Nivaran Pain Relief Centre

Exercise is one of the best stress-busters for those who believe in it. Sweating it out in any form brings out renewed energy, both physically and mentally. Similarly, running unleashes vast amounts of energy and is one of the most vigorous workouts. Of late, running is a fad, and there are more and more people vying for the half and full marathons.

The following are some pointers for runners. Whether you are just beginning to or are planning for a marathon, read on to know what to do before actually running.

1. Hydration: Before getting into a running mode, take a minute to think if you have had enough water for the day. The amount of water consumed should be dependent on a number of factors including:

   • Weather/climatic factors including temperature, humidity etc.

   • Distance and speed of running

   • Body temperature

   • Toilet trips should be done during the day

   • Consumption of alcohol or caffeine – these will leave you dehydrated

   • Amount of water in the last 2 hours

   • Level of thirst

   • Drink water about 30 minutes before you begin to run, but not to the point that you feel water splashing in the belly and have to stop at the restroom every half an hour.

2. Food: While it is not advisable to run on an empty stomach, it is not required to eat a full meal before running. Make it easy for the stomach by eating something light like a banana or oats. These are easily digestible and do not tire you out.

3. Shoes: The most important of all, ensure you are wearing running shoes which are lightweight. Ideally, the right shoes should not cause pain in the shin or the knees and can stand the long runs. Bad shoes can cause severe damage, therefore, it is always wise to invest in a good pair of running shoes.

4. Work towards a target: Running without having a target is not of much use. Your target could be in the distance covered, time you ran, calories burned, or matching your personal best timing. Whatever you choose, with each run, keeping the route, time, and distance in mind, set a target. Track your run against that target. This can help establish personal best times and help improve performance with other runners too. It also helps get a feeling of accomplishment and a purpose.

5. Music: This just peps up your run and often adds to the spring in your foot. A nice lively song can increase the heart rate and prepare you for a longer run. Warming up to a good music also elevates mood and energy levels. Any runner would agree that he enjoys a good music during the run.

There are many structures in the lumbar spine that can cause pain. Any kind of trouble to the nerves and veins that goes through the spine, joint issues, the disks themselves, the bones and the muscles - would all be able to act as a cause behind the pain.

Numerous lumbar spine conditions are interrelated. For instance, an unstable joint can lead to disk degeneration, which can put weight on the nerve roots and cause the disk to collapse at times. The following are the main reasons behind the lumbar disk pain:

1. Problems in the muscles: The biggest reason behind lumbar disk pain is muscle strain or other muscle issues. Strain because of truly difficult work, twisting, or different activities that can put pressure on your spine like heavy lifting, cause the disk to rupture or slip at times.
2. Disk degeneration: Intervertebral disks are pads that are spongy and act as shock absorbers. This can cause pain in your disk. This condition can be referred to with many names, however, is famously known as degenerative disk disease.
3. Lumbar Disk Herniation: Herniated disks are most common reasons behind the lumbar disk pain. A herniated disk may be caused all of a sudden because of damage to the spine or truly difficult work or happen gradually as a form of general wear and tear in the spine. Leg pain (sciatica) is the most widely recognized symptom of a herniated disk.
4. Sacroiliac Joint Dysfunction: The sacroiliac joint, which attaches to the base of the lumbar spine and the tip of the tailbone, can cause lumbar disk pain or even sciatic pain if there is any kind of fracture in the joint that allows for movement or rather, limits any particular movement.
5. Spondylolisthesis: Spondylolisthesis happens when one vertebra slips behind the other or underneath it. The slip most normally happens in the lower lumbar vertebrae (e.g. L4 –L5 or L5 – S1). In case that the slipped vertebra presses the nerve root at that point, it can bring about shooting leg pain and gradually foot pain as well.

