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Holistic Health Pillars

What is Holistic Health? Holistic health practitioners work with clients to achieve specific health goals. This may include improving athletic performance, disease prevention, and the treatment of symptoms. Holistic nutritionists may help implement anti-inflammatory diets. Holistic health practitioners work with both medical professionals and the public to implement a personalized plan of action. Holistic health…

Eight pillars that support holistic health

A balanced diet is a key component of the physical wellness pillar. In addition to eating more fruits and vegetables, you should also be eating a variety of whole grains. Avoid foods with high amounts of sodium, cholesterol, or added sugar. Likewise, you should avoid fried foods. These foods can contribute to high cholesterol levels, which can have negative effects on your overall health. A healthy diet can improve many of the other pillars.

The physical and emotional aspects of health go hand in hand. Holistic health acknowledges the role of mental, spiritual, and social aspects of health. As a result, it takes the whole person into account, focusing on the connections between the body, mind, and environment. Emotional wellness is an important component of holistic health, and it can be cultivated through the eight pillars of holistic health. Listed below are the eight pillars of holistic health.

Physical health: Exercise, diet, sleep habits, hygiene, and personal hygiene are important aspects of physical health. Physical health requires adequate exercise, good rest, and a clean environment. Physical health is just the tip of the iceberg, though. It also requires that you understand your body’s chemistry and how to balance it. Nutrition is an essential part of physical health, and it gets its own pillar. Taking care of your body’s chemistry is important when making dietary and lifestyle decisions.

Cost control

There are two methods of cost control in holistic health care. One is to measure the cost of an entire system and implement changes in management based on results. Cost control in holistic health care is often difficult to achieve because costs vary according to the type of treatment provided. The other method is to identify the cost of an individual patient, and to measure the proportion of that patient who will need further care. Although holistic health care is more expensive than usual medical care, it is cost effective and can reduce mortality.

The first strategy is a health share plan, which requires the members to pay a portion of the cost of their care. These plans are more expensive than traditional medical care, but are often more effective because they treat the whole person and encourage preventative care. This approach also keeps costs low and satisfaction high, leaving more money for major medical events. The most common holistic health care costs are due to chronic illnesses and other conditions. The costs of a health share plan are shared by all members.

Another strategy for cost control in holistic health care is to use health policy commissions. The Maryland commission, for example, has been focusing on the total cost of care and hospital budgets. It has a history, and stakeholders have a vested interest in working with it. In Maryland, a Medicare waiver encourages health care providers to offer services to all payers, such as Medicare and Medicaid. These charges are then offset by increases in commercial rates.

Prevention of disease

The American Holistic Health Association advocates for the prevention of chronic disease. The emphasis on holistic health entails treating the entire person, incorporating the mind, body, and spirit into a health-promoting lifestyle. The most difficult aspects of incorporating holistic practices into the client’s life are often changes to food, which can be hard for clients to accept. However, the benefits of holistic health far outweigh the negative effects.

One of the most significant benefits of preventive medicine is lower healthcare costs. The Centers for Disease Control and Prevention report that the practice of prevention can reduce costs by more than $1 trillion annually. In fact, 90 percent of healthcare expenditures are related to chronic conditions. Preventive care focuses on the prevention of chronic disease by emphasizing long-term health, healthy pregnancy, and aging. Health screenings are an important component of this holistic approach.

The benefits of holistic medicine are numerous. First, holistic doctors focus on the whole person, rather than simply treating the symptoms of an illness. Holistic physicians believe that the mind-body connection is the key to healing. As such, holistic doctors help patients develop an understanding of their entire health profile. By integrating complementary therapies and Western medicine, holistic physicians can treat the whole person and prevent or improve disease symptoms. In addition to reducing disease risk, holistic health also emphasizes a strong doctor-patient relationship.

Medicinal plants

Medicinal plants can be used to treat various illnesses and diseases. Using them can be a natural way to improve your overall health and well-being. Here are some tips for maximizing their benefits. Read on to learn how to use medicinal plants in your daily life. We are going to go over a few examples of the most popular ones and how they can improve your health. Listed below are some of their most important benefits.

Traditional medicines have their place, but plants play a vital role in drug development. Modern scientific techniques have helped verify the ancient knowledge of the healer. These traditional remedies incorporate many aspects of the body, including their chemical composition and their psychological effects. As a result, the study of traditional medicine is helping to discover future drug leads. Medicinal plants are used in many countries and have played a vital role in traditional healthcare systems for thousands of years. Today, about 50% of all drugs that are used in clinical practice are made from natural products.

Besides examining their properties, medicinal plants can also be used for cancer treatment. The research study documented the different plant species used in cancer management among Tswana speakers. The study also provided baseline data for further studies. Future studies will focus on the phytochemical and pharmacological profiles of these plants. The findings of this study have opened the door to further investigation into the effects of these plants on the human body. It also highlights the growing popularity of natural products.

Dietary supplements

The goal of dietary supplements for holistic health is to help people improve their health and well-being by addressing the root causes of the disease. Researchers and practitioners of holistic nutrition know that the body’s chemical processes are continuously occurring. They are affected by synthetic chemicals, which disrupt these processes. They also know that abnormal substances can interfere with decision-making and brain functions. Consequently, these substances may cause long-term damage. Instead of taking synthetic chemicals, holistic nutritionists recommend natural foods and herbal supplements.

A good source for dietary supplements is the Office of Dietary Supplements. This organization helps consumers find information on dietary supplements and answers questions about their efficacy. You can also contact the manufacturers to find out more about the supplement’s ingredients and efficacy. In addition, you can visit the National Center for Complementary and Integrative Health (NCCIH) or Office of Dietary Supplements, which have websites designed to help consumers make informed choices.

Some people have tried using dietary supplements for holistic health. However, their use is not recommended for everyone. These supplements are not meant to diagnose or treat diseases and are not as safe as medicines. However, they are effective in enhancing the current routine of a person. They are not a replacement for good eating habits. A healthy diet and exercise are important factors for holistic health. And you should not neglect your diet and your health if you want to see significant results from dietary supplements.

Alternative medicine

Holistic health is all about using the correct methods to achieve optimal health. Alternative medicine attempts to achieve the same effects as medicine, but is not scientifically proven. It has no biological plausibility and has been proven ineffective. Nonetheless, many people swear by it and use it for a wide variety of conditions. Below are some common examples of complementary and alternative medicine. Read on to learn more about the benefits and limitations of alternative medicine.

A holistic philosophy views the mind, body, and spirit as one. A dysfunction in one area affects the whole person. Complementary medicine is guided by this philosophy. Many Australians seek out alternative medicine after feeling dissatisfied with conventional medical care. They don’t believe in the harsh side effects of conventional drugs. It may be more gentle and safer. In addition, it involves a collaborative approach with both the patient and provider.

The holistic health care provider may prescribe medicines and surgical procedures to treat acute or chronic pain, or recommend exercise to boost the production of endorphins. Regardless of the condition, a holistic health care provider may also ask about your diet and lifestyle, identifying foods that contribute to inflammation and stress. If you suffer from pain, your holistic health care provider may recommend acupuncture or massage therapy, or even mindful meditation to relieve tension and stress.

