Do winters remind you of painful stiff joints and reduced mobility? Do they remind you of the phrase" feeling under the weather"?

In the journey of life,one may not even realise when the association of winter shifts from festivities to joint pains.It is not only the joint pains which flare-up, but other pain conditions such as muscular pains, nerve pains, headaches, backaches, fibromyalgia etc may also increase in severity. This problem is not limited to a certain age, with a sedentary lifestyle contributing to the increased incidence across all age-groups. Coping with pain in cold winter months requires extra efforts to avoid the worsening spiral of immobility and increasing pain. Scientific studies exploring the relationship between pain and weather, have had little consensus, regardless, this is commonly observed in clinical practice. One may appreciate that it’s not easy to evaluate the relationshipas multiple factors like temperature, sunlight, atmospheric pressure, humidity, diet etc change at the same time. The other variables like diet, mood and activity levels can have a secondary impact too.

Tips To Prevent Pain Surges In Winter

From a practical perspective, it is best to focus on what we can influence like lifestyle changes. Here are some suggestions

Regular exercise

Exercise has a beneficial impact on metabolism and promotes the release of essential body chemicals. This produces a sense of well being and helps combat stiffness and pain. Warm up helps to prepare the body for the exercise and reduce injuries.Static stretching which means holding stretch position while you’re cold is not a good practice. Stretch muscles only once you are warmed up. It’s best to start with regular, slow exercises under the guidance of professionals, keeping in mind one’s pain issues and fitness levels. The workout can be gradually increased as the body adapts to the new activity levels. Generally, light aerobic workout, swimming, stationary bikes and walking are good exercise options.Simple strategies like having an exercise buddy help to stay on track and motivated.Don’t let adverse outdoor weather become an excuse as there is the option of using indoor facilities such as a gym.

Layer up and stay warm

Right dressing gear not only keeps one warm but also promotesease of motion. Heavy, bulky clothing restricts activity and is difficult to wear. One may achieve the same warmth by using multiple less bulky layers, which have added advantage of the ease of removing. Body parts with comparatively less natural insulation can be protected by simple gear such as gloves and socks. This is more important for individualst roubled by hand, foot arthritis or cold extremities.  Maintaining a comfortable home temperature also helps to reduce inactivity.

Heat therapy

Heat therapy promotes elasticity and blood flow of tissues reducing stiffness and pain. Simple measures such as warm baths, heat pads and hot water bottle can often make a big difference in your activity and pain levels.

Sensible eating

One can easily fall victim to the indulgences of the festivities & holiday season by overeating. A balanced,healthy, natural diet containing fresh vegetables and fruits, essential mineral and vitamins such as calcium, vitamin D can go a long way in supporting your joints & bones.Avoid sugary, processed food, as well as foods high in saturated fat. Foods with anti-inflammatory effect or rich in antioxidants and omega 3 fatty acids can be beneficial. Keeping yourself well hydrated is equally important.

Maintain a healthy body weight

Less weight means less pressure on joints such as the knee and hip. Reducing a few kilograms and being in the optimal BMI range can make significant difference to pain levels and mobility.

Seek help early

Be cautious especially in areas where there is snowfall, early morning frost to avoid injuries and falls. Do not ignore your pain issues.A simple knee or back pain can significantly impair one’s quality of life. These conditions are often accepted as part of ageing, stopping individuals from exploring treatment options. An experienced specialist focusing on holistic management, rather than just treating the disease can help you achieve good outcomes.

How Pain Management can be helpful

Pain specialists routinely deal with persisting pain and have a good understanding of underlying mechanisms and ways of reducing the impact on life.  Pain clinics use a multi–disciplinary approach, where specialists from different fields such as pain specialists, physiotherapists, dietician, occupational therapists, psychologists workas a team to maximise your gains. For example, if one is suffering from knee pain due to osteoarthritis then for maximum pain reduction, one needs to supplement the pain interventions (injections or other procedures) and medications with reducing the load on the joint by weight management and strengthening the joint support framework by physiotherapy and occupation therapy.

Pain clinic interventions such as ultrasound, x-ray guided injections like nerve blocks and spinal injections are routinely performed low risk, minimally invasive procedures, without the need for prolonged hospitalisation. Simple day care procedures such as Radiofrequency treatment have the potential for providing prolonged pain relief for common problems like back and neck pain. The treatments offered in pain clinics often serve as alternative to more invasive options such as surgery and as a rescue technique if surgery has not achieved the desired goals.  Some of these options are unique and the technological advancement has opened new avenues in pain management such as cooled radio frequency for managing knee osteoarthritis pain and spinal cord stimulators for managing nerve pain. Besides these, the regenerative medicine options such as stem cells and platelet-rich plasma have the potential to change the way we look at managing some of these chronic conditions.

Like in other chronic conditions such as diabetes and blood pressure, your pain therapy also needs to be adjusted as your condition changes. It is time to address chronic pain as a disease and not just as a symptom…It is time to tap the huge potential that this relatively new branch of pain medicine has in the improvement in the quality of life.

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What Effect Does Exercise Have on Joint Pain and Stiffness?

The truth is that exercising is healthy for your joints and can relief them from stiffness and pain. The surrounding muscles and tissues play an important role in maintain the joint function and strength. Weak muscles and tissues will simply put further load on your joints.

The physiological benefits of exercise include reduced risks of:

• Diabetes
• Osteoporosis
• Obesity
• Hypertension
• Coronary artery disease
• Serum lipid abnormalities

The psychological benefits of exercise are equally powerful and immediately after exercising:

• Anxiety reduces
• Promotes relaxation
• Enhances mood and well-being

Exercise with joint pain and arthritis is not only possible, but it is also suggested for reducing symptoms and keeping joints active for many years to come.Exercises can be tailored to the requirements of the patient to ensure that the pain does not increase and plays a role in strengthening of the joint.

