DARADIA: The Pain Clinic

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- 

1. 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. 
2. 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 
3. 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-counter 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. 
4. Interventional Pain Management: It is a highly effective treatment for back and neck pain. 
5. Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest must be avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs). 
6. 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. 
7. 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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The shoulders are the strongest and the most often used areas of the body as they are connected to the neck, chest, hands and elbows. Therefore, it should not come as a surprise that shoulder pain and wear and tear of this area, including the rotor cuff and bursa, is also quite common. The shoulders may face plenty of wear and tear when it comes to the ligaments, tissue and other such elements. The shoulder joint may also get injured with repetitive actions that are involved in the life of a sportsperson, a carpenter, a painter and other such professionals.

There are a number of ways in which one can deal with shoulder pain. Here are the best measures that you can take in order to deal with the same.

1. Increase the range of motion: One should increase the range and variety of motions so that the stiffness and soreness that primarily comes from repetitive actions, may be avoided. If you are only lifting materials, then you may also want to swing the arm at regular intervals to increase the blood flow and exercise the various nerves. Also, this will help in giving rest to the affected region of the shoulder. Rehabilitation therapy can help in introducing one to a range of motions that will give rest to the affected area and bring in new positions.
2. Perform strengthening exercises: One of the best ways to keep pain and stiffness at bay is to create plenty of core strength in the muscles and joints of the area. You can try out various exercises as per the physiotherapist and the physical therapy exercises so that you can build strength. This will also help in keeping the pressure off of the affected area. You can add some weights to the exercise routine so that there is extra strength built up in the process.
3. Do aerobic exercises: Aerobic exercises are known to increase the blood circulation to the area. The tendon and the bursa in particular benefit substantially from this kind of exercise. This will also bring the soreness down so that the pain and stiffness do not affect you.
4. Try heat and ice therapy: You can use ice packs to soothe the inflammation in the affected area. This is usually recommended for acute pain and new injuries. Similarly, you can use heat packs and hot showers to soothe chronic pain as and when the same returns. However, you should be careful so that the scalding temperature does not leave burns and marks.
5. Medication: You can also have painkillers as well as gels and ointments that can be used for topical relief. These must be taken with a doctor’s prescription. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

 

Our body is composed of many elements that carry out emotional and physical functions that are usually in sync with one another. It is important for these organs and other elements to be in sync for good health. All nerves are connected to the brain and are responsible for sending important signals throughout your body. Therefore, even one pressed nerve may send you warning signals such as pain to the body. It is advisable not to overlook these signals. Damage from a pressed nerve might be minor or extreme. It might bring about persistent and chronic issues. Therefore, the sooner you get a treatment for nerve compression, the more relieving experience you will have. In a few cases, you cannot reverse the damage caused by a pressed nerve. However, treatment does relieve you from the pain in most cases.

Nerves are the most vulnerable at spots in your body where they go through narrow spaces and have very less tissue to protect them. These are the places they are more likely to get pinched. A number of the causes may include:

1. If the nerve is pressed between tissues, for example, your tendon, ligament or bone.
2. Nerve compression in your neck or arm may likewise bring pain in zones, for example, your elbow, hand, wrist or fingers.
3. Aggravation or weight on a nerve root leaving the spine may bring about neck or low back pain.
4. In case a disc tears, it is known as a herniated circle that can put weight on a spinal nerve.

Some of the common symptoms of pinched nerves are:

1. Pain in the region of pressure, for example, the neck or low back
2. Transmitting pain, for example, sciatica or radicular pain
3. Numbness
4. Tingling
5. Blazing sensation
6. Weakness

To what extent you are affected depends on individual to individual. Treatment fluctuates, based upon the seriousness and reason for the pinched nerve. You may find that you benefit from just resting the affected area and by maintaining distance from any exercises that may cause you harm. If side effects endure or torment is serious, it is best to consult a specialist. You may require one or more types of treatment to contract swollen tissue around the nerve.

Treatment may include:

1. NSAIDs - Non-steroidal inflammation mitigating drugs (NSAIDs, for example, headache medicine, ibuprofen, or naproxen) may diminish swelling & helps in certain situation' but it do not work in most of the time and must be avoided. 
2. Oral corticosteroids - These are utilized to lessen swelling and agony, used in certain specific situations. 
3. Opiates - These are utilized for brief periods to lessen extreme pain. 
4. Co-analgesics - These are the main medicines for nerve pain. Carbamazepine, Pregabalin, Duloxetine etc medicines are best medicines for these situations. 
5. Interventional Pain Procedures - They are the most cost effective and non invasive methods for pain relief as recommended by the WHO. Your pain will be taken care of by the interventional pain physician or the pain specialist. 
6. Surgery - Surgery might be required for more serious issues that do not react to different sorts of treatment.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Chronic pain is one that lasts for a long time or might even last a lifetime. It could either be seasonal - that you would experience only in winters, or it may persist throughout the year. There are many ways to cope with or get rid of chronic pain. Mentioned below are ten ways in which you can deal with chronic pain: 

