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Back Pain Treatment in Delhi
Back pain is a common problem affecting 8 out of 10 people at some point in their life. It can affect people of all ages and is a common reason for seeking medical assistance. Back pain can arise due to many reasons and accounts for significant suffering & financial loss worldwide. Many people choose to treat their back pain at home with pain relieving medications, heat and ice, or stretching. So, if it’s so prevalent what are the warning signs of something serious which requires medical attention.
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Cervical Pain Treatment in India - Removemypain
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.
Neck pain may be a result of...
Local pathology
Whiplash (flexion-extension) injuries/ trauma
Be a part of a more widespread systemic problem such as ankylosing spondylitis, rheumatoid arthritis, fibromyalgia etc.
Be a result of referred pain from neighboring areas for example the shoulder joint
Neck pain usually has a multifactorial etiology -poor posture, neck strain/injuries, anxiety, depression and stress can play a role in magnifying the perceived pain. Quite often the diagnosis of simple or nonspecific neck pain is used implying postural and mechanical causes; this is contrary to other serious causes of neck pain such as fracture, tumour, infection etc.
Pain from upper neck can radiate towards the head leading to frequent headaches and that from the lower part of the neck can radiate to the shoulder, arm, chest wall and the scapula. Reduced neck movement along with localized areas of muscle tenderness known as trigger points are commonly observed along with pain.
Tag = Cervical Pain Treatment in India, Pain Management in Delhi, Back Pain Treatment in India
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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.
Pudendal neuralgia is a condition related to irritation or damage of pudendal nerve, which presents as pain or altered sensation in the genital, rectal region or deep inside the pelvis. It is more common in women and is also addressed as cyclist syndrome, Alcock’s canal syndrome and pudendal nerve entrapment. Despite the significant advances in the evaluation and management of chronic pelvic pain treatment in delhi, it often goes unrecognized.
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Finest Neck Pain Treatment in Delhi
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.
Are you tired of dealing with neck pain? We have the perfect solution for you! Come and experience the finest Neck Pain treatment and say goodbye to neck pain for good! Under the Supervision of Dr. Amod Manocha specializes in providing top-notch neck pain treatment in delhi tailored to your specific needs. Say goodbye to discomfort and hello to relief!
Why Choose Us?
Expert Care: Our team consists of experienced professionals who are dedicated to delivering the highest standard of care for your neck pain.
Personalized Approach: We understand that each individual is unique. That's why we offer personalized treatment plans designed to address your specific concerns and preferences.
Comprehensive Solutions: We provide a wide range of treatments, from advanced therapies to holistic approaches, to ensure that you find relief.
Cutting-Edge Facilities: Our state-of-the-art facilities are equipped with the latest technology to ensure the best possible outcomes for our patients.
Results-Driven: Your satisfaction and well-being are our top priorities. We strive to deliver results that exceed your expectations.
Don't let neck pain hold you back any longer. Take the first step towards a pain-free life today! Contact us to schedule your consultation and embark on the journey to a happier, healthier you.
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Revolutionizing Relief with Chest Wall Pain Treatment in Delhi
In the bustling heart of Delhi, amidst its vibrant streets and cultural tapestry, a silent struggle often goes unnoticed—chest wall pain. This discomfort, ranging from a mild ache to debilitating agony, can disrupt daily life and cast a shadow over one's well-being. However, in the midst of this challenge lies a beacon of hope—the advanced chest wall pain treatments available in Delhi. Let's embark on a journey through the innovative approaches and transformative solutions offered in the capital city.
Chest wall pain can originate from any of the chest wall structures including bones, joints, muscles, cartilage, ligaments, tendons, nerves, skin and soft tissue. It generally increases with arm movement and is accompanied by localised tenderness.
Other joints such as the one between the collar bone and sternum or the ones between the ribs and sternum can also be a source of chest wall pain. Inflammation of the cartilage connecting the ribs to the sternum is known as chostrochondritis.
