Dr. Vishnu S Mulchandani

There are numerous people worldwide who suffer from chronic pain. The experience can be quite annoying and painful, not only for the affected person but also for their loved ones and family members. Coping with the situation can be quite a challenge. Chronic pain can leave a person physically as well as emotionally exhausted. Thus, proper management is needed to deal with the situation better.

Causes of chronic pain
Chronic pain can be due to numerous reasons such as

1. Use of wrong footwear (especially high heels in case of women).
2. Injury due to rigorous and strenuous exercise.
3. Unhealthy lifestyle habits, poor posture.
4. Chronic pain can also result from a traumatic injury.
5. Medical conditions such as Fibromyalgia (a condition characterized by muscular pain, especially in the shoulder and neck region), AIDS, Cancer, Arthritis (Osteoarthritis and Rheumatoid Arthritis), Multiple sclerosis, to name a few, can give rise to chronic pain. Obese people are at a greater risk of suffering from chronic pain.
6. In some people, incorrect sleeping posture and the wrong choice of sleeping mattress can cause chronic pain.
7. With age, a person is likely to suffer from chronic pain (age related problems and disorders).

The effectiveness of the treatment depends on the severity as well as the factors responsible for the chronic pain.

1. Medications such as NSAID (Nonsteroidal Anti-Inflammatory Drugs), Tylenol, provide relief in case the pain is not very severe.
2. In severe cases, doctors may recommend the use of corticosteroid injection as well as powerful painkillers such as Fentanyl, Lortab or Roxicet.
3. Certain antidepressants and antianxiety drugs such as Duloxetine and Valium respectively may also be used to improve the condition.
4. Physiotherapy and Bioelectric therapy (the bioelectric therapy works by blocking the pain messages or signals to the brain, thereby relieving the pain) also bear fruitful results.

In addition to the above treatment and medications, certain changes and modifications in lifestyle habits can also help to cope with the chronic pain better.

1. People with chronic pain should avoid stress, anxiety, and depression as much as they can. These are nemesis that can aggravate the pain further. Meditation, yoga, breathing exercise, are great stress busters and mood enhancers.
2. Obesity is one of the underlying factors responsible for chronic pain. Maintain a healthy body weight. Eat healthy and nutritious diet, exercise regularly (even if it is only for 30 minutes). For obese people with chronic pain, rigorous exercise can prove to be harmful. Indulge in light to moderate exercise. Seek an expert help if necessary.
3. Do not compromise on your sleep. Sound sleep can work wonders for the chronic pain. Follow a healthy sleeping routine.
4. Refrain from smoking and drinking. These can make the situation worse.
5. Gentle massages can help relieve the pain to some extent. Again, it is advised to seek an expert guidance.
6. Alternate medications like Chiropractic and Acupuncture have helped many patients with chronic pain.
7. Avoid doing very strenuous physical activities.
8. Join a support group. You will not only feel better but will also be able to deal with the situation better.

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

I’m Dr  Ashok Sarin, a senior consultant nephrologist at Apollo Hospital New Delhi. I trained in Kidney Diseases at the Belfast City and Royal Victoria Hospital in Belfast, UK, which is in Northern Ireland. And besides having an MBA I’m also FRCP, Edenborough, fellow of the Royal College of Physicians, Edenborough.

We see a lot of kidney diseases today, and people are very aware. But they get very worried as to what is happening, and there is going to be kidney failure, or kidney damage, and we are going to go on dialysis and transplant. And I want to say here, that there is a lot of prevention we can do so that we do not develop serious kidney diseases. Now the most important is that we must have a good, proper lifestyle. Like,

• We should not be obese.
• We should not have a diet which is rich in saturated fats or very rich in carbohydrate.
• We should maintain our weight, we should maintain our BMI at about 30, and we should also indulge in regular exercise.

