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I was suffering with severe neck pain since last 7years , hav all type of physiotherapy and massages and chiropractor but no relief then I met Dr Sudheer and Dr minal at this center…
Very good doctor. Suffering from knee pain from last 4 years and didn’t want to get a surgery. They treated my knee pain with out surgery with stem cell therapy. I am very happy with the results.
By far the best pain management specialists in town. After consulting several places with no effect, Epione made sure that they treated my mother’s delicate pain condition with patience…
I am very thankful to doctors in Epione pain management center. My neck pain has gone which I was fighting since last 4 years . Dr sudhir Dara and dr minal have helped me come out…
I finally got relief from my back pain thanks to Epione
Mrs. Aswathi Subramanyan
Back Pain Treatment
Dr Sudheer cured me from knee pain due to arthritis
Knee Pain Treatment
I suffered from foot pain for 5 years but finally found pain relief at Epione
Mr. BVS Prasad
Foot and Ankle Pain Treatment
I can’t believe I got relieved of my back pain in a single day
Back Pain Treatment
Neck pain can be caused by several reasons but is mostly related to aging. Neck pain arises from any structure of the cervical spine which consist of vertebral bones, discs(soft structures which acts as shock absorber) in between these vertebral bones, joints formed by above and below vertebra called as facet joints and multiple paraspinal muscles and ligaments around it. As we age, the discs and joints in the neck undergo certain degenerative changes leading to a condition called cervical spondylosis. Studies show that about 9 in 10 people who are 60 years or older have cervical spondylosis.
Signs and Symptoms
In most cases, people with cervical spondylosis may not experience any noticeable symptoms. However, if symptoms do occur, the person may experience neck pain and stiffness.
Other symptoms of cervical spondylosis include:
- Neck pain that radiates to your hand, arms , shoulders
- A grinding feeling while moving your neck
- Tingling numbness of fingers
- Muscle stiffness
- Painful neck movements
- Weakness in the arms and legs
- Trouble keeping your balance
- Bladder or bowel incontinence
- Sometimes may mimic like a shoulder pain
- Continous work on desktops
- Workers doing Heavy lifting works
Cervical spondylosis develops due to the degenerative changes that occur in the spine as we age. These changes may include:
- Dehydrated disks (a condition where the vertebral discs lose its fluids due to aging)
- Herniated disks (a condition in which the inner portion of the spinal disc protrude through the outer ring)
- Bone spurs (overgrowth of bones)
- Osteoarthritis (a progressive condition that causes cartilage degeneration)
Diagnosis and tests
Initially,a person’s medical history is reviewed along with a physical examination. During the physical examination, the functioning and range of motion of the neck, shoulders, arms and legs are assessed and the reflexes and muscle strength are tested.
In addition to physical examination, imaging test, such as X-rays, MRI scan,CT scan and myelogram are recommended to confirm the diagnosis of cervical spondylosis.
MRI Scan is the gold standard for diagnosis of cervical spondylosis- It may show a degenerated disc or a bulged disc, degenerated facet joints, spinal cords, spinal canal, muscles around , soft tissue growths.
Other test like Nerve conduction study may be required.
Cervical spondylosis is usually treated with non-surgical and surgical approaches. Surgery is recommended only when the pain is severe or in presence of any RED FLAGS ( Weakness of hands and legs, incontinence of bowel and bladder).
Nonsurgical treatment options include:
- Non-steroidal anti-inflammatory drugs(NSAIDs)– Lot of over the counter pain killers are available which are helpful in decreasing the acute inflammation but its long term use is associated with complications like renal and liver dysfunction, Gastritis . They have to be used under the supervision of treating doctor for small period of time.
- Muscle Relaxants– Neck muscles goes into spasm and stiffness which restricts the neck movements. Muscle relaxants helps in relieving these spasms for short while.
- Corticosteroids– The role of steroids come in severe cases of pain because of its anti- inflammatory action. Steroids may sometimes be helpful in this condition but should be taken only when prescribed by the physician.
- Antineuropathics like Pregabalin and Gabapin plays important role in decreasing the pain signals carried by the nerve around the cervical spine. These medications are taken for few weeks and side effects are seen early in its course. Drowsiness, dizziness are the initial side effects seen which eventually subsides in due course of time. These medicines have good efficacy in such cases.
- Antidepressants– Nortryptiline aor Amytriptiline in small doses also helps t relieve such pain.
Certain neck and upper back stretching exercises are recommended to strengthen the neck muscles. These Exercises are to be avoided in cases of acute pain as doing these exercises may exacerbate the pain.
Ice, heat and massage therapy: These therapies help to relieve neck, pain, stiffness and inflammation for short term. They are not a permanent solution for this condition
Surgery is required only in case of severe pain or occurrence of RED FLAGS- Weakness of hands and legs, urine and bowel incontinence. Surgery is associated with major complications as it is done around the neck where all important structures like windpipe, foodpipe, big vessels and other important structures are present.
ADVANCED TREATMENTS AVAILABLE
Non Surgical Treatment
Nerve blocks for cervical spondylosis
Pain relief in selected patients can be achieved through medication injection into the joint and/or injections to block the nerve that innervated the joint and the adjacent tissues. Common procedures used for cervical spondylosis are cervical epidural block, cervical facet joint block and Median branch block and radiofrequency ablation of Median Nerve.
Injections into the cervical facet joint is usually done under local anesthesia and the procedure takes about 15-20 minutes. The procedure has minimal side effects and is the best effective modality for pain relief.
The cervical facet joints are supplied by the medial nerve, and blocking this nerve through medication injections can help achieve pain relief. This procedure is performed under local anesthesia and takes about 15-20 minutes.
All these procedures are done as day care procedure with the help of specialized machines and are so devoid of any complications when done by an expert.
DO’S and DONT’S
- Exercising regularly
- Maintaining correct posture while using mobile phones or computers
- Taking necessary precautions to avoidthe trauma ofthe neck
- Including vitamin D, B12 and other nutrients in the diet
- Avoid lifting heavy weights
- Avoid excessive straining of neck
- Avoid irregular and asymmetrical movements of neck and head
- Decrease the time spent of mobile phones and laptops