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“Comprehensive Multidisciplinary Pain
Management Centre” is the highest pain management facility/ centre of
excellence, which is equivalent to superspecialty cardiac / neuro / kidney
centre. Samvedana Hospital & Pain Management Institute is the only such
centre for pain management in India. At Samvedana, more than 95% of patients
with pain do not require surgery for the control of their pain.
Pain is one of the most common
reasons for patients to seek medical attention. "Pain is the most
underestimated healthcare problem. Although acute pain may reasonably be
considered a symptom of disease or injury, chronic and recurrent pain is a
disease in its own right, where pain persists long after its usefulness as
an alarm signal. Although few people die of pain, many die in pain, and even
more live in pain. The majority of patients with chronic pain acute pain,and
cancer pain are under treated or not treated.
Pain is a major cause of work
absenteeism, loss of productivity; heavy cost of treatment,5th
vital sign; after pulse, blood pressure, respiration & temperature and
11th October is observed as
“Global Day Against Pain”. Understanding pain as a bio psychosocial
disorder is a recent development and has led to pain management and pain
medicine. disability claims, in addition to suffering, disability and poor
quality of life. WHO has declared, Pain as the
“Pain Medicine”
is a new specialized branch of medicine, created to provide proper
diagnosis (Discography,
epidurography, nerve/muscle conduction studies, diagnostic nerve blocks, MRI
& other radiological studies etc), appropriate treatment and research in
Pain management. In the absence of proper education among health care
professionals and lack of awareness in the public mind in India, there is
misuse of painkillers resulting in high incidence of complications like
gastritis, kidney failure, and bone marrow depression.
Any pain which refuses to go away after medications for three to four
months, needs intervention from pain specialists. While most patients
suffering from chronic pain a few years back were recommended for surgery,
when medications failed, now pain management specialists manage with
interventional pain therapies like- Nerve blocks,
Trigger
point injections ,
Epidurals,
Adhesiolysis, Facet / Sacro iliac joint & other joint / periarticular
injections, Coeliac plexus, Stellate ganglion, Trigeminal, Lumbar
sympathetic blocks, Botox injections; and advanced pain therapies like
Vertebroplasty (Non surgical treatment for osteoporotic and metastatic
compression of the spinal vertebra),
Intradiscal therapies like Nucleoplasty, Radiofrequency lesioning,
Spinal cord stimulator implantation (Pacemaker for the spinal cord),
Intrathecal pain drug pump
Interventional pain procedures
scores over both medicine and surgery, as they do not have side effects like
medicines. Surgeries for pain, have now limited indications, usually as a
last resort. The interventional pain procedures produce immediate pain
relief, can be performed with ease by pain physicians and adequate duration
of pain relief obtained; minimum hospital stay is required and procedure can
be repeated.
It is proved beyond doubt that mono therapy (Any single therapy,
including medications) is not effective in treating chronic pain.
Integration of therapies from different disciplines and use of various
modalities (known to be beneficial in pain management) in right
combination,and in comprehensive manner, provides best opportunity for
relieving physical pain, and its effect on the body and mind (Integrated
pain management).
Hence, these inteventional pain
therapies, need to have additional therapies to relax mind (Cognitive
behavioral therapy,
Biofeedback,)
and to improve function (like Physical / occupational therapy) for better
and long term outcome in the management of chronic pain.
The most widespread chronic pain conditions are- low back & neck pain,
painful
joints (arthritis)headache (including migraine). They are so common
today that they are often seen as unavoidable part of life. There is no
nobility in suffering from pain, when relief from pain is possible.
Other pain conditions are: - and recurrent
cancer
pain, pain due to work related injury(Repeated
stress injury-RSI),
Vascular / ischemic pain , Herpes zoster pain , Trigeminal neuralgia
and other oro facial pains , Painful
diabetic neuropathy,
Myofacial pain syndromes, Chronic fibromyalgia,
Phantom limb pain (pain after amputation of the limbs),
Post-trauma/surgical pain, Chronic pelvic pain, Genito-urinary pain,
nerve entrapments etc.
“Comprehensive Multidisciplinary
Pain Management Centre” is the highest pain management facility/ centre of
excellence, which is equivalent to superspecialty cardiac / neuro / kidney
centre. Samvedana Hospital & Pain Management Institute is the only such
centre for pain management in India. At Samvedana, more than 95% of patients
with pain do not require surgery for the control of their pain.
Lesser types of pain management facilities include pain-clinics (A
single physician may specialize in specific diagnoses or in pains
related to a specific region of the body- headache clinic, Back pain
clinic), Modality-oriented clinics(Physiotherapy clinic, acupuncture
clinic, nerve block clinic).
In addition, Samvedana
provides very high level of integrated neurorehabilitation
(Rehabilitation for patients with neurological disorders, following
head/ spinal cord injury/surgery) with very high success and recovery
from major illness/ injury, improving immunity; under medical
supervision.
The Indian health care
scene has a curious mix of paradoxes. Advances in Cardiovascular surgery
or high-tech investigative facilities in India are on par with any
advanced country, at least in some cities. Though skills, advanced
equipments are available, still pain relief is not available to majority
of its population. At least a million people in India suffer unrelieved
cancer pain. The number of people suffering other chronic pain
conditions is anyone’s guess. Paradoxically, India stands high chance to
become the health destination for pain management for the world, by
using interventional pain therapies and very effective traditional
therapies unique to India.
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