Pain Specialist In Delhi for Spine Pain treatment

Epidural injections for Spine Pain treatment

Epidural injections are a pain management option for patients with leg or arm pain originating from the spine. This is also known as Radicular pain or Radiculopathy. The pain usually radiates away from the irritated nerves. For Example – the pain could be originating from lower spine and may be felt far away in the legs. Pain specialists offer non-surgical options like this one for pain relief. As the techniques used are minimally invasive, and do not involve surgical incision or prolonged recovery, the risks involved are less.

One of the causes nerve pain is the narrowing (stenosis) of the space for these nerves in the spine or narrowing of the space from which these nerves exit the spine. This may be secondary to a slip disc or rupturing of the discs.

Depending on the problem different techniques /routes may be utilised to perform epidural injection. Nerve root block /transforaminal epidural, caudal epidural, interlaminar epidural are all epidural injections. Different names are used to indicate the technique used and route of entry. The route or the technique used can have an impact on where the maximum amount of drug is deposited.

How the epidural Injection works

Generally a combination of local anaesthetics and steroid are uses in these injections. The resulting pain relief can last for a few months although some people can experience long lasting relief from these injections. Corticosteroids serve dual purpose as an analgesic as well as have anti-inflammatory property. So, they help to control both pain and inflammation.

Immediately after the injection the injection site can feel sore although this is not troublesome for most people. This is mainly because of the mechanical process of inserting needle or at time also due to irritation resulting from the injected medication. But you need not worry about this as it will fade away soon and the pain relief would become apparent as the steroids start to work.

Benefits of Epidural Steroid Injection

There are numerous benefits of epidural pain injection over oral corticosteroids:

• Epidural injection delivers the medication close to the problem as a result more drug reaches the site of action compared to when it is taken orally.
• Side effects of the epidural injection are less compared to oral corticosteroids.
• The duration for which the effect of epidural steroid injection is generally longer. This period can be effectively utilized by the patient to engage in physiotherapy and strengthen the supporting muscles.
• Epidural steroidal injections help in providing quick pain relief in case of severe pain

Epidural injection works very well in case of pain originating from lower back (thoracic spine), neck (cervical spine) and mid back (thoracic spine). You should take expert advice from experienced pain specialists in Delhi as they can give you advice regarding the most appropriate therapy for you. Generally epidural injections are more beneficial in cases where the pain travels (radiates) towards arms or legs. Discuss this option with your specialist to find out if this is the right treatment for you.

Tags >> pain management in delhi, Pain Specialist In Delhi, Pain Clinic in Gurgaon

Epidural Steroid Injections can provide quick relief in cases of pain originating from the spine

Epidural injections for Spine Pain treatment

Epidural injections are a pain management option for patients with leg or arm pain originating from the spine. This is also known as Radicular pain or Radiculopathy. The pain usually radiates away from the irritated nerves. For Example – the pain could be originating from lower spine and may be felt far away in the legs. Pain specialists offer non-surgical options like this one for pain relief. As the techniques used are minimally invasive, and do not involve surgical incision or prolonged recovery, the risks involved are less.

One of the causes nerve pain is the narrowing (stenosis) of the space for these nerves in the spine or narrowing of the space from which these nerves exit the spine. This may be secondary to a slip disc or rupturing of the discs.

Depending on the problem different techniques /routes may be utilised to perform epidural injection. Nerve root block /transforaminal epidural, caudal epidural, interlaminar epidural are all epidural injections. Different names are used to indicate the technique used and route of entry. The route or the technique used can have an impact on where the maximum amount of drug is deposited.

How the epidural Injection works

Generally a combination of local anaesthetics and steroid are uses in these injections. The resulting pain relief can last for a few months although some people can experience long lasting relief from these injections. Corticosteroids serve dual purpose as an analgesic as well as have anti-inflammatory property. So, they help to control both pain and inflammation.

Immediately after the injection the injection site can feel sore although this is not troublesome for most people. This is mainly because of the mechanical process of inserting needle or at time also due to irritation resulting from the injected medication. But you need not worry about this as it will fade away soon and the pain relief would become apparent as the steroids start to work.

Benefits of Epidural Steroid Injection

There are numerous benefits of epidural pain injection over oral corticosteroids:

• Epidural injection delivers the medication close to the problem as a result more drug reaches the site of action compared to when it is taken orally.
• Side effects of the epidural injection are less compared to oral corticosteroids.
• The duration for which the effect of epidural steroid injection is generally longer. This period can be effectively utilized by the patient to engage in physiotherapy and strengthen the supporting muscles.
• Epidural steroidal injections help in providing quick pain relief in case of severe pain

Epidural injection works very well in case of pain originating from lower back (thoracic spine), neck (cervical spine) and mid back (thoracic spine). You should take expert advice from experienced pain specialists in Delhi and Gurgaon as they can give you advice regarding the most appropriate therapy for you. Generally epidural injections are more beneficial in cases where the pain travels (radiates) towards arms or legs. Discuss this option with your specialist to find out if this is the right treatment for you.

