Doctor in sri sai mallikarjuna physiotherapy clinic
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 Splinting
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Heat Therapy Treatment
Post Pregnancy Classes
Orthopedic Physical Therapy
Treatment of Shin Splints
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Adhesive capsulitis is the medical term for a frozen shoulder, which can be caused due to a variety of reasons. Scar tissues can grow in the shoulder joint when the said joint becomes thicker. This development keeps the shoulder from rotating in a normal manner, which can lead to a frozen shoulder. The most common symptoms of this condition include severe pain and stiffness as well as inflammation. Here are the causes and ways to treat this condition.
Causes: A frozen shoulder can be caused due to a sports injury as well as an accident. Also, a hormonal imbalance can cause this condition. A weak immune system may cause inflammation in various joints of the body, which makes motion difficult. Also, diabetes can give rise to a frozen shoulder as a side effect. If you have a sedentary lifestyle and do not exercise often enough, or have just been through surgery which has led to a prolonged period of inactivity, then you can be prone to this condition. Surgery will also leave your tissue and adhesions sensitive to inflammation. Scar tissue may end up forming in very extreme cases, over a period of at least nine months. This can limit your motion.
Risk Factors: Besides diabetes, hormonal changes and inactivity, people who have been through a stroke or surgery are most susceptible to this condition. Also, patients who are suffering from thyroid disorders can end up developing a frozen shoulder too.
Physical Therapy: One of the most recommended ways to deal with this condition is with physical therapy. This kind of therapy will help you in stretching your shoulder so that you get back some motion over a period of time. This process can take anywhere between a few weeks to a few months, depending on the severity of your condition. You must ask your doctor about other treatment options if this kind of therapy does not show results even after six months of intense and regular practice. Physical therapy can also be practiced at home, once you have learnt the technique from a physiotherapist.
Medication: One of the other ways to deal with a frozen shoulder is with the help of medication. Anti-inflammatory and pain relieving medicines can soothe the discomfort. These include aspirin, ibuprofen, as well as naproxen sodium. Also, if you are undergoing a lot of pain, the doctor can administer a steroid injection in the shoulder joint.
Surgery: If medication and physical therapy do not help in treating the condition effectively, then one can go in for an arthroscopic surgery to remove the scar tissue with a small incision and other kinds of surgery for breaking the adhesions as well. In case you have a concern or query you can always consult an expert & get answers to your questions!
My mother aged 65 years has severe arthritis of both knees, should she get both knees replaced in one sitting?
You should do both knees in one sitting if the severity is same in both the knees and the patient is unable to differentiate the painful knee. In case the patient says one knee is more painful than address one knee at a lime. Your own knee is always the best till it lasts.
What are the advantages of doing both the knees in one sitting?
- Exposure to the risk of anaesthesia reduced to only once
- Aids simultaneous rehabilitation especially in severely deformed knees
- Bilateralprocedure reduces cost
- Earlier return to baseline function and convenience for the patient and relatives
- Shorter cumulative hospital stays
What are the risks associated with bilateral Total Knee Replacement (TKR) and are there any studies to support the same?
The risks of cardiac and infection related complications for bilateral TKR are lower than the combined risk of two unilateral TKRs. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-Bilateral Total Knee Arthroplasty published in The Journal of Bone And Joint Surgery.
Result: Records were available for 11.445 simultaneous-bilateral arthroplasty Procedures and 23.715 staged-bilateral procedures.
Conclusions: Simultaneous-bilateral total knee arthroplasty was associated with clinically important reduction in the incidence of infection and malfunction within one year after arthroplasty.
What is the latest Technology available which could help improve surgical outcomes?
Custom Fit Knee Resurfacing: A knee with your name on it i.e. customized specifically based on your dimensions.
Understanding Custom Fit Knee Resurfacing: You are unique and so is your individual anatomy and thus lack of accuracy leads to discomfort and even further corrective surgeries That is why Custom Fit Knee replacement surgery, which utilizes MRI (Magnetic Resonance Imaging) technology to create personalized positioning guides for total Knee replacement is recommended.
Practical Benefits Of Custom Fit Knee Replacement
- MRI of the affected knee is done based on which we can make a customized jig for better fitting of the implant for the patients
- No intra medullary instruments so minimal chances of fat embolism
- Minimally Invasive (just a 4-5 inch incision)
- Improves the speed of the operation theater time (40% reduced surgical time)
- Increases implant inventory efficiency (know sizing)
- Faster recovery of the patient
- Perfect patient alignment thus better mobilization
What is the role of body exhaust 'space' suits in Bilateral TKR?
