Chronic Nonspecific Neck Pain Cut in Half With Just an Epidural Of Local Anesthetic

July 30th, 2010

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% [?]

Drippy Nose and Nothing Helps? - Soak It With Botox (Botulinum)

July 26th, 2010

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 »

Popularity: 1% [?]

Use of Transcutaneous Nerve Stimulation and Lyrica for Post Herpetic Neuralgia

July 20th, 2010

TENS became a significant add-on when used with pregabalin for Post-herpetic neuralgia Read the rest of this entry »

Popularity: 2% [?]

Smokers 1.5 times More Back Pain - Does Quitting Become An Effective Treatment?

July 20th, 2010

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% [?]

Miracle Treatment - Low Back Post Herpetic (Post Shingles)Neuralgia Treated With Epidural Steroid and Spinal Midazolam Without Local Can Give Significant Relief For Over 3 Months

July 12th, 2010

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% [?]

How One May Obtain Significant Relief Pain With Over the Counter (OTC) Meds - Using Dextromethorphan and Some Ranting Over Poor Treatment of Non-Responders

July 11th, 2010

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.

__________
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 »

Popularity: 3% [?]

Making Your Own Lidocaine Patches

July 5th, 2010

Lidocaine patches are ridiculously expensive and yet ridiculously easy to make - here’s how. Read the rest of this entry »

Popularity: 3% [?]

7 day Buprenorphine Patch Lanched in Canada

June 23rd, 2010

Purdue has released their 7 day patch painkiller - where it fits in remains to be seen.


Read the rest of this entry »

Popularity: 5% [?]

Could Minocycline/Doxycycline Help Prevent Post herpetic Neuralgia Post Shingles ?

June 21st, 2010

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).

Read the rest of this entry »

Popularity: 5% [?]

Alternate Approaches to Post-Herpetic Neuralgia (PHN)

June 21st, 2010

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 »

Popularity: 5% [?]

Glial Cells Effect Obsessive Compulsive Disorder (in Mice Anyway)

June 20th, 2010

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 »

Popularity: 5% [?]

Steroid Epidurals - Why Some Work And Some Not So Well

June 13th, 2010

Recent findings demonstrate lying patient with bad side down for 15 minutes can almost double its effectiveness. Read the rest of this entry »

Popularity: 6% [?]

Episopic Burning Feet? - Erythromelalgia They Call It - Newer RX

May 30th, 2010
  • Erythromelalgia (EM) is a syndrome of  burning pain in the feet often accompanied by redness and  warmth,and  often aggravated by heat and exercise. Cold water soaks are the mainstay of treatment. Painkillers are usually ineffective. IV lidocaine and mexelitine hold promise. Some cases are more complex then they seem.

Read the rest of this entry »

Popularity: 8% [?]

Sciatic Pain Is Different and Does NOT Respond Much to Pregabalin (Lyrica)

May 24th, 2010

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.

Read the rest of this entry »

Popularity: 8% [?]

New Tool For Fibromyalgia Diagnosis Clinically

May 24th, 2010

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% [?]

What Can One Do For Low Glutathione Levels?

May 13th, 2010

Gluthathione levels decrease by 10-15% per decade - what can one do to help this anti-oxidant? Read the rest of this entry »

Popularity: 9% [?]

Herbals For Diabetic Neuropathy Prevention

May 12th, 2010

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 »

Popularity: 9% [?]

Nerve Entrapment in Diabetic (DM) Peripheral Neuropathy - Surgery Helps Foot Ulcers and Charcot Foot Syndrome

May 12th, 2010

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.

 

Read the rest of this entry »

Popularity: 9% [?]

Intranasal Sufentanyl and Buccal Fentanyl for Breakthrough Cancer Pain

May 11th, 2010

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.

 

Read the rest of this entry »

Popularity: 9% [?]

Does Itching Between Shoulder Blades Drive You Nuts? - Botox It

May 10th, 2010

Noctalgia paresthetica is considered nerve damage in between shoulder blades leading to itching in areas. Treatments have not been that satisfactory to date

  Read the rest of this entry »

Popularity: 9% [?]

New Treatment of Perineal / Pelvic Pain - Botox to Ganglion Impar

May 10th, 2010

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% [?]

