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Dr. Manjesh Kashinath

Pathologist, Bangalore

200 at clinic
Dr. Manjesh Kashinath Pathologist, Bangalore
200 at clinic
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Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences....more
Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences.
More about Dr. Manjesh Kashinath
Dr. Manjesh Kashinath is one of the best Pathologists in Yeshwanthpur, Bangalore. You can visit him at Medicare Diagnostic Fracture and Orthopedic Clinic in Yeshwanthpur, Bangalore. Book an appointment online with Dr. Manjesh Kashinath on Lybrate.com.

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Chronic pain is a Disease and not a symptom

Fellow of Endoscopic spine surgery (FENDS) , Fellow of Interventional spine & pain (FISP) , MD-Anaesthesiology & Pain Medicine, Fellow of Pain Management (FPM) , DA( Gold medal-Anaesthesiology & Pain Medicine) , MBBS
Pain Management Specialist, Delhi
Chronic pain is a Disease and not a symptom

People who suffer from severe, chronic back pain know how it can utterly disrupt and damage one's life. Chronic back pain can be cruel-making it hard to enjoy even the simplest daily activities, and certainly making it a challenge to carry out an exercise routine and other healthy activities. Moreover, chronic pain was not previously all that well understood. The medical profession used to believe that pain is always a manifestation of an underlying injury or disease. As such, doctors focused on treating the underlying cause of the pain, with the belief that once the injury or disease was cured the chronic pain would then disappear.

If no underlying cause could be found for the pain, then the patient was told that very few treatments are available, or worse, 'the pain must be in your head'. Unfortunately, some doctors still practice in this manner, having no appreciation for the unique problem of chronic pain, newer theories about chronic pain, and the many factors that influence a chronic pain problem.

The medical community is starting to understand that if pain is no longer a function of a healthy nervous system (signaling that there is a disease or underlying injury), then the chronic pain itself becomes the problem and needs to be treated as the primary pathology.

The Experience of Chronic Pain

Contrary to popular belief, all pain is real. This may seem like an obvious statement, but people with chronic pain are sometimes treated as if their chronic pain is either imaginary or exaggerated. In some cases, they feel like they have to prove their chronic pain to their friends, family, and doctors. Some patients are told by their doctor that there is no reason for the chronic pain and therefore 'it cannot be that bad'.

Chronic pain is a personal experience and cannot be measured like other problems in medicine, such as a broken leg or an infection. For instance, a broken leg can be confirmed by an X-ray and an infection by a blood test measuring white blood cell count. Unfortunately, there is no medical test to measure chronic pain levels.

To make matters more challenging for the patient, for many chronic pain problems, there is no objective evidence or physical findings to explain the pain. Thus, many chronic pain sufferers go from one doctor to the next searching for explanations. This process can lead to unnecessary evaluations and treatments, in addition to putting the patient at risk for actually being harmed or made worse by the healthcare profession.

Everyone experiences and expresses pain differently. Two people with the exact same injury will feel and show their pain in unique ways depending on a number of things such as:

  • The situation in which the pain occurs
  • Thoughts about the chronic pain, such as 'this is nothing serious' versus 'this pain could kill me'
  • Emotions associated with the chronic pain, such as depression and anxiety versus hopefulness and optimism
  • Cultural influences determining whether a person is to be more stoic or more dramatic in showing pain to others

The newest theories of chronic pain can now explain, on a physiological level, how and why people experience pain differently.

Types of Back Pain: Acute Pain, Chronic Pain, and Neuropathic Pain

Understanding how pain is defined is important in order to learn how to better control it. For the purposes of research and medical practice, pain can be separated into three categories:

-Acute Pain
-Chronic Pain
-Neuropathic Pain

Acute Pain

One common type of pain is acute pain, currently defined as pain lasting less than 3 to 6 months, or pain that is directly related to tissue damage. This is the kind of pain that is experienced from a paper cut or needle prick. Other examples of acute pain include:

  • Touching a hot stove or iron. This pain will cause a fast, immediate, intense pain with an almost simultaneous withdrawal of the body part that is being burned. More of an aching pain might be experiencing a few seconds after the initial pain and withdrawal.
  • Smashing one's finger with a hammer. This pain is similar to that of touching a hot stove in that there is an immediate pain, withdrawal and then 'slower' aching pain.
  • Labor pains. The pain during childbirth is acute and the cause is certainly identifiable.


