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Dr. Seema N. Alva

Anesthesiologist, Bangalore

350 at clinic
Dr. Seema N. Alva Anesthesiologist, Bangalore
350 at clinic
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
More about Dr. Seema N. Alva
Dr. Seema N. Alva is a trusted Anesthesiologist in Rajaji Nagar, Bangalore. She is currently practising at Pristine Hospital in Rajaji Nagar, Bangalore. Book an appointment online with Dr. Seema N. Alva and consult privately on Lybrate.com.

Lybrate.com has a number of highly qualified Anesthesiologists in India. You will find Anesthesiologists with more than 29 years of experience on Lybrate.com. You can find Anesthesiologists online in Bangalore and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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#877, 2nd Stage Extension, Dr. Modi Hospital Road, West Of Chord Road, Rajaji Nagar. Landmark: Near Shankar Mutt Bus stopBangalore Get Directions
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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

I am a 40 years old woman. I frequently (once or twice a month) get lower back pain either in the lumbar or above region. What could be the reason? what is the cure? I am driving car upto two hours a day.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am a 40 years old woman. I frequently (once or twice a month) get lower back pain either in the lumbar or above reg...
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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I am 50, for the last one month (not earlier), when walking feet is aching, mainly beneath the finger area especially more of left leg, that I cannot walk well. Ie. Under portions of 2nd and 3rd finger portion (mainly) of the feet is aching. Slight swelling on the feet also is observed. No other sickness now observing.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Flat foot at times causes pain. But we must rule out other causes as well rule out diabetes & vit. D deficiency or any other metabolic disorder. Physiotherapy usually helps any way take paracetamol 250mg od & sos x 5days you will need other supportive medicines also. It may have to be further investigated do ask for detailed treatment plan. Yo do not ignore. It could be beginning of a serious problem. You must have x rays of your feet done. Make sure you are not allergic to any of the medicines you are going to take.
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I am suffering from Cervical spondylosis since 4 years. I have to work on computer last 25 years. So my c4 and c5 gap seen in xray. At that time I am not working on computer continuously. But I have lift heavy weight problem may be occur hand joint pain please give me meal chart. And regular ayurvedic medicine, at present homeopathic medicine take last 4 years.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am suffering from Cervical spondylosis since 4 years. I have to work on computer last 25 years. So my c4 and c5 gap...
Hot fomentation x twice daily. Neck exercises. Neck stretching. Postural correction. Shoulder shrugs. Core strengthening exercises. Take frequent breaks at work use cervical pillow. Use back support. Self massage the back of neck.
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Hi I am having heavy joint pains is there any easy treatment please suggest me Sandeepgoud.

BPTh/BPT
Physiotherapist, Delhi
Hi I am having heavy joint pains is there any easy treatment please suggest me Sandeepgoud.
Start with physiotherapy treatment and learn exercise. Correct your posture. Take calcium; multivitamin and vitamin d 3 for 2 month. Don't sit on floor. Don't lift heavy things. Get your full body blood test also.
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I have back pain. The fact is that I gets strong when there is a urge to pee. I feel relaxed after the urination. What do I do?

Bachelor of Ayurveda, Medicine and Surgery (BAMS), DYA (DIPLOMA IN YOG & AYURVED), D.I.H.M (DIPLOMA IN INDUSTRIAL HEALTH MANAGEMENT)
Ayurveda, Nashik
I have back pain. The fact is that I gets strong when there is a urge to pee. I feel relaxed after the urination. Wha...
it may due to kidney stone . drink more water. avoid spicy ,oily food. specially fruits containing small seeds like tomato. sugar cane juice is usefull. for confermation of kidney stone first get done sonography(USG). massage with warm sesame oil to your back for 10 min daily
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I am 74 years old. I had my total knee replacement on 2nd Feb. Although I have been doing physio regularly, I still have considerable pain. How long does it take usually for the pain to subside?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi Thanks for your query. Where did you get your TKR done from? Normally pain should be better in 6 weeks time and it should be almost gone in 3 months if everything is going well. Do not hesitate to contact me if you need any further assistance. Thanks & Regards Dr Akshay Kumar Saxena
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I have head pain at the posterior end for continuous 2days. Painkillers give relief for the time being? But back to the same condition after some time. What shall I do?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
I have head pain at the posterior end for continuous 2days. Painkillers give relief for the time being? But back to t...
Homoeopathic medicine GELSEMIUM 30 ( Dr Reckeweg) Drink 2 drops every 4 hrly direct on tongue.Report me after 3 days
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How get rid of back pain. please help me.?

MS - Orthopaedics, MBBS
Orthopedist,
How get rid of back pain. please help me.?
Sleep on a hard bed with soft bedding on it. Use no pillow under the head. Kindly take biod3 max 1 tab dailyx10 paracetamol 250mg od & sos x5days do back (spine)/shoulder/knee exercises make sure you are not allergic to any of the medicines you are going to take do not ignore it. It may have to be further investigated. It could be beginning of a serious problem. If no relief in 4_5 days, then inform
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Sir I have problem in my lower back. I do my investigation like MRI. I found my l4l5 buldge so I want to know to treatment of my slip disk.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), DYA (DIPLOMA IN YOG & AYURVED), D.I.H.M (DIPLOMA IN INDUSTRIAL HEALTH MANAGEMENT)
Ayurveda, Nashik
Sir I have problem in my lower back. I do my investigation like MRI. I found my l4l5 buldge so I want to know to trea...
1) do massage with warm sesame oil or suitable oil for 15 min. Afterwards take hot fomentation for 10 min. 2) start natural calcium supplement. 3) do regular stretching exercise 4) in yoga do bhujangasan, halasan & suryanamaskar. Life-style correction 1) correct your sitting posture. 2) take small pillow or back rest for lower back. 3) foot should rest to floor easily. 4) take small break after 1 hr & walk few steps. 5) do neck & upper back extension, give feedback after 4 days. Best treated with ayurved & panchakarma procedures. 1) massage + steam 2) pinda swedan 3) agnikarma you must start ayurvedic medicines to 1) strengthen bones & muscles. 2) stop further degeneration of joint. 3) healing of joint. 4) release muscular spasm even chronic. 5) reduce swelling & pain.
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I have pain in my head above the left year since last 4 months and sometimes like vomiting and simultaneously pain in my foot.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have pain in my head above the left year since last 4 months and sometimes like vomiting and simultaneously pain in...
Advice Neck Exercises. Neck Stretching. Postural Correction. Shoulder Shrugs frequent Breaks at work Use cervical pillow Use Back Support. Self Massage the back of neck.
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I am 21 year old and i am facing legs and back pain so much. What should I do?

