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Overview

Nerve Pain: Treatment, Procedure, Cost and Side Effects

What is the treatment?

The countless nerves in our body send signals to the brain including the signal for pain. Pain has a very important function of protecting our body against external damage. But this signaling does not work properly in people with nerve pain. They might get the sensation of pain but without understanding its cause. Nerve pain, which is also known as peripheral neuropathy or peripheral neuritis, usually occurs due to some physical damage or disease.

Cancer and other tumors can cause neuropathic pain as the tumors tend to press on the surrounding nerves. Chemotherapy drugs can also cause nerve pain as they can damage the nerves. One of the first symptoms of a person suffering from HIV is nerve pain in the hands and feet. A diabetic person is prone to nerve pain as high levels of glucose in blood can damage the nerves. A person can suffer from severe nerve pain if he/she suffers from postherpetic neuralgia. Nerves can also get severed, compressed or crushed due to some physical injury and this may cause nerve pain.

The treatment for nerve pain depends on the age of the patient, underlying cause, costs and potential side effects. A person will have to undertake treatment for the underlying disease in such cases. However the different treatments options for nerve pain include use of topical treatments, anticonvulsants, anti-depressants, pain killers, electrical stimulation and, in some cases, surgery.

How is the treatment done?

The treatment for nerve pain involves the use of anticonvulsants and tricyclic anti-depressants such as Amitriptyline, Nortriptyline and Desipramine. There are also other prescribed anti-depressants such as Venlafaxine and bupropion which are very effective for some people. Doctors may also prescribe Selective Serotonin Reuptake Inhibitors (SSRI) like Paroxetine and Citalopram. Sometimes, a person may also be given non-steroidal anti-inflammatory drugs (NSAIDs) such as Aleve or Motrin to deal with nerve pain.

Sometimes topical treatments like creams, gels, lotions and patches help to deal with nerve pain. A doctor can recommend anticonvulsants together with anti-depressants to a patient suffering from nerve pain. Tricyclic antidepressants can help to deal with nerve pain caused due to diabetes, HIV or cancer chemotherapy. People suffering from severe nerve pain or from nerve pain due to cancer generally opt for opioid painkillers. Furthermore, some treatments like transcutaneous electric nerve stimulation (TENS) and repetitive transcranial magnetic stimulation (rTMS) use electrical impulses to block the pain signals sent by the damaged nerves.

When all other treatments fail, a doctor may recommend anesthetic injections to ease the pain. The doctor may also recommend surgery. Sometimes alternative therapy like meditation, acupuncture and massaging the affected nerve can produce favourable results. Making some changes in lifestyle also help to deal with nerve pain.

Who is eligible for the treatment? (When is the treatment done?)

A person suffering from nerve pain can experience symptoms of pain, a pin-and –needle sensation, numbness and weakness. A person may feel a burning or tingling and sharp sensation while the main areas where a person may experience pain are back, hands, thigh, foot and face. A person may also experience poor balance in his/her entire body and have tingling fingers of feet and slow reflexes. A person experiencing these symptoms is eligible for treatment. Nerve pain can affect a person badly and without any apparent reason. In such cases, a person can seek treatment.

Who is not eligible for the treatment?

A person suffering from pain due to cuts, bruises and or some injury is not eligible for treatment of nerve pain. A person suffering from some chronic disease or some mental ailment should consult a doctor before taking any medications for treating nerve pain.

Are there any side effects?

The side-effects associated with the use of tricyclic antidepressants are blurred vision, sweating, dry mouth, restlessness, drowsiness, dizziness and racing heartbeat. The anticonvulsants used to treat nerve pain can cause drowsiness, dizziness, swelling in the legs and feet and confusion. The possible side-effects of selective serotonin reuptake inhibitors can be dry mouth, drowsiness, nausea, nervousness, agitation, diarrhea and even sexual problems like reduced sexual appetite. Anesthetic injections can cause swelling, bruising, itching or redness in the area where the injections have been administered. They may also cause mild dizziness and nausea.

What are the post-treatment guidelines?

A doctor will generally advice a patient to take rest and to adopt a healthy diet so that he/she can keep nerve pain at bay. Light exercises may also be recommended to ease the pain. A person will also have to regularly monitor his/her blood sugar levels as high blood sugar levels can cause nerve damage. A person should incorporate foods rich in Vitamin B12 and anti-oxidants as they help to build up nerves.

How long does it take to recover?

