Voice of Calcutta :

The Modern Musculoskeletal Crisis: Manipal Hospital’s Dr. Rajesh Srinivas on Sedentary Lifestyles, Joint Pain, and the Reality of Surgery

The modern desk job has brought with it an unintended healthcare crisis. Across generations, orthopedic clinics are seeing an unprecedented influx of patients suffering from chronic back, neck, and joint debilitating conditions.

To understand the shifting landscape of bone and joint health, we sat down with *Dr. Rajesh Srinivas, a distinguished Orthopedic Surgeon at Manipal Hospital. In an insightful conversation, Dr. Srinivas breaks down the root causes of the rising spinal issues among young professionals, debunks common myths surrounding major surgeries, and shares essential diagnostic warning signs that no one should ignore.The Changing Face of Orthopedic Health

In the following question-and-answer session, Dr. Rajesh Srinivas shares his expert insights on various orthopedic concerns, offering practical medical advice and recommendations for better bone and joint health. Despite his busy schedule, he graciously devoted nearly an hour to speak with the special correspondent of Voice of Calcutta. On behalf of Voice of Calcutta, we extend our sincere gratitude to Dr. Rajesh Srinivas for his valuable time and guidance.

 *VOC : What are the most common orthopedic conditions you have been seeing recently, and how have they changed in recent years?*

Dr. Rajesh Srinivas: Unfortunately, orthopedic problems have been increasing quite significantly across all age groups, primarily driven by lifestyle shifts.

We can broadly categorize what we see by age:

 * *Young Adults:* We are inundated with cases of back pain, neck pain, and early knee pain. This is almost entirely due to sedentary lifestyles and a severe lack of regular exercise.

 * *Middle-Aged Patients:* This group splits into two. Those who are highly active frequently present with sports injuries like ligament and muscle tears. Conversely, those with sedentary habits present with chronic, long-term back and neck issues.

 * *The Elderly:* Here, degenerative conditions dominate. We regularly treat arthritis, severe knee pain, shoulder pain, and advanced cervical/lumbar spine issues.

VOC: Why are knee and back pain becoming so common among younger people today?

Dr. Srinivas : It is a sad reality. Most young professionals completely neglect their health the moment they enter the workforce. Those in desk-bound jobs sit for prolonged hours without taking breaks.

More importantly, they sit with poor posture. This causes "eccentric loading" on the spine, meaning the weight of the body is distributed unevenly. Over time, this mechanical strain transitions from simple muscular fatigue to a structural issue, leading to slipped discs and pinched nerves. Furthermore, a sedentary routine leads to rapid weight gain, which places immense, constant pressure on the knees, feet, and ankles.

VOC: How much does our modern lifestyle—including long screen times and poor posture—contribute to these issues?

Dr. Srinivas: The influence is massive; it cannot be understated. Long hours glued to mobile phones and computer monitors play a primary, definitive role in inducing early spinal degradation. Your posture dictates your spinal health, and right now, modern devices are ruining both.

## Unseen Triggers and Critical Warning Signs

VOC : Many people experience sudden bone or joint pain without any obvious injury or fall. What could be the underlying reasons?

Dr. Srinivas: This is an excellent question. We see many patients who experience sudden, severe pain with absolutely no traumatic trigger. There are three common culprits behind this:

 1. *Inflammatory Arthritis (such as Gout):* High uric acid levels can cause a sudden, agonizing onset of joint pain. It is often so excruciating that the patient cannot even bear weight to walk.

 2. *Joint Infections (Septic Arthritis):* This is a medical emergency. An infection inside the joint causes sudden, extreme pain, visible swelling, and restricted mobility, severely compromising daily function.

 3. *Neglected Old Injuries:* Often, a minor twist or micro-tear from the past is ignored because the patient could still walk. Over time, this deteriorates into a complete ligament tear or degenerative wear, presenting as sudden, shooting pain later in life.

VCC: What warning signs or symptoms should people never ignore before consulting an orthopedic specialist?*

Dr. Srinivas: I always emphasize that pain is a warning signal. You must seek immediate medical attention if you experience any of the following:

 * Pain that does not improve after *3 days* of rest, or fails to reduce in intensity.

 * Any sensation of *weakness, tingling, or numbness* in your hands, arms, legs, or feet.

 * An inability to move a specific joint or stand on your own.

 * Musculoskeletal pain or swelling that is accompanied by a *fever*.

## Prevention, Deficiencies, and the Sunlight Remedy

VOC: How important are Calcium and Vitamin D for maintaining healthy ones and joints? Are deficiencies becoming more common?

