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Dr. Gaurav Mittal

MBBS

Orthopedist, Delhi

14 Years Experience
Dr. Gaurav Mittal MBBS Orthopedist, Delhi
14 Years Experience
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Gaurav Mittal
Dr. Gaurav Mittal is a trusted Orthopedist in Shalimar Bagh, Delhi. He has over 14 years of experience as a Orthopedist. He has completed MBBS . He is currently practising at Max Hospital-Shalimar Bagh in Shalimar Bagh, Delhi. Book an appointment online with Dr. Gaurav Mittal on Lybrate.com.

Lybrate.com has top trusted Orthopedists from across India. You will find Orthopedists with more than 30 years of experience on Lybrate.com. You can find Orthopedists online in Delhi 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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Education
MBBS - - 2003
Languages spoken
English
Hindi

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#FC - 50, C & D Block, Shalimar Bagh. Landmark : Near Toyata & Nissan Showroom, DelhiDelhi Get Directions
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What I do my leg is injured due to football and for this pain I have cold in my body answer me please.

MBBS
General Physician, Mumbai
What I do my leg is injured due to football and for this pain I have cold in my body answer me please.
For pain take tablet paracetamol and for assessing the injury kindly meet a nearby Dr. For further management.
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I am having a persistent backache, why?How to get rid of it?

Ph.D, MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist,
I am having a persistent backache, why?How to get rid of it?
Have hot and cold water fomentation thrice a day for 12 days of 15 minutes duration each time use firm even and hard mattress for sleep, learn spinal extension exercise from neuro physiotherapist.
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Today I had climb upstairs 3 times till 6th floor but meri saans full rahi thi and my legs was also paining a lot and shivering and after some time later my neck getting some pressure it's like to be coughing is it normal or do I need to diagnose.

MD - Anaesthesiology, MBBS
Anesthesiologist, Warangal
Today I had climb upstairs 3 times till 6th floor but meri saans full rahi thi and my legs was also paining a lot and...
dear sneha. 1st of all 1 thing i want to clear that climbing of 6 floors is good exercise capacity for a normal daily moderately working people. if you want me to add more scientific details. climbing more than 5 flight of stairs requires at least >20ml/kg/min of o2 supply through lungs, which is far greater than normal consumption of 250 ml/min. so you are feeling all those symptoms. as far as my knowledge is concerned no need for further testing... if u want further clarification contact me by replying to this message
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I got my ankle twisted again. After getting on with this for 15 days I cant find a solution. What should I do?

BPTh/BPT, Bachelor of Science
Physiotherapist, Gurgaon
Hello , Give a detailed history of your problem so that I can help you to prevent recurrent twisting of your ankle. Till then wear ankle support to prevent further injury. Avoid heavy lifting and weight bearing activities. Thanks.
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Delayed Onset Muscle Soreness (DOMS)

Physiotherapy In Cerebral Palsy and Leprosy, MPT Neurology
Physiotherapist,
Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness (doms), also called muscle fever, is the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise.

The soreness is felt most strongly 24 to 72 hours after the exercise. It is thought to be caused by eccentric (lengthening) exercise, which causes microtrauma to the muscle fibers. After such exercise, the muscle adapts rapidly to prevent muscle damage, and thereby soreness, if the exercise is repeated.

Delayed onset muscle soreness is one symptom of exercise-induced muscle damage. The other is acute muscle soreness, which appears during and immediately after exercise.

Characteristics

The soreness is perceived as a dull, aching pain in the affected muscle, often combined with tenderness and stiffness. The pain is typically felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest. This tenderness, a characteristic symptom of doms, is also referred to as" muscular mechanical hyperalgesia.

Although there is variance among exercises and individuals, the soreness usually increases in intensity in the first 24 hours after exercise. It peaks from 24 to 72 hours, then subsides and disappears up to seven days after exercise.

Cause

The soreness is caused by eccentric exercise, that is, exercise consisting of eccentric (lengthening) contractions of the muscle. Isometric (static) exercise causes much less soreness, and concentric (shortening) exercise causes none.

Mechanism

The mechanism of delayed onset muscle soreness is not completely understood, but the pain is ultimately thought to be a result of microtrauma mechanical damage at a very small scale to the muscles being exercised.

Doms was first described in 1902 by theodore hough, who concluded that this kind of soreness is" fundamentally the result of ruptures within the muscle. According to this" muscle damage" theory of doms, these ruptures are microscopic lesions at the z-line of the muscle sarcomere. The soreness has been attributed to the increased tension force and muscle lengthening from eccentric exercise. This may cause the actin and myosin cross-bridges to separate prior to relaxation, ultimately causing greater tension on the remaining active motor units.[6] this increases the risk of broadening, smearing, and damage to the sarcomere. When micro-trauma occurs to these structures, nociceptors (pain receptors) within muscle connective tissues are stimulated and cause the sensation of pain.

