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Dr. Pugalendhi

Orthopedist, Chennai

Dr. Pugalendhi 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. Pugalendhi
Dr. Pugalendhi is a popular Orthopedist in Ambikapuram, Chennai. You can meet Dr. Pugalendhi personally at Dr. Pugalendhi@Be Well Hospital in Ambikapuram, Chennai. Book an appointment online with Dr. Pugalendhi on Lybrate.com.

Lybrate.com has an excellent community of Orthopedists in India. You will find Orthopedists with more than 43 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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#5A, Vijaya Raghava Road, T Nagar. Landmark : Near 10 Downing Street Hotel.Chennai Get Directions
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From last two days my left leg is paining at night times and normal in the morning what to do?

BHMS
Homeopath, Raebareli
From last two days my left leg is paining at night times and normal in the morning what to do?
Please do not sit/stand too long at a stretch. Take mag phos 6x - twice daily 4 tabs for next 2 weeks. Take a glass of milk daily. Get back to me after 2 weeks.
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I have been suddenly diagonized as having ankolising spondylities. I am 61 years old male . I am taking saaz dz 4 a day. My leg is stiff and having swelling in ankle of my left leg. I feel stiffness. Which exact exercises i am allowed to and physyo. ? Thanks

M.P.T
Physiotherapist,
Tab-hcqs may give you a better result in this with esofag-d in morning empty stomach. Take bath with Luke warm water even in summers. Avoid exposure to cold. Start doing mobility exes of all joints of the body after hot fomentation of the painful parts. Increasing flexibility in the body & preventing stiffness is the motto in as.
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I am 23 years old female and I am married I leaved in ahmedabad Gujarat. I am facing issue related to gynace. As it is normal issue in female PH level so please suggest. I have 1 miss delivery also and I am facing back pain also. I also want to reduce my health so Please suggest Diet also.

BHMS
Homeopath, Faridabad
I am 23 years old female and I am married I leaved in ahmedabad Gujarat. I am facing issue related to gynace. As it i...
Hello, . It's good to reduce weight at right time as many problems are directly related to overweight! Your menstrual problem can be due to that Remember, there's no magic bullet for weight loss. The key to losing weight is burning more calories than you consume. Choose a variety of healthy foods — such as fruits, vegetables, whole grains and lean sources of protein — and include physical activity in your daily routine. Go through the following general guidelines and implement them in your routine: Management: 1: Drink plenty of water (at least 2-3 l/d) or other calorie-free beverages. 2: Be choosy about nighttime snacks. 3: Enjoy your favorite foods. 4: Have 6 meals per day - 3 main courses and 3 snack meals (snack meals should be healthy). 5: Do regular exercises daily (start with light and later may be little vigorous) . Exercise decreases the stress hormone in your body, burns calories and also increases the blood circulation. Preferably brisk walking, swimming, cycling, skipping. 6: Eat seasonal fruits. Fruit helps to satisfy your sweet tooth thanks to its natural sugars, while fresh vegetables help you fill up more quickly. Fruits and vegetables contain fiber to help you feel full quickly. 7: Eat more whole grains and cut simple carbs. Whole wheat bread, oatmeal, whole wheat pasta, sweet potato, and brown rice are all excellent sources of energy and sources of nutrition. 8: Choose lean proteins instead of fatty ones. 9: Cut the salt from your diet. Eating more sodium causes your body to retain water, which can cause you to feel bloated and gain more weight. 10: Don't skip meals.When you skip meals, your body stops breaking down fat and starts breaking down muscle tissue. Muscle tissue burns more calories at rest than other tissues, so you're actually working against your goals 11: Eat at home. Going out to eat makes it too easy to cheat. Food sold at restaurants is commonly much higher in fat, sodium, and other weight-loss killers. 12: Give yourself a treat now and then. If you're attending a party or going out for a special occasion, allow yourself an indulgence. Just make sure that these indulgences don't become daily habits. 13: Go for a health walk. Gear up yourself daily for a health walk which not only shed off your extra calorie, but also reduces the stress levels. 14: Take small frequent breaks for a quick walk in between as sitting for long hours together encourages the accumulation of fat in the body! Medication: Take homoeopathic medicine - Schwabe's Phytolacca Berry tablets/ thrice daily 1/2 an hr before the meals for 3 months. Thereafter revert me back for further guidance. (Slow and steady weight loss is good. As we all know when you lose weight fast, it seems to jump right back on, whereas when you lose weight steadily over time because of changes to your diet and balancing your hormones out it tends to stay off.) All the best!
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Delayed Onset Muscle Soreness (DOMS)