What Can One Expect From Amitriptyline and Topiramate For Headaches?

May 1st, 2010

Study compared the two agents and found their effects comparable except topiramate offered better some quality of life Read the rest of this entry »

Popularity: 10% [?]

Lameness is Common in Milkherd But Probably the Cow’s Fault and Too Expensive to Fix

May 1st, 2010

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 »

Popularity: 10% [?]

IlioInguinal Neurectomy For Persistent Post Hernia Pain

April 12th, 2010

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% [?]

Shoulder Pain at Night - What Can You Do?

April 11th, 2010

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 »

Popularity: 13% [?]

IntraNasal Low Dose Ketamine For Neuropathic Pain

April 11th, 2010

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 »

Popularity: 12% [?]

Intranasal Oxytocin For Autism

April 11th, 2010

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 »

Popularity: 12% [?]

Short Functional Capacity Evaluation (FCE) Predicts Can Work Today But Not Reinjury Rates

April 11th, 2010

FCE study shows it can predict working in short term but reinjury  Read the rest of this entry »

Popularity: 12% [?]

Does Vitamin K Have a Role in CRPS (Complex Regional Pain)?

April 10th, 2010

Medical Hypotheses generated makes a case for that scenario Read the rest of this entry »

Popularity: 12% [?]

Sacroiliits Totally Unthought of Treatment - Filter Out White Blood Cells - Filtration Leukocytapheresis

April 10th, 2010

Lady with ulcerative colitis and sacroiliitis improved after leukocytapheresis (LCAP). Read the rest of this entry »

Popularity: 12% [?]

Is Low Vitamin D Related to Rheumatoid Arhritis?

April 10th, 2010

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 »

Popularity: 12% [?]

Dextromethophan For Diabetic Neuropathy, Fibromyalgia, and even Uncontrollable Laughing

April 8th, 2010

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 »

Popularity: 13% [?]

What Concerns People on Work Disability With Low Back Pain

April 8th, 2010

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 »

Popularity: 12% [?]

Do Probiotics Work In Diverticular Disease Pains ?

April 7th, 2010

Answer appears to be yes according to one study Read the rest of this entry »

Popularity: 12% [?]

Babies Show Empathy

April 7th, 2010

Contagious crying - where one baby cries when hears another cry is now considered the first signs of empathy development.

Read the rest of this entry »

Popularity: 12% [?]

Vitamin C in Press Again - Low Contributes to Disc Disease?

April 7th, 2010

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% [?]

How Effective Are Forearm Straps And Wrist Splints For Tennis Elbow ?

April 7th, 2010

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% [?]

Higher Doses Opioids Doubles Fall Rates In Elderly

April 7th, 2010

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% [?]

Would Magnesium Help Depression ?

April 6th, 2010

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% [?]

Something is Fishy With Reporting Pain Results

April 6th, 2010

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% [?]

Chronic Fatigue Syndrome +/- Joint Aches Associated With Parvovirus Antibiodies

April 5th, 2010

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% [?]

What To Do With Hip Metastases (Cancer Spread To Hip)

April 5th, 2010

Have a patient with this problem. Recent article goes over  an option. Read the rest of this entry »

Popularity: 12% [?]

How Can One Sleep On One’s Stomach ?

April 5th, 2010

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 Works Again - For Childhood Leg Pain - Complex Regional Pain

April 4th, 2010

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

Read the rest of this entry »

Popularity: 13% [?]

Inguinal Groin Pain They Can’t Figure Out - Consider Femoroacetabular Syndrome Hip

April 4th, 2010

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% [?]

Milnacipran For Fibromyalgia - Only Good On Paper?

April 3rd, 2010

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.


Read the rest of this entry »

Popularity: 13% [?]

Large Painful Legs Is Not Necessarily Obesity - Could be Lipedema - Blame Your Parents

April 3rd, 2010

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.

Read the rest of this entry »

Popularity: 13% [?]

Ergonomics For Office Neck Pains? - Get an Arm Board

April 3rd, 2010

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% [?]

What Does One Do When Trigeminal Neuralgia Comes Back?

April 2nd, 2010

After Various Procedures, Trigeminal Neuralgia can come back. Study discusses how they handled it. Read the rest of this entry »

Popularity: 13% [?]

