With age you do become more prone to developing conditions such as arthritis but for most people pain control can be optimised to reduce the impact on quality of life. This requires willing to invest time and effort on part of the affected individual.

Choosing your Pain Specialist

In the field of medicine learning continues for life and keeping up to date with the latest evidence, technological developments are essential. Understandably, around the world, there is a huge variability in the pain treatments offered based on local expertise, risks involved, ethical and social considerations, lifestyles, patient expectations and believes. Treatment cost has a huge bearing on the offered/ accepted treatment modalities.

When it comes down to choosing your doctor everyone wants the best. Not the second to best but the best. So how do you decide who is best? Or is there something like the best doctor?

• For most individuals if a doctor in the media/limelight and treats renowned people then he must be good
• For others if the doctors name comes high up on internet search engines then he/she is assumed to be good
• Some rely on the feedback/ experiences of previous patients
• Word of mouth or recommendation is important for some
• Perhaps a foreign degree/ experience is a clincher for others

If I had to choose, who treats my pain, I would not be looking at just the doctor, but also for the setup he works in. For me the key question is – will he/she be able to offer me the comprehensive services required for a long lasting solution to my pain issues.

The most important component of treatment plan is diagnosing the source on problem (if possible) and deciding on what can be done for sustained, long-lasting benefits. This requires contribution from the individual in the form of life style modifications, weight management, regular physiotherapy etc. The process starts with education patient about his condition, advice on do’s and don’ts …is your best doctor willing to spend time on these???

Equally important is to be reasonable assured that your doctor has received the necessary training and experience to safely deliver the proposed treatments

For me I need a specialist

• Who understands pain
• Who looks at pain not just as a symptom, but as a disease and
• Tries to reduce the impact on life
• Someone who is willing to make a difference, to work with me and help me move towards my goals
• Someone who may not have all the answers but is willing to search for them

Someone for whom every pain is a mystery…. waiting to be solved…. One consultation with the Doctor should be more than enough for you to gauge whether you are with your best doctor or do you still need to carry on searching….. Good Luck

The post Quest For The Best Pain Doctor appeared first on Dr Amod Blog.

Acute pain is the pain that is present after an injury until healing occurs. Pain in this situation is a protective response bringing our attention to the affected area and helping us protect, rest the affected tissue providing an opportunity for healing. As the tissue heals, the pain gradually abates.

Chronic or persisting pain is pain that persists even after the usual time required for healing. It is important to understand that chronic pain does not always signify on-going damage. Nerves have a memory (plasticity in medical terms) whereby they develop changes which remain even after the original inciting problem is corrected. A simple example to explain this is persisting leg pain even after amputation of the affected part. There are numerous mechanisms to explain this and your doctor can help you understand these better.

Impact of chronic pain is not limited to the involved person but also affects their loved ones and family members. The longer it persists the more chances that it will have an impact on multiple aspect of your life including your ability to work, sleeping pattern, mood, social life, relationship with family and friends etc. Hence it is important to take corrective measures to reverse or control the condition as soon as possible.

The management varies depending on the actual pathology, severity, co morbidities, patient preferences, available resources/ expertise and many other factors. At your first consultation with me you can expect a detailed assessment including history, examination and review of investigations. This is aimed at identifying the underlying reason for pain, so that an appropriate personalised management plan can be made. Some more tests may be requested as necessary. Close liaison with specialists in other fields such as neurology and surgery is maintained to formulate the best plan tailored to your condition and requirements. Some of the common pain treatment modalities include:

Medical management

I normally review your current medications and any existing medical problems prior to suggesting new medications or changes to current medications. Therefore it is a good idea to carry a detailed list of your medications and make of list of the ones you may have tried previously. Doses of medications tried previously are equally important as some medications if not used in right doses for the required duration are unlikely to be effective.

Different types of pain may need treatment with different medications, for example pain of inflammatory origin maybe be effectively managed with anti-inflammatory medication and pain due to irritation of nerve may need medication which help to desensitize the nerves. Hence the importance of identifying the likely pain generators prior to prescribing medications.

Interventional procedures

In certain situations I suggest procedures such as

• Injections/ radiofrequency procedures that help to reduce the pain signals being transmitted by the nerves to your brain
• Injections directly into a joint space/ around the area of problem such as a tendon or bursa which can help reduce the inflammation more effectively than medications taken orally. These procedures along with being therapeutic may also help the consultant confirm diagnosis

Regenerative medicine has opened new avenues where cells from your body are used to promote healing and reduce pain. Awareness of options such as Platelet-Rich Plasma (PRP) and stem cells is increasing and new research in this area is improving our understanding day by day.

Some interventional procedures can be done in the outpatient setting, whereas others will require a day case admission. This depends on the procedure being performed and your general health, other medical problems. We aim to reduce your pain as much as possible by offering you most appropriate interventions keeping your goals and preferences in mind and with an integrated multi speciality team approach based on biopsychosocial model of pain you have best chances of managing your pain.

Role of Physiotherapy

There are few common elements in management of most chronic pain situations like weakness accompanied by disuse of affected part for long time will require gradual mobilization and strengthening. A good chronic pain physiotherapist offers more than physiotherapy. They play an important role in

• Patient education regarding their condition, do’s and don’ts specific to their condition,
• Setting realistic goals-dividing exercises into smaller achievable steps
• Help patients understand and implement pacing of activities
• Promoting compliance, increasing confidence and making you self reliant
• Challenging your unhelpful thoughts, mitigating any false believes and minimising catastrophisation

Role of Psychology

Chronic pain can generate significant distress, anxiety and depression and all these, in turn, can magnify perceived pain. This is a normal human reaction which is often more visible to friends and family. Addressing these factors can help in reducing perceived pain and in improving quality of life. Psychologists can help you by challenging maladaptive beliefs, attitudes and emotions. They can help by

• Teaching coping and self-help strategies
• Relaxation techniques- these can be a useful tool especially in dealing with sleep disturbances and periods of increased pain
• Cognitive Behavioural Therapy (CBT)

Consult Best Pain Specialist In Delhi, Dr. Amod Manocha.

The post Treatment modalities in chronic pain appeared first on Dr Amod Blog.