Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

The backbone (spine) has smooth movement with smooth intervertebral disks. However, this fluid movement can be limited due to arthritis, which can happen due to many reasons   genetic to age to injury to infection to tumors. The lower back has two sets of spinal disks   sacral and iliac. This sacroiliac region has an elastic vertebral tissue. This could be gradually replaced with hard bone, which can cause fusion between the disks. Such a condition is known as ankylosing spondylitis (fusing disk spaces), which is a type of arthritis.

The typical symptoms of ankylosing spondylitis (AS) are morning pain and stiffness in the low back and upper buttocks, which gradually decrease as the day goes by. The symptoms usually start and continue to gradually worsen over a period of 3 to 6 months. In severe cases, there could be spinal fractures, but in most cases, pain, stiffness and reduced movement are the main complaints.

Why homeopathy for AS (Ankylosing spondylitis)?

Major benefits of homeopathy could be summarized as under:

It addresses altered immune system, treating the roots of this autoimmune disease.

It helps in pain control without side effects.

It aims at disease control.

It is absolutely safe even if used for a long time.

Homeopathic medicines are prescribed on the basis of individual case evaluation by taking into account patient s genetic, immunological and psychological parameters. It is safe and effective as a long-term therapy. It reduces pain, improves mobility and most importantly, controls the disease. It has no adverse effects.

Homeopathy helps AS patients by acting on the immune system, which is usually overactive in these people. Depending on the presenting symptoms, the doctor will prescribe a customized regimen for the patient.

Rhus Tox: This is the first medicine of choice when the patient experiences sacral/lumbar area pain that is worse at rest, with sitting, or after a period of inactivity. The pain radiates down the legs to the foot. Walking or any other activity/motion provides relief from the pain.

Aesculus: This is indicated in patients who have extremely painful and stiff low back and hips. The pain is a constant ache and there is discomfort with trying to rise from a seat, stooping, and walking, where greater effort is required. There is a feeling that the legs would give way, adding to resistance while walking.

Kalmia: This is used in patients where the back pain and stiffness are accompanied by a warm, numb, and prickly sensation. Low back pain and neck pain is associated with a burning sensation. The pain appears in sudden bursts in the early parts of the night and travels down the arm or up into the scapula.

Kali Carb: This is indicated where there is extreme weakness along with AS symptoms of pain and stiffness in the lumbosacral back area. The patient feels like he is going through a paralytic attack and must lie down to rest. This is a feeling similar to a broken back, and can extend up into the neck or down to the legs. The symptoms are more severe in the early morning hours. Changing positions in the bed worsens the pain.

If you or someone else is suffering from AS symptoms, give homeopathy a try.

Homeopathy Treatment For Ankylosing Spondylitis

Sciatica is probably one of those things which is vaguely familiar but a person is not fully aware of it. The sciatic nerve is one which is part of the spine and then spreads out over the legs. When this nerve gets pinched, it leads to sciatica, or pain of the sciatic nerve, which is tremendous! But, then, what exactly is a person to do in order to reduce the pain caused on account of sciatica?


The best answer for this is not medication, though it does have its uses, but rather, exercises which help the situation improve and reduce the risk of the person going mad due to the pain! One of the simplest exercises that a person can start with is known quite commonly as the knee to shoulder exercise. All that one needs to do is to lie down on the back and then, raise one knee and pull it across the body, with hands wrapped around it, so that it touches the opposite shoulder. This position of the knee touching the shoulder is to be held for about half a minute. About 3 repetitions need to be done and the same with the other side.


While it is important in the effort to relieve pain due to sciatica, it is equally important not to push oneself beyond natural limits, especially initially as this can cause injury. After all, more pain is the last thing which a person with sciatica is likely to want!


Since it is important to keep in mind the fact that consistency is one of the key secrets to reducing the sciatic pain, it is worth keeping in mind the standing hamstring stretch. What this exercise can boast of is the fact that it is one which can be done nearly anywhere. Also, it is pretty simple, too!


To do the standing hamstring stretch, one leg needs to be kept on an elevated surface which is not as high as the level of the hip. It is important to keep in mind that the leg is to be kept straight. The torso needs to then be bent towards the elevated leg. This process should be done slowly and again, maintained for about half a minute.


The sitting pose is useful to remember, as well. Sitting on the floor, one leg s ankle should rest on the other s knee. Like the standing hamstring stretch, the upper torso is to be bent towards the extended leg. With all these exercises, relief is not far away!


Top Ways To Get Pain Relief From Sciatica

A sprained thumb is a painful condition caused due to an injury on the ligament of a thumb. A ligament is a soft tissue, which connects bones to each other at a joint. The ligament might get partially or fully torn due to extreme backward bending of thumb causing the ligament connecting the thumb and index finger to suffer injury.