Physiotherapy In Cerebral Palsy and Leprosy, MPT Neurology
Physiotherapist,
Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness (doms), also called muscle fever, is the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise.

The soreness is felt most strongly 24 to 72 hours after the exercise. It is thought to be caused by eccentric (lengthening) exercise, which causes microtrauma to the muscle fibers. After such exercise, the muscle adapts rapidly to prevent muscle damage, and thereby soreness, if the exercise is repeated.

Delayed onset muscle soreness is one symptom of exercise-induced muscle damage. The other is acute muscle soreness, which appears during and immediately after exercise.

Characteristics

The soreness is perceived as a dull, aching pain in the affected muscle, often combined with tenderness and stiffness. The pain is typically felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest. This tenderness, a characteristic symptom of doms, is also referred to as" muscular mechanical hyperalgesia.

Although there is variance among exercises and individuals, the soreness usually increases in intensity in the first 24 hours after exercise. It peaks from 24 to 72 hours, then subsides and disappears up to seven days after exercise.

Cause

The soreness is caused by eccentric exercise, that is, exercise consisting of eccentric (lengthening) contractions of the muscle. Isometric (static) exercise causes much less soreness, and concentric (shortening) exercise causes none.

Mechanism

The mechanism of delayed onset muscle soreness is not completely understood, but the pain is ultimately thought to be a result of microtrauma mechanical damage at a very small scale to the muscles being exercised.

Doms was first described in 1902 by theodore hough, who concluded that this kind of soreness is" fundamentally the result of ruptures within the muscle. According to this" muscle damage" theory of doms, these ruptures are microscopic lesions at the z-line of the muscle sarcomere. The soreness has been attributed to the increased tension force and muscle lengthening from eccentric exercise. This may cause the actin and myosin cross-bridges to separate prior to relaxation, ultimately causing greater tension on the remaining active motor units.[6] this increases the risk of broadening, smearing, and damage to the sarcomere. When micro-trauma occurs to these structures, nociceptors (pain receptors) within muscle connective tissues are stimulated and cause the sensation of pain.

Another explanation for the pain associated with doms is the" enzyme efflux" theory. Following microtrauma, calcium that is normally stored in the sarcoplasmic reticulum accumulates in the damaged muscles. Cellular respiration is inhibited and atp needed to actively transport calcium back into the sarcoplasmic reticulum is also slowed. This accumulation of calcium may activate proteases and phospholipases which in turn break down and degenerate muscle protein. This causes inflammation, and in turn pain due to the accumulation of histamines, prostaglandins, and potassium.[7][9]

An earlier theory posited that doms is connected to the build-up of lactic acid in the blood, which was thought to continue being produced following exercise. This build-up of lactic acid was thought to be a toxic metabolic waste product that caused the perception of pain at a delayed stage. This theory has been largely rejected, as concentric contractions which also produce lactic acid have been unable to cause doms. Additionally, lactic acid is known from multiple studies to return to normal levels within one hour of exercise, and therefore cannot cause the pain that occurs much later

Relation to other effects

Although delayed onset muscle soreness is a symptom associated with muscle damage, its magnitude does not necessarily reflect the magnitude of muscle damage.

