DARADIA: The Pain Clinic

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.

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!

The sciatic nerve spreads down the spine till the legs. The pain in this nerve can feel like sparks running down your back of leg from buttock area. Anything that puts weight on or aggravates this nerve can cause pain that shoots down the back of one butt cheek or thigh. The amount of pain can increase gradually. Sciatica may feel like a gentle ache, a sharp sensation or extreme uneasiness. Sciatica can bring feelings of shivering, numbness and weakness. 

Sitting, standing up, coughing, sneezing, lifting, or straining for a very long time, might aggravate pain. Now and then, individuals experience numbness or shivering in the leg, too. 

Some of the most regular symptoms of sciatic pain include: 

1. Pain in the buttock and/or back of leg when sitting or walking 
2. Hip pain 
3. Burning sensation in the leg 
4. Numbness or trouble moving the leg or foot 
5. Shooting pain that makes it hard to stand up properly 

The most common causes of sciatic pain include: 

1. Lumbar spinal stenosis (narrowing of the spinal channel in the lower back) 
2. Degenerative disk disease (breakdown of discs, which go about as pads between the vertebrae) 
3. Spondylolisthesis (a condition in which one vertebra slips over another) 
4. Piriformis syndrome
5. Muscle spasms 

How to treat: 

Visit doctor early, have a proper diagnosis. As you can see that several diseases can cause sciatica, diagnosis is very important before starting treatment. Outline of treatment: 

1. No exercises during acute painful condition. No absolute rest is also needed. Do normal daily activities. 
2. Medications to relieve nerve pain, like pregabalin etc. 
3. Interventional pain management is the best way to confirm the diagnosis, relieve pain, and cure the condition.
4. Surgery is rarely needed.

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

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!

It is important for you to know about degenerative disc disease (DDD) and spondylosis. Spondylosis is an umbrella term for spine pain, which occurs because of degenerative conditions. Spondylosis refers to several conditions. They include spinal stenosis, which is the abnormal narrowing of the spinal canal, leading to leg pain, degeneration due to DDD and degenerative arthritis or osteoarthritis involving the spine. It may also include cervical osteoarthritis or neck arthritis.

Spondylosis is a common condition, which is age related. The joints and discs present in the neck are specifically affected as a result of this condition. It commonly develops on account of the wear and tear of the cartilage and bones present in the neck. This condition, in spite of being common, worsens with age. In many patients, symptoms are not observed externally, but pain and muscle spasms are experienced.

Many people with spondylosis do not undertake treatment in spite of suffering from the symptoms and pain. In case the symptoms are prevalent over a long time and tend to worsen, you have several modes of treatment to choose from. They may include medicines, corticosteroid injections, physical therapy and even surgery in some extreme cases.

How does DDD or spondylosis occur?

DDD is a spinal condition. It is caused due to the breakdown of the intervertebral discs. With ageing, the spine starts to show signs of wearing and tearing. This happens on account of the discs drying out and shrinking. All these age-related changes are responsible for arthritis, spinal stenosis and disc herniation. Because of these factors, pressure is likely to fall on your nerves and spinal cords, which may further cause back pain. DDD or spondylosis also develops on account of these factors.

Treatment for DDD and spondylosis

There are various modes of treatment, which are available for you to choose from in order to get relief from the symptoms and pain associated with DDD or spondylosis. It can be medicines. You may be prescribed typical painkiller medications, such as non- steroidal anti-inflammatory drugs or NSAIDS, muscle relaxants, oral steroids,etc, It can be physical therapy like ultrasound and massage, transcutaneous electrical nerve stimulation (TENS) etc. When above modalities fails interventional pain management may do miracles. There are few interventional procedures like epidurals, Rami communicantes fibre RF, or some intradiscal procedures. Rarely these patients needs surgery.

Every mode of treatment has got its own benefits, but has its limitations as well.

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

Back pain is something that affects many people all over the world. Persistent and chronic pain seems to be one of the most common complaints. Middle back pain is back pain that is felt in the thoracic vertebrae region, which is located between the base of the neck and top of the lumbar spine. The ribs attach to a long, flat bone in the middle of the chest called the sternum and wrap around the back. In case, there is a nerve around there is squeezed, disturbed, or injured, you are likely to feel pain in different spots where the nerve goes through, for example, your arms, legs, chest and the stomach.

Some of the most common causes of middle back pain are as follows:

1. Middle back pain can happen as a consequence of injury or sudden damage or it can happen through strain or poor stance after some time.
2. The most widely recognized reason for middle back pain seems to begin from soft tissue problems or muscular irritation. These can emerge from poor stance, lack of strength, prolonged sitting in front of a computer, utilizing a heavy backpack, overuse injuries, (for example, repetitive movement), or injury, (like a whiplash damage brought about by an auto crash or as a consequence of a sports injuries).
3. The middle back is a moderately normal site for inflammatory, degenerative, metabolic, infective and neoplastic conditions.
4. Middle back pain and its dysfunctions are connected with various conditions, for example, essential and optional osteoporosis (particularly vertebral cracks and hyperkyphosis emerging from vertebral bone loss), ankylosing spondylitis, osteoarthritis and Scheuermann's infection.
5. Muscle strain, overuse or damage to the muscles, tendons, and discs that are backing your spine can also cause middle back pain.
6. Weight on the spinal nerves from specific issues, for example, a herniated disc.
7. A fracture in one of the vertebrae can also cause pain in this region.
8. Osteoarthritis created by the breakdown of ligament or cartilage that cushions the little joints in the spine.
9. Myofascial pain that influences the connective tissue of a muscle or gathering of muscles.
10. In uncommon cases, pain might be brought about by different issues, for example, gall bladder disease, cancer or an infection.
11. Getting hit hard in the back can also cause chronic pain.
12. Lift something too heavy may cause pain and a sudden pressure in this area.
13. A compression fracture of the vertebra can also bring about intense or chronic pain in the middle back. The injury may bring about a fracture, however in ladies over age 50 without critical injury or somebody known to have osteoporosis, an unconstrained vertebral fracture is possible.

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

Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.

What are the common causes?

Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.

How can you control nerve pain?

Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:

1. Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.

2. Painkillers: There are painkillers available OTC which can curb nerve pain. However, painkillers such as ibuprofen, aspirin and acetaminophen do not really work well for severe pain of the nerves.

3. Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.

4. Acupuncture: This time-honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.

5. Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.

6. Relaxation Techniques: In combination with the abovementioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.

7. Lifestyle Modifications: This one’s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won’t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder. 

8. Interventional pain management. When every other options has failed, interventional pain management, like neuro-modulations, nerve blocks, spinal cord stimulation can do miracle in relieving pain.

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!