Cervical Pain Treatment in India - Removemypain

 Neck Pain is a pain posteriorly anywhere between the skull base and thoracic spine. It is the largest cause of musculoskeletal disability after low back pain. Approximately two-thirds of the population will suffer from neck pain at some time in their life with high prevalence in middle ages. Fortunately for most people the acute pain resolves within days or weeks although in some it may reoccur or become chronic.

Neck pain may be a result of...

• Local pathology
• Whiplash (flexion-extension) injuries/ trauma
• Be a part of a more widespread systemic problem such as ankylosing spondylitis, rheumatoid arthritis, fibromyalgia etc.
• Be a result of referred pain from neighboring areas for example the shoulder joint

Neck pain usually has a multifactorial etiology -poor posture, neck strain/injuries, anxiety, depression, and stress can play a role in magnifying the perceived pain. Quite often the diagnosis of simple or nonspecific neck pain is used implying postural and mechanical causes; this is contrary to other serious causes of neck pain such as fracture, tumor, infection, etc.

Pain from the upper neck can radiate towards the head leading to frequent headaches and that from the lower part of the neck can radiate to the shoulder, arm, chest wall and scapula. Reduced neck movement along with localized areas of muscle tenderness known as trigger points are commonly observed along with pain.

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How To Communicate Regarding Your Joint Pain To Your Doctor - Removemypain

 Joint pain can be a source of prolonged discomfort which one may have to endure in life. This can affect your daily activities and make you feel depressed. Joint pain specialists in Delhi NCR are daily visited by numerous patients complaining of severe pain and in search of treatments which can provide quick relief.

For you to get the most appropriate treatment, the way you explain your pain to the doctor is important. There are a plethora of options for joint pain treatment in Delhi NCR . But reaching out to the right centre with experienced and skilful professionals whom you can count upon is important.

Read below to understand the importance of accurately describing your joint pain concerns to your treating doctor:

• Joint pain is subjective, without your explaining it may be very difficult for the doctor to know what your pain feels like and how severe it is
• Joint pain can have numerous causes such as like age related wear and tear, injury, trauma, infections etc
• Involvement of multiple joint in the body may require different assessment/investigations than just one isolated joint problem. Treatment options may also differ depending on the actual pathology
• Treatments offered depend on the severity of symptoms, their impact on your life, your age, activity levels and your goals/expectations. There are many treatment alternatives –both non-surgical and surgical, depending on the assessment of the above factors
• These are some important points which may help your doctor to understand and treat your pain better:

• Explain where the pain is; how long you have had the pain and how it started. If possible point the exact place, is it in the knee, ankle or shoulder pain?
• The character of pain can help in narrowing down the possible causes. For example is it aching, burning, shouting or stabbing pain? Is it present all the time?
• Aggravating or reliving factors are equally important- Is it worse when you are walking or at night time when you are trying to sleep. is it when you sit, walk or stand?
• It is important to tell the doctor how the pain affects your daily life. This information is essential as it enables the doctor to have a clear overview of what you are feeling. While describing the impact of pain do not forget about your sleep and mood.

In case the pain is short-term, your doctor may recommend home care like –

• Applying ice or hot compression at the joint several times.
• Avoiding activity that may cause the pain.
• Using a brace to protect the joint.

Various other options are used for Joint pain treatment in Delhi NCR like steroid or hyaluronic acid injections, nerve blocks and radiofrequency treatment. They can all help to ease the suffering and improve your quality of living. Some options are specific to the joints involved. These are mostly combined with medications and physiotherapy to improve outcomes.

Tags = Joint pain treatment in Delhi, joint pain treatment in Delhi NCR, Joint pain treatment in South Delhi, Removemypain

Meralgia paresthetica treatment in delhi and gurgaon - Removemypain

 

What is Meralgia paresthetica (MP)?

Meralgia Paresthetica is a thigh pain condition that develops as a result of problems with a nerve called the lateral cutaneous nerve of the thigh. This nerve supplies sensation to the side and front of thigh. It originates from the spine and travels via the inside of the belly and groin to reach the thigh. Injury or pinching (entrapment) of the nerve can lead to numbness, pain and altered sensation in the area supplied by the nerve and this condition is called Meralgia paresthetica.

What causes this condition?

The most common cause for this condition is pinching (entrapment) of the nerve as it enters the thigh travelling in close relation to a thigh ligament called the inguinal ligament. The angle of the nerve changes as it travels into the thigh making it more liable to get pinched. Your pain specialist can further explain the anatomical details to help you understand the condition better.

