High Fever And Leg Pain

Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Stretching and strengthening exercises or use of specialized devices may provide symptom relief. These include: physical therapy. A physical therapist can instruct you in a series of exercises to stretch the plantar fascia and achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist might also teach you to apply athletic taping to support the bottom of your foot. Night splints. Your physical therapist or doctor might recommend that you wear a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and achilles tendon in a lengthened position overnight and facilitates stretching. Orthotics. Your doctor might prescribe off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly. Injections. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture. More recently, platelet-rich plasma has been used, under ultrasound guidance, to provide pain relief with less risk of tissue rupture. Lifestyle and home remediesto reduce the pain of plantar fasciitis, try these self-care tips: maintain a healthy weight. Lose weight if you're overweight or obese to minimize stress on your plantar fascia. Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency. Don't go barefoot, especially on hard surfaces. Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you're a runner, buy new shoes after about 400 to 500 miles of use. Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging. Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation. Stretch your arches. Simple home exercises can stretch your plantar fascia, achilles tendon and calf muscles. Prevention: maintain a healthy weight. Choose supportive shoes. Don't wear worn-out shoes. Heel pain apply ice use an ice pack or cold compress on your foot for 10 to 15 minutes at a time. This is especially beneficial at the end of a long day or when you’ve spent a lot of time on your feet. Or, roll a frozen water bottle under your foot. This method incorporates a bit of massage, relieving tightness in the bottom of your foot. Massage. Massaging the arch of your foot helps to relieve pain and promote mobility. Use your fingers and knuckles to deeply massage your foot for 1 to 5 minutes at a time. One technique is to place both thumbs at the center line of your arch and move them to the outer edges of your feet. Inserts. Use cushion inserts in your shoes for additional support and cushioning. Inexpensive options can be purchased off the shelf. Wear supportive shoes with thicker soles and extra cushioning for additional support that can help to reduce tension in the plantar fascia. Kinesiology tape can be used to improve arch and heel support. Night splints. Many people find quick and effective results by using night splints. They can be worn while sleeping to stretch the plantar fascia. They help to keep the plantar fascia relaxed and prevent you from pointing your feet down. Exercise foot flex use your hand to pull your toes back toward your shin. Hold this position for about 30 seconds .do each side two to three times. Toe towel grab place a small towel under your foot. Curl your toes to grip the towel. Raise the front of your foot off the floor. Hold this position for a few seconds. Release the towel as you lift up your toes and spread them as far apart as possible. Heel and calf stretch to do this stretch: 1.stand facing a wall. 2.place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3.lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4.change legs and repeat. 5.do this stretch twice for both legs. Golf ball roll roll a golf baell under your right foot. Continue for up to 1 minute. Do each foot two to three times. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Shoulder pain: do’s and don’ts for shoulder pain do’s do the prescribed exercise regularly to maintain strength, flexibility and range of motion. Do keep the affected arm supported. Use an ice pack for pain relief. Apply the ice pack 3-4 times a day for 10 minutes. Don’ts don't sleep on the affected side. Don't lift heavyweight with the affected arm. Don't jerk your shoulder to avoid stress. Don't use the arm to push yourself up in bed or from a chair. Don't participate in contact sports or do any repetitive heavy lifting. We suggest you to wear shoulder support brace which is available in two different sizes which makes the patient to feel comfortable as it maintains the shoulder in anatomical position and the short lever is maintained. The reason to maintain the short lever in the shoulder joint is it helps the shoulder to prevent the movements which itself is the key to have better progression of healing in the shoulder region. This is suggested for the following conditions. This shoulder support brace what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Strenghtening exercises 1.pendulum stretch do this exercise first. Relax your shoulders. Stand and lean over slightly, allowing the affected arm to hang down. Swing the arm in a small circle — about a foot in diameter. Perform 