There are certain ways in which this problem can be treated to a certain extent. These methods are as follows:

1. Common medications: Muscle relaxants. This solution works as an anti-depressant of the nervous system and expands as well as relaxes the tense muscles, easing pain from muscle stiffness or fits
2. Back supports: A few patients find that a back support can be used to bring comfort and gradually diminish the pain. There is some proof that using a brace every day, can speed up the healing process and lessen the pain. A back support may likewise be useful after back surgery.
3. Back Braces: Epidural steroid infusion. This infusion includes a steroid inserted specifically into the external piece of the dural sac, which surrounds the spinal chord. An x-ray, called fluoroscopy, is utilized to control the needle in the right area. The objective of the infusion is to soothe the pain by decreasing irritation around a compressed nerve root.

Hi Friends!

My name is Dr. Himanshu Gupta. I am an orthopedic spine specialist. And today I will be talking about spine elements and different type of spine conditions that we see in OPD. Most of the patients suffer from this because of the long sitting on the computer. They suffer from neck pain, back pain, postural pain, mid back pain or long-term standing, sitting while at work in an awkward posture. So the myth is that all is not only related to disc pain.

2nd all these pain can be corrected with a few activities, exercises and posture modifications. Another myth is if you have slip disc, you can never be treated for life. But this is not true. There are multiple treatments available. In most cases, the patient gets better with medicines, exercise, physiotherapy. Very rare cases when there is instability or some neurological weakness, we go for surgical correction. But there is a condition which is called interventional pain. There is the scope of minor interventions for correcting these spinal elements with simple procedures like pulse radio frequency, an endoscopic discectomy. They all are day care procedures. The patient can be discharged the same day. The results for all of these are very good.

If you are looking for any of these treatments for the neck, back, shoulder, sciatica, arm pain or slip disc, you can contact me or reach us at Nivaran Pain Relief Centre. We are available in Gurgaon. We also have other branches outside of Delhi. But there we are available once in a month.

Thank You.

Slip disk is a condition of the spinal column which consists of a stack of vertebras from the cervical, thoracic and the lumbar spine.The bones of the spine are cushioned by disks that are present to absorb shocks. Trauma to the spine may cause the disk to bulge or be ruptured. This may lead to pain in the neck and the back. 

Causes of slip disk

Slip disk is caused when the jelly like substance present in the disks bulges out. The damaged disk thus puts pressure on the adjacent nerve causing excruciating pain. The various causes of a slipped disk are:

1. Incorrect form during exercise
If you are into weight lifting, it is important that you use proper form during exercising. Moves like barbell squat and deadlifts can put pressure on the spine and lead to disk problems, if not done correctly. Make sure you work on your core strength and keep your lower back straight while exercising. 

2. Smoking
Smoking causes the disks to lose their flexibility and thus, increases the risk of slipped disk.

3. Ageing
Ageing decreases the content of water in the spine, thus leading to inflexibility.

Symptoms

The symptoms of slip disk are:

1. Pain on one side of the body that tends to aggravate over time
2. Activities such as sitting and coughing may lead to pressure on the spine causing pain
3. Your range of motion on certain movements may be restricted
4. Pain in the neck while moving it
5. Numbness in the shoulder and the neck region
6. You may experience tingling sensations in the genitals, hips and the legs
7. You may have muscles spasms which lead to sudden contraction of the muscles
8. It may also lead to partial paralysis of the lower body

Prevention

1. If you are overweight, try to reduce weight and then focus on maintaining healthy weight levels
2. Maintain proper posture while sitting or standing
3. Exercise on a regular basis to build strength and keep your joints healthy
4. Don't remain in seated position for an extended period of time. Take small breaks in between to stretch

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

You are likely to be aware that Slipped disc is a scenario where the disc, meant to cushion adjoining vertebras, slips from its original position and bulges out to press a nerve root resulting in pain. It can happen due to an injury or weakness. The condition is also known as Prolapsed or Herniated disc. Read on to know more about this condition.

Symptoms
All slipped discs don’t cause symptoms. Many individuals did not know they have slipped a disc until they met their physician. That is a reason why proper diagnosis is required before initiating any curative method, as it's related to the spine. Lower back pain may result from accidental injuries such as a sprain or strain. There are no other serious reasons to cause Slipped disc.

