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Dr. Sandeep

Pain Management Specialist, Lucknow

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Dr. Sandeep Pain Management Specialist, Lucknow
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Personal Statement

My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Sandeep
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Lybrate.com has a number of highly qualified Pain Management Specialists in India. You will find Pain Management Specialists with more than 27 years of experience on Lybrate.com. Find the best Pain Management Specialists online in Lucknow. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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I always scrub my neck using loofah scrubber but there's still dirty lines. Please help me! I don't know how to remove it.

BAMS
Ayurveda, Navi Mumbai
I always scrub my neck using loofah scrubber but there's still dirty lines. Please help me! I don't know how to remov...
Take multani mitti,Triphala, santra saal and masur atta for scrubbing. You need some medicine orally also to be taken.
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He is having pain in lower back since a week, and it pains a lot when sitting, walking and even when sleeping. Please tell what can be the possible reason and suggest some medicine.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
He is having pain in lower back since a week, and it pains a lot when sitting, walking and even when sleeping. Please...
Extension exercises x 15 times x twice daily. Bhujang asana. Core strengthening exercises. Back stretchingstretch do the cat/cow avoid bending in front. Postural correction- sit tall, walk tall. Apply hot fomentation.
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I am a 27 years old Man. My problem is sleeplessness. I am suffering from this issue since 2 years. Headache is also another problem because of sleeplessness. Can anybody suggest me something to overcome this problem. Thanks in advance.

MBBS
General Physician, Cuttack
I am a 27 years old Man. My problem is sleeplessness. I am suffering from this issue since 2 years. Headache is also ...
1.You may be having anxiety or stress. Avoid stress. 2.You need 7-8 hours of sound sleep to remain healthy. 3.Go for regular exercise, Take part in games and sports, 4.Do yoga, meditation and deep breathing exercise like pranayama to calm your mind, control your emotion, relieve anxiety and improve concentration. 5.Adhere to a specific sleep time and regular schedule 6.Take light dinner. 7.Avoid taking tea/coffee at bed time. Have a glass of warm milk at bed time . 8. Don’t go to sleep immediately after dinner. Take a small walk after dinner and if possible take hot water bath before sleep. Read a light magazine or interesting book before going to bed 9. Avoid late night. 10. Don’t sleep in day time 11. Don’t take sleeping pill 12. If no relief consult doctor.
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I am having headache. When I walk in sun. I tried some caps and home remedies but did not work please give me some solution.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda
Ayurveda, Noida
I am having headache. When I walk in sun. I tried some caps and home remedies but did not work please give me some so...
Keep urself hydrated before sun exposure. Drink water and carry water with you when going out. Having salads and raw veggies takes care of headache due to sun exposure. Do not expose yourself to high degree of temperature change often.
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I am a twenty 22 years old. I have hair fall problem and headache since last 6 month. Please give me some medicine or suggestions to overcome this disease.

M.D. - Ayurveda, B.A.M.S (Bachelor of Ayurvedic Medicine& Surgery), N.D.D.Y(Diploma in Naturopathy,Diploma in Yoga)
Ayurveda, Pune
I am a twenty 22 years old. I have hair fall problem and headache since last 6 month. Please give me some medicine or...
Start drinking lots of milk and increase protein intake in the your diet. Make a mixture of amla+reetha + shikakai powder, all in equal proportions. Take 4-5 tsp if this powder, boiled in 3 litres of water till 1-1.5 litre remains. Let it cool and then wash your hair with this and not shampoo. Extract juice of onion and add few drops of olive oil to it. Apply in riots of hair and keep for 40 min and then wash off. Start eating 1 amla daily start taking 1 tsp triphala churna daily with water and night with water after food start doing pranayam for 20 min daily. For headache, meditation and good sleep daily is useful
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I m a 27 year boy I backache as work in computer continues prefer me some medicine for this.

Fellowship in Shoulder and Knee Surgeries, DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Nagpur
I m a 27 year boy I backache as work in computer continues prefer me some medicine for this.
Dear Shekhar. Treatment for your problem depends upon you. How much you can do for yourself. Follow these instructions, and you wont need medicines. Don't sit continuously. Take a small walk every 2 hour and straighten your back and limbs. Do regular exercises to strengthen your back and other muscles. good sunlight exposure daily. And some medicines for temporary relief. Medicines are not magic and you have to take care of your body. If we give you medicines, your pain will stop for that time, but it will recur again after stopping medicine.
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Getting burning sensation on left back of stomach. And mild body joint pains. With a bit more urination.