10 revolutions in each direction, once a day. As your symptoms improve, increase the diameter of your swing, but never force it. When you're ready for more, increase the stretch by holding a light weight (three to five pounds) in the swinging arm. 2. Towel stretch hold one end of a three-foot-long towel behind your back and grab the opposite end with your other hand. Hold the towel in a horizontal position. Use your good arm to pull the affected arm upward to stretch it. You can also do an advanced version of this exercise with the towel draped over your good shoulder. Hold the bottom of the towel with the affected arm and pull it toward the lower back with the unaffected arm. Do this 10 to 20 times a day. 3. Finger walk face a wall three-quarters of an arm's length away. Reach out and touch the wall at waist level with the fingertips of the affected arm. With your elbow slightly bent, slowly walk your fingers up the wall, spider-like, until you've raised your arm as far as you comfortably can. Your fingers should be doing the work, not your shoulder muscles. Slowly lower the arm (with the help of the good arm, if necessary) and repeat. Perform this exercise 10 to 20 times a day. 4. Cross-body reachsit or stand. Use your good arm to lift your affected arm at the elbow, and bring it up and across your body, exerting gentle pressure to stretch the shoulder. Hold the stretch for 15 to 20 seconds. Do this 10 to 20 times per day. 5. Armpit stretch using your good arm, lift the affected arm onto a shelf about breast-high. Gently bend your knees, opening up the armpit. Deepen your knee bend slightly, gently stretching the armpit, and then straighten. With each knee bend, stretch a little further, but don't force it. Do this 10 to 20 times each day. Starting to strengthen as your range of motion improves, add rotator cuff–strengthening exercises. Be sure to warm up your shoulder and do your stretching exercises before you perform strengthening exercises. 6. Outward rotationhold a rubber exercise band between your hands with your elbows at a 90-degree angle close to your sides. Rotate the lower part of the affected arm outward two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day. 7. Inward rotation stand next to a closed door, and hook one end of a rubber exercise band around the doorknob. Hold the other end with the hand of the affected arm, holding your elbow at a 90-degree angle. Pull the band toward your body two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day. Shoulder exercises and stretches regular exercises and stretches can keep your shoulder strong and flexible. A few things to remember before swinging in to exercises: •stop any exercise if you have more shoulder pain. It may be too soon for you to try. •watch your form. Exercising incorrectly can also cause or worsen shoulder problems. •warm up, even before deep stretching. Light shoulder rolls, gentle movements, or even a warm shower are all ways to warm up your muscles before exercise and stretching. Pendulum stretch for range of motion•stand and bend at the waist. •let your arm on the injured side hang straight down. •keep your neck relaxed. •move your arm in a circle up to 20 times. •do once or more times in a day. Overhead shoulder stretch•sit or stand to do this shoulder stretch. •intertwine your fingers in front of you. •bend your elbows and raise your arms above your head. You can also place your hands on your head or behind it. •gently squeeze your shoulder blades together to move your elbows back. •continue for up to 20 repetitions. Repeat 5 to 10 times a day.Exercise foot flex use your hand to pull your toes back toward your shin. Hold this position for about 30 seconds .do each side two to three times. Toe towel grab place a small towel under your foot. Curl your toes to grip the towel. Raise the front of your foot off the floor. Hold this position for a few seconds. Release the towel as you lift up your toes and spread them as far apart as possible. Heel and calf stretch to do this stretch: 1.stand facing a wall. 2.place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3.lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4.change legs and repeat. 5.do this stretch twice for both legs. Golf ball roll roll a golf baell under your right foot. Continue for up to 1 minute. Do each foot two to three times. Neck pain cervical spondylosis– chronic condition with radiating pain this is cervical pain (neck pain) and that's the reason the pain radiates until the shoulder blades. If you keep ice that would help and alongside you can do hot water fermentation. You shall use cervical collar which would help you to reduce the radiating pain i.e. Due to the nerve compression. You have to go for traction and also you can do ift. Please consult the nearby therapist for quick relief. Use collar will definitely be helpful for him to maintain the good posture. And also cervical pillow can be used which might make you to have better posture of the shoulder neck and arm. 1.neck tilt: from the sitting position, tilt your head down so your chin touches your chest. Hold this position for 5 second s. Return to the starting position and repeat. Do this five times. 