A person suffering from nerve pain due to nerve damage will take a lot of time to recover. Some damaged nerves can be surgically repaired and a person will take about 3-6 months to recover from that. However, in case of nerve pain due to not so serious a cause, a person can recover within a week or two with the help of medications. However, in some cases, the nerve damage can be irreversible and a person can suffer for his/her lifetime.

What is the price of the treatment in India?

The cost of treatment for nerve pain varies greatly depending on the diagnosis, methods of treatment and the type of interventions used. If you have a minor neuropathic pain that can be treated with drugs, it may cost between Rs 5000 and Rs 20000. However, for surgical and related procedures, a person may have to pay 6-15 lakhs depending on the hospital and the city.

Are the results of the treatment permanent?

Nerve pain generally occurs to some disease or physical damage. Nerve pain causes a person to get the sensation of pain without understanding the cause. It is a complex scenario and the results depend on the condition and also the treatment that is given to the patient. When nerve pain occurs due to conditions like HIV or diabetes, a person may have to deal with the disease first. The person will recover completely only after he/she has successfully dealt with the disease. A person suffering from nerve pain due to nerve damage has a hard time recovering completely.

What are the alternatives to the treatment?

Nerve pain due to diabetes can be managed by following a healthy diet, managing the blood glucose levels, exercising lightly and also by quitting smoking and drinking. A person suffering from nerve pain in his/her foot can treat it by checking the feet regularly, going to a podiatrist and wearing comfortable shoes. The easiest and least expensive home treatment for nerve pain is a warm bath.

Safety: High Effectiveness: Medium Timeliness: Medium Relative Risk: Low Side Effects: Low Time For Recovery: Medium Price Range:

Rs 5000 - Rs 15 lakhs

Popular Health Tips

Radiofrequency Ablation For Trigeminal Neuralgia!

MD,DNB, MBBS Bachelor of Medicine and Bachelor of Surgery, Fellowship In Pain Management
Pain Management Specialist, Mumbai

Trigeminal Neuralgia is a type of chronic pain disorder, which affects the trigeminal nerve. There are mainly two types:

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.

Symptoms

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.

Causes

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
  • Smiling
  • 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.

4362 people found this helpful

Post-Herpetic Neuralgia Chronic Pain Management!

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!

4236 people found this helpful

Spinal Cord Stimulation For Chronic Back And Neck Pain!

MD,DNB, MBBS Bachelor of Medicine and Bachelor of Surgery, Fellowship In Pain Management
Pain Management Specialist, Mumbai
Spinal Cord Stimulation For Chronic Back And Neck Pain!

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!

 

4217 people found this helpful

Ozone Discectomy For Disc Prolapse!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Ozone Discectomy For Disc Prolapse!

Ozone local anaesthesia with strict real time radiological control, which ensures the proper placement of Ozone in the center of the disc making it shrink.

Low Sciatica and PIVD

Among working-age people, as many as 20 percent experience back symptoms at least every year. facet arthropathy, sciatica, muscle strain, sacroilitis, bulging or herniated discs and degenerative disc disease. Prolapsed intervertebral discs (PIVD) are the most common cause of low back pain associated with a defined structural Abnormality.

Patients who are not helped by weeks of conservative therapy are often referred for pain that has persisted beyond a four-week period should be referred to a multidisciplinary pain center.

Different Non Surgical Interventions Employed Successfully:

  • Epidural Steroid Inj.

  • Epidurogram & Epidurolysis.

  • Nerve root sleeve/ transforaminal Inj.

  • Intra-discal steroid inj.

  • Nucleoplasty- Thermal & Mechanical

  • Ozone Discolysis

Conventional treatment methods for back pain comprise lamminectomy/ discectomy microsurgery, endoscopic disectomy and percutaneous arthoscopic disectomy, among others. These are invasive methods and their goal is to remove or contain the protruding disc. However, these methods have occasionally demonstrated a discrete incidence of failure and/or recurrence. Outcome studies of lumber disc surgeries ranging from 4% to 15%, have been noted. "In case of surgery, the chance of recurrence of pain is nearly 15 percent as against less than three percent in Ozone treatment.</p> <p><strong>Reasons for the failures</strong> of conventional surgeries are:</p> <ol> <li> <p>Dural fibrosis</p> </li> <li> <p>Arachnoidal adhesions</p> </li> <li> <p>Muscels and fascial fibrosis</p> </li> <li> <p>Mechanical instability resulting from the partial removal of boney & ligamentous structures required for surgical exposure & decompression</p> </li> <li> <p>Presence of Neuropathy.</p> </li> <li> <p>Multifactorial etiologies of back & <a href=">leg pain, some left unaddressed surgically.

