Cooled Radiofrequency For Knee Pain Treatment In Delhi

Why do you experience chronic knee pain?

Chronic knee pain troubles a significant number of people worldwide. It is a common problem amongst the aging population, and can indeed be very painful and debilitating, sometime even confining individuals to the bed. The most common cause of knee pain in elderly is osteoarthritis (OA), a condition where the cartilages of the knee joint have worn out due to wear and tear. This results in friction between the bones of the joint during movement which results in pain. The impact is more in overweight and obese because of the extra load on the knees. The risk of knee OA in overweight women is nearly 4 times and in overweight men is 5 times greater. It is not just the mechanical factors which promote OA in obesity but also the co-existence of disordered glucose and lipid metabolism and the highly metabolic and inflammatory environments have a significant role.

What can be done for chronic knee pain?

Initial management involves lifestyle modification, supplements, simple pain killers and physiotherapy. It is estimated that an extra Kg of weight exerts a force of nearly three to six times across the knee while walking. Thus, weight loss is an important modifiable factor in the treatment of knee OA which the affected individual can drive. Various studies have demonstrated that weight loss improves both pain and function in obese subjects with knee OA.

Local injections are considered depending on the severity of problem and other factors such as age, functional status etc. When the pain and discomfort is severe your doctor may offer you the option of undergoing a knee replacement surgery. This involves removal of the worn out part of joint, shaping the ends of the bone and placing a metal implant. This reconstruction of the knee joint allows for smooth, pain free movement for most individuals. However some, even following the rehabilitation process, continue to experience pain.

For those who are

• Not keen on the replacement surgery or
• Not fit to have one or
• Continue to have pain after knee replacement surgery

Cooled Radiofrequency is an alternative treatment. Details about this treatment can be found in the Knee pain section of the website and in old blogs.

What causes continued pain following surgery?

The causes of knee pain following replacement surgery can be located inside the joint (intra articular causes) or outside the joint (extra articular causes).

The intra articular causes include:

• Knee joint instability
• Loosening of the implant
• Infection of the bone or the joint space
• Problems related to the kneecap (patella)
• Osteolysis (loss of bone)
• Issues related to size or type of implant

It is important to rule out the extra articular causes when a patient complains of persistent knee joint pain following surgery, because they can have serious consequences if they are missed.

The extra articular causes include:

• Localized knee problems such as tendinitis and bursitis
• Pain radiating from the  nearby joints/body parts such as spine, hip and ankles
• People who have ongoing psychological illnesses will also tend to experience longer postoperative pain
• Nerve injuries/ problems

The focus of a recent research in Oxford, UK has been weather the knee replacement should be done earlier and not as a last resort. The authors suspected that long term persisting knee pain can lead to changes in the nervous system (nerves, spinal cord and brain) which can be responsible for persisting pain even if the original cause is corrected. 

Diagnosing the problem:

You doctor will go through multiple steps in order to evaluate the pain you are experiencing. This process includes, taking a detailed history of the pain, such as when what type of pain you are experiencing and when you experience it the most. Then your doctor will go on to examine the knee, which will help him/her to further narrow down on probable causes & identify problems such as stiffness, swelling, and issues with alignment of the joint.

You will be asked to undergo investigations such as, X-ray, MRI, blood tests including inflammatory markers such as CRP and ESR etc.

How to manage this condition?

Depending on the cause of your pain, you doctor may suggest a variety of treatment plans. On some occasions pain relief medication may help to control the pain, and even get rid of it completely. Physiotherapy is another option which has proven to be effective in managing pain following knee replacement surgery. Nerve blocks are sometimes offered if nerves are suspected to be the pain generator.  Cooled Radiofrequency of the nerve supplying the knee can help in reducing or resolving your pain issues.  Sometimes repeat surgery such as revision knee replacement is required If.

Tags >> Pain Specialist In Delhi, knee pain treatment in delhi, Cooled Radiofrequency Treatment In Delhi

Pain Management In Delhi provides Fibromyalgia Pain Treatment In Delhi

Symptoms you should know 

Fibromyalgia is a chronic condition characterized by widespread body pain.  Other common symptoms in fibromyalgia include unrefreshing sleep, tiredness/fatigue, low mood and memory problems.  It is more common in women and is commonly known as ‘fibro’ or "fibrofog". No clear pathophysiological mechanism for fibromyalgia has been established, but there is evidence that patients have abnormality pain processing with increased sensitivity to various stimuli such as pressure.
As the symptoms tend to be non-specific, and there are no specific tests which can be carried out to diagnose, fibromyalgia can be challenging to diagnose. It is important that you explain your symptoms correctly and in detail to your doctor as it can aid in establishing the diagnosis.  Fibromyalgia often occurs in patients with other conditions, such as inflammatory arthritis and osteoarthritis and is not a diagnosis of exclusion.
So, if you are experiencing longstanding constant widespread body pain, with varying distribution and the cause for the pain cannot be explained by any other abnormality detected, then it might be possible that you are suffering from fibromyalgia. The symptoms are generally managed using a range of drug and non drug mechanisms. Some of the common symptoms in fibromyalgia include:

Widespread body pain and tenderness

This is the most common reason for which patients seek medical opinion/ vsit a pain specialist doctor in delhi. This differs from other conditions such as arthritis as the pain in not localised to one area or the joints only. Muscle and joint pain is commonly seen in majority of patients. The pain may vary in severity and nature (dull ache/ heaviness/ throbbing /burning) . Most often the pain is continuous although in some it may be intermittent; some others feel like the pain keeps travelling from one area of their body to another. Patients may have areas which are tender to touch with increased sensitive to pain. Long term persisting pain can lead to inactivity which can further promote deconditioning of muscles and worsening pain. It can also lead to physically inactive maladaptive posture & gait, bursitis and tendinopathies.

