Hand
surgeon in India
All
knee pain is not osteoarthritis. Young patients usually have cause of pain
other than osteoarthritis and needs detailed evaluation and imaging to find out
what causes pain and disability. There can be extra and intraarticular causes.
It ranges from intraarticular causes like Osteochondritis Dissecans of femoral
condoyle to entrapment of loose bodies causing locking episodes to
extraarticular causes like Pes Anserine tendonitis and bursits syndrome. Dr
Shrenik Shah for Hand surgeon In India.
Both
neck and back pain requires detailed work up to find the cause and the stage
/chronicity of the problem. We can help to diagnose and treat them with various
procedures. I personally do spinal manipulations where indicated for most
mechanical spinal problems without neurological deficit which helps these
patients to be pain free soon and get back to routine/ work with minimum or no
medications. Rehabilitation includes exercises and Yoga. If spasm and pain
persists then Shock wave therapy can help to relieve pain and spasm. I started
doing ESWT from 1997 and have done almost all and varied orthopedic and related
problems with good success rates and patients satisfaction and almost no
untoward side effects. Dr Shrenik Shah for Hand
surgeon In India.
Sports
medicine in India
Osteochondritis
Dissecans of femoral condoyle is Osteonecrosis and can be treated successfully
with ESWT as we treat A vascular necrosis of femoral heads. PATB syndrome too
responds dramatically with ESWT. Dr Shrenik Shah for Sports medicine In India.
There
are preliminary reports of ESWT for osteoarthritis but being multifactorial it
needs a wholesome approach and late cases may need surgery with total joint
replacement giving excellent pain relief. There is always a scope of trial of
non operative treatment before undergoing surgery. ESWT does not close the
window of surgery as it is harmless. We do everything to cure your pain.
Most orthopaedic surgeons are busy in trauma practice. Cold orthopedics form a
major lot of patients who require a detailed work up. Dr Shrenik Shah for Sports medicine In India.
We
are committed to diagnose all your problems and plan your treatment according
to imaging. Your problems are rated and followed up at regular intervals.
Follow up can be done by sending details of your recovery by e mails. I would
like to congratulate you. I can now say that I am completely healed of Plantar
Fasciitis. Last week I had a social trip to Mather an I could climb up and down
of the hill without any pain. Climbing up the hill was a like dream for me
which I thought I would never achieve in my life time because of agonizing heel
pain. And I was able to achieve it with the efforts you put in for my
treatment. I could now proudly say that today I am on my feet just because. Dr
Shrenik Shah for Sports
medicine In India.
Chronic
pain in India
This
salesman, who has a moving job and has to walk a lot, had severe posterior heel
pain more on walking. He was suffering since 1 year as no treatment was helping
him, infact it was getting worse day by day.We are best For Heel Pain In
Ahmedabad, Heel Pain In Gujarat, Heel Pain In India. Dr Shrenik Shah for Chronic pain In India.
Local
injection was ruled out due to fear of rupture of TendoachillisHe was given
RSWT and he went for uneventful recovery and is back to his job and needs no
modification in his foot wear. ESWT causes soft tissue and bony healing.Lots of
basic research has shown that more than nine neuropeptides are isolated which
play a role in repair of tissues. Dr Shrenik Shah for Chronic pain In India
Physics
also play a role. Shock waves produce cavitation phenomenon and microdisruption
of tissues and stimulates fibroblasts to make way for revascularization and
fibrosis is replaced by natural tissues to heal Biology too shows up by causing
changes in cell and cell organelles like mitochondria and golgi apparatus and
appropriate stem cell release.Hence even though there is no final word how it
works but it does work to help you heal! Dr Shrenik Shah for Chronic pain In India.
Diabetes
Foot Surgeon in India
This
patient from Punjab working in ONGC had severe pain in left shoulder on
abduction and overhead activities. His imaging showed calcifies tendinopathy of
supraspinatus. He showed remarkable improvement after shockwave therapy and
went back to his normal working schedule as calcification got absorbed along
with reduction of pain. This young man plays racket sports to keep fit daily.
Dr Shrenik Shah For Diabetes Foot Surgeon In India.
It
has been his passion and cannot do away without playing. I am a housewife and
had knee pain in 2004 and thought it may be early osteoarthritis. It prevented
me to my household chores. The pain progressed and did not respond to routine
pain killers. I was investigated and was diagnosed as Osteochondritis Dissecans
of medial femoral condoles both sides and underwent ESWT. I started recovering
soon and in about 3 months I had minimal pain and could do away without any
painkillers. I took care and did cycling exercised regularly and have recovered
back to normal and can happily take care of my family Dr Shrenik Shah For Diabetes Foot Surgeon
In India.
