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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29549
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Im a 48 year old male & I live in Southern Arizona its hot

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Im a 48 year old male & I live in Southern Arizona its hot in the summer and i drink alot of tea with sugar and lemon aid, sodas. for the last 3 years i have been getting really fat and my legs have swolen up & my right knee has started having a sharp pain on both sides. when the winter comes around i went back to normal the first 2 years but this year it's been worse and has not gone away. i'm having a hard time standing for nlong periods of time and my back is always sore. how can i get the swelling in my legs to go down??
Submitted: 10 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 10 months ago.

Hello Trent Gillispie ,
I am Dr. Arun and will be helping you today.

What is your height and weight?
Were any investigations done for swelling and pain in knee?
Are you on any medications?
Any significant past medical illness?

Customer: replied 10 months ago.

i'm 5'6" and about 215lbs


no investigations i have been wearing a knee brace


no meds nopast illness


on the outside of my knee there is a small muscle or tendon that will sometimes go on the wrong side of the bone when i 1st stand up if it does this it streaches the mussel and i have to0 reach down and push itn back to the other side of the bone where it belongs

Expert:  Dr. Arun Phophalia replied 10 months ago.

Thanks Trent Gillispie for the further information.

Swelling of the legs on both the sides can be associated because of the following reasons (It is always important to discuss this with your primary care physician for the evaluation);

1) Venous valvular incompetence

2) Obstruction of the lymphatic outflow

3) Dependent edema which can occur because of the prolonged standing or sitting.

4) Congestive heart failure

5) Kidney diseases

6) Protein deficiency

7) Hypothyroidism

8) Anemia

9) Medications

Following measures are beneficial in decreasing or resolving the swelling:

1) Avoid prolonged standing or walking for long distances in a single stretch.

2) Whenever you sit; keep your legs elevated on a chair or a sofa or stool.Do not hang the legs, otherwise gravity will increase the swelling.

3) Exercises / physical therapy

a) Lie down straight and raise your leg and feet for 10-20 seconds. Repeat this for ten times (twice a day whole set).

b) When you sit; pull the feet towards you for 10-20 seconds. Repeat it for ten times twice a day.

4) Raise leg end of your bed by 6 inches.

Back and knee pain can be due to overweight and degenerative arthritis. Following measures would help in backache;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

3) Local analgesic gels or sprays / ointment

4) Hot fomentation

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or brace

8) Reduce weight for long term benefit.

You can start the following exercises;

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up lifting the head and shoulders from the bed / couch. Hold for ten seconds, then slowly lower to starting position. As strength builds, aim to complete one sets of ten curls. The exercise should be done twice a day (both the sets).

This is a slide show for the exercises (you can pick up your own set, which suits you);

http://www.mayoclinic.com/health/back-pain/LB00001_D

Knee pain too would get better by'

Physical therapy
Deep electrotherapy
Acupuncture
Knee brace which you are using (use only when walking otherwise it would increase the swelling in legs).

Following is the detailed advisory;

1) Knee care in the activities of daily living. Few simple self-care measures can be remarkably effective in ending pain cycle.

a) Avoid prolonged standing or walking or sitting with joint in a single position.

b) whenever you sit, keep the knee stretched and fold them intermittently.

c) Squatting, sitting cross legged should not be done.

d) Avoid climbing stairs.

e) Avoid sitting legs unsupported or hanging.
f) Reduce weight if over weight/obese.

2) Rest: Taking a break from your normal activities reduces repetitive strain on your knee, gives the time to heal and helps prevent further damage.

3) Anti-inflammatory medications

4) Physical therapy; the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Ideal is supervised physical therapy. Stretching exercises are also part of the physical therapy regime.

5) Orthotics and bracing.

6) Glucosamine and chondroitin orally for about 1-2 years and a trial of diacerin for three months.

7) Hyaluronic acid injections in knee.

8) Local analgesic sprays and ointments to your skin may help relieve the pain and stiffness of osteoarthritis.

9) Deep Electrotherapy by physical therapist.

These are the exercise resources for the knee. You can pick the exercises which suits you;

http://bigkneepain.com/knee-exercises.html

http://www.pamf.org/sports/king/kneerehab.html



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Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29549
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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