Frequently asked Questions

lyphedema sleeveLymphoedema Stockings are compression stockings that force the flow of lymphatic fluid and hence prevent build-up.

Lymphoedema is a build-up of lymph in the fatty tissues under the skin. This leads to swelling in the arms.

Secondary lymphoedema is seen in cancer patients where lymph nodes are removed along with the tumour.

It is estimated that about 30% of women undergoing breast cancer treatment will develop lymphoedema.

Lymphoedema may develop immediately after surgery (short-term lymphoedema) or even after many months (long-term).

Anti-embolism stockings provide a mechanical pumping action and assist in forcing the blood through the veins. This reduces the possibility of clot formation.

Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood thickens and clumps together.

Most deep vein blood clots occur in the lower leg or thigh. They also can occur in other parts of the body.

  1. Inspect foot daily. Check your cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Consult your doctor if you notice anything unusual.
  2. Wash your foot with lukewarm (not hot) water. Keep you foot by washing them daily. But you should use only a lukewarm water-the temperature you would use on a new born baby.
  3. Cut nails carefully. Also, file the edges. Don’t cut them too short, since this could lead to ingrown toe nails.
  4. Get periodic foot exam. See your podiatric foot and ankle surgeon on a regular basis for an examination to prevent the foot complications of diabetics
  5. Do not walk barefoot. Wear footwear even at home. You may step on sharp objects and get a scratch or cut
  6. Do not sit with legs crossed. It reduce the blood circulation to the foot
  7. Use correct footwear. Choose your footwear after consulting your doctor. Always wear footwear with loose cotton socks.
  8. Take care of your diabetes. Keep your blood sugar levels under control
  9. Don’t smoke. Smoking restricts blood flow in your foot
  10. Don’t trim corns or calluses. No “bathroom surgery”-let your doctor do the job
  11. Don’t apply heating or cooling pads to legs. Diabetic patient cannot sense the actual temperature so it may damage the skin.
  12. Do not walk with ulcer in the foot. Walking with ulcer foot will delay the healing process since it requires pressure offloading.
  • ACL: – Anterior Cruciate Ligament
  • Anterior:- the front aspect of the body in the anatomical position.
  • Cartilage:- soft cushion likematerial at end of the bones to avoid friction.
  • Dislocation:- out of joint eg. Patella dislocation
  • Distal:- away from the centre of the body.
  • Effusion:- swelling
  • Femur:- Thigh bone
  • Haemarthrosis:- bleeding in to the joint
  • Interference Screw:- fixation device for ACL graft
  • Lateral:- outer side
  • LCL:- Lateral Collateral Ligament
  • MCL:- Medial collateral ligament
  • Medial:- Inner side
  • Meniscus:- shock absorbing tissue on the top of Tibia bone.
  • MRI:– Magnetic Resonance Imaging
  • Patella:- Knee cap
  • Patellofemoral Joint:- Joint between Patella and Femur
  • PCL:- Posterior Cruciate Ligament
  • PKR:- Partial Knee Replacement
  • Posterior:- behind
  • Popliteal Fossa:- the back part of the knee joint
  • Quadriceps muscle:- Thigh muscle
  • Retropatellar:- behind the knee cap
  • ROM:- range of movement (or range of motion)
  • SLR:- straight leg raise
  • Subluxation:- partial movement eg:- Patella subluxation
  • Synovial Fluid:- joint fluid for lubrication
  • Tendinitis:- inflammation of the tendon
  • Tendinosis:- chronic tendon injury
  • Trochlea:- the joint space at the front of the femur
  • TKR:- total knee replacement
  • Tibia:- shin bone
  • UKR:– unicondylar knee replacement (same as partial knee replacement)
  • Varus:- inward angulation of the knee joint
  • Valgus:- outward angulation of the knee joint

The following options are available for Surgical Treatment of Varicose Veins.

1. Phlebectomy:

Phlebectomy is a minimally invasive surgical procedure to remove the varicose veins. There are two basic types of Phlebectomy – Ambulatory Phlebectomy and Transilluminated Powered Phlebectomy (TIPP).

