Let us together rewrite a part of Rheumatology.

Twenty years of research and working in Chronic Pain has revealed facts that are undeniable and has resulted in evolving the new technique of unmasking the underlying problem. By this research new modalities have been devised and algorithm established for the treatment of Osteo-Arthritis Knee Joint, Chronic low back Pain and other major myalgic problems. This work has given new concepts that are supplemented by clinical results. Our findings are:



1. Pain knee attributed to OA is not due to narrowing of the joint space neither because of reduction in the surface cartilage nor to drying up of the synovial fluids. These changes in the joint seem to be remaining silent. Pain knee in OA is a referred pain that originates in lesions proximal to the knee joint. On the medial side this lesion is upon the Adductor Tubercle and on lateral side it is upon the origin of lateral head of Gastronemius.

2. Trigger spots are identified as the cause of Chronic Low Back Pain. The trigger spots identified turn out to be fibrositis, tendonitis or at times fasciitis in the strong paravertebral Muscles. These trigger spots behave as foreign body in the soft and supple tissue of the muscles mass creating a focus of irritation that causes pain leading to spasm of local group of muscles and spasm through spinal reflex. This is the mechanism of causation of Lumbago & Lumbago-Sciatica. These lesions are trigger spots and as they are taken care of the whole problem of Lumbago-Sciatica is resolved in a week time.

3. Cervical Spondylosis ( like Low Back Pain ) is also due to various trigger spots in strong Paravertebral Muscles of the Dorsal and Cervical region. Thus despite changes in cervical vertebrae cervical pain can be very easily treated in three to four days of treatment with lasting cure for months and years.

4. Now we are concentrating upon Fibro_myalgia to understand and to find an answer to this problem.
Alhamdulillah we are treating these conditions with a satisfactory rate of success that is now well established in our Clinical practice. Papers on the above subjects have been published as appended below and these can be studied on Pakmedinet .com.
1. Syed Zahid Hussain Bokhari Tendonitis: The major cause of pain in osteoarthritis Knee joint.
J Ayub Med Coll Abbottabad 2012;24(3-4)
Pain and Plegia Centre Dabgari Gardens Peshawar, Pakistan

2. Syed Zahid Hussain Bokhari, Samina Zahid.
Treatment of frozen shoulder
J Postgrad Med Inst Apr - Jun 2009;23(2):184-8.
Pain and Plegia center, Peshawar
3. Syed Zahid Hussain Bokhari, Samina Zahid.
Pain management in Lumbago: role of acupuncture in addition to local steroid infiltration at trigger points
J Postgrad Med Inst Apr - Jun 2007;21(2):141-5.
Pain and Plegia Centre, Dabgari Gardens, Peshawar
4. Syed Zahid Hussain Bokhari, Samina Zahid.
The role of Acupuncture in arthritis of the knee joint in addition to local steroid injection
J Postgrad Med Inst Jan - Mar 2006;20(1):36-9.
Dabgari Gardens Peshawar and Hayat Abad Medical Complex, Peshawar
Book recently published on this subject:

Syed Zahid Hussain Bokhari, (Author)
Latest on Osteoarthritis and Myalgia(First Edition): The Technique of "Unmasking and treating the underlying problem. Paperback
ISBN-10: 1490969357 ISBN-13: 978-1490969350
CreateSpace Independent Publishing Platform; 2 edition (July 28, 2013)
(Available on

The main concept is that this work has proved that the conventional concepts for Pain Knee joint/ Chronic Low Back Pain/ Cervical Spondylosis are not valid.

Our conviction is that the findings we have presented may cause a revolution in the treatment of Myalgic Problems and may altogether change the concepts in certain parts of Rheumatology.


It is a primary finding and it may be a break through.

These problems pose a major challenge. Medical Sector is unable to conclude ways to address the situation. Today’s Research on these Medical Problems, being done in the West, is looking at it from a different angle that may be wrong. They are trying to find biochemical changes as cause of OA while in fact it may be that biochemical changes are a result of Long Standing Painful condition rather than a cause.

This basic discovery requires for its further research conducive atmosphere, joint efforts and sophisticated facilities. These findings have clinically proved to be existent and treatments are giving uniform results / recovery in Pain Knee joint of OA origin, Chronic Low back Pain including Lumbago_ sciatica & Cervical Spondylosis. To varied extent this treatment modality also covers Sports injuries and Myalgic Problems of Various origins.
There is a will to introduce this Algorithm to the Modern Medical Knowledge. This is possible after its efficacy has been established through thorough working in a Teaching atmosphere. This treatment also needs to be standardized through cross discussions after analyzing the data obtained through strenuous efforts. Opening a scientific discussion through Clinical Presentation Conferences where this Data will be presented and would be open to discussion. The final result of these efforts can be reaped in the form of Joint papers to be published in International Journals introducing this simple technique to the world of Modern Medicine. West is equally crippled by the Myalgic and Rheumatic Problems and wants its solution.


  • Consultants are invited to acquaint themselves with this technique and to introduce it in their Institutions for the wider benefits of the patients. We will extend any help required.

  • This technique and concept is still in the introductory phase even though it has been developed and thoroughly improved in our clinical practice.

  • Forum is open for discussion among the Doctors.

  • Some basic information about this latest technique and its outcome in various Painful Conditions is given in the links of the five diseases.

  • Ultimate aim is to inculcate these findings in to the modern medical knowledge and to introduce this technique of “Unmasking and treating the underlying Problem” as the “Ultimate Pain Management”.

For furthering the cause of Medical Knowledge, let us together begin to rewrite a part of Rheumatology

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