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Knee Pain Treatment
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Joint And Muscle Problems
Treatment of Nerve And Muscle Disorders
Acl Reconstruction Procedure
Joint Dislocation Treatment
Knee Care Procedures
Joint Replacement Surgery
Ankle Pain Treatment
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Treatment of Joint Dislocation
Treatment Of Disk Slip
Treatment Of Herniated Disc
Knee Injury Treatment
Treatment of Spine Injuries
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This is the question most elderly patients from all walks of life ask me, be it a learned advocate or the local farmer.
Guess the answer? it is a big yes!
Knee osteoarthritis is the wear and tear that happens in the knee joint. At times we fail to understand that our knees also age along with us! so they may not be in a situation to behave the save way they behaved 20 years back, when you used cycle or trot a few miles to your school or college or the way you were comfortable squatting or kneeling whether it is fit sanitary purposes or religious causes
The fact is the knees have to be tamed well and should not be battered the same way as it was a few decades back!
Now coming to our original discussion, yes, you are allowed to walk!
But how do you do it when you are already suffering from pain?
You could rest your knees for a few days - usually a week, if you have severe pain. Your doctor could help you with some low dose pain killer tablets and ointments. On top of it all, the single best way to reduce your knee pain is lifestyle modifications!
What's the lifestyle modification we are talking about?
1) no climbing up or down stairs!
2) no sitting on and getting up from the floor!
3) no kneeling! and
4) a big no to squatting in the toilet!
Doctor, you must be kidding! how am I supposed to live without these?
Restrict the number of times you climb stairs.
Use a chair/sofa to sit! at unavoidable situations, use a stable support to sit on the floor and then to get up! do not place too much stress on your knees when you get up from the floor!
Absolutely no kneeling! for religious prayers, use a shall flat stool to sit and offer your prayers, but do not kneel!
Use a western (raised) toilet commode for sanitation! if you can't afford to change your present indian ones, use a wooden/plastic raised seat with a central opening temporarily until you can arrange a permanent raised one!
Should I spend time walking or not?
Yes you should!
Walking helps to rebuild the joint!
Walking strengthens the thigh and leg muscles!
Walking helps you lose weight!
Walking keeps your body active and prevents lethargy!
Last but not the least!
Walking pacifies the mind and prevents psychological problems!
So what are you waiting for?
Get out your shoes and burn your calories!
I am suffering from pain in my lower back brain when I read or concentrate on something it get start paining and I am cannot able to remember things properly.
Aged 63 weight 92 kgs height 5' 6" suffering from knee joint pains particularly feeling difficulty while climbing stairs/getting down. Plain walk there is no problem. Diabetic but under conrol for the last 2 years Please suggest me some homeo remedy.
Sir Heavy Pain in lower back always. Please give some in-house ways to get the way completely out. Very fed up.
Sometime my girlfriend's neck pain happens when she works. What should she do? Any ideas, moov are not working.
I have done 200 dumbbells in gym. Which led to muscle pull it's paining suggest me I can't even type.
I have checked my uric acid and its level is 10.3, I have pains in joints and muscles mostly in legs. Please suggest me best treatment and precautions.
I was born in 1957 and I under go surgery in germany in the upper part of my back (cerfical c5) despite I feel ok but I suffer continuous pain in the back and shoulders.
Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-
Exercise based recovery/physiotherapy: your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.
- Medications: your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
- Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
- Opiates, for example, hydrocodone, for pain relief
- Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
- Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
- Home treatment: in case your condition is less severe, you can attempt a couple of things at home to treat it:
- Take an over-the-ounter pain reliever, for example, acetaminophen or a calming medication, for example, advil or aleve.
- Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
- Exercise routinely to help you recover quickly.
- Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.
- Acupuncture: acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
- Bed rest: severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (dvt, blood clots in the legs).
- Support/brace use: temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.
- Lifestyle: losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.
Once the conservative treatment fails:
Early aggressive treatment plan of back leg pain has to be implemented to prevent peripherally induced cns changes that may intensify or prolong pain making it a complex pain syndrome. Only approx 5% of total lbp patients would need surgery approx 20% of discal rupture or herniation with neurologically impending damage like cauda equina syndrome would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then. Depending upon the diagnosis one can perform combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon patient`s pathology response to treatment. Using precision diagnostic therapeutic blocks in chronic lbp, isolated facet joint pain in 40%, discogenic pain in 25% (95% in l4-5 l5-s1), segmental dural or nerve root pain in 14% sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of lbp after conservative treatment has failed.
