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The Quiet Rise of Interventional Pain Management Services at a Teaching Hospital in Kerala
- Asian Pain Academy
- 3 days ago
- 4 min read
Real Story of Dr Jithin Mathew Abraham at Believers Church Medical College Hospital, Kerala
For years, patients with chronic pain in many parts of India had limited options. Medicines helped some, physiotherapy helped others, but many continued to suffer—moving between departments without lasting relief. Dedicated pain services inside teaching hospitals were still developing, and interventional pain care remained largely outside the public eye.
That picture is now beginning to change.
At Believers Church Medical College Hospital, St. Thomas Nagar, Kuttapuzha, Thiruvalla, Kerala, a steady shift has been taking place—led not by a new department, but by an anaesthesiologist who chose to expand the boundaries of his specialty.
A Career Built Inside the Hospital System
Dr. Jithin Mathew Abraham completed his MD in Anaesthesiology nearly ten years ago and has spent his professional life within a tertiary care teaching hospital. His work has included routine and complex anaesthesia, academic responsibilities, and postgraduate training.
Over time, this commitment resulted in his promotion as Professor of Anaesthesiology.
Pain medicine was not an early career plan. The idea took shape when hospital administrators and clinicians recognised a growing number of patients with chronic spine pain, joint disorders, nerve pain, and cancer-related pain—many of whom required more than medications alone.
Choosing Structured Training in Interventional Pain Management
Rather than beginning pain practice informally, Dr Jithin opted for formal education. He completed a hands-on pain management training program, followed by a one-year Fellowship in Pain Medicine at Asian Pain Academy.
Colleagues say this period was crucial—not only for learning procedures, but for understanding patient selection, imaging guidance, and long-term pain management within safe limits.
From Shared Responsibility to Focused Pain Practice
Initially, pain patients were seen alongside routine anaesthesia duties. As outcomes improved, referrals increased from orthopaedics, neurology, oncology, and general medicine.
Gradually, pain work began to occupy a larger share of his clinical time.
Today, Dr. Jithin works in the operation theatre two days a week. On the remaining days, he focuses entirely on pain management. The pain clinic functions under the Department of Anaesthesiology, maintaining close coordination with other specialties.
Patients are typically seen after specialist evaluation, which means many of those who reach the clinic require procedural intervention—naturally leading to a higher number of procedures relative to OPD visits.
Clinical Work in Numbers in Interventional Pain Management
Clinic data from 2025 reflects this growing role:
625 patients evaluated for acute and chronic pain
455 interventional pain procedures performed
In a teaching hospital setting, these numbers indicate sustained clinical activity and increasing trust from both patients and referring doctors.
Spine Pain Remains the Largest Burden
Neck and low back pain formed the majority of cases.
Commonly performed procedures included:
Transforaminal epidural steroid injections
Cervical, lumbar, and caudal epidural injections
Cervical and lumbar facet joint diagnostic blocks and injections
Such Interventional Pain Management procedures require careful imaging guidance and anatomical precision—areas where anaesthesiology training plays a key role.
Addressing Musculoskeletal Pain
Beyond spine pain, the clinic gradually became involved in treating joint and soft tissue pain.
Patients were referred for conditions involving the shoulder, hip, knee, and smaller joints. Interventions included:
Sacroiliac joint and piriformis injections
Shoulder hydrodilatation, PRP therapy, tendon fenestration, and calcific barbotage
Ultrasound-guided procedures for elbow, wrist, hand, ankle, and foot pain
Many patients reported improvement after months or years of persistent discomfort.
Ultrasound as a Daily Tool in Interventional Pain Management
One noticeable aspect of the clinic’s work is the routine use of ultrasound guidance.
Dr Jithin regularly performs nerve-related procedures such as hydro-dissection and nerve release for:
Carpal tunnel syndrome
Occipital nerve pain
Spinal accessory and dorsal scapular nerve entrapment
Genitofemoral and ilio-inguinal neuralgia
This approach has helped improve accuracy while reducing complications.
Managing Severe and Cancer-Related Pain
The clinic also handles patients with advanced pain conditions, including cancer-related pain.
Procedures performed include:
Stellate ganglion blocks
Superior hypogastric plexus blocks
Celiac plexus blocks and alcohol neurolysis
Sympathetic paravertebral blocks
Such interventions are not commonly available in many teaching hospitals, making their presence significant for patient care.
New Developments in Pain Treatment
In addition to conventional procedures, the clinic has introduced:
PRP injections
Ketamine and lignocaine infusion therapies
Botox injections for spasticity and dystonia
Recently, another important step was taken. Radiofrequency pain procedures were started, with three medial branch block-guided RF cases completed successfully last week.
A Quiet but Meaningful Change
Dr Jithin Mathew Abraham’s work reflects a broader change in Indian healthcare. Pain medicine is no longer limited to private clinics or late-career shifts. With proper training and institutional support, it can grow within medical colleges and benefit a larger section of society.
His journey shows that anaesthesiology, when expanded thoughtfully, can play a central role in long-term pain care—offering patients relief, dignity, and continuity within a trusted hospital environment.
And in the process, it quietly reshapes how pain is understood and treated in India’s teaching hospitals.
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