Doctor in Max Super Specialty Hospital-Saket
Cancer Pain Management
Epidural And Spinal Anesthesia Techniques
Diagnostic Cardiac Procedures
Treatment of Transcutaneous Electrical Nerve Stimu
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Knee problems can be quite annoying but if this problem becomes regular, it brings life to a standstill. The movement becomes restricted. Many associated problems slowly crop up. Thus, it is best to nip the problem in the bud. While some people might experience a problem in the full knee, in some people, only a single compartment (tissue or cartilage) of the knee may be affected. For such patients, Unicondylar Knee Replacement comes as a blessing.
The Unicondylar knee replacement, also known as the Unicompartmental Knee Replacement or Partial Knee Replacement is the most sought-after knee replacement surgery. The surgery involves replacing only the worn out or affected part (cartilage) of the knee, thereby preserving the healthier cartilages and tissues of the knee.
In the last few years, incidences of osteoarthritis have been on the rise. The unicondylar knee replacement surgery has made life a lot easier for people suffering from osteoarthritis (a condition where the articular cartilage or the connective tissue present within the knee joint begins to wear out).
The unicondylar knee replacement is ideal for people with:
- Severe osteoarthritis (Median or Lateral) that results in painful, swollen and stiffened knee.
- Only a small portion of the knee is affected.
- A person experiences great difficulty in movement.
- People over 48 years of age are mostly advised to undergo this surgery. Many young people with osteoarthritis opt for this surgery.
However, the surgery may not be a wise idea for
- A person with Rheumatoid Arthritis and Angular Deformity (acute).
- A person whose larger portion of the knee is affected.
- A person who had undergone osteotomy (surgical excision followed by reshaping of bones).
- People with an unstable or weak knee should avoid this surgery.
Pre- surgery, a person should
- Avoid taking any anti-inflammatory and herbal medicines (minimum 10 days before the surgery).
- Get yourself medically examined for any health complications (that might interfere with surgery).
- Follow a healthy lifestyle. Avoid smoking and drinking.
- For the surgery, the patient is either given a general anesthesia or a spinal (or epidural) one.
- Next, a compressing device (tourniquet) is put around the upper part of the thigh. This is done to avoid excessive blood loss during the surgery.
- A 7cm incision is made over the knee.
- The damaged parts (bones and cartilages) of the knee are then carefully removed.
- The surgeon next replaces the excised parts with metallic implants. Once the metallic part fits into the knee, it is adhered to the bone with (or without) bone cement.
- The surgeon then stitches the incised area, followed by dressing and bandage.
- The surgery is less invasive with a quick recovery time.
- The surgery replaces only the affected knee part.
- Blood transfusions are seldom required.
- A person gets back to normal life faster.
- The surgery requires less time (~ 1-2 hours).
You need to be careful about:
- Infection at the incision site, though it is very rare.
- Injury in blood vessel, ligaments, or nerves.
- Fracture in the bone
Conventional medicine treats pain with the help of medications; by either blocking the transmission of pain signals in the body or by correcting the underlying problems caused by the pain in the first place. However, traditional and alternative forms of medicine such as acupuncture manage pain issues within the body through the means of redirecting disrupted energy flows. One of the very few forms of alternative treatments used in conjunction with conventional treatments, acupuncture is seen as a mercurial rise in popularity in the past few decades.
What is acupuncture?
Acupuncture dates back to ancient China, about 2500 years ago. It has been widely practiced there for a number of millennia, not only pain relief, but also for treating many ailments. Acupuncture isn’t just considered a form of therapy, but a holistic form of medicine. Acupuncture works on the principle of the flow of energy within the body, also known as ‘Qi’, in traditional Chinese medicine. Acupuncture strives to correct the disruptions in ‘Qi’ that may cause pain by manipulating over 2000 of the specific pressure points within the body with the help of specially created needles.
Where is acupuncture effective?
Acupuncture is very effective in treating a host of ailments, especially in relieving the associated pain. Some of the areas where acupuncture has proven its effectiveness are:
1. Treating nausea and vomiting caused due to chemotherapy treatment for cancer patients
2. Very useful in treating post-operative pain caused due to dental procedures
3. Rehabilitating patients who have suffered strokes
4. Fibromyalgia (musculo-skeletal pain with fatigue accompanied by sleep and memory issues)
5. Effective in combating withdrawal symptoms caused due to addiction
6. Pain from menstrual cramps
7. Tennis elbow
8. Osteoarthritis (a type of arthritis caused due to the erosion of tissues present at the ends of one’s bones)
9. Pain of the lower vertebrae within the spinal column
How does acupuncture work within the body?