Lumbar Spinal Stenosis Symptoms, Treatment & Causes

Lumbar spinal stenosis facts

Lumbar spinal stenosis is a lower back condition whereby either the spinal canal (central stenosis) or one or more of the vertebral foramina (foraminal stenosis) becomes narrowed.
Lumbar spinal stenosis is typically caused by degenerative arthritis.
Patients can develop low back pain as well as pain, weakness, and numbness or decreased sensation in the legs.
Surgery is recommended when other nonsurgical treatments have failed and for patients with increasing weakness of the legs or loss of bowel or bladder function.
Surgery includes a lumbar decompression with or without a lumbar fusion.
Surgery is most reliable for the relief of leg symptoms and less reliable for the relief of back pain.

What is the lumbar spine, and what is lumbar spinal stenosis?

The lumbar spine is made up of five vertebral bodies in the lower back. Nerves coming off the spinal cord travel though the spinal canal and exit the canal through small openings on the sides of the vertebrae called foramina (singular = foramen). These nerves transmit sensations from the buttocks and lower extremities through the spinal cord to the brain and transmit motor signals from the brain to the lower extremities to produce movement of the legs, toes, and joints of the lower extremities.

Lumbar spinal stenosis is a condition whereby either the spinal canal (central stenosis) or one or more of the vertebral foramina (foraminal stenosis) becomes narrowed. If the narrowing is substantial, it causes compression of the spinal cord or spinal nerves, which causes the painful symptoms of lumbar spinal stenosis, including low back pain, buttock pain, and leg pain and numbness that is made worse with walking and relieved by resting.

Lower Back Pain Treatment

So, how is low back pain treated? Well, as described above, the treatment very much depends on the precise cause of the low back pain. Moreover, each patient must be individually evaluated and managed in the context of the underlying background health status and activity level.

What causes lumbar spinal stenosis?

The most common cause of lumbar spinal stenosis is degenerative arthritis and degenerative disc disease. As with other joints in the body, arthritis commonly occurs in the spine as part of the normal aging process and as a result of osteoarthritis. This can lead to loss of the cartilage between the bones at the joints, formation of bone spurs (osteophytes), loss of the normal height of the discs between the vertebrae of the spine (degenerative disc disease, also known as spondylosis), and overgrowth (hypertrophy) of the ligamentous structures. Further degeneration of the lumbar discs can lead to slippage of one vertebra on another, a process referred to as spondylolisthesis. Each of these processes can reduce the normal space available for the nerves in the spinal canal and result in direct pressure on nerve tissues to cause the symptoms of lumbar spinal stenosis.

Lumbar spinal stenosis can also be caused by other conditions that decrease the space of the spinal canal or vertebral foramen. These can include

tumor of the local structures or metastatic tumors (tumors that originated in another part of the body and spread to this location),
infection,
various metabolic bone disorders that cause bone growth, such as Paget's disease of bone.

These causes, however, are much less common than degenerative arthritis.

What are risk factors for lumbar spinal stenosis?

The major risk factor for lumbar spinal stenosis is aging because it is associated with degeneration of the spine. Another less common risk factor is osteoporosis as it can lead to compression fracture of the lumbar vertebrae that results in lumbar spinal stenosis.

What are lumbar spinal stenosis symptoms?

Lumbar spinal stenosis can cause

low back pain,
weakness,
numbness,
pain,
loss of sensation in the legs and feet.

In most situations, the symptoms improve when the patient is sitting or leaning forward. Typically, painful sensations shoot down the legs with continued walking and diminish with resting. These leg sensations sometimes mimic sciatica. This particular activity-related symptom is sometimes referred to as pseudoclaudication (or neurogenic claudication) because it mimics the true claudication of poor circulation from the narrowed blood vessels of peripheral vascular disease. Standing and bending backward can make the symptoms worse. This is because bending forward increases the space in the spinal canal and vertebral foramina, while bending backward decreases this space. It is therefore more comfortable for patients to sit or lean forward. Patients are frequently unable to walk for long distances and often state that their symptoms are improved when bending forward while walking with the support of a walker or shopping cart.

The symptoms commonly worsen with time. This is because degenerative arthritis is a progressive disease that gradually becomes more severe with time. If left untreated, the compression on the nerves from lumbar spinal stenosis can lead to increasing weakness and loss of function of the legs. It can also lead to loss of bowel and bladder control and loss of sexual function.

A doctor can help determine if one's symptoms are from lumbar spinal stenosis or a different condition. Many other disorders can cause similar symptoms that mimic lumbar spinal stenosis including

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How do health care professionals diagnose lumbar spinal stenosis?

The medical evaluation begins with a complete medical history and physical examination to get clues to the diagnosis of lumbar spinal stenosis. During the medical history, the patient will be asked questions regarding symptoms, including how long they have been present, what makes them better or worse, what prior treatment the patient has had, and what other medical conditions they have. These questions can also help the doctor distinguish lumbar spinal stenosis from other disorders that may produce similar symptoms.

The physical examination often consists of testing the range of motion in the back and feeling for areas of tenderness in the back. The legs may be examined for range of motion, strength, sensation, reflexes, and pulses. The hips and knees may also be examined because problems with these joints can often causes symptoms similar to those of lumbar spinal stenosis.

After the examination, the physician may order imaging studies to detect anatomic signs of lumbar spinal stenosis. This often begins with plain X-rays of the spine. The doctors may also order an X-ray of the patient's pelvis and hips, depending on findings from the physical examination. The X-rays can show the doctor various signs associated with spinal stenosis, including loss of the normal intervertebral disc height, the presence of bone spurs (osteophytes), and spinal instability (abnormal motion between the vertebrae). The ultimate diagnosis of lumbar spinal stenosis is made by an MRI scan (magnetic resonance imagining scan) or CT scan (CAT scan or computerized axial tomography). These are more advanced tests that are used to visualize the nerves in the lower back and detect if they are being compressed from lumbar spinal stenosis.

Sometimes, special nerve tests, including electromyogram (EMG) or nerve conduction studies, may be ordered. These tests can identify damage to or irritation of the nerves caused by long-term compression from lumbar spinal stenosis. These tests can also help determine exactly which nerves are involved.

QUESTION

The term arthritis refers to stiffness in the joints.
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What is the treatment for lumbar spinal stenosis?

In most situations, the treatment for lumbar spinal stenosis begins with conservative (nonoperative) treatments. This can include medications to reduce inflammation, even short courses of oral cortisone medication, and pain medications. There are also several medications directed specifically at nerve pain that are helpful in lumbar spinal stenosis, including gabapentin (Neurontin) and pregabalin (Lyrica). Physical therapy can help for many. Cortisone (steroid) injections in the lumbar spine, referred to as epidural injections, can also reduce the symptoms by decreasing inflammation and swelling around the nerve tissue. These are sometimes repeated up to three times per year.

Surgery

Surgery may be indicated for those who do not improve with the above treatments or if there is severe or progressive weakness or loss of bowel or bladder function (cauda equina syndrome). Depending on the examination findings and imaging studies, there are various surgical procedures available to treat lumbar spinal stenosis, ranging from laminectomy to fusion procedures.

The main goal of surgery is to remove the structures that are compressing the nerves in the spinal canal or vertebral foramen. This is referred to as lumbar decompression surgery (laminectomy, laminotomy, foraminotomy). In some patients, this can be performed alone, but in other patients, it must be combined with lumbar fusion. If too much of the compressive structures need to be removed to free the nerve, the vertebrae may become unstable (spinal instability). This leaves the vertebrae with abnormal motion. If this occurs, a spinal fusion can be performed to attach the vertebrae together and eliminate the motion at that level. Sometimes this requires metallic hardware to be installed in the vertebrae to adequately support and fix the involved bone.