1. Meditation: Meditation and deep breathing can help ease pain and strain on the muscles. Concentrating on the breath, overlooking your thoughts, causes the body to unwind. While you can learn to meditate by yourself, taking a class is a better idea. 
2. Lessen stress in your life: Negative sentiments like depression, uneasiness, stress, and outrage can make the body more sensitive to pain. By figuring out how to take control of anxiety, you may discover some relief from pain. 
3. Help get rid of pain with the natural endorphins from exercising: Endorphins are cerebrum chemicals that enhance your mindset while blocking pain signals. 
4. Exercise has another pain decreasing impact - it reinforces muscles, preventing re-damage and further pain. Furthermore, practice can hold your weight down, decrease heart problems and control glucose levels - particularly critical if you have diabetes. 
5. Cutting down on alcohol: It is not easy to rest with pain and liquor can aggravate pain issues. In case you are living with chronic pain, drinking less or no liquor can increase your pain improvement process. 
6. Join a care group, meet others living with chronic pain: When you are with individuals who have chronic pain and share what you are experiencing, you don't feel alone. You additionally gain advantage from their knowledge in adapting to the situation. 
7. Try not to smoke: Smoking can intensify pain flow issues and increase danger of heart or respiratory diseases 
8. Track your pain level and exercises each day: To treat the pain, your specialist needs to know how you have been feeling between visits. This will help in prescribing the right kind of exercise so that your muscles get their strength. Keeping a log or diary of your everyday "pain score" will help you track it. Towards the end of every day, take note of your agony level on the 1 to 10 pain scale. 
9. A sound eating routine: A nutritious diet is essential from multiple points of view - supporting your digestive system, reducing the risk of heart diseases, keeping your weight under control, and enhancing glucose levels. To eat a low-fat, low-sodium diet, these are important: new leafy foods; cooked dried beans and peas; entire grain breads and oats; low-fat cheese, milk and yogurt. 
10. Discover approaches to keep yourself occupied: When you concentrate on pain, it worsens as opposed to getting better. Rather, discover something you like doing - a movement that keeps you occupied and thinking about things other than your pain. You will not have the capacity to maintain a distance from pain, but rather you can take control of your life. 
11. Visit a doctor to make a diagnosis: Self-treatment is always dangerous. Have a diagnosis from a pain physician and treat it early.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Most diseases, small or big, acute or chronic, accident or infection, have one common factor - pain. In most cases, in addition to reducing the severity of the infection or the impact to various structures from the trauma, managing pain assumes a bigger role. It is only when the pain is controlled can the bigger picture of disease management be done, as the patient would be inconsolable.

To this effect, in addition to pain killers, the most inexpensive and easily available modes of pain management are heat and cold. Though all are not aware, there are specific instances where heat and cold should be used as listed below.

Heat: Some of the common modes to heat therapy include heat pads, warm baths, paraffin wax system, hot water bottles, air-activated heat pack, or warm oils. Heat acts by improving blood circulation and nutritional supply to the body parts and is best suited for stiff joints and muscle soreness. 

Some common ways to heat therapy include:

1. A warm shower or bath in the morning - this will ease morning stiffness and get you ready for exercise.
2. Apply a heating pad on the sore/stiff areas for up to 20 minutes - Use optimal, bearable temperature to avoid skin burns.
3. Wrap the affected area for 15 to 20 minutes with a moist heat pad. A wet towel can be put in the freezer and then warmed up in the microwave. Moist heat pads are also available with local pharmacies.
4. Warm mineral oils can be applied to the stiff joints of hands and legs. Leave it in place for 15 to 20 minutes before washing it off.
5. For sore hand and foot joints, warm paraffin wax can be applied using the equipment available at drug stores. This will help ease the pain and soreness. Soak in a warm whirlpool.

Contrary to heat therapy, cold therapy acts by reducing blood flow to the affected area and numbing the nerve endings, thereby reducing the perception of pain. It works well for acute pain cases like fresh injuries and post-exercise inflammation.

1. A cold wrap with ice cubes can be applied to the painful area for about 15 to 20 minutes. This can be repeated if required after a break.
2. Alternately, a wet towel can be put in a plastic bag and kept in the freezer for 15 minutes and then used as a cold pack.
3. The affected joint can be submerged in a container of ice and water.
4. Cold gel packs are available at stores - these won't leak, will stay cold longer and can be easily wrapped around a joint.

