Dr. Ravi Akbari

Neck pain is a common medical condition, which can be easily treated if proper care and medications are taken. It usually occurs due to strained neck muscles, often caused bad posture, though there might be other causes as well. Rarely, neck pain can be a symptom of a more serious problem as the condition is relatively mild in nature. The symptoms of a neck pain are very obvious which refers to any kind of discomfort in moving your neck on a daily basis. Along with this you might also have headache, stiffness of the head and muscle tightness.

Some of the most common causative factors of neck pain are listed below:

1. Muscle strains: A muscle strain generally happens when you exert too much pressure on your neck continuously for long periods. It also happens when you have your neck fixed in the same position for long hours of the day. Muscle strains in the neck may occur when you keep your neck bent in the wrong way while doing activities like reading a book, looking at your mobile phone or working over your laptop for extended hours.
2. Worn joints: Just like all the other bodily joints, the neck joint also tends to wither and degrade with age. This phenomena is known as the wear and tear of the joints. The bones of the neck joint tend to wither with time, thereby making your joint frail and exposing it to various pains and medical conditions.
3. Nerve compression: Nerve compression is a medical symptom whereby, there is excessive pressure put on one particular nerve in the body. Herniated discs or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord, hence causing a long lasting neck pain. Damage caused from a nerve compression may be minor or severe depending on the pressure applied. It may cause temporary or long lasting problems depending on the degree of damage caused. The earlier you get a diagnosis and treatment for nerve compression, more quickly you will find relief.
4. Whiplash: Neck related injuries are common phases of pain and discomfort caused due to an external damage to the neck as a result of a tragic sports related or vehicular accident. A neck injury is also known as a whiplash and it refers to an injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip. Whiplash mostly occurs during accidents, physical abuse or other trauma. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

Sciatica is a very common neuropathic pain that is caused by damage to the sciatic nerve, a large nerve that runs from the lower back region down the end of each leg. It is the largest single nerve in the body.
This condition affects around 4 out of 10 people at some point of their lives. The nature of the pain varies from a mild ache to a sharp stinging sensation and may cause feelings of numbness and extreme weakness.

Causes of Sciatica
The causes for the onset of Sciatica are numerous. Some of them are as follows:

• Slipped lumbar disc
• Muscle inflammation
• Internal bleeding
• Pregnancy
• Obesity
• Awkward sleeping position
• Uncomfortable footwear
• Spinal injury

How can physical therapy help?
There are many ways of treating Sciatica, such as medication, acupuncture and surgery, which can provide relief. The most common and easy treatment method however is physical therapy. A progressive and controlled exercise routine that is specifically tailored to the nature of the condition in consultation with a physical therapist acts as an effective remedy in treating the problem. It alleviates pain and also eliminates the chances of relapse.

Physical therapy exercises used to treat Sciatica are of many types. They are a combination of core strengthening, muscular stretching and aerobic conditioning routines, which aim at correcting the root of the problem.

The different types of exercises employed to treat Sciatica include the following:

1. Strengthening exercises: These aim at strengthening the spinal column and the pelvic region, which includes the hips and buttocks. They help in making the muscles and ligaments in this region more robust and allow for improved flexibility and support.Lunges and squats are some of the examples.
2. Stretching exercises: These provide pain relief through improved agility and flexibility. The most important aspect of these routines is stretching and exercising the hamstring. Hamstring, stretches, calf stretches and tricep stretches are a part of stretching exercises.
3. Aerobic conditioning: These are cardiovascular exercises of low intensity, which provide pain relief through the release of endorphins and the facilitation of fluid and nutrient exchange. Examples of these are swimming and brisk walking. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.

Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. There are 2 types of arthritis the knee joint in the human body can get afflicted with. They are:

Osteoarthritis 

The form of arthritis which, with increasing pain, slowly wears down the joint cartilages is called osteoarthritis. This form of arthritis usually affects people after the age 40. The symptoms of osteoarthritis include:

1. Severe pain in the knee joints
2. Pain after walking up the stairs and it subsiding once you are on rest
3. Severe pain after the movement of joints for a long time
4. Pain that becomes worse in rainy days
5. Joints becoming stiff after waking up in the morning but they improve in the latter part of the day
6. Pain which also occurs in the thighs and the genital regions coupled with joints swelling and joints getting stiff after rest.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic form of arthritis caused because of the knee joint inflammations. This form of arthritis can occur at any age. Being an auto-immune disease, its symptoms include, but are not limited to:

1. Severe pain in the morning
2. Mild fever accompanying the pain
3. Joints suddenly becoming swollen, red and warm causing, immense pain
4. Sudden stiffness of the joints
5. Pain that increases in cold weather
6. Mild fever, extreme tiredness and weakening of the muscles

Doctors are still doubtful about what exactly causes the disease; but the deformation of the immune system might cause the damage of the joints, causing people who are already suffering from obesity, smokers, and women, in general, more prone to this disease.

1. If you are overweight or obese, losing some of those extra pounds can go a long way in reducing the pain.
2. Muscle-stretching exercises are effective in keeping the knee joints flexible.
3. Dry needling, cupping, taping can help to control the pain and keep the joint supported.
4. Prescribed dosage of anti-inflammatory drugs such as Tylenol, Motrin, and Advil or injections of hyaluronic acid might relieve your pain.

If regular treatments do not work, you might opt for knee-replacement surgery and osteotomy (the process of cutting a bone with the help of surgery) which might better the alignment of the knee by transforming the bone shapes.

Physiotherapy for knee arthritis

Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions. The main goals of physiotherapy for your knee arthritis are:

1. Reduce your knee pain and inflammation.
2. Normalise your knee joint range of motion.
3. Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
4. Strengthen your lower limb: calves, hip and pelvis muscles.
5. Improve your patellofemoral (knee cap) alignment and function.
6. Normalise your muscle lengths.
7. Improve your proprioception, agility and balance.
8. Improve your technique and function eg walking, squatting. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

Muscle strain or muscle pull is a condition, which is characterized by damage to the muscles or its adjoining tendons. Undue pressure can be exerted on the muscle when you are carrying out routine activities such as sudden lifting of heavy things or playing contact sports. The damage to the muscle is usually in the form of partial or complete tearing of the tendons and fibres attached to the muscles. The small blood vessels in the muscles can also be damaged by the tearing of the muscles, leading to local bleeding and bruising.

The symptoms of muscle pain are:

1. You will experience pain even while resting
2. There will be bruising, swelling and redness around the affected area
3. You will experience weakness of the muscles and tendons
4. The movement and mobility of the muscle will be impaired
5. You will experience pain when you use the affected muscles

The causes of a muscle strain are:

1. Playing contact sports can lead to injuries
2. Lifting heavy things
3. Exercising without a proper warm up routine
4. Lifting extremely heavy weights during exercise without proper acclimatization
5. Sleeping on one side only for a long period of time
6. Not stretching properly
7. Falling from a height

The treatments for muscle strains are:

1. Pain medications: You can opt for pain relieving medications such as non-steroidal anti-inflammatory medications to help combat the associated pain of a muscle strain.
2. Rice: Rice stands for rest, ice, compression and elevation. This treatment is usually the first step after suffering a strain, before opting for medications. This treatment prevents further aggravation of the problem.
3. Compress: You can alternate between hot and cold compress to reduce the swelling and pain.
4. Stretches: Once the affected area has healed, it is important for you stretch the muscles to improve their mobility and strength. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

Can you think of anyone who is into cycling (professional or a regular cyclist) and has not faced any injuries? You would have to think real hard, as injuries are a very common part of cycling. Right from the stage when a person starts learning to whatever stage they decide to stop at, injuries are a part and parcel of it.

There are, however, some tips that can help you avoid or reduce the incidence of injuries and their impact. These are gaining importance, as there are more people getting into the sport. Follow these and have a happy time cycling away!

