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Harmony Clinic

Nagpur, Maharashtra

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Back Pain

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Knee Pain Treatment

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Pain is the most common complaint a person comes to a doctor with. Illness, Injuries, Infection, Degeneration are some of the common reasons of pain. It is a human tendency to neglect pain till the time it greatly interferes with daily routine. According to experts, this negligence makes the pain chronic and more harmful. Currently millions of people are suffering from chronic pain, mainly BACK PAIN, KNEE PAIN, HEADACHE, CANCER PAIN, FIBROMYALGIA, LEG PAIN WITH SWELLING etc. We at HARMONY pain management center aim at comprehensive NONSURGICAL approach to treat pain at its origin. The patient is looked as a whole and the cause of pain is evaluated, diagnosed and treated to his satisfaction. A stepwise plan including a combination of different modalities of treatment is offered as per the individual’s needs, circumstances and preferences.+ Read More

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Back Pain
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Back Pain

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Back Pain is an extremely common medical problem. Studies have shown that more than 80% population suffers from severe backpain at least once in their lifetime. It is also one of the leading causes of absentism from work. Research has shown that there is great amount of money spent for the diagnosis and treatment of Backpain. Definitely there is significant physical, emotional and financial impact on the patient.

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Knee Pain Treatment
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Knee Pain Treatment

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Knee joint is the largest and most frequently used joint in the body. Hence Knee pain is one of the commonest complaints in the patients seen in OPD of pain consultant, orthopaeditian or physician. Most of the times knee-pain is because of Osteo-Arthritis, a common degenerative process, with disabling symptoms in almost 20% of the population over the age 55 years.

Now even people between age group 45-55 are also coming with similar complaints. The other common causes of knee pain are-cruciate ligament injuries, collateral ligament injuries, patellar tendinitis or dislocation, hamstring tendinitis, infection like T.B. or a generalized disorder like rheumatoid arthritis etc. A correct diagnosis is crucial for effective treatment.

A through history regarding onset, character, location of pain, aggravating factors along with proper examination of the knee will clench the diagnosis. Xrays provide a good clue. The management of knee pain aims towards alleviating the symptoms and reduction in the progression of the disease.

The initial treatment is with NSAIDs and/or Cox2 inhibitors along with chondroitin or glucosamine sulfate, topical capsaicin as well as other preparations. There is definitely a role of interventions like intra-articular injection of methyl prednisolone or triamcenalone or a newer agent hyalouronun, visco supplementation especially in younger age group and patients not getting adequate relief with conventional management.

Rest and exercise are part and parcel of the treatment.

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Diabetic Neuropathic Pain
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This term represents pain in a variety of painful diseases where there is involvement of nervous system, primarily or secondarily. This type of pain is caused by injury to any nerve, accidental or post surgical.

There is change in the functioning of pain pathways carrying sensations to brain. It can also be a sequel of disease like Diabetes or infection like Herpes or compression of nerve like in Trigeminal Neuralgia. Many a times it is associated with Cancer (before or after surgery/radiation). There are instances when the cause is unknown.

The pain is classically burning or pricking type after a gap of few days or weeks of primary injury or infection or disease. There can be abnormal response to a particular stimulus (very sensitive). The pain can vary in severity over time or situation.

There can be associated symptoms like skin changes in colour, temperature, sensitivity, muscle strength, sleep disturbances, behavioral changes (emotional), and bowel/bladder changes. Diagnosis of neuropathic pain is difficult at times.

This type of pain is never relieved with usual pain killers There are specific medications which are very effective. Also sometimes nerve blocks or interventional pain management techniques are needed. In the next article I will elaborate more on common types of neuropathic pain.

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Fibromyalgia Treatment
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Fibromyalgia Treatment

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Fibro means Fibrous tissue and Myalgia means muscle pain. Fibromyalgia is a whole body musculoskeletal chronic pain syndrome (pain for long duration). It is one of the commonest entity in general population but rarely diagnosed and treated properly. The reason being unawareness about its existence.

Though pain is the major complaint, a person with Fibromyalgia, sometimes feels tired during routine activities, can not concentrate on one thing, forgets small recent things, gets stiffness in the body in the morning, feels depressed or anxious, may not get a sound sleep.

He or she may get headache, loose motion or constipation, frequency or urgency for urination for which no cause is found after spending lot of money and time on various tests and doctors. FM is found to be common in females than males. The cause of Fibromyalgia is not known but some muscular injury in the past can be the reason.

Myofascial trigger points for pain is most important diagnostic clue for Fibromyalgia. These points can be located at Neck (back/front), Shoulder, Elbow, Waist, Buttocks, Knee. Also, there can be pain at Jaw, Chest, Abdomen, Arm and Leg. This condition is well diagnosed and treated at Harmony Pain Clinic.

The management of Fibromyalgia is multimodal. Trigger points which start the pain are to be treated first. Oral medications (other than the usual pain killers), Hot and Cold Therapy, Injections with specific medicines and in specific amount and at specific time interval are few examples of therapy. Physiotherapy, Exercise, REBT, Biofeedback, relaxation techniques, Life style modifications are adjuvants.

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Cancer Pain

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More than one million people are diagnosed of cancer every year in India. Most of them need some treatment for pain which is associated with tumour mass. Unfortunately their pain is not relieved satisfactorily in almost 70% of the times.

It may be due to lack of awareness of cancer pain in general population and a standard consensus over the treatment options in medical practitioners. Pain in cancer population is multi origin. It can be due to tumour infiltration or involving a nerve or a nerve plexus, spread in bones, abdomen, lungs, liver or any other tissue. Sometimes it can occur during treatment like radiotherapy or chemotherapy. There may be a psycho-social element also. The treatment of pain is dependent on the cause of pain. Hence a multimodal approach is needed.

There has been tremendous advance in cancer pain management since a decade. Along with usual pain killers, few other medicines are now available for pain relief. Nerve blocks and/or plexus blocks, sympathectomy, intraspinal drug infusion or neuroablation are some of the recent interventional pain techniques. A pain clinic offers a holistic solution to cancer pain patient taking care of all the dimentions of pain.

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Scar Pain

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Many patients have pain at the site of operation after a few days of operation. The common operative procedures predisposing painful scars are Thoracotomy (chest), breast surgery, Hernioplasty, kidney stone surgery, amputation, appendicectomy etc.

It can be due to trauma to the superficial nerves. Damged nerves cause persistent pain. Sometimes there are painful points in the scar rather than the whole scar being painful. Changes can also occur in the pain pathways carrying the sensations to the brain.

On examination, many patients have a palpable nodule related to scar. They give rise to spontaneous painful discharges. There can be increased response to any painful stimulus if this pain is not controlled early.

There are various options available for scar pain in PAIN CLINICS. There are medications other than usual pain killers, injections to be given in the scar, nerve blocks, IMS, Trans cutaneous nerve stimulation etc.

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