The longer pain goes on the more susceptible it is to other influences and developing into a chronic pain problem. These influences include such things as the ongoing pain signal input to the nervous system even without tissue damage, lack of exercise (physical deconditioning), a person's thoughts about the pain, as well as emotional states such as depression and anxiety.

Chronic Pain

There are at least two different types of chronic pain problems - chronic pain due to an identifiable pain generator (e.g. an injury), and chronic pain with no identifiable pain generator (e.g. the injury has healed).

Chronic pain due to an identifiable pain generator

This type of chronic pain is due to a clearly identifiable cause. Certain structural spine conditions (for example, degenerative disc disease,spinal stenosis and spondylolisthesis can cause ongoing pain until successfully treated. These conditions are due to a diagnosable anatomical problem.

If the pain caused by these types of conditions has not subsided after a few weeks or months of conservative (nonoperative) treatments, then spine surgery may usually be considered as a treatment option.

Chronic pain with no identifiable pain generator
This type of pain continues beyond the point of tissue healing and there is no clearly identifiable pain generator that explains the pain. It is often termed 'chronic benign pain'.

It appears that pain can set up a pathway in the nervous system and, in some cases, this becomes the problem in and of itself. In chronic pain, the nervous system may be sending a pain signal even though there is no ongoing tissue damage. The nervous system itself misfires and creates the pain. In such cases, the pain is the disease rather than a symptom of an injury.

The term 'chronic pain' is generally used to describe the pain that lasts more than three to six months, or beyond the point of tissue healing. Chronic pain is usually less directly related to identifiable tissue damage and structural problems. Examples of chronic pain are: chronic back pain without a clearly determined cause, failed back surgery syndrome (continued pain after the surgery has completed healed), and fibromyalgia.

Chronic pain is influenced by many factors, such as ongoing pain signal input to the nervous system even without tissue damage, physical deconditioning due to lack of exercise, a person's thoughts about the pain, as well as emotional states such as depression and anxiety. Chronic pain is much less well understood than acute pain.

Neuropathic Pain

Neuropathic pain has only been investigated relatively recently. In most types of neuropathic pain, all signs of the original injury are usually gone and the pain that one feels is unrelated to an observable injury or condition. With this type of pain, certain nerves continue to send pain messages to the brain even though there is no ongoing tissue damage.

Neuropathic pain (also called nerve pain or neuropathy) is very different from pain caused by an underlying injury. While it is not completely understood, it is thought that injury to the sensory or motor nerves in the peripheral nervous system can potentially cause neuropathy. Neuropathic pain could be placed in the chronic pain category but it has a different feel then the chronic pain of a musculoskeletal nature.

The neuropathic pain feels different than musculoskeletal pain and is often described with the following terms: severe, sharp, lancinating, lightning-like, stabbing, burning, cold, and/or ongoing numbness, tingling or weakness. It may be felt traveling along the nerve path from the spine down to the arms/hands or legs/feet. It's important to understand neuropathic pain because it has very different treatment options from other types of back pain. For example, opioids (such as morphine) and NSAID (such as ibuprofen, COX-2 inhibitors) are usually not effective in relieving neuropathic pain. Treatments for neuropathic pain include certain medications, nerve 'block' injections, and a variety of interventions generally used for chronic pain.

When Acute Pain Becomes Chronic Pain

It is critical for a doctor and a patient to have an understanding of the difference between acute pain and chronic pain. With acute pain, the pain is a symptom of injured or diseased tissue. When the injury has finished healing, the correlating pain will subside. For example, with a herniated disc, once the pressure on the nerve is alleviated the acute pain stops. For this reason, medical treatment for acute pain focuses on healing the underlying cause of the pain.

Additionally, with acute pain, the severity of pain directly correlates to the level of tissue damage. This provides us with a protective reflex, such as to stop an activity when it causes pain. However, chronic pain does not serve a protective or other biological function. Treatments will be different depending on the underlying cause of the pain.

Chronic Pain Development

Not all pain that persists will turn into chronic pain. Different people experience chronic pain very differently. Likewise, the effectiveness of a particular treatment for chronic pain will often differ from person to person. For example, a particular medication or injection for a herniated disc may provide effective pain relief for some people but not for others.

One problem is that not all patients with similar conditions develop chronic pain, and it is not understood why some people will develop chronic pain. Also, a condition that appears relatively minor can lead to severe chronic pain, and a serious condition can be barely painful at all.

