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All About Sciatica or back pain

All about Back Pain or Sciatica | Chronic Spine Pain

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels from the low back down the sciatic nerve into the back of the legs.

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels from the low back down the sciatic nerve into the back of legs.
It is a very common condition with a prevalence of about 1 million cases per year in India. Sciatica is commonly due to entrapment or irritation of the sciatic nerve which is one of the main nerves of the lower limb. The most common cause is a prolapsed disc (slip disc). Although the incidence is more after the age of 40, with sedentary lifestyle, younger patients are also affected.

Symptoms of Sciatica:
1. Low back ache / hip pain radiating to legs
2. Electric shock like sensation / tingling /numbness in legs
3. Spinal pain aggravated on bending forward
4. Back pain while standing up from the sitting position
5. The pain of Sciatica can be excruciating and “not relieved by simple painkillers”.

How is Sciatica Diagnosed?
1. Detailed history along with thorough clinical examination
2. X ray of Lumbosacral spine
3. MRI of Lumbosacral spine

Our Non-Surgical Treatment Plan for Sciatica:
1. Initially a trial of medicines is given according to severity of pain and general health.
2. Physical rehabilitation of your spine will be done by our specialist through physical therapy and exercise along with medication.
3. You will be explained in detail regarding posture / ergonomic corrections in your daily life for preventing further aggravation of your condition.
4. Patients who have severe pain will be treated with “Epidural Steroid Injection”. This treatment has proven efficacy in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?
Epidural Steroid Injection is a proven, safe and an effective treatment based on the concept of Interventional pain management to relieve the pain of Sciatica. Epidural Steroid Injection is a procedure done in an Operation Theatre using X-Ray guidance to locate the exact level of injection. A drug mixture consisting of a Steroid with Local Anaesthetic is injected into the epidural space of the affected nerve root. Steroid has anti-inflammatory properties thus decreasing nerve inflammation resulting from disc prolapse. This is a day care procedure i.e. the patients are discharged on the same day. Generally, a single injection is sufficient to relieve patients of their pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient’s response.

*If you have Sciatica with following symptoms, you may require spine surgery:

  1. Weakness of legs
  2. Loss of sensation over legs
  3. Loss of control over urine or stools
  4. Trauma to spine.

Non-Surgical Treatment Options for Back Pain Or Sciatic pain available at Painex:

  • Root Sleeve Epidural Injections/Transforaminal injections
  • Cervical Epidural Injections
  • Facet Blocks
  • Spinal Cord Stimulation
  • Radiofrequency Lesioning

Please consult with our Super Sepcialised Pain Management Doctors today, Click here to book an appointment.


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Knee Pain : Its Causes, Prevention and Treatment

Knee pain is one of the most common problems we come across at pain clinics.

Why is Knee Pain So Common?

The knee joint is a large hinge type of joint which consists of 3 bones, 3 joints, about 11 ligaments and 13 bursae. Thus, it is a complex joint. Also, due to standing, it has to bear almost the entire weight of the body. This is another price we humans have to pay for our erect posture. The weight borne by the knee increases manifold during running, jumping etc. With age, wearing of the articular cartilage causes friction and misalignment between the articular surfaces, leading to what we commonly know as osteoarthritis.

What Are the Causes of Knee Pain?

There may be several causes of knee pain. Some of the most common ones include:

  • Knee osteoarthritis
  • Ligament injury
  • Myofascial pain
  • Chondromalacia patellae
  • Deformities of the knee (valgus/varus) leading to malalignment and secondary osteoarthritis
  • Post trauma osteoarthritis

How to Prevent Osteoarthritis / Knee Pain?

  • Weight management: Being overweight / obese puts extra pressure on the already overburdened knee joint. Managing your weight and cutting down those extra pounds will definitely work wonders.
  • Exercise: Regular exercise ensures mobility and lubrication of the joint. However caution must be exercised if you are overweight, as certain types of exercises like running, skipping, jumping, aerobics can damage your joint. In a damaged knee, exercises should be done only under expert supervision.
  • Footwear: Even though this may seem like a minor point, proper footwear prevents or even reverses malalignment of the knee, acts as shock absorbers and prevents further damage to the joint.
  • Avoidance of Squatting / Sitting Cross Legged: These postures further reduce the space in the knee joint leading to more friction. These postures should be consciously avoided.

What is the Treatment of Knee Pain?

  • Weight management: Should be done only by expert advice by means of diet and exercise.
  • Physiotherapy: Which mainly focuses on quadriceps strengthening exercises.
  • Pharmacotherapy: Medicines may be prescribed which will reduce the pain. If needed long term, adverse effects must be kept in mind. Over the counter pain killers, which ae medically known as NSAIDs or non-steroidal anti-inflammatory drugs act beautifully to reduce the inflammation and the pain. However, on long term use, they are a disaster for the kidney!
  • Intra-articular Steroid Injections: Steroid injections into the knee joint reduce pain and inflammation. However, the benefit is short term. On repeated injections, the knee joint cartilage may get damaged. Therefore, it is not advisable to take more than three injections per year.
  • PRP Injection: This is a type of regenerative therapy. In osteoarthritis, it not only halts disease progression, but may even reverse few of the changes.
  • Genicular Nerve Block: Injection of local anesthetic along with steroid is given to the nerves that carry pain sensations from the knee joint. The effect may be short lived. After a diagnostic injection, depending on the pain relief, radiofrequency ablation of the nerve can be done.
  • Radiofrequency Ablation of Genicular Nerves: This gives long term pain relief. In this technique, nerves carrying pain sensations are permanently blocked with radiofrequency ablation.