He
suffered for long and more than 3 local hydrocortisone injections were given
without much relief. His daily activities too suffered and now cannot work in
office due to his dominant hand was affected. He underwent RSWT and went on to
heal so well that he is back to his playground and enjoys life fully. Dr
Shrenik Shah Diabetes Foot
Surgeon In India.
Extracorporeal Shock Wave Therapy in India
Practicing
Chartered Accountant was suffering since long with bilateral lunatomalcia with
no relief with routine conservative treatment by orthopedic surgeon. I am a
regular badminton player and keep fit due to regular exercise and sports
activity. I enjoy sports and cannot think life without friends and sports early
in the morning at sports club. Dr Shrenik Shah For Extracorporeal Shock Wave Therapy In
India.
I
was in great pain when I had tennis elbow and did not respond to routine
treatment and how long can I stop playing? I promptly underwent ESWT and
started recovering soon. With due care and precautions I came out without much
ado and started playing with support. I am pain free since then and would
strongly recommend this treatment to all. Dr Shrenik Shah For Extracorporeal Shock
Wave Therapy In India.
He
could not write and sign due to pain and all his activities of daily life was
affected. He was virtually disabled due to affection of both wrists.With only
one sitting of ESWT he gradually improved and is back to his usual busy
practice of CA as his bones revascularised without collapse and near normal
wrists. Family physician having AVN of femoral head secondary to steriods was
depressed due to pain and disability. He underwent three sittings at an
interval of about 6-8 months and healed so well that he is not only practicing
well and does home visits but also had been to Australia and Egypt for site
seeing and does difficult yoga postures and pranayam which is his passion. Dr
Shrenik Shah For Extracorporeal
Shock Wave Therapy In India.
Knee
Pain In India
Most
patients want to go back to their moving job as soon as possible and do not
tolerate orthotics well. Hence RSWT is one such therapy which cures the inflammation
and regenerates the tissues whether it is ligament/ fascia or tendon. Hence
there are no recurrences and the disease halts down. The patients do not need
orthotics or physic and are up and about on their feet soon. The success rates
are more than 90-95% in most heel pain. Dr Shrenik Shah For Knee Pain In India.
The conservative approach can be rest and splintage and local steroid injection
with care not to penetrate tendons. The resistant and recalcitrant cases
are subjected to RSWT and the results are promising and can result into
cure.Calf cramps is a very common disorder and many time it is episodic but
sometime is nagging and almost occur every night and cause sleeplessness,
forcing an individual to stand up or squeeze the calf for immediate relief. Dr
Shrenik Shah For Knee Pain In India.
Cause when looked for is difficult to pinpoint and most investigations turn out
to be normal. One need to treat these with simple ways to start with like
calcium supplements and multivitamins and muscle tonics like L-carnitine. The
results are unpredictable and many times they recur. Sometimes they even lead
to other muscle cramps and spasms affecting both upper and lower limb muscles.
Quinine may be tried in resistant cases. Dr Shrenik Shah For Knee Pain In India.
Tennis
Elbow In India
Intraarticular steroids-beneficial in short term but the effect is small and
not well maintained. Physiotherapy – pain should guide the therapy. In
stage 1 it aggravates pain. In stage 2 physical therapy and stretching may be
effective. Hydro dilation- as an outpatient treatment it is better than
manipulation under anaesthesia but range of motion does not improve. Oral
steroids-the effect does not last beyond 6 weeks. Dr Shrenik Shah For Tennis Elbow In India.
Manipulation
under anaesthesia: done for patients not responding to conservative treatment
for more than 4-6 months. Prevent over manipulation and use short lever arm to
prevent fracture. The rehab needs intravenous analgesics and physiotherapy for
at least 2-6 weeks. Open capsular release: Aim is to release
coracohumeral ligament and rotator interval. It is more or less abandoned due
to post-operative pain and stiffness, extensive subdeltoid scarring and intra
and extra articular contractures. Dr Shrenik Shah Tennis Elbow In India.
Arthroscopic capsular release: It has its own role and advantages but is
technically demanding. It is difficult to release the capsule 360* especially
if the joint is tight. The release of anteroinferior capsule has the risk of
recurrent stiffness, anterior dislocation and axillary nerve palsy. Pain pumps
are needed post operatively and / or interscalene indwelling catheter block for
better rehab. CPM is useful in refractory cases. Dr Shrenik Shah For Tennis Elbow In India.
