Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?


The neck and back are closely related, and pain in one area can easily affect the other. Both neck and back pain have become lifestyle problems, due to prolonged sitting and incorrect working postures. Treating one area can help in subtly treating the other and also reduce the onset of pain. 

Pain in neck and back can be due to strained muscles, wrong posture, injury or stress due to knots in muscles and can be easily treated with a number of ways such as physical therapy, muscle relaxants and trigger point injection. Also, facet joint arthritis occurs due to degeneration of joints in elderly, excessive strain in some type of jobs or injury. Physical therapy along with injection in the nerves that carry a message from these joints to the brain along with medications that can numb sensation and Radiofrequency Rhizotomy for long-term relief is performed by pain specialists. Disc prolapse of neck/ lumbar vertebrae can also cause back pain.

Read on to know the best ways to manage back and neck pain, as the following techniques work for both.

Ice and heat therapy: Alternating heat and ice therapy can help reduce pain. It helps by reducing the sensation of pain and improving blood flow, thereby providing relief.
Physical therapy: Exercising and stretching, whether as a preventive measure or as a part of therapy, can work wonders. It improves the agility of the bones and tendons, improves movement, reduces stiffness, and relieves pain. A program should be drawn up based on the patient s overall health condition and symptoms. Patients should be monitored for any improvements or changes in symptoms.
Pain medication: When nothing else works, then pain medications become the next course of action. These can be taken for immediate relief, but cannot treat the pain permanenetly.
Steroids: Injecting corticosteroids into the bone and joint spaces can help with acute pain management.
Collar or brace: A neck collar or brace is used to keep the neck in place to reduce movement and provide support, thereby, it helps in reducing pain.
Acupuncture: Each area has associated pressure points in the body. These pressure points are identified and needles are applied to provide relief from pain.
Massage: The Massage can help by stimulating tissues, improve blood flow and also to relax muscles. The herbal oils that are used provide added benefit too, and so periodic massages are being widely used for pain management of neck and back.
Chiropractic therapy: This involves manipulation of the spinal cord with the belief that the spinal cord could be incorrectly settled. The cord is manipulated to get it to the correct location, thereby relieving pain and stiffness and improving movement
TENS (transcutaneous electrical nerve stimulation): The nerve in the affected area is stimulated by electrical impulses, thereby providing pain relief. This needs to be repeated at frequent intervals and is often reserved for acute cases.
Surgery: Often, used as a last resort, where all other measures have failed. Whether it is a herniated disk or a pinched nerve, the cause is identified and then surgery planned.


Back & Neck Pain - Different Ways Pain Can Be Managed!

Osteoporosis is a Latin word for  porous bones . A healthy bone holds tiny spaces within it resembling a honey comb. Osteoporosis causes an expansion in the dimension of these spaces so much so that the bone loses out on its density and strength, at the same time turning brittle and thin on the outer part. People afflicted with osteoporosis are prone to experiencing fractures at the slightest stimulation while engaging in daily chores. It usually affects one s wrists, hip and the spine, thus rendering a stooped posture, loss in height and back pain as a result of a collapsed vertebra. Factors such as lowered estrogen count in women and testosterone in men, long term use of certain medications, certain medical conditions such as damage to the liver or the kidneys and a sedentary lifestyle along with excessive tobacco and alcohol consumption make one vulnerable to osteoporosis.

Tips To Help you manage and prevent it-

Medications: Zoledronic acid, Ibandronate, Risedronate and Alendronate are some of the widely used medicines to combat the risks of fracture. However, these medicines carry considerable side-effects, for instance adnominal pain, nausea or a heart-burn like sensation. Ipriflavone, a laboratory manufactured product, in combination with calcium can be used as an alternative medicine to inhibit bone loss and alleviate pain.

Quit smoking: Smoking escalates the rate of bone loss and the chances of sustaining another fracture.

Refrain from excessive alcohol intake: Alcohol meddles with one s bone formation. Also, excessive alcohol intake might cause one to feel tipsy and thus fall down, aggravating risks of injuries and fractures even more.

Be careful while walking: Choose low or flat heeled footwear with soles that do not slip. Watch your step. Be careful with rugs, slippery surfaces, electrical cords or other scattered substances which might make you trip over and fall. Install  grab bars  in your house so that you can hold on to them if you suddenly feel unsteady on the feet.

How Can You Deal With Osteoporosis?

Arthritis is a very painful disease. It restricts you from doing a lot of the activities you would love to engage in. However, there are steps you could take to reduce the chances of it happening to you. Here are some tips, which help you in preventing Arthritis:
1. Take Omega-3 fatty acids
Research proves that the regular consumption of Omega-3 fatty acids, present in fish, result in decreased risks of rheumatoid arthritis. Omega-3 fatty acids are also found in foods such as olive oil and walnuts.

2. Take Vitamins and olive oil
Vitamins are crucial, especially A, C and D. Vitamin A can be found in carrots. vitamin D can yet again be found in fish while vitamin C can be found in strawberries, mangoes, pineapples and oranges. Olive oil is also useful because it contains polyphenols which reduce the chances of developing arthritis.

3. Eat ginger and broccoli
Ginger and broccoli are two of the most therapeutic foods for various reasons and the chances of getting arthritis are also proven to reduce due to these foods.

4. Avoid injury
Although this is very hard to do sometimes, avoiding injuries do reduce your chances of getting arthritis.

5. Control your weight
This is very important, especially for your knees. It has been proven by researchers at John Hopkins University that if you are 10 kg overweight, then 30 to 60 extra kilograms of weight fall on your knees.

6. Exercise
Strengthening your muscles around your joint decreases the pressure on the joint. If there is less pressure on the joint, then the chances of arthritis are reduced. The best way to decrease pressure on the joint and strengthen your muscles is to exercise.

6 Tips To Prevent Arthritis

Joint Replacement Surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced with artificial joints, such as metallic, plastic and ceramic joints.
These surfaces closely replicate the original anatomy.

When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade IV osteoarthritic knees of  people over 50 years when have pain, swelling and deformity fail to respond to medicines, physiotherapy, injections and rest.

Aim of the surgery

    Correct the deformity: Relieve the pain and give near full movements almost immediately after the procedure. Details including techniques and safety, it is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.
    Anaesthesia: Usually it is the spinal cord epidural where one is rendered numb for 3 to 4 hours waist down. Sometimes a general anaesthesia is given. A 4 to 5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimetres) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.
    Recovery: Stand up and walk a few steps with a walker the day after the procedure i.e. in 24 hours. Physiotherapy in hospital for 5 to 7 days and/or walking, progressively longer walks and exercises over the following 15 days. Stitches are removed in 15 days. The patient can return back to normal activity in 4 to 8 weeks the surgery.
    Activities: Normal walks of 3 to 5 km per day Climbing stairs, cycling, swimming, and driving can be performed with the new implant(s) now.
    Avoid: Squatting/kneeling Prohibited: contact sports like football, cricket, tennis; jumping; adventure sports Longevity of joints: 15-35 years depending on the materials used.

Joint Replacement Surgery - When Should You Go for  it

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

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