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Title: Role Of Spirituality And Cognitive Behavioral Therapy In Treatment Of Intractable Neck Pain
e-poster Number: INSIM115
Category: Pain
Author Name: Dhwani Walavalkar
Institute: Seth G S Medical College and KEM Hospital
Co-Author Name: Dr. Sweta Salgaonkar, Dr. Yogita Patil, Dr. Vinod Digraskar
Abstract :
Pain is disruptive to the patients personal and professional live and greatly impacts their quality of life. A 28 year old male presented to us with complaint of neck pain. He was working and preparing for higher education during his free time. There was no significant premorbid trigger and the start of the pain was spontaneous. He described his symptoms in an elaborate manner. The location of the pain was nape of neck, intensity in terms of Visual Analogue Scale was 10/10, frequency was a few hours a day, every 2-3 days; with increase in frequency during exam periods.
During episodes of pain he would feel sad, his sleep quality was affected and he complained that he had increased forgetfulness. He had previously visited pain physicians. He was prescribed T. Gabapentin 300 mg, T. Nortryptilline 25 mg, T. Baclofen 10 mg. He received Greater and lesser occipital nerve block and multiple sessions of dry needling. He was advised to consult a psychiatrist who started him on antidepressants. His pain reduced by 30% with these treatments.
On examination, tenderness was present over paraspinal muscles and cervical extension was painful. MRI showed C6-C7 diffuse disc bulge with paracentral protrusion. We gave him Ultrasound guided bilateral greater and lesser occipital nerve block and offered him weekly sessions of Cognitive Behaviour Therapy. He was counselled extensively and advised to meditate regularly. After 3-4 weeks he had significant pain relief. His VAS score was 3/10. Mindfulness and spirituality reduce stress and improve relaxation.