MP generally affects one side although in up to 20% of patients both sides may be involved. Men are more likely to have MP with a peak incidence between the age of 40-60 years. It can be challenging to pinpoint the exact cause as to why this condition develops although it has been observed to occur more commonly in association with conditions such as:

• Increased abdominal pressure as seen in pregnancy or distension of abdomen due to increased fluid in belly (ascites)
• Obesity (BMI> 30)
• Tight clothes/ belts in the waist area such as jeans, military armour and police uniforms
• Diabetes and other conditions affecting nerves such as alcoholism
• Underactive thyroid (Hypothyroidism)
• Nerve injury due to seat belt injury or injury associated with surgeries such as hip or back surgery, surgeries requiring bone grafting, keyhole (laparoscopic) hernia repair
• Growth/ swelling of the nerve (neuroma)
• Difference in the length of the two legs
• Activities involving repetitive leg motion for long hours such as walking or cycling. MP is seen associated with sports such as gymnastics, soccer and strenuous exercise, bodybuilding.

What are the symptoms of Meralgia paresthetica?

The main symptoms of this condition include

• Pain, burning, aching or stabbing sensation in the front and outer side of the thigh, extending as far as the outer side of knee. This may be accompanied by groin and buttock pain
• Altered sensitivity in the front, other side of thigh
• Numbness, tingling sensation
• Worsening of symptoms with certain positions such as squatting, walking or standing for long hours. Lying down with legs bent towards the tummy (hip flexion) or sitting may help to reduce the symptoms severity.

As this nerve does not control any muscles, there is no muscle weakness.

How is Meralgia paresthetica diagnosed?

In most cases, the diagnosis can be made by the history and examination. Simple tests such as altered sensation in the area supplied by nerve, pressure on the nerve in the groin, moving the hip backwards may reproduce the symptoms and help in establishing the diagnosis. An ultrasound scan can be useful. I have previously identified nerve abnormalities with ultrasound scans prompting other investigations.

Investigations such as MRI scans may be requested to confirm the suspicion or to rule out other conditions with similar symptoms. Other specialist investigations such as nerve conduction studies or neurography are sometimes required. Often an ultrasound guided injection is used to confirm the diagnosis and provide relief.

How is Meralgia paresthetica treated?

This condition has good prognosis and mild cased can resolve spontaneously or with conservative management. The treatment involves lifestyle changes, medications, physical therapy and ultrasound guided injections or radiofrequency treatment. Surgery is rarely required and is considered for chronic refractory cases not responding to other measures.

Lifestyle changes– these include

• Avoiding tight clothes and belts
• Weight loss (if indicated)
• Rest and avoiding activities which provoke the symptoms

Medications. Different types of medications are used including neuropathic medications (painkillers used for nerve pain) and anti- inflammatories.

Ultrasound Guided Nerve Block

The involved nerve can be identified with the help of ultrasound and guided injections can help relieve the pain. It involves injecting local anaesthetics and a small dose of steroid close to the problem site. The combination helps to reduce pain and inflammation. The injection can be performed as an OPD/ day care procedure and it not only helps confirm the diagnosis but can also provide lasting relief. Skilled clinicians can identify individual branches of the nerve. Ultrasound guidance not only helps to ensure accuracy but also minimises the risk of complications.

Ultrasound Guided Pulsed Radiofrequency (PRF) Treatment

In cases where the effect of the nerve block does not last long, this option can be utilised to prolong the pain relief. The procedure involves identifying the nerve under ultrasound guidance followed by placement of a special needle close to the nerve. The needle is connected to a radiofrequency machine which is used to interfere with the pain signals being transmitted by the nerve. This procedure can provide lasting relief and I prefer this option over other options such as neurolysis as it is associated with less complications/ side effects.

Cryoablation

This method involves freezing of the affected nerve to interrupt the pain signals being transmitted to the brain resulting in pain relief. The procedure does not require any cuts or incisions and involves placing a small probe near the affected nerve. A pressurised coolant travels through the probe and creates an ice ball at the tip of the probe thereby freezing the nerve. As the nerve is not damaged during the process it can regenerate without any permanent damage. This procedure can provide prolonged pain relief, usually lasting 6-8 months although some studies have found even longer lasting benefits. If required repeat freezing of the nerves can be performed with good results.

Surgical management. This is rarely required and is considered for non-resolving severe symptoms. The options include

• Decompression – this involves releasing the pressure off the nerve
• Excision of part of the nerve (neurectomy). This can lead to permanent numbness in the area supplied by the nerve.

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