Let the memory of hiking304 be with us forever
  • 22 years old
  • Born on March 2, 1980 .
  • Passed away on April 17, 2002 .

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.





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.















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.














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.













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.















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.













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.











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.













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.

















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.





























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