Doctor in Physiotheraphy Research Institute & Hospital
Spinal Surgery Disorders
Treatment of Neurological Problems
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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Ever faced a nagging low backache that just won't quit? You could be dealing with sciatica. Sciatica or sciatic nerve pain is not a diagnosis in itself but is a symptom of a deeper problem. Conditions that trigger sciatica include degenerative discs, spinal stenosis, a herniated disc in the lumbar region or spondylolisthesis. Whether your sciatica pain is persistent or sporadic, it can make routine tasks difficult to perform. The good news is that there are a number of remedies to ease this pain and improve the health of your spine.
- Hot and cold therapy: Sciatic pain that extends down to the thighs can be relieved by alternating between a heat pack and an ice pack. Each pack can be applied for about 20 minutes at a stretch every two hours. However, this does not treat the sciatic nerve itself.
- Pain medications and steroid injections: Over the counter pain medication like ibuprofen or muscle relaxants can help alleviate pain and reduce inflammation. In chronic cases, epidural steroid injections may also be prescribed to address the inflammation and pain. Pain relief provided by medication and steroid injections can last for a few days or a few months depending on the person.
- Yoga: Sciatica patients looking for long term relief often turn towards alternative forms of treatment like yoga. Yoga helps strengthen muscles, increases flexibility and improves posture. This is more beneficial towards preventing sciatica problems from arising than treating ongoing sciatic pain. When practising yoga with a sciatica problem, it is very important to understand your body's limitations and not overextend your back muscles.
- Massage: A massage that treats sciatic pain is very different from the usual massage you may get at a spa. A massage to relieve sciatic pain involves putting pressure on the inflamed part of the back and the piriformis muscle. This is the muscle that sits over the sciatic nerve and triggers sciatic pain. In most cases, 3 to 4 massage sessions at intervals of 7 to 10 days can have effective results on sciatic pain.
- Physical therapy: Sciatica patients often find the slightest movement extremely painful. While lying in a bad is tempting, it can actually worsen the pain. Exercise increases blood flow to the spine and helps flush out toxins. Going for a walk, light aerobics or swimming are ideal ways for a sciatica patient to exercise.
- Chiropractic manipulation: This involves realigning the spinal column and is an effective way of treating underlying conditions that trigger sciatic pain. These spinal adjustments should only be performed by licensed chiropractors or osteopathic physicians.
Ayurveda is an ancient healing technique that is very effective for today's lifestyle ailments. For many people a low back ache can be quite a pain. While strong pills and capsules may give you temporary relief they do not address the core issue and have a number of side effects. Ayurveda on the other hand, addresses the trigger to the back ache and has no side effects. Intrigued; take a look at these ayurvedic techniques to cure low back pain.
Cut out on spices
We may think it unrelated, but low back pain is often accompanied by indigestion. Spinal cord nerves connect to back muscles and digestive organs. Hence, a small change in your diet can have a great impact on your health. Spicy food aggravates the digestive system and has a drying effect on the body. By cutting back on spices and oil, the digestive system can work better and there will be less stress on the nerves connecting the spinal cord and back muscles and thus lesser back aches.
Warm your body
According to ayurveda, back pains are caused by an increase in vata dosha or the amount of air and ether elements in the body. Warming the body can help lower these levels. Apply a heat pack to the back as a way of keeping the external body surface warm. Additionally, add warm food to your diet. This opens out any blockages in your digestive system and in turn reduces low back pain.
Ayurveda is very closely linked to yoga. Padahastasana is a yoga asana which addresses lower back pain by opening up the digestive channels and allowing the vata dosha to flow easily through the body. To practice this asana stand with your legs together and lift your arms straight above your head while inhaling. As you exhale, bend forward from the hips while keeping your back and legs straight. Try and touch your toes. Hold the position for as long as possible and come back to the starting position while inhaling.
Anuloma Viloma is a breathing exercise that balances the vata dosha. This is a technique that involves breathing from alternate nostrils. To begin, close the right nostril with your thumb and inhale through the left nostril. Close both nostrils and hold your breath for a few seconds. Then, release through the left nostril. Repeat this process, starting from the left nostril.
