* Harmful and undesirable effects on all systems of the body. This leads to personality changes such as irritability, depression, loss of sleep (Insomnia)
and even high blood pressure.
* Chronic backache or headache affects the work capacity and productivity of every-one and more so of a professional or executive.
* Loss of million working hours (Absenteeism) leads to heavy financial burden of society, at large.
* Low Back Pain (Sciatica or Radiating pain in limbs, Pain after Back Surgery, Discogenic pain)
* Cancer Pain of Pancreas, stomach, kidney, uterus, lungs, bone
* Headache- Migraine
* Myofascial Pain- Tennis Elbow, Frozen Shoulder, Tort Collis.
* Pain due to less blood supply in lower or upper limbs (Ischemic Limb Pain)
* Neuropathic pain
* Pelvic and Urogenital Pain- Interstitial cystitis
* Muscular Pain due to sprain
* Neck Pain- Computer Professionals
* Spondylitis of Neck or Back
* Any Pain lasting for more than six months.
Introduction - Pain relief is basic human right. The chronic pain has many aspects such as nociceptive, somatic, visceral, neuropathic, musculo-skeletal and psychological. The ultimate result of chronic pain lead to reduction in quality of life apart from physical and psychological disturbances. That’s why it is mandatory multimodal approach to have total pain relief. This will help the patient and family in toto with reduction in side effects of medication, confidence and overall improvement in quality of life.
There are following multi modal treatment approaches :
various groups of medications are available :
Pain block is injection of pain killing drugs in or around the nerves, ganglion or plexus (nerve bundle). The nerves are thread like structures which carry pain and touch sensations, so we feel touch and pain. The pain killing or relieving drugs reduces only pain sensation from nerves to cause pain relief. The pain blocks are done under guidance of fluoroscope, CT scan or ultra sound.
The medication used are local anaesthetics such as Xylocaine, Bupivacaine, Ropivacaine; neurolytic agents such as Alcohol, Phenol in Glycerine or Almond oil. The steroids such as Triamcinolone Acetonide, Dexamethasone, Depomedrol act as anti-inflammatory agent to reduce inflammation and swelling of nerves.
once pain relief is done patients are reffered for physiotherapy. The various modalities such as short-wave diathermy, exercises, laser, traction and many more are used. Which is for improvement in muscle tone, decreasing of rigidity and spasm to increase mobility, increase in blood supply and muscle activity. A rehabilitation program also provided as per need of individual patients.
Emotional disturbances goes hand in hand with chronic pain. For symptoms like depression and anxiety are mentioned above.
Pain has many components so following alternate therapies acts as supportive to total pain management.