About Mitigate Pain Clinic

Meet Dr. Jeshnu Tople

Dr. Jeshnu Tople is a distinguished Interventional Pain Physician with a passion for transforming lives through advanced medical interventions. With years of experience in the field, Dr. Tople has earned a reputation for his commitment to excellence and patient-centric approach. He is known for his proficiency in diagnosing and treating a wide spectrum of Pain conditions, ranging from sports injuries and Joint Pain, nerve related pain, Cancer Pain  to complex musculoskeletal disorders.

Dr. Tople believes in a holistic approach to healthcare, combining the latest medical advancements with compassionate patient care. He is dedicated to staying at the forefront of Pain Medicine research and technology, ensuring that his patients receive the most effective and cutting-edge treatments available.

Our Treatments

Upper and low Back Pain
Neck Pain
Disc Prolapse
Frozen Shoulder

Trust of Thousands of Patients

Frequently Asked Questions

What is pain management? What is intervention pain management?

Everyone experiences pain. Pain is a debilitating issue and even more when it is chronic. Pain hurts not only physically but also emotionally.
Pain Medicine is a medical super-speciality that deals with the treatment of various types of pain. Chronic pain can be treated by various ways such as oral medications, physiotherapy, counselling and interventions.
In interventional pain management, pain is treated by minimally invasive pain and spine interventions (MIPSIs) with or without the use of X-rays or ultrasonography. Different pain interventions include but are not limited to percutaneous techniques such as radiofrequency ablation, ozone injection, facet joint injection, sacroiliac joint injection, epidural injection, sympathetic blocks, hydrodissection, hydrodilatation, spinal cord stimulator, intra-thecal pump, vertebroplasty, kyphoplasty, etc.

Osteoarthritis is normal ageing process. When do I need to visit pain clinic?

Yes, osteoarthritis is normal ageing process. However this ageing of joints can be halted or sometimes can be reversed by certain interventions. This may include injection of gel or injection of PRP (platelet rich plasma) into the joint.
Moreover, if the ageing process is too advanced to halt or revert but causing pain, there are interventions to relieve this pain also. So, one with a problem of osteoarthritis should visit the pain clinic as early as possible. Even in advanced osteoarthritis there is treatment available to get rid of pain.

Apart from total knee replacement (TKR), are there any treatment options available for knee pain due to osteoarthritis?

Yes, interventional pain management provides an option. Total knee replacement is usually advised in the advanced stage of osteoarthritis. However all patients may not be medically fit to undergo such an operation or some may not want to undergo surgery. In such cases, interventional pain management provides a treatment namely radiofrequency ablation of genicular nerves which will take away the patient’s pain so that one can lead a pain-free life.

I have been suffering from headache for a long. How can I identify if I am suffering from migraine? How can it be treated?

Headache can occur due to various problems and migraine is one of the common disorders causing headache. Migraine is a chronic disorder and needs long term treatment. Treatment includes oral medications. But oral medications may not be effective in a few patients. In that case injection of botox can be helpful.

What is trigeminal neuralgia? What treatment options are available for this painful condition?

Trigeminal neuralgia is a chronic pain condition, also known as tic douloureux, where the fifth cranial nerve i.e. trigeminal nerve is affected. In this condition, the pain is so severe and debilitating, it is also known as ‘suicide disease.’
Treatment is usually started with oral medications and dose is increased gradually to achieve pain relief. However in some patients oral medicines may not be as effective after prolonged treatment. In such patients, radiofrequency ablation of the ganglion of the trigeminal nerve, namely gasserian ganglion, is done to achieve pain relief.

I am suffering from neck pain and I have been using neck collar all day long. How can I deal with this condition?

Neck pain can be due various problems like muscle spasm, facet joint or slip disc. Finding out the cause of the pain and its treatment is advisable. Neck collar as such has no role in such treatment. It can be helpful for initial 3-4 days in acute severe pain. But must not be used for a longer duration. If used for a longer duration it can cause more harm rather than advantage. Same is true for lumbar belts

What is fibromyalgia? How can it be treated?

Fibromyalgia is the condition affecting your musculoskeletal and nervous system , causing generalized pain all over the body. Besides pain, it can cause mood disorders, sleep disturbances, chronic fatigue, headaches and high sensitivity to touch.
Combination of medication, exercise, managing your stress, and healthy habits may ease your symptoms enough that you can live a normal, active life.

I am suffering from low back pain. What is the treatment for low back pain?

Low back pain pain treatment depends on the cause of low back pain. Common causes for low back pain are disc diseases, facet arthropathy, sacro-iliac joint pains, myofascial or muscular pains, spondylolisthesis, spinal canal stenosis, sprains and strains of ligaments. Other causes are skeletal irregularities, infections, tumor, inflammatory diseases of the joints, fibromyalgia etc.

I am suffering from slip disc/sciatica. Doctors have advised me surgery. But I don't want to undergo surgery. What non-operative treatment options are available for slip disc/disc prolapse/sciatica?

