The Direction
"There appears a light on the ocean of sorrow, suffering and pain... ...which brings new hope, Pleasure and comforting gain."

~ Dr.P.S Ajrawat

Pain Blog

Jan 23, 2010

Dr. Ajrawat's Air-Pulse Autonomic Meditation Therapy®

Features in Yoga Journal- A National Magazine


Jan 22, 2010

A  New Hope for Millions of Pain Sufferers With Diabetic Neuropathy

Diabetic Neuropathy- Treatment Outcome


Dec 30, 2009

Breakthrough Treatment for Diabetic Neuropathy Introduced

Dr. Paramjit Singh Ajrawat introduces a breakthrough multi-modality treatment for diabetic neuropathy, providing new hope for millions of diabetics around the world.

My new model for pain management is designed to significantly reduce or eliminate the pain of diabetic neuropathy, restore the circulation to the damaged nerves, allowing sufferers to regain their lives and live free from pain and associated disability.

Lanham, MD (PRWEB) December 30, 2009
-- Diabetics around the world now have new hope for relief of their pain associated with diabetic neuropathy with the introduction of Dr. Ajrawat’s Dynamic Model for Pain Management, a multi-modality treatment created by Dr. Paramjit Singh Ajrawat. Dr. Ajrawat’s system utilizes a variety of treatment modalities to bring relief to those with diabetic neuropathy.

Dr. P.S. Ajrawat, M.D., a pioneering, qualified pain specialist who is fellowship trained and certified in pain management, has used creative and innovative research to reach his new landmark treatment. This revolutionary treatment modality uses a combination of treatment models to bring relief, including sympathetic nerve blocks, trigger point injections, antidepressants, narcotic and non-narcotic analgesics, Dr. Ajrawat’s Air-Pulse Autonomic Meditation Therapy and physical rehabilitation, including strengthening and stretching exercises, psychotherapy, walking alternated with jogging and diet.

“Diabetic neuropathy is becoming more familiar due to frustration from both the medical community and diabetics regarding the wont of achieving optimal results using conventional or newer approaches, including the use of medications like gabapentin, exercise and other adjunctive treatment measures,” Dr. Ajrawat says. “My new model for pain management is specifically designed to significantly reduce or eliminate the pain of diabetic neuropathy, restore the circulation to the damaged nerves, allowing sufferers to regain their lives and live free from pain and associated disability.”

Diabetic neuropathy is a disorder of the nerves caused by high levels of sugars in the body in which people with diabetes can, over a length of time, develop nerve and tissue damage in various parts of the body, including the peripheral nerves, heart, digestive system, kidneys and reproductive system. Different types of diabetic neuropathies exist, including peripheral neuropathy, autonomic neuropathy, proximal neuropathy and focal neuropathy.

Diabetic neuropathy can result from multiple factors, including high blood sugar levels, autoimmune deficiency, neurovascular factors (ischemia) or decreased blood supply to the nerves. Complimentary factors like smoking, alcohol intake and use of various medications such as cancer treatment drugs can contribute to or precipitate the condition.

Pathogenesis of diabetic neuropathy include micro vascular changes like vasoconstriction which can lead to capillary basement membrane and endothelial hyperplasia and eventually to low oxygen tension and hypoxia, micro vascular dysfunction and ischemia. Neuronal dysfunction can develop simultaneously that is neuronal ischemia and ultimate manifestation of neurological as well as other symptoms and signs like pain, numbness, burning and tingling.

Symptoms of diabetic neuropathy vary from numbness or tingling to a burning type of pain in the toes, feet, legs, arms, hands and fingertips.

In addition, diarrhea, constipation, indigestion, weakness, dizziness, problems with urination (urinary incontinence or loss of bladder control), erectile dysfunction, impotence, vision change, fasciculation, muscle weakness, and difficulty standing, walking or weight bearing are common. Other symptoms include depression, anxiety, insomnia, weight loss and loss of functionality (the inability to walk or stand).

Up to now, diabetic neuropathy treatment has been oriented toward pain relief and associated symptoms mainly through the use of pharmaco-therapeutic approaches including anti-diabetics, antihypertensives like ACE Inhibitors, narcotic analgesics, gabapentin and similar preparations, and other adjunctive approaches like TENS and acupuncture. However, these treatments have been met with little success.

