Articles on pain management

Pain Management: Why Is It Important

Dr. G P Dureja, Spine and Pain Specialist
Most of the people suffer from different kinds of pain because of various reasons. Most of the people also tend to ignore it and move on. It is not advisable to ignore pain because you don’t know if that is casual or something serious to pay attention to. Avoiding pain will only make it worse, so it is essential to manage and treat pain. What is pain management? As the name suggests, managing your pain in a way that either it is treated or relieved, is pain management. It is also a branch in medicine called Pain Medicine, which involves in-depth procedures and techniques to ease out the pain. What are the types of pain?Majorly pain can be classified into two types, acute and chronic. Any pain that is short lived or short lasting comes under acute pain while, any pain that is long lasting or forever, comes under chronic pain. Chronic pain generally is the pain that lasts for 3 or more months. Based on, where, in the body, the pain is present, there are further three types. Somatic This type of pain is more like an exterior pain. Caused generally by the activation of receptors on the body surface or musculoskeletal tissues, it can be treated with proper rest and medication. Surgical pain comes under this type. Visceral Internal pain caused due to damage to the organs or tissues is known as visceral pain. This is not localized to just one body part. It might pain in different organs or body parts. Neuropathic Pain related to the spinal cord or peripheral nerves is called neuropathic pain. It generally occurs at the level or below the level of injury. How can you manage pain?Managing acute pain is easier than chronic. You can involve in a healthy lifestyle and physiotherapy but for advanced management and care, there are pain hospitals that manage pain well. These healthcare facilities are established especially to diagnose and manage chronic pain. What are the kinds of pain that can be treated?Various kinds of chronic pain can be treated in pain hospitals such as cancer pain, back pain, knee pain, neck pain, arthritis, fibromyalgia, migraine, etc. What are the treatments available? There are various treatment procedures that are involved in treating pain. These can be simple and complex both. It truly depends on upon the kind of pain you are suffering from. Some pain needs just lifestyle modification and counseling to be treated while the others require more complex treatments. Treatments like X-Ray guided injections, intrathecal pump implants, radiation therapy, Botox therapy and Platelet rich plasma therapy are some from a several more. These treatments can be very effective when performed by experts.

3 Essential Tips to Prevent Back Pain

Dr. Sidharth Verma, Pain Management Specialist
Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.Figure showing back muscles and their attachmentsSince prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips.Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.Lift objects correctly and maintain proper posture:While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed. While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pin point the diagnosis and appropriate management.

Low Back Pain: What All You Must Know

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
Back pain is a problem which is very often faced by all the human beings at least once in their lifetime. This pain, if not taken seriously can turn into a deadly disease which can put your life at stake.Some important facts about back painLow back pain is the most common musculoskeletal complaint, with potentially devastating consequences.90% of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first. Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.The incidence of back pain is highest between the ages of 35 and 55.Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.Early interventional treatments in back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.Newer Developments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts.Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.Must visit Interventional pain and spine specialist :-If you have moderate to severe low back pain that lasts more than a couple of Days;If you have back or leg symptoms that have gotten worse; If your symptoms have not gone away after 2 weeks of home treatment; Or, if improved symptoms flare up again.A physical examination by pain specialist and possibly an imaging (x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.Physical Therapy: TENS, UltrasoundHeat and Cryotherapy:These Modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain. They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition.Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain. Facet joint injections: An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radiofrequency otomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3rd of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus, reducing the volume and lessening the pressure on nerves.Intradiscal Electrothermoplasty (IDET) This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc. These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Quick tips to a healthier backFollowing any period of prolonged inactivity, begin a program of regular low-impact exercises. Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.Yoga can also help stretch and strengthen muscles and improve postureAlways stretch before exercise or other strenuous physical activity. Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced. At home or work, make sure your work surface is at a comfortable height for you. Sit in a chair with good lumbar support and proper position and height for the task.Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books. Wear comfortable, low-heeled shoes. Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed. Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Three Tips to Reduce Back Pain as You Grow Older

