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Dr. Vikas Kumar Goyal

Orthopedist, Delhi

0 - 400 at clinic
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Dr. Vikas Kumar Goyal Orthopedist, Delhi
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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.
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Dr. Vikas Kumar Goyal is a trusted Orthopedist in Rohini, Delhi. You can consult Dr. Vikas Kumar Goyal at Dr v k goyal in Rohini, Delhi. Save your time and book an appointment online with Dr. Vikas Kumar Goyal on Lybrate.com.

Lybrate.com has a number of highly qualified Orthopedists in India. You will find Orthopedists with more than 35 years of experience on Lybrate.com. Find the best Orthopedists online in Delhi. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Dr v k goyal

150-151, pkt- 3,sector-24,rohini,near delhi public schoolDelhi Get Directions
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Netaji Subhash Palace, Near N Tower, Wazirpur District Centre Lala Jagat Narain Marg Landmark : Near Netaji Subhash Place Metro Station.Delhi Get Directions
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Procedures That Can Help Treat Slip Disc & Sciatica!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Procedures That Can Help Treat Slip Disc & Sciatica!

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.

Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in – Acute radicular pain due to irritation or inflammation.

  • Symptomatic herniated disc with failed conservative therapy
  • Acute exacerbation of discogenic pain or pain of spinal stenosis
  • Neoplastic infiltration of roots
  • Epidural fibrosis
  • Chronic LBP with acute radicular symptoms
  • Epidural- lumbar injection

ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

  • There is minimal or no radiological finding.
  • Multilevel imaging abnormalities
  • Equivocal neurological examination finding or discrepancy between clinical & radiological signs
  • Postop patient with unexplainable or recurrent pain
  • Combined canal & lateral recess stenosis.
  • To find out the pathological dermatome for more invasive procedures, if needed

Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

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

4489 people found this helpful

Hy sir I am Bharath and Ma frnds felt down on ma shoulder , my right back muscle got solen and also it's paining very badly , not able to do 1 push up , do plz tel me sum medicine to cur dat?

MBBS, M. S. Orthopedics, M.ch. Orthopaedics, MD - Sports Medicine
Orthopedist, Delhi
You'll need to take rest for a couple of days. Start some pain killer and muscle relaxant. After the pain has subsided need to check if there is any rotator cuff tear
1 person found this helpful
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My dad is bedridden from last 3 months, please help me with a complete diet chart. He is suffering from severe head injury with left shoulder multi rib fractures, moving all limbs partially.

D.A.M.S( A. M.), D.AC/B.E.M.S
Acupressurist, Mumbai
My dad is bedridden from last 3 months, please help me with a complete diet chart. He is suffering from severe head i...
You should take Acupressure therapy and take Biochemic Nat mur 200x + Calc phos 200x . 4 tab each thrice a day with warm water and take it 5 days and consult private online.
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3 days before I go to jogging suddenly my left Knee getting pain. What should I do?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
3 days before I go to jogging suddenly my left Knee getting pain. What should I do?
Do apply ice fomentation thrice a day for 5 days regularly Do revert for further assistance Best Wishes
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Sprained my right ankle, feeling bad pain with mild swelling. Got xray done and xray shows bones in normal condition. I think its a ligament injury.

DNB, MBBS
Orthopedist, Delhi
For simple ligament injuries also plaster is recommended for 3 weeks. This gives rest to the part and ensures that the ligaments heal in proper position and u don't end up with persistent pain.
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Should I wear a knee brace to support my knee rather than undergo major surgery for ACL reconstruction?

Fellowship in Shoulder and Upper Limb, Fellowship in Joint Replacement, MS - Orthopaedics, MBBS
Orthopedist, Mumbai
Should I wear a knee brace to support my knee rather than undergo major surgery for ACL reconstruction?
It depends on your activity level and symptoms. If you have instability symptoms then you should be treated for it. If you are into professional sports then you should be treated aggressively. In any case it is advisable to try focussed physiotherapy for cal insufficiency. Knee brace is temporary.
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I got hurt in my left hand wrist which led a minor fracture in the same. I had got a consult and had the fracture band for a month but after that the left hand used to work inefficiently as it did before and has a minor pain if heavy work is done although its past 3 year.

DHMS (Hons.)
Homeopath, Patna
Hi, you should go for physiotherapy take: arnica mnt 200 x1, 5 drops morning ledum pal 200 x1, 5 drps hypericum 200 x1, 5 drps. Calendulla30 x3, 5 drops daily report after a month. Tk care.
1 person found this helpful
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I am suffering from back pain, neck to legs since 2009 and now. What should I do? please advise.

