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Bio Medical Waste Report For Shalimar Bagh

Month Red Autoclave(Infected Plastic Waste) Yellow- Incineration(AnatomicalWaste & Soiled Waste) Blue Autoclave (Glass- Bottles) Black Cytotoxic- Incineration( Cytotoxic Contaminated Items) White- Sharp Total Bags Total Weight(In KG's)
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Apr-17 924 2963.50 954 2994.10 239 1017.30 103 279.20 1645 606.40 3865 7861.00
May-17 1175 4624.12 1028 3498.40 276 1524.34 87 195.01 1803 823.85 4369 10665.71
Jun-17 1060 4511.45 902 2886.66 293 1324.05 76 194.00 2057 1100.69 4388 10016.85
Jul-17                     0 0.00
Aug-17                     0 0.00
Sep-17                     0 0.00
Oct-17                     0 0.00
Nov-17                     0 0.00
Dec-17                     0 0.00
Jan-18                     0 0.00
Feb-18                     0 0.00
Mar-18                     0 0.00
YTD 3159 12099.065 2884 9379.155 808 3865.69 266 668.705 5505 2530.94 12622 28543.555

Joint Pain & Other Common Musculoskeletal Conditions

Home >> Our Specialities >> Pain Management >> Conditions Treatments >> Joint Pain & Other Common Musculoskeletal Conditions

Clinical Directorate

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Globally, musculoskeletal pain is a common reason for disability and seeking medical help. It may be localised to one area or present as a widespread, multisite pain. This section focuses on minimally invasive non-surgical interventions available via pain clinic for joint pain and some other common musculoskeletal conditions.

Shoulder Pain

Shoulder pain may be an isolated problem localised to the shoulder or be a part of widespread pain as in rheumatoid arthritis. Diagnostic ultrasound scan is an effective bedside tool as it can reliably identify common shoulder pathologies and reduce the requirement for additional investigations.

Some of the common reasons for shoulder pain include:

  • Inflammation, injury or weakening/tear of muscles and tendons around the shoulder joint (rotator cuff)
  • Damage to bones, cartilage of shoulder joints as in arthritis of glenohumeral, acromiocalvicular joint
  • Bursitis
  • Frozen shoulder or Adhesive capsulitis
  • Spasm/injury of muscles between the neck and shoulder
  • Referred pain from surrounding areas like neck for example in nerve entrapment or neck joint arthritis

Common minimally invasive non surgical interventions offered in pain clinic for shoulder pain include:

  • Suprascapular nerve block & Pulsed Radiofrequency
    Suprascapular nerve block is performed under x-ray or ultrasound guidance for a variety of painful shoulder conditions such as frozen shoulder, shoulder joint arthritis, rotator cuff tears, bursitis and nerve entrapment. Radiofrequency treatment can help to prolong the pain relief.
  • Subacromial Bursa Injection
  • Acromioclavicular and Glenohumeral joint injections
  • Dry needling and Barbotage for calcific tendonitis
  • Hydrodilatation for frozen shoulder
  • Biceps tendon sheath injection
  • Platelet Rich Plasma (PRP) injection

Hip Pain

Hip pain is a common condition and can be quite disabling because of the impact on walking. Pain may be localised to the front, side or back of the hip joint. Common cause for anterior hip pain is joint problems such as arthritis, that on the outer side of hip is a group of conditions addresses together as greater trochanteric pain syndrome whereas posterior hip pain may arise multiple sources such as sacroiliac joint, lumbar spine, piriformis muscle etc. It is important to evaluate the spine as spine pathology commonly coexists and can be responsible for producing, exacerbating hip pain.

Common minimally invasive, non surgical interventions offered in pain clinic for hip pain include:

  • Femoral and Obturator nerve block & Radiofrequency- This procedure offers an alternative for patients who are not keen or are unfit for hip replacement surgery. This can also be offered to patients with persisting pain after hip joint replacement. It is a minimally invasive procedure performed as a day case under local anaesthesia and does not involve any surgical incisions. The procedure is aimed at interrupting the transmission of pain signals from the hip joint.
  • Ultrasound guided hip joint injection
  • Injection for Trochanteric bursitis, gluteal muscle tendinosis
  • Injection for iliopsoas tendinitis, bursitis
  • Lateral Cutaneous Nerve of thigh block and radiofrequency

Knee Pain

Knee pain can be a source of significant disability in all age groups as it limits mobility. It can be classified into traumatic or non traumatic and based on the site of pain into anterior, medial, lateral and posterior knee pain. Pain from other sites such as hip and lumbar spine can also present knee pain. In the above 50 years age group raised BMI is an important risk factor for developing symptomatic osteoarthritis.

