Chronic neck pain without a disc protrusion or facet indications (negative blocks) gets no respect. One can have pain from internal disc disruptions in a neck disc and have nothing to show for it. Now it looks like the patient’s pain can be cut in half for months with just injections of local, epidurally. Read the rest of this entry »
Popularity: 1% [?]
Idiopathic rhinitis is a condition where the nose drips for no reason - it can be resistant to treatment though Botox has been found helpful Read the rest of this entry »
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TENS became a significant add-on when used with pregabalin for Post-herpetic neuralgia Read the rest of this entry »
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This was a large Canadian study and results demonstrated “this association remained significant after controlling for sociodemographics and any lifetime anxiety or mood disorder.” If smokers back pain dropped to normal after quitting, this would result in a 33% improvement. This is significantly better than the 20% some treatment can manage and might constitute a major objective for pain relief. Read the rest of this entry »
Popularity: 2% [?]
Post Herpetic Neuralgia (PHN) is a horrendous disease with limited options. A group with low back version of this were treated with 60 mg methylprednisolone and 2 mg midazolam in saline epidurally. Note - no local anesthtic block was necessary. Though pains started at near 10/10 on the pain scale, the highest it got after 3 months was 5.5/10. On average, painkiller pill consumption went from 25 tablets/day to 5/day even after 3 months. These results are miraculous and I hope to spread the news. Read the rest of this entry »
Popularity: 3% [?]
NOTE - many drugs could be effected by treatment below (and potentially dangerously) and so this should be supervised by your doctor or your pharmacist -especially if on Warfarin. There are rare cases of Dextromethorpan “Benylin cough syrup” dependence mentioned here but cases were usually people with widespread dependency drug issues.
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In the USA, a combination of Dextromethorphan and a drug to prevent its metabolism (quinidine) may have significant non-narcotic pain relieving potential though inhibition of NMDA receptors. It can be easily reproduced with DM cough capsules and grafefruit juice. Read the rest of this entry »
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Lidocaine patches are ridiculously expensive and yet ridiculously easy to make - here’s how. Read the rest of this entry »
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Purdue has released their 7 day patch painkiller - where it fits in remains to be seen.
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Glial Cells are immune cells in the nervous system - they have been getting considerable press over their part in activating chronic pain. It has now been suggested that Minocycline (and hence Doxycycline), tetracyclines that suppress glial cells function, could help prevent post herpetic neurralgia (PHN).
Popularity: 5% [?]
Post herpetic neuralgia is a terrible disease that can be mitigated by certain measures. There are some old and some new treatments that might be missed: Read the rest of this entry »
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Injection of wild type glial brain support cells into mutant OCD grooming mice helps abate the mice’ OCD some. Read the rest of this entry »
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Recent findings demonstrate lying patient with bad side down for 15 minutes can almost double its effectiveness. Read the rest of this entry »
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Recent guidelines for treating Neuropathic pain have drawn extensively from results with Diabetic and Post Herpetic Neuropathy. I have written about how those results cannot be generalized to treatment of Radiculopathy (sciatica either of back or neck). see here: Etanercept (Enbrel) for Radiculitis (Sciatica).
Now that Pregabalin has failed to help Lumbosacral radiculopathy, this is more clearly true.
Popularity: 8% [?]
A series of 6 self-administered questions proved helpful in delineating fibromyalgia risk. A cut-off of 5/6 positive answers “gave the highest rate of correct identification of patients (87.9%), with a sensitivity of 90.5% and a specificity of 85.7%”. Read the rest of this entry »
Popularity: 8% [?]
Gluthathione levels decrease by 10-15% per decade - what can one do to help this anti-oxidant? Read the rest of this entry »
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Though ignored by chronic pain groups, Alpha Lipoic Acid, and L acetyl Carnitine have shown promise if taken early in course of diabetic peripheral neuropathy Read the rest of this entry »
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Despite repeated studies demonstrating beneficial effects by Dellon and his contemporaries, resistance to idea of entrapment as being part of DM neuropathy continues. Recent studies demonstrate dramatic results from decompression.
Popularity: 9% [?]
Breakthrough cancer pain occurs at least once in 2/3 of cancer patients. Either morphine sc injections, which require a needle, or fentanyl intranasal, which requires multiple sprays, has been used. Sufentanyl intranasal spray requires much less.
Popularity: 9% [?]
Noctalgia paresthetica is considered nerve damage in between shoulder blades leading to itching in areas. Treatments have not been that satisfactory to date
Popularity: 9% [?]
Sometimes chronic perineal pain comes out of the blue and one could certainly use a secret weapon. Botox to ganglion impar reduced one case of perianal and genital pain from 8/10 to 2-4/10 for months. Read the rest of this entry »
Popularity: 9% [?]
Study compared the two agents and found their effects comparable except topiramate offered better some quality of life Read the rest of this entry »
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Recent study found lameness to be 36% in diary farms but control would take effort and there are financial constraints to fixing it. It just like being on WCB. Read the rest of this entry »
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Of those post hernia pain cases that responded to ilioinguinal nerve freezing block, “complete or partial pain relief was achieved in 66.7%” Read the rest of this entry »
Popularity: 12% [?]
What can be worse than not being able to sleep because your shoulders are sore - what can you do? Am trying to put together a list. Read the rest of this entry »
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I have reluctant to use ketamine because of undesirable side effects including hallucinations. Now it looks like much can be achieved even with low dose using S isomer form. Read the rest of this entry »
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Oxytocin nasal spray (18 or 24 IU) improved emotional recognition in autistic children. This is not the first time it has been shown to have social effects. May not last long so might be relegated to emergencies.. Read the rest of this entry »
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FCE study shows it can predict working in short term but reinjury Read the rest of this entry »
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Medical Hypotheses generated makes a case for that scenario Read the rest of this entry »
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Lady with ulcerative colitis and sacroiliitis improved after leukocytapheresis (LCAP). Read the rest of this entry »
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Recent study found variations of RA by latitude and suggested low vitamin D might be cause. I don’t think it’s that simple Read the rest of this entry »
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Technique was devised to beef up dextromethorphan (DM cough syrup) ) by combining it with quinidine sulfate which prevents the former from being metabolized Read the rest of this entry »
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Recent Article takes a survey of concerns of low back pain patients sent for rehab. The results are no surprise. Read the rest of this entry »
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Answer appears to be yes according to one study Read the rest of this entry »
Popularity: 12% [?]
