knee and joint pain

Comprehensive overview of knee and joint pain, its symptoms, causes and relief measures

 

What is the prevalence of knee and joint conditions in the UAE?

Knee Pain is one of the most common complaints these days among people of all age groups. Every individual experiences this issue at some point in their life. The level of pain also varies in each individual. For some, the pain may be so extreme that it limits daily activities and in others, it may not be as severe and may not be so much of a hindrance in their daily life. In both cases, what people fail to realize is that they are dealing with a condition that needs to be attended to and not ignored at all.

 

In your opinion, what are the main causes of these problems?

Knee pain is a very common issue that can happen at either the knee joint, the knee cap or the ligaments of the knee. There is not just one particular reason for the cause of knee pain because the knee has various parts. It could be caused due to physical injuries that occurred during some physical activity, continuous injury, a mechanical problem like dislocation of the knee cap, obesity or because of a certain condition like arthritis. Arthritis is a very common cause of knee pain which is further divided into different kinds like Septic Arthritis caused by a bacteria attacking the joint, Post-traumatic Arthritis which may develop years after having a knee injury etc. Most of the time body movements do not pose  a problem but constant wear and tear or injury are what leads to severe pain. The knee is the largest joint in the body. The bones inside the knee joint are covered by an articular cartilage which provides a smooth gliding surfacing for joint movements. When any of this is disturbed the body reacts in the form of pain.

 

Does the lack of exposure to sun rays and vitamin D deficiency play a role in the prevalence of knee and joint conditions?

Vitamin D is extremely necessary for the body to absorb calcium and promote bone growth. Deficiency of Vitamin D results in soft and fragile bones in children which lead to rickets causing bowed legs and other skeletal deformities whereas in adults misshapen bones leads to a condition called Osteomalacia. Vitamin D deficiency also causes a lot of other health problems including obesity. Since knee and joint conditions are prevalent in people of all ages, the amount of Vitamin D requirement also varies. Aged people need more Vitamin D than the younger ones, dark-skinned people need more than the fair skinned, overweight people also need it more. Vitamin D is not a vitamin because a vitamin is something our body cannot make and hence needs to be provided by something we eat or with supplements. Our body can make Vitamin D from exposure to sunlight. People with very low Vitamin D are more likely to develop bone or joint pains. Rickets, Osteomalacia, and Osteoporosis are the most common bone disorders found in adults. Osteomalacia is caused by a defect in the bone-building process and Osteoporosis results from the weakening of a previously constructed bone.

 

How many patients visit Aster Hospital for these types of consultations? And what is the percentage of these patients who undergo surgical procedures?

Aster provides comprehensive Orthopedic care including surgical and non-surgical care. We are equipped with state of the art equipment and procedures and offer advanced procedures in various fields to give our patients the best treatment. Aster has a number of experienced and respected orthopedic specialists who have to their credit the knowledge and expertise in their field.

 

What are the precautionary measures to avoid knee and joint injuries?

Staying physically active and keeping the body fit is the best way to avoid the risk of knee pain or injury. However, in certain cases, knee problems caused by a particular activity or by accident cannot be avoided as they can’t be foreseen. There are certain preventive measures that can be taken to avoid any serious knee or joint issue. Firstly, being healthy by eating a balanced diet and maintaining a healthy weight to avoid excess stress on the knee. Secondly, always wearing sensible shoes that fit perfectly and offer the right kind of support because this helps maintain the leg alignment when walking. Wearing insoles in shoes to maintain a balanced body posture is also advisable. These are two things that people generally tend to ignore because they don’t realize how wearing the right fit shoe helps avoid serious consequences. Stretching the thigh muscles before beginning an activity reduces tension on the tendons and relieves pressure on the knee during the activity. Certain exercise routines can be followed that aid in strengthening the leg muscles. Taking the stairs up is a very good practice, riding a bicycle is a good way to make the leg muscles stronger. Weights are also a way to strengthen the leg muscles supporting the knee but these workouts need to be done under the supervision of a trainer. Sudden change in workout routines should be avoided, the intensity and duration of the activity should always be changed with a gradual build up. Opting for workouts that are strong but of low impact to the knee is recommended. A physiotherapist should be consulted for exercises.

 

What are the symptoms that patients need to be aware of that call for consulting a specialist?

Knee Pain that is caused as a result of a strenuous activity and that is usual could be managed at home itself or one that is caused because of a minor injury could be self- observed for a day or two and then the required steps can be taken. However, if you are suffering from extreme pain it is better to seek medical help. When unsure of whether or not to consult a doctor, some symptoms that need to be taken into consideration are continuous pain that lasts for days or weeks, any form of swelling or redness around the knee, any feeling of instability in the joints, acute injuries discomfort or difficulty in walking etc. On experiencing any of these symptoms it is best to consult an orthopedic specialist who as per diagnosis will suggest the necessary treatment.

