International Pain Centre

The pudendal nerve is paired, meaning there are two nerves, one on the left and one on the right side of the body.

Cervicogenic headaches can mimic migraines, so it may be difficult to distinguish a cervicogenic headache from a migraine headache. The primary difference is that a migraine headache is rooted in the brain, and a cervicogenic headache is rooted in the cervical spine (neck) or base of the skull region.

Hello,

Mera naam Doctor Amod hai, main ek brain specialist hoon . Aaj hum ek or nayi condition lekar ke hajir hue hain. Agar apane mere purane videos dekhe hain to pichhali bar maine back pain ke bare mein baat kari thi yani ki reed ki haddi ke nichle hisse ke dard ke bare mein baat kari thi, uske bad humne agale video mein sciatica ke bare mein baat kari thi yani ki naso ka dard jo reed ki haddi se uth ke niche pav ki tarafe jata ho. Aaj ham ek different condition ke bare mein baat karenge jiska naam hai frozen shoulder. Yah ek kandhe ke dard ki condition hai Jo bohot logon ko pareshan karti hai mere pass roj-marra kafi sare marriz aate hai is pareshani ko lekar ke is condition mein kandhe mein dard hota hai, kandha akda hua yani ki stiff mehsoos hota hai aur kandhe ki movement mein kafi pareshani aati hai yani ki kandhe ko hilane mein roj-marra ki jindagi mein apni baju hila kar ke kam karne mein kafi taklif hoti hai logon ko aur durbhagyapurn is condition ko improve hote hue kafi samay lag jata hai to isliye marriz mari kafi pareshan hote hain. To is condition ke bare mein aur jyada janne se pahle yeh jaruri hai ki ham thoda sa kandhe ki anatomy yani ki uski banawat ke bare mein thoda sa samajh le.

To iske liye main aapko ek chhota sa video clip dikhata hoon. To main aapko kandhe ke jod ki banawat is model ke madad se samjhunga. Kandhe ke jod mein teen haddiyan aati hai aur unko main aapko abhi dikhaunga is model ki madad se, Ham left kandhe ko dekhenge aur agar ham ye chamadi hata de to andar ka jo dhaancha hota hai wo aisa dikhta hai to ham left kandhe per concentrate kar rahe hain to wo jo jod hai yahan per hai aur aap dekhenge yahan par 3 haddiyan kam kar rahi hai aur yah ek baju ki haddi hai jiska upar wala hissa thoda gol akkar mein hai. Ek or haddi hai jo piche se aati hai usse ham scapula kahate hain aur yah baju ki haddi ke sath judti hai. Agar main aapko isko piche se dikhaun to ye haddi aapko samajhne mein aasani hogi ki ye kahan per hai aur agar ham chamdi wapas lagayen to samajh payenge ki yeh haddi kahan per hai.

Aage ki taraf se jo teesri haddi athi hai use ham clavicle ya collarbone bhi kahate hain aur ye bhi shoulder joint mein bhag leti hai to ye jo joint hai ismein abhi jo baju ki haddi hai ye upar wala hissa jo hai iska kafi gol hai aur bada hai aur ye jo scapula ke jis bhag mein jakar judta hai agar aap usko dhyan se dekhenge to judne wala bhag kafi chhota hai. To in dono ke size mein kafi fark hai to isi vajah se ham shoulder joint ko itna move kar paate hain, but ie joint ko stability dene ke liye yeh jo aap safed-safed dekh rahe hain bohot sare ligaments ajaate hain taki apni jagah per rahe, aage piche donon taraf aur isi jod ke aas paas ek capsule hota hai jo is jod ko cover karta hai pura acche se.

Ab isko aur stability dene ke liye ismein bohot sari muscles ajaati hain taki wo jodh apni jagah per rahe hai aur movement hum jitni karna chahte hain wo ho sake aaram se ye jo muscles hai aage ki taraf hai aur piche ki taraf hai in sab ko jod karke rotatot cuff bolte hain. Ab dekhenge maine individually ek-ek muscle ko highlight kar raha hoon. To piche ki taraf ye teen muscle hai aur aage ki taraf kafi muscles aur bhi hai ab yah sab mil jul kar ke shoulder joint ko apni jagah per rakhte hain aur Jo itni sari movements ab ham kar sakte hain usmein madad karte hain to ye hai shoulder joint ki banawat.