Contagious crying - where one baby cries when hears another cry is now considered the first signs of empathy development.
Popularity: 12% [?]
Recent Hypothesis forwarded that low Vitamin C sets the stage for disc disease and once disc degeneration started, it is a self fueling inflammatory disease. Read the rest of this entry »
Popularity: 12% [?]
Looks like extension wrist splint straps help a bit but tennis elbow bands don’t do much Read the rest of this entry »
Popularity: 12% [?]
Epidemiological study found aged on over 50 mg morphine equivalents had double the fracture rates. Question is why… Read the rest of this entry »
Popularity: 12% [?]
Recent article suggests Magnesium might help depression but has more theoretical than actual data to prove it Read the rest of this entry »
Popularity: 13% [?]
There is a growing tendency to separate out responders and non-responders in studies and report on the success of responders. This stinks like fish… Read the rest of this entry »
Popularity: 13% [?]
Recent study found 41.5% of chronic fatigue cases had abnormal parvovirus antibodies versus 7% of controls and with these antibodies. 73% of the positive CF cases had problems with joint pains. Actual Parvovirus B19 DNA was found in 5.5% of the chronic fatigue cases and in none of controls. Read the rest of this entry »
Popularity: 13% [?]
Have a patient with this problem. Recent article goes over an option. Read the rest of this entry »
Popularity: 12% [?]
I have a patient who has widespread pain and can’t sleep on her sides. What is most comfortable is my massage table with a hole for the face. I have looked for portable versions of that and came across a possibility Read the rest of this entry »
Popularity: 12% [?]
Pamidronate has been show to work in Complex Regional Pain - Often triggered by fractures. Now severe pain after a leg fracture was helped by pamidronate in a child
Popularity: 13% [?]
Recent article found 10-15% of inguinal groin pain actually comes from an abnormality of the front of the hip joint. These people often are involved in multiple investigations when, injection of hip joint with local, proves the diagnosis. Read the rest of this entry »
Popularity: 13% [?]
Article in press using large number of cases, demonstrates statistical superiority of Milnacipran in Fibromyaglia. Although thoroughly disguised, absolute results don’t look that great.
Popularity: 13% [?]
Large legs, with little pitting, is an abnormal accumulation of fat in the legs, often hereditary in nature and very often mis-diagnosed. The pain is treatable.
Popularity: 13% [?]
A Review of ergonomic studies was able to (?gleefully) trounce all studies as having inadequate design but could not ignore that an arm board could help office neck pain. Read the rest of this entry »
Popularity: 27% [?]
After Various Procedures, Trigeminal Neuralgia can come back. Study discusses how they handled it. Read the rest of this entry »
Popularity: 13% [?]
Recent article found morning fatigue seem more related to biological factors, and evening fatigue more by “behavioural” factors. Read the rest of this entry »
Popularity: 13% [?]
Article in press offers chemotherapy neuropathy scale. Read the rest of this entry »
Popularity: 13% [?]
After having a spinal, persistent headaches can occur from leaking spinal fluid through the hole requiring an injection of partient’s blood to be injected to “dural patch” the hole. Now was case resolved by just injection local into back scalp blood vessels. Read the rest of this entry »
Popularity: 13% [?]
Read Recent Article on How Fall Risk Assessments tools in elderly might lack validity because they don’t take into account how elderly will have good and bad days. Similarly, Functional Capacity Evaluations (FCE’s) do not take into account that discs have good and bad days that are not predicable and that the course of disc disease in the neck and back is unpredicable as well. Read the rest of this entry »
Popularity: 13% [?]
Pentosan is marketed in this country as Elmiron, an agent that will help protect bladder lining from interstitial cystitis. Now question is, could knee subcutaneous injections protect knee joint lining and be a “disease modifying osteoarthritis drug (DMOAD)”. Open trial on mild - moderate osteoarthritis knee is promising. Read the rest of this entry »
Popularity: 13% [?]
In order to get significant improvement in quality of life, 30% and preferably 50% improvement of pain needs to be reached. Unless you are a responder, no one medication is guarenteed to do that
Popularity: 13% [?]
8% Capsaicin patch NGX-4010, now marketed as Qutenza, and was approved in the USA for treatment of Post herpetic Neuralgia (post shingles pain). One application can give some relief for a 1-3 months Read the rest of this entry »
Popularity: 13% [?]
People on either Proton pump inhibitors(PPIs) or histamine-2 receptor blockers (H2RAs) have a 1.3 - 1.7 times risk of hip fracture. This risk disappears after stopping the medication for 3-5 years. With PPIs causing bacterial overgrowth, and with it stomach and possible mood issues, these drugs are looking less and less enticing.. Read the rest of this entry »
Popularity: 14% [?]
Using lactulose breath hydrogen test (LBT) to diagnose Small Intestinal Bacterial Ovewrgrowth (SIBO), 91% of children with chronic abdominal pain had evidence of bacterial overgrowth versus 35% of controls. Read the rest of this entry »
Popularity: 13% [?]
Recent study analysed daytime drowsiness in FM/CFS using abnormally fast time to fall asleep (sleep latency); 80% had abnormal tests. They found gene type HLA DQB1*0602 was obtained in 74 (43%) of subjects - which is 5 times what you would expect in the general population (P < 0.0001).
Popularity: 14% [?]
Others might content that if it’s just pain - take a pill and move on - but it’s more than that - it includes the fatigue Read the rest of this entry »
Popularity: 14% [?]
Study from McMaster University Ontario found oral antibiotic treatment in mice resulted in changes in bacterial flora that increased anxiety-like behaviour. Gut Bacterial Overgrowth found in 50% of people on Proton Pump Inhibitor Ulcer Pills. Are these pills driving us crazy?
(image from:http://www.novamind.com/connect/nm_documents/
show_branch/Power/3DDB0D16-D6F9-4EB8-B3C9-EF5050564DD1/2039310965)
Popularity: 14% [?]