Bishop's weed seed tea
Tea made from the seeds of Bishop's weed is can provide instant pain relief from low back pains. This is suitable for men and women of all ages except those with heart problems.
The core principle of ayurveda is to listen to your body's messages. These techniques will help you become more tuned to your body's needs and keep you free from back aches.
Fibromyalgia is a condition characterised by chronic widespread body pains and increased responsiveness to pressure. Women are at a higher risk of suffering from this disorder than men. Fibromyalgia can be treated with physiotherapy, pharmacotherapy and combined efforts of physician and the patient.
- Pain: Fibromyalgia is characterized by pain that has no apparent reason. It can affect different parts of the body and presents itself in different ways. Some people may experience a stabbing pain while others complain of a persistent dull ache. This pain may be affected by climate changes or stressful situations. There is a reduced threshold to pain, because of certain chemical ( neurotransmitters) abnormalities in the brain. Pain is generalized, felt above and below the waist, right and left side of body, arms, legs, neck and back.
- Abnormal Sensitivity: Fibromyalgia patients are extremely sensitive to environmental changes that involve sight, sound and smell. For example, cigarette smoke can make a fibromyalgia patient extremely nauseous while loud music can give the person an instant headache. Lights that are brighter than normal can also make such a person feel uncomfortable. Patients have an abnormal sensitivity to pain, which leads to generalized aching of the body and tender points.
- Muscle & Joint Stiffness: Fibromyalgia patients often experience stiff muscles and joints without any form of strenuous activity or other reason. This may be localised to one group of muscles or affect the whole body. For some patients, this pain is worse in the morning or when sitting for extended periods of time. However, moving around does not provide any significant relief.
- Chronic fatigue and exhaustion: There are two main reasons for a fibromyalgia patient to complain of tiredness. Firstly, the condition itself drains a person of energy even without overexerting themselves. Secondly, pain and joint stiffness can hamper a person’s sleep and lead to sleep deprivation. Over time, this can become a vicious cycle of tiredness and insomnia. Chronic fatigue also affects a person’s immune system causing his or her energy levels to drop.
- Cognitive impairments: Fibromyalgia patients also complain of a compromised short term memory. They often face difficulties recalling the names of people they have recently met or other newly acquired information. These people may also have trouble concentrating on tasks for extended periods of time and experience mental sluggishness also known as fibro-fog.
- Irritable bowel syndrome: Bowel disturbance is another common symptom of this disease. Passing stool may become difficult due to a combination of pain and muscle stiffness. With time, this problem can worsen unless addressed with laxatives. However, an over-dependence on laxatives can lead to further problems.
- Somatic Symptoms: Apart from pain, patient experiences unrefreshing sleep and fatigue throughout the day. Other associated features can be depression, abdominal cramps, chest pain, tingling.
- Lab Tests: Fibromyalgia is a clinical diagnosis. There are no definite laboratory tests. In fact, most conducted tests will turn out to be normal.
- Treatment: Foremost important is education of patient and caregivers, regarding the nature of the disease. The patient needs to indulge in recreational activities and undergo supervised physiotherapy. There are potent medicines to correct the chemical imbalance in the body thereby increasing the pain threshold and leading to a better quality of life.
What is Spinal Stenosis: The narrowing of the gaps in the spine or the backbone is called as Spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.
Causes of spinal stenosis: It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine
Symptoms of spinal stenosis: There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.
- A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.
- Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.
- Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.
- Medications such as the antiinflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Muscle relaxants like gabapentins might also be recommended. In some case anti depressants might also be given to provide relief from pain.
Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.
My husband feels mild pain in right portion of his rib cage in the x ray the image is also not clear can you suggest any treatment or medicine.
I have a joint pain on my knees starting from april 2019 it become much more harder to walk around, I am a businessman so I have too run around. I also workout daily so is there any solution for that.
Knee replacement is a surgery wherein an artificial joint is used to replace a diseased, damaged or worn out knee. This surgery is common among people who fall in the age group of 60-80, but recent trends seem to suggest that younger people are opting for this surgery as well. The lifetime of the artificial knee joint is around 20 years, provided the knee is well cared for.
