better back posture

What’s causing your back pain? Is it poor posture

If you haven’t had an accident or picked particularly heavy weight before the back pain episode, chances are that it is caused by prolonged poor or bad posture. You could get rid of lower back pain and back injury by following good posture best practices. Understand why and how posture affects your back.

We often hear that good posture is essential for good health. We tend to actually recognize poor posture only when we see it formed as a result of bad habits carried out over years and evident in many adults. But only few people have a real grasp of the importance and necessity of good posture.

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buttock pain wallet

Buttock Pain? Is your heavy wallet to blame

Buttock Pain

Is your heavy wallet to blame?

Do you experience a sharp pain right at the centre of your buttock; especially when you sit? Do you get a sharp shooting pain radiating down your legs?

Well, this could be because of your big fat wallet. When it comes to wallet, size matters !

Carrying a big wallet in your back pocket can cause a major trouble to your back & buttocks. Your wallet may be a one stop locale for keeping your cards, cash, bills & coins. But sitting with heavy wallets in your back pocket can put a lot of stress on your buttocks, back and hip. The problem starts when your nerve in the buttock, known as SCIATIC NERVE gets pinched between your wallet & buttock. It causes pain in your hip and/or buttock. It can also cause pain all the way from your buttock down your leg.

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office stretch for pain relief

5 minute Office Exercises: Back, Neck pain

Make time for Office stretches and improve your productivity.

Taking the time to stretch throughout the day anywhere – in office or at home, can have numerous health benefits. Stretching can improve flexibility and is an important activity to warm up or cool down after exercise. Stretching can also be a fun and healthy break from your computer screen during the work day. These stretches along with correct sitting posture at workplace, also helps you to keep all those pain in the back and neck away.

This Office Stretch Sheet provides you with 6 simple and effective stretches that you can complete whilst sitting at your work station. The newly developed Standing Stretch Sheet is perfect to do before a lunchtime walk, and for those who have standing roles.

Try The Banana,  The Emu,  Reach for the Sky, The Rock, The Twister and The Yes & No today.

We recommend you repeat each stretch twice, and hold each time for 20 seconds.

Print a copy and pin it up next to your workstation to remind you and your colleagues – Have you stretched today?


5minute ReLiva office stretching exercises while Sitting at your desk in office


Related Reading:

Ergonomics Programme for Corporate Employees

Working long on Computer : Carpal Tunnel Syndrome

Ergonomics: Does it matter in your workplace

Neck Pain : Managing at Home

Physiotherapy, a sustainable solution for workplace Health & Wellness


De Quervain tenosynovitis

All About DeQuervain’s Tenosynovitis

There are two stages of the treatment for De Quervain’s syndrome or De Quervains tenosynovitis. It is a painful condition affecting the tendons on the thumb side of your wrist. In case of acute stage, when there is inflammation the goal is reduction in inflammation and preserving movements. Subsequently, once the inflammation subsides the goal is improvement in function.

Acute stage treatment

  • Splint to support the thumb and the wrist and which provides support and helps healing procedure.
  • Help identify aggravating activities and suggest alternative postures
  • Cryotherapy (e.g.: cold packs, ice massage) to reduce the inflammation and edema
  • Therapeutic Ultrasound (i.e. phonophoresis) or electrically charged ions (i.e. iontophoresis)-Ways in which a medication can be driven into the soft tissues through skin and promote faster healing.
  • Plan and suggest activity modifications to correct abnormal position of the hand in a particular activity.
  • Corrective exercises: Help in maintain the correct postures of the hand and thus enable better healing, promote faster rehab and aid in the prevention of further complications.

Second stage treatment (once inflammation subsides):

The goal is to work on the range of motion, Flexibility, Strengthening, Preventing recurrence

  • Thermal modalities to promote and aid in healing.
  • Transverse friction massage to break the adhesions.
  • Therapeutic exercises – starting with Range Of Motion (ROM) exercises, and as the patient progresses, adding strengthening exercises
  • Ergonomic workstation assessment as needed (Design work place to prevent further injuries after assessment of the same)
  • Educating the patient to either avoid or decrease repetitive hand motions, such as pinching, wringing, turning, twisting or grasping..
  • Rehabilitation exercises to prevent recurrence.
  • A home-exercise program for the maintenance of the goals achieved by the physical therapist and hence aid in faster recovery of function..

Physiotherapy treatment DeQuervains

Ultrasound therapy for wrist


Exercises for wrist and thumb rehabilitation

What is deQuervain’s Syndrome ?

