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Post-Herpetic Neuralgia Chronic Pain Management!

Dr.Snehal Panchal 86% (80ratings)
MD,DNB, MBBS Bachelor of Medicine and Bachelor of Surgery, Fellowship In Pain Management
Pain Management Specialist, Mumbai
Post-Herpetic Neuralgia Chronic Pain Management!

The condition of persistent pain in the body, where an outbreak of the Varicella Zoster virus has caused Shingles, is termed as post-herpetic neuralgia. It is a debilitating complication of the herpes zoster virus. The blisters that occur in shingles develop a crust formation and neuralgia begins after these crusts are formed. It may also occur in people who do not produce the crustaceous lesions. A burning pain that is long-lasting, even after the rash and the blisters disappear, is observed. There is a criteria of the pain to be persistent for around three months for the confirmation of post herpetic neuralgia.

The cause of this condition is damage of the sensory nerves that can occur due to the movement of the reactivated Herpes Zoster virus from the nerves to the skin. In an individual affected with chickenpox, the infection can involve dorsal root ganglia, where the virus lies dormant. Under conditions like stress due to infection or in an immuno-compromised individual, after a period of time, reactivation of the virus takes place. This reactivation causes production of Shingles on the body. The dormant virus reaches the skin and reactivates to produce lesions.

With an increase in age, the chances of developing post-herpetic neuralgia also increase. It primarily affects older individuals in the age group of 60 to 70 years. Treatment is aimed at pain management and providing symptomatic relief, with improvement of the neuralgia over a period of time. Symptoms of this condition are limited to the area of shingles’ outbreak. Trunk is commonly affected on a unilateral site. It can also occur on face. Common symptoms include pain lasting 3 months or longer after healing of the shingles rash, allodynia, numbness over the affected area and itching. Even a slight touch of cloth over the affected area can cause alleviated pain to the individual. Disturbed sleep and development of clinical depression is usually associated with post herpetic neuralgia. The medications given for post herpetic neuralgia are aimed at pain relief and resolving of symptoms. Management of chronic pain can be brought about by the use of a combination of pain relieving drug classes.

Some commonly used drugs for treatment of post-herpetic neuralgia are as follows:

  1. Topical Agents: Numerous topical agents have been effectively used in the treatment of post-herpetic neuralgia. In patients with allodynia or an alleviated pain sensation, topical lidocaine patches are very effective. The nociceptive activity of small nerve fibers is decreased by use of Lidocaine. Also, the brush of clothing is avoided by the patch serving as a protective barrier itself. Another topical agent that has proved effective in pain relief is Capsaicin. Its clinical use is limited due to the burning sensation caused by its application. With regular use, however, the burning sensation gradually reduces. Capsaicin should be used for a minimum period of a month to aid pain relief. Low systemic absorption of the topical agents ensure few side effects caused by them.
  2. Antidepressants: The standard drug therapy for treatment of post-herpetic neuralgia include the use of antidepressant drugs. Drugs like Nortriptyline, Amitriptyline are the most commonly used drugs amongst the tricyclic antidepressants for pain relief in post-herpetic neuralgia. These drugs are however associated with various adverse effects like sedation and cardiac dysrhythmias. Other drug classes like Serotonin reuptake inhibitors are used in individuals with low tolerance to the tricyclic antidepressants. Depression symptoms are relieved by the use of this drug class. Specific relief of the chronic pain of post-herpetic neuralgia is not achieved much efficiently though.
  3. Anticonvulsants: Neuropathic pain can be relieved by many anticonvulsant drugs. Drugs like Pregabalin have lesser side effects and also require a lesser monitoring than previously used anticonvulsant drugs like Carbamazepine.
  4. Opioids: Long term use of opioids shows significant risks like sedation and mental clouding. These drugs are considered safe for use without causing cardiac or hepatic adverse effects. When opioids are prescribed, stool softeners and laxatives should also be given to avoid constipation. Other pain management protocol includes cryotherapy, ablation of the affected roots of nerve, anterolateral cordotomy and even the use of electrical nerve stimulation. The physician should evaluate the best suitable pain management option and provide treatment accordingly.