Lekin ab agar ham frozen shoulder ki baat karein to jo sabse important cheez hai wo hai joint ka capsule. To ab is condition frozen shoulder mein yeh Jo joint ka capsule hota hai yah ek kisi karan varsh tight ho jata hai tight hone ki vajah se jo baju ki jo haddi hai uska upar wala jo gol hissa hai uski jo movement ki jagah hai wo kam ho jaati hai aur kafi samay tak tight rahane ke baad vahan per jo capsule hai wo chipakne lag jata hai baju ki haddi ke sath jisse ham adhesions bhi kehte hain to is vajah se baju ki movement mein dard aata hai aur movement jo hai wo kam ho jaati hai yani ki restrict ho jaati hai. Ab yah capsule tight kyon hota hai? Isko acche se abhi tak ham samajh nahin paye hai lekin haan ya condition kafi sari cheezon ke sath commonly dekhi jaati hai yani ki jaise diabetic patients jo hote hain unme is condition ki hone ki sambhavna ek non-diabetic se panch guna jyada hoti hai.

Aise hi jitne logon ko frozen shoulder hota hai har teen mein se ek aadami ko diabetes ya pre-diabetes jaisi condition ho sakti hai. Uske alawa thyroid problems ke sath bhi is condition ko jyada commonly dekha gaya hai aur agar kisi karan varsh aapka shoulder kafi samay ke liye move na kiya jaaye yani ki immobilize ho jaaye ki chot lagne ke baad ya stroke hone ke baad to us condition mein bhi yah frozen shoulder ke develop hone ke chances jyada hote hain. Iske alava auraton mein 40 se 60 varsh ki aayu ke beech mein yeh condition ko jyada commonly dekha gaya hai, to ye to baat ho gayi ki frozen shoulder hota kya hai? Aur kyon hota hai? Aur kis mein ho sakta hai?ab isko diagnose karne ke liye kya karna hota hai. Iska jo diagnosis hota hai wo jyadatar clinical hota hai yani ki aap clinic mein doctor ko dekhenge agar usko examination karne ke baad, history lene ke baad lagega ki yah ho sakti hai condition to wo diagnose kiya ja sakta hai ki yeh frozen shoulder hai ya nahin? Lekin kabhi-kabhi ham iske alawa khoon ki jaanch bhi mangte hain yeh dekhne ke liye kahin aapko diabetes ya thyroid to nahi hai problem sath mein aur aise hi ham MRI ya ultrasound scan be mangte hai karne ke liye kyonki aisi jo dard uthati hai ya jo problem hoti hai aur bohot sari conditions mein bhi ho sakta hai. jaise shoulder joints ke bursa ki problem ya gardan se nikalti hui nason ki problem to isliye ham kafi bar MRI scan ya ultrasound scan ki madad lete hain yeh dekhne ke liye ki koi aur karan to nahin hai is condition ka? Kya hamara diagnosis sahi hai ya nahi.

Ab ek bar diagnosis ho jaega uske bad bohot sare log mujhse yehi aakar puchte hain ki kya yah apne aap theek ho sakta hai? Haan bilkul apne aap theek ho sakta hai lekin kabhi-kabhi is condition ko apne aap theek hone mein kafi lamba samay lag jata hai, 2-3 saal ya usse jyada bhi aur kabhi-kabhi kafi samay ke bawjud puri jo movement hai wapas nahin aati hai to aap khud sochiye agar aapka kam karne wala main hath, yani ki dominant hath itne samay ke liye out of action ho jaaye yani ki aap usko puri tarah se istemal na kar payein to aap ki roj-marra ki jindagi mein usmein kitna prabhav padega to aapki recovery ko speed karne ke liye yani ki usko jaldi karne ke liye bohot sari cheezon ki madad li jaati, to ham agale section mein a jaate hain jise ham bolate hain treatment. To treatment karne ke liye pain clinic ek acchi jagah hai kyunki yahan per ek multi-disciplinary approach use ki jaati hai yani ki bohot sare specialist jo alag-alag tarike ka kam karte hain sath milkar ke aapko ek maximum benefit yani ki fayda pahunchane ki koshish karte hain.