Another explanation for the pain associated with doms is the" enzyme efflux" theory. Following microtrauma, calcium that is normally stored in the sarcoplasmic reticulum accumulates in the damaged muscles. Cellular respiration is inhibited and atp needed to actively transport calcium back into the sarcoplasmic reticulum is also slowed. This accumulation of calcium may activate proteases and phospholipases which in turn break down and degenerate muscle protein. This causes inflammation, and in turn pain due to the accumulation of histamines, prostaglandins, and potassium.[7][9]

An earlier theory posited that doms is connected to the build-up of lactic acid in the blood, which was thought to continue being produced following exercise. This build-up of lactic acid was thought to be a toxic metabolic waste product that caused the perception of pain at a delayed stage. This theory has been largely rejected, as concentric contractions which also produce lactic acid have been unable to cause doms. Additionally, lactic acid is known from multiple studies to return to normal levels within one hour of exercise, and therefore cannot cause the pain that occurs much later

Relation to other effects

Although delayed onset muscle soreness is a symptom associated with muscle damage, its magnitude does not necessarily reflect the magnitude of muscle damage.

Soreness is one of the temporary changes caused in muscles by unaccustomed eccentric exercise. Other such changes include decreased muscle strength, reduced range of motion, and muscle swelling. It has been shown, however, that these changes develop independently in time from one another and that the soreness is therefore not the cause of the reduction in muscle function.

Possible function as a warning sign

Soreness might conceivably serve as a warning to reduce muscle activity so as to prevent further injury. However, further activity temporarily alleviates the soreness, even though it causes more pain initially. Continued use of the sore muscle also has no adverse effect on recovery from soreness and does not exacerbate muscle damage. It is therefore unlikely that soreness is in fact a warning sign not to use the affected muscle.

Repeated-bout effect

After performing an unaccustomed eccentric exercise and exhibiting severe soreness, the muscle rapidly adapts to reduce further damage from the same exercise. This is called the" repeated-bout effect.

As a result of this effect, not only is the soreness reduced, but other indicators of muscle damage, such as swelling, reduced strength and reduced range of motion, are also more quickly recovered from. The effect is mostly, but not wholly, specific to the exercised muscle: experiments have shown that some of the protective effect is also conferred on other muscles.

The magnitude of the effect is subject to many variations, depending for instance on the time between bouts, the number and length of eccentric contractions and the exercise mode. It also varies between people and between indicators of muscle damage. Generally, though, the protective effect lasts for at least several weeks. It seems to gradually decrease as time between bouts increases, and is undetectable after about one year.

The first bout does not need to be as intense as the subsequent bouts in order to confer at least some protection against soreness. For instance, eccentric exercise performed at 40% of maximal strength has been shown to confer a protection of 20 to 60% from muscle damage incurred by a 100% strength exercise two to three weeks later. Also, the repeated-bout effect appears even after a relatively small number of contractions, possibly as few as two. In one study, a first bout of 10, 20 or 50 contractions provided equal protection for a second bout of 50 contractions three weeks later.

The reason for the protective effect is not yet understood. A number of possible mechanisms, which may complement one another, have been proposed. These include neural adaptations (improved use and control of the muscle by the nervous system), mechanical adaptations (increased muscle stiffness or muscle support tissue), and cellular adaptations (adaptation to inflammatory response and increased protein synthesis, among others).

Prevention

Delayed onset muscle soreness can be reduced or prevented by gradually increasing the intensity of a new exercise program, thereby taking advantage of the repeated-bout effect.

Soreness can theoretically be avoided by limiting exercise to concentric and isometric contractions. But eccentric contractions in some muscles are normally unavoidable during exercise, especially when muscles are fatigued. Limiting the length of eccentric muscle extensions during exercise may afford some protection against soreness, but this may also not be practical depending on the mode of exercise. A study comparing arm muscle training at different starting lengths found that training at the short length reduced muscle damage indicators by about 50% compared to the long length, but this effect was not found in leg muscles.

Static stretching or warming up the muscles does not prevent soreness.[12][13][needs update] overstretching can by itself cause soreness.

The use of correctly fitted, medical-grade, graduated compression garments such as socks and calf sleeves during the workout can reduce muscle oscillation and thus some of the micro-tears that contribute to doms, proper nutrition to manage electrolytes and glycogen before and after exertion has also been proposed as a way to ease soreness.[15][16] consuming more vitamin c may not prevent soreness, but oral curcumin (2.5 gram, twice daily) likely reduces it.