Not all patients require surgery. Various factors like, amount of pain, duration of pain, neurological examination, MRI findings, associated diseases, shall be taken into consideration to decide treatment plan. Oral medicines, injection of ozone and/or steroid into and around the disc, injection of PRP, biacuplasty are some of the non surgical, minimally invasive treatment options which can help to relieve the symptoms.

What is rheumatoid arthritis? What is spondyloarthritis? What is ankylosing spondylitis? What are common arthritic pains and treatment options?

In rheumatoid arthritis, the body's immune system attacks its own tissue, including joints. Rheumatoid arthritis affects joint linings, causing painful swelling and stiffness of joints and loss of joint function. Over long periods of time, it can cause bone erosion and joint deformity
Spondyloarthritis is an umbrella term for diseases that involve both the joints and the entheses (the sites where the ligaments and tendons attach to the bones). The most common of these diseases is ankylosing spondylitis. Others include reactive arthritis, psoriatic arthritis and enteropathic arthritis. Spondyloarthritis, in most cases, primarily affects the spine. Some forms can affect the peripheral joints -- those in the hands, feet, arms and legs. Spondyloarthritis has two main symptom patterns. For most people, the first and predominant symptom is low back pain. If not controlled, spinal involvement can progress, resulting in fusion of the vertebrae and limiting the spine’s mobility. Less commonly, the main symptom is swelling in the arms and legs. This is referred to as peripheral spondyloarthritis.
Diagnosis of spondyloarthritis is based mainly on the results of a medical history and physical exam, but doctors may order imaging and blood tests to confirm the diagnosis A blood test for the HLA-B27 gene can also help confirm a suspected diagnosis of spondyloarthropathy. However, not everyone with the gene have or develop arthritis. Therefore, a positive finding by itself doesn’t mean spondyloarthritis.
Several medications, including various pain killers, are effective for relieving pain and inflammation in spondyloarthritis. When joint swelling is not widespread, injections of a corticosteroid medication directly into the joint or membrane surrounding the affected area can provide quick relief. For long term control of disease, doctors may prescribe disease-modifying antirheumatic drugs (DMARDs) to relieve symptoms and prevent joint damage. DMARDs are most effective for arthritis that affects the joints of the arms and legs. Newer class of drugs called Biological agents are effective for arthritis of the both the spine and joints of the arms and legs. However, they are expensive and can increase the risk of serious infections and should be taken under expert guidance. Antibiotics may be helpful for reactive arthritis.
When inflammation destroys the cartilage in the hips, knee, shoulder, surgery to replace the joint with a prosthesis, called joint replacement, can relieve pain and restore the joint’s function.

I am a 78 years old female with a vertebral body fracture that occurred when I fell in the toilet. How can it be managed without operation?

Vertebral body fracture after a minor fall or trauma is fairly common in elderly population. Majority of these patients have either been previously evaluated for osteoporosis or are already under some form of medical treatment for osteoporosis at the time of the fall. These fractures are also the initial signs of a previously unrecognized osteoporotic process.
Focused clinical examination with investigation like MRI and CT scan can help to chalk out the best treatment plan to manage pain. Minimally invasive techniques, such as percutaneous vertebroplasty and balloon kyphoplasty are useful for treating painful vertebral fracture. In this procedure under fluoroscopic guidance bone cement is injected in the vertebral body which provides strength to your bone and helps to reduce pain. Patients can be sent home walking after a few hours of monitoring.

I have been prescribed nerve medication by my pain physician? What are common side effects of these drugs?

These medications are also known as co-analgesics and can be prescribed for nerve-related (neuropathic) pain. These medications are often prescribed if you have burning or shooting pain (nerve injury or ‘neuropathic pain’). Anti-neuropathic medicines can help to reduce or “calm down” nerve activity and reduce pain.
Drowsiness, dizziness, headache, dry mouth, nausea, constipation are the most common side effects of these medications, but these are not serious and more common during the initial week of therapy. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: vision changes (such as blurred vision), unusual bleeding/bruising, muscle pain/tenderness/weakness (especially with fever or unusual tiredness), swelling hands/ankles/feet.

I am a 55 year male diabetic from more than 10 years and lately I am suffering from burning and tingling in my feet. What is diabetic neuropathy? How can this be managed?

Diabetes is one of the most common diseases of modern society. The deranged blood glucose level affects our body from head to toes including nerves. Long standing and/or poorly controlled diabetes can cause damage to nerve conduction leading to pain and decreased sensation of hands and feet. This condition is called Painful Diabetic Neuropathy.
Diabetic Neuropathy is a continuous process which when untreated can be life or limb threatening. The progression can be delayed by tight control of diabetes by oral or injectable medicine. The pain i.e. burning and tingling of painful diabetic neuropathy can be controlled with medications and minimally invasive interventions such as sympathetic blocks, radiofrequency ablation and spinal cord stimulator.

I am a 45 year old lady suffering from heel pain. What is Plantar fasciitis? How can these be managed?

