Lybrate.com has a number of highly qualified Anesthesiologists in India. You will find Anesthesiologists with more than 25 years of experience on Lybrate.com. Find the best Anesthesiologists online in Jalandhar. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Cancer Pain Management
Epidural And Spinal Anesthesia Techniques
Treatment of Transcutaneous Electrical Nerve Stimu
Submit a review for Dr. Pawanjeet Singh Bali RaizadaYour feedback matters!
I have a left sided shoulder pain and I can not work early because of shoulder pain. This pain for last two months.
I am diabetic and having b. P. Both are well under control. But I feel tired, I am not fresh in the morning, always feel sleepy. I have leg pain too.
Hello hi I am guravaiya I am 31 year old I am suffering from right shoulder joint it has been paining very much what should I do now.
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:
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.
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 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.
Few daily habits to get rid of Back Pain
Hi I am Dr. Sidharth Verma and today I will tell you about Back Pain and how to prevent back pain. So back pain is, one of the most common pain which hampers the activities of mankind and it is so common that all of us will suffer from it at some point in our lifetime.
So how can you prevent that?
You can very easily prevent back pain and most of the cases which we see in our daily practice are due to lifestyle disorders and some other factors. So as far as lifestyle is concerned. Humans, when they evolved and became erect, so their back pain is the cost they have to give; and as the back is made of very small, small bones which are known as vertebrae. This is a model of the human back, you can see there are small, small bones which make up the back and there are a lot of small intervertebral discs in between. These are the structures that provide cushion and hold the vertebrae and there are a lot of small, small joints and many nerves and structures which are coming out, therefore, the back is a very complex structure and if you do not maintain it properly then you might have back pain. Now, this is all complicated stuff. Furthur, I will tell you how to easily prevent it.
First and foremost is which you can do from day 1 is maintain adequate hydration. Human body is 70% water, and if you see the back, The back has intervertebral discs and they are 90% water. So if you are not hydrated well then you will probably have more problems.
Number 2 is to control your body weight. So it has been seen that in patients or in persons who are obese, this problem occurs more. That is, they have more back pain. The causes are many but you should try to control your weight this will result in lesser back pain.
Number 3 is proper posture while you are you are doing your jobs or in your workplace or while you are driving or you are travelling. By proper posture, I mean that you should always sit with your back straight, and not hunching forward. This is one of the techniques.
Number 4 you should avoid sitting for long period of time without taking a break. This will help you to redistribute the weight of the back to different muscles and this will avoid fatigue, thereby resulting in lesser incidence of back pain.
Number 5 is selecting ergonomic furniture. Ergonomic furniture means which is designed for your body. If you go to the market usually the furniture and the kind of furniture you will get is designed more or less for a similar kind of individual maybe 5 ft 5 inches height or maybe who is sitting for a few hours. However, in actual practice, if you see that nobody is the same so everyone is different and hence you will need to have ergonomic furniture which will be specifically designed for you or there is kind of furniture available which has lots of keys or levers with which you can adjust the height, for example, the chair or the table where you are going to sit or at your workplace, you can get it all adjusted. And it may seem very difficult but if you actually start doing it is very easy. Most of the chairs which we use in our offices, they are rolling chairs which have adjustable levers and height as well as the seat quality and backrest all of it can be adjusted. Similarly the height of the tables can also be adjusted in many cases, if not all. So you can have these ergonomic furniture and this also will help.
Another factor which is responsible for majority of back pain, is unaccustomed activity. By unaccustomed activity I mean, that if you are not used to a particular activity and you do it once then probably you will have some problems. Say for example there is a folder which is kept at a height and you want to fetch it and you stretch your hand and you stretch it so much that your back muscles and your full arms, hand has to stretch so much which is unphysiological. So in these cases, it may result in micro injuries or macro injuries and this may result in back pain. Another common example can be, while lifting heavy loads. So in our routine structure, most of the people are sitting or doing jobs which do not involve lifting of heavy loads. So if you lift some heavy load on one particular day say for example, I got something to install in my house and when that thing comes and I lift it and I try to fit somewhere then that is unaccustomed for me because I am not doing it every day. So this may result in unaccustomed stress and sprains and strains to my back and this may result in back pain. So these are how you can prevent it.
