Find numerous Neurosurgeons in India from the comfort of your home on Lybrate.com. You will find Neurosurgeons with more than 39 years of experience on Lybrate.com. You can find Neurosurgeons online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Treatment of Neurological Problems
Treatment of Nerve And Muscle Disorders
Treatment of Paralysis
Joint Dislocation Treatment
Treatment of Spondylosis
Treatment Of Disk Slip
Treatment Of Herniated Disc
Treatment of Spine Injuries
Brain Tumor Surgery
Treatment of Disc Prolapse
Spinal Cord Injury Medicine
Accident Injuries Treatment
Spine Surgery Treatment
Submit a review for Dr. Milind SankheYour feedback matters!
Sir I m taking stalopam plus from 4 months. I feel positive. Now I have been switch to stalopam 10. I am now suffering from sleeplessness. And some tensions and depressed some time in day. Tell me what to do for my sleep. I want to get rid of these medicines.
I am 59 yrs pro musician recently I am suffering from nerve problem, as I cant work properly with my left hand. Please suggest some remedy for this.
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.
Treatment of spinal stenosis:
- 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 anti inflammatory 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 antidepressants 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.
PHYSIOTHERAPY TREATMENT OF HEAD INJURY
The treatment may comprise of the following measures:
IMPROVES ALERTNESS OR AROUSAL THROUGH SENSORY STIMULATION:
The patient who is drowsy or confused need to be stimulated by makes them more alert and awake. The therapist should encourage the patient’s cooperation during the treatment. The main aim is to stimulate the reticular activating system by making the patient sit or even stand in the tilt table.
The therapist should provide tactile, visual, auditory and Proprioceptive stimulation to the patient that will send facilitatory signals to the brain and will enable the alert response to be provoked. Auditory stimulation can be given by speaking to the patient during the course of treatment. Visual stimulation is given by showing familiar faces, objects or movement in the visual field of the patient.
Proprioceptive stimulation by giving traction and approximation at joint structures is very helpful in stimulating the arousal response in the patient.
PREVENTION OF SPASTICITY:
As hyper tonicity generally sets in almost all head injury cases various measures need to be taken to keep them under control. Gentle passive movement, gradual rhythmic sustained stretch, prolonged icing for 20 minutes over the muscles, biofeedback, proper positioning are certain measures that needs to be employed for controlling spasticity.
MAXIMISE THE PATIENT’S FUNCTIONAL CAPACITY:
The main aim of this management is to improve the ROM, improve the control of voluntary movement, strengthening paretic muscles, improve the coordination, balance and teach various safety measures.
The treatment should be wide spread over the periods of time as the patient’s attention span and endurance is very less.
NEUROMUSCULAR TRAINING can be given through the development sequence by inhibiting abnormal movement pattern and by facilitating normal movement pattern.
The patient may give activities like bridging, prone on elbow, on all fours, side lying to sitting, sitting, kneeling, half kneeling, standing and walking.
PROPER DOCUMENTATION is necessary of the entire event through- out the day. Infact the routine of the patient should be maintained in the register and the patient need to be reminded of various activities especially if the patient has memory problems. The patient may be given register with photo and names of various health professional visiting him so that each day’s program can be entered. This will benefit both the patient and his acquaintance to know regarding the activities given to the patient.
USE OF VESTIBULAR BALL while training the patient for crawling, bridging, sitting, balance helps in building the Proprioceptive stimulation and teaches proper control to the patient.
Each task has various subtasks which need to be mastered by the patient so that he learns the actual activity using normal movement combination and performs it with precision. Like for training the patient to get up from bed, he may be taught to do asymmetrical push up with the trunk in partial rotation, then lower leg patterns are incorporated and finally the whole task of get up from sidelying is practiced.
REPETITION ACTIVITIES is key like any other neurological disorders. Ambulation training should always be done in upright position training the patient in each and every phase of the gait cycle. If the patient’s balance is poor then assistance may be used.
FUNCTIONAL ELECTRICAL STIMULATION has been shown more effective than kinetic joint training in certain types of cases. The upper extremity also appeared to use specific synergies for hand use in different positions. Clients often can opens hand in out stretched arm position but will be unable to perform the same action when the elbow is flexed. Some patient with minimal functional deficit in th upeer limb may be given some assistive devices or support for the hand so that they can perform some basic activity like eating, combing, writing, etc. this technique helps the shoulder and other proximal structures to produce appropriate movement sequences for hand use but does not facilitate hand function. The treatment however does provide whole task practice even though some basic component of the function is substituted by other means.
REVERSING TASKS in some patients helps in developing increased control by modifying a task or synergy as well as making the muscle work both eccentrically and concentrically. For instance lowering a glass of water on the table may help the patient in getting th glass close to the mouth by improving motor control of biceps during eccentric contraction.