PATIENT INFORMATION

PAIN MEDICINE

Identifying a pain specialist

Dr Tariq Ahmad Tramboo MD. FIPP Vice chairman of world institute of pain for india.

Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromayalgia. Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors. Pain medicine is a new specialty of medicine that deals with the evaluation and treatment of people with acute or chronic pain. Acute pain usually follows surgery or injury and resolves as the body heals itself.

Pain is chronic when it persists after healing has taken place. Disk prolapsed and certain degenerative diseases such as arthritis can also cause chronic pain.

A pain specialist may have several specialties, such as anesthesiology, neurology, neurosurgery, or physiatry. He or she has received at least a year of additional training specifically in pain management. Treating pain usually involves a team approach to manage not only the pain itself but such factors as anxiety, depression, family issues and quality of sleep—all of which can affect how we feel pain. Often, patients are not referred to a pain center until they have suffered needlessly for many months or years with pain. It is a goal of pain specialists and the Delaware Pain Initiative to educate patients and their health care providers that pain should be managed early and aggressively. Early referral to a pain center that offers comprehensive evaluation and treatment of pain, not just injections, is the best way to minimize the suffering and disability often associated with undertreated pain.

Management of pain involves conservative treatment and minimally invasive treatment

Minimally Invasive Techniques Minimally invasive techniques are very effective and safe. They prevent patients from going into chronic stage of pain. And they can save patients from undergoing major procedure like surgery. These procedures are being routinely done here through relief interventional pain clinic. And many national and international doctors receive training here at our center and thousands of patients are saved from mutilating surgeries. Procedures done routinely for chronic pain through our center in India (J&K, Dehli, Hyderabad,Rajisthan, Gujrat and Mumbai) Egypt, Swizerland and italy are

Facet rhizotomy In some low back pain programs, if three facet block injections provide good but temporary relief of the patient’s pain, a facet rhizotomy injection may be recommended. The purpose of a facet rhizotomy injection is to provide lasting low back pain relief by disabling the sensory nerve that goes to the facet joint.

Facet joint injections Facet joint injections are performed for facet joint pain. Facet joints can be injected with long acting local anaesthetic and anti-inflammatory steroids, which can alleviate facet joint pain for long periods.

Facet joint denervation This is a straightforward procedure that is normally carried out if you have had a successful result from facet joint injections. Special needles are carefully placed under continuous fluoroscopy so that their tips lie exactly on the nerves that carry pain signals from the facet joints. Radiofrequency energy is then passed through the needles so that that tissue at the tip is heated to about 80 degrees C for about a minute. This coagulates and inactivates the nerves.

Pulsed radiofrequency treatment Passing alternating radiofrequecy energy through tissues without significantly heating it can selectively inactivate pain-carrying nerve fibres, which tend to be smaller in diameter than the fibres that control muscles and allow normal sensation. Conventional radiofrequency treatment results in the coagulation of all tissues at the tip of the needle, including all nerve tissue. In most situations this does not matter, but in some situations it is important to maintain as much normal nerve function as possible.

Discography Discography involves the insertion of a thin needle into one or more discs. Then either saline is injected into the disc to see if it is painful, or radio-opaque contrast dye is injected and x-rays will be taken to show the internal structure of the disc.

Epidural steroid injection The word ‘epidural’ simply refers to a layer of supporting tissue outside the spinal cord. In an epidural a solution of long acting local anaesthetic, long acting anti-inflammatory steroid, and sometimes other pain modifying drugs is injected into the epidural space in the spine.

Transforaminal epidural injection This is an important adjunct to epidural steroid injection and the two are normally done together. If you have lumbar radiculopathy or cervical radiculopathy, you will probably also have one or more transforaminal epidural injections.

Sacrolliac joint steroid injection In the first instance a solution of long-acting local anaesthetic, long acting anti-inflammatory steroid, and sometimes other pain modifying drugs is injected into one or both joints. If this is successful the joint can then be denervated in a similar way to facet joint denervation.

Selective nerve root block (SNRB) for diagnosis and back pain management Another common injection, a selective nerve root block (SNRB), is primarily used to diagnose the specific source of nerve root pain and, secondarily, for therapeutic relief of low back pain and/or leg pain.

Lumbar sympathetic block Injection needles will be positioned and then there are three main ways to produce the block: injection of a long acting local anaesthetic to produce a diagnostic block to safely see if your pain can be treated this way; injection of a neurolytic substance such as phenol or alcohol to destroy the lumbar sympathetic nerves; and the use of radiofrequency energy to similarly destroy the nerves in a highly controlled way.

Stellate ganglion block The stellate ganglion is a collection of autonomic sympathetic nerves, which lies in front of the spine at the level of your larynx. It can be a site where pain signals from the face, heart, or arm are processed. It can therefore sometimes be useful to block it.

Dekompressor discectomy The Stryker Dekompressor is a relatively new technique for the decompression of contained lumbar herniated discs. A special device the size of a needle is inserted into the affected disc. This then rotates like a drill removing some of the nucleus of the damaged disc, thus decompressing it and allowing the bulge to reduce. This in turn reduces the pain from both the disc and the nerve root.

Percutaneous disc nucleoplasty This is a relatively new technique for the decompression of contained lumbar herniated discs. A special device the size of a needle is inserted into the affected disc. This probe has radiofrequency electrodes at its tip and is slightly angled. It is moved around inside the disc vapourising a very controlled amount of disc nucleus, typically 1 – 2 ml.

Vertebroplasty It involves the injection of bone cement into the crushed vertebral body, which stabilises it and reduces pain by reducing movement at the fracture site. It is well established and straightforward to perform, usually as a day-case procedure. A newer alternative treatment is Kyphoplasty.

Kyphoplasty It involves the insertion of needles into the damaged vertebral body, through which balloons are passed. These are inflated under high pressure, which expands the VCF and corrects the deformity. Once corrected, liquid bone cement is injected into the vertebra to permanently fix the restored shape.

Spinal cord stimulation Spinal cord stimulation can be very effective at treating nerve pain (neuropathic pain) and dysfunction from a number of different conditions. It has been shown to be particularly effective at relieving resistant nerve pain such as lumbar radiculopathy following spinal surgery. It involves the implantation of a wire and a device the size of a matchbox.

Sacral nerve root stimulation This is a new and effective treatment for a number of loosely related bladder and bowel control problems. The other main treatment alternative is spinal cord stimulation. The main risk is infection, which can occur in up to 5% of patients.

Intrathecal pump implant Intrathecal drug delivery devices are advanced pain management systems for patients whose pain cannot be adequately be controlled by conventional oral or systemic analgesics. Delivery of strong painkillers such as morphine directly into the cerebrospinal fluid can avoid many of the unpleasant side effects of conventional drug delivery.

We can be approached through our website www.nucleotomy.com , www.ozonediscectomy.com . email : taria363@yahoo.com

Source:- http://www.groundreport.com/Business/Medical-tourism-starts-picking-up-in-Kashmir-valle_2/2915558