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Dr. Gowri Shankar Patnaik

Orthopedist, Chennai

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Dr. Gowri Shankar Patnaik Orthopedist, Chennai
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
More about Dr. Gowri Shankar Patnaik
Dr. Gowri Shankar Patnaik is an experienced Orthopedist in Nungambakkam, Chennai. She is currently practising at TOTAL REHAB in Nungambakkam, Chennai. You can book an instant appointment online with Dr. Gowri Shankar Patnaik on Lybrate.com.

Lybrate.com has an excellent community of Orthopedists in India. You will find Orthopedists with more than 35 years of experience on Lybrate.com. You can find Orthopedists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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TOTAL REHAB

#3, Total Rehab Bhavani Mansion, 4th Lane Nungambakkam High Road, ChennaiChennai Get Directions
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I am advised by my doctor to take dolo for my arthritis pain for my knee pain. Of course it is very effective and it relieves my pain up to 2-3 days. I am not diabetic. Is it safe to take very often for a prolonged time?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. Dolo is actually paracetamol, so it is quite a safe medicine if taken in prescribed dosages and especially your liver function should be ok, so get it checked before regularly taking it. Do not hesitate to contact me if you need any further assistance. Thanks & regards
1 person found this helpful
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My wife is a beautician, suffering from arm and shoulder pain, she is a diabetic. So I have to see neurologist or orthopedic ? please suggest.

Diploma in Acupuncture, Pranic Healing, MD - Acupuncture
Acupuncturist, Bangalore
This can be rectified by alternate medicine especially by acupressure / acupuncture. You can consult me before going for other therapies.
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Hello sir, my father, aged 90 years have survical spondilitous (always feels giddiness). Can you please suggest any soft medicine.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
It could be due to cervical spondylosis this is quite a common condition rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Use no pillow under the head. Any way take caldikind plus (mankind) 1tab odx10days paracetamol 250mg od & sos x 5days do neck & back (spine) exercises contact me again if need be. Use of cervical collar will give you relief. Make sure you are not allergic to any of the medicines you are going to take.
1 person found this helpful
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I am having pain in right leg and l4 and l5 problem However I got my reports it says sterilization of l5 with hypoplastic l5-s1 Interverbal disc And L4 l5 level causing compression of thecal sac, bilateral literal canal narrowing nd compression bilateral exiting nerve roots. Can I be safe by some exercises?

Master of Occupational Therapy (MOT), Bachelor of Occupational Therapy (BOT)
Occupational Therapist,
I am having pain in right leg and l4 and l5 problem However I got my reports it says sterilization of l5 with hypopla...
Take hot water fermentation daily and avoid jerk in spine, avoid maintaining one posture prolonged duration, avoid forward bending and back ward bending. Consult any nearest physiotherapist.
1 person found this helpful
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I've lymph node at the right side of the skull base, behind the ear. This is for 3 days now and it's swollen a bit & painful when I turn my neck. Which specialty doctor to consult.

MD Radiation Oncology, ESMO Certified Medical Oncologist, DM Medical Oncology (Pursuing)
Oncologist, Mumbai
I've lymph node at the right side of the skull base, behind the ear. This is for 3 days now and it's swollen a bit & ...
This appears to be a swelling caused due to infection. You need to consult an ent doctor. Start doing gargle with warm water along with 1 small spoon of salt.
1 person found this helpful
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I am 17 years old boy. I have pain around my neck. It is so painful. And have more pimples in my face and back of my back. And have pain in my legs. Sometimes any sound and pain comes while walking.

BPT
Physiotherapist, Gurgaon
I am 17 years old boy. I have pain around my neck. It is so painful. And have more pimples in my face and back of my ...
You should do stretching exercises for the whole body n take should calcium n vit d supplements. For neck, do some posture correction. Whatever screen, you are using. It should be at your eye level!
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I am 20 years old and I have desk job in a showroom and I have backpain by this how it can be cure.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), DYA (DIPLOMA IN YOG & AYURVED), D.I.H.M (DIPLOMA IN INDUSTRIAL HEALTH MANAGEMENT)
Ayurveda, Nashik
I am 20 years old and I have desk job in a showroom and I have backpain by this how it can be cure.
1) correct your sitting posture , 2) take small pillow or back rest for lower back. 3) foot should rest to floor easily 4) take small break after 1 hr & walk few steps. 5) do neck & upper back extention ,give feedback after 4 days
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I have a very unique problem. I feel some hindrance when I bend my neck. My throat does not pain or I dont have any irritation in my throat. But when I bend my neck, I feel some disturbance. But no pain. Please advice

MPTh/MPT
Physiotherapist,
You have to strengthen your neck muscles. As your neck muscles are week. Go for neck isometfics exercises. This will be helpful.
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How can I loss cholesterol and fat from my body with normal died. And I'm feeling pain in my back bone.