Most common reason is “high grade osteoarthritis” due to wear and tear of the knee joint. The pre-hospital study of the Knee joint is mandatory and would decide what kind of Replacement is suitable to the patient. If there is diabetes or hypertension associated with this, then it should be controlled well before undergoing surgery. Hemoglobin of at least 10 gm% is required.
If the mobility in your knee joint is reduced leading to impaired functioning of the knee joint, then you might need a knee replacement surgery. You may experience pain while walking, sitting and, in some cases, resting as well.
Some of the common reasons why you may opt for this particular surgery are:
- Gout, where, small crystals are formed inside the joint.
- Rheumatoid Arthritis, an autoimmune disorder, wherein the immune system of the body attacks the body’s healthy tissues.
- Hemophilia, wherein, the blood ceases to clot normally.
- Injuries to the knee.
- Disorders that cause unusual bone growth (bone dysplasias).
- Death of bone in the knee joint following blood supply problems (avascular necrosis).
- Knee deformity with pain and loss of cartilage.
- Unusual growth of bones in the knee joint.
Knee replacement surgery is classified into:
- Partial Knee Replacement: In this surgery, only one part of the joint is replaced.
- Total Knee Replacement: Total knee replacement surgery involves replacement of both sides of the knee joint.
The usual hospital stay period is around 2-3 days after the surgery is completed. Initially, you will require the help of crutches to walk for at least 2 months. You may also be asked to do gentle knee strengthening exercises. It may take up to It takes 3 weeks to start performing activities of home. It may take three months to recover completely from a knee replacement surgery.
You might be an elite athlete or just a commoner. There is always a possibility for you to develop lower back pain while carrying out your daily activities. You might not be aware but regular activities like sitting at the computer, running on the treadmill or simply crawling into your bed for a good night's sleep can affect the health of your spine. You are always at the risk of damaging your spine. These damages lead to back pain. It has been found that faulty postures can cause back pain by causing straining of the back muscles, injuring the tendons and damaging the vertebrae or ligaments.
Back pain can be caused due to the overuse of a particular activity or for undertaking a new activity. However, it is often very difficult to pinpoint the exact reason behind the occurrence of back pain. Here are the common causes of lower back pain:
- The screen trouble: You are likely to develop back pain, if you spend long hours sitting in front of the computer. Researchers believe that spending nine hours or more a day by texting on smartphones or tablets or typing on the computer is dangerous. You must take a break at regular intervals while working on the gadgets to avoid back pain. Your monitor of the computer should be placed at the level of your eye.
- You skip the core exercises: The health of your spine depends on the core regions of your body as well. The core region includes your back, side, pelvic, and buttock muscles. It is important that you practise the core exercises like lunges, squats, and planks. They help in strengthening the muscles around your core region and keep your spine healthy.
- Improper sleep pattern: Your sleeping pattern is as much important as your walking or sitting pattern when it comes to the health of your spine. If you sleep on your stomach, pressure is placed on joints and muscles. This may cause straining of the muscles or ligaments in the spine region.
- Smoking: Cigarettes are not just unhealthy for your lungs or heart, they are equally bad for the spine. Cigarettes contain nicotine. Researchers have found that nicotine hampers the flow of blood to the vertebrae and disks in between the spine. Insufficient supply of blood to the spine region results in low absorption of calcium by the bones in this region. Therefore, you end up developing back pain.
- Blame it on your emotions: Back pain adds to your emotional stress. But believe it or not, the reverse is equally true. Depression and emotional stress, increases or sometimes even initiates back pain. When an individual is depressed, his or her glands release stress hormones known as cortisol. This hormone causes the muscles in the back region to tense up.
Ways to get rid of lower back pain
- You must lie on your back.
- It is then advisable to lift your left leg, as high as you can
- Thereafter, keep the legs straight in a raised position.
- You are then supposed to hold your lower thigh with both hands.
- You can then pull the leg toward your upper half of the body
- Hold this position for some 10 to 15 seconds.
- Position yourself back in the starting position.
- Repeat the same with the right leg.
- Do this 2-3 times with each leg to get rid of the lower back pain.