Dr. Ajrawat’s Dynamic Model for Pain Management is a conservative model for pain management administered by a qualified pain specialist (fellowship trained and certified in pain management) that addresses all components of diabetic neuropathy, including both the physical and psychological. Treatment results have been optimal and outstanding.

Dr. Ajrawat’s approach to treating diabetic neuropathy is based on his method of increasing blood supply to the nerves through the use of various modalities such as sympathetic nerve blocks and daily use of his scientific meditation therapy, Dr. Ajrawat’s Air-Pulse Autonomic Meditation Therapy®. The Air-Pulse therapy is based on Dr. Ajrawat’s concept of bi-directional psychosomatic autonomic feedback to reverse damage done to the nerves caused by ischemia. With close follow up and treatments, repetitive use of sympathetic nerve blocks, Air-Pulse therapy, antidepressants, analgesics, physical rehabilitation and psychotherapy, the results have been incredibly positive.

“Treating Physician’s (pain specialist) training, knowledge, clinical skills, dedication, positive therapeutic alliance with the patient, active patient participation, close follow ups and treatments and conservative approach is absolutely essential for a favorable treatment outcome”, says Dr. Ajrawat.

Air-Pulse therapy is an autonomic meditation therapy which is revolutionary, scientific, non-denominational medical therapy that helps restore the lost homeostatic balance in mind and body. It helps minimize the ischemia and restore circulation through natural means by establishing a balance between sympathetic and parasympathetic components of the autonomic nervous system.

With the help of this self-administered meditation therapy the efferent mechanisms are balanced by afferent mechanisms, a new paradigm -- a scientific revolution. It also helps normalize the levels of various neurotransmitters such as serotonin, nor-epinephrine, acetylcholine, dopamine and glutamate, among others. Studies conducted by Dr. Ajrawat show this approach helps not only decrease pain, but also restores loss of function and lowers the dosage intake of various anti-diabetic medications, oral as well as parenteral.

Individual and group psychotherapy provided by Dr. Sukhveen Kaur Ajrawat, M.D., a board certified psychiatrist, helps patients with pain associated stress and depression and mental disability associated with diabetic neuropathy.

Hence, with use of Dr. Ajrawat’s Dynamic Model for Pain Management, iatrogenic morbidity and pain is significantly reduced or eliminated. The patient’s healing is enhanced by their active involvement in this revolutionary therapy and therapeutic process.

For more information about Dr. Ajrawat’s Dynamic Model for Pain Management or its use for treating the pain associated with diabetic neuropathy, visit or

Contact: Dr.P.S.Ajrawat

Mobile: 240-375-1205


Oct 25, 2009

Dr. Pritam Singh- A stalwart passes away

Dr. Pritam Singh father of Dr. Paramjit Singh Ajrawat, was a stalwart who recently passed away. He was born in village Tanda, District Gujrat, Pakistan in 1920. He has left behind an amazing legacy of a decorated world war 2 veteran, pioneer, a world class physician, educator and a humanitarian. He was former principal of medical college Amritsar and a pioneer in the field of Anesthesiology. He graduated from Glancy Medical college Amritsar in 1937, joined the army in World War 2 as a second lieutenant and served on the Burma front where he was promoted to the rank of major at the age 26 and was honored with one of the highest award known as Mention in Dispatches for his distinguished service. He was also the recipient of famous Burmah Star Medal for gallantry and service. In 1956, he arrived in USA for higher training and graduated as a fellow in anesthesiology from Hartford General Hospital of Yale University School of Medicine. He had the honor of personally visiting with Kennedy family in Hyannisport in Massachussetts in 1956. After completion of his training, he introduced the new field of Anesthesia at Amritsar Medical College and later became professor and head of the department of Anesthesia and president of Indian Society of Anesthesiologist and vice president of World Federation of Anesthesiologist. He was the editor of Indian Journal of Anesthesia for many years. He also served as director research and medical education for the state of punjab. He served as Professor at University of Cincinnati, Ohio for three years. He served as personal physician to the president of India. He was one of the founders of Khalsa College at Begowal, Kapurthala, Punjab, India. As a professional  he served the Sikhs and non Sikhs alike with compassion and dedication. Dr Pritam Singh was a highly respected as an individual and a professional by his peers and public. He enjoyed the honor and distinction of producing more than thirty seven physicians in his immediate family. His students are highly placed in some of the top institutions of the world. His loss as an individual and a professional is currently felt all over the world. May god bless his soul and give strength to Ajrawat family to bear the loss