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

4239 people found this helpful

Tinnitus: Ringing In The Ears And What To Do About It

MBBS, Diploma In Otorhinolaryngology (DLO), DNB (ENT)
ENT Specialist, Delhi
Tinnitus: Ringing In The Ears And What To Do About It

Tinnitus is a disorder which is characterized by a constant perception of a ringing noise in the ears. This is not the condition in itself, rather it signals some other underlying condition such as an ear injury or age related hearing loss. It is not a serious condition, although the symptoms can worsen with age. If you are affected by this disorder, you might experience or ‘hear’ a constant ringing sensation in the ears, even if there are no external sources of noise. These sounds could range from being a buzzing, ringing, to a hissing sound. This condition has mighty chances of interfering with your daily routine.

It is classified into two types:

  1. Objective tinnitus: This disorder is caused by muscle contractions or a blood vessel problem.
  2. Subjective tinnitus: The more commonly occurring type, it is caused by damage to the auditory nerves or regions of the brain that interpret sound.

The causes of this disorder are:

  1. Exposure to loud noise: If you are exposed to loud noises such as the ones emanating from firearms or heavy machinery over a prolonged period, it can lead to tinnitus.
  2. Aging: Aging can cause progressive loss of hearing, thus triggering tinnitus.
  3. Blockage of the ear: There is earwax present in the ears, the function of which is to trap dirt and bacteria. Excessive earwax accumulation leads to loss of hearing, resulting in tinnitus.
  4. Modifications of the ear bone: Any stiffening of the middle bone in the ear could impair your hearing and result in this condition.

Certain factors such as smoking, age, sex (men are prone to this disorder) and heart related disorders increase the risks of being affected by this condition.

Treatment
The treatment of this condition begins with the identification of the underlying condition, if any. The various treatment options are –

  1. Removal of earwax: Excess earwax has gotten rid of which can relieve symptoms of tinnitus.
  2. Suppression of noise: Certain machines, known as white noise machines, produce random sounds such as the sound of rain or the sounds of waves, thus eliminating the ‘hearing’ of sounds which are common to this condition.
  3. Medications: Certain medications such as alprazolam and nortriptyline can help reduce the severity of the symptoms.
4221 people found this helpful

4 Causes Of Constant Ringing in Ears And Its Treatment!

Dr.Sachin Goel 88% (10ratings)
MS - ENT, MBBS
ENT Specialist, Ghaziabad
4 Causes Of Constant Ringing in Ears And Its Treatment!

Tinnitus is a disorder which is characterized by a constant perception of a ringing noise in the ears. This is not the condition in itself, rather it signals some other underlying condition such as an ear injury or age related hearing loss. It is not a serious condition, although the symptoms can worsen with age. If you are affected by this disorder, you might experience or ‘hear’ a constant ringing sensation in the ears, even if there are no external sources of noise. These sounds could range from being a buzzing, ringing, to a hissing sound. This condition has mighty chances of interfering with your daily routine.

It is classified into two types:

  1. Objective tinnitus: This disorder is caused by muscle contractions or a blood vessel problem.
  2. Subjective tinnitus: The more commonly occurring type, it is caused by damage to the auditory nerves or regions of the brain that interpret sound.

The causes of this disorder are:

  1. Exposure to loud noise: If you are exposed to loud noises such as the ones emanating from firearms or heavy machinery over a prolonged period, it can lead to tinnitus.
  2. Aging: Aging can cause progressive loss of hearing, thus triggering tinnitus.
  3. Blockage of the ear: There is earwax present in the ears, the function of which is to trap dirt and bacteria. Excessive earwax accumulation leads to loss of hearing, resulting in tinnitus.
  4. Modifications of the ear bone: Any stiffening of the middle bone in the ear could impair your hearing and result in this condition.

Certain factors such as smoking, age, sex (men are prone to this disorder) and heart related disorders increase the risks of being affected by this condition.