Fatigue After Breast Cancer? - Some Possible Factors

April 2nd, 2010

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% [?]

Hurt After Cancer Chemotherapy? - Check Out Chemotherapy Neuropathy Scale

April 2nd, 2010

Article in press offers chemotherapy neuropathy scale. Read the rest of this entry »

Popularity: 13% [?]

Post Dural Puncture Headache Relieved by Occipital Nerve Blocks

April 2nd, 2010

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% [?]

Limitations of Functional Capacity Assessment Like Fall Risk Assessment In Elderly - One Shot Assessments Don’t Account For Good and Bad Days.

April 1st, 2010

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% [?]

New Possible Knee Arthritis Treatment - Subcutaneous Knee area Injection of Pentosan

March 31st, 2010

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% [?]

What Does It Take to Feel Substantially Better In Fibromyalgia?

March 31st, 2010

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

Read the rest of this entry »

Popularity: 13% [?]

Concentrated Red Pepper Patch For Post Herpetic Neuralgia - 60 Min Use -Some Better For a 1-3 Months

March 31st, 2010

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% [?]

Ulcer Pills and Fractures

March 30th, 2010

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% [?]

Kids With Chronic Abdominal Pain Have Very High Rates Of Gut Bacterial Overgrowth

March 29th, 2010

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% [?]

Do Some Victims with Fibromyalgia(FM) and Chronic Fatigue Syndrome(CFS) Have Sleep Genes?

March 29th, 2010

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).

Read the rest of this entry »

Popularity: 14% [?]

There is More To Chronic Pain Disability Than Just Pain - the Fatigue

March 29th, 2010

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% [?]

Do Gut Germs Affect Your Mood and What Hath We Wrought With Newer Ulcer PPI Pills That Cause Bacterial Overgrowth?

March 29th, 2010

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)

Read the rest of this entry »

Popularity: 14% [?]

Sore Pubic Joint - Osteitis Pubis How Does One Treat It?

March 27th, 2010

Article in press reviews literature and treatment measures for osteitis pubis

Read the rest of this entry »

Popularity: 17% [?]

Venlafaxine Helps Non-Cardiac Episodic Sternal Chest Pains in Young People

March 26th, 2010

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% [?]

Vitamin C Strikes Again - ?Prevents Post Surgical Wrist Complex Regional Pain

March 26th, 2010

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% [?]

At Last - A Treatment For Jaw Osteonecrosis

March 25th, 2010

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

Read the rest of this entry »

Popularity: 14% [?]

Smoking Doubles Chances of Chronic Pancreatitis Problems

March 25th, 2010

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% [?]

Lidocaine Eye Drops For Ophthalmic Postherpetic Neuralgia

March 25th, 2010

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% [?]

New Treatment For Shoulder Tendonitis - Hyaluronate

March 25th, 2010

In cases without complete tears, FIVE weeks of weekly subacromial injections of Hyaluronate was helpful. Read the rest of this entry »

Popularity: 14% [?]

At Last Some Sense In Shoulder Injections - Three Shots

March 25th, 2010

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% [?]

What Can One Expect After a Hysterectomy?

March 25th, 2010

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% [?]

Localized Cause of Back Pain - Inter-Spinous Process Bursitis “Baastrup’s Disease”

March 25th, 2010

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% [?]

Women Suffer More From Chronic Pain Than Men In Canada

March 25th, 2010

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.

Read the rest of this entry »

Popularity: 14% [?]

Chronic “Back” Pain Missed in Elderly - the Costo-Iliac Impingment Syndrome

March 25th, 2010

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.

Read the rest of this entry »

Popularity: 14% [?]

Snapping Sound in Neck

March 24th, 2010

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 »

Popularity: 14% [?]

Painless Keloid Injections

March 23rd, 2010

OK, I’ll bite - how’s that done? Read the rest of this entry »

Popularity: 14% [?]

Successful Treatment of Fresh Post Amputation Phantom Pains - And Maybe Should Be Used in Any Post Surgery Pain Situation?

March 23rd, 2010

After a below knee amputation, pain was successfully remitted with combination of duloxetine and pregabalin. Read the rest of this entry »

Popularity: 14% [?]

Cancer Intermittent Bowel Obstruction - Octreotide Injections May Work Well

March 23rd, 2010

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% [?]