Surgery for lumbar spinal stenosis can be very successful in most patients in relieving the leg symptoms of ambulatory pain, sciatica, and numbness. However, depending on the severity of the nerve compression and the length of time the nerve has been compressed, there may be some permanent damage that is not relieved with surgery. The success for back pain relief is less reliable with surgery than the relief of leg symptoms.

More recently, surgical procedures that are somewhat less invasive than traditional lumbar decompression have become available. Interspinous devices that have been used in certain patients for this purpose include X-Stop and Coflex devices.

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Is it possible to prevent lumbar spinal stenosis?

Unfortunately, the degenerative changes responsible for lumbar spinal stenosis can occur as part of the normal aging process. There is little that can be done to prevent lumbar spinal stenosis. For some patients, exercises and/or physical therapy can prevent aggravation of symptoms.

What is the prognosis for lumbar spinal stenosis?

The outlook for patients with lumbar spinal stenosis varies and depends on the severity and duration of symptoms at the time of initiation of treatment. Ultimately, the outlook depends on an individual's response to treatment. The response to treatment is also dependent on the severity and cause of the lumbar spinal stenosis as well as the underlying medical condition of the patient.

What Causes an Umbilical Hernia?

What are umbilical hernias?

In newborns, if the gap in the abdominal muscles doesn't close and a small part of the baby's intestines pokes through the opening, it creates an umbilical hernia. In adults repeated abdominal muscle strain, chronic health conditions that put strain on the abdomen, muscle weakness due to age, obesity, and pregnancy can lead to umbilical hernias.

A hernia is a condition where your intestines bulge through a weak spot in the muscle covering them. Umbilical hernias happen in the area right around your belly button.

Umbilical hernias are most common in newborn babies. They happen when the abdominal muscles don't seal up entirely after the umbilical cord is removed. A small section of the intestine will poke through the gap and cause the belly button to bulge out. These hernias are not painful and are not usually dangerous.

Signs of umbilical hernias

The main sign of an umbilical hernia is visual as you can usually see them. Umbilical hernias look like a small bulge coming from a baby’s belly button. The bulge usually isn't big and probably won't hurt or cause discomfort. You may notice that it looks smaller when the baby is lying down. It might be more noticeable if your baby is crying or straining their abdominal muscles.

Adults can also get umbilical hernias and they look similar to hernias in babies. You may experience pain or pressure because of the hernia.

In rare cases, the bulging part of the intestine can get stuck in the hernia opening. When this happens, it's called an incarcerated hernia. The intestine can become strangulated or cut off from its blood supply in this situation. A strangulated hernia is a serious problem and needs emergency surgery.

Symptoms of a strangulated hernia include:

Abdominal pain and tenderness
Fever
Constipation
Vomiting
Reddish or purplish discoloration from the hernia bulge

Causes of umbilical hernias

Before a baby is born, they rely on the umbilical cord for nutrients and oxygen. The cord extends from the baby's abdomen to the placenta. After birth, the cord is no longer necessary and doctors separate the baby from the cord.

Usually, after the cord is gone, the gap in the abdominal muscles close up naturally. But in some cases, it doesn't and a small part of the baby's intestines pokes through the opening, creating an umbilical hernia.

Adults can also get umbilical hernias, even if they never had them as babies.

There are several reasons that adults can develop umbilical hernias, including:

Repeated abdominal muscle strain
Chronic health conditions that put strain on the abdomen, like ascites or chronic cough
Muscle weakness due to age
Obesity
Pregnancy, particularly pregnancies with more than one fetus

When to see the doctor for umbilical hernias

If a hernia is strangulated, you need to see a doctor right away. A strangulated hernia needs emergency surgery to repair. Otherwise, the intestine can lose blood supply and the tissue starts to die. Once that happens, your surgeon will need to remove that part of the intestine.

QUESTION

What is a hernia?
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Diagnosis of umbilical hernias

A doctor can identify an umbilical hernia by examining it. They may press on it gently to see if it can be pushed back into the abdomen. They will ask if it is causing any pain or discomfort

Umbilical hernias in babies usually go away over time. Most close on their own by age three or four. If it has not closed yet by around that age, doctors often recommend surgery.

Adult umbilical hernias do not tend to close up without surgery.

Treatments for umbilical hernias

Hernia surgery requires general anesthesia and takes place in a hospital. The whole operation should only take 20–30 minutes. Most people can go home the same day.

Your doctor will make a small incision near the belly button and move the intestines back into the abdominal cavity. They will then stitch the muscles together to close the gap. Finally, they'll close the incision to complete the operation.

Complications are unusual, but there is a risk of infection after any surgery. Call your doctor if you experience new or worsening pain, bleeding, fever or chills, or if you think the surgical wound is infected.

Low Back Pain: Exercise, Causes, Treatment, Symptoms & Diagnosis

The low back, or lumbar area, serves a number of important functions for the human body.Source: iStock

Low back pain facts

Functions of the low back, or lumbar area, include structural support, movement, and protection of certain body tissues.
Pain in the low back can be a result of conditions affecting the bony lumbar spine, intervertebral discs (discs between the vertebrae), ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Treatment of low back pain is optimally directed toward a diagnosed or suspected specific cause. For acute back pain from lumbar strain, use of a home remedy initially can be beneficial.

Low Back Pain Treatment

Epidural Steroid Injection

Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back (lumbar radiculopathy) causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy, which causes pain.

Learn more about epidural steroid injections for back pain »

Important structures of the low back that can be related to symptoms in this region include the bony lumbar spine, discs between the vertebrae, ligaments, spinal cord, nerves, muscle of the low back, internal organs of the pelvis, and the skin covering the lumbar area.Source: Bigstock

What is the anatomy of the low back?

To understand various causes of low back pain, it is important to appreciate the normal design (anatomy) of the tissues of this area of the body. Important structures of the low back that can be related to symptoms in this region include the bony lumbar spine (vertebrae, singular = vertebra), discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.

The bony lumbar spine is designed so that vertebrae "stacked" together can provide a movable support structure while also protecting the spinal cord from injury. The spinal cord is composed of nervous tissue that extends down the spinal column from the brain. Each vertebra has a spinous process, a bony prominence behind the spinal cord, which shields the cord's nervous tissue from impact trauma. Vertebrae also have a strong bony "body" (vertebral body) in front of the spinal cord to provide a platform suitable for weight bearing of all tissues above the buttocks. The lumbar vertebrae stack immediately atop the sacrum bone that is situated in between the buttocks. On each side, the sacrum meets the iliac bone of the pelvis to form the sacroiliac joints of the buttocks.

The discs help to minimize the impact of stress forces on the spinal column.Source: Bigstock

What is the anatomy of the low back? (Continued)

The discs are pads that serve as "cushions" between the individual vertebral bodies. They help to minimize the impact of stress forces on the spinal column. Each disc is designed like a jelly donut with a central, softer component (nucleus pulposus) and a surrounding, firm outer ring (annulus fibrosus). The central portion of the disc is capable of rupturing (herniating as in a herniated disc) through the outer ring, causing irritation of adjacent nervous tissue and sciatica as described below. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae to each other and surround each of the discs.

The nerves that provide sensation and stimulate the muscles of the low back as well as the lower extremities (the thighs, legs, feet, and toes) all exit the lumbar spinal column through bony portals, each of which is called a "foramen."

Many muscle groups that are responsible for flexing, extending, and rotating the waist, as well as moving the lower extremities, attach to the lumbar spine through tendon insertions.