Treatment

The soreness usually disappears within about 72 hours after appearing. If treatment is desired, any measure that increases blood flow to the muscle, such as low-intensity activity, massage, hot baths, or a sauna visit may help somewhat.

Immersion in cool or icy water, an occasionally recommended remedy, was found to be ineffective in alleviating doms in one 2011 study, but effective in another. There is also insufficient evidence to determine whether whole-body cryotherapy compared with passive rest or no whole-body cryotherapy reduces doms, or improves subjective recovery, after exercise.

Counterintuitively, continued exercise may temporarily suppress the soreness. Exercise increases pain thresholds and pain tolerance. This effect, called exercise-induced analgesia, is known to occur in endurance training (running, cycling, swimming), but little is known about whether it also occurs in resistance training. There are claims in the literature that exercising sore muscles appears to be the best way to reduce or eliminate the soreness, but this has not yet been systematically investigated.

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I'm suffering from back pain shoulder pain etc what should I do or which balm I must use to cure it .my weight 41 age 20.

BPTh/BPT
Physiotherapist, Kolkata
I'm suffering from back pain shoulder pain etc what should I do or which balm I must use to cure it .my weight 41 age...
Take IFT over back pain area SI joint and Ust and TENS on cervical to shoulder for 2 weeks use good LS spine brace of Good quality Tynor Company do not sit on floor use chomote and avoid sofa and revolving chair.
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What is Hereditary Angioedema and How Can it be Treated?

D.V.D, MBBS
Dermatologist, Delhi
What is Hereditary Angioedema and How Can it be Treated?

Hereditary Angioedema is a rare skin related disorder and as the name suggests it is also a genetically inherited condition. This condition mainly afflicts the throat, abdomen and the limbs of the patient, with a certain kind of swelling. This swelling can become fatal if not treated on time. Here is everything you need to know about the condition and its treatment.

Causes: A rare genetic mutation of the SERPING1 gene can cause this condition. Usually, this gene is known to produce C1 esterase inhibitor, which is a kind of blood protein. This blood protein is an important element of one’s immune system and is usually involved in the biochemical reactions that control the body’s response to inflammation causing elements. This is done when the blood protein produces a hormone known as Bradykinin. If this blood protein does not function in a normal manner, then there is excessive production of this hormone, which leads to swelling and inflammation.

Type One: There are various types of Hereditary Angioedema that can affect various parts of the body. Type one is one of the most common kinds and can be found on the face, hands, abdomen, throat, as well as feet and genitals of the patient. The severity and frequency of attacks cannot really be predicted and the patient may suffer from attacks throughout his or her life. The best way to treat this type of Hereditary Angioedema is with the help of antihistamine drugs and prednisone which can fight allergic attacks.

Type Two: This kind of Hereditary Angioedema has the same symptoms as type one and is caused by a malfunction of the C1 inhibitor, rather than the Bradykinin hormone as one can see in type one. This condition can also be treated with anti-allergy drugs.

Type Three: This is very rare kind of Hereditary Angioedema. In fact, medical science is yet to find a conclusive body of knowledge that can point to the exact causes and symptoms of this condition. Coagulation is one of the main causes recognised so far. This condition is much more common in women than it is in men, and it usually shows up as facial swelling.

Timely Treatment: While there is no cure for this condition, one can prevent a flare up of the symptoms by taking C1 inhibitors and Bradykinin receptors as well as enzyme inhibitors. It is important to get early treatment for the symptoms and to have constant access to a hospital and its emergency unit. One should also keep track of attacks and symptoms and get regular check-ups done by a doctor to detect the earliest signs of the same to avoid fatalities.

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I have an ACL reconstruction on my right knee last 4 months ago . I have some pain when I hold my total weight on right leg . And when I'm doing squats I hear some sounds inner side So please help me about this issue I'm really scared of this.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I have an ACL reconstruction on my right knee last 4 months ago .
I have some pain when I hold my total weight on rig...
after ACL reconstruction physiotherapy must ur muscle required strength nw so do gradually strength exercise but firstly reduce pain and increase mobility and rang of movement
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I have shoulder pain from 1 months. If I take heavy bag upon my shoulder then there will be escessive pain. What should I do?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
I have shoulder pain from 1 months. If I take heavy bag upon my shoulder then there will be escessive pain. What shou...
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. You are very young and if you have not sustained any significant shoulder injury, then this pain can be due to weakness in your muscles, or some bit of soft tissue strain or inflammation. If there are no s/s of inflammation like swelling, skin redness or local warmth etc, then you can start with gentle anti inflammatory medications, ice packs for local application, analgesic spray after fomentation and see how it goes in the next 2-3 weeks, and if it does not improve, then we will have to get some investigation done for evaluation. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
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I am suffering from headache and some pain in my back also and it is going with me since last 3 days I m very upset please help me.

