Pain Management in Vellore

Pain that lasts longer than three months behaves differently to acute pain. The nervous system becomes more sensitive, movement patterns change, sleep suffers, and everyday activities feel threatening. Modern pain management addresses all of these — not just the tissue where pain started. Our approach combines exercise, manual therapy, pain education, sleep hygiene, and behavioural pacing.

Common referrals include chronic low back pain, cervical spondylosis, fibromyalgia-type presentations, complex regional pain syndrome, persistent post-surgical pain, tension headaches and migraine, temporomandibular joint (TMJ) pain, and neuropathic pain (post-stroke, post-herpetic, diabetic). We do not use opioids and we do not perform injections. What we do is carefully paced loading, honest education, and behavioural strategies.

First-line pain care in the 2020s is not rest, not passive modalities, and not endless imaging — it is graded movement, education, and self-management. We aim to give you tools you can use for years, not sessions you must return to forever.

Many patients arrive after months or years of pain, multiple scans, and several previous therapists. We do not repeat what has not worked — we start with a fresh assessment and an honest conversation about what the evidence actually supports.

For patients who work at CMC Vellore, VIT, or in central-Vellore businesses, we offer early-morning and late-evening slots so treatment does not conflict with shift work or teaching hours.

We treat chronic pain seriously but we do not treat it dramatically. Long-term change comes from small, repeatable habits — a 10-minute morning routine, a short walk at lunch, a wind-down routine before bed — layered over structured clinic sessions.

For patients whose pain interacts with mood or sleep, we discuss when a referral to a psychologist, sleep specialist, or pain physician would add value. Multidisciplinary care is not a luxury for persistent pain — it is often what makes the difference.

You are not going to be told your pain is imagined, nor that surgery is your only option. What you will get is a plan you can follow, honest updates on progress, and a clear stopping point when you are self-managing well.

What we do not do: we do not prescribe medication, we do not perform injections, and we do not use passive modalities as the whole treatment. Where medication changes are needed we coordinate with your doctor.

Multidisciplinary referrals: for patients whose pain interacts strongly with mood, sleep, or life stress, we discuss when referral to a psychologist, sleep specialist, or pain physician would add value. Persistent pain is often best managed by a small team, not a single clinician.

Flare planning: everyone with persistent pain has flare days. We build a written flare-plan into your program — what to do in the first 24 hours, what to keep doing, and what to modify — so a bad day does not become a bad week.

Realistic timeframes: most persistent-pain plans run twelve to sixteen weeks with sessions once or twice a week early, tapering as self-management becomes reliable. We aim to give you tools you can use for years, not sessions you must return to forever.

Evidence base in brief: for persistent (chronic) pain, current guidelines (NICE 2021, IASP, WHO) recommend exercise, graded activity, pain-neuroscience education, and behavioural strategies as first-line care. Long-term opioids and repeated imaging are explicitly discouraged in the absence of clear red flags.

What a good outcome looks like: a 30 to 50 percent reduction in pain intensity, halving of flare frequency, return to a valued activity, or reduction in medication reliance — any of these are meaningful. We agree the specific target with you at intake.

Red-flag surveillance: night pain that wakes you from sleep, unexplained weight loss, fevers, or bladder or bowel changes are escalated to your physician the same day. Persistent pain rehab is not appropriate when a red flag is present.

Discharge and maintenance: at the end of the twelve- to sixteen-week program we discharge you with a written maintenance plan and a follow-up point in three months to check that gains have held.

Sleep as a lever: sleep quality has a large, well-documented effect on pain sensitivity. Every persistent-pain plan includes basic sleep hygiene — consistent sleep and wake times, screen and caffeine cut-offs, and a wind-down routine — as a non-negotiable first step.

Pacing rules explained: pacing is not doing less; it is doing steady amounts across the week rather than boom-and-bust cycles. We agree specific weekly volumes for walking, household tasks, and any hobby activity, and we adjust weekly based on symptom response.