“No one needs to suffer pain unnecessarily”

Interventional pain management consultant, Dr Lakshmi Vas runs the Ashirvad Pain Relief Clinic, started in November 2005 for pain management. She has practised at Prince Alykhan Hospital and Breach Candy Hospital since 2002.

She is a member of the Indian Society for the Study of Pain (ISSP) and the President of the Bombay branch of ISSP.

The expert took time off her busy schedule to answer Sify readers’ queries on managing pain. Read the chat transcript here.

Hi madam when i use the mouse i get hand pain , but when i am not using i am normal , how to avoid this pain ?
Sounds like extended RSI . You need to do regular neck and forearm exercises . Check for deficiencies and correct them. Also look at ergonomic ways of using mouse

My mother aged 64 has been suffering from osteo arthritis for almost 7-8 years. What is the best cure as she is surviving on pain killers every alternate day.
She can see me . We have a composite treatment for knee problems. If the OA is bad, I will advise her surgery. If not our treatment will make her comfortabble

Suffering from knee jt & toe pain for the last 3 yrs and wrist pain recently. I m 40, my wt is 70kg & ht 5ft 6in. I have 2 sons of 7 and 4.5 years & had MTP once. I have fed breast milk to them for 2.5 years each. Pl suggest

Please check for deficienciies. Contact a pain specialist as these pains are reversible

Hi, my wife had a CS in Nov 2010 and gave birth to a sweet baby girl. Since then she is having problems with her back especially waist area. What is the reason and how can she get rid of the pain?
She may be deficiient in vitamiins and calcium. She should see a pain specialist so that proper work up and treatment can be undertaken. These pains are reversible

I am having consistent pain in my lower back and my left shoulder, because of which i dont get proper sleep in the night .
With constant pain sleep disturbbane is common. You need to seea pain specialist for proper work up and treatment

hi. i took physio for right sacroileac joint pain. but this worsens in winter and if i sit long hours. is it a serious problem? is there any other other way out?
Yes it can become a serious nuisence. It can be treated with probable SI joint injection followed by IMS( dry needling of muscles ) You can see me for this

I have pain in left knee, what is the remedy . my age is 51 years , i am suffering from thyroid and diabetes
You will benefir from a proper addressla of your problems. Investigaton for deficiencies, IMS, physiotherapy will together help you

what are the pros and cons of laminectomy
Witha big disc, laminectomy can help, . It is the only answer if you have motor deficits like weakness. However , about 20-30% of all back surgeries can fail to relieve pain. This is the biggest hassle of back surgery. If someone is lucky to get into the other 70 % surgery is great. Other cons are that here are possibilities of later innstability and facet problems

I am 53, suffering with severe left shoulder to neck pain & joints pain. Many orthos tried. Physiotherapy is temp relief. Can u suggest?
Please see me. This pain CAN definitely be relieved. No need to suffer unnecessarily

iam 46 having pain in right si joints for the last three years mri,bone scan ok .according to doctors the pain is due to enlargenebt of bone which is creating pressure on a particular nerve.Is this true,what is the remedy to get releive from pain
COuld be true. But your pain is likely to be because of muscles around that joint. This will respond to a treatment called IMS which I do. You can contact me

I have leftshoulder paid & unable to turn towards left. Physiotherapy is not working. Consulted many orthos, can you suggest?
This is frozen shoulder which has to be addressed well. otherwise this pain is likely to continue for another year after which it will subside automatically. But the pain can be severe . So please get treated . You can contact me at 24121070/71

Mother (77) former cancer patient, is osteoporotic and suffers from slip disc (multiple discs). Pain is being managed by miacalcic nasal spray. But pain re appears when spray is discontinued. Is there any more effective and less costly remedy?
There is remedy that is cheaper called osteophos 70mg once a week on empty stomach. she has to keep moving for 30 mins after this . This is the only cheaper treatment. Regular mild exercises walking will also help. There is a definite treatment with parathormone injections which is more expensive than youur present treatment

dear mam, i have back pain, annular tear in 1 disc. pl tell me how to prevent back pain from increasing?
You are likely to need an epidural injection by a pain specialist. These injectioons should be Xray guided .

doc, my father, 68, has pain in legs due to varicose veins. he walks abt 3 kms daily. is there any other way to prevent pain?
He probably has very stiff calf muscles . He should do stretches for these . A treatment called IMS will also help a lot. You can contact me

hi mam iam 45 yrs old, i get severe headache whn in summer when i step out in the sun after abt 11 am. what could be the cause. pl suggest some treatment
Many types of migraine are triggered by sunshine. You can wear dark glasses of course or take treatment by a pain specialist if it persists