Neuropathic Foot Pain That Nothing Else Works - New Foot Cream Mix

March 23rd, 2010

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 Could Mean Pain and What About Iron For Restless Legs?

March 22nd, 2010

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% [?]

What Is the Fibromyalgia (FM) & Depression Connection?

March 21st, 2010

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:

  • the uncertainly that goes with the diagnosis (do I have something more serious?)
  • the need for continued search for primary and secondary pain generators
  • the stigmatization that comes from having an invisible disease
  • the poverty and struggle one has when dealing with insurers

Read the rest of this entry »

Popularity: 14% [?]

So How Does One Really Test For Carpal Tunnel?

March 20th, 2010

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% [?]

Pregabalin (Lyrica) For Post Nerve Damage Pain

March 20th, 2010

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% [?]

Doctors Embracing Biopsychosocial Model For Chronic Pain Still Missing Boat?

March 20th, 2010

Recent British study found doctors using Biopsychosocial Model For Chronic Pain were actually concentrating on psychological approaches even when it was inappropriate

Read the rest of this entry »

Popularity: 15% [?]

Self Questionnaire For Inflammatory Arthritis

March 19th, 2010

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% [?]

Chronic Pain, Depressed, and Desperate? Consider Medical Supervised Fasting

March 19th, 2010

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% [?]

Hypnotherapy and Biofeedback For Irritable Bowel Syndrome (IBS) - and for Functional Abdominal Pains in Kids

March 19th, 2010

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% [?]

Chronic Severe Pain - For Gd’s Sake Don’t Forget Peripheral Pain Generators

March 18th, 2010

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% [?]

Shoulder Joint Arthrtis - Don’t Forget Lubricants

March 18th, 2010

Recent Review of Hyaluronate in Shoulder joint arthritis found it effectve for control Read the rest of this entry »

Popularity: 15% [?]

Neck Pain Not Synonymous With Anxiety

March 17th, 2010

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 »

Popularity: 15% [?]

Newer Treatment For Ingrown Toenails - Once Spicule Out and Healed, Metal Brace It Straight = Orthonyxia

March 16th, 2010

Spicule removal and later, metal bracing nail straight, has been shown equivalent to partial matrix excision

Read the rest of this entry »

Popularity: 16% [?]

Latest in Skin Piercings

March 16th, 2010

Not to Miss in the Trend For Body Piercing, I Offer This Technique of Nail Piercing Read the rest of this entry »

Popularity: 15% [?]

Determining If Veretbral Compression Fracture

March 15th, 2010

Various new approaches help define vertebral compression fracture so can be earlier diagnosed. Read the rest of this entry »

Popularity: 15% [?]

Anterior Shoulder Dislocation - Putting It in Yourself

March 15th, 2010

Recent article describes how to relocate your own shoulder dislocation using modified Milch technique

Read the rest of this entry »

Popularity: 15% [?]

Shingles Vaccine Finally Available in Regina

March 15th, 2010

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% [?]

Article: A sterile, simple, effective & pain free method of removal of adhesive dressings

March 15th, 2010

OK - I’ll bite - how does one do that?… Read the rest of this entry »

Popularity: 15% [?]

Renal Colic? - Try Desmopressin Nasal Spray Plus NSAID Suppository

March 14th, 2010

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% [?]

Intra-Bladder Lidocaine Freezing to Diagnose Bladder Pain Syndromes and Lidocaine Treatments for Bladder Pain

March 14th, 2010

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% [?]

New Measures For Treatment of Chronic Pancreatitis - Anti-oxidant Micronutrient Therapy and Spinal Cord Stimulation

March 14th, 2010

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% [?]

Lower Dose Gabapentin and Imipramine work in Neuropathic Pain

March 13th, 2010

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 Functional Somatic Symptoms May Had Defunct Pain Modulating Circuits

March 13th, 2010

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% [?]

What Does One Do To Prevent Post Surgery Pains?

March 13th, 2010

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% [?]

Good Free Review of Testicular Pain Management

March 13th, 2010

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 Tennis Elbow Treatment - Inject Lubricant (Hyaluronate)

March 12th, 2010

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% [?]