Dr. Jyotsna Gupta, Gynecologist/Obstetrician
As you get older, your back needs attention. Here are some tips to help you reduce back pain.TIP 1 - RIGHT NUTRITION Right nutrition is most essential requirement for back pain. nutrition is provide by sufficient nutrient which gives strengthen to our musculoskeletal system of body. Nutrient which provide sufficient nutrition are:-TIP 2 - REGULAR EXERCISE  FOR BACK Extra weight means extra stress on your body , which lead to back pain .for those that carry weight in the belly region, the strain on the back  only increases. Find an eating plan that works for you, and get your  BMI under control. As we can see today,most of our activities are sedentary which does not strengthen up our back muscles rather they weaken them. It is even more necessary to exercise regularly. But make sure to try it with the guidance of an expert. (Either a PT or Yoga therapist.Regular exercise builds up the strength of our musculature, mobilises & lubricates our joints and improves the flexibility the most required.Not just that even the nourishment to our musculoskeletal system improves with an improved blood circulation.The different activities which help our spine and back to strengthen can be - yogic asanas, sun-salutations(for those who can), swimming, cycling and walking.TIP 3 - RIGHT POSTUREAs all of us know that we spend lots of time through the day sitting for most of the activities.so it is apparent that your back takes the burden of sitting most of time. If a right posture is maintained, it can prevent of our back problems.Make sure to let your spine take its natural curvature while sitting. you need to keep in mind proper spine alignment not just when watching TV or sitting at your desk at work. The position you sleep in can go in wrong way keeping back pain occur. the best position is on your side in a relaxed fetal position with your knee bent .place a pillow between your legs, so that as you sleep, the top leg does not slide forward, causing a twist in your lower back .consider also using a small pillow under your neck, so that your spine stay in alignment as much as possible. Remember to focus on your small daily movements, such as how you pick up objects (always bend at the knees)how you carry your purse or backpack(make sure it’s not too heavy and wear your backpack on both shoulder), invest in a new mattress or/and pillow that are firm and prevent your spine to curve, and add some gentle stretching to your morning routineDr. Jyotsna Guptahttps://www.facebook.com/gynecologistindelhi/http://gynecologist-delhi.webs.com/

Myths and Facts About Low Back Pain

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
· Low back pain is the most common musculoskeletal complaint, with potentially devastating consequences.· 90%of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first.· Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.· The incidence of back pain is highest between the ages of 35 and 55.· Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.· The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.· People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.· Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.· Early interventional treatments in Back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.· Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.· Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.NewerDevelopments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.· If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .· Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.· If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.· Must visit Interventional pain and spine specialist :-· if you have moderate to severe low back pain that lasts more than a couple of days;· if you have back or leg symptoms that have gotten worse;· if your symptoms have not gone away after 2 weeks of home treatment;· or if improved symptoms flare up again.·  A physical examination by pain specialist and possibly an imaging(x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.· Physical Therapy: TENS, Ultrasound, Heat and Cryotherapy:o These modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain.o They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition. Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.Facet joint injections:An injection used to determine if the facet joints are the source of pain.These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radio frequency Neurotomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus reducing the volume and lessening the pressure on nerves.These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Following any period of prolonged inactivity, begin a program of regular low-impact exercises:· Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.· Yoga can also help stretch and strengthen muscles and improve posture· Always stretch before exercise or other strenuous physical activity.· Don’t slouch when standing or sitting.When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.· At home or work, make sure your work surface is at a comfortable height for you.· Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for along period of time, rest your feet on a low stool or a stack of books.· Wear comfortable, low-heeled shoes.· Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.· Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.· Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body.Do not twist when lifting.· Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles.· If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Killing Your Back Pain Is Easier Than You Think!

Dr. Vishwas Virmani, Physiotherapist
Perhaps you have an old injury that you ignored and is now bothering you. Or maybe you slept in an odd position and woke up to feeling really uncomfortable and uneasy. Whatever might be the reason for your back pain, this is one problem that is hard to easily get rid of. However, there are relief therapies to reduce your back pain, which, eventually completely cure your back pain. These are:Cold therapyEven with all the high tech medical options available, a simple ice or cold pack application can still be one of the more effective, proven methods to treat a sore back or neck. Ice is typically most effective if it is applied soon after an injury occurs, or after any activity that causes pain or stiffness.Ice can also be very helpful in alleviating postoperative pain and discomfort. While any form of applying cold to the injured area - such as a bag of ice wrapped in a towel or a commercial ice pack - should be helpful, combining massage therapy with ice application is a nice alternative for pain relief.Heat therapyWhile the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain.In addition, heat therapy—such as heating pads, heat wraps, hot baths, warm gel packs, etc.—is both inexpensive and easy to do. Some patients find more pain relief with heat (either moist heat or dry heat) and others with ice. You can also try alternating the 2 therapies.Note: If you still do not see any changes in your condition, check with your doctor.