Understanding the Pain: Chest wall pain encompasses a spectrum of conditions, from musculoskeletal strains to more serious underlying issues. Often dismissed or misdiagnosed, this pain can stem from various sources such as muscle strain, rib injuries, or even cardiac concerns. Proper diagnosis and targeted treatment are essential for alleviating discomfort and preventing further complications.
Cutting-Edge Treatments: Delhi's medical landscape boasts a plethora of cutting-edge chest wall pain treatment in delhi tailored to address chest wall pain comprehensively. From state-of-the-art diagnostic imaging technologies to minimally invasive interventions, patients have access to a wide array of options.
Advanced Imaging Techniques: Modern diagnostic tools like MRI, CT scans, and ultrasound enable precise identification of the root cause of chest wall pain. This ensures accurate diagnosis and facilitates personalized treatment plans.
Interventional Procedures: Delhi's healthcare facilities offer a range of interventional procedures aimed at providing rapid relief from chest wall pain. Techniques such as
nerve blocks, trigger point injections, and radiofrequency ablation target specific pain generators, offering long-lasting symptom relief.
Physical Therapy and Rehabilitation: Holistic approaches incorporating physical therapy and rehabilitation play a pivotal role in managing chest wall pain. Delhi's rehabilitation centers employ tailored exercise regimens, manual therapy, and posture correction techniques to strengthen muscles, improve flexibility, and enhance overall well-being.
The Human Touch: Beyond the realm of technological advancements, Delhi's healthcare providers are renowned for their compassionate care and patient-centric approach. From the initial consultation to post-treatment follow-ups, patients are guided with empathy and expertise every step of the way. This human touch fosters trust, instills confidence, and empowers individuals on their journey to recovery.
#PainspecialistinDelhi#ThoracicspinetreatmentinDelhi#ChestwallpaitreatmentinDelhi#PainManagementinDelhi
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Persisting Pain After Knee Replacement
How Common Is Persisting Pain After Knee Replacement And Why Is It Important ?
Pain is the most important indication for joint replacement surgery and although surgery is successful in a vast majority of patients, some continue to have persisting pain. As per research evidence, approximately 9% after hip and 20% after knee replacement have an unfavourable pain outcome. 20% implies 1 in 5 patients, a significant number. Despite the high prevalence, the condition remains under acknowledged and can be rightly addressed as a silent epidemic.
Persistent pain not only has an adverse impact on the quality of life but often leaves patients confused or blaming themselves for the pain or the decision to go ahead with surgery. It can have an impact on mobility, general health, mood, sleep and lead to functional limitation with social isolation. When no obvious cause is found, the problem may be downplayed leading to the dissatisfaction, frustration, anger, tension or breakdown of the doctor–patient relationship, promoting doctor shopping. Somewhat ironically, persisting pain can sometimes be a consequence of surgery that was performed to alleviate pain.
Risk Factors for Persisting Pain after Knee Replacement
Persisting pain may have more than one reason, with a wide range of factors influencing the outcomes. It is important to know about these as some of them are modifiable.
Some of the known risk factors include
Poor mental Health including major depression, anxiety
Catastrophization (Constant worrying and exaggerated negative orientation towards pain experience)
Presence of other chronic pain conditions
Surgical factors include infection, instability, implant loosening or failure, alignment problems with the implant (misalignment), soft-tissue impingement, nerve injury and extensor mechanism problems (patellar malt racking and non-resurfaced patella)
Severe preoperative pain. Some studies have linked poorly controlled pain after the operation to increased chance of developing chronic pain whereas other studies have found insufficient evidence.
High number of comorbidities (other medical problems). Pre-existing heart disease has been found to be an independent risk factor for pain at 5 years after knee replacement. The peripheral edema (swelling), sedentary lifestyle/ reduced engagement with physical therapy may contribute to increased pain levels.