Post-Chest Surgery (Post - Thoracotomy) Shoulder Pain Cure But Only in Those With Sore Shoulder Muscles - Suprascapular Block and New Way to Do Block

March 11th, 2010

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% [?]

Frozen Shoulder Simple Test - Coracoid Tenderness

March 11th, 2010

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% [?]

Prior Motor Vehicle Accident (MVA) Doubles Chance Persistent “Troublesome Neck Pain” .

March 11th, 2010

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% [?]

New Cure For Untreatable Warts - Inject Them With MMR vaccine

March 11th, 2010

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% [?]

Botulinum For Scalene Based Thoracic Outlet Syndrome (TOS)

March 10th, 2010

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% [?]

Platelet Rich Plasma(PRP) Treatment Takes a Hit - Doesn’t Work For Achilles Tendonopathy or Maybe It Does…

March 9th, 2010

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% [?]

New Hope For Uncontrolled Visceral Abdominal Pain

March 7th, 2010

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% [?]

Post Hernia Surgery Pain Protocol and Other Options

March 6th, 2010

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% [?]

Yes, Virginia, Steroid Caudal Blocks Are Effective (At least For Spinal Stenosis)- and So Older People With Back Pain After Two Blocks Walking Are Better.

March 6th, 2010

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% [?]

Is Cervical Spondylotic Myelopathy Genetic?

March 4th, 2010

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% [?]

? Sciatica Option - Drug For Pulmonary Hypertension Gives Relief

March 4th, 2010

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% [?]

Telling If Your Cat Is Using Opioids

March 4th, 2010

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% [?]

Thoracic Intra-Articular Meniscoid Folds - A Plaisable Pain Generator

March 4th, 2010

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% [?]

Does Chronic Pain Cause Cancer? - The Answer is NO

March 2nd, 2010

Article in press found no increase in cancer in chronic pain patients Read the rest of this entry »

Popularity: 17% [?]

Prolotherapy to Mid Tendon Achilles Tendonopathy - Only Mildly Better Results When Compared to Eccentric Loading Exercises - How Could That Be Better?

March 1st, 2010

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% [?]

Surgery For Diabetic Peripheral Neuropathy - Another Option Not Available Here

February 28th, 2010

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% [?]

Diabetic (DM) Neuropathy - Think B12 Deficiency and More so if on Metformin

February 26th, 2010

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% [?]

New Painkiller for Back & Knee Pains - Raloxifene (Evista) - a drug for Osteoporosis

February 23rd, 2010

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% [?]

Patients with Irritable Bowel (IBS) Should Avoid Shift Work

February 22nd, 2010

Irregular hours are hard on people with IBS according to one nursing study Read the rest of this entry »

Popularity: 17% [?]

Groundbreaking News - A “Cure” For Chronic Discogenic Back Pain??

February 22nd, 2010

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% [?]

New Chronic Pain Gene Identified - Beta2-Adrenergic receptor (ADRB2) - and Genes For Achilles and ACL Knee Ligament Problems

February 22nd, 2010

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% [?]

Immunoglobulin Infusion Improves Complex Regional Pain

February 19th, 2010

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% [?]

Opioid Phobia Takes Hit - “Iatrogenic opioid addiction… rare” According to Cochrane Library

February 19th, 2010

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% [?]

Severe Chronic Pain Kills

February 15th, 2010

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% [?]

Breast Cancer Help - Soy helps prevent recurrences and Free Maid Service

February 13th, 2010

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% [?]

New Hope For Chronic Daily Headaches - Continuous Infusions of Dihydroergotamine

February 13th, 2010

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% [?]

Oxycodone and St. John’s Wort - a bad combination and Oxycodone and Death Rates

February 13th, 2010

St. John’s wort may reduce oxycodone (oxycontin, oxy-IR, etc.) levels by 50%. Read the rest of this entry »

Popularity: 18% [?]

Indigestion - when ulcers Pills don’t work - Think Nocturnal Bile Reflex - Helped by Domperidone

February 4th, 2010

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% [?]

Is Ganoderma Lucidum herbal any Use?

January 16th, 2010

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% [?]

Botulinum / Botox for Neuralgia/Neuropathic Pain

January 10th, 2010

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% [?]

Helping Prevent and Treat Post Shingles Pain / Post Herpetic Neuralgia - Can It Be as Simple as Vitamin C to Help?

