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Dr. Ashok Paolegar

Orthopedist, Mumbai

1800 at clinic
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Dr. Ashok Paolegar Orthopedist, Mumbai
1800 at clinic
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
More about Dr. Ashok Paolegar
Dr. Ashok Paolegar is one of the best Orthopedists in Malad West, Mumbai. You can consult Dr. Ashok Paolegar at Ashwini Orthopaedic Nursing Home in Malad West, Mumbai. Book an appointment online with Dr. Ashok Paolegar and consult privately on Lybrate.com.

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Ashwini Orthopaedic Nursing Home

1st Floor Sachdev Appartment,Vishal Nagar,Mith Chowki, Malad West. Landmark:-Opposite Giridhar Park Bus Stop, MumbaiMumbai Get Directions
1800 at clinic
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Non-surgical Treatment for Cervical Spondylosis - Tips!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Non-surgical Treatment for Cervical Spondylosis - Tips!

Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-

  1. Exercise based recovery/physiotherapy: Your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.
  2. Medications: Your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
    1. Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
    2. Opiates, for example, hydrocodone, for pain relief
    3. Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
    4. Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
  3. Home treatment: In case your condition is less severe, you can attempt a couple of things at home to treat it:
    1. Take an over-the-counter pain reliever, for example, acetaminophen or a calming medication, for example, Advil or Aleve.
    2. Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
    3. Exercise routinely to help you recover quickly.
    4. Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.
  4. Acupuncture: Acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
  5. Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs).
  6. Support/brace use: Temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.
  7. Lifestyle: Losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.

ONCE THE CONSERVATIVE TREATMENT FAILS:

Early aggressive treatment plan of back & leg pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only approx 5% of total LBP patients would need surgery & approx 20% of discal rupture or herniation with Neurologically impending damage like cauda equina syndrome 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 patient`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&L5-S1), 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. 

NEED FOR NON-SURGICAL OPTIONS: Outcome studies of lumber disc surgeries documents, a success rate between 49% to 95% and re-operation after lumber disc surgeries ranging from 4% to 15%, have been noted. “In case of surgery, the chance of recurrence of pain is nearly 15%. In FBSS or failed back surgery the subsequent open surgeries are unlikely to succeed. Reasons for the failures of conventional surgeries are:

  1. Dural fibrosis
  2. Arachnoidal adhesions
  3. Muscles and fascial fibrosis
  4. Mechanical instability resulting from the partial removal of bony & ligamentous structures required for surgical exposure & decompression
  5. Presence of Neuropathy.
  6. Multifactorial aetiologies of back & leg pain, some left unaddressed surgically. 

EPIDURAL ADENOLYSIS OR PERCUTANEOUS DECOMPRESSIVE NEUROPLASTY is done for epidural fibrosis or adhesions in failed back surgery syndromes (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 Sciatica gets complicated by PIVD with disco-radicular conflict causing radicular pain sometimes disabling. In this era of minimally invasive surgery lot many interventional techniques have evolved to address the disc pathology. We are still working for the ideal, safe & effective technique to tackle disco- radicular interphase. Here now we have devised a mechanical neuroplasty or foraminoplasty technique using an inflatable balloon tip catheter with guide wire via targeted transforaminal or interlaminar route aided by drugs instillation. Selected patients are procedured fluoroscopic guided with local anesthesia under prescribed sedation aseptically via preselected route depending upon location & type of PIVD causing root insult. First a suitable size needle is placed at desired site confirming with radiolucent dye through which hyaluronidase with saline or LA was injected. A flexible guide wire is passed at selected location & direction on which the inflatable balloon is threaded to the area of interest.

Adhesiolysis is achieved mechanically with inflating balloon for 10 seconds at a time & location. We inflated the balloon with contrast agent to have visualization of adhesiolysis & opening up of adhesions or root route. Here the balloon pressure & time has to be kept in minimum to avoid neurological damage, for which we inflate balloon for 10 seconds at a time. Close observation is made to balloon shape, pressure & patient`s response. Once dilatation is done the drug mixture of steroid with LA & or hynidase/ hypertonic saline is instilled over nerve in epidural space. We have logically used same approach for our Balloon Neuroplasty & foraminoplasty as it is safe & targets exactly the area of disco-radicular interphase or conflict. We can manage to address both the exiting and traversing nerve roots with single entry just by manipulating our guide wire to the place of offence. The procedure can be done via transforaminal route at level or level above or below, especially via S1 foramen. Now we are employing this technique for fresh cases coupling with Intradiscal decompression aided by instant disc retrieval by epidural balloon inflation with good results. The IDD is done by Coblation/ Laser/ DeKompressor or RF Biacuplasty. There is scope of coupling this technique with endoscopic spine surgery. By adding “Balloon Neuroplasty” to the armamentarium of the interventional pain management many patients can be benefited & relieved of previously interventionally unmanageable disco-radicular pain including FBSS sufferers. 

