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Dr. Sreeram

Orthopedist, Chennai

70 at clinic
Dr. Sreeram Orthopedist, Chennai
70 at clinic
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
More about Dr. Sreeram
Dr. Sreeram is one of the best Orthopedists in Vadapalani, Chennai. Doctor is currently associated with Sri Narayana Child and Teen Care in Vadapalani, Chennai. Don’t wait in a queue, book an instant appointment online with Dr. Sreeram on Lybrate.com.

Lybrate.com has an excellent community of Orthopedists in India. You will find Orthopedists with more than 44 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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#G8,100 Feet Road, Jawaharlal Nehru Road, Vadapalani. Landmark: Opp. Hotel Bhimas, Near SRM University, ChennaiChennai Get Directions
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I am always suffers from muscle sprain some time hamstring some time neck sprain and shoulder sprain. How to deal it? And why is that so?

BHMS
Homeopath, Bangalore
I am always suffers from muscle sprain some time hamstring some time neck sprain and shoulder sprain. How to deal it?...
Take homoeopathic medicine Rhus tox 1M 4Pills 4Times 4days n its good if u ll feel better..u just have a tendency...don't wry..if doesn't come down revert back ll help u ever more better..
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I am 17 years old I am suffering my back and neck pain from 1 years ago, what should I do?

BAMS
Ayurveda, Ambala
I am 17 years old I am suffering my back and neck pain from 1 years ago, what should I do?
First of all check your posture when you are lifting any material like heavy bucket. And try to lift the heavy bucket without bending your back. You may lift the bucket after bending your knees only. This will definitely help you. * gentle massage with lukewarm mustard oil of your waist area will also give you relief. * surya namaskar is only exercise which you need to do. * in diet vegetable protein of cereal, b complex supplements and half teaspoon of haldi in a cup of milk for seven days will give you enough relief.
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I have waist pain for last 10 to 12 days. Firstly pain occurred in the middle part of waist but it is now in entire waist including lower part of waist also. I use Nise gel but it relieves for a little time. Now pain is severe. Please advise.

DNB ORTHO, MNAMS (Membership of the National Academy) (General Surgery) , MS ORTHO, MBBS
Orthopedist,
I have waist pain for last 10 to 12 days. Firstly pain occurred in the middle part of waist but it is now in entire w...
Hot waterfomentation with volini gel electro theraphy tab accept th bd tab pre m od at night meltocal sachet once a day for 4 week co rosiflex sachet once a day for 4 week local application of ark spray start these and revert back avoid exercises and start exercises after pain get relived
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Enter question for you or someone else. For e. G.I am 25 year old male and have backache for last 2 months. I have used pain relief ointment cream for couple of days but haven’t got any relief. What should I do now?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Enter question for you or someone else. For e. G.I am 25 year old male and have backache for last 2 months. I have us...
Extension exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times.
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Flat Foot Pain - Ways It Can Be Treated!

M. Ch. (Ortho), DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Delhi
Flat Foot Pain - Ways It Can Be Treated!

Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot.

This can be a painful condition. Let us look at the ways in which it may be cured.

  1. Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
  2. Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot’s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
  3. Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
  4. Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.
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My dad has a problem of legs everyday my dad legs start ache what should I do for my dad please help me sir.

BPTh/BPT
Physiotherapist, Mumbai
My dad has a problem of legs everyday my dad legs start ache what should I do for my dad please help me sir.
Hi = relax and stay positive. = increase fluid intake. = eat seasonal fruits for natural vitamins = do streching of hamstring, quadriceps, and calf muscles. = if you are overweight, reduce weight by cycling or swimming as it gives low impact on joints. = do check your calcium and vit. D = apply moist heat pad to affected joint and muscles. If still you dont get relief consult physiotherapist as there are various causes for leg/ joint pain and some test may be required for further investigation. Best wishes.
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I suffer from Subacromial decompression/Supraspinatus tear of left shoulder. I don't want operation. Any medicines to cure this otherwise.

BPTh/BPT
Physiotherapist, Delhi
Sir to improve your Shoulder ROM u should take Wellscience Orthocare and Omega 3. Go for Physiotherapy also to reduce Pain and Swelling
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Rheumatoid Arthritis: A mystery solved with lucidity

MBBS, MD - Internal Medicine, Diploma in Echocardiography, Diploma in Rheumatology
Internal Medicine Specialist, Kolkata
Rheumatoid Arthritis: A mystery solved with lucidity

Vital notes:

