Tailbone Pain or Coccydynia Pain Treatment In Delhi
What is tailbone pain?
Tailbone pain or coccydynia is pain at the lower most aspect of the backbone called the coccyx. Coccyx is positioned at the very bottom of your spine, near the buttocks and is formed of 3 to 5 of fused bony segments. Its structure including length, angle of the curve and degree of mobility varies significantly between individuals. It was once believed to be remnant of the lost tail with no relevant function. Now we understand that it provides support for sitting and a place for attachment for various muscles, tendons, and ligaments.
What causes tailbone pain?
Trauma and falls are the most frequent cause of coccydynia. Trauma can lead to break, dislocation, subluxation or bruising of the coccyx and the surrounding area. Minor repeated trauma such as during prolonged periods of sitting on hard surfaces might often go unrecognized. Spasm of the pelvic floor muscles can pull on the coccyx and lead to pain. Rare causes of coccydynia include cancers and infection. Sometimes coccyx pain is referred from the spine.
Coccydynia is four or five times more common in women. Anatomical changes in the shape of pelvis, coccyx and childbirth may account for this. Some studies have found that it is more common in obese individuals.
Signs and symptoms of tail bone damage:
Most patients present with a dull ache, which changes to a sharp or throbbing pain with activities such as getting up from a sitting position or prolonged sitting. With time the severity and duration of pain can increase. Activities such as sexual intercourse and opening of bowels may become painful. The pain can radiate towards spine, legs and affect day-to-day activities.
When should I see doctor?
Tailbone pain is can be self-limiting and resolve on its own within few weeks to months. Those with moderate to severe pain interfering with daily activities and adversely affecting the quality of life should seek medical advice sooner. Other common reasons for medical consultation include – persisting pain despite conservative management, uncertain diagnosis, associated symptoms such as signs of infection or swelling etc.
The pain physician will take a complete history, and do an examination to narrow the possibilities. You may be asked to undergo investigations such as X-ray, CT or MRI scan to confirm diagnosis and rule out other conditions with similar presentation.
How is this condition managed?
There is variety of treatment options ranging from lifestyle modifications/ conservative management to injections. Simple measures that can help include
- Find an experienced pain physician/ doctor who can help you to confirm the diagnosis and treat the condition
- Avoid prolonged sitting especially on hard surfaces and bumpy rides as while travelling on in a car/ bus
- Modify your sitting posture to reduce pressure on coccyx such as leaning towards one side or leaning forwards while sitting. One should be careful with this as it can often place extra pressure on other areas leading to new pain symptoms.
- Using a doughnut-shaped or wedge (V-shaped) cushion while sitting
- When getting up from the sitting position do so slowly
- Avoiding aggravating factors such as constipation
- Appling heat or ice to the affected area
- Simple over-the-counter pain relievers
- Physical therapy. Aimed at pelvic floor relaxation techniques, postural retraining and stretching exercises
For severe or persisting pain the pain specialist may consider
- Medication. Stronger pain relief medications
- Injections. These are used to break the pain cycle and involve placement of local anaesthetic and steroids near the pain generator. Commonly performed injections include
- Injection of joint or ligaments surrounding the sacrum and coccyx such as the sacrococcygeal joint
- Ganglion Impar nerve block. Nerve blocks help to interrupt a nerve’s ability to transmit pain signals
- Manipulation. This can be used in combination with injection therapy or separately. Massaging the muscles attached to the tailbone might help in reducing pain
- Surgery. Surgical removal of coccyx is known as a coccygectomy. Because of the associated risks (infection, wound healing problems) and poor outcomes, this procedure is not commonly recommended/ used
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Tags >> Coccydynia Pain, Coccyx Pain Treatment In Delhi, Tailbone Pain Specialist in Delhi, Tailbone Pain Treatment, Tailbone Pain Treatment In Delhi
Pain Management In Delhi For Common chronic pain Conditions
Pain is a common reason for medical consultation. Over the years, studies evaluating the Global Burden of Diseases have found chronic pain conditionsamongst the leading causes of disability worldwide. The impact of chronic pain can vary, ranging from an occasional distraction or discomfort to constant severe debilitation. Some examples of common chronic pain conditions include back and neck pain, sciatica, diabetic neuropathy, headache, frozen shoulder, persisting post surgical pain, cancer pain, abdominal pain, pelvic pain and fibromyalgia. Pain in a significant proportion of these conditions is amplified by stressful and sedentary life style with obesity, lack of regular exercise, smoking, poor workplace ergonomics contributing to the increasing incidence and severity.