Young age and female gender
Pain Assessment
Most patients with persisting pain after the replacement surgery would return to the operating surgeon for a reassessment. Sometimes a second opinion from another surgeon is sought. Careful assessment in required to identify the problem and this involves detailed history, clinical examination (including the spine, hip and knee), psychological exploration, review of preoperative images & operative records, new investigations (serological, radiological and microbiological), assessing response to treatments and joint aspiration/ diagnostic injections if indicated. Sometimes despite extensive evaluation and best attempts using all modern technology at our disposal, the cause of pain cannot be identified. In such cases a trial of conservative therapy including pain relieving medications and physical therapy is often suggested.
Management Of Persisting Knee Pain After Knee Replacement Surgery
Treatment of chronic pain after knee replacement is challenging. It requires a multidisciplinary team approach with input from orthopaedic surgeon, pain physician, physiotherapist, psychologist and many others. The aim is generally improvement in function and quality of life. Once the cause of persisting pain is known the treatment can be directed accordingly.
Anatomically the cause of pain may be located
Extra articular (outside the knee joint at a distant site such as spine)
Peri articular (around the joint) such as tendinitis (ten on problem), bursitis (inflammation of bursa)
Intra articular (inside the joint) such as joint instability, loosening of implant, issues related to size/type of implant, infection, osteolysis (loss of bone), kneecap problems
How Can A Pain Physician Help ?
A pain specialist plays an important role in management of persistent pain and this includes
Identifying the type /source of pain. This is especially relevant when issues with implant have been excluded and surgery is not required/not possible. Diagnostic joint injections can help differentiate whether the pain is coming from inside the joint or from an external source. If required, some joint fluid can be aspirated (removed) at the same time to evaluate for infection. Similar injections can be used to identify pain sources around the joint by trigger point injections, nerve blocks etc.
Regulating pain medications. This is an essential component of overall management, best performed by professionals who are aware of all options and their limitations. Pain physicians are more familiar with use of stronger pain killers and some options such as capsaicin & Lidocaine patches as they use it more often. Sometimes small changes in medications can make a huge difference in the pain levels.
Treating nerve pain. Nerve pain after knee replacement often goes unrecognized and may be responsible for persisting pain in approximately 6%-13% of patients. Typically, it presents with electrical shock like or burning sensation, numbness or altered sensitivity, although it can also present as an aching sensation associated with stiffness. Sometimes thickening of the nerve (neuromas) can be a source of persistent pain.
Infrapatellar branch of the saphenous nerve. This is a small nerve running from the inner to the outer side of the knee below the kneecap. An injury to this nerve or a neuroma can be a common cause of persistent knee pain. Pain physicians can treat this successfully in an overwhelming majority of patients with nerve blocks, radiofrequency or cryoablation procedures.
Nerve blocks are offered if nerves are suspected to be the pain generator. A simple OPD performed procedure can often help identify the pain source and provide prolonged relief.
Pulsed Radiofrequency can be performed as a day case in an attempt to prolong the pain relief, in case the effect of the nerve block is short lasting. This is similar to nerve block but uses special needles and a radiofrequency machine to interfere with the pain signals being transmitted to the brain.
Cryoablation. This specialised technique involves application of cold to cause temporary disruption of the nerves ability to transmit pain signals without causing permanent nerve damage.
Other specialist interventions used to provide pain relief include
Radiofrequency Ablation of Genicular nerves. Knee joint is supplied by many nerves and these are collectively addressed as genicular nerves. This procedure involves an initial diagnostic test whereby a small amount of local anaesthetic is injected close to these nerves. If this produces effective pain relief then one proceeds with the radiofrequency ablation. In radiofrequency ablation special types of radio waves are used to create a heat lesion around the nerves interrupting the transmission of pain signals to the brain. These nerves are approached with help of needles placed under x-ray and ultrasound guidance with no requirement for any surgical incisions. This is a safe, non-surgical procedure performed as a day case under local anaesthesia.