Understanding the need for Nano-Technology 

  1. The various treatment options have confused clinicians and investigators due to high failure rate and complications associated with different kinds of surgeries and interventions. There has been a surge of interest in the search for a safer alternative method of decompressing the nerve roots maintaining the structural stability.
  2. Another safe least invasive alternative therapy that has been receiving exposure in Europe is the use of medical Ozone (02/03 mixture) in the treatment of PIVD. Epidural steroid injection, transforaminal epidural decompressions has a high success rate (up to 85%), but chances of recurrences are there specially if these interventions are done at later stage. anaphylaxis following intradiscal chymopapain injection. Injection of Ozone for discogenic radiculopathy (low back pain with radiation to legs) has developed as a revolutionary alternative to chemonucleolysis and disc surgery .

The use of ozone revolution for treating disc diseases 

Muto suggested an intradiscal injection of Ozone for a disc Ozone injection into the intervertebral disc. After that successful outcome has been reported from various European centers. It is very important to note from those reports that complications are remarkably few. Not a serious single life-threatening complication was found even after 120,000 cases of Ozone nucleolysis, which stresses the safety of these procedures.

The most critical portion of performing any of the minimally invasive procedures is the accuracy and safe positioning of the needle (or terminal device) in the centre of the disc space. The risk in ozonucleolysis is particularly minimised, with the use of a very thin 22/25-gauge needle. It may take anywhere from 5 to 30 minutes to position a needle in the centre of the disc space under radiological guidance. Once the needle is safely placed in position, ozonucleolysis is completed in only another 2 to 3 minutes.

How does water contained within the domain of proteoglycans. The water binding capacity of the proteoglycan molecule is partially a property of its size and physical shape, but the main force that holds water to the molecule stems from the ionic, carboxyl (COOH) and sulphate (SO4) radicals of the glycosaminoglycan chains. The ozone can have a direct effect on these carboxyl and sulphate groups, breaking down some of these glycosaminoglycan chains which make up the proteoglycans. The destruction of these cross-linked structures reduces their ability to hold water therefore diminishing the size of the herniation by collagen fibers and signs of regression (vacuole formation and fragmentation)- a sort of disk “<strong>mummification</strong>.”</p>

<p> </p> <p><strong>By Inhibiting inflammatory Nociceptors</strong></p> <ul> <li> <p>Synthesis of Prostaglandins & Secretion of Proteinases</p> </li> <li> <p>Liberation of Bradykinin and Pain Inducing Products</p> </li> <li> <p>Several studies suggest disc inflammation as a mechanism of sciatica due to disc herniation. Ozone has been shown to have an effect on the inflammatory cascade by inhibiting synthesis of proinflammatory prostaglandins or release of bradykinin or release of algogenic compounds; increased release of antagonists or soluble receptors able to neutralize proinflammatory cytokines like interleukin (IL)-1, IL-2, IL-8, IL-12, IL-15, <a href=">interferon, and tumor necrosis factor. Therefore, by reducing the inflammatory components there is a corresponding reduction in pain.

By stimulating fibroblasts & immunosuppressor cytokines 

  • Local production of Antioxidant Enzymes
  • Another action which may prove to be one of the most important is the stimulation of
  • Release of immunosuppressor cytokines like transforming growth factor, and IL-10 fibroblastic activity by ozone. Fibroblasts initiate the repair process by stimulating the deposition of collagen. Although yet to be validated, this mode of action could explain the resolution of PIVD on CT scans and the small percentage of patients who have relapses after the completion of treatment plan.
  • Ozone may have a reflex therapy effect called ‘chemical acupuncture’, breaking the chain of infection which is healed with antibiotics.

     

    In fact, over 120,000 patients have been treated successfully worldwide using the injection of medical ozone with a success rate of 80-90% and with a near nil rate of procedure-related complications. “The procedure is a safe and effective alternative to open surgical procedure. Patients get the advantage of going home after a short recovery on the same day. They generally go to work within a week and are spared prolonged absence from work and disability,” The treatment relieves pain substantially and, after two sittings, people "can go back to work under medical guidance".

    Comparison: 1. More hospital stay One day/day care 2. Complications of prolonged surgery& spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular in 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.