Chronic or longstanding pain does not always signify ongoing damage. Conditions such as arthritic knee or back pain are often accepted as part of aging process, stopping people from exploring treatment options. It can, however, cause significant distress and compromise the quality of life. With the correct help, you can control your pain better and make your life easier. A pain specialist can help to diagnose the cause of your pain and work towards relieving/ reducing it and minimise the impact on your daily routine. This is how the approach of pain management specialists is different:
Knowledge and experience
When you receive specialist training in a subject and deal with specific conditions on a daily basis (chronic pain in this case) your experience/ learning is bound to reflect your treatments and outcomes. The education and the training received helps in successfully diagnosing and treating pain issues. In India the opportunities for specializing in Pain Medicine are limited with no nationally ascribed curriculum. In the western countries pain medicine is reorganized as a separate specialty with numerous training and super specialization opportunities. Pain clinics form an integral part of most reasonable sized, good hospitals. Pain specialists generally undertake a detailed assessment of every aspect of pain and try to address problems comprehensively.
I have spent a year doing pain research and another year in pursuing advanced training in the field of pain medicine in London, UK. This is addition to the basic and intermediate training in pain medicine during my 7 years of initial anaesthesia training in London, UK. Subsequently I have worked as a Chronic Pain Consultant in UK
Treating the cause of the pain and not just the symptoms
Pain specialists try to explore why a problem may have occurred as this is important to prevent reoccurrences. Once the underlying problem has been resolved, the pain may automatically ease off giving you lasting relief. This is better approach than just taking medications for temporary relief. Understandably this may not be possible in all cases but this should not become a deterrent to trying.
Treating the body as a whole
Pain management specialists are trained to visualize body as a whole and use a multidisciplinary approach while addressing chronic pain. They don’t concentrate on just controlling the pain, as they understand that pain can affect multiple facets of life from mental health to relationships to jobs to social life etc. Each person is unique and experiences/ processes pain differently and hence the need for individually tailored therapies. They use a combination of modalities including physiotherapy, medications, injections/ interventional therapies, psychological therapies, Complementary and alternative therapies including Acupuncture, TENS, acupressure, and meditation along with patient education to achieve the best possible results.
Categories >>Chronic Pain
Tags >> chronic pain management in delhi, pain management in delhi, Pain management specialist, Pain Specialist In Delhi
Migraine & Headache Specialist & dOCTOR iN dELHI
Headaches are a common problem that affects people of all ages worldwide. There can be many reasons why people can develop headaches and these poor neck position while working or sleeping, stress, overwork, medical conditions such as degenerative disease of the spine, trauma, sinus problems, strokes, infections etc. Headaches which keep recurring are called recurrent headaches and those that tend to persist for a long period of time are called chronic headaches.
Headaches can hinder day to day activities and severely affect the quality of life especially in individuals who experience frequent severe headaches or long lasting / constant headaches . Recurrent headaches can be quite difficult to handle since they tend to develop suddenly, not giving you an opportunity to prepare for it and plan your day. There a variety of measures that you can take in order to reduce the impact and frequency of these headaches. Some of these are quite simple, but most people doubt the effectiveness and hence are hesitant to implement. These can work synergistically with the other management options suggested by your pain specialist. These include
General lifestyle modifications
- Regulating your sleep cycle: Having a regular sleep cycle goes a long way in helping to reduce these headaches. Good sleep environment plays an important role and includes a darkened bedroom, a quiet place where you are comfortable and it helps to unwind. Some find a relaxing hot bath helpful in unwinding prior to heading off to bed. It is advised to avoid watching TV, using laptops or mobiles before you go to bed.
- Hydration: Keep yourself well hydrated, because dehydration is a known trigger of headaches, and can worsen preexisting headaches.
- Regular meals: Have you meals on time. This another important factor that plays a role in the development of headaches. Low blood sugar/ hypoglycemia can trigger headaches. If you are in the habit of skipping meals or eating late and heavy meals, then you should consider changing this.
- Avoiding triggers: Other trigger/ precipitating factors may vary from individual to individual. From particular foods to the brightness of TV screens to loud noises, certain smells etc there are numerous factors. You are the best person to identify these and avoid them as much as possible.
- Tea and coffee: Minimize your intake of coffee and tea, because they are known to precipitate headaches. Avoid taking them late in the evenings and just before going to bed.
- Quit smoking
- Stress management and relaxation: Learn how to manage your stress in a productive manner and practice relaxation techniques.
These general measures, when used in combination with advice from your pain specialist can help you control your headaches better. Some of the common medical interventions used in management of headaches include:
Medications:
Medications for headache can be used to terminate the headache at the time you are experiencing it or can be taken as a preventive measure to reduce your chances of developing a headache. Preventive medications are usually taken when people experience frequent or continuous headaches, and they should be taken as prescribed by your doctor. Too much of any medication can also end up being the cause of your headache as well, and is given the name Medication Overuse Headache. The different medicines used for recurrent headaches are:
- Antidepressants: These medications, besides the pain relieving effects can also have other beneficial effects like reducing anxiety and sleep disturbances. The drug selected will depend on your individual situation.
