Rathi Orthopaedic & Spine Clinic

Hello friends,

I am Dr Akhilesh Rathi I am practicing Orthopaedic and Orthoscopic surgeon in Dwarka.

Today I will be discussing about shoulder pain in the elderly, shoulder pain has been a very common problem and you must have heard that term frozen shoulder, heard similar kind of terms in your relatives or elderly people. So, these days very effective treatment for these kind of pain are available and because these diseases can be very debilitating. People are there who are unable to lift their arms to the routine course, so in these patients there are lot of treatment options are available if timely manage they can be done even in the non surgical way. So to start with the first and foremost treatment for most shoulder problems like the rotator cuff tendinosis and rotator cuff tear most patients can we manage with simple stretching exercises, range of motion exercises, shoulder strengthening exercises and some physiotherapy. So these patients recover well and they are able to manage their pain and regulate their routine with these exercises. Apart from these around 10 to 20% of the patients who do not improve with these exercises and are suffering from bigger tears or bigger problems, in these patients there highly advanced treatments are available nowadays. What we call as shoulder arthroscopy, arthroscopy means like you have must heard about laparoscopy where surgery is done in the abdomen through small portals. Nowadays, we can do surgery in the shoulder through small tiny incisions, 3 to 4 incisions and repair all the damage muscle in there. So even in those patients who are unable to lift their arm or move there arm or shoulder is stiff despite the physio, despite the exercises in those patients we can make it better. We can even think about having almost 100% normal kind of lifestyle. So I would like to restress is whenever you are having any shoulder pain, any stiff shoulder and it is not improving after 4 to 6 weeks then please do get it checked by an orthopaedician near you and most likely it will manage with physiotherapy and exercise and if it doesn't improve with physio, exercises I think you might need injection the shoulder or maybe orthoscopic surgery which can make it normal and which can repair the damaged muscle. Because if you delay too much, there are chances the damage muscle may retract and it may not be fixable even with the orthoscopy anymore. So the timing of your visit to your doctor is important, don't delay, don't ignore your shoulder pain, don't ignore your stiff shoulder. So because if you ignore it then you won't be able to operate and fix it arthroscopically, in those cases in which we done lake, the muscle has already retracted or is unrepairable then we need to replace the joint. So the best option is get yourself timing check, if your shoulder pain is not going in 4 or 6 weeks think about visiting your doctor and get it fixed and thank you all for listening to me patiently.

You can take my appointment online through Lybrate or any other online portal. I am available in sector 7 Dwarka, I have a clinic by the name of Rathi Orthopaedic and Spine Clinic.

Thank you so much.

Hello friends,

I am Dr Akhilesh Rathi I am a joint replacement, orthoscopic and orthopedic surgeon practicing in Dwarka.

Today I will be talking about the knee pain in elderly, knee pain in elderly is very common issue and you must have seen people around you elderly people having a lot of knee issues. So the first and foremost issue, we get manage is simply by some lifestyle modification, exercises, some weight control all these things help a lot in making knee pain better. So quadriceps exercise are the key to any kind of knee pain, plus there are some sessions which we can take at with the physiotherapist which help in making the knee pain better, also a lot of supplements are available like glucosamine and many other are available which your doctor can prescribe you so that it can improve the cartilage damage and also prevent further damage. Apart from that you can also take about some injections which are available which are the hydraulic acid and other viscosupplements which are available for improving the knee pain and the cartilage quality. So most of the patients almost believe me 90 to 95% of the pateints can be managed with this simple measures. In those patient in home despite all the measures have mentioned patient is still having pain, he is still having difficulty walking, he is still having difficulty in doing his routine course we should think about other options. Usually if the age is around 66, 55, 60 we can think about knee replacement surgery and if the patient is of younger age we can think about other osteotomy surgeries like the white osteotomy. So knee replacement is a good option in these patients in home other measures like the conservative measures I have already discussed are not working. So the timing of knee replacement is very important considering the fact that we only change the joint and not the muscle. So if you are not walking for a significant period of time maybe a year or two because of the knee pain your muscles will go down and despite the knee replacement your surgery may not be a successful. So usually my indications for knee replacement, includes if you are walking distance going down you are not able to walk for 20 to 30 minutes and the stretch, your knees are bending and your xray is showing significant osteoarthritis grade 3 or grade 4 osteoarthritis, you should think about knee replacement. So to conclude I will like to say that knee problem have solution and most of the time you can manage it with simple measures like your weight control, exercises and lifestyle modification like avoiding squatting, sitting cross legs, avoiding for long standing and avoiding stairs. Also kindly note and never said not to walk, so even in severe pain maybe a day or two you can avoid walking but otherwise walking is good for your knees so don't cut it out and a timely done knee replacement can save you from lot of medical issues apart from saving your new problems.

Thank you so much.