Pain clinic at govt. super speciality hospital sees uptick in patients, doctors say more awareness needed

Chronic pain can be debilitating but there is low awareness on how the pain could be managed. At the Tamil Nadu Government Multi Super Speciality Hospital’s (TNGMSSH) Pain Clinic — among the very few such facilities in the government sector in Tamil Nadu — doctors are seeing more patients year after year but are of the view that more awareness on pain management could help in early interventions and better quality of life.

Chronic pain can be debilitating but there is low awareness on how the pain could be managed. At the Tamil Nadu Government Multi Super Speciality Hospital’s (TNGMSSH) Pain Clinic — among the very few such facilities in the government sector in Tamil Nadu — doctors are seeing more patients year after year but are of the view that more awareness on pain management could help in early interventions and better quality of life.

Established in 2017, the clinic has treated over 4,800 outpatients and performed 752 procedures so far. The number has been slowly yet steadily rising. “We cater to two categories — cancer pain and non-cancer pain (mainly musculoskeletal pain). Here, a majority of our patients — nearly 60% — are those diagnosed with cancer. Pain management will aid in better compliance of drugs, and will help in improving their quality of life. Sometimes, it will prolong their survival rate,” D. Ashok Kumar, head of the department, Pain Medicine and senior consultant, Department of Anaesthesia, TNGMSSH, said.

But there is lack of awareness on pain medicine among doctors as well as patients. “Usually, doctors send their patients for pain relief in the last stages after exhausting all treatments. Most of the patients we see are in advanced stages of cancer. This is primarily because of low awareness. Starting pain management early will help in more than one way. We now have a member in the Tumour Board to formulate therapy in the initial stages of cancer so that patients will get the benefit of pain relief,” he said.

Non-cancer pain is mostly due to low back ache, shoulder pain, neck pain, heel pain, chronic headache, nerve pain, knee joint pain and other ligament injuries.

Dr. Ashok Kumar said the clinic offers interventional pain relief for all cancers such as gastric, colon, uterine, oropharyngeal and breast. “We do intervention with local anaesthetic drugs and steroids. In the last two years, we have been performing radiofrequency (RF) ablation for cancer and musculoskeletal pain; another modality of desensitising nerves to achieve pain relief. It has picked up well now. We are doing image-guided intervention for pain relief procedures using fluoroscopy, ultrasound and advanced CT machines,” he added.

The results are showing: at least 90 to 95% of patients diagnosed with cancer have good pain relief following pain interventions, he said. “Most of them experience sleepless nights due to the pain. Now, the majority tell us that they sleep well after pain management,” he added.

Facial pain such as trigeminal neuralgia is a major concern and patients do suffer in taking up day-to-day activities. RF ablation of the trigeminal nerve is an important procedure done here, he added.