Doctor in We Care Ortho & Wellness Clinic
Knee Pain Treatment
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Joint And Muscle Problems
Treatment of Nerve And Muscle Disorders
Acl Reconstruction Procedure
Joint Dislocation Treatment
Knee Care Procedures
Joint Replacement Surgery
Ankle Pain Treatment
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Treatment of Joint Dislocation
Treatment Of Disk Slip
Treatment Of Herniated Disc
Knee Injury Treatment
Treatment of Spine Injuries
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Patient Review Highlights
Dr. Sachin Singh provides answers that are very helpful, professional, practical and knowledgeable. I was visited the doctor clinic, and after 2 monrhs treatment, my problem gone. The main positive thing about doctor is listing carefully and try to describe the technical thing of your problem in easy language and suggest better solution.
Dr.Sachin listens to every patient so carefully ,he is very mild & a great consultant , his staff members are also very helpful.
Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.
If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket. Shoulder pain can happen due to various reasons, vary from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc.. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.
In case of middle to old age, injuries that can cause shoulder pain are-
- Biceps Tendonitis
- Acromio-clavicular Joint arthritis
- Scapular Dyskinesia
- Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
- Superior labral anterior/posterior (SLAP tear)lesion
Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to...
- Bankart lesion
Diagnose Shoulder Pain-
Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:
- X-rays: Through an x-ray one can view the shoulder in many different views
- Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
- MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
- Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.
Treatment for Various Types of Shoulder Pain-
- For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
- Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.
SLAP Lesions --
- Pain relief and physiotherapy as first step If this fails then following surgical options are available
- Arthroscopic debridement or repair of labrum
- Biceps tenotomy or tenodesis
In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.
It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.
Remember "a stitch in time saves nine".
Adhesive Capsulitis: An Overview
If you are taken aback by the very mention of this condition, you must know this is something you face every now and then. The problem is not too serious until it persists and hence people do not bother to look up terrifying medical terms for the case. Adhesive capsulitis or frozen shoulder is a condition that could arise from a host of reasons. It is usually characterized by a marked stiffness in and around the shoulder blade felt either in the middle of the night, early in the morning or while trying to move a hand close to the end of its reach. Frozen shoulder might become a chronic problem in which case remedying it takes a minimum of one or two years.
Factors leading to Adhesive capsulitis
- This condition is prevalent amongst patients of diabetes.
- Lack of movement of a limb, either of the two hands, due to a fracture or a surgery can result in the same.
- Adhesive capsulitis occurs when the capsule of connective tissues ensconcing the ligaments and bones of your shoulder joint tightens around them hindering free and easy movement.
How is Adhesive Capsulitis Treated?
There are various treatments for adhesive capsulitis. Even though the condition usually gets better on its own, improvement can take two to three years. Over 90% of patients improve with non-surgical treatments, including the following:
- Physical therapy
- Corticosteroid injections
- Anti-inflammatory medications
Surgery can be performed for patients who see no improvement after non-surgical measures are taken.
How is subacromial bursitis different from Adhesive capsulitis?
While a frozen shoulder affects your entire shoulder area, subacromial bursitis affects a single point in the shoulder blade. The topmost boney part of the shoulder blade is referred to as the acromion. The acromion is placed above the ball- and- socket joint without touching the bones directly. The subacromial bursa is a soft cushion like thing that prohibits friction between the muscles or tendons of the shoulder joint and the acromion. An irritable subacromial bursa is referred to as subacromial bursitis.
How is Subacromial Bursitis Treated?
Subacromial Bursitis can be treated in a number of ways, including:
- Avoiding activities that aggravate the problem
- Resting the injured area
- Icing the area the day of the injury
- Taking over-the-counter anti-inflammatory medicines
What do you mean by rotator cuff tear?