D.A.M.S( A. M.), D.AC/B.E.M.S
Acupressurist, Mumbai
Getting burning sensation on left back of stomach. And mild body joint pains. With a bit more urination.
You should take acupressure therapy and take biochemic mag phos 12x + nat phos 12x, 4 tab each thrice a day with warm water and take it 5 days.
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I AM 54 year old. I have knee problem so I can't walk, I have sugar between 300 to 400 from last month. Taking glimmer ds regularly. Should I change medicine or any other.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I AM 54 year old. I have knee problem so I can't walk, I have sugar between 300 to 400 from last month. Taking glimme...
Knee advice. Avoid sitting cross legged. Avoid squatting- quadriceps exercises- lie straight, make a towel role and put it under the knee, press the keen against the role, hold it for 20 secs. Repeat 20 times twice a day. This will help relieve some pain. Core strengthening exercise- straight leg raised with toes turned outward, repeat 10 times, twice a day. Hams stretching- lie straight, take the leg up, pull the feet towards yourself, with a elastic tube or normal belt. Repeat 10 times, twice a day. Sports taping- stretch the tape from both ends and apply on the affected area contrast fomentation (hot and cold).
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I have an habit of sleeping only on right side mostly, so the I am suffering from neck pain. What I have to do for this problem.

BAMS
Ayurveda, Bangalore
I have an habit of sleeping only on right side mostly, so the I am suffering from neck pain. What I have to do for th...
Hi, Apply Rumalaya liniment and massage for 10 mins and give hot water fomentation. This can be done thrice daily. If the pain is severe, take tab. Yogaraja guggulu 1-1-1 with hot water after food. Use soft medium sized pillow while sleeping. Perform neck exercises for 10 mins in the morning and evening regularly.
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My back pain every day and I have face this problem suffering 8 to 10 month please tell me answer.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
My back pain every day and I have face this problem suffering 8 to 10 month please tell me answer.
Homoeopathic medicine SPONDYAID ( BAKSON) Drink 10 drops in 20 ml fresh water 3 times daily CALCAREA PHOS 6X ( Dr Reckeweg) Chew 4 tab 3 times daily Report after 15 days
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I am 62 male weight 99 kg severe knee pain any solution other than pain killer ? healthy 6 feet with no vices.

MSPT (Master of Physical Therapy)
Physiotherapist, Indore
Get your x ray done and do quads hams and calf muscle strengthening and stretching exercises. Go for physiotherapy and do regular cycling. Thanks and regards Dr. Ritesh kharnal
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As per doctor suggestion blood test (CBC) have been done due to fever and joint pain from last Friday.In my report everything thing is OK except lymphocyte which is 16 and total platelet count is 162. Please suggest what does it mean?

MD(EH)/AM/Accupressure
Acupressurist, Chandigarh
As per doctor suggestion blood test (CBC) have been done due to fever and joint pain from last Friday.In my report ev...
Dear Lybrate user, Reason may be high fever. If for any reason your blood platelet count falls below normal, the condition is called thrombocytopenia. Normally, you have anywhere from 150,000 to 450,000 platelets per microliter of circulating blood. Because each platelet lives only about 10 days, your body continually renews your platelet supply by producing new platelets in your bone marrow. Thrombocytopenia can be inherited or it may be caused by a number of medications or conditions. Whatever the cause, circulating platelets are reduced by one or more of the following processes: trapping of platelets in the spleen, decreased platelet production or increased destruction of platelets. Trapped platelets Normally, your spleen works to fight infection and filter unwanted material from your blood. An enlarged spleen — which can be caused by a number of disorders — may harbor too many platelets, causing a decrease in the number of platelets in circulation. Decreased production of platelets Factors that can decrease platelet production include: Leukemia Some types of anemia Viral infections, such as hepatitis C or HIV Chemotherapy drugs Heavy alcohol consumption The reasons of low lymphocites are about same.
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I am 52 yrs old. Having pain in legs especially in foot. Cant stand for a long time. I am flat footed

BPTh/BPT
Physiotherapist, Bangalore
It could be plantar fascitis take ultrasound sessions till the pain comes down. Dr. Avanthiprabhakar
2 people found this helpful
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Mujhe 3 years se pet ki problems hai bhot ilaj karaya par kuch time ke liye rahat milri hai Maine avhi ek ultrasound karaya hai jisme ek ganth aayi hai main y janna chahta hun y gath tb ki to nahi.