My mother is 58 years old, she is suffereing from Arthritis problem for knee pain and give NSAIDs. Is there any other safe treatment for Arthritis problem?
There are safer medications as well as treatments which can make her very comfortable. You need to see a pain specialist. You can contact me

dear maam.ive bn having low backache for the past 3.5 yrs.. it aggravates when i sit down for more than 15-30. i have spondylolysis in my l3-l4 vertebrae. can postural problems give rise to backache for such a long time? pl advice
Yes. This kind of problem is maily because of muscle spasms ad has a good outcome with a treatment called IMS. you may contact me

hi madam, my right leg hip is fractured in 2007.. that time i have one operation and 3 screw in my hip… that time this doctor said me this screw are not remove after 1 or 2 yrs. this is the life time… So i remove this screw or not.. pls suggest me..
Depends on the type of screw. Preferable to remove it if your ortho has advised it

dear doctor, i get migraine whenever i am tense. the pain spreads down to the back of the neck and goes only if i sleep fro few hours. pl advice
Migraine is a disease of sensitive people who tend to get tense. Yoga and stress management will help . I have a treatment for migraiine which works well

hi doctor, im having knee pain for last 2yrs. cant climb stairs. arthritis ruled out. what could be the reason how to prevent this from worsening?
Pains like these are common. But you can be made painfree completely by one of my treatments. You may contact me.

madam, my aunt is suffering from restless leg syndrome for past 20 yrs. she cant walk much because of arthritic knees. pl advice
You can see me call 24121070 for apptment . This is an unusual problem so will require proper analysis and treatment

hi madam, pl tell me how it to work out if we have pain in back all the time. is yoga safe of physiotherapy exercise? can we go to a gym?
You need to see a pain specialist. If you have pain all the time you may be having some problem. Better to iinvestigate and treat

hello doc, pl ell us if there is anyway to prevent back pain in young adults
Regular exercises particularly back exercises with repetitive flexion and extension. Yoga has the best of these.

doctor i have 4 disc bulges and fell better with yoga. however i cant stand for more than half an hour at a stretch. what is the remedy?
You need structured pain management. See a pain specialist

i used to do brisk walk for around 3 KM every day but i realise pain in the back after walk

Do stretches of the back before and after walk.

Hello, Some time I am suffring lower side back pain and I am unable to walk, some time suddenly start pain in my bone at my finger, tow and knee, respect Dr kindly advice me?
Sounds like a myofascial pain. Need to check for deficiencies of VIT B12 and D3 . See a pain specialist for proper work up

Doc,My wife is suffering from back pain for the last 5 yrs.Not a case of disc slip but, lower back bone seems dehydrated (MRI scan). . She has hyopthyroidism also and was facning non specific body pains too in past.
She needs structured pain management . You have to consult a pain specialist who can address non specific back pains like your description

I am suffering from severe back pain very often, I am weighing about 90 kgs, I travel on bike a lot, the pain is back below left spinal cord,
You need to see a pain specialist for correct diagnosis and treatment If in Mumbai you can contact me

doc, my wife 62 suffered brain stroke and has clots mainly in thelamus. she feels heaviness in head and pain all over her right halff. she is taking daxid, cipralex and maxgillan since years. please suggest ways for a less painful life. thanks.
Thalamic pains can be very distressing. If you live in Mumbai you can see me as this is a complex central pain. contact a pain specialist wherever you are. You should check for deficiencies of vit B12 and D#. Also do regular knee exercises as suggested bya physiotherapist.

madam, im having rhuematoid arthritis inmy fingers. it is very painful. i tried ayurveda but no use. is there any treatment for this?
Yes there are some medicines, physiotherapy and a treatment that I do for reducing muscle pains called IMS or dry needling. All these together can help you

hello doctor, i underwent surgery for hernia and have back pain since then. pl tell me if it is ok to practise yoga or have to go to a ortho?
Yes Yoga can help. But do it with a teacher under supervision. You should check for deficiencies of vit B12 and D3.

doctor, my sister has flat foot and she is a dancer so she has a lot of leg pain. is there any cure for this?
Yes some exercises will help Also an arch support

I suffer from cartilage damage in my left knee, though i walk carefully a wrong footing gives rise sudden and massive rise to pain, which last 2/3 days. How to reduce the pain when it happens?
You should check for deficiencies of vit B12 and D#. Also do regular knee exercises as suggested bya physiotherapist. if pain still persists you need to see a pain specialist

hi doctor. my mom was diagnosed with lumbar pain and sciatica 2 years ago. she has 2 rounds of physio and has been practising yoga. her pain aggravates everytime she stands or sits for long periods. they say chronic pain will never go,. pl help
Your mother needs to see a pain specialist in your area. correction of deficiencies will also help

hi rupali, how to get rid of neck pain – i sit on my pc for 9 hrs at a stretch
Answer would be to get up every hour stretch your neck walk around a bit then sit down at your PC. Also do regular neck exercises. Learn this from a physiotherapist.

hello doctor. i am arthritic for the last 5 years. i have been told that exercise helps. is it true?
Yes, Please check your vit B12 and Vit D3 levels. If they are abnormal correct them by advice of your doctor . Execises and deficiency correction help in a big way. If pain persists in spite of this you have to see a pain specialist

dear doctor, pl tell us how to manage growing pain in children?
Growing pain is refferred to the pain iin the calf or feet of children. I am afraid that the only answer for this would be stretches of the calf

hi do regular workouts increase wear and tear and cause joint pain?
Yes unless they are precede by stretches before and after the workout. These stretches should last at least 1/4 the workout period

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