2.side-to-side neck tilt. From the same starting position, tilt you neck toward one shoulder, leading with your ear. Hold for 5 seconds and then return to the starting position. Do this five times on each side. 3.neck turn. Look straight ahead, then turn your head to one side, keeping your chin at the same level. Do this five times on each side. 4.neck stretch. Holding the rest of your body straight, push your chin forward, stretching your throat. Hold for 5 seconds. From the same starting position, push your chin backward and hold for 5 seconds. Do the forward and backward stretch five times each. If any of these exercises cause severe pain or weakness in your hands or arms, stop right away and talk with your doctor. We suggest you to wear cervical collar which will help you to improve the cervical angle and also it definitely helps you to improve the neck posture due to which your neck pain is triggered more. The importance of wearing cervical collar is to give good stability to the neck and also it definitely prevents you to have excess neck movements which makes the condition worse. If you wear cervical collar you cannot turn your neck as you like which itself will help you to have better functioning of the cervical spine. This cervical soft collar what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Kidney pain vs. Back pain because your kidneys are located toward your back and= underneath your ribcage, it may be hard to tell if the pain you’re experiencing in that area is coming from your back or your kidney. The symptoms you’re having can help you figure out which is the source of the pain. The location, type, and severity of the pain are some of the things that will be different depending on whether the pain is from a problem in your kidneys or your back. How to identify kidney painkidney pain is most often caused by a kidney infection or a stone in the tubes coming out of your kidney. If the pain is coming from your kidney, it will have these features: where the pain is located kidney pain is felt in your flank, which is the area on either side of your spine between the bottom of your ribcage and your hips. It usually occurs in one side of your body, but it can occur in both sides. Type of pain kidney pain is usually sharp if you have a kidney stone and a dull ache if you have an infection. Most often it will be constant. It won’t get worse with movement or go away by itself without treatment. If you’re passing a kidney stone, the pain may fluctuate as the stone moves. Radiation of the pain sometimes the pain spreads (radiates) to your inner thigh or lower abdomen. Severity of the pain kidney pain is classified according to how bad it is — severe or mild. A kidney stone usually causes severe pain, and the pain from an infection is usually mild. Things that make it better or worse typically, nothing makes the pain better until the problem is corrected, such as by passing the stone. Unlike back pain, it usually won’t change with movement. Accompanying symptoms if you have a kidney infection or a kidney stone, you may also experience: •fever and chills •nausea and vomiting •cloudy or dark urine •an urgent need to urinate •pain when you urinate •a recent infection in your bladder •blood in your urine (this can happen with an infection or kidney stones) •small kidney stones that look like gravel in your urine how to identify back pain back pain is more common than kidney pain and is usually caused by a problem in the muscles, bones, or nerves in your back. Has the following features: where the pain is located back pain can occur anywhere on your back, but it’s most commonly located in your lower back or one of your buttocks. Type of pain muscle pain feels like a dull ache. If a nerve has been injured or irritated, the pain is a sharp burning sensation that may travel down your buttock to your lower leg or even your foot. Muscle pain may affect one or both sides, but nerve pain usually only affects one side. Radiation of the pain nerve pain may spread to your lower leg. Pain from a muscle usually stays in the back. Severity of the pain back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Accompanying symptoms other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called caudaequina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Kidney pain vs. Back pain because your kidneys are located toward your back and= underneath your ribcage, it may be hard to tell if the pain you’re experiencing in that area is coming from your back or your kidney. The symptoms you’re having can help you figure out which is the source of the pain. The location, type, and severity of the pain are some of the things that will be different depending on whether the pain is from a problem in your kidneys or your back. How to identify kidney painkidney pain is most often