I am Dr. K J Choudhury, senior consultant in pain management and in charge of pain clinic in Indraprastha Apollo Hospital, New Delhi.
Many people don't know what pain management is about. Though people know that pain is the issue with every family. And I am sure, in every family, there must be a member who is suffering from pain from 2-3 months like joint pain, headache, neck & back pain. Generally, the treatment given for any pain or painkillers is given for a time period, and if they don't subside, they seek surgical opinion from an orthopedic or neurosurgeon. But every pain does not require the surgery. So, pain management, or as we call it interventional pain management, delivers the medications where the problem is without cutting.
The drugs you normally use by mouth, they circulate all over the body through blood. But the area that requires the treatment may be a 1 mm area, so the whole body is loaded with medications. If we misuse the painkillers, it becomes an important cause of kidney failure and liver failure.
What does a pain physician do? They look at the exact source of pain. They use the specialized technique to teat the pain. And they deliver the medications mostly through needles using specialized equipments like x-ray or ultrasound to reach to the target so as they stay where it is required. So, the rest of the body is safe from the ill effect of painkillers. But all the patients do not need any surgical interventions. It is not necessary that all the painkillers will work for every painful condition. So, the pain specialist also knows that what kind of painkillers or what exponents are required.
So, I will tell you about back pain. It is common today amongst those who are not physically fit and use wrong posture while using computers, bicycles. They stress on the muscles and that could be because of pain. But if it doesn't subside with medication and physiotherapy, you can go to a surgeon who will ask you for the MRI.
Now the question is whether the disc is the cause of the pain. So, what we do is, between the 2 vertebrae, it contains a gel. When the covering breaks down because of the poor body strength then these gel causes irritation of the nerves that are going down to the legs and it is called sciatica. The most common thing is that we enter into the place where the disc material is irritating the nerve and put the healing agents.
We don't have to treat inflammation with a surgical technique. But if the patient has the unstable spine or there is a tumor or there is the narrowing of the bony canal in the spinal cord then it needs a surgical intervention. My idea is to educate you that not every patient who fails medications, require surgery. There is a much safer procedure to take care of pain anywhere in the body. Thank you very much.read more
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Treatment of Pain
Treatment of Nerve Pain
Treatment of Cervical Problem
Treatment of Neurological Problems
Treatment of Hip Disorders
Back Pain Treatment
Neck Pain Treatment
Treatment of Spine Injury
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Treatment Of Disk Slip
Chronic Pain Management
Treatment Of Herniated Disc
Treatment of Spine Injuries
Treatment of Disc Prolapse
Spinal Cord Injury Medicine
Treatment of Muscle Pain Skeleton System
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Patient Review Highlights
Dr. K J Choudhary provides answers that are very helpful. Which kind of physiotherapy Sir?
Dr. K J Choudhury provides answers that are knowledgeable. Excellent feed back
I became aware of my slip disc since 2015, I took medication and used belt which helped. However still the pain comes up in following cases 1. when I stand continuous/walk for some time, there is vibrating sensation in thighs. 2. when I sit down/sleep and then wake up and start walking, I cannot walk properly for sometime due to pain and then slowly pain goes away. What would be right thing to do to cure this? Situation is getting bad with age and weight gain as I am not able to do walk for long time, advice/suggestions will be highly appreciated. Thanks.
I am suffering form upper backache from 1 year having painkillers and ointments but not having any breleif what to do?
My mother is suffering pain due to l4-l5 slip disk problem, can you suggest me any home remedies solutions, because drs are advised to him for operation, but she is now 69 years old, so we are not prepare for any such type of operation.
My father is suffering with pain around his waistline He is 75 years old and has a tall body structure He doesn't want to get any hard medication because they make side effect, looking forward to an advise His regular working and daily lifestyle is getting hampered due to the trouble. We want to know what should be the diet, exercise, lifestyle therapy, and medication how should we be avoiding any particular nature of food, work ,stress ,related to carrying of heavy weight or any action and prolonged work.
I feel severe body pain before leaving bed. Due to air lock my muscles becomes stiff and it is very difficult to move an inch to leave bed. I feel 30% to 40% free after one our exercise. Is there any solution?
I am 45 years old. I am suffering from waist pain. How to solve this problem please suggest me as soon as possible. Thanks.
Hi, 5 saal pehle meri spinal cord ke lowest part (coccyx Cx) me kaafi jyada injury hui thi, internally. Ab last one year se continue pain ho raha h, x-ray me koi injury nahi aayi. Mai continuous bike bhi chalata hu, tab jyada pain hota h. Es condition me kya koi cancer ka risk hai? Please doctors clear my doubt.
Lower back pain is fast becoming an epidemic not just among elderly, but across all age groups. Primary causes of back pain are quite a few including lumbar hernia, disc degenerative disease (DDD), spondylosis etc., but the symptoms are usually the same excruciating pain in the lower region of the spine, followed by stiffness. Since back pain is caused due to a number of spinal problems, it manifests differently in different patients. The pain may be dull, burning or sharp. It could also be felt at a single point or over a broad area and could be accompanied by muscle spasms or stiffness or even shooting pain in one or both legs.
Back pain can also be differentiated according to time period:
- Acute: Pain lasts for less than three months.
- Recurrent: Acute symptoms reoccur over time.
- Chronic: Pain lasts longer than three months.
Sometimes symptoms resolve on their own, but in many cases conservative treatment, such as physiotherapy, which often work better than surgery, becomes essential. Alternate therapies like surgery, acupressure, acupuncture as well as yoga and Ayurveda also help.
Physiotherapy - Exercises that work
Since the reason for low back pain is not always same, a patient’s treatment too should be tailored for his specific symptoms and condition. This is what the physiotherapist will do design an exercise plan based on the patient’s specific problem and its cause.
Physiotherapy treatments may include:
- Manual therapy, which includes direct spinal manipulation aimed at improving the mobility of joints and soft tissues
- Strengthening and flexibility exercises
- Education about what do and what not to do
- Training for proper sleeping positions, lifting, bending, and sitting as well as for working at home and at work
- Use of heat/cold treatments or electrical stimulation to help relieve pain
Physiotherapy exercises help support the back and strengthen muscles so that the spine is cushioned properly. This is why physiotherapy is relevant as a treatment for backache. Treatments like traction help in lengthening the spine and relieving compression of nerves that cause sciatica, radiating pain into legs largely due to lumbar herniation. If back pain is extreme, a patient will require physical therapy along with medication, which will help in managing pain and bringing inflammation down. But in the long term, being physically active, going for walks, sitting properly and maintaining a good posture will help the most. In case you have a concern or query you can always consult an expert & get answers to your questions!