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 Spondylosis
Arthritis And Pain Management Treatment
Heat Therapy Treatment
Post Pregnancy Classes
Orthopedic Physical Therapy
Treatment Of Disk Slip
Treatment Of Herniated Disc
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Patient Review Highlights
Great Experience. Visited home for giving physiotherapy to my dad to make able to recover from Paralysis. Dr.Vyas was very friendly & got immediately connected with my father which helped him to be able to walk on his own within a week.Dr.Vyas is an Experienced professional and a friendly doctor.I strongly recommend Dr.Vyas for Physiotherapy.
I was suffering from pain from last 3 years as i got treatment from Dr.Mukesh Vyas i felt really good i had been to many of doctors before but i was not getting relief.
Running is something which has an unparalleled ability to give people a boost of energy and make them feel good for the rest of the day. So, it is fair to say that running injuries can be just so disappointing! After all, being prevented from doing a thing you love is never a nice situation to be in!
But, all that need not be the case, as long as a person is willing to spend a little time on learning to reduce the chances of running injuries, a lot of free and enjoyable time spent running is just awaiting him or her!
The first thing which can go a long way in preventing running injuries from occurring is making sure the body is strong. There are quite some ways this can be done but among the most common is to perform exercises which are targeted to help the areas and muscle groups which are made use of when a person runs.
The wall press is a fairly well-known exercise and with good reason! It simulates the impact of the process of running on the gluteus medius, which is a muscle but without the risk of injury. To do this, a person would need to stand with one side close to a wall. Then, the knee is to be bent at a ninety-degree angle so as to prepare the muscle for activation prior to pressing it against the wall for a time period of somewhere between 20 and 30 seconds. This exercise can do wonders! However, the person doing it should make sure that his or her shoulder does not touch the wall while doing the exercise.
Keeping in mind the fact that the entire leg is a unit which is supposed to move smoothly so as to avoid injury, strength needs to be built to bring about uniformity. Remember, it is the imbalances which cause a lot of injuries! Another exercise to be done is the single leg balance on the forefoot.
The effects of this exercise have a beneficial impact all the way up to the hip! The exercise is pretty simple and it is to be done preferably barefoot. Three to four repetitions are recommended, for as long as possible, with the heel off the ground.
Standing jumps may seem to be quite simple, but they really can have a significant impact! Jumping onto a step of medium height and enough width increases the elasticity of the muscles involved and can even burn some calories!
She is ill from 4 days. Had weakness and muscle ache and headache. She is also suffering from throat infection. Currently she is taking antibiotics anti inflammatory and multi vitamin tablet by consultant to hospital. What should I do for her muscle cramps and headache?
I think I'm suffering from muscular dystrophy! As my veins are becoming visible in my hands and feet And from few weeks I find my walk is not straight like I want to step straight forward but my leg moves to a slight different direction I also slipped on stairs in my college after which I had severe pain in my thigh and calf muscles! What should I do? Am I really suffering form muscular dystrophy?
I fell down while walking downstairs. My left foot is cramped and pain is there for 4 days. Please suggest what to do to remove pain and be back to normal.
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.
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.
Pain is inevitable after the plaster is removed from the location of the broken wrists. Since the wrist hasn’t moved for well over a couple of weeks, the hand might feel vulnerable to perform routine tasks. Along with the prescribed medication, physiotherapy is mighty effective in healing the wrist and getting the old balance back. The process of physiotherapy should be typically started when the pain diminishes and the Doctor gives his go-ahead for the same.
What are the benefits?
This is primarily done to get back the muscle strength. Physiotherapy also helps in gaining mobility and function of the wrist that has been affected because of the injury. While therapy does not heal the fracture, they ensure bones of the wrist get denser and stronger. This ensures that future injuries are effectively prevented.
Flexion: This is the process of bending the wrist in the forward direction and holding the posture for 5 seconds. 3 sets of 10 flexions should be done in one session.
Extension: This is the opposite of flexion. In this exercise, the wrist should bend backwards and 3 sets of 10 extensions should be performed in each session.
Side Movement: The wrist should be moved sideways much like the motion performed during a handshake. Each movement should last for 5 seconds and 3 sets of 10 such movements should be performed in each session.
Wrist Stretch: This is the process of bending the wrist with the help of the other hand. The next process is to stretch the fingers backwards with the help of the other hand. This posture should be held for 15 seconds and 3 sets should be performed.
Wrist Extension: This is an exercise where the body weight is placed on the wrist by keeping the palms down and legs straight. This exercise should be repeated thrice each lasting for 15 seconds.
Grip Strengthening: A soft rubber ball should be kept in the palm and squeezed for 5 seconds. This activity should be done 15 times twice.
Wrist Supination: This exercise involves the flipping of the forearm up and down for 5 seconds each. It can be done in sets of 10 each.
Once a person gets comfortable with the stretching exercises, the same exercises can be done with some weight in hand to further strengthen the muscles. Isometric exercises can also be practised. This is beneficial since they do not involve muscle contraction. A mix of all these exercises will help to mobilise the wrist. Apart from these exercises, certain other activities such as swimming, driving and cycling can be practised to ensure speedy recovery of the artist. At any point of time, a physiotherapist should be consulted before taking up any new exercise or activity that involves the wrist.