According to modern medicine, the specific pressure points utilized by acupuncture within the body help in releasing chemicals that can block or at least reduce pain. It encourages the flow of chemicals from the brain, which act as nerve and pain blockers. It also helps stimulate the muscles and nerve endings, which can lessen inflammation and thus help in reducing pain.
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The shoulder is one of the most important joints in the body that uses a ball and socket to join the arm to the rest of the body. Any pain can make it difficult to carry out motion in a comfortable manner. The shoulder consists of the long arm bone called the humerus, the collarbone or the clavicle, as well as the shoulder blade called the scapula. A layer of cartilage provides essential padding to the bones in this area and its two main joints. There are a number of issues that can cause shoulder pain.
Let us get to know the six most common ones.
- Rotator Cuff Injury: This is the most common cause of shoulder pain and it occurs when the four muscles or the tendons are injured. These muscles and tendons usually control the movement of the arm. This injury can involve strains and tears which may also be caused by constant lifting of heavy objects.
- Rotator Cuff Tendonitis: This condition affects the tendons and muscles that help in moving the arm freely. This usually happens due to inflammation in the tendons. It is commonly experienced by patients who are actively involved in sports and other heavy physical pursuits in their line of work.
- Frozen Shoulder: This is a debilitating condition that restricts the free movement of the arm and is also known as adhesive capsulitis. When the shoulder tissues become too thick, it leads to the growth of scar tissue that hinders proper movement and causes pain.
- Osteoarthritis: Osteoarthritis is a condition that comes as part of aging bones that also become hollow and brittle over the passage of time, which leads to joint and bone pains in various parts of the body. It is a degenerative disease that is caused due to prolonged wear and tear as well as other factors including family history and sports injury.
- Bursitis: This condition is known to affect the fluid-filled sacs that lie in between the joints. These are known as bursae. When the bursae suffers from swelling, the effect usually shows up as pain in the joints.
- Tendon Sheath Inflammation: The fibrous tissue that connects the bones and the muscles is called a tendon. The presence of the tendon makes it possible to pursue activities like running, jumping, lifting, gripping and more. It is protected by a sheath known as synovium, which also lubricates the same. Any injury or tear to this sheath can cause shoulder pain.
Acute and persistent pain that does not abate and gets even worse should be treated with immediate medical intervention.
Rotator cuff tendinosis, Frozen shoulder and Tendon sheath inflammation are more common in Diabetic patients. Essential part of treatment of these conditions include diabetes control and physiotherapy. However in chronic and refractory cases Arthroscopy may be required. Many times chronic rotator cuff tendinosis ends up in rotator cuff tear as a result of minor trauma.
A Tennis elbow is a painful condition that affects the tendons due to a condition known as tendinitis, which causes inflammation. This condition will end up restricting the free movement of the elbow and the arm due to the pain and stiffness that it causes. This is due to the fact that these tendons are the tough band of connective tissues that hold the muscles and the lower arm with the bone. Repeated gripping motions and continued tugging as well as activities like weight lifting, tennis, squash and other like carpentry, painting writing and typing, can lead to this condition.
Here are a few methods of treatment and the questions that revolve around them.
- Do I have to restrict my movements: Yes, when you have tennis elbow, the very first thing you must do is to give rest to the tendons by curbing those activities that have caused the condition or those which can aggravate the pain and stiffness. Lifting heavy objects, gripping things for prolong periods, other physical pursuits like tennis and other games and more will need to stop so that you do not stretch, strain or pull the tissue.
- Can I take pain killers: Yes, you can take pain killers like ibuprofen and acetaminophen in case the pain is unbearable? Always ensure that an orthopaedic specialist takes a look at your arm before prescribing the medicines to you.
- Is an ice compress good for this pain: You can use the RICE method for acute pain that is less than 72 hours old. For more persistent pain, you must see a doctor. The RICE method refers to Rest, Ice, Compression and Elevation. In this method, you can keep your arm elevated and give it rest. You can also use an ice compress and keep it tightly wound with an elastic bandage so as to avoid swelling.
- Can I take injections for this condition: Corticosteroid injections may be used for very severe cases. This contains the cortisol hormone and can give good results in the short run.
- Are there any non invasive methods for treatment: You can try non-invasive procedures like shock wave therapy which will help in fixing the pain and promote motion gradually. This procedure is usually conducted with the help of shock waves that are passed to the skin.
- Is exercising a complete no no: In this case, many orthopaedic surgeons and doctors will ask you to go through physiotherapy so that you can get used to movements and motion after prolonged pain. These exercises will also strengthen the muscles of the area.
Talk to your doctor if the pain is particularly debilitating and discuss surgery for the same.