 

UAE residents and medical tourists complain of the high costs associated with orthopedic surgery especially if they do not have insurance. What is your comment on that? (Might be good to highlight that Aster provides affordable high-quality health care which is in line with the group’s vision.)

The Department of Orthopaedics at Aster Hospital is a state-of-the-art facility offering comprehensive care to patients of all ages. We have an exceptional team of doctors comprising orthopedic surgeons and physical medicine experts who have the experience and expertise to handle various cases and are supported by specialty-trained nurses, patient counselors and physical rehabilitation therapists. They follow international treatment protocols to ensure optimal, evidence-based care to patients, at affordable prices as compared to the other hospitals in Dubai.

Orthopedic surgery procedures performed in Aster Hospital are cost effective compared to the surgery cost in other developed nations. Besides the cost, patients save time and getting the treatment is very convenient and fast. Countries that operate public health-care systems, such as Canada, U.S., and the U.K. often have long waiting periods for certain operations.

Aster DM Healthcare is committed to providing world-class Healthcare, at affordable costs. Lack of insurance cover or its limitations is faced by citizens in all countries. Patients are finding that insurance either does not cover orthopedic surgery (such as knee or hip replacement), or limits the choice of the facility, surgeon, or prosthetics to be used.

 

Does Aster Hospital provide attractive healthcare packages that encourage medical tourism?

Aster Hospital offers comprehensive treatment plans and wellness packages for patients that are coming from other countries. The packages have detailed inclusions and exclusions, making it easy for medical tourists to select a treatment that is suited to their budget. To further assist overseas medical tourists, we assist with travel requirements including visa requirements (if needed) and the option of booking both hotel stays and return flights. Patients can Skype with our doctors and discuss their treatment plans before they plan their travel. On arrival, a representative of the team will receive the patient at the Airport and we provide transport to Hospital or Hotel as per the admission plan. A Guest Relation Executive will complete formalities like registration, admission and signing of the consent forms and so on. Interpretation and translation services are also available on request. Post treatment, patients can keep in touch with our medical team for follow-up once they are back in their country.

 

Knee and joint pain is now common among the youth as well and is not restricted to the elderly, what are the causes for this?

Knee pain is very generic, it doesn’t limit itself to people of a particular age. Knee and joint pain are rather common among the youth because of various underlying reasons. A lot of young individuals who are involved in any form of physical activity or those who are very actively involved in sports suffer from knee and joint pain.  The pain will be experienced gradually and will flare up on repeated flexing on the knee. In such cases the causes may be inappropriate training (gym) techniques or excess sports activities, ignoring certain injuries leaving them to recover on their own, inflexibility of the thigh muscles supporting knee movement etc. There are also other causes for knee pain in teenagers and young adults. In today’s day and age, children prefer to stay at home and watch TV or play on their mobiles rather than going out for some physical activity which leads to obesity. An inactive lifestyle is a core contributor to aches and pain. Physical demands at home and work have become lesser owing to technological advancements and conveniences.

 

Dr. Ranjith Narayan

Orthopaedic Specialist, Aster Hospital

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ThinkstockPhotos-477061785

Managing Stress On Your Fertility Journey

There are many reasons for stress 
  • Changing of jobs
  • Changing homes
  • Dealing with the major illness of yourself or your loved one.
  • Emotional stress
  • Death of a loved one
One of the major reason researchers added for stress is trying to conceive. The fertility journey is loaded with lots of stress.
Normally the journey doesn’t start that way. In the start, people pretend to be more optimistic and assuming that they will get pregnant in few months. No one ever thinks that they’re going to be the ones to have trouble with getting pregnant and having a baby.
But then as the time passes and the reality hits in, the stress level goes high and increases the disappointments of countless heartbreaks. The distress of actually not getting pregnant, having miscarriages or even seeing your friends get pregnant increases the stress and the cycle becomes a vicious circle.
It is very confusing to decide whether stress is the reason for infertility or infertility is the reason for stress.
The answer is both. Chronic stress can affect ovulation by changing signals to the brain and pituitary gland that regulate the production of the reproductive hormones.