Plantar
Fasciitis In India
A total of 93 patients with frozen shoulder were treated after the routine
conservative treatment failed for 3-6 months. The average age was 53 years with
46 patients of left shoulder and 44 right and 4 were bilateral affection. The
average shock waves were 1650 in heavy (ESWT) and 3000 in soft shock (RSWT)
waves. Dr Shrenik Shah For Plantar
Fasciitis In India.
Few
required more than one sitting when there was a plateau in recovery. The
results were almost similar in both modalities of shock wave with 75-85 %
excellent to good results. The patients were left alone after treatment with
instructions to use minimum or no medications and were guided to use their
shoulder according to their pain threshold. No physiotherapy was scheduled but
home care was according to instructions to actively mobilize the shoulder in
pain free range of motion. There was slow and steady gain of movements as pain
subsided of its own. It nearly took 2-4 months to settle down in most cases.
The cases who did not respond at the end of 6-8 weeks were advised to undergo
another sitting. About 5 cases in RSWT group needed more than one sitting, and
they all responded well and eventually recovered fully. Dr Shrenik Shah Plantar Fasciitis In India.
Visual analogue scale which was around 8-10 before treatment dropped to 1-2 at
the end with excellent regaining of range of motion in most cases (75-85%).
There are no untoward side effects and it can be given to high risk patients
with uncontrolled co morbidities like diabetes, hypertension and other cardiac
and post operative cases. Dr Shrenik Shah For Plantar Fasciitis In India.
Heel
Pain In India
Epicondylitis,
medial or lateral , of elbow is known since more than 100 years and by far is
the commonest cause of pain around elbow. The cause of epicondylitis remains
unclear but commonly results due to overuse injury. The routine conservative
treatment is not successful in all cases and local steroid injections are
widely used by orthopedic surgeons. Steroid injections are not successful as
well in resistant cases and they have their own drawbacks and failures. Surgery
is not done as a routine as the results are not predictable. Dr Shrenik Shah
For Heel Pain In
India.
Extracorporeal shock wave therapy (ESWT) is a good option for such resistant
Epicondylitis and is safe, effective and well accepted by patients. Dr Shrenik
Shah For Heel
Pain In India.
In
a retrospective study patients who were resistant to routine conservative
treatment were studied . All patients were evaluated clinically and
ultrasonography was done for confirmation and documentation. ESWT is safe
and effective noninvasive treatment option for chronic Epicondylitis before
embarking on surgical treatment. Dr Shrenik Shah For Heel Pain In India.
Avascular
Necrosis In India
Bone
is a vascular tissue which is hard but has maze like architecture with
trabaculae and bone cells with blood vessels arborizing all over. The stress on
the bone constantly remodels the tissue and blood supply is prime factor for
the bone metabolism. Dr Shrenik Shah Avascular
Necrosis In India.
Because of some diseases or drugs or unknown cause the bone undergoes avascular
necrosis and will not be able to withstand the loads and may collapse and
ultimately lead to biomechanical derangement and arthritis as an end result. Dr
Shrenik Shah For Avascular Necrosis In
India.
Till date there are no drugs to enhance the bone circulation or repair the dead
bone. No surgery can cure the dead bone but only replace it by artificial
means. ESWT is the only treatment modality which can revascularise and
regenerate the bone altering the bone metabolism so that it can once again work
as living bone and withstand the loads and remodel. ESWT is commonly done
for AVN of femoral head, femoral condyle, talus, scaphoid, lunate, humerus, and
metatarsal heads. Dr Shrenik Shah For Avascular
Necrosis In India.
Frozen Shoulder In India
Frozen shoulder is frustrating both for
patient and the treating doctor. The amount of pain and suffering is many times
beyond one’s threshold and imagination. The mental makeup of the patient is so
bad that depression sets in and even leads to suicidal thoughts. Dr Shrenik
Shah For Frozen Shoulder In India.
Analyzing and studying lots of
these patients including some of my dear and near ones has given me some
insights which I want to share with you. Frozen shoulder is known for
more than 100 years but still cause is unknown. The management is equally
difficult as the outcomes are unpredictable. Do we have a fixed way of treating
it? Well not yet. The physiotherapy is counterproductive in most cases and
patients are non-compliant as it is extremely painful and movements gained are
soon lost due to severe pain and spasm. Dr Shrenik Shah For Frozen Shoulder In
India.
