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Dr. Vivek

Orthopedist, Mumbai

400 at clinic
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Dr. Vivek Orthopedist, Mumbai
400 at clinic
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I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning....more
I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning.
More about Dr. Vivek
Dr. Vivek is one of the best Orthopedists in Bhayander East, Mumbai. He is currently associated with A Care Orthopedic in Bhayander East, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. Vivek on Lybrate.com.

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A Care Orthopedic

No. G/1 Giriraj Tower,Mira Bhayander Road, Sai Baba Nagar,Bhayander East,Landmark: Opposite Indian Petro Pump, MumbaiMumbai Get Directions
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Hi I'm Vignesh from Chennai, And I have neck and shoulder pain past few years and also my face skin became very dry and glowness.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Hi I'm Vignesh from Chennai, And I have neck and shoulder pain past few years and also my face skin became very dry a...
Avoid toward bending and long sitting and lifting heavyweight do neck stretching exercise and shoulder. Do hot fermentation and avoid computer work. Calcium supplements otherwise x-ray and physiotherapy treatment.
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I got sudden pain in lower back. Pain in left side of the body. Weakness. I consume thyronorm.

MBBS, DNB (Orthopedics)
Orthopedist, Bangalore
I got sudden pain in lower back. Pain in left side of the body. Weakness. I consume thyronorm.
With thyroid disorder there is associated muscle weakness. There is nothing to get worried about. Its important to maintain hydration, good posture and keep exercising. If the pain is too severe meet a physiotherapist so that they can do ultrasound massage or interferntial therapy and relax it.

Back Pain Management

BPTh/BPT
Physiotherapist, Pune
Back Pain Management

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-

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.

  • Medications: your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
  • Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
  • Opiates, for example, hydrocodone, for pain relief
  • Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
  • Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
  • Home treatment: in case your condition is less severe, you can attempt a couple of things at home to treat it:
  • Take an over-the-ounter pain reliever, for example, acetaminophen or a calming medication, for example, advil or aleve.
  • Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
  • Exercise routinely to help you recover quickly.
  • 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.
  • 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.
  • 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).
  • 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.
  • 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:

  • Dural fibrosis
  • Arachnoidal adhesions
  • Muscles and fascial fibrosis
  • Mechanical instability resulting from the partial removal of bony ligamentous structures required for surgical exposure decompression
  • Presence of neuropathy.
  • 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 and 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 relievingback 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.

2 people found this helpful

I am a 17 years old male and have foot pain for last three months. What could I do?

BPTh/BPT
Physiotherapist, Mumbai
I am a 17 years old male and have foot pain for last three months. What could I do?
Hi +wear soft padded footwear. +do stretching of calf muscles +learn strengthening exercise of ankle +take contrast bath at physio clinic. Do reply to discuss detailed treatment plan. Wishing you a good health.
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Sir My Right Hand wrist pain when I bend downward and see a inflammation when bend downward what the reason sir I want to know please.

Master of Occupational Therapy (MOT), Bachelor of Occupational Therapy (BOT)
Occupational Therapist, Delhi
Sir My Right Hand wrist pain when I bend downward and see a inflammation when bend downward what the reason sir I wan...
It might be overuse syndrome or tendon injury Apply ice pack Apply pain relieving gel Wrap crape bandage Do ball squeezing activity multiple times a day
1 person found this helpful
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I am suffering from pain on my right elbow for about nine months ago.I can't take even 5kg weight straightly.Please suggest remedy for it ?