Feb 19, 2009

Dr. Ajrawat's Air-Pulse Autonomic Meditation Therapy®

Register for Free Seminar in Vancouver, BC, Canada

Feb. 27- March 1st, 2009 . Call 301-474-7246


Jan 19, 2009

From a Painfully Static to a Gainfully Dynamic Way of Living Once More!
The Story of a Chronic Pain Sufferer
By Gary Grewal

Oct 9, 2008

Dr. Ajrawat's Air-Pulse Autonomic Meditation Therapy®

Receives Patent Trademark. A Scientific Meditation Therapy

For The New Age.

Dec 25, 2007

Dr. Ajrawat's Dynamic Pain Management  Model™

Biosychosocial Model for evaluation of chronic pain and

Multimodalty Treatments for effective pain management

 by a qualified (fellowship trained and certfied) pain specialist

is the key.

Pain Management-Treatment Outcome

Myofascial Headaches

"From the Enigma of Disability & Pain
to the Path of a Happy & Productive Lifestyle"

By Susan Merritt


Sep 16, 2007

Enigmatic Pain Sufferer

Pain Patient's Enigma: I, as a qualified (fellowship trained and certified) pain specialist, frequently encounter pain patients, who are absolutely desperate and at their wits end because of not having been properly diagnosed and effectively treated. Such desperation leads to loss of mental and physical vitality. Often one's outlook about life changes with persistent pain, one loses ones capability to live effectively and one ages faster than one could imagine. Such was the plight of Michel Valois and millions of other pain sufferers, who seldom see the light at the end of the tunnel. What is frustrating for me as a pain specialist is my limitation and ability to treat very few patients, as every patient needs one to one expert  & quality care for  a favorable treatment outcome.To address that challenge, I am planing to start the Pain Radio on the internet to educate pain sufferers world wide, who seek right professional help. I am also committed to training more physicians in pain management who in turn can provide quality and effective care. Those of you who read this column please send me your suggestions. Thanks!

Dr.P.S. Ajrawat

Pain Management- Treatment Outcome

“Back from hell, slowly but surely”

By Michel Valois

On February 28, I had a radical prostatectomy for cancer, in one of the best place in the US for that surgery. I am 69, but I was, at the time, in the best possible shape: stretching every morning since ten years, treadmill two days a week since 5 years. In the 6 weeks before the surgery, I was running 4 miles in one hour every other day. I felt and looked younger than my age.

Unfortunately it was the beginning of the worst period in my life. After two months, I thought I had added ten years to my age. Even with a lot of pain killers I was suffering and even with sleeping pills I had to go to the bathroom eight or ten times during the night. No pill, no sleep. My surgeon, at the three-month post-surgery visit, was lost, not knowing what was going on and what to prescribe, except a routine pill for the bladder.

I decided to see another urologist, in my area, with a good rating from Consumer-Checkbook, to have a second opinion and hopefully get some relief. Perhaps I had another cancer somewhere? He ordered urine and blood tests and a CT scan and he did a cystoscopy. He saw nothing wrong. Good news, he said; no infection, no cancer. But from there on, what to do? As soon as there was no flesh to cut, I was not an interesting case and he rather rudely told, to my wife and I, he couldn’t do anything for me. Move along, I have other patients waiting!

If urologists couldn’t do anything for me, I had to find someone else able to alleviate my pain. I had no previous experience of pain management, but I had heard about that discipline. I thus looked after a “pain management doctor” on the web. I found Dr Ajrawat and took an appointment.

This first appointment was a pleasant surprise. I was used to doctors that keep you ten minutes the first time, and then 3 minutes each time. With Dr Ajrawat the diagnostic took one hour and a half. He told me “It’s an ethic choice: with my patients, I don’t look at my watch”. I was already going better!

It’s a lot of things: trigger point injections, nerve blocks, physical rehabilitation, Dr. Ajrawat's Air Pulse Meditation, psychotherapy, strengthening and stretching exercises, and medication. Not surprisingly it takes time: three more-than-one-hour sessions a week for 6 weeks or more, depending on the case. But, surprises succeeded to surprises. First I had leg shorter than the other and that caused posture compensations and then cramps. In fact I discovered that I had low-intensity pains in the muscular mass I didn’t know (or I didn’t want to know). Then I had the feeling of pains moving from one place of the body to another, from thighs to back or to shoulders for example.