  • RA is a chronic debilitating joint disease that affects small joints of hands and foot.
  • More common in females aged 20 to 50 years.
  • It is not synonymous with Rheumatic Fever which occurs in children aged less than 15 years.
  • It has got nothing to do with monthly Penicillin injections and checking ASO titre. Somebody on Penicillin injections or being checked for ASO titre should change the doctor immediately.
  • Untreated disease may cause deformity of hands and foot causing deterioration of quality of life.
  • Erosion of small joints along with loss of entire joint architecture is the basic disease process.
  • Early morning stiffness of joints along with swelling of one or more small joints of hands is very characteristic.
  • Treatment is done with Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide and short courses of steroids.
  • Difficult diseases are treated with costly injections called biologics.
  • The motto of treatment is “ catch early, hit hard and achieve and maintain treatment goal “
  • Lung and cardiac complications are common in long term disease.
  • Rheumatologists but not the Orthopedicians nor neurologist are the best person to treat the disease.                    

 

Introduction:

Rheumatoid Arthritis is an autoimmune disease of mankind where the cells and molecules who are responsible for security of our body, misidentify the joint tissue as foreign substance and start destroying them similar to the way they usually do when a bacteria or virus enters the body. This misdirected attack towards our own body is called autoimmune phenomenon.

The worst affected parts of the body are the joints of hands and foot. These small joints that are responsible for performance of day to day activities like eating, holding, writing, typing, washing etc become painful and swollen causing stiffness and deformity.

This results in poor quality of life and subsequent depression. Early diagnosis and continuous treatment with specific medicines is cornerstone of treatment.

 

What are the symptoms?

Symptoms vary from person to person and also from early stage to late stage of the disease.

 In early stage there may be mild pain and stiffness involving 1 to 4 small joints of the hands and feet with a typical pattern of stiffness of those joints after rising from bed. During this phase it is very difficult to diagnose the disease. But it is very important to catch the disease in this stage. Researchers have proved that joint damage and bony erosions start even before the symptoms have manifested and hence earlier the treatments better the results.

In a full blown case of Rheumatoid arthritis the picture is very classical of a middle aged female presenting with pain and swelling of hand and foot joints along with early morning stiffness that responds to steroids brilliantly. Wrists and the knuckles are predominantly involved. Patients are unable to hold a pen or open the door or do cooking etc. Gripping the wrist firmly causes pain and the hand joints are warm.

In a advanced case of the disease we often find elderly people presenting with crooked hands with areas of permanent swelling and skin changes due to chronic friction. The skin fold may contract chronic fungal infections and the joints are swollen and painful.

A few other organs are damaged in silence and they create serious problem at the advanced stage of the disease. Lungs, Heart and Blood Vessels are frequently affected. There is accelerated cholesterol deposition in arteries of heart causing increased risk of heart attack and brain stroke. These patients frequently contract infections which are difficult to treat.

Involvement of spine or low back is uncommon. However, cervical spine or the neck region is the only part of the spine that may be affected in this disease.

 

What is the difference between Rheumatic Fever & Rheumatoid Arthritis?

There is a heaven & hell difference between these two entities. Rheumatic Fever is a disease of childhood. It usually occurs in children aged less than 15 years and is characterised by excruciating pain, swelling and redness of one or more big joints of arms and legs that responds excellently to Aspirin. This disorder may cause cardiac problems and is the leading cause of Valvular Herat disease in India. It is often characterised by some skin rashes and rarely neurologic problems. The disease process, the causative agent and the clinical symptoms are completely different from that of Rheumatoid arthritis.

 

Why Penicillin injections are given on a monthly basis?

Patients of Rheumatic fever often suffer a damage to the valves of the heart during the attack of Rheumatic fever. This damaged valves are potential sites of infections that may develop in the later part of the life. This infection is called Infective Endocarditis and may cause serious complications if not addressed properly. Penicillin injections are given as a form of prevention of development of this infection and have got no relationship with the wellness or cure of the disease. People who are aged above 15 years and are being treated with penicillin for the first time for joint pain occurring in small joints of hands should immediately change their doctor and consult a rheumatologist.

 

How is Rheumatoid Arthritis diagnosed?

Rheumatoid Arthritis is diagnosed by its classical symptoms and some laboratory investigations. To identify early rheumatoid cases we usually follow a scoring system which includes counting of number of joints involved, the duration of the symptoms, checking ESR and CRP in blood and looking for the positivity of Rheumatoid Factor and Anti CP Antibody. Patients with high values of Anti CP Antibody are very much likely to suffering from rheumatoid arthritis and also they are very much likely to suffer a aggressive disease course

 

Does each and every patient of rheumatoid arthritis develop crooked hands and foot?

No. Not all patients suffer from such a devastating complications. There are important characteristics which if present predict severe destructive disease. Females, Smokers, High values of Anti CCP or Rheumatoid Arthritis, Family History of Rheumatoid Arthritis, Early evidence of Joint destruction on X Ray are a few important features who will go forward to develop destructive disease.