BPTh/BPT
Physiotherapist, Mumbai
Do u have a history of fall on that hand? Was your forearm pulled ? If not we need to check your neck as many times pain comes from the neck. Or it can be tennis elbow . Golfers elbow
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Hai respected sir. My wife is suffering from severe pain in back both shoulders and consulted so many doctors said that back bone of the neck has been pressed so do not do any weights lifting and work hard even not doing hard work the pain is spread from top to middle of the back, pain is severe daily.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Hai respected sir. My wife is suffering from severe pain in back both shoulders and consulted so many doctors said th...
Neck Advice Hot fomentation x twice daily. Neck Exercises. Neck Stretching. Postural Correction. Shoulder Shrugs . Core Strengthening Exercises. Take frequent Breaks at work Use cervical pillow. Use Back Support. Self Massage the back of neck.
1 person found this helpful
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I am a 20 years old male and have a backache for last 2 months. What should I do?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am a 20 years old male and have a backache for last 2 months. What should I do?
Bhujang Asana – Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day.
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I am a software engineer my job hours 8 sitting in chair so I have back pain till 6month ago I am doing job on 3years.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I am a software engineer my job hours 8 sitting in chair so I have back pain till 6month ago I am doing job on 3years.
Long sitting is your problem sit straight and tk a soft pillow for back support and tk physiotherapy treatment must for you.
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Sir . I am a mariner last day I lifted some heay thing nw I suffering for back pain wht I should do. Nw am at ship. please gve me sme advice.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Sir . I am a mariner last day I lifted some heay thing nw I suffering for back pain wht I should do. Nw am at ship. p...
Do take postoral and spinal extension exercise from physiotherapist apply hot and cold water fomentation for thrice a day for 7 days regularly do revert for further assistance best wishes.
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There been pain in my both ankles from 2 years, when diagnosed, I have been reported with increased uric acid - 7.3. Can you suggest a cure. Thanx.

MD - Pathology
General Physician, Amritsar
Take tablet zyloric 100 daily. Initially you will experience more pain for a week, take pirox dt twice daily for one week. Don't take non- vegetarian food. Limit intake of dairy products. You can take pulses in limited quantities. Avoid beans. Symptoms will take 3-4 weeks to recover.
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I am 19 years old when I wake up from my sleep I have notice there iz pain in my back what would be the reason behind it or else its because of weakness.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am 19 years old when I wake up from my sleep I have notice there iz pain in my back what would be the reason behind...
Apply Hot Fomentation twice daily. Avoid bending in front. Postural Correction- Sit Tall, Walk Tall. Extension Exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. Bhujang Asana – Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day. Back Stretching- lie flat, pull one of the knee forward to chest, hold for 3 seconds, then bring the other knee forward to the chest and again hold for 3 seconds. Then pull both knees towards the chest and hold for 3 seconds. Repeat 10 times each exercise twice a day. Do the cat/cow stretch. Get on all fours, with your arms straight and your hands directly under your shoulders; your knees hip-width apart.
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I am 32 years Girl, suffering from back pain since last 2 months, What should I do ?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am 32 years Girl, suffering from back pain since last 2 months, What should I do ?
Sleep on a hard bed with soft bedding on it. Use no pillow under the head. Kindly take biod3 max 1 tab dailyx10 paracetamol 250mg od & sos x5days do back (spine)/shoulder/knee exercises make sure you are not allergic to any of the medicines you are going to take do not ignore it. It may have to be further investigated. It could be beginning of a serious problem. If no relief in 4_5 days, then inform
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I am 33 years old iam suffering from back pain last four months and I had 3 surgery left.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Not all patients of backache & pain joints need surgery. Most of them can be managed without operation morning stiffness in back & other joints is quite a common condition. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Any way take bio d3 max 1tab odx10days ibuprofen 200mg od & sos x 5days do back (spine) exercises contact me again if need be. Make sure you are not allergic to any of the medicines you are going to take.
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I am 33yrs old I have lumbar spondyolisis i, e low back pain what should I do please give me the remedies.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Zirakpur
I am 33yrs old I have lumbar spondyolisis i, e low back pain what should I do please give me the remedies.
Pl inform the extent of pain and radiation of pain to legs, if so. Do physio, Yoga and drink warm water. For the time being pl start decoction of chavya, Chitrak, Shunthi, Peepal, peeplamool made at home. Also Nycanthes leaves (Paarijat) decoction should be used. Report after two weeks with info asked above with lab test reports, if any.
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Knee Pain

M.SC. in Sports Injury, BPTh/BPT
Physiotherapist, Mumbai
Knee Pain
Knee pain usually occurs due to weak muscle around your knee joint. People who are doing daily brisk walks, jogging and running are more likely to get knee pain so for that they should reduce to thrice a week and the other days can do recumbent cycling, swimming or cross trainer (elliptical cycle).
This actually reduce the load exerted on your knees and will give some rest from impact which occur due to jogging or brisk walking. Regular icing after such strenuous activities will also the minimize the risk of injuries to the knee joint.
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