1(a). Ambulatory Phlebectomy: In Ambulatory Phlebectomy using a scalpel or needle doctor punctures the skin near to the varicose vein and inserts a small hook into the hole and grasps the vein and remove it. The area is covered with a compression bandage or a compression stocking (varicose vein stocking).

1(b). Transilluminated Powered Phlebectomy: Transilluminated Powered Phlebectomy is slightly more invasive compared with Ambulatory Phlebectomy. After making two small incisions, the surgeon inserts a tumescent canula illuminator that contain a fiber optic light which illuminate the vein and makes it easily visible. Fluid containing local anesthetic is infused under the skin loosening the vein from the surrounding tissues. A vein remover instrument is guided to the vein, which is suctioned into the instrument where it is cut into small pieces and removed.

2. Venous stripping: Venous stripping procedure is similar to Phlebectomy, where all parts of the saphenous vein main trunk is removed through the incision made near to the varicose vein.

3. Vein Ligation: In this surgical method incisions are made above the problematic vein and the vein is tied off, to cut off the blood flow to the varicose vein. This vein gradually becomes less visible.

Phlebectomy:

Phlebectomy is a minimally invasive surgical procedure to remove the varicose veins. There are two basic types of Phlebectomy, Ambulatory and Transilluminated Powered Phlebectomy (TIPP).

Ambulatory Phlebectomy: In Ambulatory Phlebectomy using a scalpel or needle doctor punctures the skin near to the varicose vein and inserts a small hook into the hole and grasps the vein and remove it. The area is covered with compression bandage or compression stocking.

Transilluminated Powered Phlebectomy: Transilluminated Powered Phlebectomy is slightly more invasive compared with Ambulatory Phlebectomy. After making two small incisions surgeon inserts a tumescent canula illuminator that contain a fiber optic light which illuminate the vein and makes it easily visible. Fluid containing local anesthetic is infused under the skin loosening the vein from the surrounding tissues. A vein remover instrument is guided to the vein, which is suctioned into the instrument where it is cut into small pieces and removed.

Venous stripping: Venous stripping procedure is similar to Phlebectomy, where all parts of the saphenous vein main trunk is removed through the incision made near to the varicose vein.

Vein Ligation: In this surgical method incisions are made above the problematic vein and the vein is tied off, to cut off the blood flow to the varicose vein. This vein gradually becomes less visible.

Following are the non-surgical treatment methods adopted in the treatment of varicose veins,

  • Leg elevation & exercises
  • Wearing Graduated Compression Stockings
  • Ultrasound guided foam Sclerotherapy
  • Endovenous thermal ablation
  • ClariVein®

Leg elevation & exercises:

Leg elevation and exercise often provides temporary symptomatic relief.

Wearing Graduated Compression Stockings:

Wearing graduated compression stockings with variable pressure gradients (Class I, II & III) has proven to reduce swelling and improve blood circulation thereby stops the progression of the condition. The pressure grades and the styles (below knee or above knee) should be selected under the supervision of the doctor.

Varicose vein patient are advised to wear graduated compression stockings even after any surgical or non-surgical treatment methods. Apart from controlling the progression of varicose veins compression stockings will prevent the re-occurrence of varicose vein problem.

Ultrasound guided foam Sclerotherapy

The procedure involves injecting foam into the affected veins to inject and destroy the affected veins. The procedure is usually done on either the long saphenous vein on the inside of your thigh or the short saphenous vein on the back side of the calf muscle. After the procedure the patient will be advised to wear a graduated compression stockings.

Endovenous thermal ablation

The procedure involves passing a probe into the affected vein to heat up and seal the vein from inside using Laser rays or Radio Frequency waves.

Endovenous Thermal ablation done using Laser rays is known as Endovenous Laser Ablation and that using Radio Frequency is known as Endovenous RF Ablation.

Patient is advised to wear graduated compression stockings for a certain period.

ClariVein®

Clarivein is minimally invasive methord used to treat varicose veins using anesthetic. The procedure involves inserting a rotating catheter into the vein and releasing a drug to seal it from inside. After the procedure compression stocking will be applied to the leg.

Though the causes of varicose veins are many, the following groups are at higher risk.

