Doctor in Sterling Hospital
Cancer Pain Management
Epidural And Spinal Anesthesia Techniques
Treatment of Transcutaneous Electrical Nerve Stimu
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Hi, I have some tumours like structure or tumours around my Throat and neck. They are not paining. They are just increasing lil bit in size. Are they harmful for me or not? What should I do?
Cooled Radiofrequency Ablation is a process which involves minimum incision, along with a non-narcotic out-patient treatment option that can help treat and provide relief from chronic pain, thereby improve one’s quality of life without the need to go for a surgery. This is an advanced procedure, through which the cooled radiofrequency energy is used in order to target the sensory nerves quickly as well as quite safely, which result in pain and help shut out the transmission of pain signals to the brain.
Osteoarthritis can hamper any joint whenever the cartilage wears out over a period of time. This generally strikes big joints like the knee, resulting in pain, swelling and the area becoming stiff, which results in the movements getting restricted. According to the data released by the American Academy of Orthopedic Surgeons close to 10 million Americans had to suffer from osteoarthritis of their knee in the year 2010.
Cooled Radiofrequency can also help treat various other conditions which include:
- Cervical Joint Pain
- Genicular Neurotomy
- Lumbar Pain
- Hip Osteoarthritis or Joint Pain
- Chronic Knee Osteoarthritis.
Cooled Radiofrequency Ablasion is marketed as COOLIEF. COOLIEF is a minimally-invasive procedure, quite often compared to steroid injections. Still, patients tend to report better relief from pain, functionality of the area when the procedure was implemented and satisfaction, which is not the case with injections.
As per a study by FDA, six months after the procedure has taken place, a mere 5% of the patients of the COOLIEF group reported the same kind of severe pain compared to 37% of patients, who get treated with steroid injections.
While there are patients who experience relief from pain in the knee due to Osteoarthritis for close to 2 years, for some, there is no recurrence of pain at all in future.
How Does It Work?
The procedure followed for treating mild to moderate Osteoarthritis is quite similar to the traditional radiofrequency treatments. Still, unlike traditional procedures related to Radiofrequency, COOLIEF makes use of cooled radiofrequency energy for targeting the nerves in a more safe and secured manner. The overall heat produced is much less in this case, which helps to increase the effectiveness through relief from pain.
Now before initiating the procedure of COOLIEF, the concerned doctor conducts a diagnostic procedure which aims to locate the exact source of one’s pain and hence tells the doctor where the COOLIEF must go. The doctor would then use a particular device along with a small needle to reach out to the nerves which are causing pain. This device helps to generate radiofrequency, which uses the energy to get the nerves heated. As the device sends heat waves into the nerves, water also gets circulated through the area. This induces two things:Without any additional effort, a large treatment is created. Targets the source of pain without even going for excessive heating.
The procedure takes less than an hour and does not even require general anesthesia. The pain can continue for close to 2 weeks but still, patients can return to their normal activities after taking a day’s rest.
Typical Trigeminal Neuralgia and Atypical Trigeminal Neuralgia.
The typical form or this disorder results in certain episodes of severe, sudden, shock-like pain in one side of the face, which lasts for seconds to few minutes.
Trigeminal Neuralgia may have symptoms which include one or more of patterns like the following:
- Some episodes of severe,
- Shooting pain which may seem like an electric shock.
A person might come across spontaneous attacks of pain or even attacks which might get triggered by certain things like touching the face, chewing, speaking or even while brushing the teeth.
When trigeminal neuralgia occurs, the trigeminal nerve’s function gets disrupted. The problem occurs through a contact between an artery or a vein and the trigeminal nerve at the base of one’s brain. This contact puts pressure on the nerve, thus causing it to malfunction.
Trigeminal Neuralgia can occur due to people getting aged or due to any kind of disorder that causes damage to the myelin sheath that protects certain nerves. A number of triggers can lead to the pain of trigeminal neuralgia, which include:
- While shaving
- When someone touches one’s face.
- When a person is eating something.
- While brushing teeth
- Washing one’s face.
