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I was suffering with severe neck pain since last 7years , had all type of physiotherapy and massages and chiropractor but no relief then I met Dr Sudheer and Dr minal at this center…
Dava Ramesh
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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.
Meghana Reddy
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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…
Deepthi K
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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. Sudheer Dara and Dr. Minal have helped me come out…
Sanjana Tirkey
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I finally got relief from my back pain thanks to Epione
Mrs. Aswathi Subramanyan
Back Pain Treatment
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Dr Sudheer cured me from knee pain due to arthritis
Mrs. Padmaja
Knee Pain Treatment
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I suffered from foot pain for 5 years but finally found pain relief at Epione
Mr. BVS Prasad
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I can’t believe I got relieved of my back pain in a single day
Mr. Sreekanth
Back Pain Treatment
Neuropathic Pain
Treatment in Hyderabad
This condition arises as a direct consequence of a lesion or disease affecting the somatosensory system.
Signs and symptoms
- Patients typically have symptoms of pain as
- electric shock
- burning
- shooting
- pin and needles
- atypical sensations like worms crawling
- loss of sensation,decreased sensation
- pain at the area of decreased sensation
- numbness
- hyperalgesia
- allodynia
Types of Neuropthaic Pain
Site of Injury
Peripheral
- CRPS I/CRPS II (involvement of Sympathetic nervous system)
- Painful Polyneuropathy
- Lancinating Neuralgias
- Phantom Pain (+/- involvement of Sympathetic nervous system)
- Nerve Compression
- Neuroma Formation
Mixed
- Avulsion of Plexus (+/- involvement of Sympathetic nervous system)
- Postherpetic Neuralgia (+/- involvement of Sympathetic nervous system)
Central
- Central Pain (+/- involvement of Sympathetic nervous system)
Predominating pain mechanism
Predominating “central” pain generator
- Deafferentiation Pain (response to either peripheral or CN system injury)
- Sympathetically Maintained Pain (associated with focal autonomic dysfunction)
Predominating “Peripheral” pain generator
- Painful polyneuropathies (multiple mechanisms probably involved)
- Painful mononeuropathies
1. Lancinating Neuralgias
2. Nerve Compression or Inflammation Nerve Transection
CAUSES:
Polyneuropathy
- Diabetes (IDDM & NIDDM)
- Alcoholism
- Human Immunodeficiency virus
- Hypothyroidism
- Renal failure
- Chemotherapy induced (vincristine, cisplatinum, paclitaxel, metronidazole)
- Anti-HIV drugs
- B12 and folate deficiencies
Mononeuropathy
- Entrapment syndromes
- Traumatic injury
- Diabetes
Plexopathy
- Diabetes
- Avulsion
- Tumour
Root syndromes and radiculopathy
- Compressive lesions
- Inflammatory
- Diabetes
Post-herpetic neuralgia
Trigeminal neuralgia
Phantom limb pain
RSD/causalgia/CRPS
Management
Pharmacotherapy
Non-pharmacotherapy
Interventions
Pharmacotherapy
- Tricyclic antidepressants & SSRNI’s/SSRI’s
- Anticonvulsants
- Opioids
- Topical agents
- NMDA Antagonists
- Other drugs
Non Pharmacological treatment
- Physical Therapy
- TENS Therapy
- Occupational Therapy
- Cognitive Behaviour Therapy
Interventions
- Neural blockade– nerve blocks have been used by physicians for generations for the treatment of neuropathic pain,
- Implanted Neural Stimulator or spinal cord stimulators– implanted stimulators of the dorsal column of the spinal cord or of the injured peripheral nerve
- Implanted Intrathecal Infusion Pumps
Evidence for the efficacy of pumps administering morphine, hydromorphone, and Baclofen - Decompressive Neurosurgery
Select patients with well-defined lesions may benefit from surgical exploration and decompressionWell accepted for carpal tunnel syndrome, but unfortunately underutilized for patients with painful nerve compressions elsewhere - Ablative Neurosurgery
Procedures are rarely indicated, and are performed far less frequently now than in the past. Cutting nerves usually relieves pain only temporarily, if at all.