Risk Factors
Factors that increase the risk of a slipped disc are:

1. Professions involving the lifting of heavy item frequently
2. Professions involving continuously sitting for a long time like driving
3. Sportspersons involved in weightlifting or similar activities.
4. Obese Patients
5. Aging

Diagnosis
The first step of diagnosis involves enquiring about the complete medical history and physical exam to check nerve function and muscle strength. For this purpose, leg- raising test is conducted wherein you may be asked to raise the leg to observe the pain sensation. Your doctor would also check for an increase in pain while applying pressure on a nerve, sometimes with the help of a specialized tool. Other diagnostic tools that may be utilized are:

1. Nerve conduction test
2. Magnetic resonance imaging (MRI) scan
3. Computerized tomography (CT) scan &
4. X-rays

Treatment
Nonsurgical treatments are the preferred course of action. You will be prescribed pain relievers, which helps in reducing the pain associated with a herniated disk. Also, the use of heat or cold, compressing methods, which have been found to cure similar cases are advised. It is also recommended to avoid bed rest, as it prevents any chances of putting the disc back in normal position.

Chiropractors are also one of the preferred choices of consults because exercises and physical therapy, with gentle stretching provide relief from pressure on the nerve root. These are some essentials to be performed one by one or together in combination for bringing the spinal column back to its normal shape. This is what physicians do with a more accuracy to treat patients suffering from the slipped disc without surgery.

But it is essential to follow your physician instructions and go about the therapy thoroughly else the condition can worsen and surgical reinstallation of the spine would be the only course of action. Ultimately, the bottom line is not to be anxious about the protruded disc and to keep going about your normal tasks as usual under the supervision of your physician to get cured.

In today’s day in between surgical n conservative measures there is another treatment modality Called Interventional Pain n spine treatment n this has excellent potential for chronic non healing discogenic back pains or leg pains. In case you have a concern or query you can always consult an expert & get answers to your questions!

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:

1. 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 harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. 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.
3. 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.
4. 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, such as 

1. 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.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. 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!

Since childhood, we are told time and again to stand tall, sit straight and maintain a good posture. We can do this only because of the spinal column. However, with age, the spinal column may be affected by osteoporosis. This is a muscular skeletal degenerative disease that reduces bone density. In the case of the spine, it can cause deformities, vertebral compression fractures and can even be fatal. Thankfully, these fractures can be treated with medication and surgical intervention.

• Kyphoplasty is one of the surgical procedures commonly used to treat spinal osteoporosis fractures. This is a minimally-invasive surgery that aims at reducing pain, stabilizing the vertebrae and restoring the normal height of the spine. This surgery may be performed under local or general anesthesia. To begin the procedure, a small incision is made in the back. The doctor then places a narrow tube through this incision and uses fluoroscopy to place it correctly in the pedicle of the broken vertebrae. A balloon is then inserted through the tube and carefully inflated. As the balloon inflates, it elevates the vertebrae and returns the spine to a normal position. This balloon also creates a cavity inside the vertebra by compacting the soft inner bone. Once this cavity has been created, the balloon is deflated and removed. A cement-like material known as polymethylmethacrylate is then injected into the cavity to fill it up. This cement hardens quickly and stabilizes the spinal column. The procedure may then be repeated on the other side to correct deformities and ensure uniformity.
• Hospitalization is not usually required for this procedure and the patient may go home on the same day. Most patients experience immediate pain relief while others may see the reduced pain within 2 days of the surgery. Kyphoplasty is considered to have the highest chances of success if it is performed within 6 weeks of sustaining the fracture. Heavy lifting and any form of strenuous exercising should be avoided for at least 6 weeks. Other than this, patients can return to their normal lifestyle. To prevent further bone loss, medication will be prescribed that should be taken regularly.
• As with any surgery, there are a few risks to this procedure. This includes a reaction to anesthesia, infections, spinal cord compression or nerve injury and an allergic reaction to the balloon. However, the surgery has a high success rate and complications are rare.