To ek acche pain clinic main aapko dwaaiyan di ja sakti hai, vahan per physiotherapy ka option bhi available hota hai, uske alawa injections ka option bhi available hota hai aur in sabko jab ham ek sath istemaal karte hain to aapko fayda aane ka chances jyada hote hain. To treatment ke liye jyadatar ham davaiyan jaise ki anti-inflammatory davaiyan ya sath mein physiotherapy dono ko milkar ke hum istemal karte hai kafi logon ko isse rahat ajaati hai lekin agar kisi vajah se aap yah davaiyan nahin le sakte hain to aapke jo treating doctor hai wo aapke liye or strong davaiyan bhi recommend kar sakte hain yah dekhne ke bad ki aapki aur kya health conditions ha, aapki umra kya hai wo sabh madhya nazar rakhte hue aur davaiyan bhi recommend kar sakte hain. to agar aapko davaiyon se aur physiotherapy se achha response milta hai to yah bohot acchi baat hai lekin kisi vajah se achha response nahin bhi milta hai to aur bhi options hai jisse aapko aaram diya ja sakta hai aur unme se ek bohot important option hai injection. Ye injections jo kiye jaate hain basically frozen shoulder ke liye do tarhe ke hote hain, ek to shoulder joint ka injection aur dusra hota hai capsule ko stretch karne ke liye yani ki distant karne ke liye injection aur research me yeh dikhaya hai ki dono ko ek sath istemal karne se aur jyada fayda aane ki umeed hai.

To isliye jab main apne clinic mein yeh kam karta hun to main jyadatar dono ka ek samay per istemal karta hoon aur uske bad mareez ko physiotherapy ke liye bhi bhejta hoon to sab kuch istemal karne ke bad response jyada aane ka chance hai. In injections ke bare mein thoda sa aur baat karen to Jo keh de ke jod ka steroid injection hai wo goli lene yani ki oral tablets steroid lene se alag cheez hai jab ham tablets kehte hain to usmein side effects jyada aate hain aur lamba response aane ke chances kam hote hain. Jabki jahan per agar problem hai agar ham vahan per injection karein to side effects ka 5 guna kam hone ka chance hai aur uske response behtar hone ka be chance hota hai.

Ab dusri cheez jo humne baat kari thi wo thi capsule ke distention yani ki hydrodilatation, hydrodistension ismein ham kya karte hain ki ham jod ke andar pani ya koi sunn karne ki dawa yani ki local anesthetic dalte hain aur isko dalne ka purpose ye hai ki ham capsule ko stretch karen usko stretch karne se jo judav ya chipkaw ya adhesions bane hue hain wo khulte hain thode se aur movement mein aaram aane ka chance badhta hai. To yeh dono hi procedure OPD mein kiye ja sakte hai aur ultrasound use karne se inki safety aur inki accuracy jyada badhti hai aur jyada achha response aane ka chance hota hai. Ab kuch aise bhi log hote hain jo yah sab kuch karne ke baad bhi unka response achha nahi aata hai to aise logon ko ham bohot bar surgeon ke pass bhejte hain dekhne ke liye ki wo aur kya kar sakte hain. Main is condition ke bare mein aaj itna hi kehna chahunga aur mujhe umeed hai ki jo bhi maine jankari aapko di hai wo aapke liye ya aapke kisi jankar ke kam ayegi.

Thank you

Hi,

I am Dr. Amod Manocha, Pain Management Specialist. Maine last video mein jodon se uthne vale dard ke baare mein baat kari thi. Aaj hum ek aur dard ke baare mein baat karenge jo reed ki haddi se uth sakta hai. Common language mein ise sciatica kaha jaata hai. Bohut baar ye galat sense mein istemal kiya jaata hai. Aaj hum iske baare mein detail mein baat karenge. Ye ek symptom hai jaise peat dard. Bohut log ise diagnosis samjhate hain. Peat dard kideny mein pathri, liver ki problem, aanton ki problem ki vajah se ho sakta hai. Ye sare symptoms hain. Vaise hi sciatica bhi ek symptom hai jo bohut karanon se ho sakta hai. Sabse common karan hai ki agar spine mein koi disc bulge kar rahi ho aur kisi nerve pe dabav daal rahi ho toh uska dard paanv ki taraf jaata hai and use hum sciatica kehte hain. Uske aur bhi bohut sare karan ho sakte hain. Ye aap ka diagnosis nahi hai, symptom hai. Sciatica ek khaas tarah ka dard hota hai jo peat se and buttock area se uthta hai and niche paanv ki taraf jaata hai. Generally, ye dard jalan ya fir jhanjhanahat ki tarah ya bijali ke jhatake ki tarah describe kiya jaata hai.