4671 people found this helpful

Nerve Damage - Never Ignore The Signs!

MBBS, MS - General Surgery, MCh - Neurosurgery
Neurosurgeon, Guwahati
Nerve Damage - Never Ignore The Signs!

A healthy nervous system is essential for an individual's body to function normally. Comprising of nerves and cells, the system is responsible for carrying messages from and to the brain and spinal cord from other parts of the body. Thus, damage to a nerve may impair the functioning of your body with less-identifiable symptoms to life-threatening conditions. Understanding the types of nerves and the symptoms due to nerve damage helps you to seek medical help when necessary.

Understanding your nervous system

Three types of nerves connect our body parts

  1. Sensory Nerves: These are finest nerves spreading all over the body which transfers every sensation back to the brain and the spinal cord which makes us feel. Our brain processes this information, and then we feel the sensation.
  2. Autonomic Nerves: These nerves control the blood pressure, temperature or digestion and other involuntary as well as the activities which are partially controlled by us.
  3. Motor Nerves: These nerves control the movements done by us that are the voluntary movements, and the brain processes those actions by taking information from these nerves.

What happens when nerve damage occur?
When the autonomic nerves are injured or damaged the symptoms includes the inability to feel or sense the pain in the chest in case of heart attack or angina or any other issues. A condition named as hyperhidrosis in which you sweat or perspire a lot can occur, and in some people, the opposite (anhidrosis) that is very less sweating might be observed. You might feel lightheaded with dry sensation in mouth and eyes. There might be a problem with the digestion and constipation on a regular basis. You might even experience a malfunction of the bladder along with problem during the sexual act.

Any damage to the sensory nerves can cause pain in different parts of the body along with the problem of sensitivity. You might feel highly sensitive to individual elements or motion whereas other people might observe a drop in their senses. There might be numbness, burning sensation or prickling at certain parts of your body. Peripheral neuropathy is a classic example that occurs due to damage to sensory nerves.
In case of damage to motor nerves or the neurons, one may experience weakness along with muscle atrophy. You might face twitching which is also referred as fasciculation. The dangerous part of harm to the motor neurons is the thing that it can cause paralysis in the person.

Other Prevalent Symptoms
A common symptom of any nerve damage is experiencing a problem in moving certain parts of the body, walking, or running. You might feel stiffness in the legs while changing position if you sit or stand in one position for a long time. Few patients may feel dizzy or clumsy which could be due to the drop in the sensation in your body.

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

2034 people found this helpful

Popular Questions & Answers

Mere left kamar me Nash me dard h Jo ki ye left goli me bhi. Hota h mujhe lagbhag 4 month ho gye MRI ki report me Nasho par load btaya h.

MBBS, DNB - Orthopedics/Orthopedic Surgery
Orthopedist, Indore
Dear lybrate-user Lower back pain is because of so many reasons Starting from simple postural problem to compression at nerve roots One of d most common one is L4-5 disc disease causing nerve compression For seeking a relevant advice you need to answer few questions, Has to undergo proper set of specific tests to rule out certain specific disorders. Every case needs a detailed understanding through certain investigations and evaluations. However rest/ hot fomentation and few days of muscle relaxants usually works well It would be great if you can share your MRI report (if not public then can share in private) The good news is - its always treatable if timely addressed Good luck.
2 people found this helpful

I am suffering from severe lower back pain. Whenever I start stretching the left lower back starts paining. I have done x-rays several times. The report says there's no injury in bones. I think it's the problem of nerves. Suggest me any therapy or medicine for this.

M.S - Orthopaedics
Orthopedist, Mohali
At your age most common cause of backache is faulty habits and posture. Correct your posture while sitting along with start with stretching exercise gradually. Apply hot water packs twicee daily. Hope this help you in your query.
1 person found this helpful

Burning sensations in my feet and feel tired, when diagnosed for PP SUGAR level, it was 158, my weight is 93 kg. Please help me, I have gas problem and BPH.

