Knee pain treatment in India | Removemypain

What is Vitamin B12?

Vitamin B12 is a vital nutrient that plays an important role in our overall health. It is essential for:

Producing red blood cells (important for carrying oxygen in the body)

Maintaining healthy nerves and brain function

DNA production

Helping convert food into energy

The human body cannot make Vitamin B12 on its own. We must get it from food or supplements.

Why is Vitamin B12 Important for Pain?

Vitamin B12 supports the health of nerves, which means it can play a key role in pain conditions—especially nerve-related pain.

Research shows that Vitamin B12 can be helpful in treating:

Diabetic neuropathy

Postherpetic neuralgia

Chronic low back pain

Peripheral neuropathy

Chemotherapy-related nerve pain

Aphthous mouth ulcers

Morton’s neuroma

How Does B12 Help with Pain?

Nerve Healing: It helps repair damaged nerves and supports nerve regrowth.

Reduces Inflammation: It reduces inflammation linked to chronic pain.

Improves Nerve Signals: It boosts nerve conduction and the ability of nerves to send signals properly.

Supports Brain Chemicals: It helps balance neurotransmitters like serotonin and noradrenaline, which can reduce pain.

Works with Painkillers: It may reduce tolerance and dependence on opioids when used together.

Signs and Symptoms of Vitamin B12 Deficiency

Early symptoms:

Weakness and fatigue

Pale skin

Headaches

Mild mood changes

Intermediate symptoms:

Tingling or numbness in hands and feet

Breathlessness

Heart palpitations

Mouth ulcers or a red, swollen tongue (early to intermediate signs)

Advanced symptoms:

Memory problems

Depression, anxiety, mood swings

Poor balance or coordination

Weight loss, poor appetite

Constipation or loose motions

Visual disturbances

In some cases, long-term deficiency can cause permanent nerve damage, so early detection is key.

Who Is at Risk of Vitamin B12 Deficiency?

You may be at risk if you:

Are in the elderly age group

Follow a vegetarian or vegan diet

Have had stomach or intestinal surgery

Suffer from digestive issues like celiac disease or Crohn’s disease

Take acid-lowering medications like PPIs or H2 blockers

Take metformin for diabetes

Are pregnant or breastfeeding

Sources of Vitamin B12

B12 is mainly found in animal-based foods:

Meat, poultry, fish (especially liver)

Eggs and dairy (milk, cheese, curd, paneer)

Fortified cereals and plant-based milk (almond or soy milk)

Note: B12 is not naturally found in plant foods, so vegetarians need to ensure they get it from dairy or fortified foods.

How is Vitamin B12 Deficiency Diagnosed?

Doctors may recommend tests such as:

Blood test for B12 levels (normal range: 200–950 pg/mL)

Homocysteine or methylmalonic acid tests (for unclear cases)

Blood count to check for anaemia

How is Vitamin B12 Treated?

Depending on severity, your doctor may suggest:

1. Oral Supplements/ nasal sprays- Ideal for mild deficiencies.

2. Injections

Used in moderate to severe cases or if absorption is poor and in those with neurological signs. Injections are often needed—daily/ alternate days at first, then weekly or monthly.

For those with chronic absorption problems, lifelong treatment may be necessary.

Most people feel better within days to weeks of starting treatment, especially with fatigue and mood symptoms. Nerve symptoms can take longer and neurological damage is difficult to reverse.”

Can B12 Cause Side Effects?

Vitamin B12 is usually very safe. Side effects are rare but may include:

Mild allergic reactions

Acne-like skin rash

Nausea or upset stomach

Always consult your doctor before starting B12 supplements, especially if you are on other medications.

Important Tips

Avoid alcohol, processed foods, excessive coffee, and sugary snacks, which can worsen B12 absorption.

If you are vegetarian or elderly, consider regular B12 testing.

Do not ignore symptoms like tingling or weakness—early treatment can prevent permanent nerve damage.

Final Word from Dr. Amod Manocha

Vitamin B12 plays a powerful role in nerve health and pain management. Many people are unaware they may be deficient, and this deficiency can worsen or even cause chronic pain.

If you have nerve-related pain or any of the symptoms listed above, talk to your doctor about checking your Vitamin B12 levels.

Simple blood test can help Early treatment is effective and safe Don’t wait for serious symptoms to show up

Back pain is a common problem affecting 8 out of 10 people at some point in their life. It can affect people of all ages and is a common reason for seeking medical assistance. Back pain can arise due to many reasons and accounts for significant suffering & financial loss worldwide. Many people choose to treat their back pain at home with pain relieving medications, heat and ice, or stretching. So, if it’s so prevalent what are the warning signs of something serious which requires medical attention. Some of these are addressed as red flags in medical terminology to warn the clinician of the possibility of serious underlying pathology.