The problem is quite common among basketball, rugby and football players. For this reason, it is known as a sports injury. Skiing may also cause extreme pressure to the thumb, causing a ligament tear. Injury due to skiing is called skier s thumb.

The injury causes pain, bruising and tenderness. It can cause swelling on just the thumb or sometimes on the entire hand. In severe cases, weakness and instability in the region can be seen. A sprained thumb weakens the ability to pinch and grasp things. The patient will have trouble holding a glass, turning a knob or writing. An untreated injury may lead to joint stiffness, muscle weakness, scar tissue formation, instability of the thumb or even arthritis. It is strongly advised to visit a professional therapist for an early diagnosis and treatment.

Usually, an X-ray leads to an apt diagnosis of the injury. The doctor also ascertains damage to the bone and ligament and develops a treatment plan. Some ligament tears can be treated using a splint or cast. A chronic ligament tear might not heal and would require surgical intervention.

A partial or mild ligament tear can be managed through useful home remedies like putting an ice pack, bandage or splint. It is also advised to keep the thumb elevated and restrict its movement. A heat pack is beneficial as it can ease pain and relax the muscles. However, heat pack must be avoided during the first 48 hours of injury as it can lead to bleeding.

If there is a chronic injury and the ligament is completely torn, a surgery is needed. A surgery helps join a new ligament to the bone in case the torn ligament fails to heal. It also helps reconnect the injured ligament to the bone. Sometimes, there might be bone damage as bone fragments might get pulled away with the ligament. In such cases, bone fragments need to be put back in their position through surgery. After the surgery, a cast or splint is put till it heals completely.

An early visit to a physiotherapist has potential advantages. A therapist can fasten the healing process, help relieve pain and improve a person s ability to resume daily tasks. Massages and strengthening exercises are initiated to avoid re-injury and instill strength in the injured region. Physiotherapy also helps immensely after surgery through planned mobility exercises that regain movement and strength.  

Sprained Thumb- Causes and Treatment

Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.
Since prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips.
Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.
Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.
Lift objects correctly and maintain proper posture:While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed.
While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.
Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.
Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pinpoint the diagnosis and appropriate management.

3 Essential Tips to Prevent Back Pain

As you age, many parts of the body start to wear down. Your spine is no different in this regard. When age affects the condition of the cervical section of the spine, it is known as cervical spondylosis. Other names for the disorder are neck arthritis or cervical osteoarthritis.

Even though age causes most cervical spondylosis, other factors may also be responsible for the onset of the disorder. Here is a look at some common causes for the same.

Causes for cervical spondylosis:

  Bone spurs - Your body may try to strengthen the joints by growing additional bone tissues. These are known as bone spurs. These spurs can pinch down on the nerves and the spinal cord, leading to pain and other symptoms.

  Dehydrated discs - The spine houses shock-absorbing pad-like structures between the vertebrae, called discs. These discs contain a gel-like substance that gives them its unique shock absorbing properties. Over time, the gel dries out, causing greater friction between bones during movement.

  Injury - A neck injury can lead to cervical spondylosis. The disorder may not appear as soon as you suffer from the injury but may take years to develop.

  Excessive physical strain - Some profession may require people to lift heavy weights or overexert themselves physically. These people may develop cervical spondylosis later on because of this work.

Symptoms of cervical spondylosis:

Here are some symptoms that are commonly associated with cervical spondylosis.

  Shoulder pain - Patients suffering from cervical spondylosis often complain about pain in the shoulder blade. This pain increases while the person is standing, sitting, coughing, sneezing and tilting their head backwards.

  Weakness - People with cervical spondylosis also suffer from muscle weakness. For instance, you may not be able to grab things tightly in your hands, if you suffer from the spinal disorder. Furthermore, lifting the arms may be difficult.

Other minor symptoms of cervical spondylosis include stiffness in the neck that grows worse with time and headache that affects the back part of the head.

Treatment for cervical spondylosis:

Treatment is not necessary in many cases due to the absence of any distinguishing symptoms. However, if the spondylosis interferes with normal life, medical intervention is required. Treatment for the disease includes-

  Physical therapy - Physical therapy sessions often help deal with the pain and stiffness resulting from the cervical spondylosis. Your doctor will prescribe weekly sessions, which will aid to reduce the symptoms of the condition after some time.

  Medications - Pain medications help manage the discomfort related to the condition. However, these drugs do not have any long-term effect on the body. They only provide temporary relief from the pain.

  Surgery - Surgery for cervical spondylosis is uncommon. However, if the condition does not respond to other forms of treatment, the operation may be required to remove bone spurs, herniated discs and rectify parts of the spinal column.

You can also ask your doctor about home remedies to follow to manage the symptoms of the disease.

Cervical Spondylosis - How Can It Be Treated?

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