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Back Pain Treatment in Delhi From Pain Specialist in Delhi Dr. Amod Manocha
Pain Specialist in Delhi
In simple words, low back pain can be defined as pain experienced in the bottom region of spine (between lower margins of ribs and the gluteal folds). It may remain localised to back or radiate to the legs.

Sciatica is a term used for pain radiating down from the lower spine to the legs. Most common cause of sciatica is irritation or compression of the nerves as they exit the spine on their way to the legs. It may be accompanied by numbness, tingling and weakness in the distribution of the affected nerve.

Globally low back pain (LBP) is one of the leading causes of disability. LBP is an important cause of limitation of activities, absence from work with resultant economic implications. In industrialised countries lifetime prevalence of non-specific low back pain is estimated at 60–70%.Despite the high incidence and intensive research into this area, pain generators are not easy to identify and the diagnosis Nonspecific Low Back Pain is used commonly. This is different from situations where a specific cause such as fracture, infection, neoplasm etc. responsible for pain generation can be identified.

Potential Sources & Causes
Back pain can originate from numerous sources and some of the common causes include

Disc herniation (Slipped Disk), degenerative disc disease
Facet and Sacroiliac Joints
Muscle and ligament sprains/injuries
Narrowing of spinal canal- Spinal Stenosis
Spondylolisthesis
Fractures, trauma
Autoimmune diseases
Infections

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Neck Pain Treatment Gurgaon by Pain Specialist in Gurgaon Dr. Amod Mancoha
Neck Pain Treatment in Gurgaon

Neck Pain is a pain posteriorly anywhere between the skull base and thoracic spine. It is the largest cause of musculoskeletal disability after low back pain. Approximately two-thirds of the population will suffer from neck pain at some time in their life with high prevalence in middle ages. Fortunately for most people the acute pain resolves within days or weeks although in some it may reoccur or become chronic.

Neck pain may be a result of...

Local pathology
Whiplash (flexion-extension) injuries/ trauma
Be a part of a more widespread systemic problem such as ankylosing spondylitis, rheumatoid arthritis, fibromyalgia etc.
Be a result of referred pain from neighboring areas for example the shoulder joint

Neck pain usually has a multifactorial etiology -poor posture, neck strain/injuries, anxiety, depression and stress can play a role in magnifying the perceived pain. Quite often the diagnosis of simple or nonspecific neck pain is used implying postural and mechanical causes; this is contrary to other serious causes of neck pain such as fracture, tumour, infection etc.

Pain from upper neck can radiate towards the head leading to frequent headaches and that from the lower part of the neck can radiate to the shoulder, arm, chest wall and the scapula. Reduced neck movement along with localized areas of muscle tenderness known as trigger points are commonly observed along with pain.

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Sport Injury Treatment in Delhi by Pain Specialist Doctor in Delhi - Dr. Amod Manocha
Sports Injuries Prevention

Overuse and trauma are two common factors responsible for sports injuries. Both intrinsic (such as age, fitness level, muscle strength etc) and extrinsic factors (such as equipment, environment, type of activity etc) play a role in injuries.

Prevention of injuries may involve changing of training schedule, gear, training, practicing environment and style and many other factors. Primary prevention deals with prevention of an injury whereas secondary prevention is about prevention of re occurrence of injury. As "Prevention is better than cure," here are some tips that can help you prevent sports injuries. Whilst most of these may seem like common knowledge, you would be surprised by how many injuries can be avoided by following these tips.

Tip 1: Understand the importance of physical conditioning and know your limits
This factor is often overlooked by amateurs who easily succumb to temptation and overindulge. It is easy to get carried away when you return to sports after a long time. Knowing ones limits, gradually increasing the intensity and duration of training can help in injury prevention. Regular exercise is an effective way to energize your body and keep fit. On the other hand aggressive training beyond ones capabilities and the resulting overuse, fatigue, poor judgment makes injuries more likely.

Be mindful of old injuries and listen to your body. Warning signs such as joint pain, tenderness, and swelling are reasons to re-evaluate your technique and routine.

Tip 2: Invest in the right sporting gear
This includes every essential bit of equipment required for playing a particular sport, starting from the right shoes to the protective equipment such as helmets, gloves, protective pads etc. Right gear not only protects you from injuries but can also enhance your performance.

Tip 3: Warm and stretch your muscles
Warmed up muscles are less prone to injuries and overlooking warm-up sessions can cost one dearly. Warm up raises the core body temperature and gears up the body for the intended exercise. It helps by increasing the blood flow to muscles improving the muscle efficiency, range of motion and stretching the muscles being used in particular sports. Stretching to the point of tension (not pain) helps to reduce stiffness and improve flexibility, thereby reducing the chances of injury.

Warm up may be general or specific to the intended sport. The right exercises would vary depending on the sports. Starting the sport at a slow pace can be helpful. If you closely observe your sporting idols, you will always see them warm up prior to any game.

Tip 4: Use the right technique and follow the rules of the game
Correct techniques to play a sport are defined to minimize the chances of injuries and maximize your performance. The same can be said about the rules of the game. Incorrect overzealous manoeuvre can predispose one to injuries and hence the importance of concentrating on the precise technique. One example which I can quote as I commonly see this in my clinic is back injuries due to incorrect dead lift technique. Often that temptation to add the extra 5kgs compromises the technique predisposing one to injuries.