Comprehensive Approach to Back Pain

Dr. Rakesh Kumar, Physiotherapist
Perfect physio is always with you in your pains. Please read specially who are in chronic back or musculoskeletal pains. The mind-body issue Traditionally we have thought of pain as a signal transmitted from the periphery to the brain – such as when a finger touches a hot plate. This understanding of pain serves well for very brief acute pain; however, it is only a small part of the story when pain is longer lasting. Just as there are nerve tracts that carry pain signals upward to the brain, there are also tracts coming down from the brain that regulate the sensitivity of the spinal cord and thus determine how much pain we perceive. These tracts can amplify pain – making a trivial stimulation seem terrible – and can block it, which probably explains why quarterbacks and combat soldiers can carry out remarkable activities, and only after some time realize that they’ve been injured. Additionally there are genetic differences in the responses to stimulation. For example, a metal disc heated to exactly 120° and placed on the forearm will be experienced by some as barely uncomfortable (pain of 1/10) and by others as excruciating (pain of 9/10). Functional brain imaging at the time of the experiment confirms that those who report severe pain actually have greater activation of several areas in the brain that process pain, while those who feel little pain have little brain activation. Thus we conclude that, unless other factors interfere, pain is whatever the patient tells us it is. Is it mental? Psychological factors rarely seem to be an important cause of prolonged pain, but they invariably affect it – for better or for worse. Attention and vigilance account for much of the psychological modulation of pain. Pain that the brain thinks is important will be amplified, and those that it thinks are of no consequence will be lessened. (Just as a mother in a noisy New York apartment sleeps soundly as ambulances and car horns sound through the night, but awakens instantly when her baby whimpers.) Mood profoundly affects pain, and even something as simple as reading a short story that it either funny or tragic changes people’s thresholds and tolerance to experimental pain. Research over the last 35 years has demonstrated that pain, as well as numerous other factors, change the central nervous system in ways that lead to prolonged pain, even when the illness or injury that initiated it has healed. In fact, most chronic pain is more attributable to sensitization of the nervous system than to problems in the body parts that hurt. These findings help to explain why people with normal-looking feet can have constant burning, why perfectly healthy people have headaches, and why the majority of people with chronic back pain have no findings on exam or imaging to account for it. In the past, it was often assumed that when people had serious complaints of pain in healthy body parts, that their pain was imagined, psychologically induced, or exaggerated. We now know that this was a misjudgment on the part of medical providers. What you think governs what you do Behavior, however, is another matter, and here psychological and environmental reinforcers play a prominent role in determining function. So we see people with very severe health problems and very severe pain who have well preserved work, play, and socialization, while we see others with far less pathology whose lives appear to have stopped. In addition to such obvious factors as anxiety, stress, and depression, there are others that impact function. One is the person’s intellectual understanding of their health – the person who believes that activity endangers their spinal fusion may become an unnecessary invalid, while a more confident person with the same medical condition may be golfing. A person’s confidence in his/her own strength and abilities is also important. Those who feel competent tend to function better and have better quality of life than those who lack self confidence.Catastrophic thinking Catastrophizing, the tendency to assume that the worst that can happen is true, has been shown to promote pain and dysfunction. In the case of back pain, a person whose thoughts tend to run in the direction of, "This is horrible, there’s no way I can stand it, I’m damaged for the rest of my life," will likely suffer more (and have less fun) than one who thinks, "the majority of people have back pain, and I’m getting more than my share of it, but I know there will be days that are better and days that are worse."Who’s got the power? People who believe that their future depends on others – surgeons, spouses, Workers’ Compensation insurors, foremen, etc, – tend to be more depressed, more functionally impaired, and in worse pain than those who recognize that they are in charge of their own lives.Learn to Live with It These may be the most feared words that a person with chronic pain can hear, with the implication that the rest of your life is going to be about enduring suffering. Fortunately that is not the case. Those who learn to live with pain do have to accept that there is so far no cure for most chronic pains, but most go on to have joyous and productive lives in which they feel a blessing and not a burden to their loved ones. It’s not easy or automatic, and we don’t come with instruction manuals telling us how to do it. These may be useful hints:Acceptance In order to do what we can, we need to stop trying to do what we can’t. At some point, it’s time to stop looking for diagnoses and cures, and to decide to make the best life possible out of an unfortunate situation. Acceptance does not mean giving up; it means taking charge and having the fullest life possible, despite the pain.Fitness There may be nothing more important for reducing pain and increasing function than maintaining physical fitness. It clearly improves not only pain, but the anxiety and depression that often accompany it. Yes, it hurts at first. Yes, it would feel better at first to take a pain pill and go to bed. But over the long term, the fitter you are, the better you’ll feel – and the more you’ll be able to do with those who love you. You do need advice for this, though. The wrong exercises can increase many pains, and most patients require a slow and gradual increase in activities in order to avoid overdoing and crashing. Fitness means weight management as well. Many studies show that obesity is associated with chronic pain. Weight loss is difficult, but with commercial weight loss programs that provide food guidance along with ongoing support, one can lose weight and keep it off without ever going hungry.Staying active One of the fathers of pain psychology noted that patients who have something better to do don’t seem to hurt as much. The converse of this is the aphorism that if your life is empty, pain will fill it up.Indeed, most patients find that when they’re preoccupied with their grandchildren, or involved in some activity that consumes them, they are much less aware of the pain. Medical advice to "let pain be your guide" is great for acute pain, but it is toxic for chronic pain. Seek clear answers from your physician as to whether you are at risk for harm to your body (as distinguished from hurt), and then let life be your guide. Interpersonal support During acute pain, most have loved ones who are sympathetic and helpful. As the pain becomes chronic it seems that whatever they do is wrong. If they note that there isn’t much physical disease going on and wonder if you’re exaggerating the pain, it tends to lead to depression, anger, and decreased function. If they baby you, wait on you, and/or begin to make decisions for you, it tends to lead to regression, helplessness, and then depression. If friends get tired of hearing about the pain and drift away, it leads to loneliness and resentment. It seems that the best response for those who love you is to accept that the pain is real, that they can’t take it away, and that you aren’t sick and don’t need to be treated like a child. It helps if they give attention in the form of an invitation to the movies or a picnic rather than in the form of caretaking. It is important that loved ones ensure that your pain does not govern their lives.