Tags >> Pain management in Delhi , Pain Specialist In Delhi , Spine Pain treatment

Pain Specialist In Delhi for Chronic pain

Pain, no matter how trivial, is an unwelcome guest. It can be associated with undue suffering and disability which everyone would like to avoid. It is helpful to understand the types of pain one may experience. Pain can be categorized as acute or chronic pain.

Acute pain is the pain that is present after an injury until healing occurs. Pain in this situation is a protective response bringing our attention to the affected area and helping us protect, rest the affected tissue providing an opportunity for healing. As the tissue heals, the pain gradually abates.

Chronic or persisting pain is pain that persists even after the usual time required for healing. It is important to understand that chronic pain does not always signify on-going damage. Nerves have a memory (plasticity in medical terms) whereby they develop changes which remain even after the original inciting problem is corrected. A simple example to explain this is persisting leg pain even after amputation of the affected part. There are numerous mechanisms to explain this and your doctor can help you understand these better.

Impact of chronic pain is not limited to the involved person but also affects their loved ones and family members. The longer it persists the more chances that it will have an impact on multiple aspect of your life including your ability to work, sleeping pattern, mood, social life, relationship with family and friends etc. Hence it is important to take corrective measures to reverse or control the condition as soon as possible.

The management varies depending on the actual pathology, severity, co morbidities, patient preferences, available resources/ expertise and many other factors. At your first consultation with me you can expect a detailed assessment including history, examination and review of investigations. This is aimed at identifying the underlying reason for pain, so that an appropriate personalised management plan can be made. Some more tests may be requested as necessary. Close liaison with specialists in other fields such as neurology and surgery is maintained to formulate the best plan tailored to your condition and requirements. Some of the common pain treatment modalities include:

Medical management

I normally review your current medications and any existing medical problems prior to suggesting new medications or changes to current medications. Therefore it is a good idea to carry a detailed list of your medications and make of list of the ones you may have tried previously. Doses of medications tried previously are equally important as some medications if not used in right doses for the required duration are unlikely to be effective.

Different types of pain may need treatment with different medications, for example pain of inflammatory origin maybe be effectively managed with anti-inflammatory medication and pain due to irritation of nerve may need medication which help to desensitize the nerves. Hence the importance of identifying the likely pain generators prior to prescribing medications.

Interventional procedures

In certain situations I suggest procedures such as

• Injections/ radiofrequency procedures that help to reduce the pain signals being transmitted by the nerves to your brain
• Injections directly into a joint space/ around the area of problem such as a tendon or bursa which can help reduce the inflammation more effectively than medications taken orally. These procedures along with being therapeutic may also help the consultant confirm diagnosis

Regenerative medicine has opened new avenues where cells from your body are used to promote healing and reduce pain. Awareness of options such as Platelet-Rich Plasma (PRP) and stem cells is increasing and new research in this area is improving our understanding day by day.

Some interventional procedures can be done in the outpatient setting, whereas others will require a day case admission. This depends on the procedure being performed and your general health, other medical problems. We aim to reduce your pain as much as possible by offering you most appropriate interventions keeping your goals and preferences in mind and with an integrated multi speciality team approach based on biopsychosocial model of pain you have best chances of managing your pain.

Role of Physiotherapy

There are few common elements in management of most chronic pain situations like weakness accompanied by disuse of affected part for long time will require gradual mobilization and strengthening. A good chronic pain physiotherapist offers more than physiotherapy. They play an important role in

• Patient education regarding their condition, do’s and don’ts specific to their condition,
• Setting realistic goals-dividing exercises into smaller achievable steps
• Help patients understand and implement pacing of activities
• Promoting compliance, increasing confidence and making you self reliant
• Challenging your unhelpful thoughts, mitigating any false believes and minimising catastrophisation

Role of Psychology

Chronic pain can generate significant distress, anxiety and depression and all these, in turn, can magnify perceived pain. This is a normal human reaction which is often more visible to friends and family. Addressing these factors can help in reducing perceived pain and in improving quality of life. Psychologists can help you by challenging maladaptive beliefs, attitudes and emotions. They can help by

• Teaching coping and self-help strategies
• Relaxation techniques- these can be a useful tool especially in dealing with sleep disturbances and periods of increased pain
• Cognitive Behavioural Therapy (CBT)
• 
  
• Tags >> Acute pain, Best Pain Specialist In Delhi, Chronic Pain, Pain Specialist In Delhi

Plantar fasciitis (Joggers Heel) Treatment is done by our pain specialist in Delhi and Gurgaon

What is Plantar fascia?