Persistent or worsening back pain. Back pain often goes away in a few days or weeks but if it is persisting or progressively increasing then its a reason to seek medical attention.

Back pain is associated with progressive numbness, tingling, or weakness. This could be a symptom of a pinched nerve, slipped disc or narrowing of the space in the spine (slipped disc) and requires medical attention

Inability to control your bowels or urination (incontinence) Spinal nerve compression can have an impact on one’s ability to control bladder and bowel function, leaving to incontinence. This is a severe symptom and requires immediate medical attention.

Back pain starts after an accident. If your back pain began after a fall, accident or an injury

Back pain that is worse at night

Back pain associated with unexplained weight loss. .

Back pain with Fever. This could be a sign of infection or ongoing inflammation

Back pain in extremes of ages (too young or too old patients) or in high risk individuals such as those with severe osteoporosis or prolonged use of steroids or drug abuse history

Tag = Pain Specialist in Delhi, Pain Treatment in Delhi, Back pain treatment in Delhi, Back pain treatment in Gurgaon

Neck Pain Treatment Gurgaon | Neck Pain Treatment in Delhi

Majority of us would experience neck pain at some point in our life. Neck Pain can disrupt daily routine activities. Muscle spasm, pain can make it difficult to turn head and activities such as driving become difficult. It is not uncommon for the neck pain to radiate to shoulders or lead to persistent headaches. Neck pain is more commonly observed in middle ages and may have a mechanical or postural basis. Most uncomplicated neck pain is associated with poor posture, anxiety and depression, neck strain, injuries. Fortunately majority of cases are not due to serious causes. If you are experiencing unresolving or severe pain, you should seek medical opinion from neck and shoulder pain treatment specialists in Delhi so that timely diagnosis can be done and corrective action can be taken.

Some common causes include –

Muscle sprain, spasm/ increased tension

Poor posture and work ergonomics

Incorrect positioning of the neck while sleeping

Aging: Degenerative disc disease and spinal osteoarthritis become more common as we age

Injuries/ Whiplash: Whiplash neck involves sudden jolting of neck forwards and backwards and is commonly observed in vehicular accidents. This can cause excessive stretching of neck muscles, ligaments or other injuries which can be associated with neck pain.

Neck pain can be a part of more widespread medical issues such as in fibromyalgia, arthritis, ankylosing spondylitis, infections, cancer etc. You can approach Pain Management Specialists in Delhi for diagnosing your problem and suggesting suitable solutions

It is advisable to seek early medical attention if you experience any of the following

Persisting symptoms or severe pain not responding to usual care or medications

Pain starting after fall, injury

New onset numbness, weakness or tingling in arms

Gait or balance problems

Loss or urine or stool control

Signs of infection/ meningitis

Pain worse at night time/interfering with your sleep

Some of the pain management techniques for neck pain include:

Lifestyle changes: Incorrect/ ignored posture while working on laptops mobiles etc can put excessive cervical spine strain leading to pain. Certain professions can be more prone to develop neck pain. Simple posture awareness and improvement, taking regular breaks can go a long way in reducing symptoms.

Medications: Anti-inflammatory drugs such as ibuprofen or naproxen and pain relievers like acetaminophen may initially be prescribed by your doctor. Sometimes medications like muscle relaxants or stronger painkillers may also be suggested by your doctor.

Physical Therapy: Regular exercise, good posture, stretching can help to reduce/ prevent to prevent unwanted stress and tension to your neck muscles. Heat or cold application may be used during the initial phases of injury to facilitate your recovery and physical exercise. Depending on the severity, time since injury and your recovery the specialist may recommend limiting normal physical activity or slow range-of-motion exercises or strengthening exercises.

There is research evidence supporting the use of specific strengthening exercises as part of a routine practice for chronic neck pain, cervicogenic headache and radiculopathy.

Ergonomics & Posture Simple posture changes and better workplace ergonomics can help in preventing/reducing neck pain. Measures include adjustment of furniture height and computer position such that

Eyes point directly at the top third of the screen

Forearm is parallel to floor

Feet should be flat on the floor with thighs parallel with the floor

While sitting in office chair it’s a good practice to have back aligned against the back of the office chair and avoid slouching. Avoid sitting in one place for too long. Taking regular breaks to walk around and stretch is a good practice.

Relaxation techniques: relationship between stress and increase pain is well known and easily appreciated by most patients. Measures to deal with stress and anxiety help in more effective pain management.

Massage Therapy: The evidence supporting the use of massage therapy is limited although some people do find it useful in the short term. Massage can help in relaxing, loosening of muscles but it is important to remember that wrongly done massage can lead to harm.

