Dr. Anjana Gupta

Hello friends, I am physiotherapist, Dr Anjana Gupta. I did my studies from SMS medical college, Jaipur in 1986. After completing my studies, I joined government job in JP Pant Hospital, attached to Molana Azad Medical College. I served the government of India for almost 12 years. Now I am practising in Greater Kailash 2. There I had enough experience in Orthopaedics and neurological cases. Today I am going to discuss Cervical Spondylosis neck pain.

The most common cause of the neck pain is our daily lifestyle itself. Spending 8-10 hours in front of computer in an incorrect posture can lead to muscle spasm. A patient has acute onset of pain and the condition can be so painful that the range of moment of the patient can be restricted, there could be a sudden restriction of a neck or sudden restriction of a muscle. The muscles get strained and the pain can go to the head, shoulders and arms.

Another cause of neck pain is an accident or an injury to the neck that can involve the muscle or the disc surrounding the bones.

The radiculopathy gives the symptoms of numbness, the tingling sensation in the arms or the area around the shoulders.

The Degenerative diseases can also involve the nerve in the arm and give rise to nerve symptoms.

Treatment of the Cervical Spondylosis depends  on the complete assessment, thorough examination by physiotherapist which check the trigger points. The trigger points are the very acute painful areas present in the muscles. The trigger points can be in the bicepes, or the scapular area, or it could radiate in the hands causing the Carpal Tunnel syndrome.

After the examination, we plan the protocol to relieve the patient from the pain. The main aim of the therapist is to relieve the acute pain the patient is suffering from. Our treatment plans are to relieve the patient from the pain and put him on a regular graded exercises for the strengthning of the neck or shoulder muscles.

We have different modalities in the physiotherapy. The modalities could be ultrasonic, Inter Ferential Therapy (IFT), Infrared and the numerous modalities. Or it can be the simple ice packs that can reduce the pain and the acute spasm in the patients suffering from pain.

I am practising in Greater Kailash, part-2. I have got my own Physiotherapy clinic. My clinic staff is well trained and is equiped with various physiotherapy equipments with the latest state of art equipments, we are here to serve the community, we are here to serve the people suffering from pain. I can just say to come in the clinic and give us the chance to serve.

Thank you.

Cervical osteoarthritis is also known as cervical spondylosis. It is a medical condition which involves changes in the joints of neck, bones and discs. This is generally caused due to the deterioration of the muscles owing to old age. With age, the cervical spine breaks down and loses all its fluids. This leads to stiffness in the spine. It occurs usually in middle aged and old aged people. This causes stiffness and severe neck pain. Corrective surgery is helpful to cure Cervical Osteoarthritis.

Symptoms of Cervical Osteoarthritis:

1. Pain and stiffness in the neck.
2. Headache which usually emerges from the neck.
3. Severe pain in the arms and shoulder.
4. Not being able to turn the head or neck fully while driving.
5. Muscle spasm and abnormal reflexes.
6. Grinding sensation or noise caused while bending the neck.

Cervical Osteoarthritis can be cured by physiotherapy in the following ways:

1. Heat modalities- In this method the pain and stiffness is reduced by putting heat on the affected area. This type of therapy is called heat therapy.
2. Neck exercise- Regular stretching and bending exercises for the neck can reduce pain and stiffness
3. Manipulating therapy- This form of therapy is used by massage therapists. They massage and manipulate the joints so that the muscles can function smoothly.
4. Hydrotherapy- This therapy involves exercising in a pool. Hydrotherapy is extremely beneficial for people having severe joint pain and stiffness.
5. Cervical traction- This is a common non-surgical treatment which cures pain in the neck by opening the cervical foramen (hole or passage).

Physiotherapy is the most natural and safe way of curing cervical osteoarthritis. If you are diagnosed with cervical spondylosis, you should start physiotherapy as soon as possible. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

The knee joint is made up of several elements including the knee cap, meniscus, connective tissue, tendons, ligaments, cartilage, and muscles. Damage to any part of the knee can cause chronic pain.

What can cause knee pain:

Fractures: These are caused by the breaking up of the kneecap due to falls or collisions.ACL Injuries: Caused due to the tearing of the anterior cruciate ligament (that connects the femur and the shinbone). Especially common in sportspersons such as footballers or basketball players.Meniscus tears: The meniscus or the rubber-like cartilage (that acts as a shock absorber) can be torn by sudden jerks or excess pressure.