BHMS
Homeopath, Hyderabad
Talk to your doctor and also do a detailed report - fasting sugar, PP and HbA1c, along with other tests like CBC, ESR, urine routine, TSH, lipid profile etc. Let the doctor examine you physically and correlate with the report findings. Focus on reducing the weight in a systematic way (introduce mild exercise initially and later increase the intensity and duration of the exercise ). Eat only healthy food (more of natural and organic food) and avoid outside food (processed/packaged food and beverages etc ). Learn yoga from an expert to obtain good response from the body. Read about healthy lifestyle changes from the internet and adapt those good habits with determination. You can also update all the findings (including the doctor's opinion) after some time. You can add Homeopathy which is safe and effective. You can contact me for further details regarding Homeopathic treatment.
1 person found this helpful

I am facing right leg nerve problem from my hip to the knee. I am getting pain behind the leg knee. This was there past 2 years, and was it less past days. Now I have started morning walk near 4 km per day now a days getting have pain. I cannot bend towards. Cannot stand properly. Pls suggest how to rectified. I visited columbia Asia hospital it's waist of time and money.

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
Leg PainIf you have leg pain then you have to rule out the casues for having leg pain. First of all check your weight and your haemoglobin levels, as Anaemia always leads to the symptoms of being tired and also having leg pain though there are no issues with the knee joint or back pain. If not if the pain radiates down the back of thigh and legs then it might be due to sciatica. Kindly consult the nearby physiotherapist. Hope you recover soon from the leg pain. Pain in the back while walking and standing Pain in the right legIf you have leg pain please check your body weight and your hemoglobin levels, as Anemia always leads to the symptoms of being tired and also having leg pain though there may not be any pathological reasons for back pain. My suggestion would be to wear MCR Chapels which will help you to prevent the weight falling on the If you have back pain while walking and standing first of all check your weight and your hemoglobin levels, as Anemia always leads to the symptoms of being tired and also having back pain though there may not be any pathological reasons for back pain. My suggestion would be to wear MCR Chapels which will help you to prevent the weight falling on the back. And also should check whether you have flat foot on the right leg that also might be the reason to have pain in one particular leg Pain in the left side of the leg/thighThe compression of the sciatic nerve should be around the right side that's the reason you have pain in the left side. That's the reason you cannot sit or stand and it is exactly around the L5 vertebrae where the sciatic nerve passes by.

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Nerve and Brachial Plexus Injury

Hello, everyone. I am Dr Anubhav Gupta. I am a consultant cosmetic surgeon at Sir Gangaram Hospital, New Delhi.

Today I am going to discuss the nerve and brachial plexus injury.

What is nerve Injury?

In our body, from the brain to all other parts there is a network of nerves which sends the signal and tell us what to do. So if there is any injury in the network of filaments called nerves, then it is called as nerve injury.

What is Brachial Plexus?

A brachial plexus is a group of nerves which helps our hands to function. It starts from the spinal cord through the shoulder to the arm and to the hand. If there is any particular part which damages the neck that is called as Brachial plexus injury.

How long should I wait before being evaluated by my physician after the injury?

Whenever this nerve injury happens, these are the closed injuries. You will not see anything on the surface but you may have paralysed or weakness of a particular part. So as soon as the weakness, there is some numbness or there is paralysis of any part of the body. You should immediately contact your plastic surgeon.

Can a Brachial plexus injury be treated?

If you would have asked this question 20 years ago, then I would have said NO. But now, it is possible to treat them and with very good results.

What will happen if I do not take any treatment?

See what happens is, all the muscles in the body are innervated. If there is any injury in the nerves then it will cause weakness and ultimately paralysis of these muscles. Now, these muscles become paralyse then all these joints become stiff. S it is like a machinery if the current is not going then ultimately you will end up with that particular part of body useless.

How long does it take to after the nerve surgery for the function to return?

This is a very good question. Most patients do not realize. Basically, it is a scientific fact that whenever we have an injury to a nerve. Let us say suppose there is an injury to this level, then the part which is distilled to this becomes degenerated. When we repair, when we do the surgery, it gradually moves. It moves with the speed of 1mm per day after a latent period of 1 month. So approximately 2.5 cm (1 inch) per month. So it takes few months to function. Immediately after the surgery, you cannot expect the movement of the hand. It takes some time and it is scientifically calculated that how it comes.



If you have any queries related to nerve issues, you can contact me through Lybrate.
Play video
Chronic Pain
Symptoms and Treatment for Chronic Pain

Hi. I am Dr. Shantanu Mullick from Navi Mumbai, Pain Clear Clinic. Today, the whole world is suffering from chronic pain.