Cooled Radiofrequency Ablation. Cooled Radiofrequency treatment is a minimally invasive treatment performed on a day care basis under local anaesthesia. The treatment aims to deactivate the nerves responsible for transmitting pain signals from the painful knee. It involves placing needles close to these nerves under x-ray or ultrasound guidance followed by heating of nerves to reduce the pain signals being transmitted. It differs from conventional Radiofrequency (described earlier) as it has water circulating through the device and can create a larger treatment area increasing the chances of success. Normal activities can generally be resumed soon after the procedure.
Spinal Injections – All nerves supplying the knee joint originate from the spine and interventions targeted on these (such as pulsed radio frequency of dorsal root ganglion) can help reduce the pain.
Identifying your needs and directing you to other experienced professionals (such as physiotherapists, occupational therapists, psychologists) as required.
Tags- Knee Pain Treatment in India Back Pain Treatment in India Pain Management in South Delhi
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Pains Associated With COVID-19
WHO declared COVID-19 outbreak as a global pandemic on 11th March 2020. One year on and we are still haunted by the mysteries of this virus as more and more evidence accumulates supporting COVID-19 as a complex multisystem disease rather than just being restricted to the lungs.
The widespread perception is that COVID infection has the following probable outcomes – recovery in two to three weeks, hospital admission or mortality is severe cases. For some patients however, COVID 19 is not a discrete infection lasting a few weeks but marks the start of a long-term illness with ongoing and often debilitating symptoms. This is addressed as Long COVID. This diagnosis brings more uncertainty into picture and challenges the clinical, governmental assumptions about COVID.
Long COVID is perhaps the first illness name to be coined by patients themselves through social media. Persisting pain and fatigue is one of the prominent symptoms of Long COVID. This blog explores the relationship between COVID-19 infection and pain, including the pains related to acute infection and those persisting after the infection.
What type of pains does one experience at the time of acute COVID-19 infection?
Muscle pain and fatigue are commonly seen in acute COVID -19 infection with an incidence of approximately 44%. COVID-19 associated pain is described by most as a diffuse ache or soreness, similar to that one experiences after exercise. The difference being that these pains are not localised to one body part and take a longer time to resolve. Compared to the joint pains, muscle pains are more commonly seen in the acute phase.
Even the so called “mild COVID-19” cases can be troubled by miserable, debilitating symptoms such as headaches, body aches and extreme fatigue. Pains associated with acute COVID-19 infection and their incidence range are as follows
Muscle & Joint pain 1.5 – 61 %
Headaches1.7 – 33.9%
Sore throat 0.7 – 47.1%
Chest pain 1.6 – 17.7%
Abdominal pain 1.9 – 14.5%
What is the cause of COVID-19 infection associated pains?
The exact cause behind these pains remains unknown but generalise soreness, pain and fatigue are not uncommon with viral infections and most of us have experienced these with seasonal flu. Multiple mechanisms are postulated to be contributing to these pains such as
Virus triggered inflammation and body’s immune response
Direct muscle damage
Blockage of blood vessels by clots leading to the poor blood supply to the muscles etc.
The relative contribution of these factors remains unknown. Besides these, stress and low mood play a role in modulating the pain perceived by an individual.
How can we manage these pains?
For most people these pains respond to simple painkillers such as paracetamol. If this is not sufficient then other pain killers can be used after consulting a specialist, as these need to be chosen carefully depending on your current health status, organ function and severity of COVID infection. Simple measures such as ensuring adequate hydration, nutrition and adequate rest may be helpful in reducing the pain.
How long do these pains last for?
For most individuals these will get better as one recovers in 2-3 weeks. However, in some patients it may persist for longer periods.
What is Long-COVID and what are its symptoms?
A study conducted in Italy evaluated 143 patients for persisting symptoms, 60 days after the initial onset of COVID-19 symptoms. In this study joint pains and chest pain were present in 27.3% and 21.7% of patients respectively. Other commonly present symptoms included fatigue (53.1%) and dyspnoea (43.4%).
