Gautam Das

• MBBS, DCH, MD, FIPP, FIAPM
• Managing Director at Daradia: The Pain Clinic, Kolkata, India

Tarsal tunnel syndrome (TTS) is a compression neuropathy of the posterior tibial nerve or its branches within the tarsal tunnel. It commonly presents with symptoms such as burning pain, tingling, and numbness in the plantar aspect of the foot. However, in patients with diabetes, distinguishing TTS from diabetic neuropathy can be challenging due to...

Lumbar canal stenosis (LCS) is usually due to degenerative conditions in the older age group. Patients with LCS commonly present with low back pain, radiating leg pain, and neurogenic claudication. Treatment options for severe canal stenosis are mostly surgical but alternative treatment can be caudal epidural steroid in those individuals who refuse...

Myofascial pain syndrome is a common cause of chronic pain affecting the daily activities of patients. Different modalities of treatment are being tried in those patients. Ultrasound-guided erector spinae plane (ESP) block has increasingly been used for the treatment of chronic pain. We present a case of a 65-year-old male treated with ESP diagnost...

Caudal epidural steroid injection is commonly given for chronic low back pain with radiculopathy. Ultrasound-guided injection has become a common alternative for fluoroscopy and has demonstrated a high success rate. However, intravascular or intrathecal injections cannot be monitored in ultrasound. In this case report, we encountered partial vascul...

Trigger finger is a common disorder characterized by the locking or snapping of a digit, that occurs due to blocking of tendon gliding at the pulley and is usually seen due to stenosing tenosynovitis and thickening of the pulleys. Ganglion cysts are typically found in the wrist and hand, with the most common sites being the dorsum of the wrist and...

Background In knee osteoarthritis (KOA), cooled radiofrequency ablation (C-RFA) and conventional radiofrequency ablation (Conv-RFA) are seldom compared directly, and long-term outcome is unclear. Aim The aim is to compare the efficacy and safety of C-RFA and Conv-RFA in patients with Kellgren and Lawrence grade ≥3. Settings and Design This prospe...

Osteonecrosis of the hip is a progressive degenerative condition which necessitates early detection and initiation of therapy. Medical management and surgical intervention are the widely used options available for these patients. Another nonsurgical interventional option available for these patients is ultrasound-guided intra-articular injection us...

Postherpetic neuralgia (PHN) is a complex and debilitating painful condition characterized by sharp, shooting pain along the distribution of the affected nerve. There are different modalities of treatment available including different systemic medications, topical, and invasive nerve blocks. Cryoablation is one such option available for the managem...

Supraorbital neuralgia is a severe, painful, difficult-to-treat condition that is often misdiagnosed. It is characterized by pain and tenderness in the region of the supraorbital notch and forehead, with transient pain relief with a supraorbital nerve block. Supraorbital neuralgia is resistant to pharmaceutical treatment, so non-pharmaceutical mana...

Tendinopathies like lateral epicondylitis are a difficult problem requiring lengthy management. Emerging regenerative therapy like autologous blood, PRP, Extracorporeal shock wave, tenotomy have a significant role in the management of recalcitrant lateral epicondylosis. The below mentioned case has been a failure even after promising management tri...

Sacroiliac joint (SIJ) is one of the most common but underdiagnosed sources of lower back pain, with the prevalence of 15%–30%. Treatments of SIJ pain most commonly involve conservative strategies that are exercises or medications. Various methods for nonresponders of SIJ pain are local anesthetic with or without steroid injection, radiofrequency d...

Introduction: Fibromyalgia and spondyloarthropathy are both chronic musculoskeletal conditions that often present with overlapping symptoms, making accurate diagnosis and management challenging. Identifying the prevalence of fibromyalgia in patients with spondyloarthropathy is crucial for optimizing patient care and treatment strategies. Methods: T...

Complex regional pain syndrome (CRPS) is a debilitating condition with severe chronic pain in the affected regions of the body. Stellate ganglion block is used as one of the treatment modalities for sympathetically mediated chronic pain like Complex regional pain syndrome(CRPS) and various peripheral vascular diseases. 5%dextrose injection as compa...

People all over the world suffer from persistent low back pain, often caused by spinal canal stenosis. In long term cases of spinal canal stenosis, perineural adhesions can form and that further exacerbates the pain. Transforaminal epidural adhesiolysis is beneficial as it breaks down the adhesions and allows more precise delivery of drug to the ta...

In patients with symptomatic osteoarthritis knee (OAK), cryoneurolysis (CRYO) and cooled radiofrequency ablation (C-RFA) are reported to be effective and safe; however, they have not been compared directly. The objective of this study is to compare CRYO and C-RFA of the genicular nerve (GN) in terms of efficacy and safety profile in patients with K...

Purpose In patients with symptomatic osteoarthritis knee (OAK), cryoneurolysis (CRYO) and cooled radiofrequency ablation (C-RFA) are reported to be effective and safe; however, they have not been compared directly. The objective of this study is to compare CRYO and C-RFA of the genicular nerve (GN) in terms of efficacy and safety profile in patient...