So it’s truly an amazing thing to discover different stress relieving activities. Few of them are mentioned below:
1) Write it down: Studies show that maintaining a journal can help relieve stress. People who do not have anyone to share their stress/problems, this can turn out to be the best option. Keep it personal and express whatever you like.
2) Connect with nature: The fresh air, gentle breeze, the sunshine and Vitamin D can help to calm you down. If you feel some stress, go out and explore the nature, this will give you exactly what you need to push through the stress you’re feeling at the moment. Exercise can also help in stress reduction. It can both reduce your anxiety and improve your mood.
3) Meet your companions and family: We are social creatures and there is always a want and need of a friend or a companion for support. The fertility journey can be such a lonely, isolating one that this support is crucial for your wellbeing.
4) Spend time with your partner:  This journey can overtake your life, if you plan a date day or a date night every once in a while where you do the activities together that you enjoy, and talk about things other than your fertility, that will do wonders for both of your stress levels. It’s really important to remain connected with your partner during this time. You’re on the fertility journey together, and it’s the kind of thing that can bring you closer together.
5) Take the help of your Doctor: It’s very important to take a consultation with a doctor and seek their help. For appointments with our doctor at Aster IVF, you can call us at 800 900 800 or email us at info@asterivf.com.
Dr. Sreelatha C G
Specialist Obstetrics & Gynaecology
Aster IVF & Women Clinic
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Gastroesophageal reflex disease

The gastroesophageal reflex disease is a chronic condition of mucosal damage caused by acid coming up from the stomach to esophagus. It is usually caused by changes in the junction between stomach and esophagus including abnormal relaxation of lower esophageal sphincter (les) or a hiatal hernia, obesity, zollinger Ellison syndrome, high blood calcium level etc.

 
Signs and Symptoms

• Heart Burn an acidic taste in the mouth

• Regurgitation

 
Less Common:

• Pain in swallowing /sore throat

• Nausea

• Chest Pain

• Coughing

 
Investigation

1. Upper GI Endoscopy

2. Esophageal ph monitoring

3. Barium swallow x-rays study

4. Esophageal manometerY

5. Medical management involves lifestyle modification which includes weight loss, advance of certain Medical management involves lifestyle modification which includes weight loss, avoidance of certain foods, elevating head end of bed, stop smoking and medications like PPI.

 
Indications of operations:

• Failed medical management

• Noncompliance

• High vol reflux

• Severe esophagitis/benign structure

• Barrett’s esophagus

 
The treatment of choice is laparoscopic Nissen fundoplication (floppy) with hiatal hernia repair if present. Patients undergoing laparoscopy has less pain, short hospital stay and faster return to work. We operated two patient at Aster hospital Mankhool both of whom had GERD with a hiatal hernia. Patients were aged 32 years and 56 years on PPI for few years and both had severe symptoms of chest pain. They had undergone endoscopy and PH studies and manometer,

 

 

Understanding Manometry

The throat(esophagus) is a strong tube that interfaces your throat to your stomach. With every swallow, the throat(esophagus) muscle contracts and pushes nourishment into the stomach. At the lower end of the throat, a valve (an uncommon sphincter muscle) stays shut aside from when sustenance or fluid is gulped or when you burp or regurgitation.

 

 

What is esophageal testing, also called manometry, and why is it performed?

Esophageal testing or manometry measures the pressures and the example of muscle withdrawals in your throat. Variations from the norm in the constrictions and quality of the muscle or in the sphincter at the lower end of the throat(esophagus) can bring about agony, heartburn, and/or trouble gulping. Esophageal manometry is utilized to analyze the conditions that can bring about these side effects.

 

 

 

Rahul Tugnait - General Surgery-min-min

Dr, Rahul Tugnait

MBBS, MS ( surgery), MRCS(England), FIAGES, FAMS Specialist General Surgeon

Aster Hospital, Mankhool

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orthopaedic

Orthopaedic Surgery FAQs

What is the prevalence of Orthopaedic issues in the  UAE? Do you witness more patients with orthopaedic issues caused by injuries or diseases?

 

Though however there is no exact prevalence or studies scientifically done in this regard at UAE. In general reviews and individual assessments; the prevalence of orthopaedic degenerative diseases associated with work  are amicable. Secondary to misuse or use too much of the body parts irrelevant to the physical fitness of an individual are more compared to trauma or sports injuries. As the foreign workers are more at all the categories of the jobs including hard manual laborers in UAE concentrating on time, job, earnings and ignoring the quality of life and health at present and future.

What are/is the most common Orthopaedic issue you witness at the hospital or clinic  – knee pain, osteoporosis, sports injuries etc.?

Degenerative diseases involving the axial skeleton are witnessed mainly at the healthcare sectors. Like for Eg: Knee, Hip, Shoulders, Elbows, Spine, and Limbs are more witnessed both at clinics & hospital. Osteoporosis, Occupation induced injuries or hazards and sports injuries are mainly  undiagnosed generally as the accessibility of a common labour worker to the specialist is hindered due to inadequate time and work constraints apart from the insurance restrictions and policies. All of this leads to the advancement or worsening of the diseases.