- 'Space' suits maintain a more sterile environment and offer more mobility to the surgeons.
- Space suits are used to help reduce contamination from the operating teams from entering the wounds.
- The impure air exhaled by the operating team is pushed down by the rotating fan in the helmet of space suits and absorbed by the laminar air flow in the 0.T.
In case you have a concern or query you can always consult an expert & get answers to your questions!
ACL Surgery is basically Anterior Cruciate Ligament reconstruction, which is carried out for patients suffering from damaged ligaments which can lead to stiffness, pain and decreased mobility among a host of other symptoms and ailments. This kind of surgery aims at repairing the ACL with the use of grafts taken from other parts of the patient’s body. These grafts are used to replace the damaged ligaments.
Read on to know what you can expect in the recovery phase following an ACL surgery.
- Rehabilitation exercises: The rehabilitation process starts right after the surgery when the patient is given muscle strengthening exercises right after being wheeled back into the room from the operation theatre. These exercises will be given to the patient by the doctor or the physiotherapist who will show the correct way to do them and what all to avoid while doing them. Also, a gradual walking program will be started where the patient will first be helped when it comes to walking indoors, and then taken outdoors to practice walking on more natural terrain. Other motions can also be introduced gradually to exercise.
- Crutches: The patient may be asked to use crutches for a while right after the surgery. This is usually done to ensure that the body and the knees are strong enough to support full weight carriage and bearing without putting pressure on the newly operated region. Full weight bearing usually comes about within ten days after the surgery, and until then the patient is asked to take it easy.
- Knee extension: In the first few weeks after the procedure, the patient will experience swelling or inflammation in the area as well as some amount of trepidation when it comes to using the knee extension. The patient will be asked to do ninety degree knee flexicons before graduating to full knee extension gradually. In this phase, right after the surgery, the patient will also be encouraged to gain back control of the quadriceps as well as patellar mobility.
- Swelling: In the first two to three weeks after the surgery, there will be some amount of swelling. Usually, in the first two weeks after the surgery, the focus is on controlling and preventing any undue swelling and inflammation with elevation and ice.
- Strength and confidence: Once the initial three to four weeks are over, the focus will shift towards strengthening the core muscles with running and jogging for short periods. This will also improve the patient’s confidence in the restructured knee.
Ensure that you have a detailed discussion with your caregiver and orthopaedic specialist so that you are mentally prepared for recovery and rehabilitation. In case you have a concern or query you can always consult an expert & get answers to your questions!
What is a slipped disc?
Injury or weakness can cause the inner jelly like portion of the disc to protrude through the outer ring. This is known as a slipped or herniated disc. This causes pain and discomfort. If the slipped disc compresses one of your spinal nerves, you may also experience tingling, numbness and pain along the affected nerve. As the lumbar spine (lower back) carries most of the body weight, it tends to âslipâ more than higher levels.
What is the anatomy of disc herniation / herniated disc/ slip disc /sciatica?
Human spine is made of up 33 bones (vertebrae) that are cushioned by discs. These vertebrae are divided by region: neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). At the lower end of your spine, you also have the sacrum and the coccyx, which is commonly called your tailbone. Discs are present between these bones. The disks protect the bones by absorbing the shocks from daily activities like walking, lifting, and twisting. Each disc has two partsâa soft, gelatinous inner portion (nucleus pulpous) and a tough outer ring (annulus fibrosus). Together, the vertebrae and discs form a tunnel through which the spinal cords and nerve pass.
What are the causes of slip disc?
The etiology/cause of slip disc is multifactorial; there is no evidence to prove/disprove the quantitative effect of one or other. The risk factors for slip disc can be:â¨â¨â¢ life style: stress and emotional tension, poor posture -standing for long periods of time or sitting incorrectlyâcan cause slip disc, heavy physical work, lifting or forceful movement, bending, or awkward positions can really hurt your back.â¨â¢ obesity: being overweight puts pressure and stress on the back, especially the low back. Carrying excess weight aggravates other health conditions such as osteoporosis (weak bones), osteoarthritis (joint pain), rheumatoid arthritis (an autoimmune disease), degenerative disc disease (described above in the aging section), spinal stenosis, and spondylolisthesis.
What are the symptoms of herniated disc or slip disc?
