Dr. Gurinder Bedi

Mobility for a person is very important, and when you look through, the hip is a very important component to this. It connects the upper and lower parts of the body and helps in movement. It is a ball and socket joint, where the hip bone provides a socket, into which the upper part of the thighbone (femur) sits into, allowing for free movement.

Like any other human organ, the hip also is prone to damage. Be it natural ageing, infection, injury, or diseases, hip movement can be affected, leading to limited movement and increased pain and stiffness. For these people, being able to get back a hip which will allow them to be back on their feet is a boon for sure. It helps in relieving pain and improving mobility, almost giving people a second lease of life.

Reasons for hip replacement:

1. With natural ageing, the hip joint can lose its ability to move, due to normal wear and tear of the hip and thigh bones
2. Diseases of the hips (infectious or autoimmune) can also lead to hip replacement
3. Injury or trauma is another major cause that requires hip replacement
4. Joint problems, leading to repeated dislocations
5. Tumours of the relevant bones

Understanding the procedure in detail

1. The affected bones (whether diseases or worn out) are replaced with a prosthesis which is compatible with the normal body tissue.
2. While some materials fuse to the natural bone, others do not and are simply placed as a separate unit
3. This is a surgery which requires hospitalisation and stays for up to 5 days depending on patient’s overall health condition
4. The entire procedure may take a couple of hours and is usually done under general anaesthesia
5. An incision is made through the side of the hip
6. Both the hip and the thigh joints are prepared, diseased tissue removed, re-shaped, etc. to make way for the prosthesis
7. The prosthesis is introduced through the same incision and positioned into place
8. As noted earlier, there are two types. The ones which fuse to the bone have pores in them into which normal bone eventually grows.
9. The other variety is the cemented version, and a glue is used to keep it in place
10. Most doctors now use a combination, that is cement a porous prosthesis, into which bone will grow, and the incisions are closed
11. The patient stays in the hospital for 1 to 4 days depending on overall health
12. Once discharged, infection and pain control are continued
13. Exercise and physiotherapy play a major role in restoring normal function
14. Weight management is also very important

Osteoarthritis is a condition that causes cartilages in the joints of a human body to wear away. The joints in your body are made of bones and the ends of each bone have cartilages to prevent friction between them. Certain factors like age, nutrition or health threats can cause the cartilages to break down into bits and pieces. As a result, bones come into direct contact with one another causing the joints to swell or to turn tender.

Take a look at the following factors that can cause osteoarthritis

1. Stress on specific joints due to certain postures: The triggering cause behind acute joint pain could be the way you sit for long hours in a day. A sportsperson might face joint pains due to his or her occupation. Similarly, any person required to sit or stand for a long stretch of time due to his/her jobs can suffer from osteoarthritis as well.
2. There might be a deformity in any of your joints: A person born with joint deformities might suffer from arthritic problems later in life. Severe accidents can lead to deformities too.
3. You may have suffered injuries that resulted in the condition: Joint pains needn’t always require an impactful injury. Mild or heavy injuries can lead to arthritis all the same. Defects in the joint cartilage could be passed on through genes.
4. Age could also be a contributing factor: If a person is aging, his or her chances of developing osteoarthritis increase manifold. Age can make your bones and cartilages go weak. As you grow older, the capacity of your bones to absorb nutrition also decreases.

Prevalent symptoms that help you identify osteoarthritis

1. A grinding sensation in the joints: A person suffering from osteoarthritis will experience continual bouts of grinding pain in the joints. This may keep him or her from walking, sitting, working or even resting. The grinding sensation is indeed disabling.
2. You tend to face stiffness in the bones: Patients with this kind of arthritis have been reported with lacking flexibility in their joints. If they are sitting for too long, or have been inactive for some time or might have just woken up from sleep, they are likely to experience stiffness in their bones. Joints even turn sore in such situations.
3. Extra bits of bones could create trouble: Extra bits of bones that develop at a later age are also referred to as bone spurs. They stick around the sore area and make movement a real challenge.