Rotator cuff is a group of tendons and muscles located on top of the upper arm bone or humerus. The cuff helps to hold your arm in place allowing easy movement. Acute stress or physical exertion can lead to muscle cramps or might even make the tendons tear apart. Tennis players, swimmers, or people lifting heavy weights are prone to Rotator Cuff Tear. This condition leads to excruciating pain and tenderness in your shoulder blade.
What's the Treatment for a Rotator Cuff Tear?
As bad as these injuries can be, the good news is that many rotator cuff tears heal on their own. You just need to give them a little time. You also should:
- Rest the joint as much as possible. Avoid any movement or activity that hurts. You may need a sling.heal
- Ice your shoulder two to three times a day to reduce pain and swelling.
- Perform range-of-motion exercises, if your doctor recommends them.
- Consider physical therapy to strengthen the joint.
- Use anti-inflammatory painkillers, or NSAIDS, like Advil, Aleve, or Motrin.
More serious rotator cuff tears require surgery. One procedure is shoulder arthroscopy, usually an outpatient procedure. In case you have a concern or query you can always consult an expert & get answers to your questions!
I have pain in lower back from last few months. My sitting job for 8 to 9 hrs and also pain in my right knew. When I walk I feel pain in my back on kidney side. My ultra sound for abdominal is normal but fatty lever. Please advice.
Hi Sir, My age 25 I am suffering with lower back pain since 1 and half year my MRI shows l5-S1 disc bulge I unable to sit at least 20 minutes I tried many physiotherapy treatments but no relief qhat I have to do sir, but one doctor told me endoscopic Discectomy surgery shall I go that side Sir please tell me.
Sometimes children suffer from conditions where their feet may not be in proper shape or size which can affect their posture. Most of the times the disorders correct themselves as they grow up but certainly there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment. Some of the common orthopedic disorders found in children include:
1. Flatfeet: While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.
2. Toe Walking: Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.
3. Pigeon Toes: In toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when upper part of the leg bends more than it naturally should causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually the condition corrects on its own with age and does not interfere with sport activities which involve running.
4. Knock-Knees: It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum), since their bodies go through natural shift in alignment. Usually treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.
Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50.
Knee replacement is mainly of two main types:
- Total knee replacement where both the sides of knee joints are replaced
- Partial knee replacement where only single side of the joint is replaced
In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage, and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less.
In total knee replacement, four steps are performed:
- Removal of damaged cartilage surfaces, which is at the ends of the femur and tibia, with a small quantity of underlying bone.
- Replacement with metal components, which help as a recreated surface of the joint
- Incision of knee cap with a resurface made of a plastic button, which is optional based on the case
- Insertion of a medical-grade plastic spacer amid the metal components. This creates an effortless gliding surface.
After general or spinal anaesthesia, an incision of 8-12inches is made in the front part of the knee. Joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin as well as knee cap is attached to the artificial joint with either cement or a special material.
After Effects of the Procedure-
After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery.
There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping.
Presently, over 90% of total knee replacements function well even after 15 years of surgery. Hence, knee problem is no problem at all!
In case you have a concern or query you can always consult an expert & get answers to your questions!
The human hand is made up of 27 bones and a number of tendons and ligaments. An injury to any one of these bones or a disease that affects the bones and ligaments can make you experience excruciating pain in your hands. This pain can affect your ability to perform simple day to day tasks like holding a spoon or writing.
Some common reasons your hand may pain are muscle strains, fractures, arthritis and carpal tunnel syndrome. Apart from pain relieving medication, there are a number of ways you can deal with this pain.
- Hot and cold compresses: Hot and cold therapy is ideal for any type of muscle or ligament injury. A cold compress helps in reducing the pain and inflammation by constricting blood vessels and numbing the area. On the other hand, a hot compress dilates blood vessels and increases the flow of blood and oxygen to the affected area. Ideally, the two should be used alternatively for 10 to 20 minutes each. A bag of frozen vegetables or ice wrapped in a towel makes an easy cold compress. To treat your hand with heat, use a moist heating pad or a hot water bottle. You could also dip your hands in warm water.
