Lybrate.com has a nexus of the most experienced Physiotherapists in India. You will find Physiotherapists with more than 33 years of experience on Lybrate.com. Find the best Physiotherapists online in Mumbai. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Knee replacement
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
Submit a review for Dr. Indu SinghYour feedback matters!
I usually go to gym everyday and do all kinds of workouts. This morning, I was doing squats with weights on (weight - 35 KGS). Suddenly I felt a pain in lower back and stopped squatting. From that moment, I couldn't walk freely, I am unable to shift from a position of comfort, gives me pain even when I am sitting in a chair. Is this serious? Even while lying on my back also I cannot move on my left/right as I can feel the pain. Please suggest that course of action.
4 year ago I met with a vehicular accident. That time I had hairline fracture to my shoulder. Most of times I am having pain to my shoulder and neck. Please held.
I am working in accounts and most of the time sitting in front computer and having a pain at my hip bone joints and sometimes also observing a tingling sensation in my legs. What to do,
I am facing problem of back pain, So please tell me that what I have to do for this. What kind medicines I have to take.
Is the Ankayology spondilitis treatment is possible ? if yes where (i mean ayurveda, Homeopath or other
My mother is 45 years old every night she has the leg pains problem. Everything is okay in the tests. What we should to relief her pain?
37 year old male. Have knee pain while climbing steps since many years. Also have lumbar back pain once a week. Could there be problem with knee/back.
I am 23 years old male and visit the gym. I have pain in right knee. Tried many things but did not work out. What should you do kindly suggest?
I am 28 years old. Sometimes I suffer from a severe backache due to which I find breathing uncomfortable due to pain. So what should I do.
Sir this is anil kumar I have met with an accident from then I am facing a problem in my knee problem so I need your suggestion.
I am 50 yrs my knee musles are steave unable to fold freely. It was happening since 1 month,whether it calcium defiency ?
I am 32 and mother of a girl child. My girl is 18 months old. I always have pain in my hands, joints, foot, knees. My skin complexion has become darker as compared to what it was before marraiage. Please advise.
Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.
Causes of knee pain
Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -
- Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains
- Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain
- Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition
- Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain
- Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful
- Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint
Symptoms of knee pain
Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.
Related Tip: Three Ways to Protect Your Knees?
Due to sudden jerk in a train I got pain in my right foot, a few months back. X rays were done and doctor said that there is no crack or fracture. The pain is severe. All local hot/cold and some ointments have been applied but no re leaf.Please advise (66 years)
I am a 25 year male I have muscle wasting in left hand and the nerves can be seen. I can't lift heavy objects and drop them eventually. I can't even hang with my left hand. I had undergone MRI and nerve conduction test. The doctor (neurologist) said I have monomelic amyotrophy but no one in my family has this except my elder brother but his hand is not weak as mine and he also don't have that much wasting. Please help I think I am going to lose the ability to work with left hand. Sometimes my hand freezes and I cant even bend my fingers. I don't have any wasting in other parts of the body.
The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).
The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.
If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.
Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.
If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.
Once the conservative treatment fails:
Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.
Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.
Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.
LESI: Lumbar Epidural Steroid Injection
Indicated in – Acute radicular pain due to irritation or inflammation.
- Symptomatic herniated disc with failed conservative therapy
- Acute exacerbation of discogenic pain or pain of spinal stenosis
- Neoplastic infiltration of roots
- Epidural fibrosis
- Chronic LBP with acute radicular symptoms
- Epidural- lumbar injection
ESI Treatment Plan
Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.
SNRB- Selective Nerve Root Block
Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if
- There is minimal or no radiological finding.
- Multilevel imaging abnormalities
- Equivocal neurological examination finding or discrepancy between clinical & radiological signs
- Postop patient with unexplainable or recurrent pain
- Combined canal & lateral recess stenosis.
- To find out the pathological dermatome for more invasive procedures, if needed
Provocative Discography - Coupled with CT
A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.
Percutaneous Disc Decompression (PDD)
After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed
Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.
Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.
Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)
A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.
In case you have a concern or query you can always consult an expert & get answers to your questions!