Arthritis: The chief cause of lingering knee pain, arthritis itself can be of a number of types.

• Osteoarthritis, which is a result of deterioration of cartilages due to wear and tear
• Rheumatoid Arthritis, an inflammatory chronic disorder
• Septic Arthritis, causing pain, swelling and redness.
• Gout caused due to the development of uric acid crystals in the joints

How to deal with it:

• Exercise: Moderate to intense exercise is prescribed for one and all. This, of course, depends on one's overall health and age. If you are already suffering from joint pain, then you may want to go easy on the exercise with a focus on building muscle strength and foundation. If you are healthy, then some amount of daily exercise as a routine will keep those knees in prime working condition and well lubricated as well. Inactivity and a sedentary lifestyle can affect the knees very badly.
• Dealing with Load: Weight is a big one. Carrying around extra pounds and kilograms can be detrimental for your knees in the long run. Your knee is not equipped to handle the excessive weight. It already supports three to five times your weight when you get up and walk around or indulge in some mild jogging. One must be careful of those extra pounds to take the load off the knee and keep it from falling prey to damage.
• Do not Ignore: Warning signals such as chronic or acute knee pain should not be ignored. Remember to see a doctor or an orthopaedic specialist to find out if you have contracted an infection or if you may have suffered a fracture due to an injury.

Ligament Injuries-

The ligaments around the knee are strong. However, sometimes they can become injured. They may be stretched (sprained), or sometimes torn (ruptured). A ligament rupture can be partial (just some of the fibres that make up the ligament are torn) or complete (the ligament is torn through completely). The majority of knee ligament injuries are sprains and not tears and they tend to settle down quickly.

ACL injury and other ligament injuries can be caused by:

• Twisting your knee with the foot planted
• Getting hit on the knee
• Extending the knee too far
• Jumping and landing on a flexed knee
• Stopping suddenly when running
• Suddenly shifting weight from one leg to the other

These injuries are common in soccer players, football players, basketball players, skiers, gymnasts, and other athletes.

Treatment-

1. Rest the knee. 
2. Ice your knee to reduce pain and swelling.
3. Compress your knee. 
4. Elevate your knee on a pillow when you're sitting or lying down.
5. Wear a knee brace to stabilise the knee
6. Practise stretching and strengthening exercises if they are recommended.

For severe collateral ligament tears, you may need surgery to attach the ligament back to the bone if it was pulled away, or to the other part of the ligament if it was torn in the middle.

Meniscus Tear-
A meniscus tear is a common knee injury. The meniscus is a rubbery, C-shaped disc that cushions your knee. Each knee has two menisci (plural of meniscus)-one at the outer edge of the knee and one at the inner edge. The menisci keep your knee steady by balancing your weight across the knee. A torn meniscus can prevent your knee from working right.

A meniscus tear is usually caused by twisting or turning quickly, often with the foot planted while the knee is bent. Meniscus tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily.

Treatment may include:

1. Rest, ice, wrapping the knee with an elastic bandage, and propping up the leg on pillows.
2. Physical therapy.
3. Surgery to repair the meniscus.
4. Surgery to remove part of the meniscus. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

Patients experiencing low back pain are regularly recommended to a physiotherapist for exercise based recovery. This is done before a patient considers other aggressive options like back surgery. The objectives of exercise based recovery are to eliminate back pain, increase functioning and educate the patient about a regular pain prevention program for back pain in the future.

Low back stiffness is to a great extent dependent on the abdomen and lower back muscles. The abdominal muscles give support by putting pressure on the abdomen, which is then exerted, on the spine. This provides an external support column from the front of the spine. The low back muscles balance out the spine. Simply put, the hard spine and circles are surrounded by muscles, and the stronger these particular muscles are, the less strain is put on the plates and joints of the spine. The patient needs to develop a belt of muscles around the spine.