The plantar fascia is a long, thin strong band of tissue in the sole of the foot, extending from the heel to the front of the foot. It acts as a shock absorber and supports the foot arch.

What causes plantar fasciitis?

It is believed that plantar fasciitis is caused by damage or irritation of plantar fascia due to excessive strain resulting in heel pain and stiffness. The pain is most often felt below the heel close to the site of attachment of the plantar fascia to the heel bone. In the majority of cases, a specific cause or reason cannot be identified although certain factors can predispose one to the development of this condition. These include

ObesityConstantly being on your feet, especially on a hard surface/ increased activity or repetitive impact activity such as running/sports (especially involving hard surfaces /courts)Tight calf musclesHigh foot arches or flat feet

What are the symptoms of plantar fasciitis?

Plantar fasciitis is most common in people between the ages of 40 to 60 years, although it can occur at any age. It is twice as common in women compared to men.

Common symptoms of plantar fasciitis include:

Sharp, burning or aching pain on the bottom of the foot near the heel. It can extend to the arch area of the foot. Pain with the first few steps in the morning or after a period of rest. The pain generally subsides after a few minutes of walking Increased pain after exercise or activity

How is plantar fasciitis diagnosed?

The diagnosis is made clinically based on the history and examination findings. In the clinic, an ultrasound scan can help confirm the diagnosis.

X-rays are used for ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs (small pieces of bone that can grow on the underside of the heel bone) are often seen on an x-ray. Approximately 3 in10 people have a heel spur and few of them have heel pain

Magnetic resonance imaging (MRI) scan is sometimes requested to confirm the diagnosis and rule out other conditions with similar presentation.

What are the treatment options for plantar fasciitis?

Plantar fasciitis is commonly described in the literature as a self-limiting condition. A significant number of patients with improve within 10-12 months, although it can be disabling and impact negatively the quality of life. Treatment options include

Rest/ Activity modification. Decreasing or stopping the activities that make the pain worse especially activities such as running/ step aerobics where the feet pound on hard surfaces ie. Rolling your foot over a cold water bottle or ice can help. Applying ice wrapped in a towel to the affected area helps reduce pain. This can be repeated 3 to 4 times in a day. Avoid using for too long or applying directly to the skin as it can cause ice burns. Nonsteroidal anti-inflammatory medication. Drugs such as ibuprofen or naproxen reduce pain and inflammation. These should be used as advised by your doctor. Exercise. Plantar fasciitis is aggravated by tight feet and calf muscles. Stretching the plantar fascia and the calf muscles several times a day can help to relieve the pain. Night splints work by creating a constant mild stretch of the plantar fascia and they do need to be worn for some time before the effects become apparent. Tolerability can be an issue and in some cases even putting them on for 10 min before betting out of bed in the morning can be helpful in reducing the early morning symptoms. Weight management – healthy body weight can help by reducing the load on the plantar fascia. Supportive shoes and orthotics can help in reducing the impact/heel irritation especially in individuals with flat feet. Avoid walking barefoot and use supportive footwear with a stiff outer sole and a shock-absorbing insole. Custom made orthotics are more likely to be better tolerated although there is no strong evidence to show that custom made orthotics lead to more improvement. Extracorporeal shockwave therapy (ESWT)– this option is utilized more for runners as there is some evidence of effectiveness in this subgroup.CORTISONE/ STEROID INJECTIONS – this is a common treatment choice for patients not resolving to simple measures. There is moderate quality evidence demonstrating the short term beneficial effects of these injections. It is best to perform the injections under ultrasound guidance as this increases the accuracy of injections. Using low doses of steroids can help limit the potential local side effects. You may be asked to avoid running and other high impact activities for some time (approx. 2 weeks) after the injection.PRP injections. Platelets are one of the blood components. They help in clotting and contain growth factors which promote the healing process. PRP is prepared from one’s own blood by placing it in a spinning machine to separate the platelets.  Growth factors released from the platelets influence and accelerate the repair process, utilizing the body’s natural healing ability. These injections are best performed under ultrasound guidance and have the potential of providing prolonged relief.

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How To Communicate Regarding Your Joint Pain To Your Doctor

Joint pain can be a source of prolonged discomfort that one may have to endure in life. This can affect your daily activities and make you feel depressed. Joint pain specialists in Delhi NCR are daily visited by numerous patients complaining of severe pain and in search of treatments that can provide quick relief.

For you to get the most appropriate treatment, the way you explain your pain to the doctor is important. There are a plethora of options for joint pain treatment in Delhi NCR. But reaching out to the right-center with experienced and skillful professionals whom you can count upon is important.

