Prevention of postoperative pain and preservation of Quadriceps muscle strength is essential for mobilization after total knee replacement (TKR) surgery. Peripheral nerve blocks are important modalities of pain management. We have compared adductor canal block (ACB) versus femoral nerve block (FNB) for assessment of the intensity of pain, duration of analgesia, consumption of tablet paracetamol as rescue analgesic, and Quadriceps range of motion following TKR. A double-blind randomized prospective study was carried out on 74 patients scheduled for TKR under spinal anesthesia. Patients were divided into two equal groups. Group ACB (n = 37) received ACB and Group FNB (n = 37) received FNB at the end of the operation. The intensity of postoperative pain was assessed by the Visual Analog Scale (VAS) score. Duration of analgesia and Quadriceps range of motion were assessed postoperatively. Group ACB showed low cumulative VAS, increased duration of analgesia, and increased Quadriceps range of motion (P ≤ 0.5) compared to Group FNB. Ultrasound-guided ACB is a better alternative to FNB for postoperative analgesia and better Quadriceps function in patients undergoing TKR under spinal anesthesia.

Tennis elbow pain is a chronic pain disorder due to continuous movement and repetitive strain injury in extensor origin of forearm muscle. Many times, it presents with partial or interstitial tear in muscle. Platelet-rich plasma is a good treatment option for cure of chronic pain. Although medication and physiotherapy are primary treatment options, interventional pain procedure with ultrasonography-guided autologous platelet-rich plasma is a recent advance for the management of chronic tennis elbow pain.

Entrapment neuropathy of the dorsal scapular nerve is known to be one of the common causes of pain in the interscapular region. Patients with entrapment neuropathy can experience sharp, stabbing, and burning pain or an itching sensation at the neck, shoulder, and arm, as well as in the interscapular region. This nerve impingement or entrapment often leads to pain in the upper extremity and back. The signs and symptoms of dorsal scapular neuropathy bear a striking resemblance to several other diagnosis or findings in the cervicothoracic, scapular, and posterolateral arm areas; hence, diagnosing the condition can be difficult. Here, we present a case of a 29-year-old female patient who came to the outpatient clinic of Daradia Pain Hospital and was successfully managed with hydro dissection of dorsal scapular nerve.

Mental neuralgia is a chronic debilitating neuropathic pain condition that is persistent, severe, and substantially interferes both with quality of life and recreational and daily activities. Pain is excruciating, often described as an electric shock-like sensation by the patient. We are reporting a case in which ultrasound-guided percutaneous cryoneurolysis is described and demonstrated in a patient with mental neuralgia where multiple other modalities of treatments failed. The current pharmacologic therapy is inadequate and intolerable with side effects such as somnolence and nausea. Cryoneurolysis is an alternative method that utilizes extremely cold temperatures with freezing and then simultaneously defrosting to reversibly ablate peripheral nerves and is potentially a novel method for chronic pain management.

Baastrup's syndrome or “kissing spine” is a common pathology of the vertebral column among the various conditions of the degenerative spine disorders. This syndrome is generally missed by clinicians; therefore, it is underdiagnosed and subsequently mismanaged. We report the case of a 61-year-old female who presented with chronic, ongoing, low back pain of several years duration who had been managed conservatively by various specialities over the last few years with no improvement.

Low back pain (LBP) is one of the most common chronic pain conditions which can arise from any of many potential pain generators. A thorough history, clinical examination, and investigations can give clues about the source, but ultimately, it is clinched by diagnostic interventions. Our case report is of a 70-year-old man who presented with complaints of LBP with symptoms of neurogenic claudication. Examination suggested sacroiliac joint involvement, however, the magnetic resonance imaging pointed to lumbar canal stenosis. Respecting the clinical findings, it was decided to proceed with diagnostic blocks of S1, 2, and 3 followings which the patient had excellent pain relief. We would like this to be a reminder of the importance of diagnostic blocks in identifying the pain generator and also of not relying solely on radiological findings.

Thalamic pain is a neuropathic pain that may be induced in patients recovering from a cerebrovascular accident. Ultrasound-guided lumbar sympathetic ganglion block (LSGB) has been used to treat pain from various diseases. A 43-year-old man came to our clinic with persistent pain described as a burning sensation on the left lower limb of his body. The pain was resistant to any typical neuropathic pharmacologic medication. We approached the treatment using the ultrasound-guided LSGB technique, then administered 5 milliliters (ml) of injectate that contain 4 ml of 1% lidocaine and 1 ml of 5 milligrams (mg) dexamethasone on each of L2, L3, and L4 lumbar sympathetic ganglion chain levels. Thus, our patient received 15 ml of injections in total. After four visits and within 6 weeks of treatment, there were some improvements and a reduction of the Numeric Rating Scale pain score on each visit. LSGBs coupled with ultrasound-guided technique seem to benefit our patients with thalamic pain.