Pain Clinic

Pain Clinic at Jaslok Hospital & Research Centre :

The Pain Clinic at Jaslok Hospital & Research Centre was established in 2001 as one of the initial ones in Mumbai. It specializes in providing comprehensive, compassionate and patient-centric care including advanced and state-of-the-art advanced therapy options to improve functioning ability and the quality of life for our patients.

It is unique in offering the entire spectrum of minimally invasive pain and spine procedures (MIPSIs) by experienced , credentialed and internationally trained doctors.

Some of the common conditions treated at Pain clinic are :

• Back pain +/-Sciatica pain, Disc Prolapse and Facetal Arthropathy
• Radiculopathy pain of upper/lower extremity
• Post spinal surgery pain /Persistent Spinal Pain Syndrome (new term for Falied back surgery syndrome)
• Chronic Osteoarthritis pain from knee /Shoulder /Hip
• Complex Regional Pain Syndrome [new term for Reflex Sympathetic Dystrophy]
• Peripheral Vascular Disease pain
• Diabetic Neuropathy pain
• Trigeminal Neuralgia /Occipital Neuralgia /Post herpetic Neuralgia
• Myofascial Pain Syndromes / Fibromyalgia Syndrome
• Cancer Pain with /without metastasis
• Chronic Post-surgical pain e.g. Post thoracotomy pain; Post-inguinal hernia surgery pain; Phantom limb pain

Since there are so many different causes of pain, there cannot be a single option for everyone. An individualized treatment plan is developed based on detailed assessment of the patient’s current condition and needs. By and large, a multimodal approach is advocated to give optimum pain relief to our patients.

What are the options to treat chronic pain??

in the Pain clinic at Jaslok hospital, by and large a multimodal approach is advocated to give the optimum pain relief. The Pain Physician after a detailed evaluation identifies a potential pain generator, orders investigations as necessary to consolidate the clinical diagnosis and uses the following main options in conjunction with other modalities physical therapy, psychological counselling etc as per individual requirement.

Drugs:

• Regular Pain killers- Paracetamol, NSAIDs
• Strong Painkillers- Morphine and similar drugs for terminally ill patients with intractable pain.
• Additional medications- Antidepressant [small doses] or Anticonvulsant drugs for some neuropathic pain syndromes.

Interventional Techniques:

• Interventional Pain management has evolved as a separate specialty with a distinct role in comprehensive patient management and adds immense value to a super speciality tertiary referral hospital like Jaslok hospital, Mumbai.
• It is a very crucial component of management which aims to block the conduction of painful impulses. There are numerous interventions which can be offered based on distribution of pain and likely pain generator..
• These techniques can be categorised into different varieties as follows.

Minor Procedures:

• Performed in the minor OT or ultrasonographic guidance on outpatient basis.
• Some examples are: Peripheral Nerve Blocks-Occipital nerve block, Ileo-inguinal blocks, Lateral Cutaneous Nerve of Thigh block, supraorbital nerve etc
• Trigger point injections/Dry Needling
• Refill of Intrathecal Drug pumps, Programming of Neurostimulation devices.

Regenerative Therapies:

• We have launched a dedicated department of Restorative and Regenerative Medicine at Jaslok hospital where precision based therapies like Platelet rich Plasma (PRP) ,BMAC and many others are available for Pain and soft tissue injuries.

Major Procedures:

• These are performed either on daycare basis or sometimes as indoor patients to monitor/ to titrate pain relief and any adverse effects.

As per the international recommendations, these procedures are performed with precision to target the source of pain in the main operation theatre with fluoroscopic OR USG Guidance. Majority of these are performed under local Anesthesia +/- minimum sedation and monitored Anaesthesia care.

We have the state-of-the-art infrastructure with the latest G4 radiofrequency lesion generator to perform long-term pain relief after a successful response to diagnostic block for a variety of targets like Trigeminal/Sphenopalatine /Facet/Stellate/Sacroiliac joint, knee and shoulder joints.We have a large experience of treating patients with intractable Trigeminal Neuralgia.

List of Major Procedures performed by our Department:

For Spinal Pain

• Epidural –Lumbar/Caudal/Thoracic injections
• Cervical Epidural Injection
• Transforaminal Epidural/Selective Nerve root blocks
• Facet joint Injections
• Percutaneous [Racz] epidural Adhesiolysis
• Discography/IDET/Pulsed RFA

Head, Neck, Face, Arm and Chest pain

• Intercostal nerve blocks
• Piriformis muscle injection
• Mandibular /Maxillary/ Glosso-pharyngeal Nerve block
• Trigeminal / Sphenopalatine ganglion blocks
• Stellate Ganglion block
• Brachial Plexus block / Catheter
• Suprascapular nerve block
• Abdomen, Pelvic and LE pain
• Lumbar Sympathetic block
• Splanchnic nerve ablation
• Superior Hypogastric plexus block
• Ganglion Impar block

Advanced Pain therapies

• We have one of the largest experience in the country of performing Neuromodulation-ie Spinal cord stimulation and intrathecal pump implantation for Pain.

Trial of Intrathecal pump or Spinal cord/Peripheral nerve stimulator

• Permanent Implantation of Intrathecal pump/Spinal cord Stimulator/Peripheral Nerve Stimulator
• Motor Cortex Stimulation for intractable post stroke pain

For further information and appointments

Dr. Preeti Doshi-MD FIPP FIAPM

Director and In-Charge of Pain Clinic

2nd Floor Jaslok Hospital & Research Centre 15, Pedder Rd, Mumbai, Maharashtra 400026

Phone: 022-66573076 / 3346

Email: online@jaslokhospital.net

Website:www.jaslokhospital.net