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Modern women want to have it all, in personal and professional life. They want to experience the joy of motherhood but not the pain associated with normal delivery. For such women, epidural analgesia during labour is a blessing. Epidural analgesia/anaesthesia is given to pregnant women during childbirth. Epidural painkillers stop the pain signals transmitted nerves from uterus. This stops the pain sensation of labour. For epidural analgesia, a catheter (small tube) is inserted into the epidural space in the spinal cord. It is through this tube that the drugs (painkillers) reach the desired nerves. 

Types of Epidurals: 

Epidurals can be 

1. Injection with top-ups: Once given, epidurals help to relieve the pain that arises due to contractions. When the epidural starts to wear off, top-ups or refills are used. The refills can last for 1-2 hours. 
2. Combined Spinal Epidural: Compared to the regular epidurals, the combined spinal epidurals are powerful, quick, and more effective. Here too, epidural painkillers are made to pass through the catheter, once the first injection wears off. It is also known as Walking Epidural. 
3. Continuous infusion (patient-controlled epidural analgesia): Here, the other end of the epidural catheter is attached to a pump. This pump continuously infuses the painkillers into your back. For an effective response, top-ups may be used. Many hospitals allow patients to control the pump. 

Merits and demerits of having an epidural--

Merits: 

1. Epidurals make the delivery smooth and hassle free. 
2. Epidurals are relatively safe as only a small fraction of the medicine reaches the baby. 
3. Women stay fully awake and experience no pain during the cervix dilation. This enables them to push the baby out with more energy.
4. Depending on the requirement, the dosage of epidurals can be adjusted. 
5. Epidurals help to lower the cases of C-section delivery. 

Demerits: 
Though epidurals make childbirth easy, one cannot overlook its demerits. 

1. Infections can sometimes occur. 
2. Sometimes epidural analgesia can have a patchy effect, causing some pain to persist. 
3. Though rare, epidural can result in nerve damage. 
4. Epidurals bring about a fall in blood pressure. At times, this can be risky for the baby. 
5. Nausea, headache, itchiness, backache, soreness are the common side effects of epidurals. 
6. Epidurals relax a woman, thereby reducing their urge to push the baby out. 

Thus, they may take longer than usual to push the baby. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.

Getting through an ugly divorce is quite a difficult thing, no matter what the reason might be. Your world can turn upside down after a divorce and you have to make a fresh new start in life.

Here are some tips you should follow to get through an ugly divorce:

1. Accept the fact that it is okay to have different feelings: All feelings like sadness, anger, exhaustion, frustration and confusion are quite intense after a divorce. You should accept these reactions and they will surely decrease with time.
2. You need to give yourself a break: Accept the fact that you are weak and time is required to be back to normal functioning. Your work performance can be affected as well. Taking a break is a must after a divorce.
3. Do not try to go through the situation alone: You should share your feelings with your friends and family, and you will surely get help. Joining support groups can also be fruitful. Isolation makes your condition worse; so you must go out, interact and share stuff.
4. You should take proper emotional and physical care of your body: Eat timely, work out and relax. Try to maintain your normal daily routine and do not make major life decisions during this point of life. Abstain from too much alcohol and cigarettes as they are not a solution.
5. Avoid ugly situations: Avoid talking to your former spouse as discussions may lead to ugly situations and fights, which would enhance your misery.
6. Take a hobby: Try to do things you love to do from your heart. Join classes, take music lessons, paint pictures and slowly try to enjoy life. Making new friends is also a good idea.
7. Think positive: Positive thinking is a must and if you engross yourself in positive, constructive activities, you are likely to feel good. You need to be flexible and in case you have children, do your best to provide them an ideal atmosphere for adjusting to the situation.
8. Time can heal everything: Keep one thing in mind that life will eventually return to normal. Time heals everything and one day you will not be affected anymore.
9. Talk to your children and help them cope: You need to provide proper care to your kids for coping with the situation. Talk to your children and make them understand that they are not responsible for the divorce by any means. Try to ease their concerns, be compassionate, but maintain a direct approach. Maintain your child's routine exactly how it used to be, so that they feel less amount of sudden change. Do not involve your children in the conflict in any way.

