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Soft Tissue Rheumatism

Soft tissue rheumatism refers to aches or pain that occur as a result of normal wear and tear, or repetitive stress on a particular soft tissue surrounding a joint (ie, bursae, ligaments, muscles or tendons), or due to inflammatory arthritic conditions.

Common soft tissue problems include:
  • Bursitis
  • Elbow Pain
  • Foot Pain
  • Hand Pain
  • Heel Pain
  • Shoulder Pain
  • Frozen Shoulder
  • Rotator Cuff Injuries
  • Simple self-care steps for Soft Tissue Rheumatism
  1. Protect the affected joint with an elastic bandage, sling or soft foam pad
  2. Rest and immobilize the affected area
  3. Apply ice pack
  4. Compress and elevate the affected joint (eg, knee or elbow).
  5. Perform stretching exercises to help restore full range of motion
  6. Bursitis
  7. A bursa is a small fluid-filled sac that cushions the muscles, tendons and bones in a joint. It helps keep these from rubbing against each other and reduces friction in the areas around your joints.
Bursitis refers to inflammation of the bursa. Repeated movement and pressure on the bursa can cause it to swell and become irritated and inflamed. Trauma, bacterial infection, or crystalline deposits (eg, in people with gout) can also cause bursitis. The joints that are usually affected by bursitis are the large joints such as the shoulder, hip and knee.

A person suffering from bursitis may experience pain and tenderness around the affected soft tissue, pain that worsens with movement or pressure, and visible swelling or skin redness in the area of the inflamed bursa; all of which may restrict movement and affect daily activities.

Seek medical attention as soon as you notice symptoms, if your pain doesn't subside with self-care , or if you develop fever (a sign of infection). Your doctor may prescribe you medication to relieve pain and reduce inflammation. However, if your bursitis is caused by an infection, you may be given antibiotics, and the infected bursa may be drained with a needle.

Elbow Pain
Your elbow's many tissues and bones play an important role in giving your arms and hands their complete range of motion. However, moving the elbow or hand the wrong way, or too much too often, can cause inflammation or tearing of a muscle or tendon at the elbow (epicondylitis), which results in elbow pain.

Tennis elbow refers to the inflammation of the tendons and muscles around the bony knob (lateral epicondyle) on the outer side of the elbow. The muscles and tendons that let you extend your wrist, open your hand, and turn your palm upwards are most at risk for this problem.

Playing a racket sport, or performing tasks that involves extending your wrist or rotating your forearm (eg, twisting a screwdriver, lifting heavy objects with your palm down) can cause tennis elbow.

The golfer's elbow occurs when the tendons and muscles at the bony knob of the inner elbow (medial epicondyle) become inflamed and torn. One or more muscles and tendons along the inner elbow may be injured.

Any movement that turns the arm down and flexes the wrist can cause this problem (eg, in a golf swing).

The goal of treatment is to relieve elbow pain and regain full function quickly and safely. You can help yourself by switching hands at work, resting your elbow to help it heal itself, applying ice or taking anti-inflammatory medications, and exercising to increase your flexibility.

Your doctor may suggest you wear a splint to relieve your symptoms, or refer you for physical therapy. For severe elbow pain, your doctor may give you a steroid injection into your elbow.

Foot Pain
Plantar fasciitis is a common cause of foot pain. This chronic problem is an inflammation of the plantar fascia, a band of ligament that connects the heel bone to the bones in the ball of your foot. This inflammation may result from overuse or excess body weight, which causes the plantar fascia to tear or pull away from the heel bone. Sometimes the inflamed ligament may also irritate a nerve and cause more pain. A bony spur may also develop where the fascia and heel bone meet.

The bottom or inside of your foot may hurt when you stand. The pain usually decreases after you walk a few steps, but it may return with prolonged movement. Other symptoms include sharp pain when getting out of bed, or when you stand up after sitting for a while, burning or shooting pain in your foot, and a dull ache in the foot after standing for long periods on a hard surface, or when running.

Complete recovery may take months. In the meantime, you can self-manage your foot pain by wearing properly fitted shoes and inserts (arch supports or heel pads), performing stretching exercises, massage and application of either heat or ice.

Your doctor may prescribe you with anti-inflammatory medications, custom-made orthotic supports or heel cups, night splints, physical therapy and, if needed, a steroid injection.

Hand Pain
The carpal tunnel is a narrow space inside the wrist that is surrounded by bone and ligament. This space lets certain tendons and a major nerve (the median nerve) pass from the forearm into the hand. Thickening of the tendon sheaths or fluid retention reduces the space inside the carpal tunnel and may compress the median nerve. This leads to a painful condition that affects the wrist, hand and fingers, also known as Carpal Tunnel Syndrome.

Tingling and numbness are the most common symptoms of Carpal Tunnel Syndrome. Some people also have hand pain or even a weakened grip. At first, these symptoms may disrupt your sleep at night. Eventually they may also occur during your daily routines – you may notice symptoms while you are driving or holding a newspaper. Over time, these symptoms may become more severe.