Article in press reviews literature and treatment measures for osteitis pubis
Popularity: 17% [?]
There is a condition where intermittent sternal chest pains, angina like in character, develop.These develop in young people and workups are negative. Esophageal hypersensitivity has been shown to exist in these cases. Venlafaxine has been shown to help. Read the rest of this entry »
Popularity: 14% [?]
Severe pain after trivial injuries or surgery has been a fearful hazard. Now Vitamin C has been shown to perhaps prevent pains after wrist surgery Read the rest of this entry »
Popularity: 13% [?]
Osteonecrosis mandible from mostly IV biphosphamates can be a real hazard in cancer treatments - now it looks like teriparatide - human recombinant pararthyroid hormone peptide 1-34 - was able to help recovery
Popularity: 14% [?]
Even when adjustments made for age, alcohol consumption, prior acute pancreatitis and other factors, smoking comes out as doubling changes of chronic pancreatitis disease Read the rest of this entry »
Popularity: 14% [?]
Xylocaine 4% eye drops (AstraZeneca) can bring down eye pain in post shingles eye pain from 5.9/10 to 0.9/10 in 15 minutes, and forehead pain from 6.3/10 to 2.6/10. This relief can last 8-96 hours in responders. Read the rest of this entry »
Popularity: 14% [?]
In cases without complete tears, FIVE weeks of weekly subacromial injections of Hyaluronate was helpful. Read the rest of this entry »
Popularity: 14% [?]
There have been so many articles describing how shoulder injections fail because they only give one shot. I call this the “One Shot Wonders”. These people would need a medicine man dancing around to get any results because my feeling is that one shot does not do much for anything. Now someone with sense had shown positive results on frozen shoulders with three shots. Read the rest of this entry »
Popularity: 14% [?]
Women after hysterectomy seem alarmed by bleeding. Yet Cervical Stump symptoms can cause persistent bleeding in 17% in the abdominal hysterectomy(SAH) group and 24% in the laparoscopic group(LSH). Chronic pain issues may not go away.
Read the rest of this entry »
Popularity: 14% [?]
An MRI found intraspinous processes bursitis in 8.2% of individuals which could be causing segmental back pain.
Read the rest of this entry »
Popularity: 14% [?]
As found in a Canadian survey, staggering proportions of people are suffering from chronic pain, and it gets larger as one gets older - and the women twice as much.
Popularity: 14% [?]
With the loss of height from osteoporosis in the elderly, the lowermost side ribs can rub on the side wing of the hip crest, resulting in was patients describe as back pain. To make things worse, this rubbing restricts walking, making doctors think it is spinal stenosis. The patient then remains in pain and untreated.
Popularity: 14% [?]
I had a patient with rather audible and palpable snap with neck rotation. She was concerned she had loose joints in neck. It turned out to be coming from a snapping Splenius cervicis muscle. Read the rest of this entry »
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OK, I’ll bite - how’s that done? Read the rest of this entry »
Popularity: 14% [?]
After a below knee amputation, pain was successfully remitted with combination of duloxetine and pregabalin. Read the rest of this entry »
Popularity: 14% [?]
Intermittent bowel obstruction during end of life is terrible with pain and vomiting. Regular self administered Octreotide injections given at first hint of trouble, controlled this problem. Read the rest of this entry »
Popularity: 14% [?]
Recent article found relief of resistent neuropathic foot pain with a combination of 3% lidocaine, 0.075% capsiacin, and isosorbide dinitrate (ISDN) 0.4% in cream format Read the rest of this entry »
Popularity: 15% [?]
Celiac Disease is associated with multiple problems - migraines, restless leg syndrome (RLS), and now prevalent subclinical sacroliitis. Low iron is implicated in RLS but results on iron supplementation is mixed. Read the rest of this entry »
Popularity: 15% [?]
Most Fibromyaglia Victims are Not Depressed, yet study after study has shown it to be higher than in comparable populations. Why is that? I suggest it is:
Popularity: 14% [?]
One speaker I heard made very big about how eliciting a Tinel’s sign at the wrist was worthless for diagnosing carpal tunnel - so how does one do that? Given that sensitivities of Nerve Conduction sutdies can be from 49% - 84%, they aren’t necessarily great either… Read the rest of this entry »
Popularity: 15% [?]
Nerve injury pain can be bad - What results can you expect for Pregabalin? Recent study concludes it helps some. Read the rest of this entry »
Popularity: 15% [?]
Recent British study found doctors using Biopsychosocial Model For Chronic Pain were actually concentrating on psychological approaches even when it was inappropriate
Popularity: 15% [?]
Group is in process of putting together a self administered inflammatory arthritis questionnaire - this is what they have come up with so far… Read the rest of this entry »
Popularity: 15% [?]
Article in press summaries findings that medically supervised modified fasting (200–500 kcal nutritional intake/day) with periods from 7 to 20 days “is associated with mood enhancement and substantial pain relief.” Read the rest of this entry »
Popularity: 15% [?]
Both Hypnosis and heart rate variability biofeedback are useful in irritable bowel and, in children and adolescents, functional bowel disease Read the rest of this entry »
Popularity: 16% [?]
I have spent my adult life treating peripheral pain generators in conditions where it is impossible to get the central generators treated (failed backs for example). It dismays me to see people told there is nothing to be done because they have such and such a condition. I am devising a term for them. Nihilists refers to belief in nothing; I’m coining “onehilst” as referring to those who only believe in one thing happening at a time. A onehilist will tell you because you have Fibromyalgia or Peripheral Neuropathy that nothing can be done for you (and in some cases because you have a chronic disease you must be nuts anyway so go away). Below are two cases of nerve entrapment in people with severe pain that received significant benefit from treatment. Read the rest of this entry »
Popularity: 15% [?]
Recent Review of Hyaluronate in Shoulder joint arthritis found it effectve for control Read the rest of this entry »
Popularity: 15% [?]
Examination of a chronic neck pain group found no association of pain and anxiety - So don’t call them nuts! Read the rest of this entry »
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Spicule removal and later, metal bracing nail straight, has been shown equivalent to partial matrix excision
Popularity: 16% [?]
Not to Miss in the Trend For Body Piercing, I Offer This Technique of Nail Piercing Read the rest of this entry »
Popularity: 15% [?]