Another study from China, involving 1733 patients found that six months after discharge 76% of patients had at least one of the these symptoms- fatigue/weakness (63%), difficulty sleeping (26%), hair loss (22%), altered smell and taste (11 and 9%), and mobility issues (7%).
These persisting symptoms are addressed as Long COVID with as incidence of around 10% (varying between 10- 70 % in different studies). These studies highlight the impact of COVID even after the resolution of the acute phase. Other commonly observed symptoms include inability to concentrate, impaired memory, anxiety, and depression.
Why do some people get long lasting symptoms?
There is uncertainty regarding the underlying mechanisms responsible for Long COVID. Some of the possible causes include
A reduced response/ lack of immune response or long lasting changes in the immune system
Relapse or reinfection of the virus
New or relapsing inflammatory
Injury to multiple organs
Deconditioning
Treatment side effects
Post-traumatic stress.
What are the management options for Long-COVID?
Currently due to limited research and evidence, no specific treatments that can be offered as a cure. As the number of patients recovering from COVID-19 grows and research evidence accumulates, we may be able to answer this question better. Many patients, however, recover spontaneously with
Holistic support
Balancing rest with activity
Symptomatic treatment and gradual increase in activity
Individualized rehabilitation plans
Controlling other comorbidities such as diabetes, blood pressure, heart and breathing conditions etc.
One can make sensible lifestyle changes such
Following a healthy diet with weight management
Not smoking
Limiting alcohol and coffee
Getting quality sleep
Managing depression, anxiety and stress.
Protective role of supplements such as vitamins, if any remains unclear although maintaining normal levels is sensible.
Can Covid-19 infection cause flare-up of pre-existing arthritis?
Joint pains or arthritis after viral infections is not a new phenomenon with viral arthritis responsible for 1% of acute arthritis cases worldwide. In India joint pains after viral infections such as dengue and chikungunya are common. Concerns have been expressed regarding increase in severity of certain types of arthritis with COVID-19 infection, and how this unfolds in the future remains to be seen. Currently there are many published case reports with arthritic symptoms in lower limb and small joint of hand developing after COVID-!9 infection. Some of these patients have benefited from the use of anti-inflammatory medications and local joint injections.
Tags- Neuropathic Pain treatment in Delhi Pain Management in Delhi Best Back Pain Doctor in Delhi
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Cancer Pain Treatment In Delhi and Gurgaon - Dr. Amod Manocha
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
Pain can be of differentiated into background pain (which is always present in the background and is managed with regular medications) and breakthrough pain (pain that breaks through your regular pain relief). Breakthrough pain may occur unprovoked or may be triggered by external or internal factors. In cancer patients, different types of pain may coexist. It is not just limited to pain arising from inflammation and tissue damage for example cancer of the pancreas spreading to neighboring organs and nerves leading to visceral and neuropathic pain respectively and a distant spread to bones producing bone pain. Different types of pain present differently for example
Neuropathic/ Nerve pain is generally described as burning, shooting, electric shock-like, or stabbing pain with associated tingling or numbness. It may be a consequence of cancer itself or a result of treatments such as chemotherapy (chemotherapy-induced peripheral neuropathy- CIPN).
Visceral Pain originates from the viscera (organs in the body cavity) and is generally described as deep aching, squeezing, and cramping sensation
Bone pain presents as an aching, throbbing sensation. Some cancers have a preference to spread to bones
Pain Management
Pain relief needs to be tailored to the cause, severity, and duration of pain. In most cases, a reasonable control can be achieved by using a combination of methods. Multimodal, Multidisciplinary approach provides the opportunity to maximize pain relief and provide support not only for the physical needs but also for the emotional, spiritual, and social needs.
Tag = #CancerPaintreatmentinDelhi #CancerPaintreatmentinGurgaon #PainManagementinDelhi #PainTreatmentinSouthDelhi #BestpainspecialistinDelhi
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