Causes of RA are unclear but abnormal immune responses like body ‘s own immune system makes antibodies against own body tissue which finally leads to distruction or can damage the joints.
Another cause can be genetic susceptibility as most of the cases can occur due to inherited tendency.
Some times hormonal changes too can be esponsible for RA.
Emotional Stress and smoking can also trigger RA.
Prolonged SILICA inhalation can also lead to RA.
The rheumatoid factor is an antibody that is found in the blood of 80% of people with rheumatoid arthritis.

Symptoms of rheumatoid arthritis [RA]

• In active phase there will be joint redness ,pain ,stiffness ,swelling,and tenderness.
• Pain and stiffness worsens after the rest period.
• Small joints like wrist,fingers ,elbows are more commonly involved.
• Round painless nodules under the skin.
• Restricted joints functions.
• Fever
• In later stages Joints deformity in hands and fever.

Complications of rheumatoid arthritis [RA]

RA can damage the lung tissue, inflammation of the blood vessels, carpel tunnel syndrome .and heart affection like pericarditis and myocardial infarction.


What is sciatica?

Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. Sciatica is most commonly a result of a lumbar disc herniation. Any caus of irritation or inflammation of the sciatic nerver can produce the symptoms of sciatica.

Sciatica causes pain, a burning sensation, numbness, or tingling radiating from the lower back and upper buttock down the back of the thigh to the back of the leg.


Complications if un-treated or mal-treated:

Severe sciatica can make walking difficult if not impossible. Sometimes the symptoms of sciatica are aggravated by walking or bending at the waist and relieved by lying down.

Some of the sciatica patients take the pain-killer (analgesic) medications for the long continuous period of time that might cause renal or Gastro-intestinal complications like renal faliure or gastric ulcers.

Ankylosing Spondylitis

What is ankylosing spondylitis [AS]?

Ankylosing spondylitis is chronic inflammatory autoimmune and degenerative disease of spine and sacroiliac joint in pelvis. Tendency for this disease is genetically inherited .

In AS there is chronic inflammation of the spine and sacroiliac jts. [ sacrum-bone above the tail bone ,iliac bone –bone on both side of upper buttocks ] this chronic inflammation can cause pain and stiffness around spine ….neck and lower back.

Over time this inflammation can lead to complete fusion of vertebras together this process is referred as ankylosis .which can lead to stooped over posture.

In AS HLA-B27gene can be detected in the blood of most of the affected patients .

AS symptoms may include pain and stiffness from the neck down to the lower back in young adults and adolescents. It can also affect eyes,lungs ,heart and some times kidneys.

Cause of ankylosing spondylitis:

As is an autoimmune disease and always is genetically inherited . most of the patient carry

HLA-B27 gene .in some cases injury in young athelete can also cause AS.

Symptoms of ankylosis spondylitis:

Patient will feel pain and stiffness in low back,buttocks and hips for more than 3 months .esp in mornings and after periods of inactivity.

Fusion of spine can lead to hump on the back.

Person will feel fatigue due to inflammation of the joints.

AS can cause inflammation of eyes in 40% of the people.

In chronic cases AS can casue shortness of breath with exercise.

Complication of ankylosis spondylitis:

• Compression fracture due to weakened bones.
• Impaired vision due to uveitis.
• Breathing problems due to curvature of thoracic spine.
• Heart and kidney complications in advance stages.