Many a times these patients, suffering
immense pain are left alone with reassurance that it has a self-limiting course
and it heals in time. Majority of literature quote 18-24 months to heal but it
can take up to 10 years. Patients suffered some pain and stiffness even at an
average 7 years after onset. So it is not a good idea to leave these patients
alone but be proactive and treat them early to cut down suffering. Dr Shrenik
Shah For Frozen
Shoulder In India.
Delayed And Non Union of Bones
in India
The trigger finger is steno sing
tenosynovitis of the flexor tendons at the mouth of the sheath. It is either
acute or chronic inflammation of the sheath of flexor tendons. The routine
treatment of rest, ice application and anti-inflammatory drugs do work in some
patients. Resistant patients are offered surgery which is time tested and
result oriented hence established as a gold standard. Dr Shrenik Shah For Delayed And Non Union
Of Bones In India.
Those patients who do not want
to undergo knife, or are a high risk due to co morbid conditions like
uncontrolled diabetes can opt for Radial Shock Wave Therapy. The advantage
being a non-invasive and outdoor procedure with no need for physiotherapy or
splint age and going back to job right away for professionals. . Dr Shrenik
Shah For Delayed And Non Union Of Bones In
India.
The pain in the heel needs detailed
evaluation and imaging to confirm the cause of the pain and hence the
diagnosis. It can be planter fasciitis which is inflammation of the
ligament/fascia running from the heel to the toes or the tendon inflammation in
Tendo-Achilles at the back of the heel or tibia is posterior tendon which is
the sling to maintain the arch of the foot at the instep of the foot. . Dr
Shrenik Shah For Delayed
And Non Union Of Bones In India.
Cramps in India
It is an overuse injury of
infrapatellar tendon. The pain is nagging and does not allow the athlete to
participate in his sport. Taping techniques and physical therapy does help but
for a short duration. Ultrasonography helps to document the lesion and helps to
guide where the exact lesion is and is a definite guide line for the shock wave
therapy which does cure the illness and allows bringing back the athlete to the
sports of his choice in about 6-8 weeks. Dr Shrenik Shah For Cramps In India.
The standard teaching is to enhance the
healing by way of adding bone grafts from auto or allograft or bone substitutes
and even bone marrow injections. Various other techniques are developed from
ultrasound to electric stimulations but no single technical is gold standard
and has varied results so far in the literature. Dr Shrenik Shah For Cramps In India.
After the onset of ESWT lot of
work is being done both at basic research level and in vitro and vivo. The
success rate depends on whether the non-union is hypertrophic or atrophic
variety. The results being far better with hypertrophic variety than atrophic.
By far after the promising success with ESWT in the west ESWT is considered as
the first line of treatment for delayed and non-union of bones worldwide. ESWT
can be given even in presence of implants and there is no need of brace if the
implants are holding. The new bone formation is seen as early as 6-12 weeks
even after resistant non unions of long standing. Dr Shrenik Shah For Cramps In India.
Burning Feet Syndrome in India
Patients suffer for a long time and
have to undergo a lot of restriction in daily life. Shock wave therapy
being noninvasive is acceptable to most patients and has a promising role to
play in curing this nagging problem. Neck pain or cervical spondylitis is a
common ailment. The pain is neurogenic and excruciating at times with radiation
to back and front of the chest and up to fingers. Dr Shrenik Shah For Burning Feet Syndrome
In India.
Routine physiotherapy gives
temporary relief. Imaging studies show spondylotic changes which are
common finding in all middle and old age population. In absence of
neurological deficit these patients do well with cervical spine
manipulation. Muscle soreness in the suprascapular region and neck is
amenable to Radial shock wave therapy. Dr Shrenik Shah For Burning Feet Syndrome
In India.
I was shattered when i came to know
that i had A vascular necrosis of head of femur and took various opinions and
was confused. I had no options but surgery and then Dr Shrenik came to my
rescue and suggested ESWT. Well after first sitting I had some pain but started
recovering and soon could go my clinic and was back to my routine. I had 2nd
sitting after about 6 months and was able to travel to Australia to be with my
son. I am able to stand, walk and do all other activities. I then wanted to go
to Egypt in a conducted tour and so underwent 3rd sitting to expedite healing.
I am extremely happy and can do all Yoga postures and pranayam too. I strongly
recommend ESWT to all patients of AVN." Dr Shrenik Shah For Burning Feet Syndrome
In India.