The aorta and blood vessels that transport blood to and from the lower extremities pass in front of the lumbar spine in the abdomen and pelvis. Surrounding these blood vessels are lymph nodes (lymph glands) and tissues of the involuntary nervous system that are important in maintaining bladder and bowel control.

The uterus and ovaries are important pelvic structures in front of the pelvic area of women. The prostate gland is a significant pelvic structure in men. The kidneys are on either side of the back of the lower abdomen, in front of the lumbar spine.

The skin over the lumbar area is supplied by nerves that come from nerve roots that exit from the lumbar spine.

When we stand, the lower back is functioning to support the weight of the upper body.Source: istock

What is the function of the low back?

The low back, or lumbar area, serves a number of important functions for the human body. These functions include structural support, movement, and protection of certain body tissues.

When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.

Protecting the soft tissues of the nervous system and spinal cord as well as nearby organs of the pelvis and abdomen is a critical function the lumbar spine and adjacent muscles of the low back.

Common causes of low back pain (lumbar backache) include lumbar strain, nerve irritation, lumbar radiculopathy, bony encroachment, and conditions of the bone and joints.Source: istock

What are common causes of lower back pain?

Common causes of low back pain (lumbar backache) include lumbar strain, nerve irritation, lumbar radiculopathy, bony encroachment, and conditions of the bone and joints. Each of these is reviewed below.

Lumbar strain (acute, chronic): A lumbar strain is a stretch injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft-tissue injury is commonly classified as "acute" if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as "chronic." Lumbar strain most often occurs in people in their 40s, but it can happen at any age. The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues. The severity of the injury ranges from mild to severe, depending on the degree of strain and resulting spasm of the muscles of the low back. The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, X-ray testing is only helpful to exclude bone abnormalities.

The treatment of lumbar strain consists of resting the back (to avoid reinjury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Initial treatment at home might include heat application, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), and avoiding reinjury and heavy lifting. Prescription medications that are sometimes used for acute low back pain include non-steroidal anti-inflammatory medications, such as sulindac (Clinoril), naproxen (Naprosyn), and ketorolac (Toradol) by injection or by mouth, muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and metaxalone (Skelaxin), as well as analgesics, such as tramadol (Ultram).

Long periods of inactivity in bed are no longer recommended, as this treatment may actually slow recovery. Spinal manipulation for periods of up to one month has been found to be helpful in some patients who do not have signs of nerve irritation. Future injury is avoided by using back-protection techniques during activities and support devices as needed at home or work.

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Nerve irritation and lumbar radiculopathy causes lower back painSource: MedicineNet

Nerve irritation and lumbar radiculopathy causes lower back pain

Nerve irritation: The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths — from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles). See descriptions of these conditions below.

Lumbar radiculopathy: Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized "sciatica" pain of a herniated disc that shoots from the low back and buttock down the leg. A history of localized low-back aching can precede sciatica, or it can follow a "popping" sensation and be accompanied by numbness and tingling. The back pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body, such as the left side or right side, and not both. Lumbar radiculopathy is suspected based on the above symptoms. Increased radiating back pain when the lower extremity is lifted supports the diagnosis. Nerve testing (EMG/electromyogram and NCV/nerve conduction velocity) of the lower extremities can be used to detect nerve irritation. The actual disc herniation can be detected with imaging tests, such as CAT or MRI scanning. Treatment of lumbar radiculopathy ranges from medical management to surgery. Medical management includes patient education, medications to relieve pain and muscle spasms, cortisone injection around the spinal cord (epidural injection), physical therapy (heat, massage by a therapist, ultrasound, exercises, electrical stimulation), and rest (not strict bed rest but avoiding reinjury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary. The operation performed depends on the overall status of the spine and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (a small hole in the bone of the lumbar spine surrounding the spinal cord), laminectomy (removal of the bony wall), by needle technique (percutaneous discectomy), disc-dissolving procedures (chemonucleolysis), and others.

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Nearly everyone has low back pain at some time during their life.
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Bony encroachment causes lower back painSource: iStock

Bony encroachment causes lower back pain

Bony encroachment: Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative to another), and spinal stenosis (compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal). Spinal-nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities. Spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking the pains of poor circulation). Treatment of these afflictions varies, depending on their severity, and ranges from rest and exercises to epidural cortisone injections and surgical decompression by removing the bone that is compressing the nervous tissue.

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Conditions of bone and joint causes lower back painSource: “Scoliosis patient in cheneau brace correcting from 56 to 27 deg” by Weiss HR

Conditions of bone and joint causes lower back pain

Bone and joint conditions: Bone and joint conditions that lead to low back pain include those existing from birth (congenital), those that result from wear and tear (degenerative) or injury, and those that are due to inflammation of the joints (arthritis).

Congenital bone conditions: Congenital causes (existing from birth) of low back pain include scoliosis and spina bifida. Scoliosis is a sideways (lateral) curvature of the spine that can be caused when one lower extremity is shorter than the other (functional scoliosis) or because of an abnormal architecture of the spine (structural scoliosis). Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit from support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with the absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.

Degenerative bone and joint conditions: As we age, the water and protein content of the body's cartilage changes. This change results in weaker, thinner, and more fragile cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). Degeneration of the disc is called spondylosis. Spondylosis can be noted on X-rays of the spine as a narrowing of the normal "disc space" between the vertebrae. It is the deterioration of the disc tissue that predisposes the disc to herniation and localized lumbar pain ("lumbago") in older patients. Degenerative arthritis (osteoarthritis) of the facet joints is also a cause of localized lumbar pain that can be detected with plain X-ray testing. These causes of degenerative back pain are usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasm, and inflammation.

Injury to the bones and joints: Fractures (breakage of bone) of the lumbar spine and sacrum bone most commonly affect elderly people with osteoporosis, especially those who have taken long-term cortisone medication. For these individuals, occasionally even minimal stresses on the spine (such as bending to tie shoes) can lead to bone fracture. In this setting, the vertebra can collapse (vertebral compression fracture). The fracture causes an immediate onset of severe localized pain that can radiate around the waist in a band-like fashion and is made intensely worse with body motions. This pain generally does not radiate down the lower extremities. Vertebral fractures in younger patients occur only after severe trauma, such as from motor-vehicle accidents or a convulsive seizure.

In both younger and older patients, vertebral fractures take weeks to heal with rest and pain relievers. Compression fractures of vertebrae associated with osteoporosis can also be treated with a procedure called vertebroplasty or kyphoplasty, which can help to reduce pain. In this procedure, a balloon is inflated in the compressed vertebra, often returning some of its lost height. Subsequently, a "cement" (methylmethacrylate) is injected into the balloon and remains to retain the structure and height of the body of the vertebra. Pain is relieved as the height of the collapsed vertebra is restored.

Arthritis: The spondyloarthropathies are inflammatory types of arthritis that can affect the lower back and sacroiliac joints. Examples of spondyloarthropathies include reactive arthritis (Reiter's disease), ankylosing spondylitis, psoriatic arthritis, and the arthritis of inflammatory bowel disease. Each of these diseases can lead to low back pain and stiffness, which is typically worse in the morning. These conditions usually begin in the second and third decades of life. They are treated with medications directed toward decreasing the inflammation. Newer biological medications have been greatly successful in both quieting the disease and stopping its progression.

Pregnancy commonly leads to low back pain.Source: iStock

What are other causes of lower back pain?