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

Staying healthy involves a wholesome state of being where the mind and body are in perfect sync. A less than properly functioning body can leave you in a state of potential depression after a certain point of time, while a depressive mind can leave you feeling less than stellar where you end up imagining and experiencing pain. The health of your bones and joints is one such area that requires even more care as you start growing older. Wear and tear is just one of the reasons for degeneration while fractures and injuries can lead to a sudden halt of normal functioning of the bones and joints too. So how can you ensure bone and joint health in the long run? Follow our tips!

1. Eating Right: Pick calcium rich food like dairy products that have a low fat content, including milk and yogurt. Also, have a daily dose of green, leafy vegetables and plenty of citrus fruit and juices for your fill of calcium. Further, food like eggs and soya beans which have lots of vitamin D can also help in retaining good bone and joint health. Vitamin C rich fruit like watermelon, oranges, squash and tomatoes also help in natural tissue and cartilage repair. And finally, get plenty of Vitamin K to retain good bone density for a prolonged period with ingredients like leafy green vegetables, eggs and cheese.
2. Exercise: This is the key to good bone and joint health. Much like machinery and tools, the bones and joints of your body can also wither with disuse and prolonged inactivity. Make sure that you indulge in exercises like long walks and muscle strengthening exercises which will give your joints and bones good amount of strength as well. Remember to speak with your doctor before you start a new exercise regime so that you avoid anything that may be harmful in case you have any other ailment. Low impact exercises will strengthen the spine, while fat burning and weight loss exercises will ensure that there is less pressure on the knees and lumbar area. Swimming and resistance building exercises can also be practised for these purposes.
3. Abstinence: A major factor in promoting better bone and joint health is abstinence from all those things that can create problems in the long run, like smoking, drinking excessively and even too much consumption of caffeine and fatty food. All these things can create depletion of the natural bone mass. Also, switching to a lower heel for everyday wear footwear and changing your position during your time at your work station are a few things that will go a long way.

Take care of your bones and joints the right way today, for a healthier tomorrow. If you wish to discuss about any specific problem, you can consult an Orthopedist.

Your knees are one of the most vulnerable parts of your bodies. In case of strenuous or vigorous activities, knees are more prone to damage and injury than the other parts. Several of the knee tissues are fairly delicate and often are easily impaired. Among the other knee tissue injuries, meniscus tears are perhaps the most frequent. Meniscus is essentially a cartilage that protects and stabilizes the knee joints. However, an untoward twist or a strain can lead to a tear in the meniscus. Meniscus tears are a common phenomenon among athletes and sportsmen. They have been noted to be more recurrent in older individuals. 

Some of the early symptoms that indicate the onset of a meniscus tear are swelling and difficulty in bending or straightening of the leg. Sometimes a "locking sensation" in the knees also forebodes a torn meniscus. The inflammation potentially causes a lot of pain and irritation. While, it is fairly easy to ignore a meniscus tear for a normal knee injury, prolonged overlooking may only aggravate the pain and worsen the condition. The process of diagnosing a meniscus tear usually involves an MRI scan and an X-ray examination, over and above a detailed evaluation of the wound.

Treating meniscus tears vary according to the extent of the injury. Depending upon the location and the depth of the tear, various cures can be tried. The healing process, however, depends upon other allied factors such as age, level of physical activities and one's medical history. An external and minor injury is easily mendable. Whereas, graver injuries are resolved through surgical means. The other non-operative means include certain prescribed medicines and specific exercises. Some of the recommended ways of battling a meniscus tear can be enlisted as:

1. Resting the knee by limiting the activities that involve excessive use of the legs or they may potentially strain the leg muscles.
2. Applying ice pack can significantly bring relief to the swelling and the pain in the injured knee. Doctors advice regular use for a duration of at least 15 days.
3. Compressing the knee using an elastic bandage or neoprene sleeve reduces the swelling in the knee.
4. Prescribed medicines in the likes of non-steroidal anti-inflammatory drugs can be effective remedies for a meniscus tear. However, one must mandatorily consult a doctor before consuming such medicines.