Treatment
The treatment of this condition begins with the identification of the underlying condition, if any. The various treatment options are –

  1. Removal of earwax: Excess earwax has gotten rid of which can relieve symptoms of tinnitus.
  2. Suppression of noise: Certain machines, known as white noise machines, produce random sounds such as the sound of rain or the sounds of waves, thus eliminating the ‘hearing’ of sounds which are common to this condition.
  3. Medications: Certain medications such as alprazolam and nortriptyline can help reduce the severity of the symptoms.
2848 people found this helpful

Constant Ringing in Ears - Know The Reasons Behind It!

Dr.Parth Amin 91% (61ratings)
DNB (ENT), Diploma in Otorhinolaryngology (DLO), MBBS, SR (ENT)
ENT Specialist, Ahmedabad
Constant Ringing in Ears - Know The Reasons Behind It!

Tinnitus is a disorder which is characterized by a constant perception of a ringing noise in the ears. This is not the condition in itself, rather it signals some other underlying condition such as an ear injury or age related hearing loss. It is not a serious condition, although the symptoms can worsen with age. If you are affected by this disorder, you might experience or ‘hear’ a constant ringing sensation in the ears, even if there are no external sources of noise. These sounds could range from being a buzzing, ringing, to a hissing sound. This condition has mighty chances of interfering with your daily routine.

It is classified into two types:

  1. Objective tinnitus: This disorder is caused by muscle contractions or a blood vessel problem.
  2. Subjective tinnitus: The more commonly occurring type, it is caused by damage to the auditory nerves or regions of the brain that interpret sound.

The causes of this disorder are:

  1. Exposure to loud noise: If you are exposed to loud noises such as the ones emanating from firearms or heavy machinery over a prolonged period, it can lead to tinnitus.
  2. Aging: Aging can cause progressive loss of hearing, thus triggering tinnitus.
  3. Blockage of the ear: There is earwax present in the ears, the function of which is to trap dirt and bacteria. Excessive earwax accumulation leads to loss of hearing, resulting in tinnitus.
  4. Modifications of the ear bone: Any stiffening of the middle bone in the ear could impair your hearing and result in this condition.

Certain factors such as smoking, age, sex (men are prone to this disorder) and heart related disorders increase the risks of being affected by this condition.

Treatment
The treatment of this condition begins with the identification of the underlying condition, if any. The various treatment options are –

  1. Removal of earwax: Excess earwax has gotten rid of which can relieve symptoms of tinnitus.
  2. Suppression of noise: Certain machines, known as white noise machines, produce random sounds such as the sound of rain or the sounds of waves, thus eliminating the ‘hearing’ of sounds which are common to this condition.
  3. Medications: Certain medications such as alprazolam and nortriptyline can help reduce the severity of the symptoms.
5106 people found this helpful

Constant Ringing In Ears - How Removal Of Earwax Can Be Of Help?

Dr.Anurag Tandon 87% (72ratings)
MS - ENT, Diploma in Otorhinolaryngology (DLO), MBBS
ENT Specialist, Delhi
Constant Ringing In Ears - How Removal Of Earwax Can Be Of Help?

Tinnitus is a disorder which is characterized by a constant perception of a ringing noise in the ears. This is not the condition in itself, rather it signals some other underlying condition such as an ear injury or age related hearing loss. It is not a serious condition, although the symptoms can worsen with age. If you are affected by this disorder, you might experience or ‘hear’ a constant ringing sensation in the ears, even if there are no external sources of noise. These sounds could range from being a buzzing, ringing, to a hissing sound. This condition has mighty chances of interfering with your daily routine.

It is classified into two types:

  1. Objective tinnitus: This disorder is caused by muscle contractions or a blood vessel problem.
  2. Subjective tinnitus: The more commonly occurring type, it is caused by damage to the auditory nerves or regions of the brain that interpret sound.

Unilateral tinnitus can be the early symptom of CP angle tumour and acoustic neuroma or arterial loop around cochlear nerve. Tinnitus management is based on etiology.