Modes of treatment
If osteoarthritis is detected at an early age, it can be fought against using medications. However, when the disease is really discomforting, treatment procedures like acupuncture or regimented exercising can help a patient. Yoga also does wonders to remedy joint pain. Surgical procedures are also available but they should be fallen back upon as a lender of the last resort.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Muscle sprains and ligament tears are one of the most common injuries that medical practitioners encounter on a regular basis. These injuries are painful and can also limit one’s movement, needless to say. However, there are simple things that can be done as soon as the injury happens so that the impact of the injury can be reduced, the symptoms minimised, and recovery improved.

A sprain is a tear of the ligament. The ligament is responsible for connecting the tissue strands that connect the bone to the muscle. When this sprain affects the muscle or even the tendon, it is known as a strain.
Sprains are very common and can occur due to a fall, twist, or impact. Most commonly affected areas are the ankles and wrists. Sprains happen when there is a pull or a twist of the ankle or the joint. This is very common in athletes and can be caused by repetitive motions in the knees, wrists, elbows, etc.

The most common symptom is pain, swelling, limited movement, and sometimes bruising. The degree of these injuries depends on its severity. The most common ways to treat such injuries are as follows.

1. RICE therapy: RICE is an acronym for rest, ice, compress, and elevate. Rest the affected area immediately by stopping any further activity. Ice the area using an ice wrap, with the ice cubes wrapped in a towel or a cotton cloth. Repeat this exercise if possible for every 20 minutes. This will reduce the swelling and pain. Compress the area using a sling or a wrap. This will help in reducing the swelling. Elevate the affected area if possible above the heart. This will help control the blood flow and thereby reduce the swelling and pain.
2. Pain control: If there is pain that needs medication, go for the non-steroidal drugs like ibuprofen or acetaminophen. If it is a child that is injured, it is advisable to give non-aspirin ones.
3. Seek professional help: Most sprains can be self-limiting over a couple of days. However, it is advisable to seek medical help if there is significant pain, swelling, or numbness, open wounds or bruises, or inability to move the joint.

The doctor may decide to do the following.

1. Scanning or imaging to rule out any internal hard/soft tissue injury like fracture or tear
2. Immobilise the joint with a splint or a cast
3. Start physical therapy if there is severe pain and immobility
4. Surgical repair if there is a ligament injury

A word of caution to athletes or people who are very active physically is to go easy on the joint. In an eagerness to quickly get back to their routine, more and severe damage may be caused. This can be avoided by allowing time for complete healing.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Fibromyalgia is a musculoskeletal disorder that is characterized by pain in the muscles and the joints. This disorder leads to the development of multiple tender points on the body, wherein, a very small amount of pressure applied might result in pain. In some cases, social isolation and depression may occur as a result of this disorder.

The symptoms of fibromyalgia are:
1. You will have difficulties in sleeping at night
2. You may experience mental problems and cognitive dysfunction
3. Light and noise sensitivity
4. Irritable bowel syndrome
5. A numb feeling on your hands and feet
6. Chronic headaches
7. You may experience painful periods
8. Restless legs syndrome
9. You may be depressed

The muscles of the body tend to feel overworked, even though you may not have exercised. You may also experience deep throbbing pain and burning sensation in the muscles. In addition, it may cause symptoms similar to osteoarthritis and bursitis. You are at a higher risk of being affected by fibromyalgia if you have a family history of this particular disease.

Some other causes of this disease are:
1. Certain infections and illness may lead to fibromyalgia
2. Car accidents
3. Any repetitive motion

The treatments for this disorder include:

1. Sleep management: Optimal levels of sleep at night help in improving symptoms of fibromyalgia. Don’t drink coffee or consume spicy foods before going to bed as these have the ability to interfere with your sleep cycles.
2. Medications: The doctor may prescribe medications to manage the pain. Taking anti-depressants may be necessary if you suffer from depression.
3. Other therapies: Massage treatments help in easing the symptoms of fibromyalgia. You may continue with your exercise regimen after consulting the doctor. Relaxation techniques like mediation may help improving your mental health. You may also be asked to include various food supplements to make sure your body receives the necessary nutrients in the right amounts. In case you have a concern or query you can always consult an expert & get answers to your questions!