INTRADISCAL PROCEDURES:

PROVOCATIVE DISCOGRAPHY: coupled with CT A diagnostic procedure & prognostic indicator for surgical outcome is necessary in 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-CHEMONEUCLEOPLASTY: Ozone Discectomy a least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a day care setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. 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 post operative discomfort or morbidity and low cost. If despite the ozone therapy the symptoms persist, Percutaneous intradiscal decompression can be done via Transforaminal route with Drill Discectomy/ Laser or Coblation Nucleoplasty/ Biacuplasty/ Disc-FX / Endoscopic Discectomy are good alternatives before opting for open surgerical Discectomy; which has to be contemplated in those true emergencies, as mentioned above as the first choice. In Biacuplasty radiofrequency energy is used in bipolar manner heating & shrinking the disc & making it harder as well for weight bearing. It also seals the annular defect & ablates annular nerves relieving back pain. In Laser or Coblation Nucleoplasty energy is used to evaporate the disc thereby debulking it to create space for disc to remodel itself assisted by exercises. 

DEKOMPRESSOR: A mechanical percutaneous nucleotome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression. A mechanical device cuts & drills out the disc material debulking the disc reducing nerve compression curing Sciatica & Brachialgia. It comes in needle size of 17G for lumbar discs & 19 G for cervical discs. In lumbar region postero-lateral approach is used & in cervical discs anterolateral approach is used. 

DISC-FX & ENDOSCOPIC DISCECTOMY: In this novel technique A wide bore needle is inserted & placed sub-annular in post disc just under the disc protrusion. Disc is then mechanically extracted with biopsy forceps to empty the annular defect. This painful & sensitive annular defect supplied be sinuvertebral nerve is thermo-ablated with radiofrequency which also seals the defect to prevent & decrease recurrences. Next Higher procedure, Endoscopic Discectomy is done with endoscope put through sheath inserted via posterolateral transforaminal or posterior interlaminar approach. Mostly done under local anaesthesia its fast becoming standard of care for disc protrusion & extrusions causing spinal canal stenosis with root or cord compression with leg pain.

LASER DISCECTOMY done for closed bulging discs is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, nucleus pulposus is debulked by evaporating it by the laser energy. Laser discectomy is minimally invasive, cost-effective, and free of postoperative pain syndromes, and it is starting to be more widely used at various centers. 

SELD: Epiduroscopic laser neural decompression is considered an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, failed back surgery syndrome with morbid adhesion neuritis that cannot be alleviated with existing noninvasive conservative treatment. This Procedure is done under vision via an epiduroscope inserted via Caudal canal or Transforaminally employing front or side firing Laser fibers &/or fine instruments. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.

3720 people found this helpful

I am 51 years suffring from back rib gage pain both left and right side.Please do help

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. Actually `there are very few conditions in orthopaedics which will cause rib cage pain, usually it can be upper back pain radiating to sides or sometimes there can be inflammation of the costochondral junctions where ribs join the sternum, we have to see whether there is any other medical cause to it. My advise is to take a short course of anti-inflammatory medication which suits you, start with physical therapy and see whats happening in 10 days time, otherwise I will advise few blood tests for you as well as an opinion from a pulmonologist/chest physician. Do not hesitate to contact me if you need any further assistance.
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I have black spots on my face as well as I am also suffering from back pain. What should I do?