MBBS
General Physician, Mumbai
Mujhe 3 years se pet ki problems hai bhot ilaj karaya par kuch time ke liye rahat milri hai
Maine avhi ek ultrasound ...
If there is fever with abdominal pain with loss of weight and with high esr and with a fnac positive than only we can confirm it to be due to tuberculosis.
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Back Pain Management

BPTh/BPT
Physiotherapist, Pune
Back Pain Management

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-

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.

  • 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
  • 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-ounter 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.
  • Acupuncture: acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
  • Bed rest: severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (dvt, blood clots in the legs).
  • 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.
  • 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.

Once the conservative treatment fails:

Early aggressive treatment plan of back leg pain has to be implemented to prevent peripherally induced cns changes that may intensify or prolong pain making it a complex pain syndrome. Only approx 5% of total lbp patients would need surgery approx 20% of discal rupture or herniation with neurologically impending damage like cauda equina syndrome would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then. Depending upon the diagnosis one can perform combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon patient`s pathology response to treatment. Using precision diagnostic therapeutic blocks in chronic lbp, isolated facet joint pain in 40%, discogenic pain in 25% (95% in l4-5 l5-s1), segmental dural or nerve root pain in 14% sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of lbp after conservative treatment has failed.

Need for non-surgical options: outcome studies of lumber disc surgeries documents, a success rate between 49% to 95% and re-operation after lumber disc surgeries ranging from 4% to 15%, have been noted. “in case of surgery, the chance of recurrence of pain is nearly 15%. In fbss or failed back surgery the subsequent open surgeries are unlikely to succeed. Reasons for the failures of conventional surgeries are:

  • Dural fibrosis
  • Arachnoidal adhesions
  • Muscles and fascial fibrosis
  • Mechanical instability resulting from the partial removal of bony ligamentous structures required for surgical exposure decompression
  • Presence of neuropathy.
  • Multifactorial aetiologies of back leg pain, some left unaddressed surgically.

Epidural adenolysis or percutaneous decompressive neuroplasty is done for epidural fibrosis or adhesions in failed back surgery syndromes (fbss). A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ l. A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope sciatica gets complicated by pivd with disco-radicular conflict causing radicular pain sometimes disabling. In this era of minimally invasive surgery lot many interventional techniques have evolved to address the disc pathology. We are still working for the ideal, safe effective technique to tackle disco- radicular interphase. Here now we have devised a mechanical neuroplasty or foraminoplasty technique using an inflatable balloon tip catheter with guide wire via targeted transforaminal or interlaminar route aided by drugs instillation. Selected patients are procedured fluoroscopic guided with local anesthesia under prescribed sedation aseptically via preselected route depending upon location type of pivd causing root insult. First a suitable size needle is placed at desired site confirming with radiolucent dye through which hyaluronidase with saline or la was injected. A flexible guide wire is passed at selected location direction on which the inflatable balloon is threaded to the area of interest.

Adhesiolysis is achieved mechanically with inflating balloon for 10 seconds at a time location. We inflated the balloon with contrast agent to have visualization of adhesiolysis opening up of adhesions or root route. Here the balloon pressure time has to be kept in minimum to avoid neurological damage, for which we inflate balloon for 10 seconds at a time. Close observation is made to balloon shape, pressure patient`s response. Once dilatation is done the drug mixture of steroid with la or hynidase/ hypertonic saline is instilled over nerve in epidural space. We have logically used same approach for our balloon neuroplasty foraminoplasty as it is safe targets exactly the area of disco-radicular interphase or conflict. We can manage to address both the exiting and traversing nerve roots with single entry just by manipulating our guide wire to the place of offence. The procedure can be done via transforaminal route at level or level above or below, especially via s1 foramen. Now we are employing this technique for fresh cases coupling with intradiscal decompression aided by instant disc retrieval by epidural balloon inflation with good results. The idd is done by coblation/ laser/ dekompressor or rf biacuplasty. There is scope of coupling this technique with endoscopic spine surgery. By adding “balloon neuroplasty” to the armamentarium of the interventional pain management many patients can be benefited relieved of previously interventionally unmanageable disco-radicular pain including fbss sufferers.