Million patients they are suffering from different types of chronic pain like back pain, neck pain and cervical spondylosis. Mainly, due to their lifestyle disorders but they are also suffering from different complicated pains like cancer pain, but most of the patients they are suffering from chronic pain with frozen shoulder, knee pain, back pain. They are going for surgery but many times these surgeries may not help in that way. That is why this newer therapy, intreventional pain therapy which is nowadays throughout the world and very much effective to support this kind of chronic pain to rule out the disease as well as to treat the level of the root cause.

Normally, the patients who are suffering from the back pain, many times I have seen that after regular therapy , physiotherapy, exercise, they are not getting relief and they are going for the surgery. In those cases, interventional pain therapy will help the to rule out the cause. We do treat these patients according to MRI reports but all these treatments are done without surgery. So many times, surgery may not help these kind of back pains and in cervical pains. So in those pains, interventional pain therapy, without damaging the anatomy helps a lot. So if you see the pain where we can see the patient is suffering from disc pain. We can see here the nerve root coming there and the disc is bulge and we commonly call it as slip disc problem or disc hernation. In those cases, the surgeons are getting the bones, there is a lamenectomy but without doing surgery as per MRI report we are under forescopic guidance in the operation theatre we are going inside the disc and treating them without any surgery and day care.

So patients automatically get very good relief and after that we are able to support the patients with physiotherapy exercises and this way we can help different types of patients suffering with back pain, neck pain. On the other hand, in case of cancer pain also when the patients are not getting relief with the morphine or from very strong pain killers, we can support them with interventional pain therapy to block their pains permanently working in the spinal cord.

Another, dreadful pain condition is trigeminal neuralgia where patient is suffering from pain in the face usually the pain comes where patients complain of sharp shooting, electric shock kind of pain. It will appear on one side of the face. Actually the trigeminal nerve is coming from the brain and it is supplying the nerves of the face in three ways. Usually it happens in one side and those patients initially are treated with medical therapy and any times they are not getting support in those cases we are treating with radiofrequency ablation therapy. So different types of new treatments have for this chronic pain where patients without knowing their disease, they keep on taking pain killers and damaging their other organs of the body so that is why pain management nowadays is a very very effective subject and separate speciality to support the chronic pains those who are suffering from long types of disease.

At last, I want to say if you want to more about this, contact us through lybrate.com.


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Disk Pain
Hi I am Dr. Kirti Yadav, senior physiotherapist from Mat-Harbor family clinic, Gurgaon.
Today I want to talk about a very common problem which every one, if we count about the population 100% then 70% of people they talk about Disk pain. So I want to enlighten this topic today. If there is a normal pain and ache in your neck or back you go to a doctor and the doctor assess you and tells you to get an MRI done. Whenever you get an MRI done there is some level of disk involvement and the doctor ask you to take rest, not to do exercise and all those things and then just being fear of disk pain you don t exercise for the rest of your life.

So just to come onto that area, just to enlighten this topic, as a physiotherapist I want to tell you about the fact. Disk pain, YES it happens but it happens in 20% of the cases. The rest 50% of the cases have been misdiagnose, they take disk pain and they don t do exercise all of their life. Now we don t exercise, we don t strengthen up our muscle that is the problem that we get these pains and aches and the muscle is being stretched which is counted to be as the disk pain. Now when we talk about this, when you get an MRI done even today if I get my MRI done I will have some level of disk involvement whether the disk is causing you pain or not that is more important. The nature of pain tells you about the disk involvement.

So if you have tingling sharp shooting burning kind of pain which travels through a nerve, which travels through area, it dignifies, it signifies the disk pain. But if you have a localized dull, aching kind of pain please don t take it as a disk pain and don t take it as a nerve pain. So just coming to the treatment part. About 50% of the people who don t have disk pain, who says we have cervical spondylitis but they don t have cervical spondylitis they have trapezius muscle involvement. In that case what we do please strengthen up your trapezius muscle, please strengthen up your shoulder muscle so that you don t have these pains and aches again and again. Why this happens? This happens because of repetitive strain injuries that happens because of more of computer use more of mobile use, texting and other sedentary live cells which we are going in. So the ultimate solution for pains and aches muscular is strengthening the particular part.

If you want to know more about this, if you want to talk more about it you can contact me through Lybrate.
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Musculoskeletal Pain
Main DR Anuradha Sharma, "At my Physiotherapy laser clinic" se aaj bones, muscle, nerves injury pe baat kar rahe hai. Generally, humne dekha hai ki kuch reasons ki wajahs e in saari cheezo me injuries paayi jati hai. Jese Neurological disoders hote hai, spinal injury, gym, daily activities, sports etc. humare in parts ko injured karte hai. To aaj hum in injuries ko heal karne ke treatments ke baare me baat karenge.