Various new approaches help define vertebral compression fracture so can be earlier diagnosed. Read the rest of this entry »
Popularity: 15% [?]
Recent article describes how to relocate your own shoulder dislocation using modified Milch technique
Popularity: 15% [?]
Zostavax vaccine has to be held frozen at -15 degrees C and only set in batches of 5. Now, Lakeshore Drugs (584-0717) has gotten in a Fridge specially set and so it is available there. Catch is, it cannot be held at room temperature for more than 30 minutes so have to keep cool when taken to doctor Read the rest of this entry »
Popularity: 15% [?]
OK - I’ll bite - how does one do that?… Read the rest of this entry »
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Combination Desmopressin Nasal Spray (DDAVP nasal) and diclofenac Suppository brought prompt relief renal colic in 62.7% cases vs 30.7% in the group with suppository alone Read the rest of this entry »
Popularity: 15% [?]
20 mls of 2% Lidocaine Intravesically (into bladder) wil cause over a 50% relief of pain in patients with bladder pain syndromes - distinguishing it from other pelvic pain diseases. Read the rest of this entry »
Popularity: 16% [?]
Combination of Selenium 300 - 600 mcg, Vitamin C 540 - 600 mg, Beta Carotene 12 - 54 mg, Vitamin E 100 - 188 mg, and perhaps methionine 1.6 - 2 gm can lead to considerable reduction in chronic pancreatitis pain and attacks. It had lead to a new theory of pathogenesis of chronic pancreatitis pain. Spinal cord stimulation can result in good relief of pain in chronic pancreatitis. Read the rest of this entry »
Popularity: 15% [?]
Tested in Cancer Neuropathic pain, Gabapentin 200 mg and Imipramine 10 mg every 12 hours was found to be a superior combination Read the rest of this entry »
Popularity: 16% [?]
People with multiple sensitivities and somatic complaints may actually be experiencing untoward pains from what others would not find painful. Recent article finds this may be do to inability to muffle these sensory stimuli due to defunct pain muffling system Read the rest of this entry »
Popularity: 15% [?]
Significant numbers of people are surprized to find themselves living in chronic pain after surgery. There are a growing number of options found helpful Read the rest of this entry »
Popularity: 16% [?]
This new article in press:
Urol Int. 2010;84(2):125-131. Epub 2010 Mar 4.
Clinical Management of Chronic Testicular Pain.
Kumar P, Mehta V, Nargund VH.
Karger, the publisher, is allowing free access Read the rest of this entry »
Popularity: 16% [?]
New Study form London, Ontario: Subjects with 3 month + tennis elbow. Injection of 1% Hyaluronate into “into the subcutaneous tissue and muscle 1 cm. from the lateral epicondyle toward the primary point of pain” twice a week apart led to persistent improvement. Read the rest of this entry »
Popularity: 15% [?]
Of 92 cases of post-thoracotomy muscular only shoulder pain, 83.5% obtained satisfactory pain relief from suprascapular nerve block Read the rest of this entry »
Popularity: 19% [?]
People with frozen shoulders have more sore coracoids versus with rotator cuff tear, calcifying tendonitis, glenohumeral arthritis, acromioclavicular arthropathy and asymptomatic subjects Read the rest of this entry »
Popularity: 16% [?]
A Saskatchewan Study found people with previous MVA had twice the rate of persistent neck problems. Insurers like to play down this association but in fact this is real. Read the rest of this entry »
Popularity: 16% [?]
Study involving treatments of warts- some multiple and recalcitrant (mean ~8 months), found a 81% cure rates (versus 27.5% in control saline injection group) with intralesional injections of measles-mumps-rubella vaccine. Read the rest of this entry »
Popularity: 16% [?]
After a car accident, TOS can pinch nerves in the neck and cause neck and arm pain with arm/hand numbness that nobody can seem to find a reason for. A simple injection into the anterior scalene muscle can prove the source and Botulinum injection some relief Read the rest of this entry »
Popularity: 20% [?]
Recent Study in JAMA found PRP didn’t work more than saline injections for Achilles midportion tendonopathy. Read the rest of this entry »
Popularity: 16% [?]
One out of eight people with abdominal pain are uncontrolled with medication. This can be debilitating and affect quality of life. 66 out of 70 people had substantial symptom relief with spinal cord stimulation.
Read the rest of this entry »
Popularity: 16% [?]
Recent Article gives a flow chart for dealing with post hernia pains - all leading to a surgical nerve removal procedure called Endoscopic retroperitoneal neurectomy. Read the rest of this entry »
Popularity: 16% [?]
Article in Press Finds Caudal Epidural Steroid injection work for degenerative lumbar spinal stenosis. This condition is the bane of older individuals that can’t walk more than a 2-3 blocks without getting back - leg pain. The pain remits with rest - especially with sitting, which opens up the spinal canal. Surgery is an option; so is steroid injections given through the tailbone. Read the rest of this entry »
Popularity: 16% [?]
Old age change in the neck leading to narrowing of the spinal canal is the bane of older subjects. A Chinese study suggests, in their population, it is related to Vitamin D receptor polymorphisms Read the rest of this entry »
Popularity: 17% [?]
Case study of patient on Sitaxsentan, a selective endothelin-A antagonist used in pulmonary hypertension, found his sciatica got better while on the drug and worse when off. Read the rest of this entry »
Popularity: 17% [?]
Cashing in on recent opioid phobia, I offer this synopsis on how you can tell if your cat is using drugs… Read the rest of this entry »
Popularity: 17% [?]
Detailed dissection of Thoracic Facets has found 62% of them hold and intra-joint mensicoid fold(s) - some with blood vessels. The addition of craggy clefts, cartilage damage, ulcers and hemmorhage all suggest they could be pain generators. Read the rest of this entry »
Popularity: 17% [?]
Article in press found no increase in cancer in chronic pain patients Read the rest of this entry »
Popularity: 17% [?]
Article in Press found at 12 months, Relief scores were 73% for Eccentric Loading Exercises (ELE), 79% for prolotherapy and 86% for combined treatment in treatment of achilles tendonitis. Read the rest of this entry »
Popularity: 17% [?]