Non-Surgical Treatment Options at Painex For Knee Pain Or Slipped Disc:

  • PRP injection
  • Genicular nerve block
  • Genicular nerve radiofrequency ablation
  • Intra-articular steroid injection
  • Physiotherapy
  • Ergonomic and lifestyle counselling
  • Nutrition counselling for weight management
  • Yoga therapy


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Platelet Rich Plasma Therapy (PRP)

PRP is a blood component rich in platelets. It is a concentrated source of platelets, having different growth factors which help in the healing of bone and soft tissues

What is PRP

PRP is a blood component rich in platelets. It is a concentrated source of platelets, having different growth factors which help in the healing of bone and soft tissues


  • PRP was first developed in the 1970’s and first used in 1987
  • Proven to be effective in healing wounded tissue in sports injuries
  • Used worldwide in sports–related injuries. Few famous personalities recently treated with PRP therapy include Tiger Woods (golf) in his knee following surgery, Takashi Saito (Baseball)in his elbow, among many others.


  • Platelets from the patient’s own blood are concentrated by processing in a specialized machine, called the PRP centrifuge
  • It is successful not only in relieving the pain, but also in enhancing the healing process
  • This unique property of PRP, as regenerative therapy has helped it gain popularity amongst pain physicians


  • We make patient lie down comfortably and withdraw 15-30 ml of his blood as per requirement
  • This is mixed with a special reagent needed to yield maximum output of platelets
  • It is then transferred to a specially designed, disposable, single use container
  • The sample is then processed in the PRP centrifuge in 2-3 steps
  • Meanwhile we prepare the body part to be injected under utmost sterile precautions
  • Once we get the desired PRP, it is injected in the affected part under X-ray or ultrasound guidance

PRP can be prepared by various methods and equipment. At Painex, we have the best PRP centrifuge available in the market, along with a specially designed disposable, single use container. Being disposable and single use chances of transmitting infections like HIV, HBsAg, HCV etc are almost nullified.

Duration of Treatment

  • It varies case to case. We usually suggest between 1-3 injections, with 4 weeks interval between 2 injections
  • Alter about 6-12 weeks, patients are re-evaluated for improvement
  • Patients with more difficult injuries or advanced disease may require extensive therapy with more number of injections
  • Most of these patients can return to near normal activity within 3 months

Conditions Treated With PRP

  • Mild to moderate osteoarthritis in the hip, knee or shoulder
  • Chronic tendinitis in the elbow or ankle
  • Nerve injuries
  • Muscle tears
  • Ligamentous injuries
  • Plantar fasciitis
  • Trigger finger
  • Used in certain type of surgery like shoulder surgery to repair torn rotator cuff tendons, repair of anterior cruciate ligament (ACL)

When to Avoid PRP

  • Cancer
  • Active infection
  • Patient on blood thinning agent (can be done with due precautions)
  • Brain disorders
  • Patient with multiple medical issues

Advantages of PRP Therapy

  • It is patients own body (blood) component
  • No external injection added
  • No risk of allergies
  • Avoids risk of transmitting infection
  • Extremely safe for all age groups
  • Very few contraindications
  • No side effects
  • No other preparation needed
  • It is a day care procedure as it takes around 1 hour
  • Patient need not be fasting
  • No absenteeism from work
  • Immediate return to your normal activities
  • Near total pain relief without surgery
  • Economical as compared to surgery
  • Need for long term analgesics causing side effects is minimized
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Diabetic Neuropathy Treatment at Painex

Diabetic Neuropathy

Diabetes, is a multi system disorder and can harm the nerves resulting into what we call as “diabetic neuropathy”. About 60 to 70%

Diabetic Neuropathy
Diabetes, is a multi system disorder and can harm the nerves resulting into what we call as “diabetic neuropathy”. About 60 to 70% patients with diabetes end up having neuropathy. Diabetes is the most common cause of neuropathy worldwide.

Why Does it Occur?
Development of neuropathy in diabetes is mainly related to prolonged uncontrolled blood sugar. However a few risk factors have been identified.
Risk Factors:

1.Smoking, alcohol abuse
2.Age more than 40 years
3.History of periods of poor glycemic control.
4.Long duration of diabetes.
6.Ischaemic heart disease.

How Does It Present?
Depending on the location and type of nerve fibers involved, various types of neuropathies may be present, namely peripheral polyneuropathy, focal neuropathy, autonomic neuropathy etc. However, consult your doctor if you are diabetic and have any of the following symptoms.

1.Tingling and/or numbness in any part of the body
2.Burning foot pain, often worse at night
3.Shooting pain in limbs
4.Abnormal touch, pain and temperature sensation in palms and soles, typically in a glove and stocking distribution
5.Repeated trauma to feet which was not perceived
Diabetic neuropathic pain is typically a long lasting and nagging type of pain, which affects sleep, activity and overall quality of life.

How We Can Help?
At Painex, our consultants are specialized in treating neuropathic pain. Depending on the extent of your disease process, targeted pharmacotherapy will be given, keeping in mind the long standing nature of your pain and associated diabetes. For severe, intractable pain, other modalities in the form if monitored intravenous infusions may be recommended. Physiotherapy and counseling is offered as an adjunct. A pain free life is just within your reach. Book an appointment with us today !


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