Symptoms of a slipped disc include: sciatica â pain in buttock radiating to legâ¨â¢ pain and numbness, most commonly on one side of the bodyâ¨â¢ pain that extends to your arms and/or legsâ¨â¢ pain that worsens at nightâ¨â¢ pain that worsens after standing or sittingâ¨â¢ pain when walking short distancesâ¨â¢ unexplained muscle weaknessâ¨â¢ tingling, aching, or burning sensations in the affected areaâ¨â¢ sciaticaâ a sharp shooting pain that can extend from the buttock into the leg and sometimes into the foot.â¨â¢ muscle spasm, locked back, stiffness in back, morning stiffness.â¨â¢ although rare, herniated discs can cause you to lose bowel or bladder control known as cauda equine syndrome and one should seek medical advice as prognosis deteriorates with time. One can know whether this is happening to him or not if he has urgency /frequency of urination or loss of control of urination or sudden peri anal anesthesia.
When do I need to have a spine doctor opinion?
Patients with progressive symptoms in leg / back need a specialist opinion to diagnose and treat the problem.â¨â¨symptoms which need specialist attention (red flags) are:â¨â¨1. Persistent leg painâ¨2. Numbness in legâ¨3. Weakness in legâ¨4. Difficulty in walkingâ¨5. Unable to control urine / motionâ¨â¨symptoms like bowel and bladder urinary incontinence shall seek urgent / emergency opinion /management by the spine specialist.
Which tests will be needed to confirm the diagnosis?
Imaging studies / investigations help to arrive a diagnosis of slip disc / herniated disc and include:â¨â¢ x-raysâ¨â¢ mri scansâ¨â¢ disco grams, which are rarely utilized.
What are the treatment options for slip disc?
There are different options to treat slip disc depending on the severity and duration of symptoms. They may comprise of one or many:â¨â¨1. Drugs & medicationsâ¨2. Spinal injectionsâ¨3. Spine surgeryâ¨â¨drugs, medications, to relieve slip disc: medication alone is not the ultimate solution to your back pain, however during emergency or during severe pain these medicines may help you curb the suffering. paracetamol:â¨your doctor may call this an analgesic, they donât help reduce inflammation, though. nsaids (non-steroidal anti-inflammatory drugs):â¨these will help reduce swelling (or inflammation) while relieving your pain; thatâs how nsaids differ from paracetamol.â¨â¨muscle relaxants: which will help stop the muscular spasms.â¨â¨anti-depressants:â¨as surprising as it may seem, anti-depressants can be effective drugs for treating pain because they block pain messages on their way to the brain. They can also help increase your bodyâs production of endorphins, a natural pain killer.â¨â¨opioids:â¨in the most extreme cases, and only under careful supervision, you doctor may also prescribe an opioid.â¨â¨medication warning:â¨as with all medications, you must follow your doctorâs advice precisely.
(a) injection techniquesâ¨â¢ root block injectionâ¨â¢ epidural injectionâ¨â¢ caudal block injectionâ¨â¢ facet block injection
The options of surgery are
â¢ decompressionâ¨â¢ spinal fusionâ¨â¨the spine surgery advised for slip disc can be performed in many different ways. The success rates of surgery in slip disc/ herniated disc / sciatica is 98 % and with invention of modern technology and minimal invasive surgery techniques it nears 100 %. Spine surgery can be performed in different manners:-â¨â¨â¢ conventional open surgeryâ¨â¢ minimal invasive spine surgery â key hole spine surgeryâ¨â¢ endoscopic spine surgeryâ¨â¢ microscopic spine surgeryâ¨â¢ micro endoscopic spine surgery
â¢ facetectomy: a procedure that removes a part of the facet (a bony structure in the spinal canal) to increase the space.â¨â¨â¢ foraminotomy: a procedure that removes the bony compression over foramina (the area where the nerve roots exit the spine) to increase the size of the nerve pathway.â¨â¨â¢ laminoplasty: a procedure makes more room for the spinal canal.â¨â¨â¢ laminotomy: a procedure that removes only a small portion of the lamina (a part of the vertebra) to relieve pressure on the nerve roots.â¨â¨â¢ micro-discectomy: a procedure that removes a disc through a very small incision using a microscope.â¨â¨â¢ laminectomy: a procedure for treating spinal stenosis by relieving pressure on the spinal cord.â¨â¨spinal fusion: surgery intends to stabilize an unstable segment responsible for pain, this may involve putting some screws in your spine to increase stability.â¨â¨various options of doing spinal fusion are plf /plif/tlif/ alif/xlif.