What Is Radiofrequency Ablation for Trigeminal Neuralgia?
Radiofrequency Ablation or RFA is a technique by way of surgery, which helps to direct high-frequency heat on to the targeted areas of the body, such as tumors and tissues. When a person suffers chronic pain that means the high-frequency heat is getting targeted to the nerves.
A person suffering from trigeminal neuralgia, would have his or her doctor, who is a neurosurgeon, uses radiofrequency ablation to hit the trigeminal nerve, thereby destroying the nerve’s ability to get the pain signals transmitted to one’s brain.
Medication is the first line of treatment for trigeminal neuralgia by a neurosurgeon, to see how the patient reacts. If that person suffers from severe pain in the face and does not show any improvement through medication, then the doctor might recommend him/her to go for radiofrequency ablation surgery.
How Is The Procedure Conducted?
During the radiofrequency ablation for trigeminal neuralgia, people remain awake and asleep at different times. The process includes:
When the patient is asleep under the influence of general anaesthesia, a neurosurgeon would carefully place a needle through the corner of one’s mouth in order to reach the trigeminal nerve, which lies at the base of the skull. Then, once the X-rays confirm the needle is right in place, the neurosurgeon would wake the patient up, stimulate the nerve and ask the patient if he or she could feel the stimulation exactly at the place where the pain is experienced. This particular step confirms that the doctor has hit the right location. Once, the patient gets back to sleep, the doctor uses radiofrequency heat to minimally injure the nerve, sufficiently enough to induce a numb feeling on the face along with tingling, thus take the pain away.
Sir I am suffering from L3 4 slip disc pain last 3 months and I can't get any accidents please help me doctor. What I will do for it. (medicine).
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:
- 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.
- 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.
- 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.
- 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!
It is very challenging to find operative treatments for chronic pain that offer improved daily functioning. Spinal Cord Stimulation is an excellent pain management method that can be used for patients when their neck or back pain cannot be treated by surgery or other options.
Each year more than 14,000 patients undergo the spinal cord stimulator transplant. The procedure comprises of mild electrical stimulations to the spinal cord. This modifies the nerve activity reducing the pain sensation or sensitivity that reaches the brain.
Neurostimulation therapy recommended by doctors is very effective, especially for chronic pain sufferers. The benefit of this proven therapy is that the pain experienced by the brain is minimized to a great extent. The therapy was designed only after observing how pain is managed by the brain. The therapy approved by the FDA is used to treat the pain caused due to nerve damage in the legs, arms and in the trunk. Spinal cord stimulation for chronic back and neck pain is provided to patients in pain management centers. The staff taking care of patients in these centers are specialized and trained in pain relief -how it occurs and best ways to treat it. Injections are also used to ease the pain.
How to treat back Pain?
Probably the worst pain an individual can experience is back pain, in some cases so severe that it hampers daily life. The treatment options that are used for treating back pain include electrical stimulation to the back and medication to the spine. The most common reason for spinal cord stimulation is failed back surgery. The pain related to the following conditions can also be alleviated through this therapy, scarring of the protective layers of the spinal nerves, painful inflammation and arachnoiditis.
Devices Used for Spinal Cord Stimulation
The devices used for spinal cord stimulation are available in several types but they comprise mainly of three parts. The pulse generator with a battery, a lead wire with 8-32 electrodes and a hand-held remote control that is useful in adjusting the settings of the device, and to switch it on and off. Electrical pulses are delivered to the spinal cord through the electrodes. It is very important that the procedure is carried out by doctors who specialize in pain management or by neurosurgeons. In case you have a concern or query you can always consult an expert & get answers to your questions!
Pain management is an issue that stares back at mankind, irrespective of the underlying health condition. Whether it is a headache or a back pain, burn or fracture, heart attack or cancer, pain is always a symptom. In some cases like migraines, cancer, etc., the pain is chronic and the patient needs to be constantly on the vigil to know when an attack will ensue. This has also put high pressure on the medical fraternity to identify ways that can provide relief to these people. Various methods have been identified, and one of them is the electrotherapy.
What is done?