- Massage: A massage is a great way to treat hand pain that results from carpal tunnel syndrome. If the exact cause of pain is not known, massage the entire hand, wrist and forearm. A massage enhances blood flow to the area and hence improves flexibility and opens locked tendons. Using a few drops of essential oils such as lavender or rosemary can also aid in relieving hand pain.
- Hand exercises: If your work involves repetitive actions like typing, knitting or embroidery, the muscles in your hand can get locked into position thereby, causing pain and discomfort. To relieve this it is important to take a break from this repetitive exercise every hour and flex your hand. Try bending your fingers forwards and backwards and rotating your wrists in both directions to ensure that your joints remain smooth.
- Epsom salt water bath: For instant relief from intense hand pain, soak your hands in a bath made of hot water and epsom salts for 10 to 20 minutes. Follow this by wrapping your hands in a warm, wet washcloth and applying gentle pressure over the hand for 5-10 minutes. You should instantly feel relief from the pain and experience increased the flexibility of hand. In case you have a concern or query you can always consult an expert & get answers to your questions!
I feeling pain in my back. I am doing cycling 37 km, running 7 km, gyming 2: 30 hrs. Kindly suggest.
Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopause induced bone loss.
Causes of Metabolic Bone Diseases
- Imbalance in the level of calcium: Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmul for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth.
- Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
- Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
- Over or under secretion of the parathyroid hormone: The parathyroid hormone (PTH) stimulates the secretion of an enzyme which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+) which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.
Symptoms of Metabolic Bone Diseases
The symptoms of most of the Metabolic Bone Diseases are similar. They are:
- A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time but, unlike muscular pain, the exact region of bone pain cannot be specified.
- Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
- Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
- Defects in the bones can cause bowed out legs and a bent backbone.
- A general feeling of exhaustion is often caused by bone diseases.
- Kidney stones are an associated complication of metabolic bone diseases.
In case you have a concern or query you can always consult an expert & get answers to your questions!
As you get older, you are more prone to old age fractures. This is because of the weakening of your bones and enhanced likeliness towards falling. In case you have osteoporosis, you need to be even more careful to avoid fractures of any kind. Here are some must-read tips for prevention of fractures, which are likely because of old age.
- Exercise for improving balance and strength: Exercise directly impacts the strength of the bones. Keeping fit physically helps the reflexes to stay sharp and the muscles to stay strong. This will in turn result in lowering the risk of falling. When you are fit, you are less prone to falls. Bones do not stay fit unless you regularly work out. You should undertake exercises such as walking, weight lifting and also practice flexibility and balance exercises such as yoga and tai chi.
- Tread carefully: The selection of shoes is very important for preventing old-age fractures. You should wear shoes, which are low heeled, have rubber soles and provide proper support. Avoid leather soles. You should avoid sneakers having deep treads, which increase your risk of tripping and falling. Shoes must be worn inside the house as well. You also need to take several precautions while walking outside. In case you have arthritis, you require an assistive device to aid you with walking such as a walker or a cane.
- Certain medicines to be avoided, if possible: There are several medicines which increase your risk of falling by causing dizziness and lack of coordination. These medicines must be avoided. They include the following:
- Lighten up your surroundings: Because of old age, your vision is likely to degrade, making you prone to cataracts and other disorders. The lack of proper vision can make you fall and cause fractures. For solving this problem, you should install several lights all over your residence or workplace. Use overhead lamps, night lights for bathrooms and for your bedroom and always keep the staircases lit. It is also good to keep a flashlight beside you when you sleep.
- Fall proof your home: You should make your home safe and fall proof. The rooms should be clutter-free without piles of clothes and boxes. A carpet should be put over polished floors and rugs. Electric cords and phone lines should be away from the floor.
As you get older, you are likely to develop several health conditions, which may increase the chances of falls and fractures. Hence, all health conditions you experience should be properly treated to prevent falls and fractures. If you wish to discuss about any specific problem, you can consult an Orthopedist.