Need for non-surgical options: outcome studies of lumber disc surgeries documents, a success rate between 49% to 95% and re-operation after lumber disc surgeries ranging from 4% to 15%, have been noted. “in case of surgery, the chance of recurrence of pain is nearly 15%. In fbss or failed back surgery the subsequent open surgeries are unlikely to succeed. Reasons for the failures of conventional surgeries are:
- Dural fibrosis
- Arachnoidal adhesions
- Muscles and fascial fibrosis
- Mechanical instability resulting from the partial removal of bony ligamentous structures required for surgical exposure decompression
- Presence of neuropathy.
- Multifactorial aetiologies of back leg pain, some left unaddressed surgically.
Epidural adenolysis or percutaneous decompressive neuroplasty is done for epidural fibrosis or adhesions in failed back surgery syndromes (fbss). A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ l. A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope sciatica gets complicated by pivd with disco-radicular conflict causing radicular pain sometimes disabling. In this era of minimally invasive surgery lot many interventional techniques have evolved to address the disc pathology. We are still working for the ideal, safe effective technique to tackle disco- radicular interphase. Here now we have devised a mechanical neuroplasty or foraminoplasty technique using an inflatable balloon tip catheter with guide wire via targeted transforaminal or interlaminar route aided by drugs instillation. Selected patients are procedured fluoroscopic guided with local anesthesia under prescribed sedation aseptically via preselected route depending upon location type of pivd causing root insult. First a suitable size needle is placed at desired site confirming with radiolucent dye through which hyaluronidase with saline or la was injected. A flexible guide wire is passed at selected location direction on which the inflatable balloon is threaded to the area of interest.
Adhesiolysis is achieved mechanically with inflating balloon for 10 seconds at a time location. We inflated the balloon with contrast agent to have visualization of adhesiolysis opening up of adhesions or root route. Here the balloon pressure time has to be kept in minimum to avoid neurological damage, for which we inflate balloon for 10 seconds at a time. Close observation is made to balloon shape, pressure patient`s response. Once dilatation is done the drug mixture of steroid with la or hynidase/ hypertonic saline is instilled over nerve in epidural space. We have logically used same approach for our balloon neuroplasty foraminoplasty as it is safe targets exactly the area of disco-radicular interphase or conflict. We can manage to address both the exiting and traversing nerve roots with single entry just by manipulating our guide wire to the place of offence. The procedure can be done via transforaminal route at level or level above or below, especially via s1 foramen. Now we are employing this technique for fresh cases coupling with intradiscal decompression aided by instant disc retrieval by epidural balloon inflation with good results. The idd is done by coblation/ laser/ dekompressor or rf biacuplasty. There is scope of coupling this technique with endoscopic spine surgery. By adding “balloon neuroplasty” to the armamentarium of the interventional pain management many patients can be benefited relieved of previously interventionally unmanageable disco-radicular pain including fbss sufferers.
Provocative discography: coupled with ct a diagnostic procedure prognostic indicator for surgical outcome is necessary in the evaluation of patients with suspected discogenic pain, its ability to reproduce pain (even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options in assessing previously operated spines.
Percutaneous disc decompression (pdd): after diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed.
Ozone-chemoneucleoplasty: ozone discectomy a least invasive safe effective alternative to spine surgery is the treatment of choice for prolapsed disc (pivd) done under local anaesthesia in a day care setting. This procedure is ideally suited for cervical and lumbar disc herniation with radiculopathy. Total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at european countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post operative discomfort or morbidity and low cost. If despite the ozone therapy the symptoms persist, percutaneous intradiscal decompression can be done via transforaminal route with drill discectomy/ laser or coblation nucleoplasty/ biacuplasty/ disc-fx / endoscopic discectomy are good alternatives before opting for open surgerical discectomy; which has to be contemplated in those true emergencies, as mentioned above as the first choice. In biacuplasty radiofrequency energy is used in bipolar manner heating shrinking the disc making it harder as well for weight bearing. It also seals the annular defect ablates annular nerves relievingback pain. In laser or coblation nucleoplasty energy is used to evaporate the disc thereby debulking it to create space for disc to remodel itself assisted by exercises.
