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Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Knee replacement
Treatment of Nerve And Muscle Disorders
Treatment of Hip Disorders
Neuro Physiotherapy Treatment
Treatment of Knee Injury
Pregnancy Exercise Therapy
Treatment of Sports Injuries
Treatment of Splinting
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Heat Therapy Treatment
Post Pregnancy Classes
Orthopedic Physical Therapy
Treatment of Shin Splints
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I have a continuous pain in my lower back. It mostly happens when I drive back or sit on hard surface for ling time. Any suggestions how to heal it?
Having constant cuts/ulcers in my mouth and feeling of pain on the right side of throat mot able to recover from it from last month.
Sir I am suffering with knee problem please provide me solution I have taken pain killer tablets also but no use.
The concern of the patient is more related to the fear of something wrong, rather than the pain itself, which may be quite bearable. Before you go to consult to your doctor for your back problem, go though the checklist mentioned here, and you will be easily able to make out if your problem needs treatment or a good physiotherapy and life style modification.
Lets start with the statics.
1) back pain the most common reason for people to consult physician.
2) majority of them (and believe me about 80 to 85%) are functional which means they are not a disease but are due to improper lifestyle.
3) 10 to 15% of them are related to some pathology, and only these patients need medical help.
I know the next question in your mind, how do I know if my back pain need further consultation from a doctor, or I just want to need a physio and life style modification.
If you have any of these signs then you need consultation with a doctor.
1) duration of back pain more than 2 months.
2) localized back pain with stiffness in the morning,
3) pain not getting resolved despite good physio efforts and life style modifications
4) pain in the back with radiation to one of the legs, ie leg pain with back pain.
5) back pain associated with fever, appetite loss, or weight loss.
6) back pain with pain mainly in the night, and it arises you from sleep.
7) any association of weakness in the legs or numbness on walking.
Posture correction while work is the major remedy for postural back pain and this group is quite large.
1) use firm mattress for rest. Not a very soft one.
2) adequate support to the back while sitting on the chair, back should be kept straight but not strained.
3) regular back muscle strengthening exercises is must with this group.
When your back pain is not functional, then a consultation with your doctor is a must, most of the time the first doctor we consult is a physician, these days people are getting aware and consult an orthopaedic or a neuro surgeon. My advise is to consult a spine surgeon who are trained specially to deal with such problems. The usual examination is followed by certain blood tests and radiological investigations, like x rays and mri scanning. Out of these pathological type majority will not need surgery.
Keep strengthening your back, and prevent back pain. Remember physiotherapy (exercises) are to be done to prevent back pain and not to cure it.
I am having lower back pain from past 10 days. Earlier I suffered from motions and had the motions tablets and it got reduced. I did not go to toilet for 3 days after using the tablet. After this one day I went to the toilet with stressing a lot. From that moment I am suffering from lower back pain. Please give me some solution. The pain is unbearable.
I am having continuous pain in my tail bone. I am a sales professional and that requires travelling. The pain intensifies when I am sitting continuously. Please advice.
I have joint pain in my knee elboo Neck Some fluid is produce in my knee last year Why it so happened?
Its been long time back I got this problem. B4 itbwas not so serious but day by day nw its been 7 years since I got this disease. I pee frequently n while I pee its burning. I tried and consult many docs but no cure till now. They gave me test like urine culture. Vdrl. And hsv all this came out negative. Everyrime after I have sex or masturbate and I pee it burns alot. And white smelly juice is coming out on pressing n pushing forward my pennis tip. Doc gave like anti bacterial tab. Syrup like citralka. But no cure yet. Some doc said I have to do meatoplasy.
I have some back pain since last 3 weeks does it can be a serious problem in future? Please suggest me some medicines.
I am 63 year old male. Some time I get knee pain in the right leg. The pain is inner side of the leg.
I am 63 male, an active sportsman. My x-ray of both knee show" small peripheral and central osteophytes along tibiofemoral and patellofemoral joints. There is mild reduction in medial compartment knee joint space. Soft tissue planes are well maintained" at present I am taking neucoxia 45mg everyday which reduces knee pain and I am able to play. Can you please suggest 1)-what medicine will be more affective 2)-how long can I continue taking nucoxia 3)-is suplement colaflex of any use. Thanks n regards.
Im 23 years old and suffering from back pain from the last 2 months would you please tell me what should I do.
I am 23 Years old. In my school days and collage days I played a lot in involving in all sports activity. I am having Back Pain for 2 Years. Took XRay -NO Prob. Then Took MRI found that disc Buldge. In Lower Back and in Neck its starting. Please I have spent my money investing in all this XRay, UltraSonic, and Electric therapy. But The pain didn't left me. SO please provide me a solution If I do this! I will be completely Cured like that. The treatment that I took, just provided me temporary relief only.
My father he is 40 years old he is suffering from body pains .and wrist pain and shoulders pain. He consult many doctors but no result. He done many rest like blood test urine test. But that shows no problem. But he is now suffering with pain. Wrist if he drive bike .he can't.what is the reason.
Hi, I have lot of lower back pain. And leg pain on my left leg. Can not sit for long. tiredness all day. Headache. Bum pain. Lot of pain. Please advise.
Sir, I am suffering from backbone pain sir please suggest me medicine and exercise. I am suffering from one week. Thank you.
Benefits of Bilateral Total Knee Replacement
I am Dr. Rakesh Nair. I am an exclusive knee replacement surgeon practicing at Zen Hospital in Chembur. I am also attached to the Fortis Group of Hospitals at Vashi and Mahim and Holy Family Hospital at Bandra. Today, I am going to talk about Bilateral One Stage Total Knee Replacement. To understand the basic term which I have used here when I say Bilateral One Staged, I say both knees and one sitting. They are done together once the patient is wheeled in. They are not done in a gap of a few days. That’s what I mean by both knees and one sitting.
