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Dr. S. Kumar

BPTh/BPT

Physiotherapist, Delhi

24 Years Experience  ·  150 at clinic
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Dr. S. Kumar BPTh/BPT Physiotherapist, Delhi
24 Years Experience  ·  150 at clinic
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Personal Statement

I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
More about Dr. S. Kumar
Dr. S. Kumar is an experienced Physiotherapist in New Delhi, Delhi. He has been a successful Physiotherapist for the last 24 years. He has completed BPTh/BPT . You can consult Dr. S. Kumar at Awadhesh Physiotherapy And Rehabilation Centre in New Delhi, Delhi. Book an appointment online with Dr. S. Kumar on Lybrate.com.

Lybrate.com has top trusted Physiotherapists from across India. You will find Physiotherapists with more than 28 years of experience on Lybrate.com. You can find Physiotherapists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Info

Specialty
Education
BPTh/BPT - IPH & H, - 1994
Languages spoken
English
Hindi
Professional Memberships
INDIAN PHYSIOTHERAPY ASSOCIATION

Location

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Awadhesh Physiotherapy And Rehabilation Centre

11/20, Ground Floor, West Patel Nagar, New Delhi-110008, Landmark Near Rock Garden, DelhiDelhi Get Directions
150 at clinic
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My aunt is 36 year old and she is suffering from very bad lower back pain. She is taking few medicine but she say she is not getting any relive. She is also able to do house hold work. please plz help.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
My aunt is 36 year old and she is suffering from very bad lower back pain. She is taking few medicine but she say she...
Do Take IFT and laser Therapy for pain relief for 12 days followed by strengthening exercise from physiotherapist Best wishes.
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Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc element
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Results / Outcome

  • PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
  • Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  • PVP does augment height of VB but ideal would be kyphoplasty
  • Patient is either off medicine or on reduced doses.
  • Patient feels so well that he almost forgets if he had VB
     

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are  Metastatic VB,  Multiple myeloma VB, VB haemangioma,  Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF)   which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis.  Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient  back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
  • GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc elements.
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics.
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.

Morbidity and complication of spinal surgery 

  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

  • Cementing of fragments.
  • Thermal neurolysis of VB nerve ending due to heat of polymerization.
  • Washing away of nociceptor chemicals.
  • Neurolytic action of liquid monomer.
  • By allowing early ambulation decreasing pains of immobility & bed rest.

Complications 

  1. PVP is generally safe with low risk.
  2. Ectopic cement leak is frequent but generally inconsequential.

Outcome 

  1. PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
  2. Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  3. PVP does augment height of VB but ideal would be kyphoplasty.
  4. Patient is either off medicine or on reduced doses.
  5. Patient feels so well that he almost forgets if he had VB

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

4342 people found this helpful

When I stretch my legs I get cramps in the calf muscles. Why? What is the treatment.

BHMS
Homeopath, Sindhudurg
Hi Overuse of a muscle, dehydration, muscle strain or simply holding a position for a prolonged period, low calcium , low potassium etc can cause a muscle cramp. I advise you to consult me online for homoeopathic treatment without side effects. I need detailed case history to find out cause and treat accordingly.
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My both knee joints pains when I continuously sit on chair for 3-4 hrs. Please suggest some medicines.

BPTh/BPT
Physiotherapist, Mumbai
My both knee joints pains when I continuously sit on chair for 3-4 hrs. Please suggest some medicines.
Hello do hot fomentation for 15-20 min thrice in a day. Learn strengthening & stretching exercises from physiotherapist. This will help in reducing the pain. Revert me after 10 days thanks.
5 people found this helpful
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I have pain above knee on a muscle it started yesterday I had not done any hard work or any hard sport but it pains very bad I can move my leg but it pains. What kind of medicine should I prefer.

MPT, BPT
Physiotherapist, Noida
I have pain above knee on a muscle it started yesterday I had not done any hard work or any hard sport but it pains v...
Knee advice. Avoid sitting cross legged. Avoid squatting- quadriceps exercises- lie straight, make a towel role and put it under the knee, press the keen against the role, hold it for 20 secs. Repeat 20 times twice a day. This will help relieve some pain. Core strengthening exercise- straight leg raised with toes turned outward, repeat 10 times, twice a day. Hams stretching- lie straight, take the leg up, pull the feet towards yourself, with a elastic tube or normal belt. Repeat 10 times, twice a day. Sports taping- stretch the tape from both ends and apply on the affected area contrast fomentation (hot and cold).
1 person found this helpful
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I am 19 years old and my lower back pains but I DO EXERCISE BUT WHAT SHOULD I DO for permanent relief?