Soreness is one of the temporary changes caused in muscles by unaccustomed eccentric exercise. Other such changes include decreased muscle strength, reduced range of motion, and muscle swelling. It has been shown, however, that these changes develop independently in time from one another and that the soreness is therefore not the cause of the reduction in muscle function.

Possible function as a warning sign

Soreness might conceivably serve as a warning to reduce muscle activity so as to prevent further injury. However, further activity temporarily alleviates the soreness, even though it causes more pain initially. Continued use of the sore muscle also has no adverse effect on recovery from soreness and does not exacerbate muscle damage. It is therefore unlikely that soreness is in fact a warning sign not to use the affected muscle.

Repeated-bout effect

After performing an unaccustomed eccentric exercise and exhibiting severe soreness, the muscle rapidly adapts to reduce further damage from the same exercise. This is called the" repeated-bout effect.

As a result of this effect, not only is the soreness reduced, but other indicators of muscle damage, such as swelling, reduced strength and reduced range of motion, are also more quickly recovered from. The effect is mostly, but not wholly, specific to the exercised muscle: experiments have shown that some of the protective effect is also conferred on other muscles.

The magnitude of the effect is subject to many variations, depending for instance on the time between bouts, the number and length of eccentric contractions and the exercise mode. It also varies between people and between indicators of muscle damage. Generally, though, the protective effect lasts for at least several weeks. It seems to gradually decrease as time between bouts increases, and is undetectable after about one year.

The first bout does not need to be as intense as the subsequent bouts in order to confer at least some protection against soreness. For instance, eccentric exercise performed at 40% of maximal strength has been shown to confer a protection of 20 to 60% from muscle damage incurred by a 100% strength exercise two to three weeks later. Also, the repeated-bout effect appears even after a relatively small number of contractions, possibly as few as two. In one study, a first bout of 10, 20 or 50 contractions provided equal protection for a second bout of 50 contractions three weeks later.

The reason for the protective effect is not yet understood. A number of possible mechanisms, which may complement one another, have been proposed. These include neural adaptations (improved use and control of the muscle by the nervous system), mechanical adaptations (increased muscle stiffness or muscle support tissue), and cellular adaptations (adaptation to inflammatory response and increased protein synthesis, among others).

Prevention

Delayed onset muscle soreness can be reduced or prevented by gradually increasing the intensity of a new exercise program, thereby taking advantage of the repeated-bout effect.

Soreness can theoretically be avoided by limiting exercise to concentric and isometric contractions. But eccentric contractions in some muscles are normally unavoidable during exercise, especially when muscles are fatigued. Limiting the length of eccentric muscle extensions during exercise may afford some protection against soreness, but this may also not be practical depending on the mode of exercise. A study comparing arm muscle training at different starting lengths found that training at the short length reduced muscle damage indicators by about 50% compared to the long length, but this effect was not found in leg muscles.

Static stretching or warming up the muscles does not prevent soreness.[12][13][needs update] overstretching can by itself cause soreness.

The use of correctly fitted, medical-grade, graduated compression garments such as socks and calf sleeves during the workout can reduce muscle oscillation and thus some of the micro-tears that contribute to doms, proper nutrition to manage electrolytes and glycogen before and after exertion has also been proposed as a way to ease soreness.[15][16] consuming more vitamin c may not prevent soreness, but oral curcumin (2.5 gram, twice daily) likely reduces it.

Treatment

The soreness usually disappears within about 72 hours after appearing. If treatment is desired, any measure that increases blood flow to the muscle, such as low-intensity activity, massage, hot baths, or a sauna visit may help somewhat.

Immersion in cool or icy water, an occasionally recommended remedy, was found to be ineffective in alleviating doms in one 2011 study, but effective in another. There is also insufficient evidence to determine whether whole-body cryotherapy compared with passive rest or no whole-body cryotherapy reduces doms, or improves subjective recovery, after exercise.