As pain moves from the acute phase to the chronic stage, influences of factors other than tissue damage and injury come more into play and influences other than tissue input become more important as the pain becomes more chronic.

Pain medicine and pain management as a medical specialty is relatively new. However, now that chronic pain is becoming recognized as a primary problem, rather than always being a symptom of a disease, the specialty of pain management is starting to grow.

1 person found this helpful

My wife (33 yrs) is suffering from body pain including back since from 2 weeks. Completed blood tests for viral fevers and c. P. K done. Its negative. Since 10 days cal360 and rivotril tablets are taken but no improvement.

DPM
Psychiatrist, Mumbai
My wife (33 yrs) is suffering from body pain including back since from 2 weeks. Completed blood tests for viral fever...
In the absence of any orthopaedic problem, body pain and other physical complaints can be part of depression. What are her other complaints? if the reasons are psychological she may feel better with amitryptiline 10mg or pregabalin. Consult your local doctor.
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I think I am loosing my self I feel so unhealthy stress tired body pain all the time.

MD - Psychiatry
Psychiatrist, Chennai
I think I am loosing my self I feel so unhealthy stress
tired body pain all the time.
Kindly consult a psychiatrist and get your stress evaluated. Stress is the feeling of being under too much mental or emotional pressure. Pressure turns into stress when you feel unable to cope. People have different ways of reacting to stress, so a situation that feels stressful to one person may be motivating to someone else. Many of life’s demands can cause stress, particularly work, relationships and money problems. And, when you feel stressed, it can get in the way of sorting out these demands, or can even affect everything you do. Stress can affect how you feel, think, behave and how your body works. In fact, common signs of stress include sleeping problems, sweating, loss of appetite and difficulty concentrating. You may feel anxious, irritable or low in self esteem, and you may have racing thoughts, worry constantly or go over things in your head. You may notice that you lose your temper more easily, drink more or act unreasonably. You may also experience headaches, muscle tension or pain, or dizziness. Stress causes a surge of hormones in your body. These stress hormones are released to enable you to deal with pressures or threats – the so-called "fight or flight" response. Once the pressure or threat has passed, your stress hormone levels will usually return to normal. However, if you're constantly under stress, these hormones will remain in your body, leading to the symptoms of stress.
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Is there any other possible cure for herniated disc except operation when the patient has started losing power in one leg while other leg is having radiative pain.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
Is there any other possible cure for herniated disc except operation when the patient has started losing power in one...
if the disc is large then you would require decompression for the symptoms u have described. otherwise the power may not recover completely.
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I have fever from three days and my body is paining severely, is this a symptom of swine flu?

MBBS
General Physician, Cuttack
I have fever from three days and my body is paining severely, is this a symptom of swine flu?
Swine Flu symptoms 1.Fever, Cough 2.Nasal congestion, Sore throat 3.Headache, Myalgia,Fatigue,dyspnoea (Shortness of breath) 4.Vomiting, Diarrhea 5.Pneumonia and Respiratory failure(In Severe cases) If you have fever ,follow the advice given below 1.Take paracetamol 500mg, one tablet sos upto a maximum of three tablets daily after food 2.cold spoonging Sos 3.Drink plenty of water 4.Take rest 4.If no relief do blood examination like ESR, CBC, Widal/ Typhidot test, Blood for mp/malaria antigen and Dengue antigen(NS1) test after consulting doctor 5. consult me for further advice
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BDS
Dentist, Bhagalpur
Consumption of counter pain relievers is advisable. A pain killer which reduces inflammation is highly recommendable. Some common ones are ibuprofen and aspirin.
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Which fruit drink controls body pains and improves blood count and its circulation to reduce fatigue.

MBBS
General Physician, Trivandrum
Which fruit drink controls body pains and improves blood count and its circulation to reduce fatigue.
Natural fruit juices are as healthy as fruits. But always avoid sweetened and artificial flavoured fruit juices available in the market as these can cause weight gain and even diabetes in the long run. Fruit as such is best because it also provides much needed fibre content in the diet which helps with digestion and proper evacuation of the bowel.
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I recently did usg of my breasts and it shows 5-6mm encapsulated left axillary lymph nodes … I am having an unbearable pain in my both breasts n during ma self breast examination I felt a small cyst like appearance in my ryt breast. After consulting a doctor he said that my right cyst is a cyclic fibroid, sometimes it vanishes and my usg did not showed anything in my right breast… Sometimes I am having a nipple discharge also and sometimes not.