Acupuncture: Certain people find Acupuncture helpful in neck pain management. When performed correctly it is a low risk procedure. The traditional acupuncture is based on the theory of restoring the energy balance in body and removing any blockages to the flow of energy.

Injections/ other interventions such as Radiofrequency ablation: These would depend on the cause of neck pain and actual pathology. They have been explained in more detail in the neck & arm pain section under treatments, on my website- removemypain.com

Ignoring persisting symptoms can aggravate the situation leading to chronic pain with reduced functionality. So, if your pain persists and does not respond to usual lifestyle changes and painkillers then seek medical opinion on time.

Tag = Pain Management in Delhi, Best pain specialist in Delhi

For More Information https://www.removemypain.com/neck-and-arm-pain.html

Sources of pain in cancer may not be easy to identify and often require detailed assessment with attention to detail. Identification of the source often holds the key to correct treatment and the ability to provide relief. Pain in cancer may originate from

Cancer itself – When cancer grows it damages the tissues. It causes inflammation, unusual stretching, irritation and all of this can lead to pain. Like if we talk about pancreatic cancer, when it grows or stretches it can irritate the diaphragm (main breathing muscle), and that causes shoulder pain

Cancer spread – when cancer grows uncontrollably then it can spread to the nearby or distant body parts like the bone, liver, kidney, lymph nodes, etc.

Associated problems like bloating, constipation, blockage of ducts, clotting problems, distention of the liver or abdomen, etc.

Cancer treatments like radiotherapy or chemotherapy are known to cause nerve pain (peripheral neuropathy. Surgery may also be associated with chronic persistent pain.

Extra stress on other body parts – Often to protect one part of our body, we put pressure on other parts for example using crutches to offload a leg may become the source of shoulder pain as the crutches place extra load on my shoulder

Other coincidental problems – it is not necessary that all pain that every cancer patient suffers is due to cancer. There could be other coincidental problems in the general population such as arthritis. So it is important to identify not only the type of pain but also the source of pain before we plan treatment.

Pain-related to cancer may have different components such as background pain and breakthrough pain. These need to be taken into account while making treatment plans. Let’s take an example of pain due to pancreatic cancer. These patients may have constant pain (background pain) and there may be increased pain that comes after eating (breakthrough pain). Breakthrough pain may happen due to provoked or unprovoked factors and when we make a treatment plan it is important to have a plan for breakthrough pain.

Tag = Cancer pain treatment in Delhi, Cancer Pain Treatment in Gurgaon, Pain management centre in Delhi

Pain affects more people than heart disease, diabetes, and cancer combined International Association for the Study of Pain (IASP)

If you do not believe this statement then let me remind you of some common scenes from your daily life. You may have stopped noticing these believing that nothing can be done or accepting them as a part of aging. BUT IS THAT SO?

…remember the grandma who grunts in pain every time she tries to get up

…. the husband who complains of a backache every morning, taking his time to overcome the stiffness before he can start his day

….aunt who finds it difficult to get out of the car because of pain

….your colleague who has to randomly take time off work because of severe headaches

…your work colleague who keeps pressing his neck complaining of neck pain

….your friend who gave up badminton because of shoulder pain

….diabetic uncle who cannot sleep as he feels his feet are on fire

….your close friend who underwent breast surgery a few years back and still complains of pain

#lifewithoutpain#justadream#

Do these sound familiar… I have not even talked about the numerous patients with sciatica, tennis elbow, heel pain, abdominal pain, cancer pain, pelvic pain, testicular pain, chest-wall pain, post-traumatic pain, nerve injury pain, etc. The list is endless. The financial burden of these problems on individuals, families, society, and government is enormous.

Yes, these are all examples of chronic pain

Yes, these are challenging to treat because pain is a very personal experience and one therapy does not work for all.

BUT YES…. there are options that can improve your quality of life significantly. After all, quality of life is important for everyone. For someone, it may all be about being able to play a few rounds of golf and for someone to attend an important meeting at work without being distracted by pain. Your goals are your goals and they are important.

Chronic pain is a frequent condition affecting an estimated 20% of people worldwide. Globally 1 in 10 adults is diagnosed with chronic pain each year. Despite this, not many are aware of the available pain management options. The general perception is that pain management is for cancer pain. Even for the majority of well-informed people, it stops at a few nerve blocks for relieving pain in cancer or trigeminal neuralgia.