Back Pain and Its Treatment by Pain Specialist

Dr. Hitesh N Patel, Pain Management Specialist
WHAT IS BACK PAIN?Out of 10 every 8 people in the world has been suffered from severe attack of back pain during their life time. Back pain is a symptoms rather than disease. Doctor finds out the cause of back pain and treats accordingly. Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.WHAT ARE THE CAUSES OF BACK PAIN?There are many causes of back pain. Long standing degeneration (wearing away) of the vertebrae and the intervertebral disc is the primary cause behind this disorder.Advancing ageJoint Problem – Lumbar Facet ArthropathyLigament or muscle injuryDisc problem – slipped disc or tear in discRepetitive back injuryRepetitive stressPoor Muscle toneOccupational trauma – lifting heavy loads on head, gymnastics, working on the computer for long hoursHOW BACK PAIN IS DIAGNOSED?Getting an accurate diagnosis of the cause of back pain is critical, because different diagnoses will require very different treatment approaches. And the sooner an accurate back pain diagnosis is made, the sooner the patient can find an appropriate treatment for pain relief and to improve his or her ability to enjoy everyday activities.The most common diagnostic tests include:X-raysMRI scansBlood TestTREATMENT BACK PAINDRUG THERAPIESPainkillers are often helpful. Pain killer as well as anti-inflammatory medicine can help you to move your back for exercise. As well as it help to reduce an inflammation in back. Pain killer has a good role in early stages back pain.In advance stages pain killers are not much useful. Also in long run pain killers can have an adverse effect on Kidney, liver and other major organs. So you should not take pain killers by your own, consult your doctor for this.EXERCISE AND PHYSIOTHERAPYSome back exercises are very helpful in early stage of back pain and to maintain a muscle strength and tone for long term.INTERVENTIONSSPINAL BLOCK / INJECTIONSAs science advances treatment of back pain is becoming less and less invasive. Now a day’s for back pain treatment minimally invasive treatments are widely available. Back pain treatment in India is keeping pace with world. All advance and minimally back pain treatment also available in India.If exercise and medicine are not working than your doctor might suggest you spinal blocks / injection. There are number of procedure for back pain. Your doctor will see all reports and then suggest you best treatment options for you. Interventions are small procedure done with a tiny needles to block pain generators or pain pathways.At LiveWell Pain & Spine Hospital we do all these pain procedure very routinely. Our expert hands at LiveWell Pain & Spine Hospital do all procedure in few minutes and you will become pain free. Our treatment for back pain is without Surgery.All these blocks are very useful and make patient life more pain free. Mostly all back pain procedure are a day care procedure and patient can go back to home on same day. These all are procedure not a surgery so hospitalization required and not incision and no scar. Pain relief usually start within one week.We have treated patients with back pain from Kenya, Tanzania, Africa, UK, USA, Russia and many more countries.Apart from many patients from Gujarat, We also got many patient with back pain from across India like Rajasthan, Maharashtra, Goa, Bangalore, Orissa, Madhya Pradesh, Punjab and many states from India.FACET JOINT BLOCKWhen back pain originates from the facet joints (located in each side of the vertebrae), a specific type of injection called a facet joint injection may reduce inflammation and provide pain relief. Doctors use live X ray to ensure the needle is correctly placed before the medicines are injectedRADIO-FREQUENCY ABLATIONIf facet joint injection successful and pain comes back within a short period of time you might get benefits from a radio – frequency ablation of medial branch. Radio frequency ablation is a specialized procedure which causes a thermal lesion on the medial branch. This procedure can give a long term pain relief.TRANSFORAMINAL BLOCKDuring transforaminal block, medications are injected into the “foraminal space which is also called an epidural space.” Epidural space is the area between the spinal sac and spinal canal, which runs the length of the canal. As the medicine is injected into the epidural space it coats the nerve roots and outside lining of the facet joints.