January 4th, 2010

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% [?]

Shingles - For God’s Sake Give a Block Update

December 28th, 2009

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% [?]

Shoulder Pain Patient Needs Help - Any Suggestions?

December 25th, 2009

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% [?]

Checklist of Simple Treatments For Depression - including in Pregnancy

December 18th, 2009

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

  • If there is significant depression, then traditional antidepressants are necessary
  • St. John’s Wort: “One small prospective study found no significant differences in fetal malformations in women exposed to St John’s wort during pregnancy, compared with pregnant women on other antidepressants and pregnant women with no teratogen exposure.49 Studies examining hyperforin and hypericin levels in breast milk have suggested safety for children and mothers,50,51 and one small prospective study suggests no increase in adverse events in children exposed to St John’s wort in mother’s milk, though cases of lethargy and drowsiness were reported.52 The data, however, are scant and long-term studies of safety are required.53 In the absence of safety data, it is recommended that women who are pregnant or intend to become pregnant avoid St John’s wort. “
  • SAMe - “As with St John’s wort, there is a lack of data regarding safety during pregnancy and lactation. Some studies have found that pregnancy may result in impaired methylation and lower levels of SAMe,73 suggesting a potential benefit from SAMe administration in pregnant women. SAMe supplementation in pregnant women with intrahepatic cholestasis has been associated with beneficial effects.74 Although SAMe seems to be a mostly safe over-the-counter agent (ie, a chemical that humans already manufacture,with no drug-drug interactions, and minimal and mild adverse effects), consideration for SAMe administration in selected cases may be reasonable. ” [but if significant depression then traditional better]
  • Omega 3 - beneficial in pregnancy [but it is not safe to leave a lady depressed in pregnancy that could otherwise be better on traditional antidepressants.]

Below is the list: Read the rest of this entry »

Popularity: 23% [?]

Severe New Pain With No Right to be There - Zoster Sine Herpete?

December 17th, 2009

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% [?]

Does “Success” of Psychological Treatments of Chronic Pain Need to be Taken With a Grain of Salt?

December 8th, 2009

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% [?]

Some Canadian Car / Motor Vehicle Accident Insurance Claim Resources

November 30th, 2009
  • I would like to compile resources for Car Accident Victims to help deal with their claims.
  • In this province, there is “no-fault” really meaning it’s the victims fault for being in chronic pain. They have to deal with case workers who are poorly trained and subjected to scams meant to block their claim.
  • They have to shell out of their own pocket any defense that doesn’t get to go to court, but is subject to a review committee that is, in my opinion, poorly educated as well (who else in North America uses the AMA Guide [for disability] unaltered?).
  • They are also subject to disability settlements that are orcestrated by a SGI physician that in one case I saw did not give any extra for pain level or chronic pain induced depression. The poor fellow with severe back pain, obviously very depressed as well, was subjected to the AMA guide 5% disability rating for his crushed vertebra pain. The ruling physician had not seen the patient. When I tried to object, I was almost kicked out, for I was only an observer.
  • If they want to object to this ruling, they would have to get an independent assessment, which in my opinion is impossible to do in this area; assessments seem to have rather an insurance company bias.
  • To this end, I am complying self- help links for accident victims Read the rest of this entry »

    Popularity: 26% [?]

What is the Worst Chronic Pain Imaginable?

November 15th, 2009

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

  • told you are a liar, faker, and drug  addict
  • victimized by doctors, insurers, and anyone in the healthcare field
  • Have insurers either cut you off or downgrade your coverage with the explicit message that your life really isn’t worth very much and there is nothing you can do about it - you are being exploited and that the way it is…
  • Find that not much is found and that medications don’t seen to work at all.
  • Have yourself hounded by narcotic controllers (Addiction experts one is forced to see through your doctor or insurer, the provincial doctor licensing body and so forth)  as being on painkillers unnecessarily and worse, with the attitude the opioids will only make you worse – again leaving you with the message that you are not worth very much to anyone.
  • Finding your life such that, the hope you had, dissolves away; as you live sleepless nights and find your life slipping away  - job, family, friends, any hobbies and interests, just gone
  • Finding that, with the pain and the persecution, along with the growing poverty, that suicide looks better and better.

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% [?]