MS - Orthopaedics, MBBS
Orthopedist,
Backache is the commonest ailment. Do not worry, rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Any way take ibuprofen 200mg od & sos x 5days you will need other supportive medicines also. Take multivitamins & other antioxidants along with. Do back (spine) exercises contact me again if need be. Make sure you are not allergic to any of the medicines you are going to take do reply back for private consultation and detailed treatment plan.
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I am a boy and I have my backbone problem last 2 years my back was so painful and I don't know what to do so please suggest me a better treatment.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am a boy and I have my backbone problem last 2 years my back was so painful and I don't know what to do so please s...
Apply Hot Fomentation twice daily. Avoid bending in front. Postural Correction- Sit Tall, Walk Tall. Extension Exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. Bhujang Asana – Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day. Back Stretching- lie flat, pull one of the knee forward to chest, hold for 3 seconds, then bring the other knee forward to the chest and again hold for 3 seconds. Then pull both knees towards the chest and hold for 3 seconds. Repeat 10 times each exercise twice a day. Do the cat/cow stretch. Get on all fours, with your arms straight and your hands directly under your shoulders; your knees hip-width apart.
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I have body pains for over 2 days what should I do?

MBBS
General Physician,
I have body pains for over 2 days what should I do?
Body pain may be because of over physical/ mental exertion or viral fever do you have other symptoms like abdomen pain/ loose motion/ dizziness/ fever/ cough/ cold/ burning or pain while urination? kindly follow advises given below 1. Tablet crocin (paracetamol 650 mg) one tablet after food stat 2. Take lot of fluids 3. Proper rest 4. Proper diet consult again if symptoms persist or worsen.
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What to do if we are having fever, body pain, headache and cough and cold altogether?

AUTLS, CCEDM, MD - Internal Medicine, MBBS
General Physician, Faridabad
What to do if we are having fever, body pain, headache and cough and cold altogether?
-always wash hands after coughing / sneezing into your hands, blowing nose, after touching someone who is sick, or using public restrooms or telephones. -cover your mouth and nose when you sneeze or cough. -get plenty of rest/sleep. Avoid people who have a cold or cold symptoms. -drink plenty of fluids (veg/tomato soups, dal water/coconut water/herbal tea etc), and eat nutritious food (like sprouts). Avoid foods or drinks with caffeine -treatment: a cold usually lasts for a week or two. Gargle to keep from getting a sore throat. Take only lukewarm water to drink during the day -use saline nasal sprays or nasal irrigation. -tablet nasorest-p once/twice daily may ease breathing. -do steam inhalation once or twice daily. take dolo-650 mg once/twice daily for fever
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I am suffering from backache and cervical. Pls. suggest me some medicine to remove my pain and stiffness.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am suffering from backache and cervical. Pls. suggest me some medicine to remove my pain and stiffness.
Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall. Extension exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. Bhujang asana -- lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core strengthening exercises- straight leg raised with toes turned outward, repeat 10 times, twice a day. Neck advice hot fomentation x twice daily. Neck exercises. Neck stretching. Postural correction. Shoulder shrugs. Core strengthening exercises. Take frequent breaks at work use cervical pillow. Use back support. Self massage the back of neck.
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I'm always having knee pain. Mention an ointment to get a relief from pain. Please advice.

BHMS
Homeopath, Raebareli
I'm always having knee pain.
Mention an ointment to get a relief from pain.
Please advice.
Take Mag phos 6x - twice daily Also do hot compresses and massage with mustard oil Do a x-ray of the affected area. Consult me for homeopathic treatment. Recommend me by clicking on recommend option and leave feedback.
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IS THERE A PINHOLE SURGERY FOR KNEE REPLACEMENT?-MINIMAL INTERVENTION? OTHERWISE WHAT IS THE SOLUTION FOR A 78 YEAR PERSON?

DNB Rheumatology, Grad. Cert. Paed. Rheumat, MD - Paediatrics, MBBS
Rheumatologist, Bangalore
Madam, You most probably have osteoarthritis. The diagnosis needs to confirmed. If in fact you have osteoarthritis then you need to be assessed for comorbidities and needs to be put on an intensive exercise program with control of pain using safe pain modfiying medications instead of pain killers. This can be done best by a rheumatologist. If you let me know where you live I can give you a refernce of a nearby rheumatologist. You can contact me via my website www.Rheumatologybangalore.Com You can get more information regarding osteoarthritis from the document below. Http://www.Rheumatology.Org/uploadedFiles/Osteoarthritis(1).Pdf
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I am 31 years old male and suffering from (lgmd) Limb-girdle muscular dystrophy. What should I do.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Muscular dystrophy in some cases is self limiting. Physiotherapy helps in preventing contractures & defomaties. Fortunately these patients are intelligent & their intellect is not affected. They should be employed in places where not much of physical force is requrid keep his moral up.
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