Pregnant women are particularly prone to this condition due to the mild fluid retention caused by pregnancy.

Certain repetitive hand activities may put you at higher risk for developing Carpal Tunnel Syndrome. Therefore, you should learn to modify the way you use your hands to lower your risk, such as keeping your wrist in neutral, watching your grip, minimizing repetitive movement, resting your hand, reducing the speed and force of hand movement, and performing some conditioning exercises to strengthen your hand and arm muscles.

Physiotherapy or injections can help relieve your hand pain. You may feel some soreness for 24 to 48 hours following the injection. But after that, you're likely to have symptom relief for many weeks.

Surgery may be required to relieve the pressure on the median nerve or if the symptoms become severe. Pain relief is usually immediate.

Heel Pain
The Achilles tendon, which connects the heel bone to the calf muscle, allows us to lift our heels off the ground, thereby enabling us to walk, run, jump or leap. Inflammation of the Achilles tendon (Achilles tendinitis) is a common condition that causes heel pain. Although it is a relatively common condition among runners, Achilles tendinitis can also occur in other sports, such as high jumping and gymnastics.

Achilles tendinitis is caused by sudden or repeated overuse or trauma to the Achilles tendon (eg, when exercising too fast or by wearing poorly fitted shoes), or as a result of certain medical conditions (eg, seronegative arthritis). Symptoms include pain behind the heel, ankle and lower calf when performing weight-bearing exercise.

You can take several steps to avoid potentially serious problems later. These include stopping weight-bearing exercise until the pain is gone, switching to non-weight-bearing exercise (eg, swimming), using warm soaks or cold packs, and wearing properly fitted shoes.

Warning: if you ignore your symptoms and continue to exercise, your Achilles tendon may rupture. This injury is serious and usually requires surgery or prolonged casting.

Your doctor may treat your pain with anti-inflammatory medications and physical therapy. You may also be given a heel pad to be worn inside your everyday footwear and sports shoes. Most importantly, follow your doctor's advice about resuming exercise.

Shoulder Pain
Your shoulders have the ability to perform a range of motion that no other part of your body has. This flexibility allows your arms to do all the things that you need them to do. However, it also makes your shoulders more likely to become injured, causing pain and affecting movement in your arm, hand, neck and shoulder.

The most common shoulder injuries include dislocation, sprain, separation, and fractures (broken bones). Shoulder injuries may occur when the arm is jerked or when you fall on a shoulder, outstretched arm or elbow. Whatever the cause may be, immediate treatment is needed to relieve pain and regain the use of your shoulder.

Frozen Shoulder
You may not use/move your shoulder much when you have shoulder pain. This can lead to “frozen shoulder” (also known as capsulitis), a condition where the unused shoulder becomes stiff and sometimes unable to move freely.

Painful shoulder inflammation can also cause sticky bands (adhesions) to grow around the shoulder joint. These adhesions make shoulder movement even more painful.

Women are more likely to have frozen shoulder than men. This problem also occurs more frequently in women in their 40s. In some cases, people with previous shoulder injuries may later develop frozen shoulder.

Initially you may experience nagging pain in the affected shoulder. Other symptoms include increased shoulder pain as you move your arm, shoulder pain that keeps you from sleeping, shoulder stiffness that makes it hard to perform daily tasks, and an arm that you are unable to raise or rotate beyond a certain point.

Your doctor may start you on an exercise program to restore your shoulder's flexibility and range of motion. The exercises may be painful initially, but they will help free your shoulder joint of adhesions. Some of these exercises can be done at home, while other may be done with the help of a physical therapist.

If your shoulder is severely “frozen”, your doctor may suggest further medical treatment. Anti-inflammatory medications can help relieve pain. You may also receive surgical treatment in the hospital

Keep in mind that no treatment can replace shoulder exercises. You need to maintain your shoulder mobility after treatment.

Rotator Cuff Injuries
The rotator cuff is a powerful team of muscles and connective tendons that attach your upper arm to your shoulder blade. A healthy rotator cuff gives your shoulder strength, flexibility and control to reach, throw, push, pull and lift objects.

Rotator cuff tendons can become inflamed or damaged in many ways. The most common cause of shoulder pain is wear and tear. Soft tissue can also become inflamed or torn from overuse, pinching (impingement) and calcium deposits (calcification).

A worn out rotator cuff may tear at weak areas. If this happens, you may feel and even hear a clicking or popping sound in your shoulder. A tear can result in pain, weakness and loss of normal shoulder movement.

Your treatment depends on the type of shoulder problem you have. These include rest, ice packs to relieve muscle spasm, heat to increase blood flow, pain medications and/or steroids to reduce inflammation and relieve pain, and exercise. If your injury doesn't improve, you may need surgery.

Once your shoulder has healed and you've learned how to move safely, you can resume living your normal daily life. Try not to strain your rotator cuff, and remember to exercise – it's one of the best ways to keep your shoulder fit and strong.

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