A divorce is extremely difficult to cope with, as one has never faced or felt such a situation before. With proper support and measures, you can get over a divorce much more easily. If you wish to discuss about any specific problem, you can consult a Psychologist.

Pain is a feeling of distress that is caused by intense damaging stimuli. It is one of the most common reasons that compels the patient to consult a physician and take painkillers. In the long run, painkillers have adverse effects on our body. While most of the times, the cause of the pain is diagnosed, there are cases in which the cause remains undiagnosed. Homeopathy is a system of medicine that is based on symptoms and has no side effects and thus, it is most effective in the treatment of both muscle and joint pains.

Here we give you a list of common homeopathic pain medications that are prescribed to give relief to patients and the circumstances under which they can be used.

1. Bryonia- It is given when there is a hot swollen joint, pain from overuse of body part or injury. The slightest movement aggravates the pain and is relieved of the pressure on the affected part.
2. Causticum - It is recommended for muscle spasm, stiff neck and pain. The character of the pain is sharp and tearing and is caused by cold dry weather. The patient is relieved by the warmth.
3. Arnica Montana - Arnica is suggested when a patient has sore, bruised feeling all over the body. The patient is very sensitive to the pain and everything on which he rests seems very hard. Arnica is a top remedy in case of injury from falling, sprain and bruise.
4. Rhus Toxicodendron- A first choice of remedy in case of rheumatism and back pain. The right side of the body is especially affected. The patient experiences stiffness and aching pain that aggravates during the rainy season, in the morning, on exposure to cold and also by rest. Pain is relieved by moving the affected parts and by warmth.
5. Cuprum Metallicum- It is given in cases of muscle twitching or severe muscle spasm. The patient feels better when the painful area is massaged.
6. Magnesia Phosphorica - This is the best medicine for all types of pain, especially when the pain is in the right side of the body. The pain is aggravated by cold and movement and is relieved by heat and rest in the general. This is suggested to relieved lower abdomen pain during menstruation.
7. Pulsatilla- This is an excellent remedy for rheumatic pains that shifts from one joint to another. Homeopathic medicine is suggested after a thorough understanding of patient symptoms and the medication differs from patient to patient. So it is better to consult a homeopathic physician to select a suitable medicine to get relieved from pain.

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis: The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles: A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries: Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few other causes behind back pain

1. Weak back muscles
2. Weak osteoporotic back bones
3. Disc disease
4. Facet joint arthopathy (degenerative or traumatic )
5. Sacro Iliac joint pain
6. Infection of the spinal bones
7. Most of us, experience back pain due to incorrect posture or longer duration of sitting. Some people inherit back pain. Degenerative disc disease can be genetic or inherited. That is why we see degenerative spinal changes causing chronic back pain in some young age group patients without any apparent cause.
8. Cancers which can be primary or metastasis
9. Psychogenic 

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

• Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.
• Consult the right physician instead of doing exercise that can aggravate your pain.
• Take a break from work and go for short walks, every couple of hours.

Treatment: 

Most often back pain will resolve itself in 3 to 6 weeks time and does not need to be treated. Please note, bed rest of no more than 2 days is required. Bed rest may weaken the back muscles and prolong back pain. If the back pain continues or increases, investigations are required. Expensive Investigations like MRI is usually over prescribed and will be needed only if neuro deficit is present or infection is suspected. 

Treatment includes

1. Physical rehabilitation and Pain medication like NSAID.
2. Neuropathic pain medications for neural compression (gabapentin or pregabalin).

Minimally invasive procedures which have revolutionised the treatment for back pain and saved millions from spinal surgeries include

1. Radiofrequency ablation treatment for Facet pain
2. Transforaminal blocks for nerve compression
3. SCS for chronic back pain
4. Intra thecal pumps
5. Intradiscal Radiofrequency procedures. ( this procedure makes the disc painless ).

Surgery should be the last option and should be restricted to patients having progressive neuro deficit. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.