Other causes of low back pain include kidney problems, pregnancy, ovary problems, and tumors.

Kidney problems

Kidney infections, stones, and traumatic bleeding of the kidney (hematoma) are frequently associated with low back pain. Diagnosis can involve urine analysis, sound-wave tests (ultrasound), or other imaging studies of the abdomen.

Pregnancy

Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors' advice. Natural labor can also cause low back pain.

Ovary problems

Ovarian cysts, uterine fibroids, and endometriosis may also cause low back pain. Precise diagnosis can require gynecologic examination and testing.

Tumors

Low back pain can be caused by tumors, either benign or malignant, that originate in the bone of the spine or pelvis and spinal cord (primary tumors) and those which originate elsewhere and spread to these areas (metastatic tumors). Symptoms range from localized pain to radiating severe pain and loss of nerve and muscle function (even incontinence of urine and stool) depending on whether or not the tumors affect the nervous tissue. Tumors of these areas are detected using imaging tests, such as plain X-rays, nuclear bone scanning, and CAT and MRI scanning.

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Uncommon causes of low back pain include Paget’s disease of bone.Source: Jmarchn

What are uncommon causes of low back pain?

Uncommon causes of low back pain include Paget's disease of bone, bleeding or infection in the pelvis, infection of the cartilage and/or bone of the spine, aneurysm of the aorta, and shingles.

Paget's disease of bone

Paget's disease of the bone is a condition of unknown cause in which the bone formation is out of synchrony with normal bone remodeling. This condition results in abnormally weakened bone and deformity and can cause localized bone pain, though it often causes no symptoms. Paget's disease is more common in people over the age of 50. Heredity (genetic background) and certain unusual virus infections have been suggested as causes. Thickening of involved bony areas of the lumbar spine can cause the radiating lower extremity pain of sciatica.

Paget's disease can be diagnosed on plain X-rays. However, a bone biopsy is occasionally necessary to ensure the accuracy of the diagnosis. Bone scanning is helpful to determine the extent of the disease, which can involve more than one bone area. A blood test, alkaline phosphatase, is useful for diagnosis andmonitoring response to therapy. Treatment options include aspirin, other anti-inflammatory medicines, pain medications, and medications that slow therate of bone turnover, such as calcitonin (Calcimar, Miacalcin), etidronate (Didronel), alendronate (Fosamax), risedronate (Actonel), and pamidronate (Aredia).

Bleeding or infection in the pelvis

Bleeding in the pelvis is rare without significant trauma and is usually seen in patients who are taking blood-thinning medications, such as warfarin (Coumadin). In these patients, a rapid-onset sciatica pain can be a sign of bleeding in the back of the pelvis and abdomen that is compressing the spinal nerves as they exit to the lower extremities. Infection of the pelvis is infrequent but can be a complication of conditions such as diverticulosis, Crohn's disease, ulcerative colitis, pelvic inflammatory disease with infection of the Fallopian tubes or uterus, and even appendicitis. Pelvic infection is a serious complication of these conditions and is often associated with fever, lowering of blood pressure, and a life-threatening state.

Uncommon causes of low back pain include infection of the cartilage and/or bone of the spine, aneurysm of the aorta, and Shingles.Source: iStock

What are other uncommon causes of low back pain?

Infection of the cartilage and/or bone of the spine

Infection of the discs (septic discitis) and bone (osteomyelitis) is extremely rare. These conditions lead to localized pain associated with fever. The bacteria found when these tissues are tested with laboratory cultures include Staphylococcus aureus and Mycobacterium tuberculosis (TB bacteria). TB infection in the spine is called Pott's disease. These are each very serious conditions requiring long courses of antibiotics. The sacroiliac joints rarely become infected with bacteria. Brucellosis is a bacterial infection that can involve the sacroiliac joints and is usually transmitted in raw goat's milk.

Aneurysm of the aorta

In the elderly, atherosclerosis can cause the weakening of the wall of the large arterial blood vessel (aorta) in the abdomen. This weakening can lead to a bulging (aneurysm) of the aorta wall. While most aneurysms cause no symptoms, some cause pulsating low back pain. Aneurysms of a certain size, especially when enlarging over time, can require surgical repair with a grafting procedure to repair the abnormal portion of the artery.

Shingles

Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.

Symptoms that can be associated with low back pain include numbness and/or tingling of the lower extremities,Source: iStock

What are risk factors for low back pain?

Risk factors for low back pain include athletic activity, heavy lifting, throwing, moving luggage, traumatic injury, kidney infection, pregnancy, osteoporosis, and aging.

What are other symptoms and signs sometimes associated with low back pain?

Low back pain can cause a wide variety of symptoms and signs depending on the precise cause of the back pain as reviewed above. Symptoms that can be associated with low back pain include numbness and/or tingling of the lower extremities, incontinence of urine or stool, inability to walk without worsening pain, lower extremity weakness, atrophy (decreased in size) of the lower extremity muscles, rash, fever, chills, weight loss, abdominal pains, burning on urination, dizziness, joint pain, and fatigue.

How do health care professionals diagnose low back pain?

The diagnosis of low back pain involves a review of the history of the illness and underlying medical conditions as well as a physical examination. It is essential that a complete story of the back pain be reviewed including injury history, aggravating and alleviating conditions, associated pain symptoms (fever, numbness, tingling, incontinence, etc.), as well as the duration and progression of symptoms. Aside from routine abdomen and extremity evaluations, rectal and pelvic examinations may eventually be required as well. Further tests for diagnosis of low back pain can be required including blood and urine tests, plain film X-ray tests, CAT scanning, MRI scanning, bone scanning, and tests of the nerves such as electromyograms (EMG) and nerve conduction velocities (NCV).

Self-care remedies for pain relief include cold pack and heat applications, topical analgesic balms, avoiding reinjury, eliminating heavy lifting, and taking over-the-counter pain medications.Source: iStock

What are treatment options for low back pain?

So, how is low back pain treated? As described above, the treatment very much depends on the precise cause of the back pain. Moreover, each patient must be individually evaluated and managed in the context of the underlying background health status and activity level.

As has been highlighted by research presented at the national meeting of the American College of Rheumatology, a very important aspect of the individual evaluation is the patient's own understanding and perception of their particular situation. British researchers found that those who believed that their symptoms had serious consequences on their lives and that they had, or treatments had, little control over their symptoms were more likely to have a poor outcome. This research points out to physicians the importance of addressing the concerns and perceptions that patients have about their condition during the initial evaluations.

Finally, it should be noted that the conditions listed above are intended for general review. There are many other possible causes of back pain, including upper back pain, that have not been discussed.

Are there home remedies or other treatments for low back pain?

Long-term optimal results often involve exercise rehabilitation programs that can involve physical therapists.Source: istock

What is the prognosis for low back pain?

The outlook for low back pain absolutely depends on its precise cause. For example, acute strain injuries generally heal entirely with minimal treatment. On the other hand, bony abnormalities that are irritating the spinal cord can require significant surgical repair and the outlook depends on the surgical result. Long-term optimal results often involve exercise rehabilitation programs that can involve physical therapists.

Is it possible to prevent low back pain?

Avoiding injury to the low back is a method of preventing low back pain. Additionally, conditioning exercise programs designed to strengthen the lumbar area and adjacent tissues can help to minimize risk of injury to the low back. Specific programs to relieve and prevent back pain can be designed with the help of physical therapists and other treating health care professionals.

Which health care specialties treat low back pain?