In India, there is huge variability in the services offered by the existing pain clinics. The lack of a recognized comprehensive training curriculum in pain medicine with government-approved minimal training standards may be one of the contributing factors. The focus of most specialists is on interventions rather than holistic management. This is contrary to most western countries where Pain Medicine is a separate specialty with a well-defined curriculum and minimum standards that must be fulfilled for one to proclaim himself as a pain specialist. The focus there is on long-term solutions using a multi-disciplinary approach and teamwork. Nevertheless, the awareness of chronic pain options is increasing with an important role being played by the media. I hope that the benefits do not get restricted to a privileged few and that all fellow brothers and sisters are able to benefit.

Dr. Amod Manocha is the Head of Pain Management Services at Max Super Speciality Hospital, Saket. He is trained as a Pain Management Specialist and an Anaesthetist in the UK. He has over 13 years of work experience in the UK including working as a Chronic Pain Consultant in many UK hospitals. Dr. Manocha believes in a multidisciplinary approach and providing evidence-based treatments at par with international standards. He is committed to providing quality care and believes in building a long-term relationship with patients based on honest communication and keeping their interests foremost.

Professional Qualifications

Fellow of Faculty of Pain Medicine, Royal College of Anaesthetists (FFPMRCA) Royal College of Anaesthetists, London

Fellow of Royal College of Anaesthetists (FRCA) Royal College of Anaesthetists, London

Post Graduate Diploma in Musculoskeletal Ultrasound (PGD MSK US) University of East London, UK

Post Graduate Diploma in Rheumatology University of South Wales, UK

European Diploma in Regional Anaesthesia & Acute Pain Management (EDRA) European Society of Regional Anaesthesia

Certificate Course in Essentials of Palliative Care Indian Association of Palliative Care, India

Diploma in Anaesthesia (DA) Safdarjung Hospital, Delhi University, India

Certificate course in Acupuncture Training Acupuncture Association of India

Post Graduate Diploma in Medico-Legal Systems (PGDMLS) Symbiosis Centre of Health Care, India

M.B.B.S. University College of Medical Sciences, Delhi University, India

For More Information https://www.removemypain.com/dr-amod-manocha.html

Tag = Best Neck Pain Specialist in Delhi, Best Back Pain Doctor in Delhi, Best Pain Specialist in South Delhi, Pain specialist in Gurgaon

See our Documents https://issuu.com/back-pain-treatment-in-india/docs/why_does_cancer_cause_pain_-_removemypain

The increasing number of pain management centres in Delhi is a proof of changing times and increasing awareness about pain management options. Neuropathic or nerve pain is one of the common reasons for pain clinic consultation.

Nerves act as the conduction pathways transmitting signals to and from the brain. Sensations including pain are transmitted as chemical and electrical signals to the brain where the pain is actually perceived. When the nerve become damaged or dysfunctional they start generating pain signals themselves. This category of pain is defined as neuropathic pain. Neuropathic pain can be severe, debilitating and you need to choose experienced doctors when it comes to neuropathic pain treatment in Delhi.

Let us first learn what causes neuropathic pain

Neuropathic pain is mainly caused by nervous system damage/dysfunction. Many factors and conditions can predispose to development of neuropathic pain. Some of the common reasons include:

Diabetes mellitus leading to a condition known as polyneuropathy where multiple nerves of the peripheral nervous system are affected

Certain Medications

Nerve compression

Nutritional deficiencies

Neoplasms

Chronic Alcoholism

Toxin exposure

Immunological diseases

Infections

Idiopathic

Treatment Modalities

It is important to consult the best centres for neuropathic pain treatment in Delhi where the team understands your pain and has extensive experience in diagnosis and management of all linds of neuropathic pain. Neuropathic pain increases the excitability of the neves, receptors and produces changes in the spinal cord such as those in N methyl D aspartate or NMDA receptor. Moreover, there is an imbalance between the excitatory and inhibitory systems further increasing the perceived pain.

If the predisposing factors or the pre-existing damage is unmodifiable then the focus shifts to stopping the condition from worsening, pharmacological management and symptom/ pain control.

In the reccase of diabetic polyneuropathy, management of blood sugar levels along with exercise and medication is helpful, especially in type 1 diabetes

In case of vitamin deficiency, vitamin administration and diet changes are recommended.

In cases of nerve entrapments, local injections can help if providing relief

Along with the management of the pain, it is equally important to alleviate other associated symptoms such as sleep disturbances and low mood.

Pharmacological Management: The use of tricyclic antidepressants, anticonvulsants, opioids, topical numbing agents and patches help in managing the symptoms of neuropathic pain. Interventions such as Nerve blocks, sodium channel blocking agents and neuromodulation is often utilised in combination with pharmacotherapy. These may not remove the causative factors but they certainly help in the management of the pain.

It is essential to consult the best pain management centre in Delhi where a multidisciplinary approach is used and the emphasis is on improving quality of life and reducing pain, and discomfort.