Shoulder Pain Management

Pain Management is taken very seriously at SKI . We do not agree with the age old concept of “No Pain No Gain”. Whether it be a post operative total knee or shoulder replacement or a patient with severe back pain who does not require surgery, we try all available modern techniques and modalities in achieving a pain free status. It is our observation, as also scientifically reported, that such patients perform very well at work, after surgery and in day to day activities. Pain inhibits efficiency.

Basic to modern pain management is an understanding of the structures involved in causing pain. We have the privilege of a Pain Management Specialist and Specialist Physiotherapists associated with the group who have extensive experience in dealing with such issues. Therapies might include simple exercises and massage, machine based modalities, injections and medication. Surgery is the last resort.

Some features hereby described elucidate the concepts on which current day pain management is based

Myofascial Pain Syndrome (MPS) is characterised by the presence of myofascial trigger points (TrPs), which are tender, hypersensitive points in skeletal muscles contained within palpable taut bands. You can feel them aspainful lumps of thickened tissue, like nodules or small peas. Pressure on an active TrP produces local pain at the TrP site and often produces distant referred pain. TrPs typically cause muscle weakness, incoordination and dysfunction resulting in pain, poor strength, stiffness, numbness, tingling, burning, etc. MPS is found in a majority of desktop workers including IT Professionals.

Gradual development of TrP's is usually due to incorrect posture, abnormal bone structure (short leg, tilted pelvis, short upper arms, etc.), poor body mechanics and ergonomic issues related to work station set up, job design, etc.

A Pain Specialist can usually predict the location of active TrP's and treat them.

Treatment is customized and might include short periods of rest, passive stretches, heat, light activity, manual therapy and injections. Manual therapy is the key advanced skill that relieves most painful patients

RSI is a multifactorial complaint syndrome affecting the neck, upper back, shoulder, upper and lower arm, elbow, wrist or hand, or a combination of these areas, which leads either to impairment or to participation problems. At times it is work related, commonly found in desktop and sedentary workers including IT Professionals.

15-25% of all computer users worldwide (both vocational and recreational) are estimated to have RSI. RSI accounts for approximately 66% of all work-related illnesses in USA (1999). A survey of 500 software professionals at Hyderabad in 2000 revealed that over 50% had symptoms of established RSI.

RSI can seriously disrupt work and domestic life. RSI is not a compensable occupational illness in India. The onus of RSI prevention is entirely on Indian workers.

Early identification of RSI and competent medical intervention is critical. Ergonomics, RSI and Myofascial Disorders do not even find a passing mention in the Indian Medical Curriculum and it is not unusual to find Indian doctors (even specialists) and physiotherapists who have not even heard of RSI, let alone have the ability to treat it.