Selecting the appropriate surface for sports is equally important especially for repetitive activities such as running, jumping where the impact force on the body is magnified by 3- 12 times. Impact force on hard surfaces is much higher increasing the injury chances.

Tip 5: Cool down
Cooling down is another injury prevention technique that helps to return the heart rate, breathing, and blood pressure to the pre-training levels. It can also help to limit the post exercise muscle soreness and flush out toxins produced during the training.

Tip 6: Adequate recovery
Adequate recovery is essential no only for avoiding injuries but also for the full training effect. Inadequate recovery can lead to tiredness, lethargy, mental fatigue and impaired performance. Adequate recovery includes warm down sessions, re stand sleep, psychological and nutritional advices.

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Best knee Pain Treatment in Delhi, Pain Specialist in Delhi - Removemypain
Knee Pain Treatment in India

Knee pain can be a source of significant disability in all age groups as it limits mobility. It can be classified into traumatic or non traumatic and based on the site of pain into anterior, medial, lateral and posterior. The common reasons for knee pain vary with age group and pain site. Pain from other sites such as hip and lumbar spine can also present knee pain. In the above 50 years age group raised BMI is an important risk factor for developing symptomatic osteoarthritis.

Genicular nerve blocks & radiofrequency ablation
This procedure is performed for chronic knee pain which may be secondary to various reasons such as osteoarthritis, degenerative joint disease and persisting pain after knee replacement. It offers a safe, effective non surgical alternative to knee replacement for patients who are either not keen or are unfit or have persisting pain after knee replacement. Genicular nerve radiofrequency is performed as a day case under local anaesthesia with no requirement for hospital stay or prolonged rehabilitation.
Knee joint is supplied by branches from many nerves and these are collectively addressed as genicular nerves. The initial diagnostic procedure involves local anaesthetic injections close to the nerves supplying the knee joint. If the diagnostic procedure produces effective pain relief then special type of radio waves are applied to these nerves, which can produce prolonged pain relief (radiofrequency ablation). The procedure alleviates pain by creating a heat lesion around the nerves which interrupts the transmission of pain signals to the brain. These nerves are approached percutaneously under x-ray and ultrasound guidance with no requirement for any surgical incisions.

Cooled Radiofrequency Treatment
Cooled Radiofrequency treatment is an option for those suffering from chronic knee pain and not keen on surgery or those left with persisting pain after knee replacement surgery. It is a minimally invasive treatment done on day care basis under local anaesthesia. The treatment aims to deactivate the nerves responsible for transmitting pain signals from the painful knee. It involves placing needles close to these nerves under x ray or ultrasound guidance followed by heating of nerves to reduce the pain signals being transmitted. It differs from conventional Radiofrequency as it has water circulating through the device and can create a larger treatment area increasing the chances of success. Normal activities can generally be resumed soon after the procedure. Less pain can lead to improved functionality and reduced medication requirements.

Saphenous nerve block & pulsed radiofrequency
Saphenous nerve is a sensory nerve which supplies the medial (inner side) of knee joint and leg. This nerve can get entrapped or injured high up in the thigh leading to groin and inner thigh pain or lower down causing knee and calf pain. Trauma and surgery are common reasons for injury especially of the infrapatellar branch of the nerve.
Most patients present with pain, increased sensitivity along the inferomedial aspect of knee although it is not uncommon to see pain involving most of the anterior knee. A nerve block can be easily performed under ultrasound guidance as a diagnostic test followed by radiofrequency treatment to produce long term pain relief.

Ultrasound guided knee joint, bursa injection
An ultrasound scan of the knee can help in identifying knee pathology and help guide the injection into the desired location. The injected drugs vary depending on the pathology being treated. The options include local anaesthetics, steroids, Hyaluronic acid or Platelet Rich Plasma (PRP). Injections around the knee joint can be either
Directly into the joint
Into the tissues surrounding the joints - such as bursa
Into the muscle or localized tender points
Hyaluronic acid occurs naturally in the cartilage and the synovial fluid that lubricate the joints. In people with osteoarthritis, injections of artificial hyaluronic acid into the joint can help in reducing pain and improving mobility.

Platelet Rich Plasma (PRP) injections
Platelets are one of the blood components. They help in clotting and contain growth factors which promote the healing process. PRP is blood plasma with concentrated platelets. PRP therapy is an attempt to utilise body’s natural ability to heal itself. Growth factors released from the platelets influence and accelerate the repair of tendon or ligaments. The procedure involves collecting a blood sample from the patient which is then placed in a spinning machine to separate different blood components. The component containing high platelets is separated and then injected under ultrasound guidance. Most people require 1-3 injections at 4 weekly intervals.

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Dr. Amod Manocha is The Pain Specialist Doctor in Delhi, Pain specialist in Gurgaon, Best Pain Specialist in South Delhi - Removemypain
Dr. Amod Manocha - Pain Specialist In Delhi and Gurgaon

Dr. Amod Manocha is the Head of Pain Management Services at Max Super Speciality Hospital, Saket. He is trained as a Pain Management Specialist and an Anaesthetist in the UK. He has over 13 years of work experience in the UK including working as a Chronic Pain Consultant in many UK hospitals. Dr. Manocha believes in multidisciplinary approach and providing evidence-based treatments at par with international standards. He is committed to providing quality care and believes in building long-term relationship with patients based on honest communication and keeping their interests foremost.

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