Dr. Amod Manocha

  What is the relation between pain and sleep? Does, not being able to sleep make the pain feel worse or is severe pain responsible for inability to sleep? The answer is both are true. Sleep is a natural analgesic (pain reliever) and a good night’s sleep can improve one’s ability to tolerate pain. For some chronic pain patients, the only respite is when they are sleeping, and loosing this luxury can have adverse consequences. Amount of sleep required by an individual varies depending upon many factors including age, but most adults require between 7 to 9  hours a night, although it can range from 5 to 10 hours. Healthy sleep comes in waves during the night and every night we cycle 4-6 times, through different stages of sleep- light sleep, deep sleep and REM (rapid eye movement) sleep. Usually we wake up after the REM stage. If pain disturbs the sleep, we end up spending too much time in light sleep reducing the REM sleep and this may result in increased pain sensitivi...

  What is piriformis syndrome? Piriformis muscle is located deep in the buttock and helps to rotate the leg outwards. It extends from the side of sacrum and tailbone to the upper part of thigh bone. One of the main nerves of the leg (sciatic nerve) runs in close relation to this muscle. Problems of the piriformis muscle such as spasms or swelling, can cause irritation of the sciatic nerve leading to sciatica like symptoms. This condition is addressed as piriformis syndrome (PS). Other names for this condition include extra-spinal sciatica, deep gluteal syndrome or wallet neuritis. What are the symptoms of piriformis syndrome? Most patients present with buttock and leg pain which is worse on sitting and with hip movements. Pain is described as a dull ache, shooting or burning sensation associated with buttock tenderness. Most patients sit with the affected side tilted upwards. Some patients complain of a swelling, sausage shaped lump sensation in the buttock. Pain commonly r...

  What is hip osteoarthritis (OA) and why does it hurt? Osteoarthritis is the commonest form of arthritis and is a common cause of hip pain, especially amongst older people. It affects about 7% of men and 10% of women over the age of 45 years. The main problem in this condition is the degeneration of the cartilage covering the ends of the bones. The loss of cartilage and its shock absorbing, cushioning effect leads to the bones coming closer to each other and their thickening in an attempt to protect the joint. Bony growth called osteophytes form around the joint edges. The joints and the surrounding ligaments, tissues may also develop swelling (inflammation). Pain in arthritis may result from Inflammation (swelling) of joints Damage of joint tissues Overloading of surrounding structures such as the muscles and ligaments fatigue and extra effort required in mobilisation Many people are not able to able to identify the symptoms of hip arthritis and often igno...