Osteomyelitis in India
Non operative treatment In India. If no
definite cause is found after thorough evaluation both clinically and radio
logically then these patients are labeled as psychosomatic ill and suffer for a
long time and undergo depression due to chronic pain. In these patients
mechanical derangement of apophyseal joint may cause pain and dysfunction and
are candidates of spinal manipulation and show excellent results. Dr Shrenik
Shah For Osteomyelitis In India.
Sports persons cannot be equated to
routine orthopedic patients as they have a high demand and cannot take rest for
long. They are highly motivated and want to go back to sports as early as
possible. It requires high degree of suspicion and knowledge to diagnose and
treat sports injury. Prevention by following basic principles of sports
medicine like warm up and cool down is the key. Dr Shrenik Shah For Osteomyelitis In
India.
Other than the evident bony
injury picked up by X-ray, soft tissue injury is difficult to diagnose. Tendinopathy
and ligament us injury needs to be evaluated clinically and confirmed by
imaging modalities like ultrasonography and MRI. When not responding to
routine conservative treatment within a given period these overuse injuries
need shock wave therapy to heal allowing the sports person to go back to
desired sports early with minimum or no support or splint. Dr Shrenik Shah For Osteomyelitis In
India.
Hip Pain in India
Hand is an organ and needs delicate
care like eye and its related structure in the body. All the joints in
the hand and wrist are interlinked and being sensate and ability to do fine
function demands utmost care. Detailed clinical examination along with
imaging studies help to precisely diagnose the hand disorder. Dr Shrenik Shah
For Hip Pain In India.
Many hand conditions can be
treated conservatively but the methodology widely differs. To prevent
disability right approach and care and patient education goes a long way.
Surgery is indicated in not all cases and not all are result oriented. Hence if
good non-operative treatment is available than patient will definitely opt for
it. Dr Shrenik Shah For Hip
Pain In India.
Shock wave therapy has a huge
role to play in grade 1 and 2 ligament us injury and soft tissse lesions which
does not allow the sports person or professionals to participate in their
desired field. It heals the soft tissues and bone and prevents undue
consequences and allowing them to resume sports or duty at a much early phase
in the healing period. Dr Shrenik Shah For Hip
Pain In India.
Non operative treatment in India
This young radiology technician had
difficulty in sitting cross-legged with painful stiffness of left hip since 6-8
months and was not getting relief due to not getting diagnosed as his X-rays
were normal. He underwent MRI which confirmed clinical suspicion of
Femoro-acetabular impingement. He underwent ESWT and was treated with care. He
resumed his swimming exercises after 8 weeks and went on to complete recovery
in 4 Months. This middle aged house wife had persistent pain in left heel since
last 6 months and could not step out of her bed in the morning due to severe
pain on weight bearing. She cannot walk barefooted. Dr Shrenik Shah For Non operative treatment In India.
She was not relieved with routine
conservative means including local injections of steroids. She was cured with
Radial Shock Wave therapy and is back to her household chores and can even walk
barefooted in her house. I am a housewife with two kids settled in Australia. I
am suffering from fibromyalgia since many years and is taken care by various
consultants and is on drugs for long. I have exacerbations on and often and
could not do Activities of daily life and got depressed. Radial wave therapy
helped me to get rid of my several problems and multiple trigger points to ease
to such an extent that i am back to my normal life and leaving to Australia
soon with minimal pain. Dr Shrenik Shah For Non
operative treatment In India.
I would strongly recommend this
treatment to many others who suffer from such intractable illness “I am a house
wife and Yoga teacher and had severe pain in the heel of sudden onset without
any reason. It was diagnosed as planter fasciitis. Routine orthopedic treatment
did not help and I could not tolerate any drugs as I caused all sorts of side
effects. Dr Shrenik Shah For Non
operative treatment In India.
Osteonecrosis in India
The results vary according to the stage
of the disease, its severity, chronicity, the previous treatments (local
injections of steroids), etc.Once the clinical diagnosis is done along with
imaging studies, counseling is done to explain the prognosis. Resistant cases
may need more than one sitting. Dr Shrenik Shah for Osteonecrosis In
India.
The benefit appears from few hours to
days and months. Usually the patients are free of drugs/ bandages/ splints and
at the same time are able to do their routine activities of daily life as the
healing occurs in soft tissue disorders. Bony problems may require some
splintages for a while. Dr Shrenik Shah for Osteonecrosis
In India.
The newer technology Radial Shock Wave
Therapy (RSWT) produces soft shock waves and recommended sittings are
about.Overall the results are promising and ranges from 70-90%. Dr Shrenik Shah
for Osteonecrosis
In India.
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