Jo major cases hai jese ki chronic and acute injuries, Acute injury jaldio heal hojati hai jabki chronic injuries ko heal hone me time lagta hai.

Physiotherapy me bohot sare treatments hai. JO chrnic injury heal nahi hopaati hai jese ki muscular pain, wo log ek baarlaser treatmentko zarur try kare kyuki usse bohot help milti hai. Aur daily activities me bhi improvement hota hai.

Ap mujhe Lybrate ke through contact kar sakte hai physiotherapy ke liye. Aur aap treatment ke baad nromal life jee sakte hai,day to day activity enjoy kar sakte hai.
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Back Pain
Few daily habits to get rid of Back Pain
Hi I am Dr. Sidharth Verma and today I will tell you about Back Pain and how to prevent back pain. So back pain is, one of the most common pain which hampers the activities of mankind and it is so common that all of us will suffer from it at some point in our lifetime.
So how can you prevent that?
You can very easily prevent back pain and most of the cases which we see in our daily practice are due to lifestyle disorders and some other factors. So as far as lifestyle is concerned. Humans, when they evolved and became erect, so their back pain is the cost they have to give; and as the back is made of very small, small bones which are known as vertebrae. This is a model of the human back, you can see there are small, small bones which make up the back and there are a lot of small intervertebral discs in between. These are the structures that provide cushion and hold the vertebrae and there are a lot of small, small joints and many nerves and structures which are coming out, therefore, the back is a very complex structure and if you do not maintain it properly then you might have back pain. Now, this is all complicated stuff. Furthur, I will tell you how to easily prevent it.
First and foremost is which you can do from day 1 is maintain adequate hydration. Human body is 70% water, and if you see the back, The back has intervertebral discs and they are 90% water. So if you are not hydrated well then you will probably have more problems.
Number 2 is to control your body weight. So it has been seen that in patients or in persons who are obese, this problem occurs more. That is, they have more back pain. The causes are many but you should try to control your weight this will result in lesser back pain.
Number 3 is proper posture while you are you are doing your jobs or in your workplace or while you are driving or you are travelling. By proper posture, I mean that you should always sit with your back straight, and not hunching forward. This is one of the techniques.
Number 4 you should avoid sitting for long period of time without taking a break. This will help you to redistribute the weight of the back to different muscles and this will avoid fatigue, thereby resulting in lesser incidence of back pain.
Number 5 is selecting ergonomic furniture. Ergonomic furniture means which is designed for your body. If you go to the market usually the furniture and the kind of furniture you will get is designed more or less for a similar kind of individual maybe 5 ft 5 inches height or maybe who is sitting for a few hours. However, in actual practice, if you see that nobody is the same so everyone is different and hence you will need to have ergonomic furniture which will be specifically designed for you or there is kind of furniture available which has lots of keys or levers with which you can adjust the height, for example, the chair or the table where you are going to sit or at your workplace, you can get it all adjusted. And it may seem very difficult but if you actually start doing it is very easy. Most of the chairs which we use in our offices, they are rolling chairs which have adjustable levers and height as well as the seat quality and backrest all of it can be adjusted. Similarly the height of the tables can also be adjusted in many cases, if not all. So you can have these ergonomic furniture and this also will help.
Another factor which is responsible for majority of back pain, is unaccustomed activity. By unaccustomed activity I mean, that if you are not used to a particular activity and you do it once then probably you will have some problems. Say for example there is a folder which is kept at a height and you want to fetch it and you stretch your hand and you stretch it so much that your back muscles and your full arms, hand has to stretch so much which is unphysiological. So in these cases, it may result in micro injuries or macro injuries and this may result in back pain. Another common example can be, while lifting heavy loads. So in our routine structure, most of the people are sitting or doing jobs which do not involve lifting of heavy loads. So if you lift some heavy load on one particular day say for example, I got something to install in my house and when that thing comes and I lift it and I try to fit somewhere then that is unaccustomed for me because I am not doing it every day. So this may result in unaccustomed stress and sprains and strains to my back and this may result in back pain. So these are how you can prevent it.
Another very common cause is sleeping on very soft mattress or sleeping for inadequate amount of time. Some people have a habit of surfing mobile phone for a long period of time and they sleep on their table chair maybe on their bed with unphysiological postures. So these will result in increased incidents of back pain. Another common cause which you can prevent is while travelling. So if you are travelling and you are driving a car for example you should adjust your seat so that your back is always upright. And while taking the support, many people ask me if it is helpful to use fancy supports that are available for the car seats. The answer is no. They will not help you. In most cases, they are just fancy items and they will not help you. However, straightening your seat will help you a lot. If you straighten your seat to a point where you are sitting independently and you are seeking only the lower back support from your seat and you are sitting on your own then probably the chances of you getting back pain are less.