Common minimally invasive, non surgical interventions offered in pain clinic for knee pain include:

  • Genicular Nerve Blocks & Radiofrequency ablation
    This procedure is performed for chronic knee pain due to various reasons such as osteoarthritis, degenerative joint disease and persisting post knee replacement pain. It offers a safe, non surgical alternative to knee replacement for patients who are either not keen or are unfit or have persisting pain after knee replacement. Genicular nerve radiofrequency is performed as a day case under local anaesthesia with no requirement for hospital stay or prolonged rehabilitation.
    The initial diagnostic procedure involves local anaesthetic injections close to the nerves supplying the knee joint. If the diagnostic procedure produces effective pain relief then special type of radio waves are applied to these nerves, which can produce prolonged pain relief. These nerves are approached percutaneously under x-ray and ultrasound guidance with no requirement for any surgical incisions.
  • Cooled Radiofrequency treatment
    Cooled Radiofrequency treatment is an option for those suffering from chronic knee pain and not keen on surgery or those left with persisting pain after knee replacement surgery. It is a minimally invasive day care treatment done under local anaesthesia. The treatment aims to deactivate the nerves responsible for transmitting pain signals from the painful knee and involves placing needles close to these nerves under x ray or ultrasound guidance followed by heating of nerves to reduce the pain signals being transmitted. It differs from conventional radiofrequency as it has water circulating through the device and can create a larger treatment area increasing the chances of success. Normal activities can generally be resumed soon after the procedure.
  • Saphenous Nerve Block & Pulsed radiofrequency
    This nerve can be easily injured as a result of trauma or various surgical procedures. Most common presentation is pain in the inferomedial aspect of knee although it is not uncommon to see pain involving most of the anterior aspect of knee joint. A nerve block can be easily performed under ultrasound guidance as a diagnostic test followed by radiofrequency treatment to produce long term pain relief.
  • Ultrasound guided knee joint, bursa injection
  • Hyaluronic acid or Platelet Rich Plasma (PRP) injections

Other Common Musculoskeletal Conditions

  • Tennis/Golfer’s Elbow (Lateral/Medial Epicondylitis)
    These conditions involve staining/overuse of forearm tendons which attach to the bony prominences on the upper arm bone close to the elbow joint. Tennis elbow involves the tendons attaching to the outer side of elbow and Golfers elbow involves the tendons attached to the inner side of elbow. In clinic diagnostic ultrasound scan followed by PRP or steroid injections and physiotherapy can help effectively deal with the condition.
  • Achilles Tendinopathy
    Achilles tendon attaches the calf muscles to the heel bone and overuse or underuse of the tendon can predispose to tendinopathy. Most common symptom is pain behind or just above the ankle with associated stiffness, swelling. Diagnosis can be made with the help of an in-clinic ultrasound scan and treatment involves rest, activity and footwear modification, weight management, medications and physical therapy. Tendon sheath injections under ultrasound guidance using PRP or steroids, extracorporeal shockwave therapy are reserved for those not responding to conservative management.
  • Plantar Fasciitis
    Plantar Fascia is a tissue band in the sole of foot which stretches from the front part of heel to the toes. Repeated stress, injuries to the fascia can lead to a condition called plantar fasciitis, which present as pain on the underside of heel worse on taking first few steps after a period of rest. It can be diagnosed by history, clinical examination. Ultrasound has the additional advantage in aiding diagnosis and identifying any partial tears, rupture of fascia or any foci of calcification, calcaneal spurs. Treatment includes using correct footwear, rest, activity modification, physiotherapy, painkillers, weight management and ultrasound guided injections - Platelet Rich Plasma (PRP) or steroid.
  • De Quervain’s Tenosynovitis
  • Injections for Proximal Hamstring Tendinopathy, Ischial Bursitis
  • Trigger Point Injections
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