It is the tenosynovitis (inflammation of the fluid-filled sheath called the synovium that surrounds a tendon and helps them glide easily) of the two tendons that control movement of the thumb. Inflammation results in pain, swelling and constricted movement of the tendons within the tunnel on the side of your wrist (Base of thumb). The swollen tendons and their coverings rub against the narrow tunnel through which they pass. The result is pain at the base of the thumb. At first, the only sign of trouble may be soreness on the thumb side of the forearm, near the wrist. If the problem isn’t treated, pain may spread up the forearm or further down into the wrist or both and thumb and limit your range of motion. As the friction increases, the two tendons may actually begin to squeak as they move through the constricted tunnel. This noise is called crepitus. It is pai nful especially when you turn your wrist, grasp anything or make fist..


Wrist Pain

Wrist Pain on movement



What causes deQuervains ?

de Quervain’s tenosynovitis is basically a combination of overuse, repetitive movements e.g.; racket sports, hammering and poor hand on wrist posture. It can be idiopathic (has no specific cause).

Common causes include:

  • Repeated hand and thumb motions such as grasping, pinching, squeezing, or wringing may lead to the inflammation of tenosynovium.
  • Holding your hand at an angle to your wrist creates a compression point that excessively rubs the tendon.
  • This inflammation can lead to swelling, which restricts the smooth gliding action of the tendons within the tunnel.
  • Scar tissue from a previous injury can make it difficult for the tendons to slide easily through the tunnel.
  • Arthritic diseases that affect the whole body, such as rheumatoid arthritis, can also cause tenosynovitis in the thumb.
  • Arthritic diseases that affect the whole body, such as rheumatoid arthritis, can also cause tenosynovitis in the thumb.


Wrist injury

Text Thumb

Benefits of physiotherapy:

  • Physiotherapy treatment reduces inflammation and accelerates healing.
  • improve strength, range of motion and endurance and correct postural and muscle imbalance which in turn prevents recurrence of condition.
  • Ergonomic corrections and activity modifications prevent various other injuries of hand and wrist along with deQuervains.
  • Physiotherapy rehabilitation exercises helps to restart all activities early.
  • Recovery is rapid if you start treatment in early stages. Chronic condition takes time as lot of changes like adhesion formations, Muscle weakness take place. But one can expect full recovery with the rehabilitation program completion.


Pregnant ladies and post-delivery mothers are affected more often. Contributory factors may include hormonal changes, fluid retention and – more debatably – lifting (baby).


Related Reading:

Working long on Computer : Carpal Tunnel Syndrome

Ergonomics: Does it matter in your workplace

Ergonomics Programme for Corporate Employees

5 minute Office Stretch exercises: Back, Neck pain

Neck Pain : Managing at Home

Physiotherapy, a sustainable solution for workplace Health & Wellness



Updated on 20th Nov, 2018

Neuralgia is basically a condition which leads to stabbing, burning, and often severe pain along the course of the nerve. This stabbing and unbearable pain makes it very difficult to carry out the basic daily activities. Also, since there is a glitch in the nerve conduction, the motor functions are also affected causing the movements to become difficult and tiring.

Pain Management, therefore forms a very important aspect of treatment in Neuralgia as it is one of the most disabling symptoms in patient suffering from Neuralgia. All these consequences of Neuralgia can be dealt well with the help of Physiotherapy. ReLiva provides physiotherapy treatment for Neuralgia at its clinics in Mumbai, Navi Mumbai, Pune and Thane.

Trigeminal Neuralgia (TN) is the most common among various types of Neuralgia. It is a chronic, debilitating condition, which can have a major impact on quality of life.

What is the treatment of Neuralgia?

A number of treatments can offer some relief from the pain caused by Neuralgia.

  • Identifying triggers and avoiding them helps.
  • Medication is most often prescribed to help control the pain
  • Physiotherapy to ease the pain and manage related symptoms of Neuralgia
  • Surgery may be considered for the longer term

How do you relieve Neuralgia pain?

TENS Physiotherapy

Pain Management forms a very important aspect of treatment in Neuralgia. Following measures have been found to be very helpful in easing the patients suffering from Neuralgia:

  1. Cryotherapy: One of the passive treatments given is cryotherapy, which is the use of cold packs or ice at the area of pain. This helps by sensitizing the area and hence blocking the sensation of pain.
  1. Transcutaneous Electrical Nerve Stimulation (TENS) is also considered one of the electrotherapeutic ways of blocking pain signals to the brain and hence reduce pain, as well as the tingling sensation that is experienced by the patient.
  2. Therapeutic massage therapy may be used to relieve pain in cases of Occipital Neuralgia, where the patient has a stabbing headache. Massaging the painful area can hit key spots of the nerve blood and oxygen flow. The increased blood and oxygen flow can help to heal damaged nerves.
  3. Apart from pain control, a physiotherapist will consider the following as an important part of the treatment:
  • Muscle strengthening
  • Improving flexibility
  • Aerobic training

How does Physiotherapy help in Neuralgia symptoms?