Having severe lower back pain with muscle spasm now the muscle twitches as X-ray shows spasm the vitamin d is 10 what to do it hurts a lot. I have this pain since 2 month.
Always make it a practice to encourage your children to inform you if they face any pain or discomfort in the neck or back before it becomes a serious problem.
Do they even treat scoliosis? Any exercises for scoliosis too? Any experience with scoliosis? I'm a girl aged 19. I have c shaped upper back scoliosis.
She's having very bad pain in her chest n her hand is also paining, feeling num. What could be the reason?
Heat treatment or thermotherapy is an effective process of healing from a sports injury. Understanding the when and how to use heat treatment is essential since it can even prolong the process of healing.
The Process Of Healing-
There are three stages of healing. The first phase is called the inflammatory phase. The goal for this phase is to ensure that no further damage happens to the affected area. It is during this phase that the swelling and the buildup of fluid happens. Heat treatment is not applicable here since it increases the blood circulation and can lengthen the healing process. The second phase is called proliferation. This is the phase where the introduction of scarring and new tissue takes place. This is the post-injury phase and heat treatment greatly helps during this time. The third phase is known as remodelling. It is the time when the new tissue matures and settles down. Thermotherapy can be applied in this phase as well.
Injuries that are treatable through thermotherapy-
Heat treatments are extremely effective in injuries such as muscle spasms along with back strains. It can also be applied to joint injuries related to a thumb, turf toe, elbow, wrist sprains and sprained ankles. The reason why heat treatment is effective in joint injuries is because heating significantly heats the bone and improves the range of motion. The idea behind any heat treatment is to make the tissue more extensible by warming it up. Exercises related to a range of motion should be performed for 15-20 minutes post the heat treatment.
How heat treatment helps in treating sports injuries?
Heat treatment significantly increases the blood circulation and help to eradicate dead skin and other toxic bodies from the origin of the injury.
It assists in metabolism of the cells.
It increases the capillary permeability.
It increases the number of nutrients and oxygen to the source of injury and speeds up the process of healing.
Heat treatments can cut down muscle spasms.
Types of Heat Treatments Available:
For heating deep tissues, ultrasound is the best form of treatment. It can penetrate up to 1.5 inches inside the skin. Basic strain injuries such as hamstring and rotator cuff are instantly treatable with ultrasound. This being said it is one of the most expensive methods of heat treatment. Then there is superficial heat therapy. This is convenient and readily available. They directly transfer heat from the source to the injury location. Common examples of these are a hot tub, paraffin bath and hot bags. The third type of heating mechanism is known as dry hot packs. They produce a steady source of heat and are run by either microwave or electricity. Caution should be taken in order to ensure that the heat does not burn the upper layer of the skin. If you wish to discuss about any specific problem, you can consult a Physiotherapist.
What are the causes for swelling on foot. Im 42 yr, weight 80 kg, im feeling small pain in foot and swelling on foot below ankle.
Hot packs are very effective as they dilate blood vessels and increase blood flow, delivering needed nutrients and oxygen to cells in the area being heated, aiding the removal of cell waste and promoting healing.
Hi, I am a 61 year old woman. However my heel has been paining for last several months when I walk. I am used to walking 5 kms per day but the heel pain has intensified. Could you suggest what I should do and if any tests are required.
Breaking a bone is, needless to say, a painful experience. But, when people have their broken bone put in a cast, they tend to forget about it until it comes out. This is quite wrong! A person would want to be up and running but does not find that the hand or the leg as it has been cast up. For weeks, the person's hand or leg barely moves and also shrinks up quite a lot!
There is a lot of pain, not only due to shrinkage when a fracture occurs. The occurrence itself causes what is known as acute pain. Then, for some weeks, the sub-acute pain just seems to persist, to the person having the fracture. The reason for this is the fact that the bone and the soft tissue are in the process of healing.
Chronic pain is a worry as it does not go away even after the healing process has ended. In order to make sure that there is a quick recovery and there is no chronic pain which is experienced at all, some of the proverbial leaves need to be taken out of the book of physiotherapy.
To start with, sometime between a fortnight and a month after the injury or the bone break has taken place, the doctor will wish to see some movement in the soft tissue that has broken around the bone. The great advantage of this is that while it may be a little bit of effort and time involved, there are great benefits by the way of less pain and swelling as the blood flows as normally as is possible.
If such movements are not done, a person can have related soreness, which can be even more of a pain! An example of this would be a broken foot or ankle causing the stiffness of the knee. When a person is already in pain, adding to his or her trouble makes no sense at all, does it?
Post one month mark, the physiotherapist would want to see more functioning so that the normal levels can be attained. A person who has a fracture should not despair as if he or she is willing to stick to the schedule given by the physiotherapist and perform all the exercises that have been set out, he or she will be back at the normal level much sooner than would have been expected!