The causes of this disorder are:

  1. Exposure to loud noise: If you are exposed to loud noises such as the ones emanating from firearms or heavy machinery over a prolonged period, it can lead to tinnitus.
  2. Ageing: Aging can cause progressive loss of hearing, thus triggering tinnitus.
  3. Blockage of the ear: There is earwax present in the ears, the function of which is to trap dirt and bacteria. Excessive earwax accumulation leads to loss of hearing, resulting in tinnitus.
  4. Modifications of the ear bone: Any stiffening of the middle bone in the ear could impair your hearing and result in this condition.

Certain factors such as smoking, age, sex (men are prone to this disorder) and heart-related disorders increase the risks of being affected by this condition.

Treatment
The treatment of this condition begins with the identification of the underlying condition if any. The various treatment options are -

  1. Removal of earwax: Excess earwax has gotten rid of which can relieve symptoms of tinnitus.
  2. Suppression of noise: Certain machines, known as white noise machines, produce random sounds such as the sound of rain or the sounds of waves, thus eliminating the ‘hearing’ of sounds which are common to this condition.
  3. Medications: Certain medications such as alprazolam and nortriptyline can help reduce the severity of the symptoms.
2593 people found this helpful

Constant Ringing in Ears - Causes + Treatment

MBBS, MS - ENT
ENT Specialist, Delhi
Constant Ringing in Ears - Causes + Treatment

Tinnitus is a disorder which is characterized by a constant perception of a ringing noise in the ears. This is not the condition in itself, rather it signals some other underlying condition such as an ear injury or age related hearing loss. It is not a serious condition, although the symptoms can worsen with age. If you are affected by this disorder, you might experience or ‘hear’ a constant ringing sensation in the ears, even if there are no external sources of noise. These sounds could range from being a buzzing, ringing, to a hissing sound. This condition has mighty chances of interfering with your daily routine.

It is classified into two types:

  1. Objective tinnitus: This disorder is caused by muscle contractions or a blood vessel problem.
  2. Subjective tinnitus: The more commonly occurring type, it is caused by damage to the auditory nerves or regions of the brain that interpret sound.

The causes of this disorder are:

  1. Exposure to loud noise: If you are exposed to loud noises such as the ones emanating from firearms or heavy machinery over a prolonged period, it can lead to tinnitus.
  2. Aging: Aging can cause progressive loss of hearing, thus triggering tinnitus.
  3. Blockage of the ear: There is earwax present in the ears, the function of which is to trap dirt and bacteria. Excessive earwax accumulation leads to loss of hearing, resulting in tinnitus.
  4. Modifications of the ear bone: Any stiffening of the middle bone in the ear could impair your hearing and result in this condition.

Certain factors such as smoking, age, sex (men are prone to this disorder) and heart related disorders increase the risks of being affected by this condition.

Treatment
The treatment of this condition begins with the identification of the underlying condition, if any. The various treatment options are –

  1. Removal of earwax: Excess earwax has gotten rid of which can relieve symptoms of tinnitus.
  2. Suppression of noise: Certain machines, known as white noise machines, produce random sounds such as the sound of rain or the sounds of waves, thus eliminating the ‘hearing’ of sounds which are common to this condition.
  3. Medications: Certain medications such as alprazolam and nortriptyline can help reduce the severity of the symptoms. If you wish to discuss about any specific problem, you can consult an ent-specialist.
2814 people found this helpful

Excess of Vitamin B12 - Can It Cause Acne?

Dr.Arshi Rahul 86% (51ratings)
Diploma In Skin Aesthetics, BHMS, Certificate Course in Skin & Vinereal Disease
Dermatologist, Pune
Excess of Vitamin B12 - Can It Cause Acne?

Is Vitamin B12 Causing Your Acne?
It’s a common belief that vitamins are essential for glowing skin and shiny hairs. But are you aware that excess of vitamin B12 can trigger acne breakouts and leave you with a dull skin? Well, you have read it correctly. Recent studies have revealed that too much vitamin B12 can worsen acne. To get a better understanding of the matter, it is best to know more about vitamin B12.

