When should you see a doctor for a Total knee replacement
Knee replacement surgery is frequently required when the knee joint has become worn or injured, limiting your movement and causing discomfort even while you are resting.
Osteoarthritis is the most common cause of knee replacement surgery. The following medical conditions can also cause knee damage:
Rheumatoid arthritis is a kind of arthritis that disturbs the joints.
Hemophilia
Gout
Abnormalities in the growth of bones
Knee deformity accompanied with discomfort and cartilage loss

Advantages of Total Knee Replacement

It reduces pain and improves knee function
Improved range of motion
Earlier return to activities
Immediate physical therapy

What to expect after knee replacement?
Knee replacement for most patients gives pain relief, increased mobility, and a higher quality of life. Most knee replacements can last up to 25 years.
Most daily tasks, such as grocery shopping and minor cleaning, can be resumed three to six weeks after surgery. If you can bend your knee far enough to sit in a car, have adequate muscular control to use the brakes and accelerator, and aren’t still on narcotic pain drugs, you can drive about three weeks after your surgery.
Low-impact activities such as walking, swimming, and golfing can be resumed after recuperation. However, it would help if you stayed away from activities with a higher impact, such as running, skiing, tennis, and other sports requiring contact or leaping. Consult your physician about any limits you may have.

Sudden or chronic physical pain or discomfort occurring anywhere on the spine or back, ranging from mild to disabling is known as back pain. Back pain can be both acute or chronic.
• Acute pain starts suddenly and lasts for up to 6 weeks.
• Chronic or long-term pain :- Back pain that remains for more than 3 months or comes and goes often is called chronic back pain. It develops over a longer period and causes ongoing problems.

Causes of back pain

Lack of exercise
Exercise is the single most important factor maintaining the health of our spine. Regular back exercises strengthen our muscles so that they can withstand the stress of our daily activities. Not doing back exercises is a sure shot way to invite early back pain.

Diseases and disorders (Structural problems)

• Prolapsed disc : The disc between the two vertebral bodies can prolapse into the spinal canal compressing on the spinal cord or the traversing roots causing back pain or leg pain.
• Spondylosis: Wear and tear of the vertebral bodies occurs with ageing, causing decrease in disc space. Abnormal bone formation occurs (osteophytes) which can impinge on the nerve roots causing pain
• Abnormal curvature: Abnormal curvature of the spine in the frontal or sagittal plane can cause back pain and discomfort. An example is scoliosis, in which the spine curves to the side.
• Osteoporosis: Age related loss of calcium from bones of the spine is an important cause of back pain after 60 years of age, especially in females. Severe cases of osteoporosis are at high risk of compression fracture of the vertebral bodies.

Posture

Improper posture is the most common cause of back pain. Adopting a bad posture while working causes excess strain on the back ligaments and muscles which leads to chronic pain. Sitting in one place for long hours is detrimental to long term health of our spine.
When to see a doctor?
We normally get relief from back pain with home remedies. rest, over the counter analgesics and hot compression should help in most of the non complicated cases. But one should seek see a doctor immediately if he/she is experiencing any numbness or tingling, or back pain that does not improve with rest, or is accompanied with weakness, fever, numbness in legs or weight loss.
Treatment
Back pain is better prevented than treated
● Regular back exercises
● Maintain ideal body weight
● Proper posture while sitting, lifting weights

Back pain can be treated after identifying the cause.
• Surgical and other medical procedures
• Medication like over the counter pain reliever, muscle relaxants etc.
• Physical therapy or physiotherapy

Role of physiotherapy in low back pain
Physiotherapy is a non surgical treatment which aims at decreasing back , improve the functioning and teach the patient a maintenance program to prevent future back pain or problems.

Physical therapy or physiotherapy is highly recommended to the people suffering from low back pain. Physiotherapy is one of the most widely used forms of treatment adopted for gaining relief from low back pain. It is used in both modes, as a single line of treatment as well as in combination with other treatments such as massage, heat, traction, ultrasound or short wave diathermy.

Physiotherapy or physical therapy is a form of treatment which helps in restoring, maintaining and improving the patient’s mobility function and well being. It is concerned with improving the quality of life by maximizing movement potential, health and fitness. Physiotherapist identifies your condition and offers advice and reassurance to manage your condition and addresses all your concerns.

What is the need of physiotherapy?

Physiotherapy helps through physical rehabilitation, injury prevention, and health and fitness. Physiotherapy is a very important part of arthritis treatment in most cases. Physiotherapy may help in treating or relieving the pain caused by following problems.

• Neck and back pain caused by problems in the muscles and skeleton

• Problems in the bones, joints, muscles and ligaments, such as arthritis and the after-effects of amputation

• Lung problems such as asthma

• Heart problems which resulted in disability

• Pelvic issues, such as bladder and bowel problems related to childbirth

• Loss of mobility because of trauma to the brain or spine, or due to diseases such as Parkinson’s disease and multiple sclerosis

• Fatigue, pain, swelling, stiffness and loss of muscle strength, for example during cancer treatment, or palliative care.

Benefits of physiotherapy?

• Reduces pain :- Arthritis or injuries can be extremely painful hindering your activeness. Physiotherapy proves really helpful in eliminating pain or reducing your pain regardless of age. It also restores the functioning of your injured or swollen muscle and joint.

• Improves mobility :- Any injury, ailment or any other condition which causes knee or joint pain also results in reduced mobility and functioning of joint. Physiotherapy is helpful in restoring the same mobility as before pain and injury.

• Improves overall strength and fitness :- It proves extremely beneficial in improving overall strength and well-being. It improves your quality of life by making you more active and fit.