1. Choose the right bike for your height and frame. Do not use cycles which are too small or too big for you.
2. Always use a helmet of the approved standards and use the helmet lock. It does not prevent scratches and skin tears, but definitely helps protect your head.
3. Common notion is that traffic rules don’t apply to cyclists. We all can remember how a cyclist gets off the bike at the signal and pushes the bike to cross over. This is wrong and the traffic rules apply as much to the cyclists as to the other motorists.
4. Using hand signals to indicate stopping, turning or changing lanes is also a practice that cyclists must follow.
5. When riding on the roads, keep safe distance from other vehicles. If there is a cycling lane, stick to it.
6. Though cycling with music in your ears is very appealing, try not to do that, especially if you are on the road where you might not be able to hear honking from other vehicles.
7. If you are cycling in a group, make sure you cycle one behind the other, not as a group.
8. Do not try bike stunts like speeding, wheeling, etc., on roads which have regular traffic. Choose off-peak hours and quieter areas for these stunts.
9. If you are crossing a pedestrian lane, get off the bike and cross it carefully.
10. Try not to use the edge of the road from where it is easy to fall off. Riding on the road helps others to notice you, so ride accordingly.
11. If you are riding at night, make sure you are wearing bright clothing; there are fluorescent colored bibs with reflectors available. The bike should also have reflectors, so others can see you and the bike.
12. For regular practice, try staying in residential areas, compared to roads which have other vehicles.
13. Ensure the bike is always maintained in a good condition with brakes and gears working properly. Get your bike serviced regularly, so it is well oiled and checked for proper functioning. If you wish to discuss about any specific problem, you can ask a free question.

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.

Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. There are 2 types of arthritis the knee joint in the human body can get afflicted with. They are:

• Osteoarthritis: The form of arthritis which, with increasing pain, slowly wears down the joint cartilages is called osteoarthritis. This form of arthritis usually affects people after the age 40. The symptoms of osteoarthritis include:

  • severe pain in the knee joints

  • pain after walking up the stairs and it subsiding once you are on rest

  • severe pain after the movement of joints for a long time

  • pain that becomes worse in rainy days

  • joints becoming stiff after waking up in the morning but they improve in the latter part of the day

  • pain which also occurs in the thighs and the genital regions coupled with joints swelling and joints getting stiff after rest.

• Rheumatoid Arthritis: Rheumatoid arthritis is a chronic form of arthritis caused because of the knee joint inflammations. This form of arthritis can occur at any age. Being an auto-immune disease, its symptoms include, but are not limited to:

  • severe pain in the morning

  • mild fever accompanying the pain

  • joints suddenly becoming swollen, red and warm causing, immense pain

  • sudden stiffness of the joints

  • pain that increases in cold weather

  • mild fever, extreme tiredness and weakening of the muscles

Doctors are still doubtful about what exactly causes the disease; but the deformation of the immune system might cause the damage of the joints, causing people who are already suffering from obesity, smokers, and women, in general, more prone to this disease.

When the knee pain is diagnosed as a form of arthritis, the following treatments are suggested:

1. If you are overweight or obese, losing some of those extra pounds can go a long way in reducing the pain.

2. Muscle-stretching exercises are effective in keeping the knee joints flexible.

3. Acupuncture and devices such as knee braces and knee caps can relieve the pain.

4. Prescribed dosage of anti-inflammatory drugs such as Tylenol, Motrin, and Advil or injections of hyaluronic acid might relieve your pain.

5. If regular treatments do not work, you might opt for knee replacement surgery and osteotomy (the process of cutting a bone with the help of surgery) which might better the alignment of the knee by transforming the bone shapes.

Physiotherapy For Knee Arthritis-

Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions.

The main goals of physiotherapy for your knee arthritis are:

1. Reduce your knee pain and inflammation.
2. Normalise your knee joint range of motion.
3. Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
4. Strengthen your lower limb: calves, hip and pelvis muscles.
5. Improve your patellofemoral (knee cap) alignment and function.
6. Normalise your muscle lengths.
7. Improve your proprioception, agility and balance.
8. Improve your technique and function eg walking, squatting. If you wish to discuss about any specific problem, you can consult a physiotherapist.

Physiotherapy and sleep paralysis have a deep connection when you have to treat sleep paralyses the intelligent way. To discover the benefits of physiotherapy in healing sleep paralysis, let's get a clear understanding of sleep paralyses first and then the role of physiotherapy. 