Cryotherapy, as cold therapy is also called, is not as effective as heat therapy, though it does provide immediate relief.

Whether it is the dipping winter temperature, chilling effect of the air conditioning or a lower temperature caused due to rain, we complain about the body pain. It is quite normal when our body experiences lower temperature than it is comfortable with, various forms of aches crop up, esp. if you already have a condition or have been physically hurt.

Winters are typically associated with several types of body pains. Particularly, we’ve seen higher incidences of nerve – related pain, joint pains and vascular pains during the season.

Manage your pains by following these 6 tips:

1. Keep yourself warm: Needless to say, it’s extremely important to keep yourself warm when its gets uncomfortably cold. Clinical research has shown higher incidence of nerve – related, vascular pain and joint pains if your body is exposed to low temperatures for long periods. This is especially true if you are 60+ in age. So, dress appropriately with body warmers, sweaters and jackets

2. Keep yourself physically active: A colder weather reduces average activity levels. An average person walks up to 1,000 lesser steps when its cold. To avoid pain in knees and other joints, it’s especially important to keep up activity levels. Try and take out time for walking in the afternoons or evenings, even if it is inside your house or office.

3. Take care of your diet: It is important to ensure that your intake of Vitamin D, Calcium and Vitamin B complex is adequate. Make sure that your diet remains rich in dal, green leafy vegetables (Vitamin B complex), milk (Calcium) and cheese and egg yolk (Vitamin D).

4. Get enough exposure to sunlight: Lesser exposure to the sun causes Vitamin D deficiency during winters, which can result in fatigue, lethargy and general body pains. Make sure to get at least 15-20 minutes of sunlight exposure, ideally in the mornings around 9am to 10am.

5. Avoid the wrong foods: Actively manage your diseases like diabetes and hypertension to stay pain free. If you suffer from diabetes, make sure that you do not overeat foods with high glycemic index. If you suffer from hypertension, it is important to keep away from spicy and oily foods.

6. Get expert advice: Visit your pain specialist if your pains continue for more than 2 weeks. Be regular with your prescribed pain medications, but strictly avoid self-medication or overuse of painkillers.

How should you approach pain caused due to sports injuries?

Sports injuries can happen to any person who engages in sporting activities. These affect full-time athletes as well as those who partake in sports and exercising on an occasional basis. Most sports injuries are acute and affect the muscles and skeletal system. Usually, they are not chronic unless caused by a grave accident or left untreated.

The most common types of injuries caused due to sports are as follows:

•  ankle sprain
•  wrist sprain
•  concussion
•  knee injury
•  tennis elbow
•  hamstring pull
•  cartilage damage

Treatment of sports injuries depends on a number of factors such as the type of injury, part of the body affected, the intensity of the pain, and the patient's age and medical history.

Accordingly, the most common ways of approaching the pain caused by sports injuries are:

1. Immediate remedies

Several quick aid, home remedies are used to treat pain that is caused by minor injuries to muscles, such as sprains and strains. It involves alleviation of pain through rest, using ice packs and hot water bags, wearing supports and elastic compression bandages.

2. Medication

Many medicines such as painkillers and anti-inflammatory pills, creams and sprays effectively reduce pain caused by sports injuries. In extreme cases, morphine and codeine are also prescribed.

3. Physical therapy

A number of injuries can be treated and cured through certain exercise and workout routines. These aim at stretching and strengthening the affected area to provide pain relief through increased flexibility and muscle activity.

4. Injections

Various substances and chemical compounds can be injected into the injured area which works on the affected ligaments, tendons, and cartilage to reduced inflammation and relieves pain.

5. Surgical procedures

If the injury is too severe and the pain too intense, the best option for treatment is surgery. This is generally resorted to in case of damage to the skeleton in the form of broken bones and cracked ribs.

Devising the exact treatment method requires a thorough examination of the injury. Diagnosis can only be provided after taking into consideration the many factors that affect treatment. The method of treatment varies from case to case and consequently, the recovery time also differs. In case you have a concern or query you can always consult an expert & get answers to your questions!

What are the Different Kinds of Arthritis and How to Treat Them?

Arthritis is a very common medical condition that affects a lot of adults as they age. It occurs due to inflammation of the joints, which can be caused by a number of factors such as aging, injury or infection.

There are over a hundred different kinds of arthritis that cause various sorts of problems to those affected. However this condition can be broadly classified into two major types, which include the following:

1.Osteoarthritis - Also known as degenerative joint disease, osteoarthritis is the most common kind of chronic condition to affect the joints. This occurs when the cartilage that surrounds the joint wears away and allows the ends of bones to rub against each other causing immense pain and is often accompanied by inflammation and swelling. The primary cause of osteoarthritis is aging and occurs mainly due to pressure on the joints from lifting heavy weights.