Counterintuitively, continued exercise may temporarily suppress the soreness. Exercise increases pain thresholds and pain tolerance. This effect, called exercise-induced analgesia, is known to occur in endurance training (running, cycling, swimming), but little is known about whether it also occurs in resistance training. There are claims in the literature that exercising sore muscles appears to be the best way to reduce or eliminate the soreness, but this has not yet been systematically investigated.

I am 62 years old, 2 & 1/2 yrs ago I had been suffering from prostate problem in which cathedral was used for 10-12 days, due to this process I cought uti and thereafter all bones related problem aroused (knee joint pain & lowe back pain) etc. Although no treatment for ortho problems could have been done, after a gap of around 2 & 1/2 yrs. I started to get medicine for knee joint pain but still urine flow obstruction starts & I have to stop the medicine for ortho & get the medicins for urine like prostina & flow dart+. What should I do, could not understand, may please advise.

Fellowship of the Royal College of Surgeons (FRCS), MS - Urology, MBBS
Urologist, Ahmedabad
Dear Please get urine examination done to see if you are left with residual infection. Also see that you have usg done with postvoid residual urine, full bladder volume and wall thickness on full bladder with size of prostate. If you are constipated also solve that because passage of hard motions results in fissure giving you same complaints which will not respond to flow dart +. So let me see the reports and then only I can give you correct advice.
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My esr is 35. My ankles are slightly swelling. I found normal in the morning. I feel sometimes mild discomfort in right testicles. Creatinine and diabetes normal. I have been taking eslo 5 mg tablet since 2015.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
My esr is 35. My ankles are slightly swelling. I found normal in the morning. I feel sometimes mild discomfort in rig...
Stretch Calves Get a custom made insole. Hams Stretching. Sports Taping. Contrast bath---It is a form of treatment where a limb or the entire body is immersed in warm water followed by the immediate immersion of the limb or body in ice water. This procedure is repeated several times, alternating hot and cold. Note that the treatment should always end in the ice water, as heat will induce the body's inflammatory response, while cold helps to decrease inflammation.
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Hallo Doctor- I Santosh giri Male 36 years old And I am inform you that last six years pain my back side my doctor proscribed volini cream. But not relief. So please batter medicine proscribed. Thank you.

MD - Alternate Medicine, BHMS
Homeopath, Surat
Hallo Doctor- I Santosh giri Male 36 years old And I am inform you that last six years pain my back side my doctor pr...
Take Calc Phos 6X three times in a day for 1 week. For further proper management...please consult properly in a systematic manner...
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I feel pain in my back as soon as I sit with my back straight. This problem is haunting me continuously from a week or so. What should I do?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I feel pain in my back as soon as I sit with my back straight. This problem is haunting me continuously from a week o...
Hot fomentation x twice daily. Avoid bending in front. Postural correction. Sit tall, walk tall. Extension exercises x 15 times x twice daily bhujang asana x 15 timesx twice daily core strengthening exercises. Back stretching.
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I am 49 years old I fell down from scooter 5 days back & knee is very paining. After keeps ice for 3-4 days it has come down. But still I cannot walk easily and bend leg please suggest me.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
I am 49 years old I fell down from scooter 5 days back & knee is very paining. After keeps ice for 3-4 days it has co...
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. If you have localized knee pain and swelling after a scooter injury, then the first step in management is to get a x ray done and rule out a bony injury. Once it is certain that there is no bony injury, then initial management of a soft tissue injury can be done by intensive ice packs, knee brace, gentle anti inflammatory medications, medications to reduce swelling, activity modification etc. Once your knee pain and swelling subsides, then a re examination of knee will be done and if there is any associated instability then probably a mri scan will be required for visualization and further management. But initially a bony injury has to be ruled out because the management is totally different in case there is a fracture. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
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I'm 48 years old. And I have begun to experience knee pain in both my knees for the last nine months. Your advice please.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Bangalore
I'm 48 years old. And I have begun to experience knee pain in both my knees for the last nine months. Your advice ple...
Hi can you please specify your weight any other ailment you have like diabetes, hypertension, hypothyroidism. Till then start applying dhanvantari oil heated double boiler on the affected area leave it for half an hour wash it in hot water take rest lying down for half an hour start walking for 20 mins daily pain starts subsiding for internal medicines please specify above details thank you.
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I am not getting full sleep I can not sleep well please help me regarding this as soon as possible and I also have back pain problems too so help in it also.

