19 Year old with Subacute back pain,aggravated with walking and relieved with rest

DISC RELATED BACK PAIN 
APPROACH AND RESTORATION OF NORMALCY


Seeing his on and off pain,and finally her mother  has to drag him from gym where he was ready to ignore his radiating pain.

Young adults are so fascinated about gym obsessed with bloated up curvish body that they go to any extent.

What made me alert is positive Crossed leg SLR and SLR rt leg 30 degree. Reduced knee Jerk(L3-4),EHL power is within normal limits.

history revealed his weight lifting acts.

Look at the graph above to appreciate how bad is lifting weight for our disc.

The Posterior (back wall) is thinnest at Lumbar level,So constant pressure of nucleus populous on the annulus fibrosis first make bulge then herniate and press the exiting nerve roots,Which becomes cause of sciatica.

When we rest in prone (face down and bhujangasana ) the bulge retracts in,and wall of annulus fibrosus get a chance to heal.

So rest from "provoking" factors are MOST ESSENTIAL  ingredient of treatment programme.

 Provoking mean those actions which increases intradiscal pressure.

I saw all 99.0% patients through with their problems of pain,sciatica,listing. )1% are those who could not comply with advises of  active rest or restricted activity.

Residual pain was treated with neural stretching exercises.

BEST EXERCISE or POSE TO REST IS ↓ YOU CAN PROGRESS THROUGH ALL THE FOLLOWING STAGES ONE B Y ONE starting from top to bottom image.

Here in this video you can see how you should lift heavy things.

• My observation has consolidated a lot in last 20 years on disc problems whether acute or chronic.
• In fact to be more precise I would say I treated severe and aggravated cases with this this new understandings on discs. 
• Proper discipline and increased understanding of us regarding disc has led to much improved result now with much  lesser bed rest.
• Earlier I used to go to home after referral from orthopedic for putting patients on 10 days of continuous traction. MEANS STRICT BED REST FOR 7 TO 10 days  with bed pan for toilet activities.

ATMNIRBHAR BHARAT- UNDERSTAND YOUR SHOULDER

Something clicked into my mind very recently when our Prime Minister Spoke on AtmNirbhar Bharat. I thought why not to empower our citizens with enough knowledge so that they can save their time,Money and energy for seeing a doctor straightaway

  
I am starting with shoulder pain today as someone in his 40 hasjust seeked my help as he is having pain in his shoulder since Feb 2020,He gave a history of sudden stuck by his shoulder while rising up,Now his chief complaints are that he cant raise his arm above shoulder height without severe pain.He also explains that while resting on that arm brings lot of pain,Plus it pains while  changing feel like a sudden blow.
WHIlE EXAMINATION I observed that when shoulder is elevated in internal rotation position of shoulder it pains,whereas there is NO pain in doing elevation when shoulder is in external rotation.Video of how to do simple examination of shoulder by ONE-SELF

With simple advise of REST from provocation of pain and with some support from Physiotherapy and Non steroidal Ant inflammatory drugs ,he is 90% better and is feeling he has improved to such extent.MY CONCLUSIONS ARE :

•  Identify root of one's problem by the methods I told,one can easily treat oneself. 

• Its the Diagnosis which is important . Diagnosis is mostly possible without any Xray/CT/MRI scan. (especially in cases I am telling here or intend to tell in future).

• In this case the Rest from Provocation is doing magic. He completely refrained from raising arm with internal rotation,avoided resting on arm.

For more on my work please visit  www.facebook.com/DhirajPhysioclinic 

                                      THANK YOU                                                

YOUR KNOWLEDGE IS YOUR DOCTOR

YOUR KNOWLEDGE IS YOUR DOCTOR SO KEEP IT AS CLOSE TO YOU AS POSSIBLE

KNOWLEDGE IS WISDOM ISN'T IT ?

Here is again a COVID19 Special post !!

Why I said so is because  that in this little socialization time,when we are still in unlock 2,we still tend to keep getting only negative thoughts,negative information more often. Being a Medical person I also couldn't avoid it.

BUT I NEVER CAN AFFORD TO FORGET

I would suggest to follow SEVEN STEPS TO COUNTER COVID19

1.USE MASK WHENEVER OUT,EVEN IF YOU THINK  NO BODY IS AROUND

2.KEEP WASHING HANDS REGULARLY.

3.GARGLE TWICE FOR TWO MINUTES

4.STEAM INHALATION TWICE FOR ONE MINUTE EACH.



5.DRINK ONE CUP OF  HOT WATER TWICE.


6.TAKE ONE GLASS OF IMMUNITY BOOSTER KADAS IN SIPS THROUGHOUT A DAY.

7.DEEP BREATHING/WEIGHT TRAINING/ STRETCHING FOR FLEXIBILITY.

THE ABOVE ↑ 7  THINGS WOULD HARDLY TAKE YOUR 1 HOUR TOTAL IN A DAY.

FULL COMPLIANCE WITH ABOVE WOULD KEEP YOU 99 %UNAFFECTED BY COV19.

IF YOU STILL FIND YOURSELF POSITIVE DONT FEAR ,

1.BE CALM FIRST THING
2. UNTIL UNLESS YOU HAVE BREATHLESSNESS ON WALKING SIMPLE DISTANCE 
3.UNTIL YOUR PULSE OXIMETER SHOWS LESS THAN 92.
4. UNTIL YOUR ESR IS LESS THAN HALF OF YOUR AGE 
5. UNTIL YOUR IL 6 IS LESS THAN 20 

NO NEED TO WORRY IF IT IS MORE STILL NO WORRY 

BECAUSE NOW RECOVERY IS RULE AND DEATH IS EXCEPTION

 BY - DR.KK AGGARWAL ,PADMSHRI