Diabetic peripheral neuropathy with pain, and numb feet and toes could be the result of an entrapment like carpal tunnel and hence potentially treatable. However considerable controversy follows it. Read the rest of this entry »
Popularity: 19% [?]
According to one article, low B12 (<200 mcg) occurs in 1/2 of non-metformin using diabetics. According to another recent article, "Chronic metformin use results in vitamin B12 deficiency in 30% of patients". This could eventually lead to B12 deficiency neuropathy which unlike DM neuropathy is treatable. Read the rest of this entry »
Popularity: 17% [?]
There is a connection between osteoporosis and arthritis with arthritis settling in more in osteoporotic joints. Now an osteoporotic drug can not only help that but seems to have analgesic properties to back and knee pains if used regularly. Read the rest of this entry »
Popularity: 18% [?]
Irregular hours are hard on people with IBS according to one nursing study Read the rest of this entry »
Popularity: 17% [?]
A simple procedure injecting 1 ml of 1% methylene blue followed by 1 ml 2% lidocaine into damaged disc has achieved unprecedented results Read the rest of this entry »
Popularity: 18% [?]
Using a British Cohort born in March 1958, over 8000 individuals were blood sampled and nucleotide polymorphism sequenced for ADRB2 and COMT (Catecholamine-O-methyltransferase), the latter previously implicated in pain genetics. Only ADRB2 of certain gene types were associated with increased widepread pain (by 1.39-1.83 the OR risk) and by increased pain extent (by 1.24-1.58 the OR risk) Read the rest of this entry »
Popularity: 18% [?]
Longstanding Complex Regional Pain can be incredibly difficult to treat. Now Immunoglobulin Infusions have been shown to drop pains scores by 1.55 units. Read the rest of this entry »
Popularity: 18% [?]
With all the courses and Physician college emphasis on opioid addiction detection one would think addiction was highly likely on opioids - a Cochrane review finds quite the opposite. Read the rest of this entry »
Popularity: 18% [?]
One thing that is never considered in an insurance settlement is the fact that 10 year survival may be less in people with severe pain. A recent article plots a survival decay curve Read the rest of this entry »
Popularity: 18% [?]
JAMA article finds 4 yr mortality rates were 10.3% and 7.4% in low and high soya users and 4-year recurrence rates were 11.2% and 8.0% as well. There is a free maid service for breast cancer victims in certrain communities. Read the rest of this entry »
Popularity: 18% [?]
Repeated IV infusions of DHE (dihydroegotamine) is the standard treatment for breaking transformed migraines (into chronic daily headaches). Unfortunately, arranging patient to be seen every 8 hours is just not viable in our community. Now a continuous infusion protocol may make this procedure more available. Read the rest of this entry »
Popularity: 18% [?]
St. John’s wort may reduce oxycodone (oxycontin, oxy-IR, etc.) levels by 50%. Read the rest of this entry »
Popularity: 18% [?]
Chronic indigestion “dyspepsia” is a frequent medical problem and gets bad when ulcer pills fail to work. Now nighttime - bile reflux (regurgitation bile into stomach) may account for some. This is helped by agents that help bowel motility like Domperidone (motilium) Read the rest of this entry »
Popularity: 19% [?]
I had a patient come in and ask if Reishi mushroom - “Lingzhi” Ganoderma Luciderma is helpful. The answer is maybe… Read the rest of this entry »
Popularity: 21% [?]
I recently had the following letter:
“I am doing research on use of botulinum toxin type-a in trigeminal neuralgia.so, I will be highly obliged if you will send me some details with references about dosage and techniques used in injecting different facial muscles.”
Interestingly, the use of botulinum in neuropathic pain appears to be often intradermal(injected into skin so bleb blanches skin)… Read the rest of this entry »
Popularity: 24% [?]
It has been known for some time that taking vitamin C 500 mg twice daily following a wrist fracture can significantly reduce the chances of developing Complex Regional Pain / Reflex Sympathetic Dystrophy in that arm. Now it has been found that people with Post Shingles Pain are more likely to have low vitamin C levels and giving IV Vitamin C on three alternate days can reduce “spontaneous” pain in 62% cases by over 50%. Read the rest of this entry »
Popularity: 23% [?]
The first question I ask a shingles / herpes zoster patient is whether they would mind if what pain they currently had persisted. This is because efficacy of anti-virals could be limited…They are still fighting over whether anti-virals prevents post-herpetic neuralgia as late as November 2009 - in the Journal of the American Medical Association (JAMA):JAMA, November 4, 2009—Vol 302, No. 17, p1862:
“I stand by my statement that “[p]revention of PHN is a major concern because antiviral drugs alone do not reliably prevent this complication.” The US Food and Drug Administration (FDA), using the definition of PHN cited by Zhou et al, concluded that although treatment may decrease the median duration of pain (as a continuum), the data from well-controlled clinical trials did not provide evidence of reduction of PHN for any of the licensed drugs: acyclovir,1 valacyclovir,2 or famciclovir.3 The FDA refused to grant this indication based on its analyses and input from advisory committees. ”
So to make an impact on a potentially quality of life changing disease, nerve blocks appears to be the ticket. I can only assume those who feel there is not enough evidence , have never done one - the relief is immediate and often sustained. Fortunately, there is now a controlled trial of blocks versus anti-virals Read the rest of this entry »
Popularity: 23% [?]
Someone wrote:
“I came across this while searching the web. I have bilaterial shoulder impingement, tendonosis, tendonitis, etc etc so they say. I have been in pain since 2002. I have had 2 MRI’s that show nothing. The surgeon says there is nothing wrong but a little arthritis. I cannot sleep at night because if I roll on either shoulder it hurts and I wake up. Sometimes the pain is so bad I go for days without sleeping. It feels as if my shoulders are pulling out of the sockets. I have stabbing pains that sometimes go to the elbows. The surgeon only suggests more physical therapy or more injections….neither of which have done any good. I take pain pills constantly that I am sick of taking because at this point in time they only take the edge off and I refuse to take anything stronger. I am extremely frustrated and don’t know what to do. There IS something wrong…I can’t imagine having to live like this the rest of my life. I was a massage therapist for 10 years and injured them doing 12 massages a day. I keep telling the surgeon that just because he can’t see something doesn’t mean it doesn’t exist. Any suggestions? I’m desperate.” Read the rest of this entry »
Popularity: 25% [?]
