Pain specialist doctor in Delhi

  Chronic Post Surgical Pain (CPSP) Chronic post surgical pain (CPSP) is pain localized to the surgical site or a referred area persisting 3 months after surgery. To diagnose CPSP pain should have been absent before surgery or should have different characteristics from preoperative pain. Other possible causes of the pain such as infection, recurrence of original problem etc need to be excluded. CPSP is a common complication of surgery and rates up to 80 % in adults have been reported in some studies. CPSP is also reported in children although the incidence is less than in adults. It can have significant consequences for the individual and the World Health Organisation plans to include this as a separate diagnosis in the upcoming version of the International Classification of Diseases, ICD-11. Type of surgery influences not only the risk of development but also the severity of CPSP. Some surgeries are more prone to develop CPSP such as amputations, thoracotomy, and mastectomy. It is obs

 Dr. Amod Manocha 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. Professional Qualifications Fellow of Faculty of Pain Medicine, Royal College of Anaesthetists (FFPMRCA) Royal College of Anaesthetists, London. Fellow of Royal College of Anaesthetists (FRCA) Royal College of Anaesthetists, London. Post Graduate Diploma in Musculoskeletal Ultrasound (PGD MSK US) University of East London, UK. Post Graduate Diploma in Rheumatology University of South W

  Shoulder pain   may be an isolated problem localised to the shoulder or be a part of widespread pain as in rheumatoid arthritis. A combination of history, examination and diagnostic investigations is utilised to identify the pathology and guide further management .  Diagnostic ultrasound scan   is an effective bedside tool as it can reliably identify common shoulder pathologies and reduce the requirement of additional investigations. I routinely perform ultrasound scans at the time of initial assessment. This reduces the requirement of additional investigations and if required a guided injection can be performed at the same time. Some of the common reasons for shoulder pain include Inflammation, injury or weakening/tear of muscles and tendons around the shoulder joint (rotator cuff) Damage to bones, cartilage of shoulder joints as in arthritis of glenohumeral, acromiocalvicular joint Bursitis (Bursa allow for smooth sliding of tendons or muscles over the joint or frictional areas) Fr

Herpes Zoster is caused by the reactivation of the same virus which causes chickenpox. If you have had chickenpox before, the virus lies inactive in the nervous system till the time it gets an opportunity (such as in old age or when body’s immunity is reduced) to spread along the nerve. This produces the typical rash of Herpes Zoster accompanied by pain, numbness, itching, skin pigmentation and sometimes scarring. One out of five patients goes on to develop PHN where the pain persists for more than 120 days after the onset of rash. PHN is rare in age group below 50 years and incidence increases after the age of 60 years. Risk factors for PHN or persisting pain include older age and widespread rash with severe pain at onset. Presentation Pain character in PHN is generally burning, shooting, throbbing or electric shock like and this may occur spontaneously or in response to stimuli. It is most commonly observed in chest wall region (thoracic dermatomes) and in the distribution of ophtha

  Thoracic spine and Chest wall Pain This section covers pain anywhere between shoulders to the bottom of ribs. It can arise from Inside the thoracic cavity (inside chest) From the chest wall including the thoracic spine Be referred from the neighbouring areas and structures such as abdomen, cervical spine. Chest wall pain  can originate from any of the chest wall structures including bones, joints, muscles, cartilage, ligaments, tendons, nerves, skin and soft tissue. It generally increases with arm movement and is accompanied by localised tenderness. Some common conditions/situations leading to chest wall pain are Prolonged unaccustomed physical activity. This may cause  muscle soreness  which can persist Trauma/fall with  fracture of ribs or vertebrae . In presence of osteoporosis even trivial trauma can lead to fractures. The event may be difficult to remember specially when the onset of pain is delayed Spine  can be a source of posterior chest pain. Pain may arise from joints inclu

  Sacroiliac Joint Pain What are sacroiliac joints (SIJ) and where are they located? The sacroiliac joint is large, strong joints between lower end of the spine and the pelvis. There are two sacroiliac joints, one on each side. These joints play an important role in transmitting the upper body weight to the hips and legs and hence undergo a significant amount of stress in day to day life. They function as shock absorbers and are reinforced by multiple strong ligaments. Sacroiliac joints are supplied by a number of nerves which when irritated can hurt. What causes sacroiliac joint pain? Sacroiliac joints do not allow much movement as both too much and too little movement can become a source of pain. Some of the causes of SIJ pain include Trauma/ injuries involving the joints or the surrounding ligaments such as following a fall on the buttock or a road traffic accident. Mechanical stress due to various reasons such as previous spinal fusion surgery or leg length discrepancy leading to a

  Chronic Headache Headache is a common problem. Fortunately a significant proportion of headaches can be managed by commonly used painkillers. In certain types of headaches prophylactic agents are used to reduce the frequency of attacks. However, there still remains a subgroup of patients with difficult to manage headaches despite all measures. For this subgroup pain clinic offers  interventions and multi-disciplinary input , over and above the traditional approach of using painkillers.  Multi-disciplinary approach helps in addressing concomitant magnifiers/ triggers such as anxiety, depression, altered sleep cycle, medication overuse, life style and poor posture. In clinical practice, an overwhelming majority of headaches are either a tension-type headache, migraine, cluster headache or medication overused headache. Extra cranial sources of headaches such as nerves, joints and muscles can be easily missed. The term  Cervicogenic Headaches   is used for headaches originating from cer