Persistence of pain even after full healing of an affected area after injury or ailment is known as chronic pain. Chronic pain can also occur due to an undiagnosed underlying condition within the body. Any form of pain which lasts for more than 6 months can be categorized as chronic pain. Chronic pain might be continuous or episodic, excruciating or mild, totally incapacitating or merely inconvenient.read more
Platelet-rich plasma (PRP) is an autologous blood product with platelet concentrations above baseline values. The process involves the extraction of blood from the patient which is then centrifuged to obtain a concentrated suspension of platelets by plasmapheresis.read more
Book Clinic Appointment with Dr. Saipriya Tewari
Treatment of Pain
Treatment of Knee Pain
Treatment of Neck Pain
Treatment of Shoulder Pain
Treatment of Lower Back Pain
Treatment of Nerve Pain
Treatment of Cervical Problem
Treatment of Cancer Pain
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
Spinal Cord Injury Medicine
Submit a review for Dr. Saipriya TewariYour feedback matters!
Patient Review Highlights
Dr. Saipriya Tewari provides answers that are very helpful. Very helpful and I thought it was not curable, helped me to improve my health
I found the answers provided by the Dr. Saipriya Tewari to be knowledgeable. Thanks but can u say about what to eat to recover from it
Amit Kumar Gupta
I found the answers provided by the Dr. Saipriya Tewari to be very helpful and knowledgeable. Thankyou Saipriya Ma'am...Regards
Dr. Saipriya Tewari provides answers that are knowledgeable. k
Persistence of pain even after full healing of an affected area after injury or ailment is known as chronic pain. Chronic pain can also occur due to an undiagnosed underlying condition within the body. Any form of pain which lasts for more than 6 months can be categorized as chronic pain. Chronic pain might be continuous or episodic, excruciating or mild, totally incapacitating or merely inconvenient.
Nagging headaches or facial pain is a common issue faced by many. They can be mild or severe that and can disrupt your routine to a significant extent. If you are experiencing a disturbed vision, an upset stomach, feeling nauseous or vomiting along with the pain, you must consult your physician to identify the cause and avail proper treatment.
What are the factors that cause the issue?
Several underlying problems can be the reason for a facial pain including oral infections, a toothache, facial injuries, a skin abscess, nerve disorder or even an open sore. Sometimes constantly annoying headaches or sinusitis may also lead to facial pain. And some of the more commons issues that result in a headache are tension, anxiety, excessive stress, sleeplessness, migraines and sinus problems. A headache can also occur due to more severe causes such as tumor or cancer in the brain, neck issues, abnormalities of any kind in the blood vessels and muscles of the brain, etc.
When to seek medical help?
The symptoms of facial pain may vary depending on the factor that's triggering the pain. From swelling to open sores, redness, rashes on the skin, etc. are often associated with facial pain symptoms. People usually describe the facial pain to be an achy feeling or stabbing or cramp-like sensation on the different facial parts.
Headaches usually occur alone. However, some of its associated symptoms are blurry vision, difficulty in walking straight, confusion, trouble in speaking correctly, excessive sleepiness, neck pain, and neck stiffness. Sometimes, developing increased sensitivity to noise or light is also a symptom of headaches. Headaches can be mild to moderate to very excruciating. When the pain in the head becomes severe, it leads to vomiting and nausea.
What are the pain management strategies for this issue?
When it comes to headaches and facial pain management, the treatment options also vary depending on the causes of such pain. From stress reduction to, pain managing medications, elimination of particular foods from one's daily diet and biofeedback training are some of the most common ways of pain management. Regular exercise can also help in dealing with pain in some cases. However, if the cause of a face pain or headaches lies in some severe health diseases, prompt medical attention may be required for treating them first.
Remember, the moment you think that your quality of life is in some way impacted by head pain and facial pain, don't hesitate to look for medical assistance. Because, until unless, you do not consider undertaking proper methods of pain management suggested by a doctor, getting back to a healthy pain-free life and concentrating on your daily works may be impossible.
I became aware of my slip disc since 2015, after making x-ray tests and verified by doctor. I took prescribed 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.
Cronical Pain in left side of stomach from 1 year. I consulted doctor and do many taste ct scan, x-ray scan But no one identify problem, please help me doctor.
I have flat foot and some tear in left foot ligament when I walk for long time it gets swollen, red and pains me. So I have reduced walking. I am senior citizen 77 years old. I avoid pain killers, ointment, ankle guards I am looking for home remedies I also occasionally practice RICE.