Physician specialties that evaluate and treat low back pain range from generalists to subspecialists. These specialties include emergency medicine physicians, general medicine, family medicine, internal medicine, gynecology, spine surgeons (orthopaedics and neurosurgery), rheumatology, pain management, and physiatry. Other health care providers for low back pain include physical therapists, chiropractors, massage therapists, psychologists, and acupuncturists.

How Do You Treat Tendonitis in the Elbow?

What is tendonitis in the elbow?

You can treat tendonitis in the elbow with medications, home remedies, alternative therapies, and surgery.

Tendons are the soft tissue that connects your muscles to your bones. They are tough but flexible and can be large or small depending on the area of the body. When tendons become inflamed, irritated, or undergo microscopic tears, this is called tendonitis.

A common type of tendonitis is lateral epicondylitis, commonly known as tennis elbow or elbow tendinopathy. Tennis elbow causes pain in the backside of your elbow and forearm. This is due to damage in the tendons that bend your wrist back and away from the palm of your hand.

Symptoms of tendonitis in the elbow

Common signs and symptoms of tennis elbow include:

Difficulty shaking hands, turning door knobs, or holding objects
Pain or burning of the outer elbow
Weak grip strength

Causes of tendonitis in the elbow

Tennis elbow is most commonly caused by overuse and/or muscle strain. Repeated motions and stress may result in a series of tiny tears. These are micro-tears in the tendons that attach your forearm muscles to the bony protrusion at the outside of your elbow, also known as your funny bone.

Playing sports like tennis or racquetball with poor technique is the most common cause of tennis elbow.

Lateral epicondylitis can also occur without any known repetitive injury. This is called idiopathic lateral epicondylitis.

Who gets tendonitis in the elbow?

Tendonitis of the elbow is very common in tennis players and other athletes. Individuals who participate in other activities that require repetitive and vigorous use of the forearm, wrist, and/or hand are also at risk.

Occupations such as auto repair professionals, butchers, cooks, carpenters, painters, and plumbers are all more prone to developing tennis elbow than the average person.

Individuals between the ages of 30 and 50 are more likely to get tennis elbow, but it can occur at any age.

Diagnosis for tendonitis in the elbow

Only a licensed healthcare professional can diagnose tendonitis in your elbow. Your doctor will want to examine your arm in addition to asking about your medical history, occupation, and physical activities.

Your doctor may recommend the following tests to rule out other causes of your elbow pain:

Electromyography (EMG): An EMG can rule out nerve compression.
Magnetic resonance imaging (MRI) scan: An MRI can determine the extent of damage in your tendon or rule out other injuries.
X-rays: An X-ray can provide clear images of the bones of and around your elbow.

Treatments for tendonitis in the elbow

There are several treatments available for tennis elbow. Most patients recover without surgery.

Medications

Over-the-counter pain relief drugs like acetaminophen and Non-steroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and swelling in the elbow.

Home remedies

Your doctor may recommend you do the following:

Ice: Apply a cold pack or bag of ice with light pressure on your elbow for 15 minutes at a time. You can ice three to four times a day.
Improve Technique/Form: Ensure that your tennis strokes or other relevant motions adhere to proper form and technique.
Rest: Avoid any activities or movements that aggravate your elbow tendonitis pain.

Alternative therapies

There are various other non-surgical treatment options for tendonitis in the elbow, including:

Physical therapy: Physical therapy exercises can help alleviate elbow tendonitis pain. They can also improve your strength, flexibility, and range of motion. Your physical therapist may also perform massage, electrical stimulation, and other techniques to promote healing.
Platelet-rich plasma (PRP): PRP is a treatment designed to improve the biologic environment of the tissue. Platelets are known for their high concentration of growth factors, which can be injected into the affected area. PRP involves injections of a concentration of the patient's own platelets to accelerate healing.
Steroid injections: Steroid injections such as cortisone injections are effective anti-inflammatory treatments.
Using a brace: Using a brace can reduce symptoms by allowing the muscles and tendons of the elbow and forearm to rest.

Another alternative for treatment is called extracorporeal shock wave therapy. It is a relatively new non-invasive therapeutic procedure. This shock wave therapy induces micro-trauma to the affected tissue. The tissue responds to this by healing itself.

Surgery

If your symptoms of elbow tendonitis do not improve after 6 to 12 months of treatment, your doctor may recommend surgery.

The most common surgical approach is called open surgery. This procedure involves making an incision over the elbow to remove the damaged muscle and tissue. Healthy muscle is then reattached to the bone. Open surgery is usually performed as an outpatient procedure.

Tennis elbow can also be repaired using small incisions and tiny instruments with arthroscopic surgery. Like open surgery, it is an outpatient procedure.

Your doctor will work with you to determine the best surgical approach for you.

Complications and risks of tendonitis in the elbow

As with any surgery, there are risks with tennis elbow surgery. The most common potential complications to consider include:

Infection
Loss of strength and flexibility
Physical therapy rehabilitation
Nerve and blood vessel damage

What Are the Symptoms of a Torn Tendon in the Shoulder?

Symptoms of a shoulder tendon tear or rotator cuff tear may include dull pain, tenderness, swelling, weakness, or stiffness

Injury and overuse are the two most common causes of shoulder tendon tears. Signs and symptoms of a shoulder tendon tear may include:

Dull, deep pain in the shoulder
Pain at night, particularly when sleeping on the affected side
Tenderness or swelling in the shoulder
Inability to bear weight on the affected side
Bulge or deformation around the shoulder
Hearing or feeling a snap or popping when moving the shoulder
Shoulder weakness, which is frequently caused by pain on exertion
Shoulder stiffness with some inability to move the affected area
Inability to keep the arm elevated

Shoulder tendon tears can be either partial or complete:

Partial tear: Occurs when the tendon is not completely severed
Complete tear: Causes the tendon to split into two sections

What is the rotator cuff?

Your shoulder is your body's most flexible joint. The rotator cuff is a collection of four muscles and tendons that aid in the movement and stabilization of the shoulder joint:

Supraspinatus, which helps move the arm away from body
Infraspinatus, which aids in the arm's external rotation
Subscapularis muscle, which aids in the arm’s internal rotation
Teres minor, which aids in the arm's external rotation

Every day, these shoulder tendons and muscles are put under a lot of strain. Cleaning, painting, gardening, lifting boxes, and even recreational activities like golf, tennis, and swimming can cause shoulder tendon strain or tear.

How is a shoulder tendon tear diagnosed?

Diagnosis of a shoulder tendon tear may begin with taking your medical history and performing a physical examination. During the examination, your doctor may:

Look for areas of discomfort or pain in the shoulder
Examine the shoulder joint's range of motion and strength

An X-ray and a magnetic resonance imaging (MRI) scan may be ordered if a rotator cuff tear is suspected. Your doctor will rule out other disorders that can produce similar symptoms, such as a pinched nerve in the neck or shoulder arthritis.

Who is at risk of a shoulder tendon injury?

Shoulder injuries can happen to anyone, whether from falling on an outstretched arm, direct impact, or repetitive overuse. However, some factors may increase your risk of shoulder tendon injury:

Age: Older people are at higher risk of wear and tear due to the degenerative weakening of soft tissue. Degenerative disorders usually start at age 40 and become more common with age.
Jobs: Repetitive exertion of the shoulder can cause tiny tears in the soft tissue, and this damage can worsen over time. Construction workers, painters, and athletes are at greater risk of getting injured this way.
Smoking: Smoking reduces the flow of blood and oxygen to the body's soft tissues, increasing the susceptibility to injury and slowing the healing process. Smoking can also make it difficult to strengthen muscles and prevent future injuries.