Given Vocational Advice to Chronic Pain Patients And terminating Coverage - The “You Could be A Funeral Director Scam”

November 12th, 2009

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% [?]

Chronic Pain Can Cause Reversible Brain Damage

November 9th, 2009

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% [?]

Advice On Long Term Disability Claims

October 28th, 2009

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% [?]

Finding If a Drug Available in Canada

October 26th, 2009

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% [?]

Diclofenac Patch for Neck Pain - Could One Make Their Own Patches?

October 18th, 2009

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% [?]

3rd Retrovirus to Infect Humans Found in Fibromyalgia and Chronic Fatigue -Not Confirmed But Possible Because Poor Techniques Used

October 12th, 2009
  • Previously there were two main groups of retroviruses known to infect humans - HIV, causing AIDS; and human T-cell leukemia virus (HTLV - various types). AIDS can be associated with frank neuropathies and pain. HTLV infections “is endemic in the Caribbean, Japan, South America, and parts of Africa” ref here. Disease may be asymptomatic with” fewer than 5% of those infected develop related disease” (ref here ). Bronchitis and bladder infections are more common, however. (ref here)
  • What is most interesting however is that the previously known Retrovirus HTLV - I is associated with a 37% Fibromyalgia rate ( vs 12.9% of “controls”):
    Higher prevalence of fibromyalgia in patients infected with human T cell lymphotropic virus type I.
    Boris A Cruz, Bernadete Catalan-Soares, and Fernando Proietti
    The Journal of Rheumatology November 1, 2006 vol. 33 no. 11 2300-2303
    abstract here
  • Now a third Retrovirus has been found highly associated with Chronic fatigue, Fibromyalgia, and atypical MS
  • October 8, 2009 - Whittemore Peterson Institute in Nevada publish undisputable evidence of Xenotropic Murine Leukaemia Virus (XMLV) infection in Chronic fatigue, and furthering their research have found it in over 95% of Fibromyalgia and atypical MS as well

Retroviral Image
Read the rest of this entry »

Popularity: 33% [?]

Car Accident with Multiple Areas Involved - Here’s Proof

September 13th, 2009

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 Supports

September 13th, 2009

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% [?]

Omega 3 - Anti-inflammatory Effects

September 13th, 2009

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% [?]

Canadian Celebrity Takes World by Storm - Humor Me

August 16th, 2009

First Seen in Banff, The character has been making appearances worldwide… Read the rest of this entry »

Popularity: 30% [?]

It’s Official - Swearing Helps Pain

August 15th, 2009

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.

Read the rest of this entry »

Popularity: 30% [?]

Medial Knee OsteoArthritis (OA)- What Else Can You Do? - Unload it and more

August 8th, 2009

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% [?]

Ultrasound and TENS for Back Pain

August 5th, 2009

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% [?]

Muscle-Joint Pains, Dry Mouth and Eyes? - Maybe You Have DEMS/SAPS with Thyroid Antibiodies

July 17th, 2009

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% [?]

Vulvodynia Therapy Patient Resource

July 17th, 2009

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% [?]

New Hope For Complex Regional Pain Syndrome I - 5 days Magnesium Infusions

July 17th, 2009
  • Type I CRPS is a vague syndrome of inordinate pain with variable - vague neurologic weakness or numbness features (unlike type II in which the nerve has definely been cut). Typical scenario is after a wrist fracture in patients with low vitamin C levels. Limb can become very painful, tender to touch, cold, and weak - more or less useless. Pains can become overwhelming.

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% [?]

New Hope For Refractory Neck Pain - Botulinum “Botox” - But Not Cheap

July 17th, 2009

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% [?]

Hyaluronan for Base Thumb Osteoarthritis (OA)

July 16th, 2009

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% [?]

Polymyaglia Rheumatica(PMR) - A New Look - Not as Easy as Seems

July 16th, 2009

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% [?]

You Need to Do Local Work to Get a Feel for Pain - Tragic Hip Example

July 9th, 2009

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% [?]

Knee Pain After Hernia Surgery - Any Ideas?

June 29th, 2009

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% [?]

Attenuation of Pain After Spinal Injury May be Possible

June 18th, 2009

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% [?]

Self Help Book Resources in Chronic Pain

April 18th, 2009

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% [?]