M.Sc - Dietitics / Nutrition, DNHE, P.G. Diploma in Panchkarma, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Hapur
I am not getting full sleep I can not sleep well please help me regarding this as soon as possible and I also have ba...
Sleep disorders and muscular pain is generally seen in the patients suffering from anxiety, stress or depression. Take necessary steps to overcome anxiety stress and depression. Keep your digestion fit. Avoid spicy oily n fried junk food. Avoid tea coffee and aerated drinks.
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I have developed tingling sensation/numbness mostly in sole and palm.However sometimes it is felt at the other part also.I have also developed pain in my shoulders. With the input of medicine(Jalra M 500/50),the diabetese is under control.I am also suffering from gas formation in my stomach which always disturbs me while i amm attending a meeting/conference. Please help. 48 yrs.Male

MS - Orthopaedics
Orthopedist, Delhi
Your symptoms can be due to diabetic neuropathy or less likely due to cervical spine pathology. You need to visit an Orthopaedic Surgeon for detailed clinical examination and investigations including MRI scan of the cervial spine.
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When I woke up in the morning I always have lot of pain under my right heal which hampers me from walking normally for about 1 to 2 minutes. My age is 55 yrs. And my height.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
When I woke up in the morning I always have lot of pain under my right heal which hampers me from walking normally fo...
Avoid sitting cross legged. Ankle stretching. Ankle strengthening exercises. Avoid squatting. Quadriceps exercises. Core strenthening exercises. Stretch calves get a custom made insole. Hams stretching. Sports taping. Hot fomentation.
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Ankle Sprain: Causes, Symptoms and Treatment!

MBBS, D.ORTHO, DNB (Ortho), Fellowship Joint Replacement, MNAMS
Orthopedist, Mumbai
Ankle Sprain: Causes, Symptoms and Treatment!

An ankle sprain can make life miserable. A sudden twist or stretching (due to incorrect walking, incorrect posture, wearing high heels, walking on an uneven and rough surface, exercise, games) can result in ligament(s) tear (partial or complete tear), affecting the ankle. An ankle sprain is often confused with a twisted ankle. However, the two are different as chalk and cheese. A sprained ankle can be extremely painful, taking few weeks to months to heal completely (depending on the severity).

Symptoms:

An ankle sprain is independent of age and sex, affecting anyone and everyone under the sun. The symptoms characteristic of an ankle sprain includes:

  1. The affected region of the ankle may swell up immediately.
  2. Difficulty in walking. In severe forms, a person may find it difficult to place a step.
  3. The area appears bruised and tender.
  4. Excruciating pain and discomfort (severe case).
  5. Stiffness and, in some cases, discoloration of the skin around the tear.

At no point should the sprain be taken lightly. Seek medical assistance at the earliest. Negligence on your part can aggravate the situation. In extreme cases, an ankle sprain can add to your agony and discomfort, affecting the joints, bones, blood vessels, tendons, and cartilage.

Diagnosis and Treatment:

Diagnosis:

Accurate diagnosis can make the treatment effective, thus accelerating the recovery process. In case of an ankle sprain;

  1. Physical examination of the affected area and a thorough case study is an important diagnostic step followed by many doctors.
  2. X-ray of the affected ankle region can help in a better and more accurate diagnosis.

Treatment:

The course of treatment depends on the extent of the damage. In case of a minor sprain, doctors mostly recommend

  1. Keeping the affected ankle area bandaged (ACE bandage) and well protected. A crutch or a brace is a blessing for people who face difficulty in walking.
  2. Time and again, apply a cold compress on the sprained ankle. A cold compress can help reduce the swelling effectively.
  3. In case of extreme pain and swelling, your doctor may recommend an acetaminophen (Tylenol) or ibuprofen
  4. Rest as much as possible. While sleeping, use cushions or pillows to keep the leg elevated.