What are treatment options for rotator cuff tears?

Tendon tears range in size from microscopic injuries to complete ruptures in which the tendon is completely torn from the bone. Furthermore, sometimes the initial injury results in a secondary tear.

Mild to moderate tears

If you suspect a rotator cuff tear, speak to an orthopedic expert. They may recommend the following treatment for mild to moderate tendon injuries.:

Anti-inflammatory medications
Steroid injections
Physical therapy

In some cases, a combination of rest, conservative treatments, and patience is enough to help a tear heal on its own. A mild tear usually heals in 6-8 weeks, but a more serious tear may take up to 12 weeks to heal.

Severe tears

Surgery may be needed in severe cases, especially for athletes or people who work in construction:

Arthroscopic surgery is used to treat a partial or complete tear of the rotator cuff tendon.
For difficult tears, open surgery (with a larger incision) may be required.
After surgery, it's critical to immobilize the shoulder and gradually begin rehabilitation exercises to regain shoulder strength.

How Long Does It Take to Heal Shoulder Tendonitis? Treatment

Shoulder tendinitis can take 4 weeks to 6 months or longer to heal, depending on the severity of your injury

Shoulder tendonitis can be very painful and recovery times vary depending on the severity of injury:

Minor injuries typically heal within 4 weeks with proper treatment and care.
Moderate injuries may take about 6-8 weeks to heal.
In some cases, recovery may take as long as 6 months to a year.

Preventing further damage to the affected area is vital when it comes to shoulder tendon injuries, since they can be difficult to heal even with rest, medications, and physical therapy.

What is shoulder tendonitis?

Shoulder tendonitis occurs when your rotator cuff and biceps tendon becomes irritated or inflamed due to overuse of the arms. Different types of shoulder tendonitis include:

Calcific tendonitis: Usually caused by a buildup of calcium crystals in the shoulder tendons.
Rotator cuff tendonitis: May cause severe neck pain along with shoulder pain.
Supraspinatus tendonitis: Common among athletes.

Depending on the cause, shoulder tendonitis may be further classified as:

Acute shoulder tendonitis: Symptoms may develop suddenly due to excessive overhead activities.
Chronic shoulder tendonitis: Symptoms are typically caused by a degenerative disease, such as arthritis, or long-term repetitive wear and tear.

Who is at risk of developing shoulder tendonitis?

Shoulder tendonitis often affects people who play sports or do work that requires them to move their arms over their heads repeatedly. People most at risk include:

Tennis players
Swimmers
Baseball players
Painters
Carpenters
Plumbers
Construction or maintenance workers
Welders
Golfers

While the most common cause of shoulder tendonitis is overuse of the shoulder tendons, other risk factors can increase the chances of developing the condition:

Poor work posture (especially leaning over a computer for extended periods)
Tight muscles and tissues around the shoulder joint (may be hereditary or due to a sedentary lifestyle)
Weakness or imbalance of the muscles in and around the shoulder (possibly due to poor diet)
Severe trauma to the shoulder

What are the signs and symptoms of shoulder tendonitis?

Signs and symptoms of shoulder tendonitis may include:

Pain and swelling at the tip of the shoulder. Pain and swelling may also be noticed in the upper, outer parts of the arm.
This pain may often get worse when patients reach, lift, pull, push or lie on their sides. This can make it difficult to sleep comfortably if patients roll or sleep on their shoulders.
There may also be a clicking (grating) sensation or sound when the tendon moves.
Patients experience shoulder weakness.
Patients are unable to hold their shoulders in certain positions.
Some patients may also develop stiffness and experience decreased range of motion.

Shoulder tendonitis may cause severe complications that can limit your ability to perform daily activities. If your symptoms don’t resolve on their own within a few days, seek medical help for an accurate diagnosis and appropriate treatment.

What are treatment options for shoulder tendonitis?

Most cases of shoulder tendonitis are treatable. But the sooner you start treatment, the greater your chances of recovering faster. If caught early, conservative treatment is usually successful.

Depending on the severity of your condition, your doctor may recommend home remedies, physical therapy, or surgery.

Home remedies

Rest: Restrict any activities that make symptoms worse, including lifting things overhead and or making forceful reaching movements.
Ice: Applying an ice pack or cold compress may reduce shoulder swelling and provide relief from pain.
Posture: Maintaining proper posture may reduce strain on the shoulders and arms.

Physical therapy

If your symptoms of shoulder tendonitis interfere with your normal daily functions for more than 1-2 weeks, see a physical therapist.

Your physical therapist may recommend functional training with strengthening and stretching exercises using slings and braces.
In some cases, a steroid injection may be administered directly into the shoulder. This can temporarily reduce pain, although it will need to be repeated once a month for 3 months.

Surgery

If you are still in pain after trying these conservative treatments, your doctor may recommend a procedure to help repair the damage in the rotator cuff, either with open surgery or a minimally invasive procedure. The general goal of surgery is to make more space for the rotator cuff by removing parts of the bursa that are damaged or inflamed.

What Is the Best Exercise for Plantar Fasciitis? 6 Stretches

Are your heels painful to walk on? Find relief with these 6 plantar fasciitis stretching and strengthening exercises

Plantar fasciitis can cause pain and tension around your heel and calf. But with these 6 doctor-recommended stretching and strengthening exercises, you can find some relief and improvement of symptoms over time.

Aim to do each exercise 2-3 times a day, but not necessarily all at once.

6 best plantar fasciitis stretches and exercises

The following exercises are not only effective but also easy to perform at home on a daily basis. If you aren’t sure about how to perform them correctly, ask your doctor or physical therapist.

1. Toe stretch

Sit on the floor and keep your leg extended.
With the help of your hand on the affected side, pull your big toe on the affected foot towards you.
Hold this position for 15-30 seconds.

2. Towel stretch

Sit on the floor or a chair holding a folded towel under the ball of your affected foot.
Keeping your back and knees straight, try pulling the feet towards your with the help of the towel.
Hold this position for 15-30 seconds.

3. Calf stretch

Stand facing a wall with your back straight and arms extended on the wall.
Bring your affected leg backward, a step away from the unaffected leg.
With the heel of the back leg on the floor, bend your front knee so that you feel a stretch in the back leg.
Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg.
Hold the stretch for 15-30 seconds.

A slight variation in the exercise involves bending your back knee a little and then performing the exercise. However, your back heel should be still on the floor. This will stretch a different set of muscles in the back leg.

4. Towel curl

Sit in a chair and place a small towel on the floor.
Curl the towel towards you using only your toes on the affected foot.
Release the towel by pushing the towel away from you.

5. Tennis ball roll

In a sitting position, roll a tennis ball under your affected foot using the arch of your foot.
As your condition improves, perform the same exercise in a standing position.

6. Marble pickups

Put 10-20 marbles and a bowl on the floor.
Sit in a chair in front of the marbles, keeping your feet on the floor.
Using the toes of your affected foot, try to pick up one marble at a time and place it in the bowl, doing this until all the marbles are in the bowl.

How do doctors diagnose plantar fasciitis?

To diagnose plantar fasciitis, your doctor will take your medical history and perform a physical examination of your foot. They check for tenderness in any location on your feet.

Usually, no tests are necessary for diagnosing plantar fasciitis. However, an X-ray of the affected foot may be ordered if your doctor wants to:

Rule out a stress fracture.
See if bone spurs are causing the pain.