I have compiled a simple list of measure known to help depression that can be given to patients. It was initially compiled with pregnancy in mind but concerning herbals, there are Pregnancy issues. However here are suggestions from a recent obstetrical review:
Obstet Gynecol Clin North Am. 2009 Dec;36(4):789-807,
Update and critique of natural remedies as antidepressant treatments.
Mischoulon D abstract here
Below is the list: Read the rest of this entry »
Popularity: 23% [?]
Over the years, I have had patients come in with severe one-sided regional pains with no good reason for it to be there. In each case, I have suspected Herpes Zoster prodrome and initiated antivirals with resolution without rash. I could never know for sure if I was right, but the patients have all been happy with outcome… Read the rest of this entry »
Popularity: 23% [?]
One of the problems defining chronic pain as a psychological condition, is the fact that psychological treatments have somewhat mediocre results. So when I find an article claiming results, I am suspicious. Here is an example: Read the rest of this entry »
Popularity: 24% [?]
Popularity: 26% [?]
What is the worst pain imaginable? Neurogenic pain of course…
What is the worst non-neurogenic pain? – acute headache of course…
Now combine the two in a condition where it is guaranteed you will be
Over the years of my practice, I have seen three cases of this disease and find myself horrified and ashamed to be a part of a medical system that can do that to some people.
Can anyone guess the condition? stay tuned – I hope to have this written up soon…
Popularity: 27% [?]
Recent study of “disability pensioners” given vocational advice and brief cognitive behavioural program found it only got “negligible” amounts of people back to work. Terminating disability coverage, because vocational advice was given, is nothing more than a scam. Read the rest of this entry »
Popularity: 28% [?]
Brain damage in certain areas has been seen in chronic back pain, Complex Regional Pain Syndrome, Fibromyaglia, and so on. The question is whether the damage causes the pain or visa versa. In hip pain patients, the at least partial resolution of this atrophy following successful hip surgery suggests the pain causes the damage. Read the rest of this entry »
Popularity: 26% [?]
The following is a verbatum copy of an article in the Canadian Pain Coalition Newsletter with permission from Mr. Wheeler, and contains some useful Canadian info. Read the rest of this entry »
Popularity: 28% [?]
I’ve had questions if Savella/Milnacipran available in Canada. It is not. Checking the Health Canada site offers that info. Read the rest of this entry »
Popularity: 26% [?]
A weeks worth of patch wear was associated with a significant relief of neck pain though the deeper trigger knots were still sore Read the rest of this entry »
Popularity: 27% [?]
Retroviral Image
Read the rest of this entry »
Popularity: 33% [?]
I get the impression some car accident victims get an eye rolling response to claims of multiple injuries. Here’s an example of low back and upper thoracic (high chest) back fractures while wearing a three point seat belt. Read the rest of this entry »
Popularity: 29% [?]
Sacroiliac instability is common and contributes to back pain and maybe even headaches. Where can you get good SI supports? Read the rest of this entry »
Popularity: 29% [?]
Having a load of steroid response “Fibromyaglias” (as diagnosed by rheumatologists), I have been accumulating a list of anti-inflammatory agents. Omega 3 appears to have some promise. Read the rest of this entry »
Popularity: 29% [?]
First Seen in Banff, The character has been making appearances worldwide… Read the rest of this entry »
Popularity: 30% [?]
Pain Clinics are becoming very big into psychological coping - well, they better teach patients to swear more - as swearing has now shown to alleviate pain.
Popularity: 30% [?]
Waiting for a knee replacement and the quality of life is poor? Most often the inner knee cartilage wears out first. Measures to take the load off the inner knee are helpful. Read the rest of this entry »
Popularity: 32% [?]
I have found home ultrasound helpful in chronic back pain but there has been little research in its effectivenesss. Now there is a study in low back pain combining it with exercise that found it useful. TENS worked well to but I find if there is any instability, TENS might aggravate the problem so ultrasound is safer. Read the rest of this entry »
Popularity: 32% [?]
DEMS - dry eyes and mouth syndrome; SAPS - sicca asthenia polyalgia syndrome
These cases do not qualify for sjogren’s syndrome but have “Sicca [dryness] symptoms and “nonspecific musculoskeletal pain”. They were found to have 59.2% thyroid peroxidase antibody rate compared to 20.4% controls P= .0009. Read the rest of this entry »
Popularity: 31% [?]
As a male doctor, I have trouble imparting all the info needed for someone with vulvodynia. Fortunately, Corrie Anne Goldfinger did her Master’s thesis at Queen’s University on the subject. It is available
free here (~2+ MB)
Since it is openly posted, I extracted the self help sections (16 pages) and have posted it as a doc file. This could be printed for patients or at least the link given….
There is a brochure included which was the hard work of Evelyne Gentilcore-Saulnier which I neglected to credit - good work there….
word file free here
let me know if this was useful!
Popularity: 31% [?]
I have mentioned previously how IV pamidronate could be useful here and IV Magnesium here
Now it looks like repeated 4 hour magnesium 70 mg/kg infusions repeated over 5 days can have some lasting effects. Read the rest of this entry »
Popularity: 31% [?]
Botox reduced pain in chronic neck pains (average 9.1+ years) for at least 2 month versus placebo -randomized and blind !! 150 - 300 unit was used per sesssion. Read the rest of this entry »
Popularity: 31% [?]
Injectable “lubricant” hyaluronan gives some relief of Carpal-metacarpal OA Thumb. One ml was injected weekly over 3 weeks. Read the rest of this entry »
Popularity: 31% [?]
Due to lack of rheumatists in Regina, I have been forced to deal with complex pain cases that in part have an inflammatory nature. Some fit a PMR profile that requires more difficult management than I am used to. Below is a summary of articles (one German) which creates a new picture of the disease for me: Read the rest of this entry »
Popularity: 36% [?]