Dekompressor: a mechanical percutaneous nucleotome cuts drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression. A mechanical device cuts drills out the disc material debulking the disc reducing nerve compression curing sciatica brachialgia. It comes in needle size of 17g for lumbar discs 19 g for cervical discs. In lumbar region postero-lateral approach is used in cervical discs anterolateral approach is used.
Disc-fx : endoscopic discectomy: in this novel technique a wide bore needle is inserted placed sub-annular in post disc just under the disc protrusion. Disc is then mechanically extracted with biopsy forceps to empty the annular defect. This painful sensitive annular defect supplied be sinuvertebral nerve is thermo-ablated with radiofrequency which also seals the defect to prevent decrease recurrences. Next higher procedure, endoscopic discectomy is done with endoscope put through sheath inserted via posterolateral transforaminal or posterior interlaminar approach. Mostly done under local anaesthesia its fast becoming standard of care for disc protrusion extrusions causing spinal canal stenosis with root or cord compression with leg pain.
Laser discectomy done for closed bulging discs is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, nucleus pulposus is debulked by evaporating it by the laser energy. Laser discectomy is minimally invasive, cost-effective, and free of postoperative pain syndromes, and it is starting to be more widely used at various centers.
Seld: epiduroscopic laser neural decompression is considered an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, failed back surgery syndrome with morbid adhesion neuritis that cannot be alleviated with existing noninvasive conservative treatment. This procedure is done under vision via an epiduroscope inserted via caudal canal or transforaminally employing front or side firing laser fibers /or fine instruments. If you wish to discuss about any specific problem, you can consult a pain management specialist.
Hi, My Dad has Uric Acid problem. His uric acid level came out to be 8. Yearly or within 2 years, he usually gets gout attack. Currently, he is having swelling, pain and redness in his knee. I wanted to know what vegetables and fruits are preferable for him which do not increase the uric acid level and which all vegetables/fruits he should basically avoid. Can you help with a proper diet chart to follow? Also, are mangoes preferable to eat in such condition?
I am a 23 year old male and I am suffering from severe back pain since a long time. I have taken lots of medical treatments but not getting any improvement. Pls help me. All my reports are normal too.
Hi Doctor, Please help me for some sickness which I get at every one week or two. I am getting high pain generally at back neck. And head also from back. These happens generally when I am tired. Or after sex. Even after sex I used to get pimples in my chest and more in back. Please give some remedy. Regards, Mohindra Amarnath.
Sir I have pain in my back. One year ego in MRI L. S. SPINE 2D STUDY FOLLOWING IMPRESSION WAS FOUND. .1. L4/5 inter-vertebral disc shows subtotal dessication with diffuse disc bulge and bilateral posture -lateral predominance with bilateral facet joints arthrosis, causing thecal sac indentation and mild indentation of bilateral exiting nerve root at the level of L4/5 .2. No infective focus. The medicine 1-indocap-sr 2-Rezole-20 tab And Depomedral injection Was run for five month along with exercise. And I completely well. But one month ego the pain at same place started again. The pain increase after sitting 2 or 3 hours of sitting. SUGGEST ME WHAT I HAVE TO DO NOW.
My father is having a back pain from past 5 6 days. He is having a pain in the middle of the back. So please suggest some prescription. Thank you.
I am 23 year old, since from 2 years I am getting neck pain, I met so many doctors and took medicine, but still pain is there, so please help me and give some advise.
I am a football player. I got injured while playing as my soft tissues of my knee got destroyed. Its almost 6 months and it hasn't been completed heeled. When it get hurt it just sweets n so much pain is there I can't even walk properly then. Kindly give me some good solutions for it!
I am 30 year old man having regular back pain and pain in my lower feet back side in both legs since 4 months so is it something very serious or having some problem.
Regularly exercise- atleast 45 minutes of brisk walking
Do stretches before you start any game or exercise
Adequate hydration 3-4 litres of water a day
If you have a desk job take breaks every 1 hour and stretch out/ small walk 2-3 mts.
desk top at eye level and knees at 90 degrees.
Maintain posture- sit erect and use an ergonomic design chair with lumbar support.
Do not slouch on the sofa
When carrying a heavy load bend down at your knees and lift. (google proper lifting technique)
When shifting a wardrobe or large cupboard or carrying something heavy get an extra pair of hands.
Give up smoking.
Sleep well and if you have a neck problem use a cervical pillow.
Firm mattress will help.
Practice core strengthening exercises for the low back.
You can get in touch/ book online appointment and queries will be answered.