BPTh/BPT
Physiotherapist, Delhi
I am suffering from headache and some pain in my back also and it is going with me since last 3 days I m very upset p...
If your upper back is paining, the cause of your headache could be of cervical origin. Take care of your posture. Drink lots of fluid. Apply ice pack on neck, dont use soft pillow, keep a towel roll underneath neck. Do some shrugs n neck side bending n see if its better. But if lower back is paining, both should be dealt separately for detailed treatment.
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Hi i'm 27year old and my right knee got injured months back and its still pains a lot. I undergone operation also but still its hurts a lot. What to do.

Diploma in Acupuncture, Pranic Healing, MD - Acupuncture
Acupuncturist, Bangalore
Hi i'm 27year old and my right knee got injured months back and its still pains a lot. I undergone operation also but...
Identify the mid point 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.
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I am 23 years old boy and sometime I facing joint pain in my leg. I am pure vegetarian and drinks lots of water and eats fruit regularly.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I am 23 years old boy and sometime I facing joint pain in my leg. I am pure vegetarian and drinks lots of water and e...
OK with this tk calcium supplements and do stretching exercise. . do hot fermentation . avoid strain
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I suffering previous 10 years from rheumetic arthritis disease. Please help.

MS - Orthopaedics, MBBS
Orthopedist,
Have you tried meditation? please try meditation as taught by SSY or Vipashyana This is the best remedy Because in ten yrs You must have tried almost every thing including methotrexate Rhematoid disease is a psycho somatic condition
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Sir mere pairoo me kafi pain rhta h weekness feel hoti h any soultion yrr m job krta hu mkoo kafi prblm hoti h kafi weakness aa chuki h mjhme mko kya krma chahiye.

Doctor Of Physical Therapy (DPT), Bachelor of Physical Therapy
Physiotherapist, Bangalore
Sir mere pairoo me kafi pain rhta h weekness feel hoti h any soultion yrr m job krta hu mkoo kafi prblm hoti h kafi w...
Try doing stretching exercises for leg muscles daily and use heat ot ice on painful area three times a day for 10 minutes. If pain is still there then see a physiotherapist.
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Hi, I am 28 years male. From few days my little finger and half of the near finger getting numbness. Fingers are active and I can feel pain. But I am struggling with numbness. Mostly edge of the little finger part more numbness. Can any one help me why I am getting this problem?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
It is because of nerve deficit, to rule out do nerve study and clear the problem and rule out if it is of vascular lesions if any for your numbness and also it can be of cervical spondylolisthesis the reason for your numbness of asympthommatic cause and do have examined by neuro musculoskeletal physiotherapist or neuro physician or orthopaedician asap.
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I am 40 years old female. I have leg ache from last 1 month. I tried pain relief creams but I can't get rest from this problem. Please give me expert advice.

D.P.T
Physiotherapist, Hyderabad
I am 40 years old female. I have leg ache from last 1 month. I tried pain relief creams but I can't get rest from thi...
Dear lybrate-user. As you are sufeering from 1 month of leg pain. I advice you to reduce your weight. Do some regular excercises and as of now to reduce pain take ultrasonic therapy.
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I am suffering from pain in my upper outer arm and the pain is severe when I do work in some positions. Please sugest treatment for the same.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. If you have localized pain with no s/s of any inflammation or infection like swelling, skin redness, local warmth on touch etc, I will advise you to start with: - intensive physical therapy initially under supervision of a physical therapist and then at home - you can take short course of anti inflammatory medication like tab etoshine on sos basis especially when there is an episode of pain, swelling etc. - adequate calcium & vitamin d intake if levels are low in body - ice packs can applied if your pain is acute, then hot fomentation can be done at home - analgesic spray for local application like dynapar qps spray can be used and is easily available. We will observe you for a period of around 10-14 days, and if your symptoms are not subsiding, then I will advise you some investigations. Do not hesitate to contact me if you need any further assistance. Thanks & regards Dr. Akshay kumar saxena consultant orthopaedics fortis hospital, new delhi.
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I have pain in my backbone and I cannot do any work so can you please give me some medicine to cure thisvpaon.

M.Sc - Dietitics / Nutrition, DNHE, P.G. Diploma in Panchkarma, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Hapur
I have pain in my backbone and I cannot do any work so can you please give me some medicine to cure thisvpaon.
Apply mahanaryan oil on effected area and do fomentation after that. Avoid carrying heavy weight. Do light exercises.
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