Categories
Oro-facial Pain

Constant Headache

HAVING CONSTANT HEADACHE REGULARLY? GET RELIEF SOON BY DOING THIS TREATMENT

Having constant pain regularly? Now you can treat your headache with following home remedies and get to know more about the treatments which can not only cure your headache but it will also give you preventive measures.

In today’s day-to-day life people are inclined towards good lifestyle and maintain a good standard of living but they tend to forget to take care of their own health, which can harm their health in future in many ways, most commonly witnessed syndrome amongst people is Headache as many of us ignore it initially by ingesting wrong medicines for quick relief rather resolving it through proper medications.

Headache can be more complicated than most people realise. Headaches can be one of the reason which causes a person to be irritated and lose his interest from his life. They can be felt in different areas like in the centre, sides or at the back of the head. But many headaches also cause other unwanted symptoms. This article addresses the most common headache symptoms associated with the different types of headaches.

Headaches can be more complicated than most people realize. Different kinds can have their own set of symptoms, happen for unique reasons, and need different kinds of treatment.

Types of Headaches:

Once you know the type of headache you have, you and your doctor can find the treatment that’s most likely to help and even try to prevent them.

There are over 150 different types of headaches. The most common ones are:

Tension headaches which are also called stress headaches, chronic daily headaches, or chronic non-progressive headaches, they are the most common type among adults and teens. They cause mild to moderate pain and come and go over time.

Treatments:

If you get migraines or other types of headaches, you’ll probably need to use medicine to get relief at some point like preventive medicines for long lasting headaches or abortive medications to control the headaches. Each type of medication works best when you take it along with other lifestyle changes, such as diet, exercise, and relaxation therapy.

Alternative Treatments for Migraines and Headaches:

  • Biofeedback
  • Stress Management
  • Acupuncture
  • Massage
  • Herbs
  • Aromatherapy
  • Dietary Changes

Home Remedy:

Home remedies for headaches include applying an ice pack on the forehead, taking a nap, sleeping and massaging the back, neck and temples. Lying down in a peaceful area to release tension is another way to cure headaches at home. 

Natural home remedies to treat headaches include applying a cold compress to the head to reduce throbbing pain and relaxation techniques such as yoga, meditation, massages. Patients may benefit from rest in a low-lit room to minimize pain or applying gentle rotating pressure to areas of the head with the index finger or thumb for 15 seconds at a time.

Treatments in Mumbai:

There are many clinics which treats such pains like Neocare by Dr Ruchika Sood, who treats the pain through:

  • Physical therapy which includes stretching exercises, postural and strengthening exercises.
  • Medicines ranging from non-steroidal anti-inflammatory drugs, anti-depressants to muscle relaxants.
  • Massage therapy includes therapeutic massage which increases the blood flow to the area thus flushing out the toxins and making the muscle less tight.
  • Posture evaluation and ergonomic for poor posture, workplace ergonomics. 

Tips to help chronic headaches:

  • Stick to a schedule-Going to bed and waking up around the same time — even on the weekends — eating your meals on a schedule, exercising aerobically every day for at least 20 minutes: all will help protect you from getting migraines.
  • Track your triggers. Not everyone has the same migraine triggers.
  • Research shows that magnesium, riboflavin (vitamin B2), and coenzyme Q10 can help prevent migraines.

Following the above measure, taking utmost care of understanding the trigger points and taking treatments from your doctor together can be a successful step in leading a pain free life.

Categories
Oro-facial Pain

Neuropathic Pain

Today’s lifestyle and stress is the major reason for the majority of the ailments faced by the mankind, namely, Diabetes, Blood pressure, low back issues and so on, which gradually damages a nerve in the body causing pain.

80% of the pain is of the unknown origin (Idiopathic). It becomes difficult to locate the exact origin of the pain. This happens when the nerve in the particular area is damaged due to various reasons which gives rise to Neuropathy and the pain caused by the neuropathy is called as the neuropathic pain.

What is diabetic neuropathy?

Neuropathy means nerve disease or damage. Neuropathic pain is a complex, chronic pain state that usually is coupled with tissue injury. With neuropathic pain, the nerve fibres themselves may be damaged, dysfunctional or injured. These damaged nerve fibres send incorrect signals to other pain centres, causing diffused pain. The impact of nerve fibre injury includes a change in nerve function, both at the site of injury and areas around the injury.

Causes of Neuropathic Pain

Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:

Symptoms of Neuropathic Pain

Neuropathic pain symptoms may include:

  • Shooting and burning pain
  • Tingling and numbness

What is Orofacial Neuropathy:

Based on symptomatology, neuropathic orofacial pain may be divided into two broad categories: episodic and continuous. Episodic neuropathies are characterized by short electrical or sharp pain that may be paroxysmal, as in trigeminal neuralgia. Continuous burning pain is characteristic of post-traumatic neuropathy or inflammation in nerve structures (neuritis). Depending on the location of the initiating event, neuropathic pain may also be classified as peripheral or central. However, persistent peripheral neuropathies eventually involve mal-adaptive responses of central nervous system.

Trigeminal Neuralgia:

The major type of Orofacial neuropathy is called the Trigeminal Neuralgia.

Trigeminal neuralgia (TN) is an excruciating, short-lasting, unilateral facial pain.

Clinical features:

  • Onset of TN may be abrupt. TN is a unilateral facial pain syndrome.
  • Pain location is usually described according to the major branches of the trigeminal nerve.

Neuropathic Pain Treatment

Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs. Some people may require a stronger painkiller, such as those containing morphine. Anticonvulsant and antidepressant drugs seem to work in some cases.

If another condition, such as diabetes, is involved, better management of that disorder may reduce the pain. Effective management of the condition can also help prevent further nerve damage.

In cases that are difficult to treat, a pain specialist may use an invasive or implantable device to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain may significantly control the pain symptoms. Physiotherapeutic devices and treatment proves fruitful in these conditions

Other kinds of treatments can also help with neuropathic pain. Some of these include:

Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability. A multidisciplinary approach that combines therapies, however, can be a very effective way to provide relief from neuropathic pain.

Treatments in Mumbai:

There are many clinics which treats such pains like Neocare by Dr Ruchika Sood, who treats the pain through:

  • Physical therapy which includes stretching exercises, postural and strengthening exercises.
  • Medicines ranging from non-steroidal anti-inflammatory drugs, anti-depressants to muscle relaxants.
  • Massage therapy includes therapeutic massage which increases the blood flow to the area thus flushing out the toxins and making the muscle less tight.
  • Posture evaluation and ergonomic for poor posture, workplace ergonomics. 

Following the above measure, taking utmost care of understanding the trigger points and taking treatments from your doctor, together can be a successful step in leading a better life.

Categories
Oro-facial Pain

Facial Pains

There are different types of facial pains, and with correct diagnosis, there are many relief options. Some indicators to help you understand your pain.

Muscle pain or Myofascial Pain (Musculoskeletal)

Complaints like pain at the base of the skull extending at neck or face can be caused by poor sleeping postures and by over-exercising upper body at the gym. These are often confused with nerve pain. The pain may come many times a day. Each attack is short lasting and pricking in quality .

Complaints when one side of the jaw has limited sidewards movement can arise with a sudden spasm in the muscles around the joint. This can happen due to uneven distribution of the load on the joint or sudden impact injury to the muscle. The pain is usually sharp due to spasm.

Many a times the spasm in neck muscles can manifest as headache The painful muscle has tender points and trigger points. Tender points are the areas of the muscle that are painful when the doctor is performing the examination. Trigger points are the areas that refer pain to other places. There are different muscles in the head and neck region that refer pain to head area and be felt as headaches.

The important joint in the head and neck region called the TMJ Joint, just in front of both ears, and serves as a connection between the lower jaw and the skull. This joint helps you eat, yawn, talk. There are many different types of pain disorders ,which are felt as ache in temples, ear pain, facial soreness, limited range of motion of mouth, clicking and joint noise. These can be caused by different reasons some of them being grinding the teeth especially in sleep, cradling phone between neck and shoulder, biting nails or clenching teeth, etc.

Nerve Pain (Neuropathic)

Nerve pains are felt like sharp, shooting electric pain or as burning pain in the region of cheeks, nose, throat or jaw. These are short lasting but may leave behind residual pain. The important nerve of the facial region is called Trigeminal Nerve and most common painful nerve condition in the region is Trigeminal Neuralgia. This occurs because of a blood vessel pressing on the nerve inside the skull or because of other diseases like Multiple Sclerosis. There are other types of nerve pains too .

Pain because of blood vessels (Neurovascular)

Headaches affect all levels of society, affect people from almost every culture, and have been a part of the human condition since ancient times.

Headaches are a non-specific symptom in the same manner as a fever is a non-specific symptom of an infection. Every person experiences it at some time during lifetime. It becomes a disorder when headaches are recurrent and interfere with normal functioning of life.

Medically, headaches are of two types

  1. Primary headaches like migraine, tension, cluster headache.
  2. Secondary headaches happening because of an underlying condition.

It is important to share the detailed history with the doctor. This will help in the diagnosis of the headache disorder

There is a lot of overlap in headache conditions like migraine, tension type headache and Temporomandibulat Disorders. The most common headache type is Migraine.

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Uncategorized

Pain in HIV+ people

Pain is common in people living with HIV or what is called as HIV+ people. Pain can occur at all stages of HIV disease and can affect many parts of the body including the facial area  As the disease progresses, pain usually becomes more severe, but each individual person is different. While some people may experience a lot of pain, others have little or none.

Why Pain? 
The pain related with HIV maybe a symptom of HIV itself or an infection. It may also be a side effect of drugs being used. Whatever the cause, the pain should be evaluated and treated to enable the patient to have a good quality of life. 

Types of Pain seen 
The management of HIV related pain begins with the identification of pain and if possible by understanding the cause of pain.  Some of the conditions that affect the facial region are:

 ▪ Neuropathies or pain due to nerve damage. Nerve damage can be caused by HIV itself, HIV drugs, or other medical conditions such as diabetes. Facial nerve paralysis is more common in immuno-compromised people than in immuno-competent individuals. Idiopathic facial nerve palsy is the most common diagnosis given for HIV-infected patients. The cause is an infection by Herpes Simplex Virus (HSV). Herpes Zoster infection also may occur (Ramsay Hunt Syndrome) causing damage to the sensory component of Facial Nerve.

 • Various types of skin lesions (Herpetic infections, dermatitis etc.) are seen also presenting symptoms of HIV infection. The herpes simplex or zoster may cause big rashes on facial skin. 

 • Headache– Head pain can be mild to severe, and may be described as pressure, throbbing, or a dull ache. The most common causes of mild headaches include muscle tension, flu-like illness, and HIV drug side effects. Moderate or severe headaches can be caused by sinus pressure, tooth infections, brain infections, brain tumors, bleeding in the brain, migraines, or strokes.

 • TMJ Joint Pain – This pain can also be mild to severe. It may be related to conditions such as arthritis, bone disease, injury, or just aging. It can also be a side effect of some HIV drugs and medications for other conditions like hepatitis or high cholesterol.

 • Herpes Pain– Herpes is a family of viruses common in people living with HIV. Herpes viruses stay in the body for life, going into hiding and flaring up later. The varicella-zoster herpes virus first causes chickenpox and later can cause shingles, a painful rash along nerve pathways. Herpes simplex virus types 1 and 2 cause painful blisters around the mouth ("cold sores") or genital area. Even after a herpes sore heals, a person may still have persistent pain.

 • Other Types
 ◦ Painful skin rashes due to infections or side effects of HIV drugs or other drugs
 ◦ Frequent fungal infections  
 ◦ Mouth pain caused by ulcers ("canker sores") 
 ◦ Fibromyalgia or related chronic pain conditions
 ◦ Pain due to different types of cancer

Seeking help:

You may be having pain and do not want to complain about it. Or perhaps you do not want to talk about your pain because you are afraid to know what is causing it. However, pain is your body's way of telling you that something is wrong.

Talking to your doctor about how you feel & find out what is wrong and get the right treatment. Your doctor will assess the pain by your description of its severity and quality etc. So, its important to share all the details with your doctor in the history. 
  
Pain Management

Once the type and characteristics of pain are identified, you can understand from your doctor on the options about how to manage or treat it. There are medicinal and alternative therapies for it.
 
Pain relief options without medications include:
 • Massage
 • Relaxation techniques, such as meditation
 • Physical therapy
 • Acupuncture or acupressure
 • Heat and cold therapy
 Regular physical activity

What to Do if You Have Pain

When you experience pain, it is important to know how to get fast, safe relief.

 • Do not ignore your pain – Pain is the body's way of telling us something is wrong. Ignoring pain often makes matters worse and can cause more damage in the long run.

 • Assess your pain – When pain occurs ask yourself the following questions:
 ◦ How long have I had the pain?
 ◦ Did it happen suddenly or over time?
 ◦ Is the pain sharp or dull?
 ◦ What makes the pain worse?
 ◦ Does anything ease the pain?
 ◦ Is the pain limited to one place or does it spread out to other areas?
 ◦ Are there other symptoms (for example numbness, cough, or fever)?
 • Report  it all to your doctor pain He needs it to decide how best to treat you.

 •  Pain medications work best if started early on. Trying to be tough is not of much use. 


Pain is common among people living with HIV. However, it can be managed using a variety of methods. Communication is the key so if you are having pain, talk to your doctor. He or she can work with you to find the cause, manage the pain, and improve your quality of life.

Categories
Oro-facial Pain

Coronavirus Pandemic & Chronic Pain & TMJ problems

Tips to Manage

Face Pain

The coronavirus pandemic has been declared a pandemic by WHO (World Health Organization), and this situation creates a lot of panic and anxiety amongst people. Anxiety is no-ones friend, leave aside chronic pain patients. The information and news all around TV, social media groups, newspapers, etc. is feeding the devil.

Here are our few suggestions to help in the face of this pandemic, known as Covid-19.

1. Actual risk v/s fear-based risk

Majority of otherwise healthy people will recover even if they contact the disease. So, take a deep breath and be calm. Take precautions and keep peace. Most pain problems are managed by medicines that do not lower your immunity. You are doing good with your immunity if you are not on steroids or any such medicines. Discuss with your doctor and make sure you are on prescription that does not lower your immunity.

2. Hydrate regularly

Stay hydrated. Dehydration causes pain, so please drink adequate water. Despite alternatives like juices and soups, choose water because it represents fluids in readily available form for the body. It is natural and has been there since the beginning of mankind. Advantages of drinking water:

  • Maintains fluid balance
  • Reduces muscle fatigue
  • Regulates metabolism
  • Prevents constipation

3. Isolation

We know that impact of pain is reduced in individuals who perceive a greater sense of inclusion from and engagement with others. The effectiveness of therapeutic modalities is better with positive social interactions. So, isolation is not a good idea for any pain patient. Please plan to interact with few family members and friends, have online connects and engage in meaningful activities to keep your pain under check.

4. Stock your medicines

If you are on nerve pain or headache or migraine medicines for your pain problem, please make sure you have enough reserves to last you for at-least 3 weeks. Incase you run out of medicines, have a list of substitutes available.

5. Visiting your doctor

Incase you are planning to visit your doctor but did not sleep well the night before, stayed dehydrated or are feeling tired and lethargic, choose to take rest and sleep well. Call and talk to the doctors office and try to reschedule the visit. This will help you and your care provider both limit your exposure to hospital systems to emergencies only.

6. Delivery systems

Instead of collecting at various grocery, medical or food spots, please opt for home delivery.

7. Build your protective fort

The things that help one fight any chronic pain problem like:

  • Good sleep
  • Regular exercise
  • Healthy, clean food
  • Adequate water intake
  • Stress management techniques

will help you stay strong in the face of this pandemic too.

Remember, our health care is our responsibility, and this pandemic is just a reminder of the same.

Stay calm and take care.

Categories
Oro-facial Pain

Neuropathy

Suffering from Neuropathy ?      We can help

Neuropathy

Today’s lifestyle and stress is the major reason for the majority of the ailments faced by the mankind, namely, Diabetes, Blood pressure, low back issues and so on which gradually damages the particular nerve in the body causing.

80% of the pain is of the unknown origin (Idiopathic). It becomes difficult to locate the exact origin of the pain. This happens when the nerve in the particular area is damaged due to various reasons which gives rise to Neuropathy and the pain caused by the neuropathy is called as the neuropathic pain.

What is diabetic neuropathy?

Neuropathy means nerve disease or damage. Neuropathic pain is a complex, chronic pain state that usually is coupled with tissue injury. With neuropathic pain, the nerve fibres themselves may be damaged, dysfunctional or injured. These damaged nerve fibres send incorrect signals to other pain centres causing diffused pain. The impact of nerve fibre injury includes a change in nerve function both at the site of injury and areas around the injury.

Causes of Neuropathic Pain

Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:

Causes of Neuropathic Pain
  • Alcoholism
  • Amputation
  • Dental injury
  • Back, leg, and hip problems
  • Chemotherapy
  • Diabetes
  • Facial nerve problems
  • HIV infection or AIDS
  • Multiple sclerosis
  • Shingles
  • Tingling and numbness
  • Spine surgery

Symptoms of Neuropathic PainNeuropathic pain symptoms may include:

  • Shooting and burning pain
  • Tingling and numbness

What is Orofacial Neuropathy:

Based on symptomatology, neuropathic orofacial pain may be divided into two broad categories: episodic and continuous. Episodic neuropathies are characterized by short electrical or sharp pain that may be paroxysmal, as in trigeminal neuralgia. Continuous burning pain is characteristic of posttraumatic neuropathy or inflammation in nerve structures (neuritis). Depending on the location of the initiating event, neuropathic pain may also be classified as peripheral or central. However, persistent peripheral neuropathies eventually involve maladaptive responses of central nervous system.

Neuropathic Pain is a Disease
Diagnosing Neuropathic Pain is Challenging

Trigeminal Neuralgia:

The major type of Orofacial neuropathy is called the Trigeminal Neuralgia. Trigeminal neuralgia (TN) is an excruciating, short-lasting, unilateral facial pain.

Trigeminal Nerve

Clinical features:

  • Onset of TN may be abrupt. TN is a unilateral facial pain syndrome.
  • Pain location is usually described according to the major branches of the trigeminal nerve.

Neuropathic Pain Treatment

Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs. Some people may require a stronger painkiller, such as those containing morphine. Anticonvulsant and antidepressant drugs seem to work in some cases.

If another condition, such as diabetes, is involved, better management of that disorder may reduce the pain. Effective management of the condition can also help prevent further nerve damage.

In cases that are difficult to treat, a pain specialist may use an invasive or implantable device to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain may significantly control the pain symptoms. Physiotherapeutic devices and treatment proves fruitful in these conditions

Other kinds of treatments can also help with neuropathic pain. Some of these include:

  • Physical therapy
  • Working with a counsellor
  • Relaxation therapy
  • Massage therapy
  • Acupuncture

Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability. A multidisciplinary approach that combines therapies, however, can be a very effective way to provide relief from neuropathic pain.

