Pain Medicine superspecialty · interventional · evidence based
Pain Medicine is one of the recently developed superspecialty of Medicine focusing on management of chronic and cancer pain with medications and Interventional Pain procedures including Neuroablative, Radiofrequency lesioning, vertebroplasty, Percutaneous Balloon compression, Percutaneous Discectomy (Disc Fix / Endoscopic), Sympahectomy. These minimal invasive or non-invasive procedures are comparatively safe, economical, done in LA with the help of C‑arm / US Guided, does not need knife and short hospital stay and are substitute of Surgery especially in low or poor risk cases in Pain Management Clinics by a Pain Specialist who has been trained in Pain Medicine.
Such Pain Management facilities are available only in few Medical Institutions and private hospitals in India. Prof. V. Rastogi (Ex-Head Pain Division, Department of Anaesthesiology, IM, BHU) after superannuation is giving his services in Follicle IVF & Fertility Clinic, D‑194, Sector 10, Noida.
Why Pain Medicine?
- Minimally invasive
- C‑arm / US guided precision
- No knife, short stay
- Substitute for surgery
- Safe for poor-risk cases
What Is a Pain Clinic?
Also called Pain management clinics, they're health care facilities that focus on the diagnosis and management of chronic pain and procedures to deal with specific types of pain.
What kind of patients need Pain Clinic?
Patients suffering from chronic pain including: Headache, Migraine, Trigeminal Neuralgia, Neck, Shoulder, Backache (Slip Disc), Knee, Urogenital, Myofascial, Complex Regional Pain Syndrome and cancer pain are managed in Pain Management Clinic with Medications and Interventional Pain Procedures.
Advantages of Interventional Pain Procedure
- Less Invasive as compared to Surgery
- Procedures are percutaneous without an incision or cut
- Absolutely blood less
- Usually done under LA, General Anaesthesia not required
- No or Minimal Hospital Stay required
- Safe, economical, effective, feasible in poor risk cases
Pain Management services are rendered through Pain Clinic or Pain Management clinics existing in Medical Colleges, Cancer Hospitals and corporate Hospitals in India. Pain Clinic is basically designed to provide comprehensive Pain Management services to the people of Delhi and NCR by Professor V. Rastogi with an experience of 45 years and recipient of various awards in the field of Pain Medicine.
RF Lesioning of Gasserian Ganglion, Percutaneous Balloon compression are Interventional Pain Procedures for Trigeminal Neuralgia patient.
Trigeminal Neuralgia
Percutaneous RF Lumbar Sympathectomy indicated for Vasospastic Diseases of Leg.
Myofascial syndrome, Cervical spondylitis, Cervical Disc Prolapse, Ankylosing spondylitis, Facet joint arthropathy, AO joint Arthropathy.
- Trigger Point Inj.
- Median Nerve RF Neurotomy
- Transforaminal Steroid Neuroplasty
- Cervical RF Discectomy
- AO Joint Steroid+PRP/GFC inj.
- Cervical RF Discectomy with selective nerve root block
Common causes of LBA (Low Back Ache)
- >70% Mechanical
- 10% Degenerative Disc or Facet
- 4% Herniated Disc
- 4% Osteoporotic Compression
- 3% Spinal Stenosis
- 2% Spondylolisthesis
Treatment modalities for LBA in Pain Clinic
Platelet Rich Plasma (PRP) therapy uses growth factors to regenerate tissues in Osteoarthritis, Facet joint arthropathy, Degenerative vertebral disc, Acute Ligament tear, Rheumatoid arthritis, shoulder dislocation, Avascular Necrosis (AVN) head of Femur/humerus. A significant increase in size of cartilage as evidence by Ultrasound measurement is seen. Intraarticular PRP/GFC Therapy is performed under C‑arm under sterile condition in OT. It is a highly cost-effective alternative to Joint Replacement.
In-house Advanced PRP/GFC Lab
Precision Interventional Showcase
C-Arm Guided Precision
Real-time X-ray guidance ensures the needle reaches the exact pain generator with millimeter accuracy.
Expert Intervention
Procedures like RF Neurotomy and nerve blocks performed under sterile, controlled conditions.
Radiofrequency (RF) Neurotomy: Essential for Grade 3/4 OA Knee. While PRP regenerates, RF provides immediate pain relief. FDA & TPA Approved
Causes of Urogenital Pain: Interstitial cystitis, Vaginal pain syndrome, vulvar pain syndrome, Dysmenorrhoea, Anorectal pain synd., anismus, proctalgia fuga, Coccidynia, Ca Cervix/Rectum.
Treatment offered: Superior Hypogastric Plexus Neurolytic block/RF lesion, Ganglion Impar Neurolytic/RF Lesion.
More than one and half million people suffer from cancer in India, of nearly two third (One million) patients suffer from severe pain not responding to commonly used analgesics need stronger analgesic like Morphine tablets or Fentanyl patch. Still a small percentage of patients need Neuro-ablative procedures or epidural morphine infusion through an external epidural pump in Pain Clinic by a Pain Specialist.
How is cancer pain managed in Pain Clinic?
Methods include: Morphine tablets, Fentanyl Patch, Neuroablative procedures, Epidural infusion pumps, Vertebroplasty.
These advanced interventions are performed by specialists like Prof. V. Rastogi in dedicated pain clinics.
Multimodal cancer pain care
Where are cancer pain control facilities available in India? Major cancer hospitals, Medical colleges and few corporate hospitals. Such facilities are available at Heritage Hospital, Sector 119, Noida and Narender Mohan Hospital, Mohan Nagar, Ghaziabad under the supervision of Prof. V. Rastogi.