• Avoid Surgery :- In some selective cases, when the pain and mobility is managed by physiotherapy then the surgery might be avoidable. Even if surgery is to be performed, it works as pre surgery treatment.

• Recovering from a surgical procedure :- After surgery, you might experience weakness, fatigue or may feel physically unfit. Physiotherapy helps you recover faster from the surgeries. It helps you in returning to your normal activities early.

Different techniques used in physiotherapy

There a range of techniques and approaches used to improve health and well being. A physiotherapist may use any one or combinations of more than one method for treating your ailment and relieving you from the pain. These are

• Massage and manipulation
• Energy based therapy
• Movement and exercises
• Hydrotherapy
• Neurological physical therapy
• Cardiovascular physical therapy

Side effects of physical therapy

Physiotherapy is a very safe process which generally has no or less risk when performed by specialists. But in some cases, people may experience some side effects of physiotherapy such as increased pain, fatigue, swelling, increased metabolism or heart rate, or burns and rashes.

What is arthritis?

Arthritis is a disease which involves inflammation or breakdown of your joints. It is a disease that affects your joint and knee movement. There are mainly two types arthritis – osteoarthritis and Rheumatoid Arthritis. Normal wear and tear, age and previous history of any injuries causes arthritis.

What are the symptoms of arthritis ?

• Decreased range of motion
• Knee pain
• Redness and stiffness
• Swelling

What are risk factors for arthritis ?

The risk factors for this disease are

• Obesity
• Women are more likely to develop this.
• Your family history makes you more prone to it.
• Previous surgery or joint injuries are risk factor.
• You can develop this with growing age

What are the types of arthritis ?

There are different types of arthritis. These are ;

• Osteoarthritis
• Rheumatoid Arthritis
• Psoriatic arthritis
• Gout
• Septic arthritis

What is osteoarthritis?

Osteoarthritis is a chronic degenerative disease characterized by wear and tear of cartilage of the joint. Absence of cartilage causes the opposing body surface to rub against each other causing pain while walking or getting up from sitting position. Patients with advanced osteoarthritis also have joint deformities and restrictions of joint movement.

In whom does osteoarthritis occur?

Osteoarthritis is mostly and age-related disorder and typically affects people over 50 years of age. Previous injury to the knee, obesity 8 letters are another important causes of osteoarthritis in the younger age group.

What are the common symptoms of Osteoarthritis?

• Over and around knee joint more on climbing stairs, squatting or sitting crossed legs
• Loss of joint movements
• Joint deformities
• Occasional knee swelling

Treatment for Osteoarthritis

Treatment for Osteoarthritis differs depending on the stage.

• Early osteoarthritis :  In mild osteoarthritis with minimal pain, medicines usually give adequate pain relief. Knee exercises, ultrasonic sittings, weight reduction may be advised by us. However excess use of pain killers can be harmful for the body especially the kidney and is not recommended.

• Advanced osteoarthritis : In advanced osteoarthritis, the cartilage over the joints is almost completely worn out, in addition joint deformities and stiffness make medical management of this disease very unsatisfactory. Such patients get very good results with surgery which is total knee replacement.

What is Rheumatoid Arthritis ?

Rheumatoid Arthritis is an autoimmune disease where the immune of the body attacks the joints causing joint destruction and swelling. It causes cartilage destruction at a much younger age than osteoarthritis.

What are the common symptoms of Rheumatoid Arthritis?

• Joint pain and swelling
• Fatigue and tiredness
• Stiffness of joint
• Discomfort in doing regular work or movements

It is a surgery where the diseased worn out cartilage of the knee is removed and replaced with metal implants called prosthesis.

The implants are fixed to the underline bone with bone cement.

In addition, appropriate bone cuts are made so that the knee becomes straight again.

Who needs TKR?

A person may consider total knee replacement surgery if

• You are suffering extremely from arthritis in the knee or it has severely damaged the mating surface of the joint.

• Pain and stiffness in the knee is giving you trouble while walking, getting in or out or doing routine activities.

• Your knee swelling and dislocation which doesn’t turn normal after exercises.

What are the benefits of Total Knee Replacement?

• Permanent pain relief :– It provides permanent pain relief as the worn out cartilage is replaced with metal, friction between the bones of faces is prevented and hence the pain is relieved.

• Knee becomes straight again :- TKR not just helps in relieving pain but also in fixing the knee. It makes the knee straight again.

• Improved range of motion of joint :- Damage to knee leads to immobility or reduces mobility. Exercises might be helpful but in the long term it requires a permanent solution. Total knee replacement replaces your damaged part and helps in providing better mobility. It improves the range of motion of the joint.

• Feel of a natural knee :- Due to significant advances in material design and surgical techniques, the latest implants closely mimic the feel of a naturally while walking.

• Affordable treatment :- What can be better than this surgery when it is affordable too? Recent government regulations of implant pricing have significantly reduced the cost of total knee replacement, making the surgery affordable to many patients. Economically weak person may get special discount.

• Age is not a barrier :- A special reason why TKR is a better process is it has no age barrier. In fact this surgery is recommended after 55-60 years only. The surgeon will decide if you are fit to undergo surgery after looking at your blood test, ECG and urine test.

What are the risk associated with TKR?

With so many advantages of knee replacement, there are a few risks associated with it too. Risk factors are always present in any surgery but only less than 2% of people face severe complications after knee replacement.

• Blood clots
• Infections
• A small injury around knee
• Injury to nerves or blood vessels
• Continued pain

Should I delay my surgery for as long as possible?

Delaying surgery despite having a significant pain leads to poor quality of life and unnecessary suffering for the patient. In addition, waiting for long time may lead to additional deformities and may require surgery later with special implants.