Can you share more information on why patients should opt for Laparoscopic surgery, rather than traditional? (Can we have specifics)

In Orthopaedics; Arthroscopic Surgeries / Key hole Surgeries / MIS (Minimally Invasive Surgery) should have opted for patients in view of benefits for a patient and the company. As patient can be rehabilitated early, less stay in the hospital and back to work at the earliest which is beneficial to the either. And in overall, the cost expenditure will be comparably less.

  • For instance traditional might require 5 days of hospital stay, whereas arthroscopic surgeries would allow for next day recovery and treated as a day care surgery and discharged on the same day of admission most often.
  •  Is it more cost-effective? Of course, it’s more Cost-effective when taken only the surgical charges into consideration but when compared to the traditional surgeries the cost or expenditure will be less or nearly the same in overall as keeping in view of the hospital stay, Expenses on medicines. Etc having an impact in the Physical, Mental, Financial, Psychological and Occupational stress to the patient and its family.
  •  Is it more reliable? Does it have a higher chance of preventing future re-occurrences? It is reliable; Prevention of future recurrences can be done but in orthopaedics, the problems are the structural damages or changes occurring within the body. Henceforth with age and time subtle variations are expected and can be addressed accordingly.
  • Is post-operative pain management better? Yes, Post-operation pain management is easier and much better when compared to the traditional method of management as its less invasive, less tissue damage, less loss of blood and hence less pain. It is also better manageable and easily acceptable by the patients.

What are some recent studies you have come across that justify the case of minimal invasive or laparoscopic?

 

I have come across with many studies and few links are mentioned below for detailed knowledge on the topic.

–   www.ncbi.nlm.nih.gov/pmc/articles/PMC3117522/

–   orthoinfo.aaos.org/topic.cfm?topic=A00543

–   jbjs.org/content/85/11/2069

 

Following are the benefits of  MIS Spine Surgeries and  Arthroscopic Joint surgeries. 

  • Day care procedure less hospital stay,
  • Early rehabilitation,
  • More cosmetic,
  • Back to work at earliest,
  • Less morbidity in experienced hands,
  • Generally acceptable by the majority of population.

Do you have two patients that could speak on this?

 

I do have two knee replacement patients could speak about; but there’s nothing like MIS in knee replacement.

 

 Is there something different that Aster provides in laparoscopic technology?

 

We have dedicated Orthopaedic Operation Theatre and advanced Radiological facilities, Physiotherapy and rehabilitation centre which ensures faster recovery and post-operative care.

 

Dr. Manjunatha Ganiga Srinivasaiah

Orthopaedics

Aster Clinic

 

 

 

 

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Breastfeeding tips for the working mom

Your Maternity leaves are over, joining work back and worried most about the fact that you won’t be able to breastfeed your baby regularly?

Do not worry! We have a few tips that will help you continue to breastfeed your baby and be the work diva that you are.

Express and store

Pumping is easier than it sounds or looks. As long as you have a good pump around, you can conveniently pump either at home or at work and store the milk for later use. Try and opt for an electric pump rather than a manual one. Electric pumps are more efficient and take less time for getting the required quantity.

Always have a supply of sterilized bottles and keep everything ready before you sit down to pump. Some pumping machines come with their own cleaning kits however if you do not have one, keep a fresh supply of wipes ready to clean up after pumping. Once you have expressed, store the milk in favorable conditions for later use. You can also freeze the milk so that it will last longer.

Have the baby close to your workplace

If this option is available for you, take your baby to work or work from a place that is closer to your home. In this way, you can take frequent nursing breaks and feed the baby as required. Some workplaces are supportive in terms of allotting space for the baby and nanny so that you can have the baby close at all times.

In case having the baby at your workplace is not possible you can look for a day care centre close to your work area and run to it, if possible, wherever it is the time to feed.

Time the feeds

You may want to time your feeds so that you feed the baby just before leaving home and feed the baby again as soon as you are back. The remaining feeds during work time can be given as formula milk or you can have the expressed milk shared with daycare if they can keep it in right conditions and can feed the baby at right intervals.

Please remember that if you stop feeding or expressing, the milk formation will slowly reduce and you will be forced to opt for formula milk. So try to exclusively breastfeed for as long as you can so that both you and the baby reap the benefits of it!

 

Dr. Sejal Devendra Surti

Specialist Obstetrics and Gynaecology

Aster Hospital

 

 

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