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I have black spots on my face as well as I am also suffering from back pain. What should I do?
For back pain tk heat fermentation twice a day and do rest avoid long standing, sitting, continuous work.
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I am sravan having knee pain since three months I took mri doctor suggested ligament issue please suggest tablets.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Bijapur
I am sravan having knee pain since three months I took mri doctor suggested ligament issue please suggest tablets.
dear lybrate user regular application of ayurvedic medicated oil may reduce ur knee pain,avoid overuse of kneejoints and heavy works,wear knee cap often while resting to immobalise the joint.take healthy foods and proper sleep.practice benificial yogasanas and meditation.
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I am 41 years female and have pain in buttocks and legs since three months. Mri shows disc bulging. I am taking medications pregabalin sr and physiotherapy swd, ift, 3 excercises. Twice I took traction but it increased the pain. The excercises also seem to have increased the tingling and pain. Please advise.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. You have mentioned your mri shows disc bulge and you are experiencing symptoms of tingling and pain. As I suggest to all my patients, you should avoid all activities which tend to increase you symptoms so if traction and other exercises are in creasing them, it is better to avoid for sometime. You should continue with modalities as of now, and supportive medications. It will be helpful for me if I could get your mri images and a detailed neurological charting including your motor ans sensory examination. Do not hesitate to contact me if you need any further assistance. Thanks & regards Dr Akshay Kumar Saxena
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Pain on knees how to reduce this pain. And also give me a better suggestion for that pain. And also I have A diabetic problem.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Pain on knees how to reduce this pain. And also give me a better suggestion for that pain. And also I have A diabetic...
do hot fermentation. quadriceps exercises. and put a towel roll under knee and press for 10 second then release repeat 15 time twice a day
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Sir, I have pain in my left hand while doing dips exercise in gym. When I am going too low in dips exercise then I feel pain in my hand. So plc suggest me it's treatment.

BHMS
Homeopath, Raebareli
Sir, I have pain in my left hand while doing dips exercise in gym. When I am going too low in dips exercise then I fe...
Please reduce the number of times you do dips. Also take a rest of one day from taking dips and then again next day do that. There is some fault on the position of hands /you are new to doing this I think.
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Does spiking of lateral tibial spine is similar to ligament injury or in one word tissue injury? For this which homeopathic medicine or allopathic medicine will be better to over come from this type of injury?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Does spiking of lateral tibial spine is similar to ligament injury or in one word tissue injury? For this which homeo...
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).
4 people found this helpful
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My work involves sitting in the same position for almost 10 hours due to which I have severe back ache , it gets worse in the morning when I wake up from bed , can you help.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
My work involves sitting in the same position for almost 10 hours due to which I have severe back ache , it gets wors...
Tk soft pillow for back support and stretching exercise in daily routine. Avoid long sitting and toward bending. Tk physiotherapy treatment for few days.
2 people found this helpful
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What are the symptoms of back pain I have back pain from last 5 to 6 days on my left side.

BHMS
Homeopath, Faridabad
What are the symptoms of back pain I have back pain from last 5 to 6 days on my left side.
Hello. Pain in any level of the vertebra and or along with stiffness is back pain. Maintain a right standing and sitting posture, keep your back always straight, avoid carrying weight on back. Hold or carry weight divided equally in both the hands or shoulders (to avoid over straining on one particular hand or shoulder). (Excessive sitting or standing is to be avoided as well don’t carry much weight on shoulders). Exercise: Practice Shavasana or Corpse Pose as it looks like a dead body. If practiced correctly and with full efforts, can relax every body part, relaxing not only the body but also the mind: Spread the legs one to two feet apart, the toes are turned outwards, the heels facing each other, a comfortable distance apart. Bring the arms a little away from the body, palms turned upward. Relax the neck and allow it to turn to the side if it is more comfortable. Close the eyes and focus the attention on the body, breathing normally. Begin focusing each body part and relaxing it, then moving on. Keep the mind focused on relaxation, the breath should be normal. Relax the whole body. Management: -Stretching or activities that place additional strain on the back are discouraged. -Sleeping with a pillow between the knees while lying on one side may increase comfort. -Lying on your back with a pillow under your knees would also relieves pain and no pillow under your head. -Some people seem to benefit from the use of ice or heat. Take care, do not use a heating pad on ‘high’ or place ice directly on the skin. Medication: Take homoeopathic medicines - Arnica 200 and Rhus Tox. 200 - take both of them thrice daily for 1 week. Also, apply Schwabe's Topi-Arnica and Topi MP Gel on the affected area in circular motions gently thrice a day. Get back to me thereafter.
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Last month I felt on my hands, since then my both angels are paining, it pains occasionally, the pain goes and comes. My hand gets warm when it pains and from some days my left hand thumb with middle finger is PAINING. I feel like my thumb is locked. I am afraid that can it be symptoms of arthritis because my mother is also having arthritis . Can you advise me about it?