 

How Rheumatoid Arthritis is treated?

Continuous Physical activity of the involved joints is the corner stone of treatment. More the joints are active, less the damage.

Cessation of smoking is mandatory. Smokers tend to develop early joint destruction

Medicines that used in treating rheumatoid arthritis are together called Disease Modifying Anti Rheumatoid Drugs or DMARDs.

Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide are the principal DAMRDs. Of these, methotrexate is the backbone of therapy. Methotrexate is used on a once a weekly basis starting from a dose of 5 mg to 50mg/week and a weekly 5mg of Folic Acid supplement is given to neutralise the adverse effects of Methotrexate. The detail of the drugs is mentioned below.

 

Why I am being given Steroids?

Steroids are given for a short period of increased disease activity. In rheumatoid arthritis we do not prescribe steroids in a regular basis. It is often prescribed when the patient is put on the DMARDs for the first time and when there is break through pain or active disease during the treatment.

Steroids are used in low dose in a decreasing dosage pattern over weeks and usually are not continued more than a month.

 

What are Biologic agents? Why they are so costly?

Biologic agents are highly specific molecules who directly block the action of the culprit chemicals in our body that cause the joint destruction. They are highly researched molecule an d is manufactured abroad. They are usually available in injection formats and have their own side effect profile which includes reactivation of Tuberculosis and other opportunistic infections. Usually patients are checked for latent Tuberculosis Infections, HIV, Hepatitis B and C before the treatment is started.

Biologics cause excellent response to the disease causing alleviation of pain and swelling and sense of well being but unfortunately they do not provide any cure. Hence, if biologics are stopped then there are chances that the disease activity may worsen requiring more biologics or aggressive treatment with DMARDs.

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I am suffering from sciatica pain from 15days I can't sit and walk properly, I took medicines but after completion of course the leg pain begins very hard.

COMT, MPTh/MPT
Physiotherapist, Surat
I understand how painful it could be when a nerve impingement in the lower back and pain radiates to leg. At this age you are suffering from sciatica so let me recommend you something. Precautions: 1. Avoid forward bending, if required then bend your knees first and then bend forward. 2. Avoid weight lifting. 3. Sit in chairs or car seats with proper back support. 4. Place pillow under your legs while sleeping or can opt sidelying position for sleep. 5. Get enough vit d from sun as vit d keep bones strong including spine and other bones. 6. Drink plenty of water to enhance the intervertebral disks. 7. Avoid prolonged standing. 8. Change your sitting position every 15 minutes so that it does not pain. If possible visit some neuro-physio who can give you several modalities like SWD, IFT, traction etc to cure the pain. Along with it we have a special program designed in case of sciatica that is Butler’s mobilisation and Mckenzie exercises which a physio gives with the proper technique to get cure from disease. I understand your pain so I am suggesting you the following treatment that you can take at home and can get some relief from pain and discomfort. Treatment: 1. Use of Cold packs- Sometimes piriformis muscle gets tight which cause impingement of sciatic nerve leading to tingling and numbness sensation down into the leg. So ice massage can be given over the area of piriformis muscle or the entire back for 15 min. Once done with cold therapy take rest for 2-3 min to relax the muscles. 2. Since the pain is radiating you can do some below mentioned exercises which will give you immediate relief from pain if done correctly. A) Lie on bed on your stomach gently push up with your arms, resting on your forearms. Hold for 5 secs. Now slightly stretch your back muscles and count till 10 and relax. You might feel a slight pain initially but do not worry. Repeat it 15 times. B) Now that pain must have gone. And now you can push up onto your hands fully. Slowly lower down back to floor. Perform this atleast 15 times. Again a slight pain will be there initially. Once you will complete this exercise program your pain will be relieved right away. If pain is severe while doing the exercise then stop doing the exercise and immediately consult some physio to take care further. Other exercises that can be done in sciatica pain are: 1. Straight leg raising 2. Knee to chest. 3. Hamstring stretch. 4. Back extensors stretches and strengthening. 5. Gluteal stretch. All the above can be done for 10-15 times with the hold (stretch) time of 5 -6 secs Make sure to perform the exercises correctly which will give you relief from your pain and strengthen your muscles. Good Luck and Get Well Soon.
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Hi doctor. I have a stiff neck for the last 2 days. What can I do to get it right? Its troubling a liy, have taken pain killers.