BHMS
Homeopath, Faridabad
How can I loss cholesterol and fat from my body with normal died. And I'm feeling pain in my back bone.
Hello,***start taking Allium sativa Q, 15 drops with warm water twice daily for cholesterol.*** 1. Take phytolacca berry tablets (wsi), 2 tablets with warm water, three times a day, half an hour before meals. 2. fatoline drops from Haslab, 15 drops + 1/2 cup of warm water, twice a day. 3. Take 1 glass of luke warm water with lemon juice and honey in the morning for 15 days in a month. 4.Take 1 cup of green tea in the evening daily. 5. Do Surya Namaskar , yoga asans like Bhujangasana (Cobra Pose), Sarvangasana (Shoulder Stand Pose),Vajrasana (Diamond Pose), Pavanamuktasana (Wind-Relieving Pose), Matsyasana (Fish Pose) 6. avoid sweets, oily, spicy, junk food, chocolates. 7. drink plenty of water daily. 8.Eat good quantity of green vegetables, salad and fruits.
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I get burning sensation in both legs and palm when I go to bed nite or noon whenever I lie down on bed I get burning sensation why?

BHMS
Homeopath, Raebareli
I get burning sensation in both legs and palm when I go to bed nite or noon whenever I lie down on bed I get burning ...
Dear lybrate-user, buring of palms and legs is due to vit b deficiency and or nerve compression in lumbosacral region. Nothing to worry about use a medicine Rhus Tox 30 thrice a day for 5 days and consult back thereafter.
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Sir I am 60 years old I am 55 kgs in wt. I have knee pains for the last 2 to 3 yrs. I use knee caps but no use. Daily I go for 3 to 4 kms. Walking. But no use. Suggest me any tablets which can be used regularly without any side effects. Thanking you.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Sir I am 60 years old I am 55 kgs in wt. I have knee pains for the last 2 to 3 yrs. I use knee caps but no use. Daily...
Do Take IFT and laser Therapy for pain relief for 12 days followed by strengthening exercise from physiotherapist Best wishes.
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I am 40 years old female having thyroid, 68kg weight, having low back pain and shoulder pain. Please help. Cant loose my weight. Doing yoga thrice a week.

FRAS, MD - Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Alternative Medicine Specialist, Ernakulam
For loosing weight you need to control your diet, and do regular exercise followed by taking herbal medicine like ayaskriti and shuddha guggulu capsules, vrikshamla capsules, triphala churna and green tea, for your thyroid take kanchanara guggulu tab, for dosages consult me private for further details
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I have a pain in my knee and I face difficulty to walk. Please help and consult me.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have a pain in my knee and I face difficulty to walk. Please help and consult me.
Knee advice. Avoid sitting cross legged. Avoid squatting- quadriceps exercises- lie straight, make a towel role and put it under the knee, press the keen against the role, hold it for 20 secs. Repeat 20 times twice a day. This will help relieve some pain. Core strengthening exercise- straight leg raised with toes turned outward, repeat 10 times, twice a day. Hams stretching- lie straight, take the leg up, pull the feet towards yourself, with a elastic tube or normal belt. Repeat 10 times, twice a day. Sports taping- stretch the tape from both ends and apply on the affected area contrast fomentation (hot and cold).
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I am 59 yr woman with severe pain in right knee, because of arthritis. how to reduce this pain please advise.

Certified Diabetes Educator, Registered Dietitian (RD), PGDD, Bachelor of Unani Medicine and Surgery (B.U.M.S), General Physician
Dietitian/Nutritionist, Mumbai
Some common home care techniques for knee pain that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation do reply back for private consultation. And detailed treatment plan.
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When I got up from the sofa to go to the kitchen my leg started to hurt just below the knee cap and when I straighten my leg I can hear this crackling sound what is it?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
When I got up from the sofa to go to the kitchen my leg started to hurt just below the knee cap and when I straighten...
Kindly show me photograph of the affected part--knee. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Kindly take biod3 max 1 tab dailyx10 paracetamol 250mg od & sos x5days do knee exercises make sure you are not allergic to any of the medicines you are going to take do not ignore it. It could be beginning of a serious problem. If no relief in 4_5 days, then contact me again.
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Back Pain Management

BPTh/BPT
Physiotherapist, Pune
Back Pain Management

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.

Intradiscal procedures:

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.

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I am not getting morning erections from a few days. I am feeling low on sexual urges these days. Even If I get an erection, I am not able to hold it for long. What can be the cause of it? Everything was fine a week back. What can cause this sudden change?

GAMS-AYURVEDA, MD-TCM
Sexologist, Faridabad
I am not getting morning erections from a few days. I am feeling low on sexual urges these days. Even If I get an ere...
Mr. Lybrate-user ji my advice do exercise 30 minutes daily eat healthy food and almond ssfron and fruits juice please avoid alcohol and fast food and porn movie.
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I am 26 years old and having pain in my left leg ligament since 3 years. What should I do.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Hyderabad
I am 26 years old and having pain in my left leg ligament since 3 years. What should I do.
* walking regularly at slow pace without unduly straining helps as it improves blood circulation around the ligament and eases the joint. *you can use mustard oil for massage which is good in winter season for relieving pain. Eucalyptus oil is also good homoeopathy has a good treatment for this without adverse effects. Take bryonia 200---twice daily morning and evening and give feedback after 7 days
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