Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Nerve And Muscle Disorders
Treatment of Hip Disorders
Neuro Physiotherapy Treatment
Treatment of Knee Injury
Pregnancy Exercise Therapy
Treatment of Sports Injuries
Treatment of Splinting
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Heat Therapy Treatment
Post Pregnancy Classes
Orthopedic Physical Therapy
Treatment of Shin Splints
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Patient Review Highlights
Dr. Nithin Krishna K provides answers that are helped me improve my health. Thanks
1) It used to pain in L4 and L5 in my back of body for 4-5 years but now the pain is un bearable. 2) According to the MRI test, it is observed that the nerves below L4 and L5 has been succumb told orthopedist. 3) It pains in my back while Sitting and standing.
Hi, I am 24 years old. I am having knocked knees problem only in right leg, left leg is normal. How can I cure it?
I am a patient of RA from past 2 years. My joints r stiff n therefore I have problem sitting on floor. How I can make this better please help me as how to improve my movements.o
My right foot was fractured beneath the ankle. Consulted a doctor and he plastered POP. It's been 25 days and I'm taking complete rest, pain is gradually decreasing. Question is I have a commitment to go for trekking in next month. Is this good idea to go for trekking with two months old fractured foot? I heard "a fractured bone takes 3 to 4 months to heal completely" is it true?
Dear Sir, I am suffering from cervical spondylosis and frozen shoulder for the last five years. Xray report says that I.V. Disc spaces are reduced at C5 - C6 and C6-C7 levels. My all pathological reports are normal except vitamin D 18.17.I am using sprays Plus capsule and Maxnuron LC once daily and vitamin3 sachet once a week. Is this curable or should I take some other treatment? My both shoulders have very pain all the time and in the morning my neck is full of stiffness. My age is 60 years and works on computer for 6 hours daily. Is physiotherapy necessary in this condition and age.
From past 2 months whenever I get up in the morning after sleeping, my neck pains a lot. I can't move it freely. I am not using Pillow since 3-4 yrs. What can be the reason? Shall I start using pillow? Pls suggest some measures.
HI Dr. I am Saranjit Singh Sehgal age 62 years senior Citizen. I have pain in the back since from two year as I had a standing job for long hours as Manager in some reputed Sweets shop. I have got MRI done and other check up done. Report says compressive collapse fracture involving superior end plate of D12 vertebra likely osteoporosis. LS Spine, straightening Muscle Spasm. I have taken lot of medicines, physiotherapy plus exercises but still find it difficult to sit or sleep in one place for long time. Have acute pain doctors advice to walk or sit in right position. Bone test: First Metatarsal Head Right Foot 16 Heel 20. Medicines taken: Inj Voveran, Tab Mobizox. Tab Pan, Tab rantac, tramadol, Tab Gabapin, Tab Synaptolol, Tab Espran plus, Tab Calpep gold, Duke 60 K, Tab cal k2, Katadol 100, Canace, Es03 etc but still no relief. Kindly suggest the problem, treatment and best medicines so that I get relief. Dr. I am poor person not having any employment due to this problem and is not possible for me to go for vertebroplasty as this costs Rupees Four Lacs. Regards Saranjit Singh, New Delhi. Whatsapp 9717846535.
My father is suffering from lower back disc problem. He was suggested to take an injection which charges around Rs. 5000/-. My Question is, as he has busy schedule, for some days, can my father wear a belt for some relaxation? If he can which type (belt name) of belt to be used? Please doctors help me in this. Thanking you Venu.
My father has sciatica since last 10 yrs. No surg is done. Only homeopathy was taken. But it's not working right now.
PILLOWS AND MATRESSES.
“My neck pain started two days ago, Immediately I removed my pillow”
This is the very usual dialogue that I hear in my daily practice from my patients who are suffering from neck pain. Is pillow that important factor in causing neck pain or in relieving neck pain?? Let us know the facts.
Neck pain can be caused because of various reasons. Poor neck posture is one of the reasons for neck pain. So, what should be your sleeping posture? How can a pillow alter your normal sleeping posture?
Body needs rest and sleep gives our body rest so that body and mind work efficiently. It is very important that we maintain a normal sleeping posture so that muscles also get rest.
- Spine has to be straight
- Neck has to be in line with the body.
- It is better to avoid sleeping on tummy, as you will be forced to turn your neck to one side to facilitate breathing. Whole length of your sleep is spent with the neck turned to one side, out of alignment with the body, forcing the brain to sense something wrong and you wake up with a stiff neck. Pillow has no role here!!!
So, what kind of pillow can be used?
- Pillow can neither be too hard as it doesn’t absorb the shock/ weight of head, nor it can be too soft as the weight of the head can depress the pillow down and might take neck too low than body.