Intradiscal procedures:

Provocative discography: coupled with ct a diagnostic procedure prognostic indicator for surgical outcome is necessary in the evaluation of patients with suspected discogenic pain, its ability to reproduce pain (even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options in assessing previously operated spines.

Percutaneous disc decompression (pdd): after diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed.

Ozone-chemoneucleoplasty: ozone discectomy a least invasive safe effective alternative to spine surgery is the treatment of choice for prolapsed disc (pivd) done under local anaesthesia in a day care setting. This procedure is ideally suited for cervical and lumbar disc herniation with radiculopathy. Total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at european countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post operative discomfort or morbidity and low cost. If despite the ozone therapy the symptoms persist, percutaneous intradiscal decompression can be done via transforaminal route with drill discectomy/ laser or coblation nucleoplasty/ biacuplasty/ disc-fx / endoscopic discectomy are good alternatives before opting for open surgerical discectomy; which has to be contemplated in those true emergencies, as mentioned above as the first choice. In biacuplasty radiofrequency energy is used in bipolar manner heating shrinking the disc  making it harder as well for weight bearing. It also seals the annular defect ablates annular nerves relievingback pain. In laser or coblation nucleoplasty energy is used to evaporate the disc thereby debulking it to create space for disc to remodel itself assisted by exercises. 

Dekompressor: a mechanical percutaneous nucleotome cuts drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression. A mechanical device cuts drills out the disc material debulking the disc reducing nerve compression curing sciatica brachialgia. It comes in needle size of 17g for lumbar discs 19 g for cervical discs. In lumbar region postero-lateral approach is used  in cervical discs anterolateral approach is used. 

Disc-fx : endoscopic discectomy: in this novel technique a wide bore needle is inserted placed sub-annular in post disc just under the disc protrusion. Disc is then mechanically extracted with biopsy forceps to empty the annular defect. This painful sensitive annular defect supplied be sinuvertebral nerve is thermo-ablated with radiofrequency which also seals the defect to prevent decrease recurrences. Next higher procedure, endoscopic discectomy is done with endoscope put through sheath inserted via posterolateral transforaminal or posterior interlaminar approach. Mostly done under local anaesthesia its fast becoming standard of care for disc protrusion extrusions causing spinal canal stenosis with root or cord compression with leg pain.

Laser discectomy done for closed bulging discs is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, nucleus pulposus is debulked by evaporating it by the laser energy. Laser discectomy is minimally invasive, cost-effective, and free of postoperative pain syndromes, and it is starting to be more widely used at various centers. 

Seld: epiduroscopic laser neural decompression is considered an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, failed back surgery syndrome with morbid adhesion neuritis that cannot be alleviated with existing noninvasive conservative treatment. This procedure is done under vision via an epiduroscope inserted via caudal canal or transforaminally employing front or side firing laser fibers /or fine instruments. If you wish to discuss about any specific problem, you can consult a pain management specialist.

2 people found this helpful

Hi am a volleyball player. Everyday I practised and finally I get too much legs bone pain too much I couldn't walk.

BPT
Physiotherapist, Delhi
Hi am a volleyball player. Everyday I practised and finally I get too much legs bone pain too much I couldn't walk.
It should be excessive exertion to the joint and muscle. You should reduce the practice time for sometime and do the knee, hip and ankle strengthening exercises. And take calcium tablet for 1 to 2 month.
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Sir actually my head is paining every day in morning at least 5 to 6 min is very slowly and then stop paining so what I do.

PGDHHM, MBBS
General Physician, Delhi
Sir actually my head is paining every day in morning at least 5 to 6 min is very slowly and then stop paining so what...
Such headaches r usually due to tension headache, inadequate sound sleep, migraineor excess coffee intake in evening/night. Are there any other complaints eg nausea, blackouts, weakness, fever. Drink a glass of water on getting up. Avoid tension/ stress. Do deep breathing exercises. Reduce coffee intake. Hope this helps you.
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I haven't been able to sleep since 2 days and I am having a severe headache, tried multiple home remedies, but didn't work, what to do? Please help me!

BHMS
Homeopath, Raebareli
I haven't been able to sleep since 2 days and I am having a severe headache, tried multiple home remedies, but didn't...
Ginger can help reduce inflammation of the blood vessels in the head, thus providing relief from a headache. Mix equal parts of ginger juice and lemon juice. Consume it once or twice a day. Another option is to apply a paste of one teaspoon of dry ginger powder, also called sonth, and two tablespoons of water on the forehead for a few minutes.
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