Pain specialist doctor in Delhi

  What is Iliotibial band syndrome? Iliotibial band (ITB) is a thickened band of tissue that runs along the outer side of thigh from the pelvis to the shinbone (just below the knee joint). It helps to transmit forces from the hip to the knee and acts a stabiliser of the outer side of knee, playing an important role in postural control. With bending and straightening of the knee this band moves over the lower outer end of thigh bone and sometimes repeated motion can cause the ITB to irritate the surrounding tissues. This is addressed as iliotibial band syndrome (ITBS) or IT syndrome. It manifests as pain along the outer side of knee after repetitive motion. Although anyone can develop this condition, it occurs more frequently in athletes and those participating in activities involving frequent knee bending and straightening. Key points about iliotibial band syndrome Iliotibial band syndrome causes pain on the outer side of the knee This condition can affect anyone, although is more ...

  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 f...

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...

  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 headac...