Post Doctoral Research (Ph.D.) (A.M) (Oncology), Integrative Oncology for Physicians (MSKCC, N.Y, USA), Doctor of Natural Medicine (N.D/ N.M.D), Ayurveda (I) Cert., Advanced Strategic Management (APSM), B.E (Computer Sc. & Engg.), Clinically Relevant Herb-Drug Interactions (CME) - (Cine-Med Inc. USA)
Alternative Medicine Specialist, Bhubaneswar
I recently did usg of my breasts and it shows 5-6mm encapsulated left axillary lymph nodes … I am having an unbearabl...
Hi lybrate-user, going by your doc's diagnosis, there is nothing to worry as such. Cyclic fibroids, in breasts, are benign, transient and exhibit symptoms exactly as you describe. I would advise you to try avoiding caffeine/ products, sweets, chocolates, dairy products, alcohol, smoking, high calorie/ fatty/ oily/ greasy foods including fast foods etc all as they aggravate the condition. However, do include more of fresh turmeric, garlic, ginger, whole grain cereals, leafy greens like broccoli, spinach, cauliflower, carrots, tomatoes, amla, pineapple, apple etc all to your diet on a day to day basis. Avoid flesh foods excepting fresh fish which is beneficial in this condition. Use olive oil for your salad dressings as well as cooking in general. You can also use either extra virgin olive oil or evening primrose oil, as suitable, for gently massaging both your breasts including the nipples to ease out pain. This can be followed by a warm compress alternating with a cold compress for 10 to 15 minutes which alleviates pain. Hope this helps. Take care and all the very best.
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I have fever and body pain since 2 week. I tried Disprin and D cold total for 7 days but I didn't get well. Please recommend treatment for me.

MBBS, cc USG
General Physician, Gurgaon
I have fever and body pain since 2 week. I tried Disprin and D cold total for 7 days but I didn't get well.
Please re...
Hello, Measure your temperature and tell me reading Tell me if you are having other symptoms like cough/ throat pain/ burning urine/ stomach pain so that we can confirm cause of fever. And Get your following test done and review with reports 1.CBC 2. Urine R/M 3.Typhidot 4. Malarial antigen 1. Avoid exertion 2. Take tablet paracetamol 500 mg after food (If No Drug Allergy) as and when required for fever more than 99 f (maximum 3 tablets with gap of 8 hr can be taken in a day) for 3 days 3. Lot of fluids to be taken consult me again with reports
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Sir my mother 45 years old. Unke sar me hamesa jalan rahta hai aur pure sarir me bhi dard rahta hai.

MBBS, MBA (Healthcare)
General Physician, Delhi
Sir my mother 45 years old. Unke sar me hamesa jalan rahta hai aur pure sarir me bhi dard rahta hai.
check your BP. check your eye sight. take crocin pain relief one sos in case of severe headache.take rest and good sleep. avoid stress. inform if nor t ok.
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I am feeling very drowsy from one week. Instead of all this feelings pain in body. Give some advice so that I can get a healthy feel.

PDDM, MHA, MBBS
General Physician, Nashik
I am feeling very drowsy from one week. Instead of all this feelings pain in body. Give some advice so that I can get...
You can feel weak due to lack of essential nutrients, not getting enough sleep, a weak immune system, excessive drinking, skipping meals, emotional stress, and too much physical labor. Persistent weakness can be caused by health problems like anemia, arthritis, hypothyroidism, a sleep disorder, cancer, chronic fatigue syndrome, diabetes and heart disease. In these cases, it is very important to find out the exact cause behind your weakness. To feel energetic and refreshed in life, you must exercise daily for at least 30 minutes, maintain your ideal body weight, follow a good diet, sleep properly, drink water throughout the day to keep your body hydrated, avoid alcohol and stop smoking.
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I have pain in neck shoulders am suffering from allergic bronchitis and not consuming any medicines for this. I have gastric problem eventhough having food on time. I am 30 years male and get urge for masturbation frequently. I dont know why?