caused by a kidney infection or a stone in the tubes coming out of your kidney. If the pain is coming from your kidney, it will have these features: where the pain is located kidney pain is felt in your flank, which is the area on either side of your spine between the bottom of your ribcage and your hips. It usually occurs in one side of your body, but it can occur in both sides. Type of pain kidney pain is usually sharp if you have a kidney stone and a dull ache if you have an infection. Most often it will be constant. It won’t get worse with movement or go away by itself without treatment. If you’re passing a kidney stone, the pain may fluctuate as the stone moves. Radiation of the pain sometimes the pain spreads (radiates) to your inner thigh or lower abdomen. Severity of the pain kidney pain is classified according to how bad it is — severe or mild. A kidney stone usually causes severe pain, and the pain from an infection is usually mild. Things that make it better or worse typically, nothing makes the pain better until the problem is corrected, such as by passing the stone. Unlike back pain, it usually won’t change with movement. Accompanying symptoms if you have a kidney infection or a kidney stone, you may also experience: •fever and chills •nausea and vomiting •cloudy or dark urine •an urgent need to urinate •pain when you urinate •a recent infection in your bladder •blood in your urine (this can happen with an infection or kidney stones) •small kidney stones that look like gravel in your urine how to identify back pain back pain is more common than kidney pain and is usually caused by a problem in the muscles, bones, or nerves in your back. Has the following features: where the pain is located back pain can occur anywhere on your back, but it’s most commonly located in your lower back or one of your buttocks. Type of pain muscle pain feels like a dull ache. If a nerve has been injured or irritated, the pain is a sharp burning sensation that may travel down your buttock to your lower leg or even your foot. Muscle pain may affect one or both sides, but nerve pain usually only affects one side. Radiation of the pain nerve pain may spread to your lower leg. Pain from a muscle usually stays in the back. Severity of the pain back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Accompanying symptoms other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called caudaequina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 

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Dr. Krishnan Nair M PMBBS, DPHGeneral Physician

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Most probably you had pst surgical urinary tract infection which led to high fever with shivering .//and there may be bleeing in situ --which led to second surgery.//after that --you may have developed deep vein thrombosis --which is diagnosed by ultrasound called colour doppler study// these are some complications -in surgical procedures //you have to strictly obey instruction on lifestyle and movements ;physiotherapy ; check-ups & medication etc given by your doctor until complete recovery - 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain can affect people of any age, for different reasonsas people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. •acute pain starts suddenly and lasts for up to 6 weeks. •chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems. Home advise: •resting from strenuous activity can help, but moving around will ease stiffness, reduce pain, and prevent muscles from weakening. •applying heat, ice, ultrasound, and electrical stimulation — as well as some muscle-release techniques to the back muscles and soft tissues — may help alleviate pain. •as the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. •the patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence. Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional. There are two main types of exercise that people can do to reduce the risk of back pain: •core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back. •flexibility training aims at improving core flexibility, including the spine, hips, and upper legs. We suggest you to wear lumbosacral corset (belt) which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Uses of lumbosacral corset (belt) a lumbosacral corset adds pressure to the intra-abdominal area. This adds stability to the spine. It is prescribed to people suffering from moderate to severe pain. Other benefits of using a lumbar spine belt are: 1.helps in a certain degree of immobilization of facet joints. 2.reduces pain to allow continuation of normal activities. 3.speeds up the healing process. 4.the pressure exerted by a lumbar spine belt helps in stretching the erector spine muscles. 