What Is Vitamin B12?
It is one of the most complex vitamins. It has a very complicated chemical structure. It has an organic molecule, surrounding an atom of cobalt. Our body can use three types of vitamin B12. These types are known as cobalamin. We are also prescribed vitamin B12 supplements sometimes by the doctor. These supplements contain Cyanocobalamin, which is easily converted into methylcobalamin and 5-deoxyadenosyl cobalamin in the body. Our body needs vitamin B12 to produce certain enzymes, which are needed for making a detoxifying a substance called homocysteine and haemoglobin production.

Why is vitamin B12 essential for us?
Vitamin B12 is needed for the good health of the cardiovascular and nervous system. It promotes the production of haemoglobin and red blood cells.

According to a recent study, an excess of vitamin B12 in the body triggers the occurrence of pimples or acne breakouts. In the presence of vitamin B12, the acne producing bacteria thrives. Vitamin B12 helps these bacteria to pump out inflammatory substances that cause acne. Vitamin B12 changes the gene expression of the bacteria and causes pimples. They found that vitamin B12 changed the gene expression of the skin bacteria, which could have led to acne-promoting inflammation.

Can you use ointments and lotions with B12 for acne?
There is still no proof that creams or ointments containing vitamin B12 are useful for treating acne. It cannot be confirmed too that these creams help psoriasis. On the other hand, there is no evidence that these creams worsen acne. Therefore, it will be wrong to reject such ointments just because they have vitamin B12. It is advisable to consult your dermatologist for the best remedy.

B12 Deficiency and Acne
Acne can also be caused due to vitamin B12 deficiency. People who use retinoid drugs often need additional B12 injections to prevent homocysteine. Retinoid drugs in the form of pills can hinder in the proper functioning of enzymes, especially cystathionine-beta-synthase. Injection of vitamin B12 ensures better functioning of the enzymes and prevents your skin from any breakout. If you wish to discuss about any specific problem, you can ask a free question.

3472 people found this helpful

Know The Cure For Recurrent Headaches!

MBBS, Post Graduate in Anaesthesiology, DA DNB Anaesthesiology (Gold Medalist)
Pain Management Specialist, Hyderabad
Know The Cure For Recurrent Headaches!

Headaches arise due to various reasons. Stress, tension, migraine, overwork and several medical conditions may cause headaches of different types. Such headaches are also called chronic headaches, and many cases of headaches are recurrent in nature. This indicates that the headaches might reappear or reoccur.

Headaches are quite frustrating and affect your entire health and performance. Recurrent headaches are even more troublesome as they strike back when you almost thought they were gone. There are several ways to deal with or control recurrent headaches. They include the following:

A. Medical treatment: Medicines can be used to treat the underlying cause of a headache and if these fail, medicines to cure the headache are used.

The different preventive medicines for recurrent headaches are:

  1. Antidepressants: Tricyclic antidepressants by the likes of nortriptyline can be prescribed for treating recurrent headaches. These medications help in curing any kind of depression, anxiety and disturbances in sleep, which usually lead to recurrent headaches. Antidepressants like the selective serotonin reuptake inhibitor or SSRI and fluoxetine are also used.
  2. Beta blockers: Beta blockers, commonly used to treat hypertension, also prevent migraine-related headaches. They include atenolol, metoprolol and propranolol.
  3. Anti-seizure medicines: Several anti-seizure medicines help in the prevention of migraine and also cure daily recurrent headaches. They include topiramate, divalproex sodium and gabapentin.
  4. NSAIDs: Prescribed nonsteroidal anti-inflammatory drugs like naproxen sodium also help in reducing headaches, which appear daily. NSAIDs are used in cases of a severe headache.
  5. Botulinum toxin: Onabotulinum toxin A or Botox injections can be used to get relief from recurrent headaches and are ideal for people whose daily medications are not effective enough.

B. Alternative medicine procedures
Other than medications, alternative therapies to get relief from concurrent headaches can be utilized. They include:

  1. Acupuncture: This ancient procedure involves the use of thin needles, which are inserted into certain areas of the skin at defined points. Acupuncture reduces the frequency and intensity of headaches.
  2. Massage therapy: Massage therapy reduces stress, gives relief to pain and provides relaxation. Massaging of the tight muscles at the back of the head provides relief.
  3. Herbs and nutrients: Several organic herbs help in preventing migraine headaches and reduce the intensity of headaches. They include butterbur and feverfew. Vitamin and mineral supplements can be taken to reduce headaches and prevent them from reoccurring. Coenzyme Q10 supplements, magnesium sulfate supplements can reduce the frequency of several headaches as well.
  4. Investigational approach: A surgical implant, which is a battery operated electrode, can be placed around the occipital nerve. The electrode implant sends energy pulses to the nerve, and headache is eased.