Dr. Srinivas: The Silent Orthopedic Crisis: How Modern Lifestyles Are Reshaping Joint and Spine Health” bone strength. Without them, structural bone density drops drastically. This is especially crucial for women post-menopause, who require a structured, scheduled intake of calcium to prevent osteoporosis.

However, bone health is not an isolated metric. It requires proteins, collagen, and regular physical exercise. Muscles and bones work in absolute coordination; you cannot have strong bones without strong muscles.

Today, deficiencies are incredibly common because people are working indoors—either in offices or working from home. Sunlight is our primary source of Vitamin D. If you do not expose yourself to the sun, your levels will plummet.

*Doctor's Recommendation:* To naturally synthesize Vitamin D, get exposed to direct sunlight *before 9:00 AM* for at least *40 minutes* daily, ensuring maximum skin exposure.

Additionally, Vitamin B12 deficiencies are highly prevalent, particularly among vegetarians. This must be managed through a disciplined diet rich in millets, dry fruits, leafy greens like palak (spinach) and methi (fenugreek), dairy products like buttermilk and cheese, or eggs and meat for non-vegetarians.

## Accidents, Ligaments, and the Myth of Surgery

VOC: Ligament injuries are frequently reported after bike or road accidents. Why are these specific injuries so frequent?*

Dr. Srinivas: Road traffic accidents (RTAs) and domestic falls are the leading causes of ligament trauma. The frequency of RTAs is exacerbated by driver negligence, a lack of traffic discipline, sudden braking, and poorly maintained, slippery, or uneven roads.

In younger individuals, the bones are inherently stronger and denser, but the surrounding ligaments are relatively more vulnerable to twisting forces. Therefore, high-impact trauma causes ligament tears in the youth, whereas the same force would result in fractures in elderly patients.

VOC: How can someone identify a ligament tear, and what immediate steps should be taken right after an injury?*

Dr. Srinivas Lifestyles Are Reshaping Joint and Spine Health”injury, it is incredibly difficult to differentiate a ligament tear from a fracture without clinical imaging, because both present with severe pain, swelling, and an inability to bear weight.

If you suspect an injury, you must follow immediate first-aid protocols before seeing a doctor:

 * *Rest:* Immobilize the affected limb completely.

 * *Ice:* Apply ice packs generously to control inflammation.

 * *Compress & Splint:* Secure the joint using a crepe bandage and a rigid splint to prevent any internal movement.

VOC: Do ligament injuries always require surgery, or can they heal on their own?

Dr. srinivas “The Silent Orthopedic Crisis: How Modern Lifestyles Are Reshaping Joint and Spine Health” surgical intervention. Ligament trauma is categorized into grades. Grade 1 and Grade 2 tears can be treated successfully through conservative management, specialized bracing, and target rehabilitation. However, a Grade 3 injury—which is a complete structural tear—cannot heal on its own and invariably requires surgery.

VOC: Does that mean the majority of everyday orthopedic problems can be resolved without an operation?

Dr. Srinivas : Absolutely. More than *90%* of the cases we see in daily practice are resolved completely without surgery. What they actually require is a proper, disciplined rehabilitation program and short-term medication. Surgery usually becomes the only option when patients chronically neglect their symptoms and present to us at an advanced, irreversible stage.

## Demystifying Joint Replacements and Spinal Procedures.

VOC: There is a widespread fear surrounding knee replacements and spinal surgeries. How justified is this concern?

Dr. Srinivas: Knee replacement is a highly successful, standardized procedure, but it is reserved strictly for advanced, end-stage arthritis. A major myth patients hold is that a knee replacement guarantees instant, effortless walking.

What patients fail to understand is that surgery only replaces the worn-out joint; it does not replace your muscles. If your muscles have become weak from years of inactivity, your recovery will be slow and painful.

Successful Recovery = Surgery (50%-60%) + Dedicated Physiotherapy (40%-50%

The clinical success of a joint replacement relies heavily on pre- and post-operative physiotherapy. If a patient refuses to commit to post-op rehabilitation, the surgery cannot deliver its optimal outcome.

VOC: What is your closing piece of advice for the younger generation to protect their orthopedic health for the future?

Dr. Srinivas: Unless a condition is strictly driven by genetics, preventing severe orthopedic issues later in life comes down to four non-negotiable daily habits:

1. Commit to a regular, daily exercise routine.

 2. Maintain a balanced, nutrient-dense diet.

 3. Keep your body weight within a healthy, optimal range.

 4. Be continuously mindful of your sitting and standing posture.

Take care of your body early, and your joints will take care of you in the futur.

Susmitasri Mukherjee, Special Correspondent