5.this belt can also be used to support the lower back while exercising. Ohelps prevent rolling oprovides stability to lumbar and sacral regions of the back ocan be used when performing actions like lifting and handling heavy items ocan also be used when playing sports orestricts back movement to aid treatment of back problems do’s and don’ts sitting do: • sit as little as possible and then only for short periods. • place a supportive towel roll at the belt line of the back especially when sitting in a car. • when getting up from sitting, keep the normal curves in your back. Move to the front of the seat and stand up by straightening your legs. Avoid bending forward at the waist. • try to keep the normal curves in your back at all times. Don’t: • do not sit on a low soft couch with a deep seat. It will force you to sit with your hips lower than your knees and will round your back. You will loose the normal curve in your back. • do not place your legs straight out in front of you while sitting (e.g. Sitting in the bath tub). Standing do: • if you must stand for a long period of time, keep one leg up on a foot stool. • adapt work heights. Don’t: • avoid half bent positions. Lifting avoid lifting if you can. Do: • use the correct lifting technique. Keep your back straight when lifting. Never stoop or bend forward. Stand close to the load, have a firm footing and wide stance. Kneel on one knee, keeping the back straight. Have a secure grip on the load and lift by straightening your knees. Do a steady lift. Shift your feet to turn and do not twist your back. Don’t: • do not jerk when you lift. • do not bend over the object you are lifting. Lying do: • sleep on a good firm surface. • if your bed sags, use slats or plywood supports between the mattress and base to firm it. You also can place the mattress on the floor, a simple but temporary solution. • you may be more comfortable at night when you use a pillow for support. Don’t: • do not sleep on your stomach unless advised to do so by your doctor or physical therapist. Bending forward do: • keep the natural curves of your back when doing these and other activities: making a bed, vacuuming, sweeping or mopping the floor, weeding the garden or raking leaves. Coughing and sneezing do: • bend backwards to increase the curve of your back while you cough or sneeze. Driving a car do: • drive the car as little as possible. It is better to be a passenger than to drive yourself. • move the seat forward to the steering wheel. Your seat must be close enough to the wheel to keep the natural curves of your back. If your hips are lower than your knees in this position, raise yourself by sitting on a pillow. Exercises for low back pain safety guidelines • an increase in your low back pain can be expected with these exercises. This is acceptable as long as your leg symptoms are not increasing. • if while doing these exercises, your pain worsens or you have new pain or symptoms, stop the exercises and discuss your symptoms with your doctor or physical therapist. • stop exercising and let your doctor or physical therapist know right away if you have any change in your bowel or bladder control or any increase in weakness in your leg or foot. Exercises ‰ •press-ups: keep your back and buttocks relaxed and use your arms to press up. Concentrate on keeping your hips down and push up your upper body as high as possible. •double knee to chest: grasp both your knees with your hands and pull toward your shoulders. Hold the stretch for 1 second. Let your knees return, but keep them bent at arms length. ‰ •lumbar spine stretches: lie on your back. Bring your knees towards your chest. Rotate your knees towards the pain. •side-lying position: lie on your side and face forward. Have both arms straight in front and bend your knees. Turn your head as you move your top arm across your body as far as you can. Keep your arm in place and turn your head back to the starting position. Look back again and turn your head farther if you can. Bring your head and arm back to the starting position. Relax and repeat 10 times on each side. •hamstring stretch: lie on your back with your legs out straight. Raise your leg up and put your hands around the upper leg for support. Slowly straighten the raised knee until you feel a stretch in the back of the upper leg. Hold, then relax and repeat 10 times on each leg. •standing arch: stand with your feet apart and hands on the small of your back with fingers pointing backwards. Bend backwards at the waist, supporting the trunk with your hands. Keep your knees straight. Hold for 5 seconds. Repeat 3 to 5 times. Side glides: stand at a right angle to the wall about 2 feet o eliminate your pain improve your muscular endurance and strength attain better posture, balance, body awareness and co-ordination improve your balance and flexibility learn to lift properly. posture when standing: make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine. Posture when sitting: a good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal. Shoes: flat shoes place less of a strain on the back. Driving: it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks. Get out of the car and walk around. Bed: you should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle. 