Most physiotherapy methods that are intended to treat low back pain and some radicular pain (pain extending down the leg), include a number of the following kinds of activities:

1. Stretching: Appropriate stretching of the muscles alongside dynamic activity will keep up the usual scope of movement and give alleviation to muscles. These are the muscles that are gradually shrinking or are an ill fit from wrong stance or nerve aggravation. For some patients it is best to follow a stretching schedule that has been exclusively made for them by their physiotherapist.
2. Dynamic exercises: These activities include the use of a number of activities that might include exercising balls, adjusting machines or particular balancing out activities. The purpose of stabilization activity is to strengthen the muscles of the spine and backing the spine through different scopes of movement.
3. Core strengthening exercises: These are particular activities to strengthen the abs and low back muscles (erector spinae) to give the previously mentioned 'belt of muscle' around the spine.
4. Abdominal strengthening: These kinds of exercises include sit-ups, crunches, stomach machines, and leg raises.
5. Hyperextensions: These can be performed on machines or by lying on the stomach and gradually raising the stomach off the ground. This activity uses the lower back muscles to "hyperextend" the spine. Make sure not to do it with sudden jerks. The stretch should be slow and gradual to prevent ligament tear from happening.
6. Lumbar traction: With lumbar traction, the patient lies on his back and is secured on a special table with a link or cable coming from the foot-end of the table that joins to a strap that has been set around the patient's hips. The link or cable is connected to weights at the foot-end of the table that gives a consistent and soft pulling power on the hips toward the foot-end of the table.

Frozen shoulder is a condition when somebody encounters continuous shoulder stiffness and pain. It could last for weeks. It is likely to occur when swelling increases around the shoulder which reduces inability to move or stretch properly. This ordinarily happens when somebody is recovering from an injury. Frozen shoulder at times happens when somebody is wearing a sling or a cast. It also occurs, if someone is recovering from surgery, experiencing joint pain or facing restraint of movement for other reasons.

A frozen shoulder can go on from a couple of months to as much as 3 years and the precise cause is unknown. Physiotherapy is often to treat this condition. It has been found that posture plays a huge part in your recovery from a frozen shoulder. The urgent goal is to get the shoulder join moving once again. The sooner this is done, the better are the odds of a quick recovery. Anti-inflammatory medicines, heat application and delicate stretching activities are performed with the assistance of a physiotherapist.

Physiotherapy is very crucial for a frozen shoulder since it is very difficult to get movement in the stiff joint without any exercise, stretching or other methods used by a physiotherapist. It is mostly crucial to get physiotherapy to:

1. To reduce pain in the shoulder
2. To increase the flexibility and strength of the shoulder
3. To enhance movement of the shoulder.
4. To increase endurance of the muscles

Physiotherapy treatment for a frozen shoulder depends on the stage you are on and is customized according to the needs of your condition. Physiotherapy treatments for a frozen shoulder include:

1. Pain relief: Pain diminishing techniques including gentle shoulder movement exercises, muscle releases, needle therapy, dry needling and kinesiology taping for pain can help during the painful swelling phase.
2. Defrosting: Shoulder mobilization and stretching are the best in order to achieve a full shoulder recovery. As your scope of movement increases, your physiotherapist will then be able to give you muscle strengthening exercises to control and keep up your recently found range of movement.
3. Warm Up: Before beginning shoulder exercises for a frozen shoulder, try to warm up your shoulder keeping in mind the end goal. That is to help blood supply in the affected area and avoid future injuries. The best approach is to extend and warm up the shoulder by applying heat for 10 to 15 minutes, scrubbing down or showering with Epsom salt.

Physiotherapy does not bring out immediate results, but gradually. Flexibility will increase gradually. One should keep in mind, not to stretch their shoulder too quickly at once. This can lead to a ligament tear. The exercises should be tender and gradual. If you wish to discuss about any specific problem, you can consult a physiotherapist.

Kegel exercises can do wonders. They can actually make your pelvic floor muscles strong. This can control your bladder leakage.
To get started, find the right muscles. To identity your pelvic floor muscles, stop urination in midstream.

1) Find the muscles you use to stop urinating.
2) Squeeze these muscles for 3 seconds and then realise for 3 seconds.
3) Add one second each week until you are able to squeeze for 10 seconds each time.
4) Repeat this exercise for 10 to 15 times per session
5) Don't do kegel while you urinate.

We should exercise in a limit. The limit is different for every one of us depending upon age and fitness levels. Because if we ignore this we loose ours judgment to eat and crave more for food. We end up with eating more and more weight gains. Exercise in limit.