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Dr. Chandrasekar

Anesthesiologist, Chennai

500 at clinic
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Dr. Chandrasekar Anesthesiologist, Chennai
500 at clinic
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Chandrasekar
Dr. Chandrasekar is a renowned Anesthesiologist in Alwarpet, Chennai. Doctor is currently associated with Dr. Chandrasekar@Girishwari Hospital in Alwarpet, Chennai. Don’t wait in a queue, book an instant appointment online with Dr. Chandrasekar on Lybrate.com.

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Girishwari Hospital

#19, KB Dhasan Road, SIB College Road, Alwarpet, Landmark: Opp. Vidya ENT Hospital, ChennaiChennai Get Directions
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Back Pain Management

BPTh/BPT
Physiotherapist, Pune
Back Pain Management

Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-

Exercise based recovery/physiotherapy: your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.

  • Medications: your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
  • Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
  • Opiates, for example, hydrocodone, for pain relief
  • Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
  • Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
  • Home treatment: in case your condition is less severe, you can attempt a couple of things at home to treat it:
  • Take an over-the-ounter pain reliever, for example, acetaminophen or a calming medication, for example, advil or aleve.
  • Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
  • Exercise routinely to help you recover quickly.
  • Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.
  • Acupuncture: acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
  • Bed rest: severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (dvt, blood clots in the legs).
  • Support/brace use: temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.
  • Lifestyle: losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.

Once the conservative treatment fails:

Early aggressive treatment plan of back leg pain has to be implemented to prevent peripherally induced cns changes that may intensify or prolong pain making it a complex pain syndrome. Only approx 5% of total lbp patients would need surgery approx 20% of discal rupture or herniation with neurologically impending damage like cauda equina syndrome would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then. Depending upon the diagnosis one can perform combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon patient`s pathology response to treatment. Using precision diagnostic therapeutic blocks in chronic lbp, isolated facet joint pain in 40%, discogenic pain in 25% (95% in l4-5 l5-s1), segmental dural or nerve root pain in 14% sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of lbp after conservative treatment has failed.

Need for non-surgical options: outcome studies of lumber disc surgeries documents, a success rate between 49% to 95% and re-operation after lumber disc surgeries ranging from 4% to 15%, have been noted. “in case of surgery, the chance of recurrence of pain is nearly 15%. In fbss or failed back surgery the subsequent open surgeries are unlikely to succeed. Reasons for the failures of conventional surgeries are:

  • Dural fibrosis
  • Arachnoidal adhesions
  • Muscles and fascial fibrosis
  • Mechanical instability resulting from the partial removal of bony ligamentous structures required for surgical exposure decompression
  • Presence of neuropathy.
  • Multifactorial aetiologies of back leg pain, some left unaddressed surgically.

Epidural adenolysis or percutaneous decompressive neuroplasty is done for epidural fibrosis or adhesions in failed back surgery syndromes (fbss). A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ l. A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope sciatica gets complicated by pivd with disco-radicular conflict causing radicular pain sometimes disabling. In this era of minimally invasive surgery lot many interventional techniques have evolved to address the disc pathology. We are still working for the ideal, safe effective technique to tackle disco- radicular interphase. Here now we have devised a mechanical neuroplasty or foraminoplasty technique using an inflatable balloon tip catheter with guide wire via targeted transforaminal or interlaminar route aided by drugs instillation. Selected patients are procedured fluoroscopic guided with local anesthesia under prescribed sedation aseptically via preselected route depending upon location type of pivd causing root insult. First a suitable size needle is placed at desired site confirming with radiolucent dye through which hyaluronidase with saline or la was injected. A flexible guide wire is passed at selected location direction on which the inflatable balloon is threaded to the area of interest.

