COVID-9 a global crisis & orthopedic health issues

The ongoing COVID-19 pandemic has had serious effects on people all access the globe. With more than lakhs of deaths globally, the world is keenly awaiting an effective vaccine.

Speaking to Sakal Times Dr Anand Jadhav, Joint Replacement and Arthroscopy Surgeon at Jupiter Hospital, Baner, Pune said,"COVID-19 virus is highly contagious and hence hospitals and doctors are forced to deliver essential healthcare services in a different manner. People all over the world have had to make several adjustments to their daily lives in order to carry on working safely and protecting themselves & their families. Adapting to this newer lifestyle is the need of the hour for all. More people are now working from home. Many are also doing their chores of daily living themselves. Such precautionary measures are needed to avoid catching the infection and also preventing it from spreading."

Dr Anand Jadhav, Joint Replacement & Arthroscopy Surgeon at Jupiter Hospital in Baner, said that orthopaedic doctors are seeing an increasing number of people with bone and joint-related problems which are arising directly as a result of the changing lifestyles during this ongoing Covid 19 crisis. These problems could be affecting the spine or the upper & lower limb joints.

Elaborating on the reasons for these rising numbers of patient problems, Dr Jadhav said, "both men and women, across various professions, are having to work from home. Use of any gadget in non-ergonomic positions, puts their neck, upper back and scapular muscles under increased and undue stress."

Reasons for orthopaedic problems:

• Continuous and prolonged use of desktops, laptops or smartphones when working from home.
• Improper sitting in non-ergonomic positions e.g. lying on the sofa or bed and sitting on the floor with laptops.
• Using smartphones with the neck bent downwards for a long time or
• Holding smartphones awkwardly over shoulder top with the neck bent sideways whilst working on laptops

Consequences of bad posture:

· Pain

· Muscle spasm,

· Neck stiffness,

· Disturbed sleep,

· Headaches

· Tingling and numbness in the upper extremities.

· Anxiety and irritability due to on-going pain &

· Inability to continue working comfortably.

Dr Jadhav further said that several families have taken deliberate decisions of stopping their housemaids from visiting their homes for daily work. Members of such families are willing to undertake responsibilities of household chores for safety reasons. More men and women are now having to do duties that they are not used to doing regularly. Repetitive actions or certain activities,that are performed with forward bending posture, put enormous strain on people's joints and their lower back.

Unaccustomed activities include:

· washing utensils

· cleaning and mopping the floors

· scrubbing of dirty surfaces or utensils

· washing clothes & drying clothes on strings above shoulder level

· stacking up dried clothes in cupboards or on higher shelves

· lifting bags or other items from the floor and

· moving furniture or heavy objects around the houses

Additionally, some people are doing self exercises to stay fit as commercial and society gymnasiums are closed. Untrained or unsupervised activities like push-ups, pull-ups, squats and weight training without proper precautions are being performed. These unaccustomed activities increase the risk of injuries. In several places, repeated lockdowns and the fear factor have forced people from doing their daily outdoor activities and regular exercises. This has resulted in weight gain leading to aggravation of knee and heel pain. The same fear factor has also stopped patients from visiting hospitals or clinics. Such delays in seeking timely advice and treatment lead to aggravation of their problems.

Dr Jadhav also noted that people who stay indoors for long hours lack exposure to adequate sunlight and consequently develop Vitamin D deficiency. Additionally, irregular eating habits and inappropriate or unhealthy food consumption contribute to other vitamin deficiencies. Such deficiencies of Vit B12 & Vit D do go on to aggravate lifestyle-related orthopaedic problems.

Orthopaedic problems caused due to prolonged use of computers or laptops & performing household chores in non-ergonomic positions:

Thankfully nearly 90 per cent to 95 per cent patients will recover within 1 to 3 weeks with simple medications and regular exercises. They are advised to take precautions about their postures when working with desktops, laptops and smartphones. Precautions whilst doing normal household activities and any modifications to these are also explained. Patients are advised to carry on their self exercises for a minimum of 4 to 6 months. This helps in strengthening their muscles and also prevents recurrence of neck or back problems. Vitamin supplements are prescribed to correct any deficiencies as these do help in reducing generalised aches and bony pains associated with such deficiencies.

If any patient's symptoms are not settling down or they are getting worse even after 2 to 3 months of conservative treatment, local injections of steroids or platelet-rich plasma (PRP) are given to the painful areas for problems like shoulder bursitis, tennis elbow or plantar fasciitis.

Dr Jadhav has a reassuring message for all patients. He mentioned that all hospitals are taking necessary precautions of hand sanitisation, physical distancing, compulsory use of face mask, time-bound OPD appointments and spacing between appointments. This makes it convenient for patients to be seen quickly in a safe environment and get their treatment initiated. Now patients need not continue to endure their problems due to the Covid 19 fear factor as this can only aggravate their pains and prolong their sufferings.