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Continue the same treatment with follow up fever must subside check cbc with gbp and fecal examination. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Because your kidneys are located toward your back and underneath your ribcage, it may be hard to tell if the pain you’re experiencing in that area is coming from your back or your kidney. The symptoms you’re having can help you figure out which is the source of the pain. The location, type, and severity of the pain are some of the things that will be different depending on whether the pain is from a problem in your kidneys or your back. How to identify kidney painkidney pain is most often caused by a kidney infection or a stone in the tubes coming out of your kidney. If the pain is coming from your kidney, it will have these features: where the pain is located kidney pain is felt in your flank, which is the area on either side of your spine between the bottom of your ribcage and your hips. It usually occurs in one side of your body, but it can occur in both sides. Type of pain kidney pain is usually sharp if you have a kidney stone and a dull ache if you have an infection. Most often it will be constant. It won’t get worse with movement or go away by itself without treatment. If you’re passing a kidney stone, the pain may fluctuate as the stone moves. Radiation of the pain sometimes the pain spreads (radiates) to your inner thigh or lower abdomen. Severity of the pain kidney pain is classified according to how bad it is — severe or mild. A kidney stone usually causes severe pain, and the pain from an infection is usually mild. Things that make it better or worse typically, nothing makes the pain better until the problem is corrected, such as by passing the stone. Unlike back pain, it usually won’t change with movement. Accompanying symptoms if you have a kidney infection or a kidney stone, you may also experience: •fever and chills •nausea and vomiting •cloudy or dark urine •an urgent need to urinate •pain when you urinate •a recent infection in your bladder •blood in your urine (this can happen with an infection or kidney stones) •small kidney stones that look like gravel in your urine how to identify back pain back pain is more common than kidney pain and is usually caused by a problem in the muscles, bones, or nerves in your back. Has the following features: where the pain is located back pain can occur anywhere on your back, but it’s most commonly located in your lower back or one of your buttocks. Type of pain muscle pain feels like a dull ache. If a nerve has been injured or irritated, the pain is a sharp burning sensation that may travel down your buttock to your lower leg or even your foot. Muscle pain may affect one or both sides, but nerve pain usually only affects one side. Radiation of the pain nerve pain may spread to your lower leg. Pain from a muscle usually stays in the back. Severity of the pain back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Accompanying symptoms other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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People of any age, back pain can affect or different reasonsas people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. •acute pain starts suddenly and lasts for up to 6 weeks. •chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems. Home advise: •resting from strenuous activity can help, but moving around will ease stiffness, reduce pain, and prevent muscles from weakening. •applying heat, ice, ultrasound, and electrical stimulation — as well as some muscle-release techniques to the back muscles and soft tissues — may help alleviate pain. •as the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. •the patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence. Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional. There are two main types of exercise that people can do to reduce the risk of back pain: •core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back. •flexibility training aims at improving core flexibility, including the spine, hips, and upper legs. We suggest you to wear lumbosacral corset (belt) which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Uses of lumbosacral corset (belt) a lumbosacral corset adds pressure to the intra-abdominal area. This adds stability to the spine. It is prescribed to people suffering from moderate to severe pain. Other benefits of using a lumbar spine belt are: 1.helps in a certain degree of immobilization of facet joints. 2.reduces pain to allow continuation of normal activities. 3.speeds up the healing process. 4.the pressure exerted by a lumbar spine belt helps in stretching the erector spine muscles. 5.this belt can also be used to support the lower back while exercising. Ohelps prevent rolling oprovides stability to lumbar and sacral regions of the back ocan be used when performing actions like lifting and handling heavy items ocan also be used when playing sports orestricts back movement to aid treatment of back problems do’s and don’ts sitting do: • sit as little as possible and then only for short periods. • place a supportive towel roll at the belt line of the back especially when sitting in a car. • when getting up from sitting, keep the normal curves in your back. Move to the front of the seat and stand up by straightening your legs. Avoid bending forward at the waist. • try to keep the normal curves in your back at all times. Don’t: • do not sit on a low soft couch with a deep seat. It will force you to sit with your hips lower than your knees and will round your back. You will loose the normal curve in your back. • do not place your legs straight out in