A few electrical impulses are directed at the area of the pain using a hand-held device. This is similar to providing electric shocks of mild intensity to the affected area (forehead, low back, neck, etc.). What this does is stimulate the nerve endings, improves circulation and muscle strength and promotes bone growth and tissue repair. The end result of all this is overall improved functioning and pain relief. Depending on the actual condition, the sessions will have to be repeated. In some patients, the electrotherapy is used in conjunction with other therapy so that they can go about their routine exercise and pain relief.
The sessions may also have to be repeated as most often these are used in individuals with chronic pain. They are also helpful in providing relief during the acute attacks.
How does it work?
The most common form of electrotherapy is known as TENS, which stands for transcutaneous electrical nerve stimulation. The area to be treated is cleansed with spirit and then small sticky pads are applied through which the electricity is passed. A hand-held device is used, through which electrical impulses are passed to the skin, which stimulates the nerve cells to provide relief from pain. It causes a vibrating and tingling sensation in the treated area. It is believed that it blocks the nerve impulses and therefore provides pain relief. Another theory states that they promote the release of endorphins which are natural painkillers; it is also very effective in case of migraine and sciatica and neck pain where the chronic pain is coupled with acute spurts.
With narcotic painkillers having various side effects, techniques like electrotherapy are gaining popularity. A small catch also is that it does not work for everybody and in most people with back pain, fibromyalgia, and migraines, requires repeat sessions for relief. The cost of each session also needs to be considered against the extent of relief achieved. However, for those whom it works, it is a very good technique for chronic pain control. In case you have a concern or query you can always consult an expert & get answers to your questions!
My toenail, along with the Matrix has halfway peeled off. I just waited for the stopping of bleeding. Then I washed it with warm water and soaked some cotton in betadine and placed over the area and put gauze and leucoplast over it. Its not paining bad. What shall I do next?
I am 27 year old female. Sir I have after 7-8 year head pain .I give me a good treatment. Sir I am very tired I have taken any more treatment sir I help me.
A headache is one of the most common ailments experienced by most people. While some have a definite cause and pattern, others come and go without a proper cause being identified. The severe ones which recur and can affect the quality of life are dreaded by the sufferers. In these people, they know the pattern to it and the thought of it can be scaring. With a lot of research being done, the good news is that there are simple but effective ways of managing these headaches.
Read on to know some of the most common simple ways to get rid of your headache.
- Quieten down: One of the triggers for a headache is bright light and sound and noise. When you try to reduce the amount of noise, light, and sound, surprisingly the headaches will disappear or reduce in intensity for sure.
- Eat on time: Hunger headaches are one of the most common types, and not many realize it. When the gap between two meals is too long, headaches occur. Eating on time is a good and simple way to manage headaches in those who are prone to it.
- Drink it up: Surprisingly, dehydration can lead to headaches, especially when combined with being out in the sun. For fear of having to pass urine, do not make the mistake of not drinking enough water. Keep sipping small amounts and prevent a headache.
- Meditate: Meditating and improving blood flow through the cells helps in preventing and/or reducing the intensity of headaches. This helps relax the muscles and improves pain tolerance too.
- Headgear: For those who are used to wearing tight headgear, loosening up can help in the relief of headaches. Be it a scarf or bandana or a hairband, this can compress blood flow and cause a headache. Loosening these can reduce a headache.
- Massage: A good massage around the forehead, neck, and shoulder is one of the best ways to relax and relieve headaches. This also soothes the nerves and improves blood flow.
- Hot/cold therapy: A good shower (preferred to bath) with alternate hot and cold water works wonders for most people with headaches. While the cold water soothes your nerves, the hot water improves blood flow and provides relief.
- Medications: Needless to say, if none of the above work for you, you would have to take medications. The trick to taking the pill that works for you (prescribed by the doctor, of course!) as soon as you realize the onset of a headache. This helps in controlling the pain quickly and getting rid of a headache.
While headaches are inevitable, there are definitely ways to manage them easily.
In case you have a concern or query you can always consult an expert & get answers to your questions!