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The goal of pain clinic is to manage acute or chronic pain by reducing pain frequency and intensity. Besides addressing pain issues, a multidisciplinary pain management program may address your functional goals for activities of daily living. Overall, a pain medicine program aims to give you a feeling of well-being, increase your level of activity (including return to work), and reduce or eliminate your reliance on medication.We use multidisciplinary approach to treat all pain conditions.
Your appointment with a pain management specialist is much like other doctor visits. focus is on your pain, the cause or contributing factors, and quickly managing it.Pain medicine doctors perform a physical and neurological examination, and review your medical history paying particular attention to pain history. You may be asked many questions about your pain, including:
Most pain medicine specialists use a standardized drawing of the front/back of the body to enable you to mark where pain is felt, as well as indicate pain spread and type (eg, mild, sharp). You may be asked to complete the form each time you visit the pain doctor. The completed drawing helps to evaluate your treatment progress.
Accurate Diagnosis Key to Treatment
Pain medicine involves diagnosing the cause or origin of pain. Making the proper diagnosis may involve obtaining an X-ray, CT scan, or MRI study to confirm the cause of your neck or back pain. Other tests, such as discography, bone scans, nerve studies (electromyography, nerve conduction study)may be performed. The correct diagnosis is essential to a successful treatment plan.
What is Intervention Pain Management?
Interventional Pain Procedures are minimum invasive percutaneous procedures which are performed to block the nerves which carries pain signals.These are done in conjunction with a program stressing muscle flexibility, strengthening, and functional restoration.
The goal of these injections is to facilitate an active exercise program and to progress patients through the pain and inflammation stage of recovery as quickly as possible. As with all injections, it should be part of a comprehensivePain treatment plan.
How the Injection Is Performed?
To ensure proper needle placement fluoroscopic or Ultrasound guidance is recommended during the injection to ensure the needle is going on the right place.If needed, an IV will be started so that adequate relaxation medication can be given. After lying on table, the skin over your lower back/buttock will be well cleansed. Next, the physician will numb a small area of skin with local anaesthetic.The physician then will use x-ray guidance to direct a very small needle into the joint. He will then inject several drops of contrast dye to confirm that the medication only goes into the joint. A small mixture of numbing medication (anesthetic) and anti-inflammatory cortisone will then be slowly injected.
What should I do and expect after the procedure?
Twenty to 30 minutes after the procedure, we will monitor you.You will report your remaining pain, (if any) and also record the relief you experience. On occasion, you may feel numb, slightly weak or have an odd feeling in your leg for a few hours after the injection. Ice will typically be more helpful than heat in the first 2-3 days after the injection. You may begin to notice an improvement in your pain 2-5 days after the injection. You may take your regular medications after the procedure.
On the day of the injection, you should not drive and should avoid any strenuous activities. On the day after the procedure, you may return to your regular activities. When your pain is improved, start your regular exercise/activities in moderation. While many patients will be successfully relieved of their symptoms, not everyone is cured.
How many Injections given?
Usually one injection for diagnosis followed by therapeutic injection. Some patients may require more than one injection. Repeat injections should be based on pre-treatment goals and the therapeutic response following the injection.
ADVANCE PAIN MANAGEMENT-
ADVANCED PAIN THERAPIES
Different radio frequency lesioning procedures are proving invaluable in pain management day by day. It is the best form of treatment for trigeminal neuralgia, different cancer pain and different kinds of spinal pain including low back pain and neck pain.
Radio Frequency (RF) lesioning involves passage of a very high frequency current through a 27 G thermocouple probe. This probe is passed through a 20/22G cannula (a kind of needle), which is insulated except at its tip. When a high frequency alternating current is passed (at 300 kHz) through the RF thermocouple probe the charged ions in the human tissue around the exposed tip of RF cannula moves to & fro. This produces electro-mechanical friction heat is generated. The thermocouple probe is not heated itself, it actually dissipates the heat generated at the surrounded tissue. Thus the heat is totally controlled by the operator. The lesion generated is shaped like a matchstick head with a diameter of 2-4mm. Beyond this distance; electrical field is weaker as it is dispersed, so no lesion is produced.
The temperature & therefore the heat lesion is maximum around the shaft and minimum at its tip. On the other hand the electrical field generated is maximum at its tip and minimum around the shaft. In the conventional RF rhizotomy type we are producing heat lesion. In the pulsed RF electrical field is producing the lesion. In pulsed RF temperature is not raised beyond 42-degree C. Electrical field produces some punch in the capacitor of small diameter nociceptive (pain transmitting) fibers. Thereby signal transmission through this fibre is stopped.