Much of the work I do is treating the “peripheral sensitization” - the tissues that become locally sensitive and knotted. Working these areas allows me to get a feel for how much is coming from the spine or other sources, and how much is being generated locally. On average, about 50% is local and 50% is “referred” - plus or minus some. Following is a tragic case of hip pain treated vigorously without looking for local causes. Read the rest of this entry »
Popularity: 32% [?]
I received the following message:
“Very interesting read, i’m on 4 days after left side inguinal hernia repair with incision and mesh. No full anesthesia. 2 mornings after surgery, after waking up the 2nd time, the back of left knee was in pain, could not straighten or bend over 90 deg. Called in to doc in morning and went back to hospital for a venus doplar check for a blood clot. It was negative. Now 4 days later and this afternoon, pain persists, but additional pain above the left knee cap, extremely painful, tender to the touch, and a bit inflamed. Doc never mentioned any to these type pains, just take some extra aspirin. So next move?……dunno” Read the rest of this entry »
Popularity: 39% [?]
Microglia spinal support nerves become activated after nerve and spinal injury an greatly potential the pain. Animal experiments show minocycline, a tetracycline antibiotic known to inhibit microglia, can reduce post spinal pain in animal subjects. Read the rest of this entry »
Popularity: 18% [?]
Let me first apologize to those with good books I have not mentioned. Please let me know and I will add them to the list: Read the rest of this entry »
Popularity: 36% [?]
A New England Journal Medicine article several years ago demonstrated that compared to placebo not much by pills worked well for OA knee. This leaves one looking for options. Read the rest of this entry »
Popularity: 34% [?]
Failed back sydrome - post-laminectomy syndrome has multiple origins. Now it appears some sympathetic overload is present as well. Read the rest of this entry »
Popularity: 34% [?]
Lon-term bone building meds intravenously (like Pamidronate) are associated with occasional oseonecrosis of jaw. Now there appears to be some hysteria that this can occur with oral medication. What are the facts? Read the rest of this entry »
Popularity: 35% [?]
In the neck, imaging can be next to useless in many cases of unresolved neck pain. Incredibily, some people are told nothing showed on imaging so it has to be in their head. Now functional (multipositional) upright MRI is demonstrating some abnormalities. Read the rest of this entry »
Popularity: 35% [?]
Having come across a case of resistant rotator cuff (supraspinatus) impingment syndrome, I have been looking for answers. Some treatments include: Read the rest of this entry »
Popularity: 48% [?]
Cervical (neck) disc disease can mimic or cause Fibromyalgic symptoms. Certain porportion of post whiplash “Fibromylagia” will fit here. Read the rest of this entry »
Popularity: 35% [?]
In Ankylosing Spondylitis, the The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Spinal Pain Visual Analog Scale (VAS) are used to obtain coverage for Etanercept.
These forms are available here unprotected. Read the rest of this entry »
Popularity: 35% [?]
Seat adjustments that take the pressure off the ischial tuberosities help relieve back pain sitting
Popularity: 37% [?]
Your body has a set of circuits to shut off pain - your endophin circuits, except in the spinal cord the endophins are called “enkaphalins” and are chemically built a bit different. The pain inhibiting spinal circuits i.e. the “descending pain modulatory pathway” go from the brainstem rostral ventromedial medulla (RVM) via the dorsolateral funiculus (DLF). Now it appears cells in this RVM can either prevent or facilitate pain. Read the rest of this entry »
Popularity: 38% [?]
Certain anti-depressants are used in chronic pain because of their painkiller effects.
Women with prior Ca. of Breast can end up on a drug called tamoxifen to help prevent recurrences. Tamoxifen has to be convered in the body by a system called cytochrome CYP2D to a drug called endoxifen. Certain anti-depressants inhibit this conversion. A recent article suggests this is can make tamoxifen more ineffective. Read the rest of this entry »
Popularity: 38% [?]
Article states “there has been a belief that DD initially causes pain because of the penetration of fluid nuclear material through annular fissures, and that pain eventually resolves as the nucleus becomes fibrotic and can no longer penetrate the fissures”. These old discs image “black” and a felt to be more painfree - yet the reverse is true. Read the rest of this entry »
Popularity: 38% [?]
Diabetics are 1.6 times more likely to have chronic musculoskeletal complaints yet in non-diabetics, a high random glucose is associated with less complaints. Read the rest of this entry »
Popularity: 38% [?]
I have seen cases of severe Irritable Bowel, combined with allergies and hives, that require multiple medications to control and are disabled from symptoms. These cases are discarded by gastroenterologists yet might represent a systemic disease called Mastocytosis. Read the rest of this entry »
Popularity: 67% [?]
Listened to talk by Dr. Anthony Kaufman.He does probably the largest amount of Trigeminal nerve microvascular decompressions in Canada (~50/year) and helps run the Winnipeg Centre for Gamma Knife Surgery.
He has a web site with detailed descriptions here
Here are some points made: Read the rest of this entry »
Popularity: 48% [?]
Afraid the “College” will get on your back for giving opioids to someone with chronic headaches? Can’t get your doctor to listen that you have no quality of life with your headaches? Well here are some guidelines (Not rules - so can be stretched) that might help you in selected cases Read the rest of this entry »
Popularity: 39% [?]
(email kept anonymous)
I have had 4 inguinal hernia surgerys an nerves where cut I have chronic pain, all day long . I have burning sharp tender pain where I was cut in my iner thigh. My right testicle is numb and pain runs down my leg. My pain management Dr . meds helps a little. I can’t take the pain; is there something I can do ? I need help really bad!!!!
First thing seems to me, to be what nerves are damaged? Read the rest of this entry »
Popularity: 39% [?]
This is a disorder with brain outlet crowding and cysts in the spinal cord. Having this condition means that you likely will be treated very poorly by the medical community because imaging is poor and people don’t want to believe your symptoms. The signs of myelopathy (spinal damage) that one can have can be very non-specific - gait issues, somewhat hyperactive reflexes etc. which can be discounted. I have on brave soul who was wheelchair bound before she received much help- and only then with help she received from th Chiari Institute in Florida. She put together a list of resources she found helpful and I have included them here verbatum: Read the rest of this entry »
Popularity: 41% [?]