Physiotherapy treatment for Neuralgia is focused on decreasing the symptoms of Neuralgia and improving muscle strength and overall quality of life. After a detailed assessment by a specialist neurological physiotherapist, your treatment may include:

  • Muscle and nerve mobilisation
  • Soft tissue stretches
  • Muscle strengthening exercises
  • Sensory and proprioceptive stimulation
  • Pain management
  • Facilitation of activities of daily living
  • Home exercise program
  • Electrotherapy (TENS/Ultrasound)

Individuals with Neuralgia substantially benefit from treatment by a specialist neurological physiotherapist. The advantages include:

  • Increased strength of muscles
  • Return to normal daily routine
  • Decreased pain
  • Maintain muscle length
  • Maintain joint range of movement
  • Decreased sensory changes
  • Learn how to manage your pain
  • Learn specific exercises to continue at home/work

What is the best treatment for Neuralgia?

Apart from medications, Neuralgia symptoms can be best treated by a physiotherapist using a combination of special techniques and exercises, which may include:

  1. Flexibility exercises in the form of stretching to help in relieving the tension from the muscles and hence reducing the pressure on the nerves, thereby reducing the symptoms. Both passive and active stretching exercises are taught to the patient and also administered as home program.
  2. To begin with, various free exercises for the affected muscles are started to maintain the muscle properties and prevent any further consequence like disuse atrophy which may result from not using the muscle for a long time.
  3. Once the basic exercise protocol has been started and the symptoms of pain reduce, strengthening exercises for the affected muscles can be commenced. The muscle strengthening exercises offer multiple benefits including the following:
    1. Posture: Strengthening exercises for the neck and back in case of occipital Neuralgia prove very useful as they allow maintaining a better posture. Poor posture, specifically being hunched over and bending your neck down, can put pressure on your nerves and lead to headaches.
    2. Reduce the intensity of pain: The strengthened muscles then what is felt usually as the muscles are now able to work more and hence do not give up soon.
    3. Ease Pelvic muscles: In case of Pudendal Neuralgia rehabilitation of the pelvic floor, abdominal, gluteal, lumbosacral and hip rotator muscles.
    4. Improve balance and stability: Strengthening of certain muscles may be done to improve core and lower extremity balance and stability.
  4. Due to Neuralgia, the nerve is under a lot of stress due to factors like external pressure and entrapment, nerve mobilization proves very helpful in relieving them from the tension. Various nerve mobilization techniques are used to reduce the symptoms of the respective nerve being hampered.
  5. Aerobic training with low impact exercises helps maintain the body functions and also induces relaxation.
  6. Walking also helps keep the mind and body healthy and active.

What is Neuralgia ?

Neuralgia is a Greek word where neuron means “nerve” and algos “pain”.

Neuralgia is an intense, stabbing, burning and sharp shooting pain caused along the path of a damaged nerve it. Generally, Neuralgia isn’t an illness in its own right, but a symptom of injury or a particular disorder. In many cases, the cause of the pain is not known. Older people are most susceptible, but people of any age. The pain may be continuous/ intermittent or caused just by a triggering factor. Neuralgia can occur in different parts of the body and can have various causes. Neuralgia is classified on the basis of the nerve affected or the cause of affection.

Almost everyone will experience mild Neuralgia at some point, but these bouts are usually temporary and tend to ease by themselves within a few days. Some types of Neuralgia are longer lasting, debilitating and so agonizing that a person’s quality of life is severely reduced.

Keep reading till the end to understand the common types of Neuralgia.

What are the symptoms of Neuralgia?

Neuralgia symptoms can be widespread, depending on the cause, location and severity of the nerve pain. However, the most common symptoms that occur with a pinched nerve include:

  • Sharp and acute pain is felt in the affected area
  • Dull, throbbing and chronic pain though the course
  • Muscle weakness is often seen in such cases
  • Patient experiences fatigue
  • There can be stiffness and soreness of the joint and the muscle
  • Patient experiences typical pain that radiates along the nerve

Which areas of my body can get affected by Neuralgia?

Depending upon the nerve affected different areas of the body can get involved. For eg; if it is trigeminal Neuralgia then one side of the face gets affected. If it is postherpetic Neuralgia, the area which is affected by herpes zoster is involved like face, back, sole etc. in occipital Neuralgia back of the head and neck is affected.

Read more about the various types of Neuralgia further down this article.