Here is how working out and exercising can help those suffering from joint discomfort

Exercise nourishes and lubricates the joints

Exercise also helps to reduce joint pain because it increases the circulation of synovial fluid, which lubricates joints. Exercise also helps in the free flow of oxygen and nutrients to the joints.

Exercise increases the blood flow

Every part of the human body, including the joints, requires good blood flow to function properly. Exercise is an excellent technique to increase blood flow and improve circulation. When a person with weak or painful joints exercises, the synovial membrane obtains more of the oxygen and nutrients it requires.

Exercise improves the range of motion

Exercise is more than just raising the heart rate and sculpting muscle. It’s also an excellent approach to increasing joint flexibility and range of motion. When the joints are regularly moved, they remain more supple and active. As a result, when daily activities put strain on the joints, they are more flexible and can withstand the extra pressure.

Exercise gets rid of cellular waste

Another significant advantage of exercise is that it eliminates cellular waste via a natural biological mechanism. Damaged cells in the joints that are no longer beneficial to the body can be eliminated by regular exercise, resulting in less pain over time.

Exercise helps build muscle around the joints.

Many people associate exercise with improving bulk and building muscle, but it also has important uses for arthritis patients. Exercise strengthens the muscles, ligaments, and tendons that surround the joints. When all of these components are strong, the joints may be cushioned and supported more efficiently, reducing joint pain.

Exercises for relieving joint pain

If the pain is severe then specialist opinion should be sought prior to commencing the exercises and one may be commenced on non-weight bearing exercises such as stationary biking or swimming. Nonetheless, the following exercises are frequently recommended for exercising with arthritis.

• Bicycling
• Walking
• Yoga
• Taichi
• Pilates
• Swimming
• Elliptical machine
• Body weight strength training

Many athletes with arthritis use over-the-counter topical pain-relievers after exercise to provide instant and long-lasting relief. But, regardless of what exercises are chosen, it is critical to start slowly and increase gradually with time. Fortunately, there are numerous forms of exercise available, as well as simple ways to alter exercises based on ones skill and ability. This means that all arthritis patients can find workouts that they love and benefit from.

Come see us for pain management

If you are experiencing joint pain, lack of mobility, stiff joints, or other physical difficulties, schedule an appointment with Dr. Amod Manocha, the top pain management specialist in Delhi and Gurgaon, as soon as possible to have your treatment plan tailored to your specific needs.

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What is sciatica?

Sciatica pain is felt along the sciatic nerve, which is the body’s longest nerve. Sciatica pain usually occurs when a bone spur or herniated disc compresses a spinal nerve root in your lower back, causing intense pain in your back, leg, and buttock.

Sciatica is more common in the elderly due to the normal wear and tear on the spine that occurs with age.However, younger people can have sciatic pain as a result of a fall, or an injury.

When you have sciatica, knowing what to do is as important as knowing what not to do, and by following these tips, you will reduce your chances of experiencing sciatica symptoms.

If you have sciatica, you may have tried everything to stop your pain, including physical therapy, and other drugs, but did you realize that every day there are several things that can aggravate your condition?

The do’s for recovering from sciatica

• Remain active and mobile: Severe pain may make bed rest essential for some time but retaining mobility as much as easily possible is essential as bedrest alone can be counterproductive. This is supported by research evidence and old days of absolute bed rest are only reserved for some specific conditions such as spinal fractures.
• Regular stretching: Stretching on a daily basis can be beneficial as can be yoga. However extreme stretches are best avoided when experiencing a flare up episode (increased pain).
• Strengthening exercises: Gentle strengthening activities are essential for future prevention and can work wonders in long term.
• Use heat or cold packs: While many people suffering with sciatica want to grab for an over-the-counter pain reliever, using either heating or cooling packs is an alternative option for pain relief. Heating pads might help relieve aching muscles that are tense. Cooling packs, on the other hand, can help reduce swelling/inflammation.

The don’ts for recovering from sciatica

• Stay away from complete bed rest: You can stay in bed for as long as you need to if you are in severe discomfort but try to maintain as much mobility as possible.
• Avoid Lifting heavy objects: You must follow your doctor’s advice, but in general, avoid lifting anything heavy especially during the acute phases of sciatica.Avoid bending and lifting objects from the ground as this places extra stress on the spine which our muscles and ligaments bear. When this is paired with the weight of the object you’re lifting, your ligaments, bones, and discs may get overloaded, causing injury. Combining twisting motions with other movements like forward or side bending should especially be avoided.
• Warming up before exercises is essential: Certain workouts with a lot of resistance can worsen your sciatica if you don’t warm up your muscles first.
• Sitting for long periods should be avoided: While many of us have professions that require us to sit for lengthy periods of time, sitting down can worsen or increase the frequency of pain. Standing desks/ variable height desksare an alternative to consider.
• Avoid taking long car trips: Of course, this isn’t always possible, but if you’re on a long trip, take frequent rests with regular change of position and stretching.
• Be mindful of your posture and ergonomics: prolonged unhealthy postures can cause increased strain of back and worsen the pain in long term.

The final word about sciatica. . . .

The majority of sciatica patients do not necessitate surgery. Usually, time and self-care therapy are all that are required. However, if basic self-care methods do not reduce your pain, interventions such as injections (nerve root blocks, epidural) can be considered. Feel free to get in touch with us for further information. 

How a pain management specialist can help with your sciatica pain

If you are suffering with sciatica pain and not getting relief, make an appointment right away with Dr. Amod Manocha, the best pain management specialist in Delhi and Gurgaon, to receive the best of his expertise and world-class treatment options.

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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 pain specialist 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.

In certain conditions they are able to offer interventions which are not available elsewhere.

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