- Apply hot or cold compression on the affected part
- Eat a balanced diet
- Don’t smoke or drink
- Exercise in a proper posture
- Don’t spend too many hours sitting before laptops or tv
When your daily activities are limited due to severe pain or joint damage, it is when a joint replacement may be the best option. Joint replacements are done to restore movement and reduce pain. The most commonly replaced joints are the hips and knees. With advances in medical technology and operational expertise, these procedures have undergone major changes in the way they are done. The success rates have also proportionately gone up.
Hip replacement: The hip is a bone and socket joint, wherein the hip joint sits in the femur, which is the thigh bone. This could require replacement either due to a severe injury or due to regular wear and tear with aging. Replacement is considered when non-medical therapies like exercise and painkillers fail to improve the quality of life. In advanced joint replacement, both the ball and socket portions are completely replaced with artificial components (could be metal, plastic, or ceramic).
Knee joint replacement: The knee is a modified hinge joint formed between three bones – the patella (knee cap), the femur (thigh bone), and the tibia (shin bone). The knee can be affected either due to regular wear and tear or as a part of the trauma. When the knee joint is affected, the patient’s ability to move is greatly diminished, and thus requires treatment. If nonsurgical measures fail, then surgical correction is required.
What happens during the joint replacement?
- These are major operations and are done in the hospital setting, with 1 to 2 days of hospitalization
- The operation takes about 4 to 5 hours
- The damaged cartilage or bone is removed and the part is prepared to receive the prosthesis
- Titanium alloy is often used as it has the unique ability to fuse to the bone
- Sometimes, plastic or ceramic is also used
- These simulate the movement that was previously produced by the natural joint
- Post operation, infection control is extremely important
- Pain control initially could be through injection, and then gradually move to an ad-hoc basis
- With the pain and limitation on movement gotten rid of, the new joint should be gradually accustomed to movement. The surrounding tissue also requires time to heal and support the normal movement.
- Return to movement should be gradual and under a physiotherapist’s guidance. Advance exercise as directed.
- Diet should be modified to ensure the required nutrition is provided for proper healing
- Other equipment like a walking stick, shower bench, handrail, or a walker may be required.
- The first few weeks could require extensive help to move around and get back to normal activities.
Whatever the part replaced, with total joint replacement, these precautions should be adhered to, to ensure complete recovery and successful return to a stage of pre-operative movement.
Damaged hips can cause great distress in carrying out daily activities, such as walking, getting dressed and many more. If you have damaged one or both of your hips, and it causes you great pain, you may require a hip replacement. It is a common form of surgery in which a damaged hip joint gets replaced with an artificial one. This is known as a prosthesis.
Conditions which lead to hip replacement
- Osteoporosis where the cartilage inside a hip joint gets worn out and the bones rub with each other as a result
- Rheumatoid arthritis, which is caused when the immune system attacks the hip joint lining by mistake
- If the hip joint gets damaged severely during an accident or fall
The purpose of a replaced hip joint is to provide pain relief, improve the hip’s function, improve your ability to carry out day-to-day activities and improve your overall quality of life.
A hip replacement is usually carried out under general anesthesia. An incision is made in the hip by the surgeon and the damaged hip joint is removed through it. It is replaced with an artificial metal alloy or a ceramic joint. The surgery takes approximately 60 to 90 minutes for completion.
After the surgery, a walking aid such as crutches is required for up to four to six weeks. You may enroll for an exercise program, which aims at regaining and improving the new hip joint functions. Regular activities can be restored within two to three months. A year is required for utilizing the new hip joint normally.
Risks of hip replacement-
There may be several complications as a result of a hip replacement. They include:
- Dislocation of the hips
- Infection at the surgery wound
- Injury to nerves and blood vessels
- Difference between the lengths of two legs
Hip replacement surgery has an alternative type of surgery, which is called hip resurfacing. During this surgery, the damaged surfaces of the bones within the hip joint are removed and replaced with a metal surface. Less bone is removed in this surgery. However, the metal surface may cause complications and health hazards.
Hip replacement is being improved upon with the advent of technology. Stronger and newer materials are being developed for prosthetics, which will allow enhanced joint mobility and longer wear. New cement-less implants are also being developed. Also, surgery assisted by computer is being used for generating an image of the hip joint.