How is plantar fasciitis treated?

Most people notice improvement of plantar fasciitis within a year of practicing the following at home remedies:

Wearing well-cushioned shoes when walking (never walk barefoot)
Avoiding wearing sandals without built-in arch support
Using shoe inserts, arch supports, or customized foot orthotics (your doctor may recommend seeing a podiatrist to learn about which insoles to use)
Using a night splint when sleeping to provide constant passive stretching of the related Achilles tendon and plantar fascia (Achilles tendon attach the calf muscles to the heels, and plantar fascia is the thick band of tissue along the bottom of the foot that connects the heel bone to the toes)
Massaging the area
Applying ice on the affected area 3-4times a day for 10-15 minutes
Avoiding prolonged standing
Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
Losing weight, if overweight
Using crutches to limit the strain on your feet

Depending on the severity of your condition, your doctor may recommend:

Cortisone (steroid) injections
Physical therapy
Extracorporeal shockwave therapy (ESWT)

If after 12 months you experience no relief from symptoms, your doctor may recommend surgery that involves either lengthening the calf muscles or cutting and releasing the plantar fascia.

How Do You Fix Medial Epicondylitis? Golfer’s Elbow Treatment

Medial epicondylitis, or golfer’s elbow, can be fixed if identified and treated early. Learn about treatment and exercises for golfer’s elbow

Medial epicondylitis is a type of tendinitis that affects the elbow joint. The medial epicondyle is a bony bump on the inside of the elbow joint. When the joint is overused or injured, it can cause inflammation and pain.

Medial epicondylitis is also commonly called:

Golfer’s elbow
Baseball elbow
Suitcase elbow

Medial epicondylitis can be fixed through rest, anti-inflammatory medications, and rehabilitation exercises.

What causes medial epicondylitis?

Often, the condition is caused by excessive use of the joint during inward rotatory movements of the wrist and fingers. Poor posture while playing sports and repetitive stress can cause micro-tears in the tendons of the forearm muscles, leading to inflammation and restricted movement of the elbow joint.

Activities that can cause medial epicondylitis include:

Playing sports such as golf, baseball, rowing and badminton
Carrying heavy weights
Carpentry
Plumbing
Painters
Construction workers

What are the signs and symptoms of medial epicondylitis?

Signs and symptoms of medial epicondylitis include:

Pain around the wrist joint (pain can involve the entire medial side of the forearm and palm)
Limited elbow movements
Red and swollen elbow
Stiff elbow
Weakening of wrist movements
Tingling sensation on the forearm and wrist

How is medial epicondylitis diagnosed?

During a physical examination, your doctor will keep your arm on a table and apply pressure while asking you to flex your arm. If you aren’t able to flex your arm and complain of pain, a diagnosis of golfer’s elbow will be confirmed.

In addition to this exam, your doctor may order an X-ray to assess the inflammatory situation of the bones inside your arm.

How is medial epicondylitis treated?

Typically, firstline treatment of medial epicondylitis involves restricting the movement of the affected elbow to stop the inflammation from progressing. Treatment may also include:

Applying ice packs
Bracing
Strengthening exercises
Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain

In severe cases, the following treatment may be necessary

Corticosteroid injections administered into the elbow joint
Surgery

Rehabilitation exercises for medial epicondylitis include:

Squeezing exercises: Helps build strength in the forearm
Finger extensions: Involves squeezing your fingers together using a rubber band, then extending your fingers as much as possible
Wrist extensions: Involves slowly lifting and lowering your wrist, and can be done with increasing weights for greater strength building
Forearm pronation and supination: Involves moving your palm to face upwards and then face downwards

Can medial epicondylitis be prevented?

Golfer’s elbow can be prevented with the following measures:

Avoiding overuse of one elbow
Wearing proper supportive equipment if needed
Stretching the elbow before intense activity
Building elbow strength to avoid injury
Resting the joint in between activities to allow for healing
Stopping activity if pain occurs
Practicing proper form and posture when playing sports

With proper preventative measures and resting of the arm, medial epicondylitis can be completely avoided.

What is the prognosis of medial epicondylitis?

Chances of full recovery of the elbow are very high if the condition is timely and properly managed. However, if ignored for a long time, it can lead to permanent erosion and damage of the elbow joint and loss of function. It is therefore important not to ignore pain around the elbow to avoid complications.

What Is Myofascial Tissue Release? Myofascial Pain Syndrome

Myofascial tissue release is a massage therapy technique focused on relieving pain from inflamed trigger points in the body caused by myofascial pain syndrome.

Myofascial pain disorder simply means longstanding muscle pain. The soft tissues in the body support muscles and bones. In myofascial pain syndrome, the soft tissue gets inflamed and develops a trigger point, which the ache generally starts from that trigger point.

Trigger points may also be spaces of tight muscle strands that result commonly from abuse, overuse or injury. Myofascial tissue release (MFTS) is a type of therapy frequently used to treat myofascial pain disorder. A myotherapist utilizes massage strategies using their hands, fingers, elbows or knuckles to ease pressure at the trigger points.

Myofascial release focuses on lessening the pain by easing the strain and stiffness in the trigger points. Often, it is difficult to understand which trigger point is responsible for which pain. Limiting the pain to a particular trigger point is truly challenging. Thus, myofascial tissue release opts for a broad range of muscles and tissues instead of single points.

Other conditions treated by myofascial release treatment include temporomandibular joint (TMJ) disorder, carpal passage disorder or potentially fibromyalgia or migraine headaches. The symptoms typically include:

Stiffness of the tissues that limit movement
A feeling of extreme tension on muscles or joints that produces pain
An ache in any part or portions of the body, including migraine or backache

What causes myofascial pain?

Myofascial pain can have two sources, pain produced from the skeletal muscle or connective tissues that are “bound somewhere around” the tight fascia. Pain may also arise from damaged myofascial tissue. This part of the tissue may contain compressed muscle strands and forms the so-called “trigger point,” which hinders the blood’s flow to the muscle strands, causing symptoms in that area, as well as areas at a distance (which share the same circulatory blood vessels).

How does myofascial tissue release work?

Most myofascial tissue release treatments function as massage therapy sessions.

The specialist will gently rub the myofascial tissue and feel for the firm or stiff regions. Typical myofascial tissue should feel pliable and flexible. The specialist will then start massaging and extending the regions that feel stiff with light manual pressure. Then, the specialist helps the tissue and supportive sheath at that point release pressure and stiffness. The cycle is repeated several times on a similar trigger point and other areas until the specialist feels the strain is completely gone.

These regions where the specialist is working may not be close to where the pain begins or is felt most precisely. Myofascial release works the more extensive framework of muscles that may be causing the pain. It attempts to lessen pressure all through the body by releasing trigger points across a wide section of the muscle framework.

What are the risks of myofascial tissue release?

Myofascial release by a professional is reasonably safe. Regardless of whether a person is attempting to relax or expecting to ease pain, massage treatment might be advantageous to reduce pain.

However, massage therapy is not ideal for the following individuals:

With burns, wounds or difficult injuries
With breaks or broken bones
With delicate bones
With deep vein thrombosis (clot) or deep vein swelling (thrombophlebitis)
Taking blood-thinning medications

In extremely rare cases, massage treatment might cause:

Interior bleeding
Shearing of blood vessels
Temporary paralysis or trouble moving the muscles
Allergic responses to oils, gels or creams
Nerve damage