Plantar fasciitis is one of the most common causes of heel pain. It is due to the body's reaction to infection, irritation or injury to the thick band of tissue joining heel to the toes (plantar fascia). It causes sharp severe pain specially in the morning as we try to get up and walk to take first steps or after standing for a long period or while standing from sitting.
Treatment includes rest, use of soft sole footwear, pain relieving medicine and sometimes certain injections like PRP.

I am a 19 year old athlete. For the last few months I have been suffering from elbow pain. What can be the reason? How to get rid of it?

Elbow pain most commonly is due to Tennis elbow and Golfer’s elbow.

Tennis elbow is the condition in which there is pain in the outer aspect of the elbow. Pain is sharp, deep aching and usually occurs during squeezing the wet clothes, brooming, or making fist and squeezing it outwards. It is due to irritation or injury of tendon joining in the bone at the outer side of the elbow. Treatment includes rest to the affected elbow, ice compression, elbow band, pain relief drugs or injection of drugs at the site of pain.

Golfer’s elbow is the condition in which there is pain in the inner aspect of the elbow. Pain is sharp, deep aching and usually occurs during making fist and squeezing it inwards. It is due to irritation or injury of muscle joining the bone at the inner side of the elbow. (opposite to Tennis elbow). Treatment includes rest to the affected elbow, ice compression, elbow band, pain relief drugs or injection of drugs at the site of pain.

I am a 72 year old man. Few months back I had herpes zoster. The rash of herpes zoster recovered. But I am still suffering from severe pain at the site of the rash. Even a simple touch of clothing causes extremely severe pain. How shall be freed from this agony?

Pain of herpes zoster subsides with the rash. However, in a few patients, pain continues. It can be severe pain, burning sensation of skin and increased sensitivity of the area and can continue even after 1- 3 months after herpes zoster infection. This is due to damage of nerve endings and skin at the affected area. Treatment can be done with oral medications, physiotherapy, or application of ointment that acts on nerves and certain interventions.

I am a cancer patient/cancer survivor, and suffering from a lot of pain. What treatment options are available for Cancer Pains?

Cancer is a condition where there is abnormal growth of cells in the body which can spread to near or distant part of the body and harm the tissue. Cancer can be painless but in the majority of cases it causes pain, 30-60% in early period and almost 90% in advanced cases. Cancer patients may have pain during the disease or during the course of treatment with drugs or procedure that kills normal and cancerous cells and also following the surgery.
Cancer pain can range from mild headache and muscle discomfort to extreme pain depending on the location of the disease and extent to spread.cancer pain can be treated with simple to strong painkillers, patches and various types of minimally invasive interventions

I am a diabetic for a long time. Recently I am having Frozen Shoulder, so I am unable to lift my arm above my head. How can this be managed?

It is a condition in which there is stiffness and pain in your shoulder joint causing difficulty in moving your shoulder. It begins slowly, worsens over the days. People who have less movement of shoulder due to injury or surgery are also at risk of developing frozen shoulder. People who have diabetes appear more likely to develop frozen shoulder. In some patients no cause can be identified. Treatment for frozen shoulder involves oral pain & nerve medications, interventional treatment like hydrodilatation, injections of PRP, sometimes steroids and local nerve numbing medications, etc.

What is phantom limb pain and how can it be managed?

Phantom limb pain is that pain which feels like it's coming from a body part that is no longer there. It occurs within the first week after removal of hand or leg, it can also be seen after many months or longer. Some people have pain in the remaining part of the limb due to nerve growth and increased sensitivity to pain. Treatment : Oral pain & nerve medications, nerve injections, and some new treatments like Sympathectomy & Spinal cord stimulator placement.

What is failed back surgery syndrome? Why am I having same pain even after surgery?

Failed back surgery syndrome is often used for patients who have not had a successful result with back surgery or spine surgery and are still having continuous pain after surgery. Reasons for failed Back Surgery are mainly not operating on the pain causing structure, incomplete surgery & scar tissue in the area after some days after surgery. Management options include nerve medicines, interventional pain management options including spinal cord stimulator placement

What is spinal cord stimulator ? where can it be used ?

A Spinal Cord Stimulator is a type of electronic device with thin wire like electrodes placed in to the spine under X-Ray vision. It is used to send electrical signals to selected areas of the spine for the treatment of certain painful conditions .It is done for people who have a pain condition that has not responded to oral pain & nerve medications and injections of the spine. It is used in Failed Back Surgery Syndrome & for pain in the hands and legs from nerve damage

What is intrathecal pump? What is Baclofen & Morphine pumps?

An intrathecal pump is a medical device used via a thin tube (catheter) to deliver medications directly into the space between the spinal cord and the protective sheath surrounding the spinal cord. The pump is placed under skin by doing small surgery. Medications such as muscle relaxants (baclofen) &pain medications (morphine), may be delivered in this manner to lessen the side effects often seen with the higher doses used in oral or intravenous route. People with form of tightness of muscle groups or people with severe cancer pain, are good candidates for that medication being given via an intrathecal pump.


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