Recurrent headaches can be controlled in various ways, which include medicines and several alternative procedures. You should consult a doctor before you start using some method.

2103 people found this helpful

How to Control Recurrent Headaches?

Dr.Sanjay Sharma 89% (305ratings)
Fellowship in Interventional Pain management , Diploma in Anesthesia, DA, MBBS
Pain Management Specialist, Jaipur
How to Control Recurrent Headaches?

Headaches arise due to various reasons. Stress, tension, migraine, overwork and several medical conditions may cause headaches of different types. Such headaches are also called chronic headaches, and many cases of headaches are recurrent in nature. This indicates that the headaches might reappear or reoccur.

Headaches are quite frustrating and affect your entire health and performance. Recurrent headaches are even more troublesome as they strike back when you almost thought they were gone. There are several ways to deal with or control recurrent headaches. They include the following:

A. Medical treatment: Medicines can be used to treat the underlying cause of a headache and if these fail, medicines to cure the headache are used.

The different preventive medicines for recurrent headaches are:

  1. Antidepressants: Tricyclic antidepressants by the likes of nortriptyline can be prescribed for treating recurrent headaches. These medications help in curing any kind of depression, anxiety and disturbances in sleep, which usually lead to recurrent headaches. Antidepressants like the selective serotonin reuptake inhibitor or SSRI and fluoxetines are also used.
  2. Beta blockers: Beta blockers, commonly used to treat hypertension, also prevent migraine-related headaches. They include atenolol, metoprolol and propranolol.
  3. Anti-seizure medicines: Several anti-seizure medicines help in the prevention of migraine and also cure daily, recurrent headaches. They include topiramate, divalproex sodium and gabapentin.
  4. NSAIDs: Prescribed nonsteroidal anti-inflammatory drugs like naproxen sodium also help in reducing headaches, which appear daily. NSAIDs are used in cases of severe headache.
  5. Botulinum toxin: Onabotulinum toxin A or Botox injections can be used to get relief from recurrent headaches and are ideal for people whose daily medications are not effective enough.

B. Alternative medicine procedures
Other than medications, alternative therapies to get relief from concurrent headaches can be utilized. They include:

  1. Acupuncture: This ancient procedure involves the use of thin needles, which are inserted into certain areas of the skin at defined points. Acupuncture reduces the frequency and intensity of headaches.
  2. Massage therapy: Massage therapy reduces stress, gives relief to pain and provides relaxation. Massaging of the tight muscles at the back of the head provides relief.
  3. Herbs and nutrients: Several organic herbs help in preventing migraine headaches and reduce the intensity of headaches. They include butterbur and feverfew. Vitamin and mineral supplements can be taken to reduce headaches and prevent them from reoccurring. Coenzyme Q10 supplements, magnesium sulfate supplements can reduce the frequency of several headaches as well.
  4. Investigational approach: A surgical implant, which is a battery operated electrode, can be placed around the occipital nerve. The electrode implant sends energy pulses to the nerve, and headache is eased.

Recurrent headaches can be controlled in various ways, which include medicines and several alternative procedures. You should consult a doctor before you start using some method.

4578 people found this helpful

How To Control Pain After Knee Replacement?

MBBS, MS - Orthopaedics, Fellowship Joint Replacement Surgery
Orthopedic Doctor, Faridabad
How To Control Pain After Knee Replacement?

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain.

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

  1. Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

  2. Patient Controlled Analgesia (PCA): This method is also known as ‘Pain Pump’. An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

  3. Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

  4. Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

  5. Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

  6. Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery. In case you have a concern or query you can always consult an expert & get answers to your questions!

3756 people found this helpful