Another very common cause is sleeping on very soft mattress or sleeping for inadequate amount of time. Some people have a habit of surfing mobile phone for a long period of time and they sleep on their table chair maybe on their bed with unphysiological postures. So these will result in increased incidents of back pain. Another common cause which you can prevent is while travelling. So if you are travelling and you are driving a car for example you should adjust your seat so that your back is always upright. And while taking the support, many people ask me if it is helpful to use fancy supports that are available for the car seats. The answer is no. They will not help you. In most cases, they are just fancy items and they will not help you. However, straightening your seat will help you a lot. If you straighten your seat to a point where you are sitting independently and you are seeking only the lower back support from your seat and you are sitting on your own then probably the chances of you getting back pain are less.
Another common thing which you can apply when you are travelling is do not drive for extended period of hours like, I have seen people who drive for maybe 6 hours at a stretch so if this is done occasionally or frequently then it may result in back pain. So if you can avoid and take a break maybe around 45 minutes to an hour every 45 minutes or an hour you can stop and walk around maybe for one or two minutes or you can get out of your car or you can just get down and have a break then you can continue driving so you can drive in bits and bytes then you can travel long distances also. But please be sure to take a small break at least so that your back is not strained unnecessarily.
Another common reason why people come with this back pain are these motorcycle riders or scooter riders who are travelling these long distances throughout the day. What they often do is that they carry these bags. So they carry these bags and backpacks and they funnily carry it on one shoulder. So it will be like a strap and they will carry it on one shoulder and they will do this throughout the day and then after one month or two months they will start having a pain on one side. So this one-sided stress is one of the reasons why people have back pain. If you are not driving a vehicle, then also if you are carrying a load or a backpack or if you are a student or if you are an office goer who has to carry these laptops. Because I have often seen these laptops come in suitcases or briefcases and obviously you have to carry them with one hand. SO it is better to switch from these one handed or one sided carrying devices to devices or bags which are distributing the load equally to both shoulders and back. So that the load is distributed and there is no asymmetrical stress that is the back, on one side, is not stressed unnecessarily.
Another common reason for people who travel a lot is that their legs are not properly placed. So, in addition to the back of the seat, the height of the seat also plays a role. In majority of vehicles however, the height is not an adjustable portion. So the one thing you can do is, you can go forward or you can go backwards that is towards the steering and away from the steering. This mechanism is available for most of the cars or most of the vehicles and with the help of this, you can have enough distance between the steering and your body so that your thighs are touching your seat till the point they can leave the seat that is until the maximum point they should be able to touch the seat. So this will again be helpful to reduce the stress on the back.
Another common cause of back pain is the lack of exercise. For exercise, I don’t mean well I don’t advise that you should go to the gym and lift weights or something like that. But by exercise, I mean exercises like walking. Even simple walking is one of the best exercises for back, swimming or even cycling, or even exercises for your abs. You may underestimate the importance of the exercises for your abs but you should know that abs they support the back to a great extent and weak abs or abdominal muscles are the common causes of back pain in healthy adults.
Other than these, there are causes like nutritional causes. By nutritional causes I mean the deficiency of specific nutrients in your diet. This may be deficiency of Vitamin D .This is one of the most common deficiencies which I see in my practice that most of the people who come to me with these deficiencies they are normal healthy individuals otherwise but due to some reasons, they have this Vitamin D deficiency. Many of them are non-vegetarians so it is a myth that you cannot have Vitamin deficiency if you are a non-vegetarian. So you may have deficiency of Vitamin D, which is necessary for the calcium metabolism and in the deficiency of this Vitamin you are more likely to have weak bones and this pain.
In elderly individuals, however, you may have other causes of weak bones and they may also lead to this back pain. So last but not the least, we have population which is ageing now. So we have more number of people who are above 40 years of age. In these people there are conditions known as degenerative conditions which is, due to age, the body starts degenerating. So if you don’t use your body properly, it will start to degenerate. In many people, who are using the body properly also, due to genetic reasons, and environmental factors, it starts to degenerate. So in these patients there are lot of conditions that develop, and these may affect the intervertebral discs, the joints of the back, the muscles, as well as the ligaments. So these conditions can lead to the back pain in this age group, the elderly age groups that is. So these are the common causes and if you are careful enough, you can easily prevent them and help yourself to prevent your back pain. Prevention is always better than cure, so I will strongly recommend that you take my advice and follow these steps, and you are less likely to have back pain.
To know more, you can always visit my Lybrate website on www.lybrate.com/drsidharthverma or you can also visit my website www.pain.org.in. Thank You.