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
If the stiff neck is spontaneous, then there is a good chance that it will go off by itself after few days if the stiff neck is resultant of trauma, you need to have proper evaluation I would advice you to 1. Avoid driving 2 wheelers 2. Avoid using pillows 3. Avoid bending neck down for long periods of time for one week in all probability, you will find stiff neck gone if the problem still persists, please get back to us.
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I am suffering from knee. Under the right side of knee cap when I am running, going upstairs and going downwards. So pls tell me whats the problem.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am suffering from knee. Under the right side of knee cap when I am running, going upstairs and going downwards. So ...
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.
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I am 21 years old I am getting neck pain while sleeping so Please suggest me medicine.

MBBS
General Physician, Mumbai
For pain take tablet paracetamol 650 mg and start with Tablet folvite 5mg once a day for six months and tablet vitamin D3 60000iu once a week for six months and do neck exercise regularly and if possible take a very thin pillow while sleeping
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I am 25 years old married female having a six month old baby. From last few weeks got pain in right ankle. Please help.

Diploma in Acupuncture, Pranic Healing, MD - Acupuncture
Acupuncturist, Bangalore
I am 25 years old married female having a six month old baby. From last few weeks got pain in right ankle. Please help.
Identify the midpoint between the ankle bone and tendons and give pressure with a blunt edge on either side of your foot for 2 minutes. Also give pressure in the web between 2nd and 3rd finger from your toe for 2 minutes. Finally give a good massage for both feet in hot water. Identify the dipping portion on the back of your knee folding. Press this dip with both middle fingers and hold your knee with your thumbs for support. Please swing 20 times morning and evenings. Give pressure the dipping point on the portion between the thumb and the index finger on the back of the palm. Press and release for 15 times where the pain is more. This will solve the problem.
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She got menopause at the age of 45. But regularly she felts back pain, thighs pain is this the right age to get menopause and it may cause further any health issues?

Master Of Surgery, DNB (Orthopedics)
Orthopedist, Agra
She got menopause at the age of 45. But regularly she felts back pain, thighs pain is this the right age to get menop...
Menopause age is 45 to 54 as per family and environmental factors. Do get investigated for osteoporosis.
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Hi. I want o ask whether there is any permanent treatment of lichen planus on the ankle ?

BPTh/BPT
Physiotherapist, Pune
Hello dear this is dr.Vyas there is not permanent treatment but u can go for homeopathy treatment. Some of them challenge for this prob.We have temporary treatment for it.
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My father having lower back pain from last 3days because picking up heavy material and they have much pain.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
My father having lower back pain from last 3days because picking up heavy material and they have much pain.
Apply Hot Fomentation twice daily. Avoid bending in front. Postural Correction- Sit Tall, Walk Tall. Extension Exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. Bhujang Asana – Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day. Back Stretching- lie flat, pull one of the knee forward to chest, hold for 3 seconds, then bring the other knee forward to the chest and again hold for 3 seconds. Then pull both knees towards the chest and hold for 3 seconds. Repeat 10 times each exercise twice a day. Do the cat/cow stretch. Get on all fours, with your arms straight and your hands directly under your shoulders; your knees hip-width apart.
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My left hand is paining badly for last 3-4 days and I am not able to rotate my hand properly plss help me my exam are going on.

BPTh/BPT
Physiotherapist, Chennai
My left hand is paining badly for last 3-4 days and I am not able to rotate my hand properly plss help me my exam are...
We need to know the cause of this pain. So, you should go for a check up by orthopedics. But for right now you can dip your hand in some hot water for 15-20 min twice or thrice a day. You can massage slowly it if there is no redness or much swelling. Try to move your hand slowly. Do not lift heavy weights. Do not do much work with that hand. You can visit a physiotherapy center for better relief.
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Hi I am 35 years man. And try for running merathon race. Facing sin pain. What I do?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. Shin pain in athletes can be due to multiple reasons but we will focus on management - intensive ice packs with limb elevation - short course of anti-inflammatory medicine - rest for around 2 weeks or till pain subsides - gradual resumption of activities after 2 weeks - pre match adequate warm up of muscles is important - get your vitamin d and serum potassium levels done and send it across to me. Do not hesitate to contact me if you need any further assistance. Thanks & regards Dr Akshay Kumar Saxena
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Hi doctor, I am 34 yrs old female and my left leg is going swelling since last four days. One month before some hard stone fallen on my foot. From till date i was feeling pain in my leg but now swelling is increasing too much, is it any serious.?

BPTh/BPT
Physiotherapist, Pune
Hi this is dr.Vyas dear plz take a x-ray to check any fracture or creak is there if not then its ligament injury u have to take crayo therapy (ICE pack).It may reduce yr swelling use iodex or any inflammatory ointment and gental massage. If not cure then go for physiotherapy sessions for ultra-sound therapy u may get relief.
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