In rare cases where the sprain refuses to heal and becomes unresponsive to the above treatment, doctors may recommend an Arthroscopy or a Reconstruction surgery.

Precaution and Care:

A little alertness and agility on your part can help to deal with an ankle sprain better.

  1. In the case of a severe sprain, try and avoid self-medication as much as possible. It can do you more harm than good.
  2. Exert minimum or no pressure on the affected ankle area.
  3. Indulge in some strengthening exercise as recommended by your physician. It is advisable that you warm up before any exercise.
  4. Avoid heavy, strenuous work as much as possible.
  5. Wearing correct footwear is important. Women who have had an ankle sprain should avoid wearing heel shoes. If you wish to discuss about any specific problem, you can consult an Orthopedist.
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Sir which is the best medicine for knee pain it's a old pain accident pain sir and its my mistake I am not go to the doctors that time Thanks

BPTh/BPT
Physiotherapist, Hyderabad
Sir which is the best medicine for knee pain it's a old pain accident pain sir and its my mistake I am not go to the ...
Hello lybrate-user, good morning. Since you said that the pain is present after you met with an accident, please consult orthopaedic immediately for diagnosis and follow their instructions. At present please do hot water fomentation if there is no swelling at the injured area. If swelling present, do icing for 15 minutes by taking some ice cubes in towel and do small circular movements at affected area. Take rest.
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Sir it has been 2 months that I am suffering from back pain lower side whenever I sit for too long or walk for too long. I have shown to 4 to 5 doctors they said x ray is fine and have given some medicines and injections and told some exercises but till today I haven't got any relief. Currently I have left medication and still suffering from the problem. please guide.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Sir it has been 2 months that I am suffering from back pain lower side whenever I sit for too long or walk for too lo...
Good. Avoid medicine. Tk physiotherapy treatment. Tk soft pillow for back support in sitting position. Do stretching exercises. Avoid toward bending.
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I have recently been having pain under my left arm leading around to my back it just started suddenly, I didn't hurt my self or anything, I need help.

BHMS
Homeopath, Bangalore
I have recently been having pain under my left arm leading around to my back it just started suddenly, I didn't hurt ...
Homoeopathic medicine spigelia 200 4pills 4 times 4 days a gap of 1 week again repeat 4 days. Try not to strain much n you should concentrate on your postures.
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I am having Spine pain problem, to pain relief taking very high dose of pain killer since a long time, now would you please suggest how can I improve?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph & digital x rays of affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Ibuprofen 200mg od & sos x 5days. Bio d3 max 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. Do reply back for detailed treatment plan. Do not ignore. It could be beginning of a serious problem.
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I have pain in my left knee, when i use stairs it seems somthing get cracked in my knee. Also having bad motion now a days m suffering from poor memory also have problem of spondlysis. Are theses problems connected to each other. Can i have one solution for all these problems.

MBBS, MS Ortho, DNB (Orthopedics), Dip SICOT (Belgium), FISOC (USA), MNAMS (Ortho), FASM (Singapore)
Orthopedist, Chennai
You have osteoarthritis of the knee. Do not odd stairs or Indian toilet. Do not sit on floor. Use diclifenac gel for local application and hot water bag. If no improvement consult your orthopedic dr.
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I am 62 years male. Last few months I am suffering from grade I osteoarthritis in both knees. What is the remedy and what precautions should I take? as per doctor's advice I am regularly in-taking jointace c2 tablets twice in a day along-with shellcal for one month.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Physiotherapy along with medicines will help. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with a soft bedding on it. Any way take bio d3 max 1tab odx10days ibuprofen 200mg od & sos x 5days do knee exercises. It may have to be further investigated make sure you are not allergic to any of the medicines you are going to take.
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