Pain, experienced in the lumbar area, is generally referred to as lower back pain. This kind of back pain may happen due to a variety of reasons including hereditary conditions as well as accidents and sports injuries. These pain generally leave your body in a state of chronic pain, depending on the area that was affected. This lumbar area is a complex of joints, nerves, ligaments and muscles which go towards providing support and posture to the human body. Here are the various ways in which you can deal with lower back pain-

1. Heat and Ice Therapy: One of the most recommended forms of treatment includes heat and ice therapy. You can use a warm bath or a heat compress and heating pad to soothe the area and bring down the pain. Ice packs can be used for inflammation and swelling. While the previous method can be used for chronic pain, the latter can be used for acute pain and more recent accidents. These methods are known to increase the blood flow to the affected area and hence bring much relief when there is pain and stiffness.
2. Choose your Activity with Caution: There are a number of activities that one can carry out even when you are suffering from lower back pain. Mild to moderate exercise that has been approved by your physician can help in soothing the area. The trick in such cases to move at frequent intervals so that stiffness and further pain does not set in. You can embark on walks and even water exercises that will help in soothing the stiff muscles. Having said that, one must remember to avoid exercises that will involve bending and standing for too long as this can aggravate the pain.
3. Rest: It is essential to sleep in the correct position and get the best amount of rest so that the muscles and joints of this area can get the required comfort and rest before being put to work again. Yet, too much inactivity is also not recommended in such cases, and hence one must not rest for too many days at a time. Further, it is important to rest in the correct position so that the lumbar area does not twist and there is no pressure on the same. It would be best to lie down on the back without crossing the ankles.
4. Pain Medication: You can get a prescription for pain medication in case the pain is unbearable. It would be advisable to take medication after consultation with a doctor. One can have oral medicines or take topical application gels and ointments that will numb the area. One can have ibuprofen, acetaminophen, aspirin and other such medicines to get relief from the pain.

Interventional pain management

Finding the right relief can be tough for patients living with chronic pain. It involves a lot of trial and error to find the therapy that works for you. The Interventional Pain Management is one therapy that is aimed to reduce your pain, as well as provide options for preventing pain in the future. It adopts a comprehensive and holistic look to treat pain with lesser risk and morbidity when compared with surgical interventions.

1. Surgery cannot be a solution to every health problem, the minimally invasive procedures of interventional pain management are cost-effective
2. Lower risk for infections and complications
3. Lower recovery time as they don’t employ large incisions or anesthesia
4. It identifies the source of pain and comes up with the right solution to alleviate pain

Types of interventional pain management

1. Epidural Steroid Injections: The prime aim of these injections is to identify the site of pain and reduce inflammation in the nerve roots as they exit the spine. A local anesthesia is administered and a steroid is injected into the epidural space. More than one injection is needed until there is a significant reduction in pain.
2. Facet Joint Injection and Medical Branch Blocks: This technique helps the patient to manage and tolerate their pain better. A steroid is directly injected into the facet joint to reduce pain. Medical branch blocks target i.e. the nerve that detects the painful sensation and sends messages to the brain. These blocks help further denervation procedure and provide long term relief.
3. Sacroiliac Injections: These injections are administered directly on the sacroiliac joint of the spine which is the cause of lower back pain.
4. Peripheral Joint Injections: Joints like shoulder, knee and hip are injected with medicines that aim to reduce painful inflammation at the source of joint dysfunction.
5. Radio frequency Ablation: This involves the use of radio waves to create an electrical current that delivers heat to the targeted nerve tissues. It results in the impairment of the nerves to transmit pain signals to the brain
6. Rhizotomy: This is another procedure where the pain signals are turned off. Heated electrodes are applied to the specific nerves to cut off the transmission.
7. Spinal Cord Stimulation: This uses electrical impulses to block pain from being perceived by the brain
8. Nucleoplasty: This is a procedure in which a which tissue is removed from the disc of the spinal cord to decompress and relieve pressure
9. Intrathecal Pump Implantation: A pain pump is placed under the skin that directly delivers pain medication to the targeted area.

These are some of the procedures of interventional pain management that aim to reduce pain, without the need of surgery or other conservative pain medications. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.