Adhesiolysis is achieved mechanically with inflating balloon for 10 seconds at a time location. We inflated the balloon with contrast agent to have visualization of adhesiolysis opening up of adhesions or root route. Here the balloon pressure time has to be kept in minimum to avoid neurological damage, for which we inflate balloon for 10 seconds at a time. Close observation is made to balloon shape, pressure patient`s response. Once dilatation is done the drug mixture of steroid with la or hynidase/ hypertonic saline is instilled over nerve in epidural space. We have logically used same approach for our balloon neuroplasty foraminoplasty as it is safe targets exactly the area of disco-radicular interphase or conflict. We can manage to address both the exiting and traversing nerve roots with single entry just by manipulating our guide wire to the place of offence. The procedure can be done via transforaminal route at level or level above or below, especially via s1 foramen. Now we are employing this technique for fresh cases coupling with intradiscal decompression aided by instant disc retrieval by epidural balloon inflation with good results. The idd is done by coblation/ laser/ dekompressor or rf biacuplasty. There is scope of coupling this technique with endoscopic spine surgery. By adding “balloon neuroplasty” to the armamentarium of the interventional pain management many patients can be benefited relieved of previously interventionally unmanageable disco-radicular pain including fbss sufferers.

Intradiscal procedures:

Provocative discography: coupled with ct a diagnostic procedure prognostic indicator for surgical outcome is necessary in the evaluation of patients with suspected discogenic pain, its ability to reproduce pain (even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options in assessing previously operated spines.

Percutaneous disc decompression (pdd): after diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed.

Ozone-chemoneucleoplasty: ozone discectomy a least invasive safe effective alternative to spine surgery is the treatment of choice for prolapsed disc (pivd) done under local anaesthesia in a day care setting. This procedure is ideally suited for cervical and lumbar disc herniation with radiculopathy. Total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at european countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post operative discomfort or morbidity and low cost. If despite the ozone therapy the symptoms persist, percutaneous intradiscal decompression can be done via transforaminal route with drill discectomy/ laser or coblation nucleoplasty/ biacuplasty/ disc-fx / endoscopic discectomy are good alternatives before opting for open surgerical discectomy; which has to be contemplated in those true emergencies, as mentioned above as the first choice. In biacuplasty radiofrequency energy is used in bipolar manner heating shrinking the disc  making it harder as well for weight bearing. It also seals the annular defect ablates annular nerves relievingback pain. In laser or coblation nucleoplasty energy is used to evaporate the disc thereby debulking it to create space for disc to remodel itself assisted by exercises. 

Dekompressor: a mechanical percutaneous nucleotome cuts drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression. A mechanical device cuts drills out the disc material debulking the disc reducing nerve compression curing sciatica brachialgia. It comes in needle size of 17g for lumbar discs 19 g for cervical discs. In lumbar region postero-lateral approach is used  in cervical discs anterolateral approach is used. 

Disc-fx : endoscopic discectomy: in this novel technique a wide bore needle is inserted placed sub-annular in post disc just under the disc protrusion. Disc is then mechanically extracted with biopsy forceps to empty the annular defect. This painful sensitive annular defect supplied be sinuvertebral nerve is thermo-ablated with radiofrequency which also seals the defect to prevent decrease recurrences. Next higher procedure, endoscopic discectomy is done with endoscope put through sheath inserted via posterolateral transforaminal or posterior interlaminar approach. Mostly done under local anaesthesia its fast becoming standard of care for disc protrusion extrusions causing spinal canal stenosis with root or cord compression with leg pain.

Laser discectomy done for closed bulging discs is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, nucleus pulposus is debulked by evaporating it by the laser energy. Laser discectomy is minimally invasive, cost-effective, and free of postoperative pain syndromes, and it is starting to be more widely used at various centers. 

Seld: epiduroscopic laser neural decompression is considered an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, failed back surgery syndrome with morbid adhesion neuritis that cannot be alleviated with existing noninvasive conservative treatment. This procedure is done under vision via an epiduroscope inserted via caudal canal or transforaminally employing front or side firing laser fibers /or fine instruments. If you wish to discuss about any specific problem, you can consult a pain management specialist.

2 people found this helpful

Dear Doctor I am 23 years old student. From Last few months my right leg is paining and I feel current like sensation and also worm moving like feeling it increases when I walk or move my leg. Kindly advise solutions for the same.

