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Dr. Amod Manocha is the Head of Pain Management Services at Max Super Speciality Hospital, Saket. He is trained as a Pain Management Specialist and an Anaesthetist in the UK. He has over 13 years of work experience in the UK including working as a Chronic Pain Consultant in many UK hospitals. Dr. Manocha believes in multidisciplinary approach and providing evidence-based treatments at par with international standards. He is committed to providing quality care and believes in building long-term relationship with patients based on honest communication and keeping their interests foremost.

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Herpes Zoster is caused by the reactivation of the same virus which causes chickenpox. If you have had chickenpox before, the virus lies inactive in the nervous system till the time it gets an opportunity (such as in old age or when body’s immunity is reduced) to spread along the nerve. This produces the typical rash of Herpes Zoster accompanied by pain, numbness, itching, skin pigmentation and sometimes scarring. One out of five patients goes on to develop PHN where the pain persists for more than 120 days after the onset of rash. PHN is rare in age group below 50 years and incidence increases after the age of 60 years. Risk factors for PHN or persisting pain include older age and widespread rash with severe pain at onset.

[bestbackpaindoctor]

Dr. Amod Manocha is the Head of Pain Management Services at Max Super Speciality Hospital, Saket. He is a certified Pain Management Specialist as per the Faculty of Pain Medicine, Royal College of Anaesthetists, UK standards He assess and treats a wide spectrum of pain conditions and has over 13 years of UK experience including working as a Chronic Pain Consultant in many renowned UK hospitals such as University College Hospitals NHS Trust. Dr. Manocha believes in a multidisciplinary approach and provides evidence-based treatment at par with international standards.

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Chronic abdominal pain is a common reason for seeking medical attention. Pain generators in abdominal pain are not always easy to identify and may be located inside the abdomen, in the abdominal wall or in the nearby organs with pain being referred to the abdomen. ACNES is a common cause of abdominal wall pain and it involves entrapment of small nerves which supply the skin of abdominal wall as they pass through the abdominal muscle (lateral part of rectus muscle). A study from a Dutch teaching hospital found approximately 2% of patients presenting to emergency department with acute abdominal pain suffered from ACNES.

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Headache is a common problem. Fortunately a significant proportion of headaches can be managed by commonly used painkillers. In certain types of headaches prophylactic agents are used to reduce the frequency of attacks. However, there still remains a subgroup of patients with difficult to manage headaches despite all measures. For this subgroup pain clinic offers interventions and multi-disciplinary input, over and above the traditional approach of using painkillers. Multi-disciplinary approach helps in addressing concomitant magnifiers/ triggers such as anxiety, depression, altered sleep cycle, medication overuse, life style and poor posture.

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Coccyx or tailbone is the last bone at the end of the spine. Pain in the region of tailbone is called coccydynia. Common causes include trauma, childbirth and repeated strain on the coccyx. Patients may have increased mobility which triggers the inflammation. Other causes include fracture, infection and tumour

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The sacroiliac joint is large, strong joints between lower end of the spine and the pelvis. There are two sacroiliac joints, one on each side. These joints play an important role in transmitting the upper body weight to the hips and legs and hence undergo a significant amount of stress in day to day life. They function as shock absorbers and are reinforced by multiple strong ligaments. Sacroiliac joints are supplied by a number of nerves which when irritated can hurt.

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Knee pain can be a source of significant disability in all age groups as it limits mobility. It can be classified into traumatic or non traumatic and based on the site of pain into anterior, medial, lateral and posterior. The common reasons for knee pain vary with age group and pain site. Pain from other sites such as hip and lumbar spine can also present knee pain. In the above 50 years age group raised BMI is an important risk factor for developing symptomatic osteoarthritis.

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Globally, musculoskeletal pain is a common reason of disability and seeking medical advice. It may be localised to one area or present as a widespread/ multisite pain. Musculoskeletal symptoms may be a consequence of orthopaedic, neurologic or rheumatologic processes and hence a comprehensive history and examination is required. Based on the findings further tests and imaging are requested to confirm the diagnosis or rule out other serious conditions.

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Pain in cancer may arise due to many reasons and is often the presenting complaint leading to the diagnosis of cancer. It may be

Related to cancer itself or its spread to other body parts

A late presentation due to side effect of treatments such as chemotherapy, radiotherapy and surgery

A result of extra stress placed on other body parts for example shoulder pain due to using of a stick for walking

A totally unrelated coincidental problem such as arthritis

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Pudendal nerve is one of the main nerves of the pelvis, with one nerve on each side. It runs from the lower back, along the pelvic floor to supply the genitals, lower part of rectum, and perineum (area between the sit bones). This nerve is closely involved with urinary and bowel functions.

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Shoulder pain may be an isolated problem localised to the shoulder or be a part of widespread pain as in rheumatoid arthritis. A combination of history, examination and diagnostic investigations is utilised to identify the pathology and guide further management. Diagnostic ultrasound scan is an effective bedside tool as it can reliably identify common shoulder pathologies and reduce the requirement of additional investigations. I routinely perform ultrasound scans at the time of initial assessment.

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Neck Pain is a pain posteriorly anywhere between the skull base and thoracic spine. It is the largest cause of musculoskeletal disability after low back pain. Approximately two-thirds of the population will suffer from neck pain at some time in their life with high prevalence in middle ages. Fortunately for most people the acute pain resolves within days or weeks although in some it may reoccur or become chronic.

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Chronic post surgical pain (CPSP) is pain localized to the surgical site or a referred area persisting 3 months after surgery. To diagnose CPSP pain should have been absent before surgery or should have different characteristics from preoperative pain. Other possible causes of the pain such as infection, recurrence of original problem etc need to be excluded.

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In simple words, low back pain can be defined as pain experienced in the bottom region of spine (between lower margins of ribs and the gluteal folds). It may remain localised to back or radiate to the legs.

Sciatica is a term used for pain radiating down from the lower spine to the legs. Most common cause of sciatica is irritation or compression of the nerves as they exit the spine on their way to the legs. It may be accompanied by numbness, tingling and weakness in the distribution of the affected nerve.