Aur dard ke sath sath paanv mein sun pana bhi aa sakti hai. Tingling bhi ho sakti hai. Uske alawa paanv mein kamjoori bhi aa sakti hai. Aur in sab ka karan jaruri nahi hai ki aap ke paanv mein ho, spine mein bhi ye ho sakta hai ya spine ke bahar bhi ho sakta hai. Kuch aise bhi signs hain jiska ache se janna aap ke liya jaruri hai. Agar aise dard ke sath mein aap ke urine ya stool ke control mein problem aa raha hai toh aise dard ko ignore na karein. Koi lamba bukhar ho aise symptom ke sath mein ya aap ke vajan mein kami aa rahi ho ya aap ke paanv mein sun panna badh raha ho, toh ye saare warning signs hain. Koi serious problem bhi aap ko ho sakti hai. Isko ignore na karein. Specialist se suggestion lein and treatment karayein. Ye ho gaye sciatica ke warning signs. Ab ye problem kyun hoti hai? Iska ek karan ye bhi hai ki agar spine mein se disc apni jagah se hil jaye, jise hum slip disc bhi kehte hain, toh ye dard peath mein bhi ho sakta hai, paanv mein bhi ho sakta hai and ye dard jyada preshan karta hai. Spine alag alag haddiyon se banta hai. Ek ke upar ek lagi hai. Har 2 haddiyon ke bich mein disc hai. Ismein nerves bhi hoti hain. Ye sharir ke khaas hisse mein jayengi har level se nikal ke. Agar ye disc piche ki taraf jayegi toh ye jo nason ki jagah hai, usko kam kar deti hai aur bahar se nikali nerves pe dabav dalegi.

Disc ke alawa aur bhi bohut sare karan hain jinki vajah se ye dard uth sakta hai. Spine ki haddiyon ki alignment agar change ho jaye toh nason pe jyada dabav pad sakta hai. Uske alawa piche joints mein arthritis aa jaye toh ye bhi jagah ko kam kar sakte hain. Uske alawa koi fracture hona, koi chot lagna, in sab ki vajaha se bhi preshani aa sakti hai. Jaruri nahi hai ki sciatica ka karan spine ke andar hi ho, spine ke bahar ya fir operation hone ki vajha se ya koi muscle jyada dabav daale toh unki vajha se preshani aa sakti hai. Toh sciatica ka asli kya karan hai. Isko janne ke liya hum spine ka MRI scan karate hain. X-ray bhi karaya jaata hai lekin humein us se detail nahi milti. MRI scan behatar information deta hai diagnosis ko banne ke liya. Uske alawa bohut log puchte hain ki kya ye apne aap thik ho sakta hai? Han, ye apne aap thik ho sakta hai. Jayadatar logon mein improvement aane ka chance hai.

Changes aayenge ya nahi, ye keh pana mushkil hai, depend karta hai individual case to case. But aap ise bich mein na chorien kyuki treatment mushkil ho jayega. Jab ye shuru ho tab hi specialist se milen. treatment aap ki healing mein bhi aap ki help karega. Ab iske liya kya treatment kiya jaata hai? Iske liya pain-killers hote hain jise hum neuropathic pain medications kehte hain. Ye medicines nerves pe kaam karti hai aur use control karne mein madad karti hai. Iske alawa hum sath mein physiotherapy bhi karte hain. Kisi kisi ko surgery ki jarurat padti hai. Kafi logon ko injection se aram aata hai. injection ke process mein hum spine ko x-ray mein dekhte hain aur sahi jagha pe medicine di jaati hai. Ye day case ki tarah kiya jaata hai. Koi behoshi ki jarurat nahi hoti hai. Kafi logon ko is se achi rahat milti hai. Isliya aap is problem ko ignore na karein. Specialist se milein and sahi treatment karayein. Ignore karna achi baat nahi hai.

Thanks!