What is sleep paralysis and its common causes?
Sleep paralysis is a sleeping disorder, its symptoms are such  that you suddenly feel in the middle of the night or in mid sleep that you can't move, react, talk, etc. and feel that your body has frozen. This immobility is accompanied with frightful or eerie visions or sounds, which are not the reality and you still hallucinate. 
This is often caused because of the following reasons, which are considered common causes of sleep paralysis:

• A medical condition called narcolepsy
• No fixed time of sleeping and waking, thus creating imbalance in sleep patterns
• Inadequate sleep through the 24 hours
• Excessive stress and workload
• Alcohol consumption or drug abuse
• A bad diet like heavy meals at night before bedtime
• Extreme caffeine consumption

If any of these things are common, you may get a sleep paralysis.

Physiotherapy in healing sleep paralysis:
If it is a one night episode, you will eventually forget this. However, in case you are a victim every night or frequently, you may need some good remedies. Medications may not suit all, but physiotherapy is a safe mode of treatment, which suits all and people of all ages. That is why try physiotherapy for sleep paralysis at home or by going to a nearest physiotherapy center or expert.

How physiotherapy helps
Physiotherapy has some unique benefits like:

1. It brings a balance in blood circulation through the body, which helps in lowering the blood pressure, normalize mood, reduce stress, and makes the blood flow to the body organs and brain better, thus inducing a good night's sleep.
2. The exercise induced on to the body through physiotherapy has a dual effect. It makes the muscles workout, and induces the massage effect too. This makes the muscles more mobile, and brings warmth on the tissues. That is why exercising before bedtime can help you get a very peaceful sleep without fearful dreams and interferences of sleep paralysis attacks.
3. You get a better mood due to increased blood circulation and the feeling of well-being due to the agile and worked out muscles. This good mood and satisfaction after a nice physiotherapy session sometime before you sleep lets the serotonin or happiness and satisfaction hormone build up in the body and brain. This makes you sleep without stress and in a nice mood thus resisting sleep paralysis. If you wish to discuss about any specific problem, you can consult a physiotherapist.

Being flexible is not always about doing splits or doing some random bending. It is about achieving a level of mobility that will not hold you back from doing whatever you are able to do. Most people think that stretching or flexing your muscles and body as the first method to defend you from pain. But if stretching and flexing can be done correctly, it can lengthen one's muscles and give one relief from pains and aches. Stretching is also done to increase the functional range of one's joints and muscles. There are various ways by which one can stretch their muscles. However, the question which looms over here is which is the correct procedure and which is the wrong one.

The Wrong Vs the Right Way: Before discussing about the correct way, let us talk about the various wrong ways in which stretching can be done. The first rule is that if stretching is causing you pain or if it is hurting you, then you are probably taking it too far. A muscle needs to relax as much as possible, if it needs to stretch. If one is stretching so hard that he or she cannot relax then the muscle will not lengthen. Stretching should never be painful.

One should also avoid stretching for an insufficient length of time. Only a few seconds of stretching will not hold the therapeutic effects of stretching.

The following methods are few of the correct ways to stretch:

1. Always start with the warm muscles. Warm your muscles by doing some aerobic movement or by applying heat with the help of a warm bath.
2. After warming your muscles, monitor your level of discomfort. Let it go once you feel pain.
3. Hold any stretch for at least 30 seconds.

Stretching the Correct Muscle: There are muscles, which need to be stretched and there are muscles, which should not be. So getting to know the correct muscles to be stretched is as important as knowing the correct procedure to stretch your muscles. Every muscle, which does not hurt should not be stretched. There are different types of muscles that cause pain like stiff, tight, short muscles and long muscles. Muscles that are tight should only be subjected to stretching. Stretching muscles that are too long is not a good idea.

Using Physiotherapists: Most people who cannot determine which muscle should be stretched and which should not be should consult a physiotherapist. Physiotherapists can quickly and easily diagnose muscular issues. They will also show ways to stretch which are most effective for particular needs.

Stretching should be made a part of one's life. It is a way by which one can become their healthiest self and avoid muscular imbalances.