In the conventional type the nerves are regenerated in future & average pain-free period varies for type of nerve. In a properly performed lesion pain free period is 3-4 years. In the pulsed RF the average pain free period is 4-24 months.
The conventional RF rhizotomy is done at sympathetic ganglions, and at purely/ predominantly sensory nerves. It is always avoided in mixed or predominantly motor nerves. Before doing actual lesioning radiological and electrical tests are done to keep the probe away from these nerves in conventional RF lesioning. The commonly performed conventional RF rhizotomy procedures are at following nerves.
In Pulsed RF as there is no heat lesioning it is safe to perform it in most kinds of nerves. It is mostly effective in nerve ganglions but also effective trunks. It may be performed in all the above procedures except trigeminal ganglion. It is mainly indicated in Dorsal root ganglionostomy. It is also done in mixed peripheral nerves like suprascapular nerve.
Vertebroplasty/Kyphoplasty
Much safer than traditional major surgery, in these elderly patients who generally have many associated medical conditions
PLATELET RICH PLASMA(PRP)
Recently, emerging evidence has suggested that Platelet Rich Plasma (PRP) may also be of assistance in the treatment of osteoarthritis and other degenerative conditions of joints. It is felt that the growth factors may assist in cartilage regeneration and also mediate benefit by providing an immune modulating effect, whereby the inflammatory cascade is dampened. Thus, PRP may act as a natural anti-inflammatory substance to result in symptomatic pain relief of sore arthritic joints.The procedure typically takes a couple of hours, including preparation and recovery time. Performed safely without the risks of surgery, general anesthesia, or hospital stays and without a prolonged recovery. In fact, most people return to their jobs or usual activities right after the procedure.it typically has long-lasting results. Research studies and clinical practice have shown PRP therapy to be very effective at relieving pain and returning patients to their normal lives. To create PRP, a small sample of your blood is drawn (similar to a lab test sample) and placed in a centrifuge that spins the blood at high speeds, separating the platelets from the other components. The process is handled manually by a lab technician, producing higher concentrations of platelets and a much more pure concentration of the beneficial blood components .The PRP is then injected into and around the point of injury.Because the patient’s own blood is used, there is no risk of a transmissible infection and a low risk of allergic reaction.
Conditions treated using PRP Therapy
Treatment
PRP injection
Try Laser Therapy BEFORE You Consider Surgery for Many conditions
Laser therapy is still a fairly unknown 21st century treatment modality that can have profound benefits for pain management and tissue healing.
The laser is typically a tiny fraction of the cost of surgery and virtually has no side effects, unlike surgery. Laser therapy can be effectively combined with a number of other treatment modalities.
A typical treatment session can take anywhere from five to 20 minutes, dependent on your injury or condition. In terms of how many treatments will be required depend upon your condition. Typically, pain relief will be achieved long before the condition it self is healed, so it’s important to remember that the absence of pain does not equal the presence of health “When you look at a pain condition that you’ve been suffering from for years, and you can get it resolved with just a few sittings ”require six to 12 treatments over a two- to four-week period of time.
Laser Therapy is used in following
Botulinum Toxin (BOTOX) Type A is a muscle relaxant derived from the bacterium Clostridium Botulinum. In controlled doses, it can provide safe, effective relief from a number of conditions.
Pain management with BOTOX injections allows pain physicians to effectively treat many forms of chronic pain. Because treatment involves just a few simple injections, most patients are eligible for treatment. The best way to determine if BOTOX therapy can be used as an alternative to other forms of chronic pain control is to discuss your individual case with a physician. By carefully analyzing your nerve pain, back pain, or other chronic ailment, a physician will be able to determine if botulinum toxin, the protein that makes up BOTOX injections, can help ease your pain and give you the relief you need. BOTOX treatment is distinctive because of its ability to treat a specific target area. These injections can be administered quickly and have fast-acting, long-lasting results.
Nearly 1 million people worldwide have experienced pain relief from BOTOX. Long-term therapy with BOTOX has been found to be safe and very effective.
Conditions treated using BOTOX Therapy
PHYSICAL THERAPY
IFC
UST
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION(TENS)
It mainly acts like an analgesic.
It helps to reduce any acute sudden pain or chronic pain
It is used in the cases like fibromyalgia, osteoarthritis , tendinitis ,sciatica , neck pain
MANUAL THERAPY
THERAPEUTIC EXERCISE
THERAPEUTIC ULTRASOUND
August 23, 2017
August 23, 2017