Is Lower Back Pain a Pain in Your Butt?

Dr. Vishwas Virmani, Physiotherapist
How to Treat Lower Back PainRemember those Ooh, aah, ouch! Iodex! ads from the 1980s, when the actors would grimace their way through aches and pains, only to suddenly discover Iodex, and be magically cured?While balms work wonders in ads, seniors dealing with lower back pain need solutions that can help them in the long run. There are a number of different reasons for lower back pain in the elderly, from serious conditions includingbone diseases like Osteoarthritis or systemic diseases like fibromyalgia, to more benig ones like inflammation of the joints.There are a number of treatment options available to seniors struggling with lower back pain. Depending on what's causing the pain, whether it's a disease or just the aging process doctors could suggest invasive and/or non-invasive treatment options.InvasiveFor example, if a growing tumour is what's causing the pain (by pinching certain nerves), doctors might suggest invasive treatments like surgery to remove the growth. They could also suggest 'Interventional Pain Therapy', which includes steroid injections to combat the inflammation that occurs in conditions like facet joint arthritis. Non-invasiveNon-invasive treatments include massage therapy, analgesic medication,and non-opioid drugs called NSAIDS. Low impact exercises like yoga can help stretch, massage, and condition your lower and mid-back muscles.A strong and supple back is essential to your overall health, especially since that's where some of our key core muscles are located.

Freedom From Chronic Pain

Dr. Nafisa Taha, Pain Management Specialist
Pain is a common symptom of most afflictions which affects our quality of life. It is a warning bell that something is wrong with our body. Generally it is seen that patients neglect the first signs of pain. eventually when the inability to perform simple day to day activity sets in, they suddenly become conscious about their ill health. But in some of these cases unfortunately the pain becomes nagging and chronic due to the patients negligence and procrastination to seek timely medical help.Chronic pain affects our personal and professional life. Expensive painkillers without medical guidance leads to other chronic problems like rise in blood pressure and blood sugar levels. Thus proper pain management is important. Treatment is tailor made for every patient with chronic pain after a thorough medical check up.Chronic pain is reduced with the latest specialised injections called pain blocks. Blocks are nonsurgical way of relieving the pain. Blocks are given for problems arising out of lifestyle disorders, due to ageing, and in people who cannot tolerate surgical procedures due to heart problems, kidney and liver problems and so on. Pain blocks reduce the patients pain significantly and allow them to lead a life without suffering, with dignity and independence.Common conditions managed are Low back pain, neck pain, headache, migraine, knee and joint pains, postoperative pains, nerve pains (diabetic neuropathy), cancer pain, musculoskeletal pains and any pain of more than 1 to 3 months of duration which is not relieved by medicines. Our aim is to reduce the physical suffering and pain .No one should suffer from pain when Safe, Scientific and Specialised non surgical treatment options are available because the Quality of Every Life Matters.