This will keep us in a healthy situation and we will not develop serious diseases like diabetes and hypertension. But once we develop diabetes and hypertension, then we must take our treatment for diabetes very regularly, and keep our HPE1C at 6 percent, a fasting sugar of 100 milligrams percent. We should also control our hypertension, and make sure that our blood pressure is 120 by 80 millimetres of mercury. Then we should avoid smoking. As I said we should indulge in exercise.

And there are other conditions which can also cause kidney damage, which is kidney stones, urine tract infection.

So if we treat our kidney stones adequately, and avoid urinary tract infection from developing, or we treat it properly, then we are unlikely to have kidney damage, and that is how we prevent kidney disease. As I said, smoking is a complete no-no, and we should not indulge socially sometimes, but over indulgence of alcohol is forbidden. And when I said that regular medical checkups, say once a year, we will come to know if there is any indication of kidney disease, and if that happens, then we can take prompt action. For example, somebody is excreting a lot of protein, then remedial actions or further tests can be done. And kidney disease, if detected early, we have a wide range of medication at the moment, it can be treated very promptly. And we do not have to go into the stage where we say kidney failure or kidney damage, or dialysis or transplant. Now this is avoidable to a great extent. I will not say completely, but to a great extent it is possible, and that is why I am emphasizing over and over again, that this can be prevented. If we are very aware of kidney disease, and we make sure that we don’t develop kidney diseases at all.

Thank you, and in case you want to consult me, you could get in touch with Lybrate

. Thank you very much indeed.

Hi friends!

I am Dr. Shakuntla Kumar. I am practicing obstetrician and gynecologist at new life hospital Delhi, and fortress hospital Shalimar bagh.

Today we will be discussing a very commonly encountered problem named Polycystic ovarian syndrome. Are you suffering from problems like hair fall, excess facial and body hair, very very oily skin along with acne, frequently encountered menstrual abnormalities or problems in periods or difficulty in becoming pregnant. Chances are you may be suffering from Polycystic ovarian syndrome. Polycystic ovarian syndrome is because of a hormonal imbalance. Mainly the female hormones like estrogen and progestogen imbalanced between the excess of male hormone happening in these women. These women also has insulin resistance in their body leading on to several other disorders like high blood pressure, diabetes and high cholesterol levels in their body. Friends, the cause of Polycystic ovarian syndrome is at interplay of hormonal disbalance compounded with environmental factors like lifestyle of the person. Because of this there is development of multiple eggs in the ovary rather than formation of one single egg. These small small eggs coming up in the ovary do not allow a dominant egg to form because of which there is an ovulation or non-development of eggs. This is the main reason why these women face difficulty in conceiving and are facing several hormonal imbalances. Now let us talk about the diagnosis of polycystic ovarian syndrome. So friends, just an ultrasound finding of multiple cists in the ovary of these women is not the sole criteria. We have certain criteria because of which we diagnose polycystic ovarian syndrome. A women may be having normal ovaries but suffering from PCOS, on the other hand she may be having Polycystic ovaries but she is a normal lady. So the diagnosis depends on certain clinical and investigational and certain ultrasound findings of the women. It is not one single criteria of polycystic ovarian coming from the ultrasound. Coming to the treatment part of these women. The treatment depends on the problems that these women’s are facing but in the root cause of these problems like the obesity part of these women. So the most important part of the treatment is weight loss and lifestyle management. So please listen to your doctor when she is saying and requesting you to lose weight, that is possible through a healthy lifestyle, a healthy diet and workout plans. Secondly, if this woman is suffering from menstrual irregularities we will correct that by improving her lifestyle and by giving her certain drugs. If she is suffering from acne or excess body hair we will be giving certain drugs to tackle that. If she is suffering from anovulation or, by that I mean difficulty in conceiving or becoming pregnant, we will be giving certain drugs to induce ovulation. This may require intake of tablets or sometimes intake of certain injections. So friends Polycystic ovarian syndrome is no longer an enigma. It can be very much cured. The only thing that is required is you, helping your doctor curing it by managing a very healthy lifestyle and through the drugs that we prescribe you taking them diligently.

Thank you very much.