Fatigue

A constant feeling of tiredness is another common symptom present in majority of fibromyalgia patients. Even after adequate periods of rest fibromyalgia patients may feel like you don’t have the energy to get through the day. Intense workouts may be a thing of the past with basic daily chores becoming an uphill task. Slowly it may start to affect other dimentions of life such as relationships, social life, work etc.

Sleep disturbances

No restorative sleep, inability to sleep and fatigue are common in fibromyalgia patients. Patients generally feel tired in the mornings. Sometimes, because of the easy fatigability, even though you fall asleep quickly the sleep may be interrupted and non refreshing. Pain and emotional disturbances may contribute to the sleep disturbances.

Mood variations

More than half the patients diagnosed with fibromyalgia, suffer from mood disturbances such as depression or anxiety disorders. And it is no surprise that people tend to feel low and worried all the time when they are experiencing pain all over their body for a long period of time. When you are having a hard time managing your day to day life, when basic functionality is like a challenge to, it’s only natural that you are going to feel a little hopeless and anxious about it. Staying active and staying connected is something that you have to make a huge effort for.

Memory problems and impaired concentration

The name fibrofog comes from the memory issues seen in fibromyalgia. Fog represent the lack of clarity or haziness. It’s a very common symptom amongst patients, where they complain of forgetting basic things like where they have left their keys, and not remembering plans they have made.

Tingling sensation in extremities

Some experience tingling sensation in their extremities especially on their toes and fingers, while some others complain of numbness. The term paresthesia is sometimes used to address these symptoms. These symptoms tend to flare up from time to time, although in some cases they can be a constant feature.

Other associated problems

Headache
It is a common problem which tends to interfere with the individuals daily life, and can be debilitating. They often develop a migraine or tension headaches from time to time. Sometimes a headache can also be due to the stiffness of the muscles in and around your neck region and upper back.
Irritable Bowel Syndrome:
There are occasions when people suffering from fibromyalgia complain of abdominal pain, have a bloated sensation in the abdomen and experience episodes of constipation or diarrhea. All of this is because of a condition known as irritable bowel syndrome. Individuals can also experience a feeling of regurgitation following meals, which is due to gastro-esophageal reflux disease, which is also associated with fibromyalgia.
Restless legs & leg cramps
Since patients having fibromyalgia, complain of a variety of symptoms as mentioned above, it is not difficult to miss the diagnosis. Therefore it is very important that you discuss your symptoms at length with an experienced doctor.

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The Pain Specialist Doctor in Delhi – Removing Pain and Restoring Fulfilled Life

Pain Management Centre In Delhi For Chronic Pain Treatment In Delhi

Pain is a common reason for medical consultation. Over the years, studies evaluating the Global Burden of Diseases have found chronic pain conditions amongst the leading causes of disability worldwide. The impact of chronic pain can vary, ranging from an occasional distraction or discomfort to constant severe debilitation. Some examples of common chronic pain conditions include back and neck pain, sciatica, diabetic neuropathy, headache, frozen shoulder, persisting post surgical pain, cancer pain, abdominal pain, pelvic pain and fibromyalgia. Pain in a significant proportion of these conditions is amplified by stressful and sedentary life style with obesity, lack of regular exercise, smoking, poor workplace ergonomics contributing to the increasing incidence and severity.
Chronic or longstanding pain does not always signify ongoing damage. Conditions such as arthritic knee or back pain are often accepted as part of aging process, stopping people from exploring treatment options.  It can, however, cause significant distress and compromise the quality of life. With the correct help, you can control your pain better and make your life easier. A best pain specialist doctor in delhi can help to diagnose the cause of your pain and work towards relieving/ reducing it and minimise the impact on your daily routine. This is how the approach of pain management specialists is different:

Knowledge and experience

When you receive specialist training in a subject and deal with specific conditions on a daily basis (chronic pain in this case) your experience/ learning is bound to reflect your treatments and outcomes. The education and the training received helps in successfully diagnosing and treating pain issues. In India the opportunities for specializing in Pain Medicine are limited with no nationally ascribed curriculum. In the western countries pain medicine is reorganized as a separate specialty with numerous training and super specialization opportunities. Pain clinics form an integral part of most reasonable sized, good hospitals. Pain specialists generally undertake a detailed assessment of every aspect of pain and try to address problems comprehensively.
 I have spent a year doing pain research and another year in pursuing advanced training in the field of pain medicine in London, UK. This is addition to the basic and intermediate training in pain medicine during my 7 years of initial anaesthesia training in London, UK.  Subsequently I have worked as a Chronic Pain Consultant in UK.

Treating the cause of the pain and not just the symptoms

Pain specialists try to explore why a problem may have occurred as this is important to prevent reoccurrences. Once the underlying problem has been resolved, the pain may automatically ease off giving you lasting relief. This is better approach than just taking medications for temporary relief. Understandably this may not be possible in all cases but this should not become a deterrent to trying.

Treating the body as a whole

Pain management specialists are trained to visualize body as a whole and use a multidisciplinary approach while addressing chronic pain. They don’t concentrate on just controlling the pain, as they understand that pain can affect multiple facets of life from mental health to relationships to jobs to social life etc. Each person is unique and experiences/ processes pain differently and hence the need for individually tailored therapies. They use a combination of modalities including physiotherapy, medications, injections/ interventional therapies, psychological therapies, Complementary and alternative therapies including Acupuncture, TENS, acupressure, and meditation along with patient education to achieve the best possible results.

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Pain Specialist Doctor in Delhi, Dr. Amod Manocha is Innovating Pain Management Medicine Discipline to Improve Quality of Life