Read below to understand the importance of accurately describing your joint pain concerns to your treating doctor:

• Joint pain is subjective, without your explaining it may be very difficult for the doctor to know what your pain feels like and how severe it is
• Joint pain can have numerous causes such as age-related wear and tear, injury, trauma, infections, etc
• Involvement of multiple joints in the body may require different assessment/investigations than just one isolated joint problem. Treatment options may also differ depending on the actual pathology
• Treatments offered depend on the severity of symptoms, their impact on your life, your age, activity levels and your goals/expectations. There are many treatment alternatives –both non-surgical and surgical, depending on the assessment of the above factors
• These are some important points which may help your doctor to understand and treat your pain better:

• Explain where the pain is; how long you have had the pain and how it started. If possible point the exact place, is it in the knee, ankle or shoulder pain?
• The character of pain can help in narrowing down the possible causes. For example is it aching, burning, shooting or stabbing pain? Is it present all the time?
• Aggravating or relieving factors are equally important- Is it worse when you are walking or at night time when you are trying to sleep. is it when you sit, walk or stand?
• It is important to tell the doctor how the pain affects your daily life. This information is essential as it enables the doctor to have a clear overview of what you are feeling. While describing the impact of pain do not forget about your sleep and mood.

In case the pain is short-term, your doctor may recommend home care like –

• Applying ice or hot compression at the joint several times.
• Avoiding activity that may cause pain.
• Using a brace to protect the joint.

Various other options are used for Joint pain treatment in Delhi NCR like steroid or hyaluronic acid injections, nerve blocks and radiofrequency treatment. They can all help to ease the suffering and improve your quality of living. Some options are specific to the joints involved. These are mostly combined with medications and physiotherapy to improve outcomes.

Tag : Pain Specialist in Delhi , Pain Management in Delhi , Pain specialist doctor in Delhi , Joint Pain Specialists in Delhi , Joint Pain Treatment In Delhi , Pain Treatment in South Delhi , Pain management centre in Delhi

Chronic Pain Management In Delhi

Chronic Pain Management In Delhi

Pain affects more people than heart disease, diabetes, and cancer combined International Association for the Study of Pain (IASP)

If you do not believe this statement then let me remind you of some common scenes from your daily life. You may have stopped noticing these believing that nothing can be done or accepted them as a part of aging. BUT IS THAT SO?

…remember the grandma who grunts in pain every time she tries to get up

…. the husband who complains of a backache every morning, taking his time to overcome the stiffness before he can start his day

….aunt who finds it difficult to get out of the car because of pain

….your colleague who has to randomly take time off work because of severe headaches

…your work colleague who keeps pressing his neck complaining of neck pain

….your friend who gave up badminton because of shoulder pain

….diabetic uncle who cannot sleep as he feels his feet are on fire

….your close friend who underwent breast surgery a few years back and still complains of pain

#lifewithoutpain#justadream#

Do these sound familiar… and I have not even talked about the numerous patients with sciatica, tennis elbow, heel pain, abdominal pain, cancer pain, pelvic pain, testicular pain, chest-wall pain, post-traumatic pain, nerve injury pain, etc. The list is endless. The financial burden of these problems on individuals, families, society, and government is enormous.

Yes, these are all examples of chronic pain

Yes, these are challenging to treat because pain is a very personal experience and one therapy does not work for all.

BUT YES…. there are options that can improve your quality of life significantly. After all, quality of life is important for everyone. For someone, it may all be about being able to play a few rounds of golf and for someone to attend an important meeting at work without being distracted by pain. Your goals are your goals and they are important.

Chronic pain is a frequent condition affecting an estimated 20% of people worldwide. Globally 1 in 10 adults is diagnosed with chronic pain each year. Despite this, not many are aware of the available pain management options. The general perception is that pain management is for cancer pain. Even for the majority of well-informed people, it stops at a few nerve blocks for relieving pain in cancer or trigeminal neuralgia.

In India, there is huge variability in the services offered by the existing pain clinics. Lack of recognized comprehensive training curriculum in pain medicine with government-approved minimal training standards may be one of the contributing factors. The focus of most specialists is on interventions rather than holistic management. This is contrary to most western countries where Pain Medicine is a separate specialty with a well-defined curriculum and minimum standards that must be fulfilled for one to proclaim himself as a pain specialist. The focus there is on long term solutions using a multidisciplinary approach and teamwork. Nevertheless, the awareness for chronic pain options is increasing with an important role being played by the media. I hope that the benefits do not get restricted to a privileged few and all fellow brothers and sisters are able to benefit.

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Pain management centre in Delhi ,Pain specialist doctor in Delhi