- Ideally the pillow has to regain its original shape faster once you wake up from lying position. If a pillow takes too long to come back to its original shape or doesn’t come at all or remains in the same shape, its time for you to change your pillow.
- If you are lying on your back, its better to use a thin pillow which supports your head and neck. Please do not use a thick pillow in this position, as it may raise or bring your head and neck forward or higher than body causing stress to your spine.
Not using a pillow when you lie down in this position can take your neck backwards and might cause trouble breathing.
Recommended to use a thin/ lighter pillow when you lie down on your back.
- If you are lying on your side (right or left), its better to go with a thicker pillow. Ideally the pillow should be as thick as the distance between your shoulder and neck, so that when you lie down on your side the neck doesn’t go down or go up and stays in line with the body. Pillow has to be used!!
Recommended to use a thicker pillow when lying on side.
Pillow is not a major cause of neck pain. Its always better to use a pillow than not using at all. Removing the pillow the moment neck pain starts is definitely not a good solution for your neck pain. Chose the right pillow and more importantly consult your Physiotherapist.
As with the pillow for neck pain, mattress is not a major cause for back pain.
- Mattress should not be too hard, should not be too soft either.
- If it is too soft, the broader areas of our body like the hips and shoulders, might press the mattress down thereby reducing the support for other body parts, which strains them as they do not get proper support.
- If its too hard, the mattress wont be able to support the various natural curvatures of our body (broader and narrower areas), forcing the muscles to work more and get strained.
- Its better to change a sacked mattress or too depressed mattress.
- Mattress should be uniform in contour.
- Lying bare on floor wont work!!!!
And more importantly consult your Physiotherapist for back related issues.
Have a pain free life…..
I just have a intrasubstance mild partial thickness tear of the supraspinatus tendon and a slightly liquid in brush items. These are the problems which are scanned in mri from my left shoulder and then my doctor asked me to he in sling for few weeks and later I have gone through physiotherapy and asked me to do for about 6 months and it's 3 month from the day of injury and I still find like some kind of wetness and like something is falling inside shoulder like liquid and all and a slightly pain is there while performing physiotherapy. So is it a major problem and do I need to go to a other doctor?
I did a little workout and squats. My thighs are paining badly and I am unable to walk and use stairs. The pain is getting worse. I also have vitamin d and calcium deficiency. Is this pain normal or there is some injury?
Hi i am suffering from slip disc l3 & l5. Doc hv suggested for surgery but I don't wan to go for it. Pls suggest me anything beside that please.
Hello Dr. I am having too much pain in my runner knee coz I start running in morning from last week.
Majority of us might have gone through the word osteoarthritis. Osteoarthritis is a degenerative disorder where it primarily affects the cartilage of the joints and then slowly affecting the other structures around the joint including the muscle. It can affect any joint of our body either a single joint or multiple joints at the same time.
Osteoarthritis involving knee is very common and can affect our daily activities like walking, standing etc. There are a large number of people suffering from knee osteoarthritis. But very few are aware of its treatment. Many people believe there are not many treatment options for knee osteoarthritis. So, this article explains more about knee osteoarthritis, symptoms, precautions and different treatments that are available. This article is based on a lot of scientific studies and recommendations from various societies that work for arthritis.
Symptoms of knee osteoarthritis:
- Pain around the knee joint, unilateral or bilateral, which gradually increases over time.
- Usually aggravates during prolonged walking, standing, sitting to standing, squatting, stair climbing etc
- Stiffness of the knee especially after rest or in the morning
- Crepitations/ sounds within the knee joint on movement
- There can be sudden flares of the symptoms
- Swelling along the joint.
- Usually affects older age group
As the arthritis progresses, the muscles around the knee joint losses its strength and hence more weight goes through the joint which can further increase the process. Stiffness also increases, the soft tissue structures around the knee joint becoming less flexible. There is decreased mobility of the joint leading to reductions in adl activities like walking. On long term there can be deformity. This can affect the person physically, mentally and socially.
Diagnosis is based on physical and radiological signs. Physician might order various tests to rule out other disorders.
There are various treatments that are suggested for osteoarthritis knee. But, unfortunately people find it difficult to chose the right treatment. So, this article describes the treatments that are currently used in the medical world, its effectiveness and research or evidence based recommendations.
- Acetaminophen/ nsaids/ pain killers are used to reduce the inflammation and pain. It can be used when there is acute flaring of pain. It should not be used on a long term or a continuous basis as it can cause certain side effects like gastrointestinal disturbances, liver or kidney damage. It is not recommended for older individuals.
- Opioids can be used if nsaids are not effective. It may lead to opioid addiction.
- Corticosteroid injections are used if there is severe pain. It can reduce the pain on a short term. But it should not be used to manage pain of osteoarthritis on a long term.
- There are not many studies to show the usefulness of hyaluronic/ glucosamine injections. Hence not recommended.
