PAIN CLINIC

Pain is a protective symptom. It tells us about something wrong with the body. But once we know what the problem is, presence of pain is annoying. It disturbs bodily functions and induces depression. Besides this when present for long time it can have bad effects on body.

So, this pain needs control to avoid its bad effects.

We in pain clinic have dedicated specialist tackling this complex issue.
We have acute pain service wherein, difficult acute pain not controlled by routine methods is separately addressed to relieve pain. Acute pain is seen in cases of trauma, after surgery, after burns, in certain medical and surgical conditions.

Chronic pain clinic deals with pain which has persisted for long i.e. chronic pain. Chronic pain is a difficult situation which does cause lot of physical, mental and emotional disability.

Few examples include neuralgias like trigeminal neuralgia, post herpetic neuralgia, persistent pain after spine or knee surgery, prolapsed disc, back pain, neck pain of spondylitis, refractory muscle, joint or nerve pain, pain in cancer, pain in leg due to reduced blood supply to leg etc.

We use latest and advanced IMAGE GUIDANCE techniques to control pain. This improves precision and results with minimally invasive technique.

Few examples of our treatment methods are as under.

• Nerve root blocks
• Facet joint blocks
• Median branch blocks / Radio frequency ablation
• Ozone nucleolysis
• Vertebroplasty / Kyphoplasty
• Sacroiliac joint injection
• Piriformis injection
• Caudal, lumbar, thoracic, cervical epidural injection
• Myofascial trigger injection
• Hypodermic needling
• Sympathetic blocks like Sphenopalatine block, stellate block, T2, T3 Block, Splanchnic block /RF ablation, Celiac block, Superior hypo gastric plexus block, Ganglion impar block etc.
• Gasserion ganglion Radiofrequency ablation / V2,V3 Block
• Occipital, intercostal, suprascpular, Genicular nerve blocks etc.
• Spinal cord stimulator implantation and monitoring
• Intrathecal morphine pump implantation
• PRP therapy
• Joint injections

We use IMAGE GUIDANCE by

• Live fluoroscopy
• Live USG
• Live CT Scan guidance

Our motto is….to improve quality of life of our patients and help them avoid medicines.

FAQ about pain management

• What is aim of pain management?
  • It is to reduce or abolish pain, improve quality of life of patient in pain and reduce analgesic burden while you are making efforts to eradicate the cause of pain.

• What is the duration of pain relief expected in various painful conditions?
  • It varies with the painful condition, pain threshold of patient, other conditions affecting pain etc. But generally once achieved, pain relief is sufficiently prolonged.
  • It may need repetition.
  • SOME TIMES.. One intervention is enough to give near permanent relief.

• If it has limited duration pain relief why should I get it done?
  • Analgesics are notorious in causing renal, cardiac and G I side effects.
  • Pain of long duration hampers the quality of life, reduces efficiency of person, increases work absenteeism causing economic loss and even bring depression.
  • Unrelieved pain, visit to many doctors with little relief, causes person to feel insecure and relatives jittery.
  • I think these reasons are enough to justify interventional pain management.

• Why the cost involved interventional pain management is higher than conventional blind blocks given?
  • We use IMAGE GUIDANCE.
  • This improves precision of reaching target.
  • This reduces the dose used.
  • This increases chances of positive results.
  • The use of OT, C-arm, and USG or CT scan guidance for IMAGE GUIDANCE adds its charges with other charges like room rent, pharmacy consumables….all put together make the total charges.
  • But it is worth .It is lesser than cumulative money spent on medicines and the agony suffered otherwise.

• Which conditions can be referred for pain management and what are the options of pain management?
  • Trigeminal neuralgia: V2, V3 Block or Radio frequency ablation of Gasserion ganglion
  • Sympathetically mediated face pain: Sphenopalatine block / RF ablation
  • Neck pain due to cervical spondylitis: Epidural blocks, Facet joint injections, Trigger injections
  • Radiating arm pain: Root blocks / Epidural block
  • Refractory shoulder pain: Suprascapular nerve block / RF Ablation
  • Intercostal neuralgia (Post herpetic and others): Intercostal block, thoracic Root blocks
  • Sympathetically mediated neck / arm pain: Stellate ganglion block / RF ablation
  • Refractory myofascial chest pain: Hypodermic needling, Pectoral nerve block
  • Upper abdominal cancer pain: Celiac plexus block / Splanchnic Block / RF Ablation
  • Lower Abdominal cancer pain: Hypo gastric plexus block
  • Pelvic cancer and non-cancer pain: Ganglion impar (inferior hypogastric) block
  • Back pain due to intervertebral disc swelling: Ozone nucleolysis, Bilateral DRG block…Very select cases TED.
  • Back pain due to facet joint arthropathy: Facet joint block / Nerve to facet joint block / RF ablation
  • Radicular leg pain: Root block, Very select cases TED
  • Buttock, groin and thigh pain due to S I joint disease: S I joint block / RF ablation with or without piriformis block.
  • Pain of ischemia in legs: Lumbar sympathetic block / RF Ablation
  • Pain in knee due to OA or RA: Genicular nerve block…in select early OA cases PRP (Platelet rich plasma) injection is added.
  • Back of head pain due to occipital neuralgia: Occipital nerve block / stimulation
  • Myofascial pain of various areas: Hypodermic needling, trigger injections, kinesio taping.
  • Refractory pain after spine surgery: blocks as per reason of pain, Spinal cord stimulator implantation if refractory cases, caudal neuroplasty in adhesions causing pain