In the meantime, I discovered by chance, a urologist knowing what I have: a supposedly rare and probably autoimmune illness, with no cure, interstitial cystitis. There is a remedy but with only long-term effect. The main thing is to follow a diet. That day, I discovered also that my first symptoms – 14 years ago – which were allegedly related to an early prostate hyperplasia were, in fact, the first signs of what I have and that the surgery had wreaked havoc in a weakened bladder. It was a relief to know what I have, even if there is no cure.

After one month of pain management, I discovered its first benefits. My first benchmark, was to recover sleep. Since one week, I sleep without sleeping pills. The level of pain is clearly lower, second benchmark. And I am regaining control on my bladder: yesterday, I didn’t put a diaper for the first time in six months, but a pad.

But there is another benefit of pain management. I had felt ten years older, and now I am going back in time. My body feels younger. The feeling and the appearance of age is strongly related to body stiffness. Knowingly or not, when we grow older, we let our body become less and less flexible. It’s like an inside ‘carapace’ limiting our movements scope. Right now, thanks to pain management, I am shedding away that carapace and going back in time. Thank you Dr. Ajrawat!

Michel Valois, Silver Spring MD


Sunday, September 3, 2007

Understanding Skeletal Disproportion!

Short Leg, Short Hemipelvis

A Major Cause of Pain In The Body

Skeletal disproportion is one of the major factors perpetuating myofascial pain. Myofascial pain in turn is one of the major causes of pain in the human body. It often results from varieties of causes including mechanical stressors like skeletal disproportion (short leg, short hemipelvis), trauma, poor conditioning of muscles, nutritional deficencies, metabolic and endocrine deficiency such as hypothyroidism. psychological stressors, poor ergonomics including faulty posture and poorly designed furniture.

Skeletal disproportion i.e. a short leg, short hemipelvis, rounded shoulders are among the common causes perpetuating myofascial pain and often misdiagnosed. The resultant effect of this misdiagnosis is persistence and perpetuation of myofascial pain in different parts of human body including head, neck, shouldrs, low back, knees and others. This often leads to chronicity of pain.

Myofascial trigger points resulting from skeletal disproportion can produce a varietiy of symptoms including pain, weakness of muscles, nausea, vomiting, numbness, tingling, dizziness, blurriness of vision, limitation of range of motion, depression, fatigue, stiffness of muscle among others.

Because of old and prevalent frame of reference, practitioners often focus more on remote causes of pain like herniated disc, pinched nerve and degenerative (arthritic) changes in the bones and believe them to be the major causes of pain. The x rays and scans are commonly used to make that determination. This results in unnecesssary diagnostic testings, inappropriate invasive (surgical) and noninvasive interventions leading to more pain and disability while the underlying cause remains undiagnosed and untreated. Advanced pain management or adjunctive single modality treatments like physical therapy or chiropractic adjustments add little to patient's comfort and overall pain relief and restoration of loss functionality. The attempts to treat pain with pain medication and other highly advertised pharmaceutical agents leads commonly to serious side effects, drug dependence and addiction Pain patient often feel frustrated, fatigued, angry, depressed and disabled. Hence pain becomes a real ordeal.

Skeletal disproportion including short leg and short hemipelvis can be easily diagnosed by observing patient's face, gait and posture. Thorough physical examination including measurement of lower extremities manually (using tape measure; using book or magazine under the feet) and x rays can easily establish and confirm the diagnosis of skeletal disproportion. Facial asymmetry, atrophy of various muscles and compensatory scoliosis are commonly associated with skeletal disproportion.

Skeletal disproportion can be corrected and perpetuation prevented by using heel lift in the shoe on the affected side, padding under buttock on affected side while sitting and using side arms and proper posture for rounded shoulders. Myofascial pain resulting from skeletal disproportion when properly diagnosed and treated can bring long term pain relief. In order to break the cycle of pain and for pain patient to get the qualified and professional help,the qualification and skills of the pain specialist are very essential. Pain sufferers must seek a qualified and skilled pain specialist who can provide hands on treatment like trigger point injections, nerve blocks, correction of skeletal disproportion, physical rehabilitation, strengthening and stretching exercises, meditation, psychotherapy, medication management, other adjunctive and non adjunctive treatments. Close follow ups, treatments, patient education and  patient's active participation in the treatment plan are essential for optimal and long term pain relief.