- Physician will decide the drug, dosage etc after thorough evaluation. Certain drugs should not be mixed with other drugs or should not be taken if there is a preexisting medical condition. Drugs should not be taken on self prescription.
- All those drugs are to be taken only on the acute exacerbation of pain or untolerable pain. It should not be made as a daily practice.
Physiotherapy is the most recommended treatment for osteoarthritis knee. It is cost effective and safe. A lot of research studies has proved that physiotherapy is much beneficial for patients suffering from osteoarthritis knee. Physiotherapy has shown to
- Reduce pain and suffering
- Increase joint mobility
- Increase strength
- Improve functional activity/ activities of daily living
- Improve overall wellbeing
- Prevent further deterioration
- Prevent surgery
Physiotherapist will initially do a full evaluation checking the grade of osteoarthritis, extent of damage, flexibility, strength, function, gait, pain, biomechanics etc. The therapist then forms treatment goals after discussing with the patient. He may use various treatments available for reaching those goals. The therapist may also use some standardised scales to know the effectiveness of treatment.
The various treatments that a physio might use are as follows:
Electrophysical modalities: are especially used when there is flaring of pain and swelling. It also helps in relaxing the muscles. Most commonly used modalities are tens, interferential therapy, ultrasound, wax bath etc. These are not needed on a long term
Manual therapy: manual therapy helps in improving joint mobility. It helps reducing the associated stiffness. It also reduces pain. Manual therapy is a skilled technique which at any cost should not be done at home by other than a physio.
Exercises: various exercises will be prescribed to boost strength, improve flexibility, increase endurance, promote overall function. Exercises are individual based and various parameters are taken into account while prescribing exercises for that particular patient. Exercises needs to be done initially with the supervision of a physiotherapist. Strength training exercises, flexibility exercises, aerobic exercises, balance exercises will be taught.
The therapist might suggest cane, shoe modifications etc if needed.
Other treatments like laser, swd, knee brace are not much effective.
Various types of surgeries can be carried on patients suffering from osteoarthritis knee. Among them total knee replacement is the most successful one where the knee joints are replaced by artificial joints. Not all patients with oa knee need surgery. The basic criterion to be thought before deciding about surgery are
- Severe degeneration and joint destruction
- Joint instability or giving away of joint.
- Failure or unable to do daily chores restricted because of arthritis
- Severe/ continuous pain, even disturbing sleep
- Worsening symptoms over a period of time
- Age (the life of implant is considered to be roughly around 20 years, failure of implant earlier might necessitate re surgery)
- Failure of all other treatments
However whether a patient needs surgery or not will be decided by the consulting orthopedician. Many factors needs to be taken into account such as age, health status etc before confirming about surgery. Surgeon will be the ultimate person.
There might be a few complications after surgery such as increased stiffness, reduced muscle strength, infection etc.
Post surgery patient needs continuous physiotherapy. Rehabilitation will take totally around three months. Physiotherapy will help in bringing the person back to his normal life.
Joint care/ precautions/ myths:
- When there is acute exacerbation of pain, it is better to take rest and prevent increase in pain.
- It is better to avoid certain aggravating activities like squatting, sitting on the floor, jumping, stair climbing etc
- Moist heat/ luke warm water application will help soothen the joint. Can be used as home remedy.
- The process of degeneration of joint cartilage cannot be modified or corrected. Further deterioration can be prevented with proper treatment. So, please do not think because the cartilage cannot be repaired, there is no point of treatment. Medical interventions will help the patient overcome the problem in a big way.
- There is no use of restricting activities overall fearing pain as this might lead to total deterioration of the patients health. However, these things has to be discussed with the physiotherapist as to what activities can be done, how to do it and how much to be done
- Studies has shown that walking, swimming or cycling is actually good for patients with oa. Once again the matter has to be discussed with the physiotherapist regarding the what, when, how (or in other words intensity, frequency, duration etc) of these exercises. Please click the link below to know more about physical activity and health.
Physical activity and health
There are a lot of other treatments that claim to heal arthritis. But these are not scientifically proven and hence not recommended. As it as already mentioned, treatment of osteoarthritis is a multidisciplinary approach and all the factors needs to be considered while giving the treatment, not just the symptoms or not just one aspect of the problem. Standard treatment helps not only in reducing pain and suffering but also prevents future episodes and improves patient overall. Its adviced for the people to have a word of caution before proceeding with unscientific treatments.
More importantly have patience in your recovery.
Even though osteoarthritis is a debilitating condition, it has very good treatment options in the medical world. As described patient should think carefully before deciding about the line of treatment for knee osteoarthritis. Proper treatment especially physiotherapy and proper joint care will help patient on a long term to lead a happier life.
Final word for patients with oa is “catch hold of your physio”
Wish you a healthier life.