Neuropathic Pain Treatment In Delhi, Diabetic Neuropathy Treatment in Delhi

1. NeuropathicPainTreatmentinDelhi NeuropathicPain • Neuropathicornervepainarises asaresult todamageorimproperfunctioningof the nerves/nervoussystem. It presentsas poorlylocalisedburning,shootingor electricshocklikepainwithalteredsensitivityintheaffectedarea.Suddenincrease inpain severityis commonly observed.Over the period oftimesometimesskin changes,weaknessandwasting ofmusclescandevelop.Theaffectedarea may developincreasedsensitivityperceivingnonpainfulstimulisuchas touchtobe painful.Alternativelypatientmayreporthavingpaininareaswhich feelnumb.Some examples ofcommonconditionswithneuropathic paininclude • DiabeticNeuropathywherepatientscomplainofaburningsensationmost commonlyinthesoleoffeet,worst atnighttime • InfectionssuchasPosthereticneuralgia,HIV • Persistentpostsurgerypainortraumainvolvingnervedamage • Druginducedneuropathyincludingthat afterchemotherapy/radiotherapy • Cancerrelatedneuropathy • Post Amputation-Phantomlimbpain • Central causessuchasspinalcordinjuries,strokes, multiple sclerosis • ComplexRegional PainSyndrome • Nutritionaldeficiencies • Screeningquestionnairesarecommonly usedindiagnosingneuropathicpain. Investigationssuchas blood tests,scans,andnerveandmuscletestsmay be requested toconfirmthediagnosis orruleout otherconditions.Dependingon the history,examinationandinvestigationfindingsthepainconditionisdiagnosed • aspossible,probable ordefiniteneuropathicpain.

2. Management Neuropathicpaincanbeseverewithsignificantimpactonthequality oflife.Sleep disturbances,anxietyanddepressionare frequentlyobservedalong withpain.Multi- disciplinaryapproachhastheadvantageofaddressingallconcomitantfactors involvedinexacerbatingpainandaffecting quality oflife.Someofthecommon interventionsinclude Medications DrugslabelledasNeuropathicagentsarespecificallyusedtotreatpainneuropathic pain.Whilstthey may havebeenmadetotreatotherconditions(likeepilepsyand depression)itisnotuncommonfordrugstobeused formultipleconditions. A number ofanticonvulsantsandantidepressantsarewellreorganisedpainkillers for nervepain.Examples ofthesedrugsincludeGabapentin,Pregabalin,Nortiptyline etc.Please followthelink tomedicationoptimisationto find outmore. Nerveblocks Nerves carrythepainsensationtothebrainandblocking this transmissioncanbe achievedbynerveblocks.Theseareusefulwhenthepaingeneratorarethenerves themselvesandinconditionswherethe focusisonreducingpain,improvingquality oflife.Anexampleofthisispersistingkneepainafterjoint replacementsurgery despitetherebeingnoproblemwiththereplacedjoint.InsuchcasesGenicular nerveswhichcarrypainsensationfromthekneearetargetedtoreducepain. Itis important to understandthatpersistingpain doesnotalwayssignify ongoing damage.Thenervestargetedwilldependon the areainvolvedand may includesympatheticnervesasinSympatheticblockse.g.stellateganglionblock, Hypogastricplexusblock. Transmissionofpainimpulsestobraincanalsobereducedbyotherinterventions suchasradiofrequencytreatmentandNeurolyticblocks. Furtherdetailsofthis arementionedinothersections ofthiswebsitedependingonthebodypartinvolved suchasforshoulderpainfurtherinformationaboutsuprascapularnervecanbe foundin the jointpain section. Intravenousinfusions Somedrugswhengiventhroughtheveinsoveraperiodoftimecanproduce prolongedpainreliefwhenthesource ofpain isthenerves/nervoussystem.These drugscanhelptoreducethesensitivity ofnervesatthe site oflesionandinspinal cordwhichinturnleadstoreducedpainsensationbeingtransmittedtobrain. Physiotherapy Asnerveinjury /dysfunctionmay beaccompaniedbyweakness/atrophyofmuscles,

3. physiotherapy forms an essential pillar of overall management. It helps in preventing deconditioning of muscles and preserving the functionality. Please follow the link for finding outmoreabout howphysiotherapycan help. Psychology Options including cognitive behavioral therapy, coping strategies and relaxation techniquescanhelpindealingwithflareupepisodesandanyaccompanyingmood disturbances.Pleasefollow thelink for findingoutmoreabouthow psychologycan help. KnowAllAbouttheTreatmentOptions for Neuropathic Pain May16,2018 Theincreasingnumberofpainmanagement centresinDelhiisaproofofchanging times andincreasingawarenessaboutpainmanagementoptions.Neuropathicor nervepainis one ofthecommonreasons forpainclinicconsultation. Nervesactastheconductionpathwaystransmittingsignalsto and fromthebrain. Sensationsincludingpainaretransmittedaschemicalandelectricalsignalstothe brainwherethepainis actually perceived.When the nervebecomedamagedor dysfunctional theystart generatingpainsignalsthemselves.Thiscategory ofpainis definedasneuropathicpain.Neuropathicpaincanbesevere,debilitatingandyou

4. needto chooseexperienceddoctorswhenit comesto neuropathicpaintreatmentin Delhi. • Letusfirstlearnwhat causesneuropathicpain • Neuropathicpainismainlycausedbynervoussystemdamage/dysfunction.Many factorsandconditionscanpredisposetodevelopmentofneuropathicpain.Someof the commonreasonsinclude: • Diabetesmellitusleadingtoaconditionknownaspolyneuropathywheremultiple nervesoftheperipheralnervoussystemareaffected • CertainMedications • Nervecompression • Nutritionaldeficiencies • Neoplasms • ChronicAlcoholism • Toxinexposure • Immunologicaldiseases • Infections • Idiopathic • TreatmentModalities • Itisimportanttoconsultthe best centres forneuropathicpain treatment in Delhiwheretheteam understandsyourpainandhasextensiveexperiencein diagnosisandmanagementofalllindsofneuropathicpain.Neuropathicpain • increasestheexcitabilityoftheneves,receptorsandproduceschangesinthespinal • cordsuchasthoseinNmethylDaspartateorNMDAreceptor.Moreover,there isan imbalancebetweentheexcitatoryandinhibitory systems furtherincreasingthe perceivedpain. • Ifthepredisposing factorsorthepre-existingdamageisunmodifiablethenthefocus • shiftstostoppingtheconditionfromworsening,pharmacologicalmanagementand symptom/paincontrol. • Incaseofdiabeticpolyneuropathy,managementofblood sugarlevelalong with exerciseand medicationishelpfulespeciallyintype1 diabetes • Incaseofvitamindeficiency,vitaminadministrationanddietchangesare recommended. • Incasesofnerveentrapmentslocalinjectionscanhelpifprovidingrelief • Along withmanagementofthepain,itis equallyimportant to alleviateother associatedsymptomssuchassleep disturbancesandlowmood. • PharmacologicalManagement:Useoftricyclicantidepressants,anticonvulsants, opioids,topicalnumbingagentsandpatcheshelpinmanagingthe symptomsof neuropathicpain.InterventionssuchasNerveblocks,sodiumchannelblocking

5. agents and neuromodulation is often utilised in combination with pharmacotherapy. These may not remove the causative factors but they certainly help in management ofthepain. It is essential to consult the best pain management centre in Delhi where an multidisciplinaryapproachisusedand theemphasisisonimprovingquality oflife andreducingpain,discomfort.