How can I prevent Neuralgia?

Here are a few tips to manage the painful attacks and prevent Neuralgia:

  • Avoid (mental and physical) stress such as anxiety, lack of sleep, long drives etc.
  • Avoid low room temperature throughout the night; it may aggravate the pain at night or on waking up
  • Identify and avoid the specific trigger factors such as cold water, gargling, certain facial movements while eating or shaving etc.
  • Avoid missing your medicine as per the dosage
  • Learn to avoid sudden, jerky movements, turning neck while driving, heavy lifting activities etc
  • Eat nutritious fresh food high in protein, antioxidants and omega-3 fatty acids
  • Maintain excellent oral hygiene to avoid dental caries
  • Do not smoke
  • Maintain proper posture
  • Establish a regular sleep schedule
  • Stay active - exercise in moderation with low-impact exercises that improve cardiovascular health while stretching and strengthening supporting muscles.

Who is affected by Neuralgia?

Trigeminal Neuralgia is rare and statistical data regarding it is limited. The estimated annual incidence of trigeminal Neuralgia is 12.6 per 100000 persons per year (4) and its incidence increases with age.

  • Trigeminal Neuralgia affects females slightly more often than males. Although the exact incidence is unknown, approximately 10,000-15,000 new cases occur each year in the United States as per a report.
  • The disorder most frequently affects individuals more than 50 years of age.
  • However, cases can occur in younger adults as well. In younger individuals, the cause is often idiopathic, but when compared to older adult cases are more likely to be caused by damage to the central nervous system as in individuals with multiple sclerosis.
  • Although extremely rare, TN can occur in children.

How is Neuralgia diagnosed?

The diagnoses of different types of Neuralgia are difficult and could take time to reach the right diagnosis. This is due to the mixed picture that the symptoms give. A person suffering from trigeminal Neuralgia could first visit a dentist as he may suffer from jaw and tooth pain, similarly a patient developing shingles could visit a neurologist before a skin specialist.

  • A Neuralgia diagnosis generally begins with the patient describing their pain to a physician.
  • From there, the physician will rule out other causes of the pain by running tests, completing a physical exam, and looking at the patient’s medical history.
  • When Neuralgia is suspected, the physician will recommend tests that will check for a tumor or multiple sclerosis.
  • Depending on the results of those tests, the physician may order advanced MRI tests that can see if there is a blood vessel pressing against the nerve.

What causes Neuralgia ?

The underlying cause of any type of Neuralgia is damage to a nerve. Each nerve in your body is protected by a coating called the myelin sheath. When the myelin is damaged or wears away from the nerve, the stabbing, severe, shock-like pain of Neuralgia results.

There are many different factors, including old age, which can cause damage to the myelin. Unfortunately, in many cases of Neuralgia, a cause can never be found. The possible causes of Neuralgia are as follows:

  1. Infection: An infection can affect your nerves. For example, the cause of postherpetic Neuralgia is shingles, an infection caused by the chickenpox The likelihood of having this infection increases with age. An infection in a specific part of the body may also affect a nearby nerve. For example, if you have an infection in a tooth, it may affect the nerve and cause pain.
  2. Multiple sclerosis: Multiple sclerosis(MS) is a disease caused by the degradation of myelin, the covering of nerves. Among the many symptoms that result from MS is Neuralgia, often in the face. Related reading: Neuro Rehabilitation: How it helps in recovery of patient
  1. Pressure on nerves: The myelin on nerves can be worn away by pressure. The pressure may come from a bone, ligament, blood vessel, or a tumor that is pressing on the nerve. The pressure of a swollen blood vessel is a common cause in trigeminal Neuralgia.
  2. Diabetes: Many people with diabetes have problems with their nerves, including Neuralgia. The excess glucose in the bloodstream may damage nerves. This damage is most common in the hands, arms, feet, and legs
  3. Entrapment of the nerve: The nerves may get entrapped between the muscles/ muscle tendons or because of the pressure caused by the bones. This leads to an interrupted transmission of signals along with increasing the wear and tear of the myelin sheath causing it to be degenerated faster.
  4. Less common causes

If the cause of Neuralgia isn’t infection, MS, diabetes, or pressure on the nerves, it may be from one of many less-common factors. These include:

  • chronic kidney disease
  • medications prescribed for cancer
  • fluoroquinolone antibiotics, used to treat some infections
  • trauma, such as from surgery
  • chemical irritation

No one in my family has Neuralgia. How did I get it?

Neuralgia is not necessarily an inherited disease. In some cases, we find evidence of family history of Neuralgia. In many cases there may not be such history. Some patients may also give family history of multiple sclerosis, brain tumor, or other neurological disease.