In the surgery, all we remove is hardly 7-8 mm of bone from the thigh bone and around 7-8 mm from the shin bone, that is the lower part and all we do is just change the cap. It’s like changing the cap of a tooth, so your bone and your muscle are your own. We are not chopping off the whole knee and replacing it. So, that is the reason why I am using the terminology Knee Resurfacing, we are changing only the cap.
Once the cap is changed, we are able to mobilize the patient, the same evening if required. And, with the advanced anesthesia techniques that we have, I am able to make the patient walk the same evening. So, there are some videos here also which would tell you the same where the patient has been operated in the morning by around 12 o’clock once he or she is wheeled out the operation theatre. In another four hours by 4 o’clock evening, the patient is walking with full weight on the leg without much pain because of the pain techniques that we in terms of the pain management.
Now, why would I say that we should be doing both knees in one sitting? So, what are the advantages of doing both knees in one sitting? If you see the further videos which I would also show you, most of the patients who come to me have severe deformities. They, like, have severe bow legs, legs which are severely bent, either towards the inside or either towards the outside. So, doing one knee and then doing another knee is not going to help at all because the patient is not going to be able to walk. So, when I do both knees in one sitting it restricts the surgical procedure so it is like saying I do everything under one anesthesia. The patient gets short of medication. The medicines also which go into the body is once you are wheeled into the operation theatre. The most important part is that the patient can be mobilized very easily because immediately both the legs are straight and the patient can walk with full weight bearing on both the legs. So, I can make the patient walk in the evening or the next day depending on how strong the bones and the muscles are. Another thing is, it reduces the hospitalization also, plus the hospital cost also goes down because we don’t double use the medication nor the stay is doubled. The stay is same; it varies between 3-7 days depending on how strong the patient's knees are before surgery. So, I would definitely advocate doing both knees in one sitting.
What are the main advantages and what would you say in terms of why wouldn’t we do a knee after a week or 10 days? There are studies which say that it is not the number of joints, so the number of knees you do in which causes the problem or the commonest cause which is an infection. The problem arises if you keep on wheeling the patient into the operation theatre. So, if somebody says that we do a knee today and then we do a knee after 4 or 5 days then cases of infection will increase because the patient is being wheeled into the operation theatre on two separate occasions. So, it is not that I have not done both the knees in one sitting, which is a better option because the chances of infection are less than doing one knee now and then doing the other knee after 4-5 days, where the patient gets the same medicines repeatedly plus he is bought into the operation theatre again and his stay also increases in the hospital.
We would be showing you some videos where the patient, how the patient is walking before surgery. If you see most of these patients, the legs are severely deformed. So, all of them I have been able to do a One Staged Bilateral Knee Resurfacing where I have done both the knees in one sitting. You see them how they are walking before surgery, you see them how are they are walking after surgery. And, if you compare the function, they are really able to walk very comfortably.
My patients even sit cross-legged after surgery but that is not. I will show you one of these videos which are showing the patient sit cross-legged after surgery. But that is not something which we promote. It is just to show that they get very good function and they would definitely be able to sit cross-legged but that is not something we tell the patient to do because that compromises on the life of the knee. So, there are a lot of records and results which say that, whether we do a Bilateral One Staged Knee Replacement or whether we a One Staged Knee Replacement, the complications in terms of infection, an embolism is always similar. In fact, it is much more in a unilateral knee than in a bilateral knee.
We use body exhaust play suits, again, during surgery. I will show you this video which is showing you the body exhaust play suits where we are working in a very sterile environment. We would not want to give any infection even from the OT personnel to the patient. So, these are body exhaust playsuits which prevent the impure air breath out of the operating team, it is not allowing it to go to the patient. In fact, it is sucked up by a rotating fan which is there on top of the body exhaust playsuits and the whole impure air is taken out from the patient’s atmosphere. Even our conventional methods of mixing cement have been changed and we are using basically vacuum mixing for cement so there again is no impurities in the bowl in which we are mixing the bone cement to fix the implants to the bone.
We have all the options in terms of the knee replacement where we even have computer assisted Total Knee Replacement. We have Unilateral Knee Replacement where basically the unilateral knee replacement is used for younger patients who have deformities or pain in the insides of the knee where only a part of the knee has been damaged, the rest of the bone is all right, that’s where we use the Unilateral Knee Replacement. The latest what we have is the Customized Jigs in Total Knee Replacement where we get the MRI done of the affected knee. On the basis of the MRI, ceramic Jigs are made and on the basis of the ceramic Jigs, the positioning of the implant can be as perfect as required. Obesity has always been, the patient has always come up to me saying, “Doc, I am little on the heavier side, I am so heavy, is it a contraindication to my surgery?” So, obesity as such is not a contraindication to surgery. Definitely chances of wound healing are a problem but, instead of a week to ten days, it will take another week to ten days for healing. Otherwise, it is not a contraindication to the surgery.
Now, a very important question which comes from the patient is, “Doctor, how long will these knees last?” So, I give a very simple answer to that is that, the more you take care of it, the longer it will last. So, the longevity of the knee all depends on how strong your muscles are before surgery, how strong your bones are after surgery or before surgery and depending on that we normally get a bone density done for the patient and we treat the patient either on a yearly injection for osteoporosis or daily injection which are meant to fill up the bone and that decides on how well the implant is going to hold on and how long the life of the knee is going to last.
For further information, you need to contact me through lybrate.com.