Knee Osteoarthrtis(OA) - Arthritis Pills Don’t Work That Well -What Else?

April 11th, 2009

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% [?]

Part of Failed Back is Overactivity of Sympathetic Nervous System

April 10th, 2009

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% [?]

Biphosphonates (bone building meds) and Jaw Necrosis - Not Seen in Oral Doses

April 5th, 2009

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% [?]

Unresolved Shoulder Pain - Look at the neck

April 5th, 2009

Came across a good power point presentation of a case of shoulder pain not helped by surgery and how the neck should have been considered:

Available here

Read the rest of this entry »

Popularity: 35% [?]

Bad Neck (and perhaps arm pains)but Normal MRI? - Need a Functional MRI

April 5th, 2009

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% [?]

Resistant Shoulder Tendonitis Treatments

April 4th, 2009

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% [?]

Upper body “Fibromyaglia” Misdiagnosis

April 3rd, 2009

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% [?]

BASDAI resource

April 3rd, 2009

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% [?]

Ischial Tuberosity Off - Loading When sitting for pain relief

February 19th, 2009

Seat adjustments that take the pressure off the ischial tuberosities help relieve back pain sitting

Read the rest of this entry »

Popularity: 37% [?]

Pain Inhibiting Circuits - Neuropathic Pain - Good Gone Bad?

December 22nd, 2008

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% [?]

On Tamoxifen? Beware of Some Anti-depressants - but only in 7%

December 14th, 2008

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% [?]

Advanced Disc Degeneration Still Very Painful

December 7th, 2008

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% [?]

Diabetic Have More Muscle Pains

December 7th, 2008

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% [?]

Multiple Allergies, Hives and Abdominal Pain - Think Mastocytosis

December 7th, 2008

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% [?]

Trigeminal Neuralgia

November 25th, 2008

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% [?]

When to Use Opioids in Chronic Headaches

November 23rd, 2008

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% [?]

? Obturator Neuralgia Needing Help

November 19th, 2008

(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% [?]

Chiari-Syringomyelia Resources

November 16th, 2008

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% [?]

Calcific Tendonitis Shoulder - Puncture as Good as Puncture/Aspiration

November 16th, 2008

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% [?]

Migraines More Common in Celiac Disease (Which Could Still Have Normal Biopsy)

November 15th, 2008

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% [?]

Would Basal Body Temperature Manipulation Help Fibromyaglia(FM)?

November 11th, 2008

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% [?]

Post-Stretococcus Reactive Arthritis – Poorly Diagnosed Treatable Chronic Pain

November 11th, 2008

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% [?]

Regina Fibromyaglia Group

November 8th, 2008

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% [?]

Got Crohn’s? - May Have Spine Arthritis Too

November 7th, 2008

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% [?]

Fibromyalgia (FM) Tragic Misdiagnosis - Myotonic Dystrophy Type 2 and Cervical Spinal Stenosis - New Treatments as Result

November 3rd, 2008

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% [?]

Nerve Pain? - 21st Century Gene Therapy

November 1st, 2008

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% [?]

Ounce of Prevention is a Pound of Cure For Neuropathic Pain

October 29th, 2008

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% [?]

New Arthritis Pain Option - Botox It

October 29th, 2008

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% [?]

Irritable Bowel - Possible Missed Protozoan Disease With Treatment

October 27th, 2008

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% [?]

Polymyalgia Rheumatica (PR) - What can Help?

October 27th, 2008

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% [?]

Possible Cure for Parkinson and Central Pains - Gamma Knife the Thalamus

October 25th, 2008

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% [?]

Got a Sinus Infection? Try a Migraine Triptan.

October 25th, 2008

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% [?]

Bacterial Overgrowth causing Chronic Pancreatitis and Rosacea - New treatment? And, for elderly, a quick way to get rid of lactose intolerance

October 25th, 2008

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% [?]

Hamstring Syndrome of Tethered Sciatic Nerve - Newer Entity With Surgical Treatment

October 21st, 2008


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% [?]

Irritable Bowel (IBS) Involves Excessive Permeability of Gut Membranes

October 21st, 2008

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% [?]

Post-mastectomy Neuropathic Pain Cure - Lymph Node Transplants

October 20th, 2008

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% [?]