Background and Aims Intra-articular steroids provide significant pain relief in sacroiliac joint pain (SIJP), but their action is short-lived. Cryoneurolysis is reported to produce prolonged pain relief in various pain conditions. However, its efficacy has not been evaluated in patients with SIJP. Thus, we compared the efficacy of cryoneurolysis wi...

Introduction: Osteoarthritis knee (OAK) is the most common form of osteoarthritis and has a global prevalence of 22.9% among individuals aged 40 years and above. Although primarily considered a disease of advancing age, OKA is known to affect the younger age group, leading to substantial clinical, economic, and social burden. Although a plethora...

Chronic pain is a frequent, intricate, and adverse condition that has a considerable influence on individuals and society at large. In India, its prevalence is around 20%. Although a spectrum of conservative treatment modalities is available, a significant proportion of patients with chronic pain syndromes remain refractory and require surgical int...

Context Ultrasound is an excellent modality for the evaluation of the soft tissue structures as well as articular pathologies of the elbow joint. Higher resolution transducers along with the superficial location of the elbow structures make them amenable for easy visualisation However, the long learning curve and the operator dependency can limit i...

The sacroiliac joint (SIJ) is a common source of pain in patients with low back pain. Untreated pain from the SIJ can lead to prolonged discomfort and financial burden. Interventional treatments for SIJ-related pain include intraarticular steroid injection and radiofrequency ablation but both procedures provide pain relief for a limited duration. C...

Platelet-rich plasma (PRP), prepared from autologous blood, is commonly used in various pathologies like hip and knee osteoarthritis, rotator cuff pathology, epicondylitis, tendinitis, fracture healing and back pain, for tissue regeneration, wound healing, scar revision, skin rejuvenating effects, and also in treatment of alopecia. It is one of the...

Among the techniques of epidural steroid injections, transforaminal injection allows for a concentrated application of steroids around the inflamed neural structure. The transforaminal injection technique can be performed via the subpedicular or Kambin\'s approach. The purpose of this article is to identify key features of anatomy of the lumbar neu...

Aim: This article aims to review the currently available evidence on the ganglion impar block (GIB) and neurolysis for management of chronic pain of malignant or nonmalignant etiology. Introduction: Ganglion impar (GI) represents the fused termination of bilateral thoracolumbar sympathetic chains. It is a retroperitoneal structure, lying behind the...

The approach to management of any patient is justified when based on evidence rather than experiences. However, there may be a class of patients for whom experience-based approach shows much better results. This article is an analysis of evidence-based guidelines versus experience-based approach. Although the protocols and guidelines deduced from e...

Cryoneurolysis is a very recent and advanced procedure in interventional pain management practice. Application of cold allows second‑degree nerve injury resulting in analgesia. Here, we are presenting a case of effective pain relief by cryoneurolysis of the lateral branches for the right sacroiliac joint in a patient suffering from hepatocellular c...

When a small skin nerve is injured or squeezed by the scar tissue, it may cause pain in the scar tissue. Patient with pain after abdominal hysterectomy, a common gynecological operation, can be an ideal model for postoperative pain studies. Cryoneurolysis of nerves is the technique used to treat neuropathic pain, but the report on its use to treat...

Multiple choice questions in pain medicine. This book will help in preparation of different examination.

Platelet-rich plasma (PRP) has been gaining popularity for degenerative joints because of its success and ease of performing procedure; however, there is a lack of standardized protocols for PRP preparation and clinical applications. Various studies have reported inconsistency and variations in their results. Evidence are inconclusive for its usage...

Introduction: Interventions in pain management hold an important aspect in diagnosing as well as treating patients in today's practices. Knowing proper procedural technique is an important aspect for a pain practitioner to avoid complications. Each individual patient is not the same, thus producing a challenge for any pain intervention. In this art...

Ankylosing spondylitis (AS) is a chronic inflammatory joint disease. Osteoporosis and fractures of the vertebral body and its dorsal arch are now well-recognized features because of the altered biomechanics of the ankylosed spine. "Seat belt" or "burst compression" fractures through the disk, juxta-end plate, and posterior segments have been observ...

Fibromyalgia (FMG) is the most important cause of widespread pain. It is commonly missed out in male patients. We report a case of FMG in a male patient, which is a less common presentation as compared with female patients.

Introduction: Facet joint arthropathy refers to a degenerative disease that affects the joints of the vertebrae. Lumbar facet joints (zygapophyseal joint) were first suggested in the medical literature as a source of low back pain (LBP) and lower extremity pain in 1911. These joints have been implicated as the cause of pain in 15 to 45% of patients...

Background: The ability to isolate and visualize the " pain " generators in the foramen and treat persistent pain by visualizing inflammation and compression of nerves serves as the basis for transforaminal endoscopic (TFE) surgery.It provides a least invasive basic access to the disc. One of the important steps is the insertion of dilator and work...

India has a high prevalence of chronic disorders which may be associated with persistent pain. Despite the availability of multiple treatment options, chronic pain is largely untreated and contributes to disability and mortality. Medical consumption of opioids remains low due to various barriers that prevent access to opioids for patients and healt...

Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events...