Alternative therapies: Dealing with pain beyond painkillers

NEW DELHI: Sarita Rani, 65, had been suffering from arthritis for nearly eight years when she was told she needed knee replacement surgery to walk without pain.

NEW DELHI: Sarita Rani, 65, had been suffering from arthritis for nearly eight years when she was told she needed knee replacement surgery to walk without pain. She said no to surgery. She has since been using natural oils and medicines for the pain. That was three years ago.

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“Her joints still hurt. She can walk, though only for a short distance. She still cannot climb stairs. She needs to massage her knee more regularly to reduce the pain,” said Rani’s husband, Shyam Sundar Gupta.

Alternative pain management therapies are increasingly being used with modern medicine to treat people like Rani who live with chronic pain.

“You must go to a doctor if the pain persists for two or three days and happens without any known cause. The important thing is, it must not be allowed to become chronic because the longer it persists, the more difficult it becomes to treat it,” said Dr Rajesh Malhotra, head of the orthopaedic department, All India Institute of Medical Sciences (AIIMS).

CHRONIC PAIN

The success rate of any treatment for chronic pain, which lasts for six months or more, is less than 70%.

“When you have lived with pain for a long period of time and the spinal cord has undergone some structural changes, even normal sensations start hur ting and the pain persists even after the cause is removed,” said Dr Malhotra.

“This is when people with chronic pain stop responding to the normal pain killers and need to take opioids, which are addictive, or anti-epilepsy medicine to calm their nerves and reduce the pain. More complex interventions may be needed in some cases, depending on the

A metal pump is surgically-implanted to deliver medications directly into the space between the spinal cord and the protective sheath surrounding the spinal cord. A device is surgically placed under the skin to send a mild electric current to the spinal cord to block out the pathways of the pain signals.

A treatment that purports to increase the amount of oxygen in the body through the introduction of duration and where the pain is occurring,” he said.

If the pain persists for more than three months, they must see a specialist.

“To resolve chronic pain, you need to treat the underlying trigger. So, specialist care is needed,” said Dr KJ Choudhury, anaesthetist and senior consultant of pain management at Indraprastha Apollo. Ozone gas is injected directly to the knee, shoulder or other joints to relieve pain and repair damaged tissues.

A neurotoxin is injected directly into area of pain to treat migraines. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. RFA can be used to help arthritis patients and patients with chronic low-back and neck pain. Hospitals.

“Do not self-medicate or use alternative treatments such as massage or acupuncture as these can aggravate injuries and conditions such as slipped disc,” said Dr GP Dureja, an anaesthetist and director of Delhi Pain Management Centre.

EASING THE PAIN

Massage, acupuncture and other alter native therapies help in early stages of pain. Often, doctors use a combination of pain management options, including physiotherapy, medicines, injections and pain-relieving mechanism such as spinal cord stimulator, an implant near the spine that sends out electrical signals to lower the pain.

Back pain is among the most common problems. Around 60% patients at Delhi Pain Management Centre have back pain related complaints.

“The profile of patients has changed completely over the past two years. Most patients, aged between 25 and 35, come with poor posture-related back problems,” Dr Dureja said.

According to Dr Malhotra, studies in India show that 10%60% of the people live with chronic pain.

“Th e Wo rl d He a l t h Organisation estimates chronic pain affects 35% of the population in their lifetime, which makes it a far more common problem than diabetes and heart disease,” said Dr Dureja.