front of you while sitting (e.g. Sitting in the bath tub). Standing do: • if you must stand for a long period of time, keep one leg up on a foot stool. • adapt work heights. Don’t: • avoid half bent positions. Lifting avoid lifting if you can. Do: • use the correct lifting technique. Keep your back straight when lifting. Never stoop or bend forward. Stand close to the load, have a firm footing and wide stance. Kneel on one knee, keeping the back straight. Have a secure grip on the load and lift by straightening your knees. Do a steady lift. Shift your feet to turn and do not twist your back. Don’t: • do not jerk when you lift. • do not bend over the object you are lifting. Lying do: • sleep on a good firm surface. • if your bed sags, use slats or plywood supports between the mattress and base to firm it. You also can place the mattress on the floor, a simple but temporary solution. • you may be more comfortable at night when you use a pillow for support. Don’t: • do not sleep on your stomach unless advised to do so by your doctor or physical therapist. Bending forward do: • keep the natural curves of your back when doing these and other activities: making a bed, vacuuming, sweeping or mopping the floor, weeding the garden or raking leaves. Coughing and sneezing do: • bend backwards to increase the curve of your back while you cough or sneeze. Driving a car do: • drive the car as little as possible. It is better to be a passenger than to drive yourself. • move the seat forward to the steering wheel. Your seat must be close enough to the wheel to keep the natural curves of your back. If your hips are lower than your knees in this position, raise yourself by sitting on a pillow. Exercises for low back pain safety guidelines • an increase in your low back pain can be expected with these exercises. This is acceptable as long as your leg symptoms are not increasing. • if while doing these exercises, your pain worsens or you have new pain or symptoms, stop the exercises and discuss your symptoms with your doctor or physical therapist. • stop exercising and let your doctor or physical therapist know right away if you have any change in your bowel or bladder control or any increase in weakness in your leg or foot. Exercises ‰ •press-ups: keep your back and buttocks relaxed and use your arms to press up. Concentrate on keeping your hips down and push up your upper body as high as possible. •double knee to chest: grasp both your knees with your hands and pull toward your shoulders. Hold the stretch for 1 second. Let your knees return, but keep them bent at arms length. ‰ •lumbar spine stretches: lie on your back. Bring your knees towards your chest. Rotate your knees towards the pain. •side-lying position: lie on your side and face forward. Have both arms straight in front and bend your knees. Turn your head as you move your top arm across your body as far as you can. Keep your arm in place and turn your head back to the starting position. Look back again and turn your head farther if you can. Bring your head and arm back to the starting position. Relax and repeat 10 times on each side. •hamstring stretch: lie on your back with your legs out straight. Raise your leg up and put your hands around the upper leg for support. Slowly straighten the raised knee until you feel a stretch in the back of the upper leg. Hold, then relax and repeat 10 times on each leg. •standing arch: stand with your feet apart and hands on the small of your back with fingers pointing backwards. Bend backwards at the waist, supporting the trunk with your hands. Keep your knees straight. Hold for 5 seconds. Repeat 3 to 5 times. Side glides: stand at a right angle to the wall about 2 feet o eliminate your pain improve your muscular endurance and strength attain better posture, balance, body awareness and co-ordination improve your balance and flexibility learn to lift properly. posture when standing: make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine. Posture when sitting: a good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal. Shoes: flat shoes place less of a strain on the back. Driving: it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks. Get out of the car and walk around. Bed: you should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle. 

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Dr. Krishnan Nair M PMBBS, DPHGeneral Physician

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Kindly take treatment under a doctor's supervision for covid at home care----- .he will give you symptomatic and supportive treatment ;advice for lifestyle changes during covid infection and post covid stage. Also he will guide you for hospitalisation if any high risk symptoms are seen. Covid infection is possible after 2 doses of vaccination. But your symptoms will be usually mild and chances of severe symptoms and death are almost nil--. Take rest ; obey covid ethiquette and take fresh nutritious food --small quantities at shorter intervals. Drink 12-15 glasses of warm fluids daily.---do steam inhalation and warm salt water gargling and do pranayama -15 times twice daily -- do oxygen concentration check up minimum 4-6 times daily and do repeat it after walking for 5-6 minutes -twice daily .----if it is below 94% or if the dip in value after walk is more than 5% -or fever is above 102 degree f continuously in spite of taking paracetamol-- in correct doses or you get severe difficulty in brething or unconsciosness or any other serious symptoms--immediately contact local covid hospital. Wish and praying for your early complete recovery --. Be confident and happy.-- thank you for this important question. 

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