Master of Occupational Therapy (MOT), Bachelor of Occupational Therapy (BOT)
Occupational Therapist, Delhi
Last month I felt on my hands, since then my both angels are paining, it pains occasionally, the pain goes and comes....
Apply hot fomentation Take bath with warm water & add salt to it Do not stress yourself Do hand stretches & contrast bath therapy- In one bowl take hot water & cold water in another bowl, first immerse your hand in hot water for 3min then immediately in cold water for 1min, keep repeating for 20min, twice daily
1 person found this helpful
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I HV slip disc and troubling since 8 months. So please advise me for being better. And I am sending my all report belong to my disease.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I HV slip disc and troubling since 8 months. So please advise me for being better. And I am sending my all report bel...
Posture care, physiotherapy, spine exercises, hot fomentation, avoid forward bending and lifting weights. Take pain killer on sos basis. These are the must do's. Depending on severity of disease, you may benefit with above treatment. In more serious cases, injections (epidural, nerve root block, etc) or endoscopic disc removal may be needed, and this can be decided only once you have been examined personally.
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I have pain in my legs, hands and body. I also have losemotions. What should I do.

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
I have pain in my legs, hands and body. I also have losemotions. What should I do.
It is called as rheumatic arthritis. If your pain is more in the distal joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. Wear elbow brace and wrist brace which will make her to feel warm and that will make the joints become firm. Hot water fermentation will help.
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I am 18 years old I have the problem of pain near the neck for last 4 yearswhat should I do.

MBBS
General Physician, Cuttack
It could be due to improper posture while sitting causing neck strain. Maintain correct posture while sitting. If you have problem during neck movement Get yourself examined by doctor to find out the reason. Take paracetamol fo pain,give hot fomentation and apply volini gel
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I have pain in my vertebral column near my neck due to which I can't study. What should I do?

DNHE, BPTh/BPT, weight management specialist
Dietitian/Nutritionist, Kolkata
I have pain in my vertebral column near my neck due to which I can't study. What should I do?
Neck pain could be postural, could be cause of slouching while sitting. Do some hot fomentation along with neck and shoulder exercises infront of the mirror and try to maintain a good posture.
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My wife is 57years old,at present she is suffering from satica (pain at right hip and right ancle from 1 month

BPTh/BPT
Physiotherapist, Delhi
Start with Physiotherapy sessions and learn spinal exercise. Don't sit on floors. Don't do forward bending. Take calcium and methylcobalamine supplement with Omega3.
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Sir My self I'm doing masturbation from past 2 years per day once but now I'm getting weight loss, hair loss, no strength, tired ness, back pain, So please tell me treatment for this sir I want to become like my old days to increase body strength.

MBBS
General Physician, Mumbai
Sir   My self I'm doing masturbation from past 2 years per day once but now I'm getting weight loss, hair loss, no st...
Please don't connected your physical degradation with masturbation.. Things on perspective is your gradual loss of vitality and body weight which not necessarily is due to masturbation. This is your thinking and this had no valid reasoning hence I suggest you to consult a good md physician. He will definitely be able to improve.
8 people found this helpful
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Dear sir I am sixtyseven years old with ortho-arthritis my main problem is cramps and pain in leg muscles which happens when I am lying down on bed [ONLY}please help.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), DYA (DIPLOMA IN YOG & AYURVED), D.I.H.M (DIPLOMA IN INDUSTRIAL HEALTH MANAGEMENT)
Ayurveda, Nashik
Dear sir I am sixtyseven years old with ortho-arthritis my main problem is cramps and pain in leg muscles which happe...
raktamokshan according to ayurveda & massage with cocconut oil for 10 min & stretching exercise will help you completely .
1 person found this helpful
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My husband got hurt jst below his knee (on his right leg), around 3 months bck. He got hurt by the sharp edge of a table. And even till today he has lot of pain. But at the look of it, thrs no swelling as such, but when we feel the painful area, it pains and also feels like a bump. Tried applying all kinds of pain relieving sprays, but its of no use. Kindly suggest us the best home remedy which can reduce the pain, since he is walking with quite difficulty. Thank u.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
My husband got hurt jst below his knee (on his right leg), around 3 months bck. He got hurt by the sharp edge of a ta...
Avoid sitting Cross legged. Avoid Squatting Contrast bath- Fill two buckets/ tubs with Very Hot Water and Very Cold water. Immerse your legs into the water for 3 minutes and then switch to cold water for 1minute. Repeat this 3 times once a day.
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