The Pain Managers

New services to reduce your agony are cropping up. And they are a big business opportunity as well.

A Patient Story

Jaideep Sajdeh, owner of Mumbai-based textile recycling firm Texool, and an active club-level cricketer, sustained a nasty knee injury while playing two and a half years ago. As a result, he had torn a ligament and cartilage, and the ensuing pain was unbearable. Doctors advised surgery, but the 42-year-old was not ready for it and thought of trying alternative medicine. That too did not work. After 4-5 months, a physiotherapist suggested a visit to Pain Clinic of India, run by Dr Kailash Kothari, an anaesthesiologist and pain management specialist.

"The doctor gave me three injections at an interval of 1-2 weeks. With the first injection itself, the nagging pain was gone," says Sajdeh. The entire treatment spread over 3-4 months cost Rs 15,000, while surgery would have cost Rs 1.5 lakh.

Gone are the days of living with excruciating and recurring pain. A new breed of super-specialist pain healers is the go-to solution. The speciality is being added to leading public and corporate hospitals. Moreover, standalone pain clinics and even chains are coming up.

Specialist Solution

Experts say that in India, chronic pain affects 30 per cent of the adult population, particularly women and the elderly. About 20-25 per cent of them suffer from musculoskeletal disorders (which affect muscles, joints, tendons, ligaments and nerves) and joint disorders. Back pain accounts for another 25-30 per cent. Headache and migraine is the reason behind 5 per cent of cases of persistent pain, while another 2 per cent suffer from pain related to cancer.

"Of the 100-120 patients who visit each of my centres every month, the majority comes for treatment of backache and slipped discs, followed by neuropathic issues and accident victims," says Kothari, whose chain has six clinics in Mumbai, and one each in Goa and Mauritius.

Says Dr K.J. Choudhary, chairman of Samvedana Hospital and Pain Management Institute in New Delhi: "Of the 10-15 chronic patients I see every day, only 2-3 require surgery to control the pain."

Treatments Offered at Pain Clinics

Pain clinics specialize in more than a dozen methods of treatment:

• Epidural (spinal) injections: given under real-time X-rays using a fluoroscope
• Radio frequency ablation: a high-frequency alternating current is used to treat a medical disorder
• Microscopic discectomy: a surgery to cure pain due to slipped discs
• Ozone therapy: more oxygen is introduced in the body by injecting ozone; used in back pain management
• Sympathetic blocks: involves injecting numbing medicine around the nerves in the lower back or neck to get rid of pain temporarily
• Blocks for cervical pain: an injection to relieve neck, shoulder or arm pain
• Cancer pain management
• Diabetic neuropathic pain management
• Advanced neuromodulation therapy: advanced medical device technologies to enhance or suppress activity of the nervous system
• Ultrasound-guided nerve blocks
• Spinal cord stimulator: a device used to exert pulsed electrical signals to the spinal cord to control chronic pain

Market Overview

A reason for the profusion could be the relatively low cost of setting up a pain clinic. "The investment in a pain clinic is about Rs 50 lakh and breakeven can happen within a year," says Kothari. The infrastructure required is not much — one or two consultation rooms and small operation theatres, physiotherapy equipment, etc. Pain clinics do not need an in-patient ward as most of the treatments do not need hospitalisation.

"Pain management is an upcoming speciality and it is yet to develop as an organised specialty," says Amit Mookim, partner, global strategy group and industry head of healthcare at KPMG. Although no industry figures are available, the size of the pain management market is at least Rs 200 crore for just the standalone centres, and this does not include the cost of related pain medication.