2.Rheumatoid Arthritis - This is the most common type of arthritis that occurs due to joint inflammation. It is an autoimmune condition, which means that it is caused by a dysfunction of the immune system that leads to inflammation of the joints. Chronic inflammation causes joint deformities and even the development of rheumatoid nodules on the skin around the joint. Two-thirds of patients affected by rheumatoid arthritis are women.

Depending on the nature of the condition and the age and medical history of the patient, diagnosis, and treatment of arthritis varies. Although there is no permanent cure for arthritis, especially the type caused by aging, a number of remedies exist that provide relief from pain.

Some of the common methods of treatment for arthritis are:

• Medication - Some medicines provide relief from the pain of arthritis if it is not too severe. These include painkillers, anti-inflammatory pills, sprays, and ointments, etc. In case of high-intensity pain, codeine is often prescribed.
• Stem Cell Therapy - This method involves drawing platelets from the patient's own blood and injecting it into the inflamed parts of the joint in order to repair damaged muscles and alleviate pain.
• Injections - A number of anti-inflammatory substances and lubricants can be injected into the affected joints to decrease pain. Ozone gas injections are an example of this.
• Surgery - In extreme cases, surgical procedures are resorted to for treating arthritis. However, successful surgery cannot always be guaranteed and it comes with its own set of risks.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Fibromyalgia is a disorder that causes widespread body pain along with sleep deficits, memory loss, mood problems and fatigue. 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.

Other Symptoms These patients may also have symptoms like burning urination, urgency of urination, numbness,loss of appetite, tingling sensation,diarrhoea, constipation, tinnitus, depression etc.

Diagnosis of fibromyalgia There are no specific test to diagnose fibromyalgia. Diagnosis is made by a doctor specialised 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.
2. Lifestyle changes like active involvement in cardiovascular exercises, swimming, yoga, meditation are important to control symptoms.
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. Sometimes these patients need interventions/injections.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Movement of the head and neck is enabled by the various joints in this region, the main role being played by the cervical spine. This is a part of the vertebra or the spine and supports the head and neck in all movements. There are cervical vertebrae, ligaments, muscles, and nerves which ensure this movement happens smoothly. However, given the complexity of the whole structure, head and neck pain are also two of the most common joint pains.

The Neck Bone’s Connected to the Head Bone…

The vertebrae of your neck (cervical spine) support the weight of your head and all its motions, which may not seem like much – until you realize your head weighs as much as a bowling ball. When your neck bones are not positioned properly, the result is tightening of the muscles and irritation of the nerves that connect with your head. Your head and neck symptoms may include some or all of the following:

1. Sharp or dull pain or discomfort in your neck
2. Stiffness in your neck
3. Inability to turn your head to one side
4. Headache
5. Shoulder pain
6. Jaw pain

Fortunately, you don’t have to live with head and neck pain – and you don’t have to take drugs to eliminate the pain. 

Causes:

The causes for head and neck pain can range from muscle strain to arthritis to pinched nerve to cancer.

1. Posture problems: Not providing adequate support when being seated grows to be a menace. With the changing lifestyle where people end up staring at a monitor, there is tremendous stress on the neck muscles, leading to pain and stiffness. There is also loss of flexibility, leading to a stiff neck and headaches.
2. Muscle strain: This can occur due to a sudden movement, either when doing something or as a result of accident (like a whiplash injury). The muscle can be torn or injured and this can result in pain, swelling, and inflammation of the affected area.
3. Stress: One of the most common identifier of stress is the constant ache/nagging pain in the back of the neck.
4. Disk herniation: When the disk is moved out of its space due to excessive movement and rotation, the disk gets herniated and the nerve gets ‘pinched.’ This can cause a sharp, shooting pain to the area where the nerve emerges out of that disk.

Spondylitis, arthritis, etc., are other chronic inflammatory conditions which can affect the neck and head areas.

Side effects:

When there is pain in the head and neck area, the whole body function is affected. The movement is limited and therefore vision, neck movements, and other functions are affected. This, in turn, affects the overall quality of life.

Management:

1. Identify the problem with a thorough examination, X-ray, and if required soft tissue examination.
2. Ice the area for relief of pain temporarily.
3. Improve ergonomics in terms of height of the monitor, seat/chair, etc., so the strain is minimized.
4. Develop an exercise regimen, which gives adequate exercise to the head and neck muscles.
5. Manage stress. Be it physical, chemical, or emotional stress, it takes a toll on the head and neck area. Managing the stress (there is no escape from it!) will definitely see the pains and stiff neck go away.
6. Engage in pain management, which is holistic (as above) and does not always resort to medications.

In case you have a concern or query you can always consult an expert & get answers to your questions!