Hi,

I am Dr. Amod Manocha, Pain Management Specialist. Yahan se pehle mai London mein as a pain consultant kaam karta tha. Meri pain se related education London se hi hui hai. Aaj main aap ko low back pain yanike ridh ki haddi me niche ki taraf jo pain hota hai, uske bare mein btaunga. Main aap ko iske bare mein isliya batana chahta hun taki aap apni problem ko samajh saken. Aur ye bhi decide kar saken ki aap ke liya konsi treatment achi rahegi. Is pain ke hone ke bohot sare karan hote hain. Inmein se ek karan hai ridh ki hadiyon ke jod mein se uthne vala dard. Aaj hum isi dard ke bare mein baat karenge. Is se pehle jaruri hai ki hum ridh ki haddi ke bare mein thoda sa jaan lein. Ridh ki haddi mein niche tail bone hoti hai and spine upar ki taraf hota hai. Ridh ki haddi 33 bones ko mila kar banti hai. Ye bones ek ke upar ek hoti hai. Inko vertebre bhi kaha jata hai. In hadiyon ke bich mein jelly type ka material hota hai jise disc kehte hain. Harr 2 hadiyon ke bich mein ek disc hoti hai. And piche ki taraf ek haddi se dusri haddi judti hai jahan pe jod hote hain. Inko facet joint kaha jata hai.

In joints mein umar ke sath badlav ata hai. Aur bohot baar ye dard dene lagte hain. Inse uthne vala dard bharipan ki tarah mehsus hota hai and deep ache bhi patient feel kar sakta hai. Ye pain generally back mein hi rehta hai. Kuch patients mein ye dard thigh se hota hua knees mein bhi jata hai. Dard ke sath sath sharir mein stiffness ya akdan mehsus hoti hai jo ki subha ke samay jyada preshan karti hai. Iske alawa sardiyon mein ye dard aap ko jyada preshan kar sakta hai. Aur kuch patients ko lagta hai ki unhe sidha hone ya challne mein thoda samay lagta hai. Yahi condition spine ke upar ke hisse me bhi ho sakti hai jiski vajah se gardan me dard aata hai aur kabhi kabhi shoulder joint tak bhi jaa sakta hai.

Abhi ke liya hum spine ke niche ke hisse ke baare me baat krenge. Is dard ko treat karne ke liya bohot sare tarike hain. Jayatar logon ko physiotherapy ya maspeshiyon ya fir core muscles ko strong karne se darad mein rahat milti hai. But is kam ko karne me samay lag jata hai. Jab maspeshiyan strong hoti hain to jodon mein dabav kam padta hai jiski vajah se humara dard kam ho jata hai. Uske alawa aap dawaiyan bhi istemal kar sakte hain dard ko kam karne ke liya. Pain management mein hum bohot baar injections use karte hain. Hum x-ray mein in jodon ko dekhte hain aur inke bohot pass dawayi dalte hain. Vo dawayi aap ke dard ko lambe samay ke liya kam kar sakti hai. Is se aap ko opportunity milti hai ki aap apne muscles ko strong kar payein. Iske alawa ek aur tarika hai is dard se nijaat paane ka. Use hum radiofrequency ablation ya fir radiofrequency treatment kehte hain. In jodon se jo dard uthta hai vo dimag tak phuchta hai.

Aur tab hume pata chalta hai ki hume dard ho raha hai. Isliya hum nerves pe focus karte hain taki aap ko pain na ho. Radiofrequency me hum ek special needle and machine use karte hain. Nerves ko hum heat karte hain. Jinki vajaha se inki kam karne ki shamta kam ho jati hai. Is se dimag ko phuchne vala dard bhi kam ho jata hai. Ye effective treatment hai jo aap ka dard 1-2 years ke liya kam kar deta hai. Aap ko moka milta hai ki aap apna lifestyle change kar saken. Ye ek daycare treatment hai. Ye local ansthesia me kiya jata hai. Is se aap ki dawaiyan kam ho sakti hain. Aap ki movement better ho jati hai. Chalna firna, subha uthna, in sab mein badlav aa sakta hai. Aur Aap lambe samay tak is dard se rahat paa sakte hain. Mujhe umeed hai ki ye jankari aapke liya beneficial sabit hogi.

Dhanyawad.