  • Age – Adults above the age of 40 are at higher risk
  • Gender – Women are at higher risk than men
  • Obesity – Over-weight people are at higher risk
  • Family History
  • Sitting or standing for long time at work e.g teachers, policemen etc
  • Lack of movement or low physical activity
  • Pregnancy – due to the increase in blood flow. Also the enlarged uterus puts pressure on the veins.

The common symptoms of varicose veins are:

  • aching and discomfort in lower limbs
  • heaviness in lower limbs on standing
  • swelling in the limbs
  • itching or tingling in the legs
  • cramps at night
  • restless legs
  • large tortuous veins seen below the skin
  • skin discoloration or venous ulcers

varicose-veins-overview-bannerVaricose veins are dilated, swollen, tortous veins of the superficial venous system of lower limbs which are seen bulging from the under surface of the skin. They are most commonly seen in the lower limbs and can be cosmetically deforming.

  1. Inspect foot daily. Check your cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Consult your doctor if you notice anything unusual.
  2. Wash your foot with lukewarm (not hot) water. Keep you foot by washing them daily. But you should use only a lukewarm water-the temperature you would use on a new born baby.
  3. Cut nails carefully. Also, file the edges. Don’t cut them too short, since this could lead to ingrown toe nails.
  4. Get periodic foot exam. See your podiatric foot and ankle surgeon on a regular basis for an examination to prevent the foot complications of diabetics
  5. Do not walk barefoot. Wear footwear even at home. You may step on sharp objects and get a scratch or cut
  6. Do not sit with legs crossed. It reduce the blood circulation to the foot
  7. Use correct footwear. Choose your footwear after consulting your doctor. Always wear footwear with loose cotton socks.
  8. Take care of your diabetes. Keep your blood sugar levels under control
  9. Don’t smoke. Smoking restricts blood flow in your foot
  10. Don’t trim corns or calluses. No “bathroom surgery”-let your doctor do the job
  11. Don’t apply heating or cooling pads to legs. Diabetic patient cannot sense the actual temperature so it may damage the skin.
  12. Do not walk with ulcer in the foot. Walking with ulcer foot will delay the healing process since it requires pressure offloading.

Yes. The chances are more for obese people with big tummy to get back pain. Overweight people invariably adopt a very poor posture .They carry their excess weight in front of them, which throws their backs into an uncomfortable hollow. This overstretches certain spinal ligaments and reduces the diameter of the foramina (holes) through which the spinal nerves emerge, increasing the risk of nerve root compression.

Pregnant women are also prone to backache because they carry the weight of their babies in front of them. This forces their spines into a painful backward bend. Exactly the same is true for a obese person with big tummy.

Yes. The wrong mattress can be a reason for causing back pain. Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to low back pain.

 

Recent studies show that a medium-firm mattress greatly improves the sleep quality in people suffering from chronic lower back pain. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.

Yes.

Doing regular exercise can help to reduce and relieve back pain, and even prevent it from returning. There’s a whole range of physical activities to keep our back healthy. Research suggests that exercise may help if you have back pain that lasts for longer than six weeks. You may be able to try:

  • walking
  • yoga
  • swimming
  • cycling
  • hydrotherapy (exercises in water)

(Note: Exercises should be undertaken only after consulting with your Physician)

Chronic back pain is typically described as lasting for more than three months. It may result from a previous injury, or it may have an ongoing cause, such as nerve damage or arthritis. In some cases, the exact cause of pain cannot be identified.

Acute back pain comes on suddenly and usually lasts from a few days to a few weeks (maximum up to six weeks). Most cases of Acute Back pain will clear up in a few days without medical attention, although recurrence after a first attack is common.

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lower-back-pain-reliefOsteoarthritis is a condition in which the cartilage that protects and cushions the joints breaks down over time. Eventually, the bones-formerly separated by the cartilage-rub against each other, resulting in damage to the tissue and underlying bone and causing painful joint symptoms.

When osteoarthritis affects the small joints in the spine, it can lead to back pain.

Osteoarthritis in other joints, such as the hips, can cause us to limp or to change the way we walk. This can also lead to back pain.

 

A slipped disc – known as a prolapsed or herniated disc – occurs when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves.