HEADACHES
PAIN MEDICINE | VITUS CLINICAL SERVICES | BANGALORE
OUR EXPERTISE
Identifying the cause of your pain using a combination of clinical examination and imaging technologies. Once the cause of pain is identified, we target our therapies using precision-based and minimally invasive injections on a daycare basis. Attention to detail and having all aspects of pain covered is our motto in providing pain control and long-term favorable patient outcomes.
OUR SERVICES
Headaches are so common that there is probably not a single adult on the planet who has not had one in their lifetime. There are more than 100 types of Headaches as classified by the International Headache Society.
Broadly Headaches are classified as primary and secondary.
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Primary Headaches are those with no structural abnormality (Eg: Migraine, tension headaches, cluster headache)
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Secondary Headaches are those with some sort of structural abnormalities (a tumor in the brain, hemorrhage in the brain).
Fortunately a vast majority of headaches are primary headaches. However when u go to your pain physician for a headache issue, they may order scans and other tests to rule out a secondary cause.
Most primary headaches are dealt with lifestyle changes and medication (for eg - tension headaches), there are a few headaches which are amenable to interventional pain management.
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Migraine
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Cluster headache
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Occipital neuralgia
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Cervicogenic headache
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Post dural puncture headache
SPINAL PAIN - BACK & NECK | MUSCULOSKELETAL PAINS – SHOULDER, HIP, KNEE | HEADACHES | FACIAL PAINS INCLUDING TRIGEMINAL NEURALGIA | CANCER PAIN | CHRONIC ABDOMINAL PAIN | PELVIC PAIN | PHANTOM PAIN | PERIPHERAL VASCULAR PAIN | POST HERPETIC NEURALGIA | CHRONIC POST SURGICAL PAIN | FIBROMYALGIA | FUNCTIONAL PAIN SYNDROMES
Most patients with Migraine manage well lifestyle changes, medication and education about the problem.
However chronic migraneurs may benefit from botulinum toxin A therapy. These are injections given at various specified spots on the head area and these may need to be repeated after 3 months. This therapy can help migraneurs decrease their headache frequency and severity. Your pain physician will help you understand the treatment and help you in decision making for this treatment.
CLUSTER HEADACHE
Cluster headache is felt as a severe sharp stabbing headache over the eye and the surrounding area. It is associated with tearing of the eye, reddening of the eye and a runny nose. The attacks happen in slusters and commonly on the same time of the day.
More often than not this pain can be managed with m medications and lifestyle changes. However in a small minority of patients, in whom the pain is sever and the medications are not helping interventional pain management techniques can be offered to you by your pain physician.
The sphenopalatine ganglion (a group of nerves in close relation to the nose) plays a role in this headache disorder. A sphenopalatine block and later sphenopalatine radiofrequency denervation can help in quick control of cluster headache. Your pain physician can give your more details of the same.
OCCIPITAL NEURALGIA
Occipital neuralgia is a headache disorder due to either entrapment or inflammation of what are called the occipital nerve a the back of the head.
Although most people with this problem acan be managed with medications there will nbe a small group of patietns who will benefit from interventional pain management. Your pain physican can educate you about such options.
An occipital nerve block is done with local anesthetic and a small dose of steroid to numb the occipital nerves. This is both diagnostic and therapeutic in nature.
Radiofrequency denervation can provide long term relief.
CERVICOGENIC HEADACHE
Cervicogenic headache is referred pain. The original pain generator is in the neck muscles and joints and this pain can be felt in various parts of the head and face.
Commonly the muscles and joints in the neck become sensitized after some sort of injury (most commonly what is called as whiplash injury). This eventually becomes a chronic pain problem and is difficult to localize the origin of the pain to the neck.
When your pain physician suspects the pain to be originating from the joints in the neck( what are called the facet joints), performing diagnostic blocks to the small nerves that supply these joints can provide dramatic (albeit temporary) pain relief and thus confirm the diagnosis. This procedure is called a medial branch blocks ( or third occipital nerve blocks).
Once the diagnosis is confirmed by these injections your pain physician can consider the option of radiofrequency denervation. This procedure involves stunning the same nerves the were blocked by the local anesthetic by specialized radiofrequency needles to achieve long erm relief.
POST DURAL PUNCTURE HEADACHE
Spinal anesthesia is a commonly done procedure to facilitate multiple lower abdominal, pelvic and lower limb surgeries. This procedure involves a fine needle placed in the fluid surrounding your spinal nerves in the lower back and injecting local anesthesia. This is an extremely safe and efficient anesthesia technique.
However a very small minority of patients develop what is called a Post Dural Puncture Headache after this procedure and usually this settles down in a few days with simple measures like rest, increasing fluid and caffeine (coffee/tea) intake.
Rarely you will need the input of your pain physician to treat the headache. Multiple interventional pain management techniques like greater and lesser occipital nerve blocks, sphenopalatine block or an epidural blood patch may be required.
Epidural blood patch involves injecting a small quantity of your own blood around the sac containing the spinal nerves so as to stop the leaking fluid caused by the spinal anesthesia injection.