BPTh/BPT
Physiotherapist, Delhi
I am 19 years old and my lower back pains but I DO EXERCISE BUT WHAT SHOULD I DO for permanent relief?
Take physiotherapy treatment and learn exercise for spine. Don't lift heavy things. Don't sit on floor. Take calcium; multivitamin and vitamin d 3 also.
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I have a desk job and for the last three month I have back pain and I want to know if there will be problem in future.

MSc in Orhopedic Physiotherapy (UK), BPTh/BPT
Physiotherapist, Bangalore
I have a desk job and for the last three month I have back pain and I want to know if there will be problem in future.
Hunching over a desk is a leading reason why people end up with crippling back pain at some point in their lives. But a few simple changes in the way you work can make your pain go away. 1-Keep your head up; Focus on aligning your head and neck right above your shoulders; avoid straining forward. 2-Be choosy with your chair: Pick one that allows your lower back to rest against a lumbar support. Then tilt the back of the chair so it’s very slightly reclined. 3-Plant your feet: Keep them flat on the floor and shoulder-width apart to quiet tension in your knees and ankles. 4-Take breaks: Getting up at least once an hour— just do some shoulder rolls—reduces pressure on spinal disks and boosts circulation. If your back pain is severe please go to a Physiotherapist for detail assessment and management of your pain. Best wishes.
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I am ajay from haryana fatehabad and I am suffering from back pain and my height is also small how can I increase my height please tell me.

BAMS
Ayurveda, Ambala
I am ajay from haryana fatehabad and I am suffering from back pain and my height is also small how can I increase my ...
Dear you can follow these methods for relief from backache (back pain): * first correct your sitting posture. Do not bend your lower back. You can use lumber belt for support. * do regular back strength exercises. Move your clockwise and anticlock wise. * do not sleep on very soft bed, sleep on slight hard cotton mattress. * do tadasana and bhjangasana for back strengthening. If you can not understand these asans you can consult me. * take calcium rich diet and calcium and vitamin d supplements regularly. *do not take any heavy weight or heavy work. * if you are over weight then follow a good and effective diet plan to loose some kilos of weight. * you can take guggalu tablets of himalaya for fast relief.
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I am a 22 years old male and everyday I get up with a backache, what should I do?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
I am a 22 years old male and everyday I get up with a backache, what should I do?
Hi Thanks for your query and welcome to Lybrate. I am Dr. Akshay from Fortis hospital, New Delhi. You are very young to actually have persistent back pains. If you have localized back pain with no other symptoms like radiating leg pain, neurological symptoms like numbness, weakness, paresthesias etc, then you can start with following recommendations for initial period of 2-3 weeks: - To maintain proper posture of your back while working and sleeping - If pain is more then you can take a short course of an anti-inflammatory medication like tab etoshine or paracetamol or one which suits you - Physical therapy initially under supervision of a trained physiotherapist and then to continue at home - 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 can be used and is easily available. - Avoid lifting heavyweight/ acute forward bending in mornings etc We will observe you for next 2-3 weeks how you respond to this conservative management protocol. If you are not feeling better, then we will have to get some investigations like, dynamic x rays of lower back and few blood tests 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. Thanks & Regards Dr Akshay Kumar Saxena Consultant Orthopaedics Fortis Hospital, New Delhi
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I get acidity and gastric influx almost everyday. I survive on pentacid tablets.But need a permanent solution to the problem.Many times ven the pentacid doesnt work and i suffer a lot. Second problem is that my heels pain a lot at the end of the day. I have a sitting job and dodnt walk much. Still i suffer from acute ache in my heels at night

Master of Physical Therapy MPT CARDIO, BPTh/BPT
Physiotherapist, Rajkot
IF YOU TRUST ME SO you have to go for natural ways like yoga pranayama. Go for art of living 6 days workshop, in that amazing learn sudarshan kriya breathing technique only 3 hrs per day it will resolve all your problems. This is the most permenent solution for your problem. Go for drugless therapy
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