Foot arch pain is used in broader context for describing pain in bones, ligaments, muscles and nerve on the foot bottom. Slight damage to any of the components in the foot bottom can cause great pain. For starters, the pain lasts for a brief period, but increases over time if the condition is left untreated. Foot arch pain is more commonly witnessed in people over the age of 60 and among athletes engaged in sports of high impact.
The treatment plan of the pain totally depends on the cause. An early and right diagnosis goes a long way in treating the condition faster. For occasional mild to moderate pain, simple solutions such as footwear change can do the trick. Doctors often suggest four simple methods. This starts with rest followed by applying ice and then trying compression and elevation.

Anti-inflammatory medications are used to treat foot arch pain. Cases that are severe in nature can be treated with steroid and anti-inflammatory injections. For extreme cases, cortisol injections are prescribed too. This is done to relieve pain and release plantar fascia. Even stretching exercises are known to give relief from the pain. Some of the recommended exercises during this period are:

1. Stretch-related to plantar fascia: This exercise should be performed by crossing the legs at the junction of the knee. The body weight should be rested on the unaffected leg and it should gradually come down to touch the toe. The idea is to stretch the plantar fascia. A set of 20 such movements should be practised on a daily basis. Each movement should last for about 10 seconds.
2. Foot flexing: This exercise can be practised before getting out of bed. This is the tie when the pain from the plantar fascia is felt the most. This exercise should be repeated 20 times each lasting for about 10 seconds.
3. Rolling stretch: This exercise should be started by sitting in a chair. A tennis ball should be placed under the foot arch and the same should be rolled back and forth for ten times at a time. The same should be repeated with the second foot. Once this posture gets comfortable, the same should be practised by standing on the ball. It is known to be extremely useful for people suffering from foot arch pain.

How to prevent foot arch pain?
1. Wear shoes that are half an inch lose as they will make feel comfortable while walking
2. Losing weight; obese tends to cause pain in the foot arch
3. Performing free hand exercise and simple stretching on a daily basis
4. Not to overuse the foot. People who stand for more than 5-6 hours at stretch on a daily basis are observed to have foot arch pain. If you wish to discuss about any specific problem, you can consult an orthopedist.

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks. If you wish to discuss about any specific problem, you can consult an orthopedist.

Tennis toe is also known as runner’s toe since athletes are mostly runners; skiers and tennis players also get this injury often. Due to its ugly appearance, tennis toe is also known as a black toenail. This injury causes bleeding under the toe along with moderate to heavy pain. Although it is not considered to be type 1 serious injury, it can still force an athlete to abstain from participating in any events. The blood from the toenail might take its own sweet time to get out of the way. As a result, the recovery time for this injury can last for weeks together. This, unfortunately, is also an ideal condition for infection to set in.

How does it happen?
This condition may arise because of the friction between the toenail and the running shoes or constant downward pressure on the toe. In case if the shoe is tighter than normal, it can damage the toenail. If on the other hand, the shoe is very loose, it can result in similar condition due to heavy pressure on the nail. Tennis toe can also arise in a situation, if the toe constantly bangs the shoe from inside. Extreme hot weather may also result in toe swelling. Finally, one may encounter tennis toe if a blow is faced on the toe. Irrespective of the cause, the blood clots inside the nail resulting in swelling and pain. Too much damage might result in falling off of the toenail altogether.

Treatment plan:
1. If the tennis toe is minor, the injury resolves all by itself
2. The toenail should be clipped together to ensure that it does not result in any friction with the shoe.
3. During the injury, it is advised that a person wears bigger size shoes with wider toe space so that it does not result in any further irritation.
4. If the toenail is torn, make sure to tap it up so that adequate protection is there from outside forces.
5. In case the injury is serious a doctor might have to intervene and drain the blood with a surgical instrument.
6. Another medical solution is to remove the toenail surgically, drain the blood and tape it up for a good one week until new nail formation takes place.

Precautionary measure:
1. Running shoes should be at least half a size bigger than the normal size.
2. Toenails should be regularly trimmed in order to avoid any injury.
3. If a person has a tendency of sweating too much, it makes sense to wear a pair of socks at all times.
4. While running, shoe laces should be tightened to avoid sudden friction between the toe and the shoe resulting into tennis toe.