- Beta blockers: Beta blockers, commonly used in management of high blood pressure and heart problems. They are helpful in the management of migraine related headaches
- Anti-seizure medicines: Several anti-seizure medicines help in the prevention different types of recurrent/ chronic headaches including migraine.
- NSAIDs: Nonsteroidal anti-inflammatory drugs are commonly used over the counter medications for mild to moderate pain, and they are effective in various different types of headaches. On frequent usage they can have harmful side effects such as gastritis and peptic ulcer disease; therefore they must be used with caution and under medical supervision.
Other interventional methods:
When simple measures such as lifestyle modifications and oral medications are not successful in resolving the headaches, then it may be worth considering other interventional methods. The intervention used will depend on the diagnosis. The common interventions include:
- Nerve blocks
- Injections of the cervical spine
- Radiofrequency treatment
- Botulinum toxin injections
Complementary & Alternative therapies
These include:
- Acupuncture – which involves the insertion of thin needles at definitive points in your body, with the intention of providing pain relief
- Massage therapy – this can help to reduce the stress and tension. It helps to relax the tightened muscles and thereby provides relief.
- Meditation and relaxation therapy
- Herbs and nutrients – Several organic herbs help in preventing migraine headaches and reduce the intensity of headaches. In deficiency states vitamin and mineral supplements can be taken to reduce headaches and prevent them from reoccurring.
It is best to seek medical advice before you starting with any of the above methods.
Categories >> Headache
Tags >> chronic headache pain, Headache Specialist In Delhi, Headache treatment in Delhi, Migraine, Pain Specialist In Delhi
Cervicogenic Headache Treatment In Delhi
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What is Cervicogenic Headache?
Cervicogenic headache in simple terms means headache originating from the neck. Even though the pain you experience is in the head or part of the face, the actual problem in lies in the neck. The possible pain generators in the neck include the joints, discs, surrounding tissues such as the neck muscles, coverings of the spinal cord and blood vessels.
Headaches afflict people of all ages. The impact is variable from mild discomfort to severe incapacitation, depending on the severity and the frequency of headaches. Often the causative factors are numerous and difficult to pinpoint. Cervicogenic headaches represent one such condition that is easily overlooked and under diagnosed, due to limited awareness about the condition. This is a treatable cause of headaches with possibility of good relief if the diagnosis is correct.
Signs & Symptoms of Cervicogenic Headache:
Some of the pointers towards cervicogenic headache include:
- Increase in headache with neck movements such as nodding or rotation of neck
- Increase pain with pressure on certain sensitive points in the neck
- Stiffness and reduced range of neck movements
- Pain is generally one sided and does not change sides. Sometimes both sides are involved
- Generally described as a pressure sensation at the back, side or front of head or in the area around the eye. It may be episodic with varying duration or present constantly. During severe episodes nausea and vomiting and other features similar to migraine can be present making the diagnosis more challenging.
The headaches often start after trauma/ injuries such as whiplash. Conditions such as occipital neuralgia (a problem associated with the nerves at the back of head) are closely linked to cervicogenic headaches.
Causes of Cervicogenic Headache:
A number of neck conditions have been attributed to cause cervicogenic headaches including:
- Degenerative changes in the joints of the cervical spine such as osteoarthritis
- Discs of the cervical spine
- Whiplash injury to the cervical spine or other sports injuries
- Spasms of the neck muscles
- Bad posture of the neck for long periods of time, such as when working or sleeping
Diagnosing Cervicogenic Headaches:
Diagnosing a cervicogenic headache can be tricky, as a number of headaches can present with similar features. Your doctor will obtain a detailed history often taking you back to when it had first started. You will be asked in detail about your pain symptoms, stress levels, work, eating and sleep habits, medication usage etc. This is usually followed up by examination. Diagnostic investigations such as X-ray, MRI, CT scans cannot conform the diagnosis but do provide support to the diagnosis. An injection is often used for confirmation of the diagnosis.
Cervicogenic Headache Management Options:
There are a variety of treatment methods for helping with cervicogenic headaches. These include:
- Lifestyle changes such as regulation of sleep cycle, workplace ergonomics
- Medication may include mild or potent pain killers
- Interventions such as joint, nerve or muscle injections. These generally involve injection of local anaesthetics with or without steroids. Sometimes Botulinum toxin injections are used for muscles
- Radiofrequency treatment can help relieve/ reduce these headaches for a prolonged duration
Management Options continued:
- Physical therapy can help to stretch and relax the muscles in and around your neck. They can help deal with the muscular trigger points
- Psychology input may involve biofeedback, relaxation therapy and cognitive behavioral therapy
- Complimentary and alternative medicine including meditation, yoga, TENS, acupressure and acupuncture
- Surgery – this may be used in cases with severe joint changes or nerve compression causing severe headache remains unrelieved by other modalities, but this is rare
Categories >> Headache
Tags >> Cervicogenic Headache Treatment In Delhi, Pain Management Centre in Delhi, pain specialist doctor in Delhi