I have Neuralgia. Does it mean my child will have it too?

No. It is not a rule.

Does Neuralgia go away?

There is no cure for Neuralgia, but treatment can help improve your symptoms. Some types of Neuralgia improve over time. More research is being done to develop better treatments for Neuralgia.

How long does it take to recover from Neuralgia?

It depends upon the cause of the condition. In postherpetic Neuralgia one may take 3 to 4 months to recover whereas three weeks into your trigeminal Neuralgia surgery recovery, you can expect to return to your normal activity level while continuing to avoid high intensity activities and longer in case of conservative treatment.

What are the common types of Neuralgia?

A. Trigeminal Neuralgia:

This type of Neuralgia is associated with pain from the trigeminal nerve, which goes from the brain to the face. In the case of trigeminal Neuralgia the affected nerves are responsible for sensing touch, temperature sensation and pressure sensation in the facial area from the jaw to the forehead. The disorder generally causes short episodes of excruciating pain, usually for less than two minutes and usually only one side of the face. The pain can be described in a variety of ways such as “stabbing”, “sharp”, “like lightning”, “burning”, and even “itchy”. The pain associated with Trigeminal Neuralgia is recognized as one of the most excruciating pains that can be experienced.

Trigeminal Neuralgia
Simple stimuli – such as eating, talking, making facial expressions, washing face, or any light touch or sensation – can trigger an attack (even the sensation of a cool breeze).Attacks may be lone occurrences, clusters of attacks, or constant episodes.

Some patients experience muscle spasm, which led to the original term for Trigeminal Neuralgia of “tic douloureux” (“tic”, meaning “spasm”, and “douloureux”, meaning “painful”, in French).

B. Postherpetic Neuralgia:

This type of Neuralgia occurs as a complication of shingles and may be anywhere on the body. Shingles is a viral infection characterized by a painful rash and blisters. Neuralgia can erupt wherever the outbreak of shingles occurred and can be mild or severe, persistent or intermittent, and can last for months or years. It will always occur along the path of a nerve, so it’s usually isolated to one side of the body.Here the underlying cause that is Shingles is treated to cure the symptoms of Neuralgia.

C. Occipital Neuralgia: 

Irritation of the main nerve that runs from the back of the skull can cause occipital Neuralgia. Occipital Neuralgia can cause intense pain that feels like a sharp, jabbing, electric shock localized to the back of the head and neck. The pain can sometimes include the forehead. But treatments for those conditions are very different, so it’s important to see your doctor to get the right diagnosis.Other symptoms include aching, burning, and throbbing pain that typically starts at the base of the head and goes to the scalp, Pain on one or both sides of the head, Pain behind the eye, Sensitivity to light, Tender scalp and Pain when you move your neck. People can confuse it with a migraine or other types of headache, because the symptoms can be similar.

D. Pudendal Neuralgia: 

Irritation of the pudendal nerve (severe pain in the distribution of the nerve), i.e. pudendal Neuralgia, may result in sensory symptoms in any or all areas it supplies and spasms of the muscles supplied by it. The sensory symptoms could manifest as itching, burning, tingling, cold sensations, and/or burning and shooting pain. The sensory symptoms may extend into the groin, abdomen, legs, and buttocks. The pudendal nerve is the only peripheral nerve that has both somatic and autonomic fibers. Thus, a person can experience increased heart rate and blood pressure, decreased motility of the colon, decreased blood flow, and perspiration with pudendal nerve stimulation.

E. Glossopharyngeal Neuralgia :

Pain from the glossopharyngeal nerve, which is in the throat, is not very common. This type of Neuralgia produces pain in the neck and throat.

F. Sciatic Neuralgia:

Shooting pain in the lower back, buttocks, legs, feet and/or toes; occurs as a result of compression of the sciatic nerve, the longest and widest nerve in the body.

ReLiva Physiotherapy helps develop an overall treatment plan for Neuralgia which not only helps in relieving pain but also helps cope up with the difficulties encountered in everyday life.

Call us at 9920991584 or write to us at and we will be happy to connect you with a physiotherapist close to you.

This article is based on inputs from Dr Swapnaja Joshi (PT).  Dr Swapnaja is a Masters in Physiotherapy. She is very popular among her patients for her positive demeanor and effective treatment. She can be found at one of the ReLiva clinics.

We provide Physiotherapy services at our fully equipped clinics in:

Mumbai | Chembur MulundThane  | Kapurbawdi  | Ghodbunder Rd | Kalwa 

Navi Mumbai | Vashi | Nerul | CardiumKharghar | Pune | Kalyani Nagar | Wakad

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