Treatments in Mumbai:

There are many clinics which treats such pains like Neocare by Dr Ruchika Sood, who treats the pain through:

  • Physical therapy which includes stretching exercises, postural and strengthening exercises.
  • Medicines ranging from non-steroidal anti-inflammatory drugs, anti-depressants to muscle relaxants.
  • Massage therapy includes therapeutic massage which increases the blood flow to the area thus flushing out the toxins and making the muscle less tight.
  • Posture evaluation and ergonomic for poor posture, workplace ergonomics.
Categories
Oro-facial Pain

MIGRAINE! NOT AGAIN!!

Treat the cause, not the symptoms

Just when you have truckloads of work lined up for the day, the last thing you want is a throbbing headache. But life has to go on, so you pop a pill and carry on with your work. That’s not the end though, because the pain returns and you wonder why?

Migraine affects the productivity of a large number of people and is more common in women than men. A migraine is different from other kinds of headache and is identified by its symptoms. The headache is frequent with pain ranging from moderate to severe. It is usually a one sided pulsating pain in the head and may be accompanied by other symptoms like nausea, vomiting, sensitivity to light and sound etc. Some people experience a visual aura like a blurred vision, spots, stars or wavy lines before the headache starts.

So what causes a migraine?

A migraine can be triggered by many things and may differ from person to person. Some common triggers can be

  • Missing meals; dieting or fasting
  • Lack of sleep
  • Exercise or physical activity
  • Oral contraceptives
  • Hormonal changes
  • Stress and anxiety
  • Certain foods like MSG or allergens

While treating migraine, it is important to find out what triggers the headache so as to avoid them. Therefore only a proper diagnosis of the condition can help in curing the ailment and prevent it from recurring.

Smita Bhide, a 22 year old management student from Mumbai recounts her harrowing days of dealing with migraine. “I was getting headaches almost every day during some months of the year. I would take painkillers and go about with my day. After a point the painkillers seem to have no effect on the pain. I couldn’t concentrate on my studies and was getting depressed”. Smita consulted Dr Ruchika Sood, specialist at Neocare. The doctor asked her to maintain a record of the timings and frequency of the headaches. She also enquired about her diet, studies and sleep patterns. It was then revealed that Smita would usually skip her meals and eat at odd hours during her exams. That coupled with stress and anxiety of completing her studies triggered the headaches..

“Taking medicines without prescription can do more harm than good. Some of them can cause serious side effects and other problems. Having frequent attacks that is more than twice in a month and regular use of painkillers for the same, needs to be examined. If migraine interferes with your daily life despite treatment then one needs to consult a doctor who specializes in headaches”, advises Dr Ruchika Sood.

Categories
Oro-facial Pain

Ear Pain not going away ?!!

IS YOUR EAR PAIN RELATED TO THE JOINT ASSISTING YOU IN OPENING OF MOUTH?

There is only one movable joint in your head – the one that helps you in opening of your mouth. You use this joint more than any other joint in your body – while you speak, while you eat, when you yawn… and can this be the cause of your ear pain?

Read on to know more.

Sometimes unexplained ear pain comes from the adjoining structure called as the temporomandibular joint. This is often due to the proximity of the two structures, common innervations and common origin.

Both the ear and the joint are neighbours to each other, with only one wall separating them.

As also, while you are growing in your mothers womb as an embryo, the structures of the ear, stapes and malleus are developed from the same structures as in your temporomandibular joint. This means both will be supplied by the same nerves.

The overlap of these two sometimes causes masking effect. That is the pain may be originating from the joint, but the symptoms may be those of ears.

Patients may experience ringing of ears aka tinnitus, dizziness, deafness, otalgia , vertigo etc. These complaints remain unresolvable inspite of multiple visits to many doctors.

Often patients would have been to ENTs, however there would be no sign of infections but prescribed analgesics would relieve pain for sometimes followed by reappearance of symptoms once the effect of analgesics wanes off.

It is in such cases that Temporomandibular joint problems must be suspected. And a visit to an orofacial pain and TMJ specialist scheduled.