MBBS, cc USG
General Physician, Gurgaon
I have pain in neck shoulders am suffering from allergic bronchitis and not consuming any medicines for this. I have ...
Hello, Kindly follow advises given below 1.Avoid using computers continuously, take rest for 5 min after working for half an hour 2. In pain free interval do neck exercise (kindly learn exercise by registered Trainer) 3. you can use thin pillow while sleeping so that normal posture of neck can be maintained 4.Maintain proper posture of body while watching TV/ studying Kindly go for cervical X ray AP and lateral and review with reports For Allergic Bronchitis you need to avoid allergen(eg Dust) as much as you can What symptom you have kindly tell me like Stomach pain/ acidity/ constipation/ Heaviness/ gas Kindly follow advises given below 1. Drink lot of water 2.Avoid food from outside, junk, fried, spicy fatty food 3.Take fibrous diet 4. Regular Physical exercise 4. Regular Meditation and about masturbation This problem can be solved by Meditation i can give you address of rajyoga meditation center near your house (this is free of cost)
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I am 20 years old I have avert pain in head and leg this a very important to get my body but nothing is the result for seng breakfast.

B.H.M.S., Senior Homeopath Consultant
Homeopath, Delhi
I am 20 years old I have avert pain in head and leg this a very important to get my body but nothing is the result fo...
You can take bio. Lat. 200 / 5 drops in little water thrice a day for one week. Revert back after one week with feedback.
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I am suffering from upper back pain from last 10 month, now some other pain on several area like in cooler bone, in both hand in chest and in back side on hips joint also start. Is this a sign of any type of cancer.

MBBS
General Physician, Cuttack
I am suffering from upper back pain from last 10 month, now some other pain on several area like in cooler bone, in b...
No it is not cancer.Don't worry. It could be due to weakness. Check your Hemoglobin, BP. Get your self examined by doctor
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I have slight body ache and cold since today morning. Temperature seems to be normal. What is it? and what should I do?

MBBS, MD - Internal Medicine
Internal Medicine Specialist, Faridabad
I have slight body ache and cold since today morning. Temperature seems to be normal. What is it? and what should I do?
Take tab. sinarest it contains ( Acetaminophen+ Pseudoephedrine+ chlorpheniramine). Acetaminophen, chlorpheniramine, and pseudoephedrine is a combination medicine used to throat infection and treat headache, fever, body aches, runny or stuffy nose, sneezing, itching, watery eyes, and sinus congestion caused by allergies, the common cold, or the flu. Do gargle with warm water thrice a day. Drink warm water also. Take plenty of water, liquid diet, dalia, green veg., orange. avoid cold things, avoid cold drinks. Avoid Oily foods. If symptoms are from more days or again persist then do few tests for confirm causes of it.. i.e. CBC. welcome in lybrate.
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Hi doctor I m not feeling well. Only full headache, hands n leg pain what should I do?

MBBS, MBA (Healthcare)
General Physician, Delhi
Hi doctor I m not feeling well. Only full headache, hands n leg pain what should I do?
Take tab crocin pain relief one sos. Check your bp. Take good sleep. Take balane diet. Consult again if not ok.
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Sir and mam I am 23 years old actually my body every day has pain what can I do please help.

MBBS
General Physician, Cuttack
Sir and mam I am 23 years old actually my body every day has pain what can I do please help.
It could be due to tension, physical strain. Reduce your stress and strain. Take paracetamol, plenty of water and rest. If no relief consult doctor
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Hello doctor, my whole body is very painful and it will yell you the best treatment and which I too cold, sometimes even in our head hurts.

MBBS
General Physician, Mumbai
Hello doctor, my whole body is very painful and it will yell you the best treatment and which I too cold, sometimes e...
For pain take tablet paracetamol 650 mg and Eat nutritious food and have adequate fluid intake and take physical rest
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Darkcircles under eyes are too heavy, heavy body pains, no sleep Please suggest what to do.

MD
Psychiatrist, Hyderabad
Darkcircles under eyes are too heavy, heavy body pains, no sleep Please suggest what to do.
Hi, I think lack of quality sleep and excessively thinking about certain things could be your problem. Some lifestyle modifications like yoga and good diet can help you. Try avoiding computer or laptop usage for prolonged periods of time. Stop watching t. V or listening to music atleast 1 hr before going to sleep. Eat your dinner atleast 2 hrs before sleep. Drink a glass of hot milk as it naturally induces sleep. Inspite of all the above measures, you condition remains the same, then probably you need some professional help.
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