Knee pain is a common phenomenon that plagues most of the people irrespective of their age. It can be the outcome of a torn cartilage or a ruptured ligament. Medical complications, such as infections, gout or arthritis (painful inflammation and stiffness of the joints) can also give way to knee pain. Minor knee pain can be eased by self-care remedies such as physical therapy or by putting on knee braces. However, few complications might demand surgical repair. Pain can be managed by the pain management specialists.
Tips to manage knee pain
- Medications such as naproxen, ibuprofen and acetaminophen can be administered to help remedy knee pain.
- Keep away from your usual chores to prevent repetitive strains on the knees, thus, allowing the injury to heal as well as to stay safe from further damage.
- Applying an ice pack in a towel can ease the inflammation and pain. But do not extend its usage for more than 20 minutes because that might harm the skin and nerves.
- To pacify the swelling, try resting your sore leg on a pillow (the idea here is to keep the affected leg elevated to reduce further pain).
- Shed off your extra pounds as being overweight increases chances of other disorders such as osteoarthritis.
- Go for regular work outs to enhance and maintain the flexibility of your muscles as excessively weak or abnormally tight muscles can contribute to injuries. Be smart while choosing your method of exercise based on the condition you are suffering from.
The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).
The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.
If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.
Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.
If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.
Once the conservative treatment fails:
Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation 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 pt`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&L5S1), 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.
LESI: Lumbar Epidural Steroid Injection
Indicated in – Acute radicular pain due to irritation or inflammation.
- Symptomatic herniated disc with failed conservative therapy
- Acute exacerbation of discogenic pain or pain of spinal stenosis
- Neoplastic infiltration of roots
- Epidural fibrosis
- Chronic LBP with acute radicular symptoms
- Epidural- lumbar injection
ESI Treatment Plan
Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.
SNRB- Selective Nerve Root Block
Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if
- There is minimal or no radiological finding.
- Multilevel imaging abnormalities
- Equivocal neurological examination finding or discrepancy between clinical & radiological signs
- Postop patient with unexplainable or recurrent pain
- Combined canal & lateral recess stenosis.
- To find out the pathological dermatome for more invasive procedures, if needed
Provocative Discography - Coupled with CT
A diagnostic procedure & prognostic indicator for surgical outcome is necessary for 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 Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The 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 postoperative discomfort or morbidity and low cost.
Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.
Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (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.
Platelet-rich plasma (PRP) is an autologous blood product with platelet concentrations above baseline values. The process involves the extraction of blood from the patient which is then centrifuged to obtain a concentrated suspension of platelets by plasmapheresis.
Are you suffering from body pains? It could be Fibromyalgia!!
Symptoms may be triggered after a surgery, physical trauma, infection, or stress. Women are much more vulnerable to this disease than men. Many people affected with fibromyalgia may have suffered from headaches, backaches, depression, anxiety, tension, temporomandibular joint disorders and irritable bowel syndrome.
Most of these patients have undergone multiple consultation with various doctors and undergone many tests but no diagnosis could be made. These patients are often ignored by doctors and family members as always 'complaining of pain'
Symptoms of Fibromyalgia:
1.Extensive Pain- Pain related to fibromyalgia is often depicted as a dull pain that lasts for at least three months. Pain can involve any body part like back, neck, chest, arms, legs. Patients have pain in multiple areas of body and painful areas change over time.
2.Fatigue- Patients afflicted with this disorder feel tired even after sleep. Such people are reported to sleep for longer hours than normal people but their sleep often gets disrupted due to sleep apnoea and restless leg syndrome.
3.Cognitive Difficulties- These patients find it difficult to concentrate at work and also suffer from memory deficits in daily activities.
Diagnosis of Fibromyalgia:
There are no specific test to diagnose fibromyalgia. Diagnosis is made by a doctor specialized in Pain Medicine using clinical methods based on symptoms and examination. Blood tests like Haemogram, Thyroid function test, RA Factor, ESR are done to rule out other diseases which can cause similar symptoms.
Treatment of Fibromyalgia:
1.First step in treating these patients is to accept their problem and discuss with patient and family members regarding the presence of such disease entity.
3.Conventional painkillers do not work in these patients. They requires special medications prescribed by a Pain Specialist for control of symptoms.
4. Counselling of patient is beneficial for associated depression.