BPTh/BPT
Physiotherapist, Delhi
Dear Doctor I am 23 years old student. From Last few months my right leg is paining and I feel current like sensation...
Take physiotherapy treatment and learn spinal exercise. Use lumber spine belt. Don't sit on floor. Don't lift heavy things. Take calcium ; methylcobalamine and vitamin d 3 for 2 month. Apply volini cream before sleeping.
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I have full body pain from yesterday. N felling sleepy every time. Feel like depressed. Is this because of weather or it have any other health issue. Please rply soon.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), PGCGO
Ayurveda, Noida
I have full body pain from yesterday. N felling sleepy every time. Feel like depressed. Is this because of weather or...
bodyache may be due to fever. take tab sudarshan vati... first. depression due to weather changes . drink 8/10 glass water/day.
1 person found this helpful
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Hello, I slipped in the bathroom. After then I have pain in my back area near shoulder. There is pain everything. The pain is sometimes severe I can' t move my neck. So suggest me some treatment for this asap. Thank you. Regards,

MSPT (Master of Physical Therapy)
Physiotherapist, Indore
Do hot formantation or go for physiotherapy and apply tens or swd. Thanks and regards Dr. Ritesh kharnal
1 person found this helpful
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When ever I play my left legs knee pain's alot. It is happening since 10 days and it is very painful. Pls help me.

Master of Physiotherapy, Bachelor in Physiotherapy
Physiotherapist, Guwahati
When ever I play my left legs knee pain's alot. It is happening since 10 days and it is very painful. Pls help me.
Hi lybrate-user it's because of muscle strain. You can get rid of it by applying a knee cap or strap your knee joint for some days around 2 weeks.in those two weeks you need to do knee rehab which follows 1. Apply ice for 5 to 10 mins in a circular manner. 2. Apply crab bandage to get rid of pain. 3. Taping can be done for strained muscle. 4. Always do warm up properly for knee joint followed by exercises and cool down. 5. For more details text back and get step by step instructions n charts. Regards.
1 person found this helpful
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I have knee injury while playing football. Now knee becomes too weak. What should i do?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I have knee injury while playing football.
Now knee becomes too weak. What should i do?
Football injuries are usually serious injuries. Get a mri of the knee. You would probably need arthroscopic knee surgery. It is a very safe procedure in our hands with uniformly good results. We have very good well equipped center in delhi. Do ask for detailed treatment plan. Don? t ignore it lest it become beginning of a bigger problem.
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I have a problem of joint pain.. Or headache in right side. My vision is normal but still I have headache n eye ache..

MPT, BPT
Physiotherapist, Noida
I have a problem of joint pain.. Or headache in right side. My vision is normal but still I have  headache n eye ache..
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.
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My age is 33 years ,from some months I suffering from pain in right hip joint. Today my doctor said this is acute vascular necrosis of right hip and also not to go for hip replacement due to age. Now what option I have?

MBBS, AFIH, PGDMLS, MD-HRM, MD-HM
General Physician, Gurgaon
My age is 33 years ,from some months I suffering from pain in right hip joint. Today my doctor said this is acute vas...
It is called as avascular necrosis of hip which means that the hip joint do not have the required blood supply and it leads to malfunctioning of hip joint I think it is better that you should consult a joint replacement surgeon at Big Institute like All India Institute of Medical Sciences etc, so that the option of hip replacement or likewise is possible to manage this at earliest thank you.
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I have been having knee pain for a long time since I have been exercising . Both the knees doesn't seem equal. Kindly suggest cure for this .

Master of Physical Therapy MPT CARDIO, BPTh/BPT
Physiotherapist, Rajkot
Dear Ranjani, send me some details UN forms of xray or any test you had done. History of exercise. Send via lybrate.
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Hi I am 30 years old since 3 days I have horrendous joint and muscles and body ache and the day before that I had a horrible migraine. I am unable to move when I rest its like my body is on fire. I feel my body to be quite warm. Can you let me know what can I do and what this signifies.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Hi I am 30 years old since 3 days I have horrendous joint and muscles and body ache and the day before that I had a h...
It requires detailed investigation and examination. Preliminary investigations suggested: hb, tlc, dlc, esr, blood sugar fasting & pp, uric acid vit d urine r/e x-ray of the affected part. Anyway it may be tried sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress 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, knee & general exercises. It may have to be further investigated. Do not ignore it. Let it not become beginning of a bigger problem. Make sure that patient is not allergic to any of the medicines that he/she is going to take. If it does not give relief in 4-5days, inform.
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