MBBS
General Physician, Mumbai
I am suffering from back pain, neck to legs since 2009 and now. What should I do? please advise.
Do exercise regularly and get your blood checked for cbc , uric acid levels and revert back with reports and also take Tablet folvite 5mg once a day for six months and tablet vitamin D3 60000iu once a week for six months
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Dr. doc, My mamma's ankles r often swelling and difficult to walk. Pls sugest what to do. Thank you.

BPTh/BPT
Physiotherapist, Kolkata
Dr. doc,
My mamma's ankles r often swelling and difficult to walk. Pls sugest what to do. Thank you.
Use heal cup inside the shoe wax bath for 15 days over ankle joint IFT over ankle joint always use good quality shoe.
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Yesterday when I was playing, I feel down with my palm support on the ground. The ground was filled with small rock pieces and sand. Now my part of palm just below my index finger has swollen up and I feel the pain whenever I try to catch a ball or do anything that involves touching of that part. What to do?

MD, MBBS
Dermatologist, Chennai
Yesterday when I was playing, I feel down with my palm support on the ground. The ground was filled with small rock p...
Use fudic cream twice daily, along with the following medicine. Please send photos of the affected part for accurate diagnosis and treatment. Consult privately or online for detailed information and prescription.
2 people found this helpful
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Male- 55. Patient of Hypertension and Type 2 Diabetic. Feeling terrible pain in my right shoulder for the past one month. Unable to sleep on my right side. Cannot raise my arm for opening T-Shirt or Vest. Also unable to reach the back pocket of my trousers.

Practical Course in Diabetology, POST GRADUATE COURSE IN DIABETOLOGY, MBBS
Endocrinologist, Jammu
You are suffering from periarthritis due to uncontrolled diabetes.Take pregabalin75 mg bedtime.Do very light exercise of shoulder not more than 2 minutes along with hot fermentation at bedtime.More importantly control your sugar.
2 people found this helpful
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I m 27 yr old. I have pain at my tailbone. I can't sit normally. I have lordosis loss and Coccydynia. Both What shud I do. It is from last one month.

BPTh/BPT
Physiotherapist, Mumbai
I m 27 yr old. I have pain at my tailbone. I can't sit normally. I have lordosis loss and Coccydynia. Both
What shud ...
Hi use orthopaedic seat for sitting. Do not sit for very long. Take break every 20 minutes. Put small pillow at low back while sitting. Do consult physiotherapist. Or you can consult me via lybrate for further treatment.
1 person found this helpful
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My husband is 34 years old. He has a pain in his ankle from last few days. What tests are require to check? What would you advice?

BPTh/BPT
Physiotherapist, Mumbai
My husband is 34 years old. He has a pain in his ankle from last few days. What tests are require to check? What woul...
Hi For pain take cold water fomentation for 20 minutes thrice a day for 5 days. If still you don't get relief and need further advice, consult me via Lybrate.
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In my bones and joints are very pain always what can I do from overcome this situation.

BPTh/BPT
Physiotherapist, Mumbai
In my bones and joints are very pain always what can I do from overcome this situation.
Hi kindly rule out your diabetes, uric acid, calcium, vitamin d and other metabolic disorders. Best wishes.
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Sir, my hands are too thin above elbow so what I do to make strong my hand muscle?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Sir, my hands are too thin above elbow so what I do to make strong my hand muscle?
Do keep strengthening with dumb bells of 3 to 5 kgs gradually of 12 min duration of thrice a day and push up on floor to minimum 12 repitations in beginning
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I am nearing 70 heart patient. Taking medicine nitrocontine, cardivaz 6.25, lanoxin, lasilaco, nerobian etc since 2006. My both legs fingers are paining. Sugar tested normal. Do you have any medicine in english, ayurveda. Kindly suggest.

DM Cardiology
Cardiologist, Delhi
Dear, get your uric acid checked, as pain in toes may be due to high levels of uric acid. Let me know the report.
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My back is aching very badly, I went to play football after 2 weeks, did a bit of warm up, after this its starting to ache very badly, kindly help. Thanks.

Fellowship in Shoulder and Knee Surgeries, DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Nagpur
My back is aching very badly, I went to play football after 2 weeks, did a bit of warm up, after this its starting to...
It may be muscle spasm. Take rest for couple of days. Use firm bed. Do not bend forward. Use hot bags. If pain still persists, you will need some medicines and physiotherapy modalities to relieve pain.
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I am 30 years old and I am having neck pain since last 4 months. What should I do, I wanna go with omeopathi. Please give me a good advice for the same.

BHMS
Homeopath, Sindhudurg
Hello sir, homoeopathy will definitely give you relief, you can message me your problem in detail good luck.
1 person found this helpful
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