Calcification seen in the Supraspinatus tendon with tendonitis is by tradition treated by puncture and aspiration of the calcific deposits. I never met anyone who did it. Now, it appears just puncturing the deposit and steroid injection into the deposit is enough to ensure long term benefit. Read the rest of this entry »
Popularity: 41% [?]
5.5 % of children with migraine were found to have elevated tTGA antibodies. They were considered Potential Celiac Disease [CD] despite normal duodenal biopsies. It is suggested “These patients might develop villous atrophy on repeated biopsies performed 1–4 years later and should be followed up closely.” Read the rest of this entry »
Popularity: 39% [?]
Subjects with Fibromyalgia have lower basal body temperatures even though “controls and patients were matched for physical activity level” in one study. Lower free T3 levels, found in some FM subjects in the study, affected pressure pain threshold (p = 0.034). I am left to wonder if bringing the basal body temperature up to “normal” with thyroid would impact pain and fatigue. Read the rest of this entry »
Popularity: 54% [?]
I have become aware of two cases of chronic pain following a Stretococcal infection. This could be a flavour of an Ankylosing Spondylitis with sacroiliits being a prime factor. As a matter of fact in those patients with persistently elevated Antistretolysin titers (ASO titers) suggestive of chronic strep infection, “Most of the subjects with high ASO titer had unclassified or undifferentiated arthritis.” Read the rest of this entry »
Popularity: 52% [?]
Monthly Support Meetings at:
Linda’s Sugar & Nails
Rosemont Shopping Centre
5010 - 4th Ave., Regina
First Thursday every month 7:30 PM
contact # - 522-8686
Popularity: 39% [?]
Recent MRI study of crohn’s colitis patients found 17/44 cases had evidence to sacroiliitis and 11 of these had back pain. HLA B27 is seen in 10% of the population. If present in any of the crohn’s patients (were in 7) - they all had sacroiliitis. This means that 11/44 = 25% of Crohn’s patients will have spine arthritis which is over twice the rate in the normal population. There are significant delays in diagnosis. Read the rest of this entry »
Popularity: 39% [?]
Since they have found the gene for Myotonic Dystrophy, they have found a subgroup not having that gene but having another gene deficit instead that is associated with milder disease. Randomly selecting Fibromyalgia cases found 2/63 cases though none of 200 controls had the gene. Another subgroup of FM patients have been found to have cervical spinal stenosis and surgery helps them. A cervical implanted stimulator is also getting good results in FM. Read the rest of this entry »
Popularity: 51% [?]
Since the early 2000’s experiments gene therapy experiments have been done on rodents using a non-replicating (Not growing) version of Herpesvirus (cold sore virus). The virus’s genetic machinery has been altered so it makes ingredients for enkephalins (spine cord morphine-like produced agent) or similar. When injected into a painful nerve segment, the virus ascends to the spinal dorsal root ganglion where it alters the cells there to make pro-enkephalins leading to significant relief for 3-7 weeks. Now human trials are scheduled for China Read the rest of this entry »
Popularity: 39% [?]
Chronic administration of minocycline (a tetracycline antibiotic) started 7 days prior to nerve injury prevented neuropathic pain in the animal model - This offers exciting possibilities for preventing post surgical pain conditions. Read the rest of this entry »
Popularity: 39% [?]
For some years, they were finding Botox into ankle, shoulder and hip joints was giving pain relief. Now injecting Botox 25 u into a thumb Metacarpal-phalangeal and 50 - 100 units into cervical facet joints gives a similar result. Read the rest of this entry »
Popularity: 39% [?]
It has been known for some time that bacterial overgrowth is a common cause/aggravation of irritable bowel. Now further concern Blastocystis Hominis and Dientamoeba fragilis infections are not being reported because labs are restricting their search for Amoebiasis and Giardiasis - but only with one stool which is suboptimal. Read the rest of this entry »
Popularity: 39% [?]
Prednisone dosage for the PR is a major concern. Initial dosages can be 20 mg daily, decreased 50% at 21 weeks. The accumulative dose is dangerous for osteoporosis, weight gain, hypertension and heart disease. Methotrexate at 7.5 mg weekly failed to reduce this accumulative dose though 10 mg did help. Now Etanercept (Enbrel) shows useful promise. Read the rest of this entry »
Popularity: 43% [?]
Gamma knife (GK) thalamotomy was used in cases of pain with Parkinson disease and other central pains.”A clinical success rate of approximately 80% with negligible complications” was achieved. Read the rest of this entry »
Popularity: 38% [?]
Cases with “sinus headaches” but negative workup were found to respond to tripans used for migraines 82% of time. 31% cases didn’t by into idea migraine and refused to be part of the study from the start - maybe, however, there is a middle ground… Read the rest of this entry »
Popularity: 39% [?]
Chronic pancreatitis is a disease associated with recurrent abdominal pains, and malabsorption with possible steatorhea (fatty looking stools), bloating, intermittent diarrhea. A recent study found Small Intestine bacterial overgrowth (SIBO) in 14/15 cases and suggested treatment would help those symptoms. In another study, SIBO is common in Rosacea and eradication led to “almost complete regression of their cutaneous lesions and maintained this excellent result for at least 9 months.” Half of elderly have lactose intolerance and treating them for bacterial overgrowth can cure it. Read the rest of this entry »
Popularity: 43% [?]
This syndrome comprises of pain in the gluteal region radiating down thigh to the posterior knee popliteal fossa. It is associated with hamstring weakness. A series of 43 cases were found in athletes and surgically rectified. This resulted in a 75% satisfaction rate. Read the rest of this entry »
Popularity: 44% [?]
For years, IBS has been known as a “psychological disease”, an intestinal spastic disease, and a segmental hypersensitivity syndrome (nerves hyperirritable). Now there is increased gut permeability, particluarly in the diarrhea predominant form. This “leaky gut” creates an immune reaction with “increased numbers of T lymphocytes, mast cells and enterochromaffin cells.” This offers new avenues to treatment like probiotics. Read the rest of this entry »
Popularity: 46% [?]
Pain post mastectomy can be an important issue. Associated with the pain is swelling called lymphedema. Now it appears transplanting lymph nodes from the groin can resolve the pain and lymphedema Read the rest of this entry »
Popularity: 41% [?]