Another common thing which you can apply when you are travelling is do not drive for extended period of hours like, I have seen people who drive for maybe 6 hours at a stretch so if this is done occasionally or frequently then it may result in back pain. So if you can avoid and take a break maybe around 45 minutes to an hour every 45 minutes or an hour you can stop and walk around maybe for one or two minutes or you can get out of your car or you can just get down and have a break then you can continue driving so you can drive in bits and bytes then you can travel long distances also. But please be sure to take a small break at least so that your back is not strained unnecessarily.
Another common reason why people come with this back pain are these motorcycle riders or scooter riders who are travelling these long distances throughout the day. What they often do is that they carry these bags. So they carry these bags and backpacks and they funnily carry it on one shoulder. So it will be like a strap and they will carry it on one shoulder and they will do this throughout the day and then after one month or two months they will start having a pain on one side. So this one-sided stress is one of the reasons why people have back pain. If you are not driving a vehicle, then also if you are carrying a load or a backpack or if you are a student or if you are an office goer who has to carry these laptops. Because I have often seen these laptops come in suitcases or briefcases and obviously you have to carry them with one hand. SO it is better to switch from these one handed or one sided carrying devices to devices or bags which are distributing the load equally to both shoulders and back. So that the load is distributed and there is no asymmetrical stress that is the back, on one side, is not stressed unnecessarily.
Another common reason for people who travel a lot is that their legs are not properly placed. So, in addition to the back of the seat, the height of the seat also plays a role. In majority of vehicles however, the height is not an adjustable portion. So the one thing you can do is, you can go forward or you can go backwards that is towards the steering and away from the steering. This mechanism is available for most of the cars or most of the vehicles and with the help of this, you can have enough distance between the steering and your body so that your thighs are touching your seat till the point they can leave the seat that is until the maximum point they should be able to touch the seat. So this will again be helpful to reduce the stress on the back.
Another common cause of back pain is the lack of exercise. For exercise, I don t mean well I don t advise that you should go to the gym and lift weights or something like that. But by exercise, I mean exercises like walking. Even simple walking is one of the best exercises for back, swimming or even cycling, or even exercises for your abs. You may underestimate the importance of the exercises for your abs but you should know that abs they support the back to a great extent and weak abs or abdominal muscles are the common causes of back pain in healthy adults.
Other than these, there are causes like nutritional causes. By nutritional causes I mean the deficiency of specific nutrients in your diet. This may be deficiency of Vitamin D .This is one of the most common deficiencies which I see in my practice that most of the people who come to me with these deficiencies they are normal healthy individuals otherwise but due to some reasons, they have this Vitamin D deficiency. Many of them are non-vegetarians so it is a myth that you cannot have Vitamin deficiency if you are a non-vegetarian. So you may have deficiency of Vitamin D, which is necessary for the calcium metabolism and in the deficiency of this Vitamin you are more likely to have weak bones and this pain.
In elderly individuals, however, you may have other causes of weak bones and they may also lead to this back pain. So last but not the least, we have population which is ageing now. So we have more number of people who are above 40 years of age. In these people there are conditions known as degenerative conditions which is, due to age, the body starts degenerating. So if you don t use your body properly, it will start to degenerate. In many people, who are using the body properly also, due to genetic reasons, and environmental factors, it starts to degenerate. So in these patients there are lot of conditions that develop, and these may affect the intervertebral discs, the joints of the back, the muscles, as well as the ligaments. So these conditions can lead to the back pain in this age group, the elderly age groups that is. So these are the common causes and if you are careful enough, you can easily prevent them and help yourself to prevent your back pain. Prevention is always better than cure, so I will strongly recommend that you take my advice and follow these steps, and you are less likely to have back pain.
To know more, you can always visit my Lybrate website on www.lybrate.com/drsidharthverma or you can also visit my website www.pain.org.in. Thank You.

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