-P.S.Ajrawat, M.D.



Attention Pain Sufferers!

Being a qualified and experienced pain specialist  dedicated to quality care for the pain patient, education of public and committed to the  professionals enhancement of field of pain management/medicine, I must share the following.
Pain patients around the world  while desperately  seeking the pain relief they deserve, often  end up  getting on a never ending merry-go-round which results in addiction, iatrogenic  morbidity and pain, leading to anger, despair and depression,  Some commit suicide, a grim scenario.
Why so?
Majority of the times it is not the health care professional's intentions or committment  but rather their lack of training and understanding about pain which becomes the source of that frustration.  Many health care professionals or providers often marketing themselves as pain specialists providing either too radical or only adjunctive and non specialized care further confuse the pain patient and complicate the care. It often leads to suppressed anger and contempt on the part of patient against the medical profession.
It has hence become imperative and essential that medical profession supply more qualified  (fellowship trained and certified) pain specialists who as specialists will provide the necessary care i.e. hands on treatments and close follow up for  much needy pain patients. Pain management should not be considered just as a hobby or some remote subspecialty where shear motivations and interest is not enough  but  must be advanced and propagated as a full fledged discipline of medicine  ready to take on the challenge of all times, the pain in a most scientific, appropriate and effective manner.
At the same time it is incumbent upon the pain sufferers to look and explore for the qualified pain specialist or professional, educate themselves about their pain disorder and get the best help. In addition patient can ask their personal physician to refer them to a qualified pain specialist with necessary training and skills who will evaluate and treat  their pain in a conservative manner. Not just mere relief of pain but rehabilitation and restoration of lost functionality constitute appropriate pain management. In addition the positive therapeutic alliance between pain specialist and pain patient is essential. It is the Gung Ho approach which will eventually bring the necessary paradigm shift.

Posted by P.S.Ajrawat, M.D.

FRIDAY | JULY 13, 2007


I am Dr. Paramjit Singh Ajrawat, a pioneer pain specialist  and a full time practitioner of pain management. I finished my training as a full time fellow from University of Texas Health Science Center in  San Antonio, Texas in 1985 and introduced pain management as a discipline in washington metropoltan area and started my independent self supporting pain center.

Being a pioneer and the first qualified (Fellowship trained and certified) pain specialist in Washington,DC area, the challenge for me was immense. But I was fully determined and resolute in bringing the necessary paradigm shift in the understanding of  pain by the public as well as the medical professionals.

I introduced  the very basic definition of pain, Bio-psychosocial Model of Illness to evaluate pain and multimodality treatments also known as Dr. Ajrawat's Dynamic Model to treat pain effectively. My wife and colleague Dr. Sukhveen Kaur Ajrawat,  who is a board certified psychiatrist has stood with me shoulder to shoulder  by providing quality care for the psychologic and psychiatric needs of the pain patienst.

I took many initiatives like introducing pain management as a discipline to local medical societies like Fairfax, Montgomery , Washington, D.C. and Prince Georges county medical societies. In addition, I introduced  it to  local medical schools like George Washington University and Howard University College of Medicine. I also introduced pain management/ medicine as a new and independent discipline to local and national referral services like Dial Doctors and Prologue.

To enhance professional  and public awareness I started the newsletter called Algology (Pain Management) update. I have over the years participated in local tv and radio talk shows. CBS news has done stories several times on the quality care we provide  and positive therapeutic results we produce.

Our pain center continues to be the leader in the area for patient and public education. We as qualified professionals are committed to providing conservative and state of the art pain management for the much needy pain sufferer. Despite all the successes and triumph I feel rather frustrated to acknowledge the fact that there are millions of people in the US and other countries who need  quality pain management desperately and are not getting from wont of qualified pain specialists and poor awareness, education and  lack of training of medical professionals. My mission is to raise the awareness about pain and its proper management, help produce qualified pain specialists, so one day we can make our world pain free.

- Posted by P.S. Ajrawat, M.D.