Friday, 26 July 2019

Managing Trigeminal Neuralgia

The “Suicide Disease” often misdiagnosed



Srikant, 68, a retired professional was experienceing constant pain in his jaws for the past 10 years. Assuming that it was a dental pain, he visited several dentists to get the ailment cured.

He had several tooth extractions done. However, the pain persisted.

Then he searched online hoping to find the exact cause of his pain. It was then that he began to suspect that his pain was caused because of a neurological disorder.

He consulted a neurologist and was then diagnosed with a 'suicidal' facial nerve disease called Trigeminal Neuralgia (TN)

Many people suffer from this suicidal disease but is often misdiagnosed as a dental or ENT problem.

TN is called the suicide disease because it is a persistent pain condition connected with nerve injury or nerve abrasion and is considered to be the most painful disease. Often, unable to bear the pain, patients are pushed to commit suicide.

Bollywood actor Salman Khan was diagnosed with the disease and was treated for it recently.

TN affects the trigeminal or the fifth carnial nerve, the largest of the 12 pairs of cranial nerves. It mainly happens because of vascular compression or tumor.

At an awareness programme held at the Health Village Hospital, Bhubaneswar, Sujata, 31 year old victim of the dreaded disease, says she often cursed herself for being a victim of the disease.

"I had a perfect family and a very supportive husband. But I suffered this pain for 10 years. Nobody told me the exact cause of the pain and I ended up spending lakhs of rupees on treatment that did not help. Finally, people around me thought the pain was imaginary and I had a mental health problem. I was latter diagnosed with this disease and was fortunately treated for the same a month ago. After several years, I am pain free now", she said.

The neuropathic pain, causes serve intermittent unexpected burning or shock like facial pain that lasts any where from a few seconds to two minutes per episode.

“It may aggravate during activities like brushing. It usually affects people after 50 years of age but we have been seeing lot of younger patients these days. The incidence is close to 12 in a lakh. Because of misdiagnosis the cases that come to the hospital for treatment are fewer."

These attacks can happen in quick succession, sometimes lasting as long as two hours. Dr. Shovan Kumar Rath, consultant pain specialist at Health Village Hospital has treated close to 100 such cases in past couple of years, with advanced RFA.

Trigeminal Neuralgia is a condition that is characterised by shooting pain in the face
       TN affects one of the largest nerves in the head: the trigeminal nerve. The trigeminal nerve is responsible for sending impulses of thouch, pain and termperature to the branin from face.
       TN can occur when a blood vessel presses on the nerve near the brain stem, multiple sclerosis or idiopathic.

       Sudden, severe, electric shock like or stabbing pain that lasts several seconds on the face.
       Pain can be felt around the nose, lips, eyes, scalp, jaw and forehead
       Pain can be feltby even the simple actions of brushing teeth, putting on makeup, touching the face, swallowing or even feeling a slight breeze on the skin.
       Pain is typically felt on one side of the jaw or cheek. 97% feel pain on just one side of the face
       The pain can come and go throughtout the day and can last for days, weeks, or months at a time

       Treatment options include medicines, surgery and Radio Frequency Ablation. Dr. Shovan Kumar Rath, an eminent pain physician of Bhubaneswar says that while some cases can be handled through medications, in severe cases, one has to go under the Radio Frequency Ablation (RFA).
       The most effective way is RFA of Gasserian Ganglion and the procedure is done under local anaesthesia in day care basis.
       The cost of the procedure may vary from ` 20,000/- to 30,000/-

Managing Osteoarthritis Knee Pain

Symptoms & non-surgical Treatment
exclusively at PAIN FREE ODISHA,Health Village Hospital, Bhubaneswar


Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.

Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people.

Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative,"wear-and-tear" type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too.

In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful bone spurs.

Osteoarthritis develops slowly and the pain it causes worsens over time.

What Causes Knee Osteoarthritis?
The most common cause of osteoarthritis of the knee is age. Almost everyone will eventually develop some degree of osteoarthritis. However, several factors increase the risk of developing significant arthritis at an earlier age.
       Age: The ability of cartilage to heal decreases as a person gets older.
       Weight: Weight increases pressure on all the joints, especially the knees. Every pound of weight you gain adds 3 to 4 pounds of extra weight on your knees.
       Heredity: This includes genetic mutations that might make a person more likely to develop osteoarthritis of the knee.
       Gender: Women ages 55 and older are more likely than men to develop osteoarthritis of the knee.
       Repetitive stress injuries: People with certain occupations that include a lot of activity that can stress the joint, such as kneeling, squatting, or lifting heavy weights, are more likely to develop osteoarthritis of the knee because of the constant pressure on the joint.
       Athletics: Athletes involved in soccer, tennis, or long-distance running may be at higher risk for developing osteoarthritis of the knee. In fact, weak muscles around the knee can lead to osteoarthritis.
       Other illnesses: People with rheumatoid arthritis, the second most common type of arthritis, are also more likely to develop osteoarthritis. People with certain metabolic disorders, such as iron overload or excess growth hormone, also run a higher risk of osteoarthritis.

A knee joint affected by arthritis may be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There are other symptoms, as well:
       The joint may become stiff and swollen, making it difficult to bend and straighten the knee.
       Pain and swelling may be worse in the morning, or after sitting or resting.
       Vigorous activity may cause pain to flare up.
       Loose fragments of cartilage and other tissue can interfere with the smooth motion of joints. The knee may "lock" or "stick" during movement. It may creak, click, snap or make a grinding noise (crepitus).
       Pain may cause a feeling of weakness or buckling in the knee.
       Many people with arthritis note increased joint pain with rainy weather.

Although there is no permanent cure for arthritis, there are many treatment options available to help manage pain and keep people staying active.
       Lifestyle modifications [WEIGHT LOSS/EXERCISE]
       Physical therapy
       Assistive devices.
       Surgical Treatment
       Recent advances in non surgical treatment [VISCOSUPPLEMENTATION/GENICULAR RF/ REGENERATIVE THERAPIES]

Stem Cell Therapy/ platelet rich plasma therapy for Knee Injuries and Arthritis:
Stem cells have an enormous capacity to differentiate into specialized tissues as well as repair and regenerate the damaged cells.  Stem cell therapies are being used to treat a number of orthopaedic conditions like osteoarthritis, rheumatoid arthritis, tennis elbow, head and shoulder pain, bone regeneration, injuries to ligaments or tendons. Stem Cell therapy for knee has helped immensely in alleviating the pain and has shown great results in the treatment of stuffed joint problems and arthritis as it is less invasive than surgeries and safe.
RADIO FREQUENCY ABLATION for genicular nerves (GNRFA) is a relatively new and lesser-known treatment option that is proving effective for certain patients. GNREA relives arthritis knee pain in maximum number of patients for duration of at least one year. In present day scenario it is the best non-surgical procedure available.

Health Village Hospital is the only Centre in Odisha to provided such treatment facility to the people of Odisha since 10 years