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I have a program that tracks where users are from – pain is worldwide:

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Reaching “Critical Mass” to Achieving Pain Control – Procedure Pearls

I have recently achieved (previously unattainable) control in some of my chronic pain subjects using recent innovations – but to acheive this required use of multiple modalities at once.

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Posted in arm, Back Pain, Botox, complex regional pain, Drugs, Fibromyalgia, Headaches, Injection, IV therapy, Leg Pains, Manual Med, myofascial pain, Neck, neuropathic, Pain Dystrophy, piriformis, post herpetic neuralgia, radiculitis, shoulder, Uncategorized | 2 Comments

Multiple Sclerosis (MS) Help – Biotin (Vitamin B7) High Dose – and What More Could You Take?

In MS cases, 1/6 noted clinical improvement over 2-8 months with Biotin 300 mg/day This is exciting not just for the improved people but potentially for a group that might not further deteriorate. Suggestion was to take 100-300 mg/day which might be tough considering commercially available Biotin comes in 10 mg (10,000 mcg). Vitamin D has promise to help, particularly since deficiency is so common and it helped to prevent relapses in pregnant women in a study this year. B12 helped nerve regeneration in Bell’s palsy and ulnar nerve transfer surgery so might be important to take at least 1000 mcg/day of it as well – though by self failed to help MS (though deficiency makes MS worse)

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Post-Herpetic Neuralgia – Transforaminal Epidural Steroid Injection Might “Cure” And New Injection Rules

Several case studies have shown that transforaminal steroids could relieve Post Herpetic neuralgia (PHN) but that procedure is under heavy scrutiny because of rare strokes, paralysis and death so use of soluble dexamethasone has been edicted.
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Sacroiliac Joint Injection Proposal

Given that I do not have Ultrasound (got rid of old one – filled a room), I have developed a SI joint technique and would like opinion re such. Also I will refer to article using SI injections.

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Posted in Back Pain, Injection | Leave a comment

Chronic Back Pain Is a Painful Vertebral Body Problem

One study demonstrates that chronic back pain is associated not so much with plain disc degeneration but with disc degeneration combined with end plate or vertebral body schmorl nodes. Another study found that people with back pain and modic type I  bony  changes benefit from vertebroplasty (hot cement pumped in) of their painful vertebral bodies.

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Posted in Back Pain, Injection, Insurer issues, pain mechanisms | Leave a comment

Is Sensitive Skin Neuropathic?

Study in Dermatology journal suggests 1/5 of subjects test positive with quiz DN4  for neuropathy

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Posted in mast cell disease, neuropathic | Leave a comment

Pseudofolliculitis cutis – ingrowing facial hair Treatments

Ok this is not a pain  condition but I wanted to put advice where patients can find it.

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Complex Regional Pain Syndrome (CRPS) – Finding Immune Mechanims Offers New Treatments

Finding high levels of  beta2 adrenergic receptor autoantibodies in CRPS cases might explain why steroids, tumour necrosis factor (TNF)-alpha antagonist
Adalimumab, IV Immmunoglobulins, and in present article Plasmapheresis can help in selected cases. In present study, these antibody titres fell with treatment at same time as pain levels fell.

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Posted in Botox, complex regional pain, Drugs, Injection, IV therapy, neuropathic, Pain Dystrophy, Stimulation | Leave a comment

Headache Just At Night – Try Indomethacin

Hyponic (night only) solely headaches are uncommon. In some ways they are distinct from migraines as the drug of choice is Indomethacin 50 mg twice daily. Continue reading

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Low Dose Neuropathic Pain Drugs Only Work in Combo – and then only a Bit

Neuropathic pain drugs by self have mediocre effects – often dropping pain by </= 2/10 points. At low dose Imipramine 75 mg/day and Pregabalin 300/day did not have significant benefit but the combo dropped VAS by One more than placebo – nothing to write home about however.

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Posted in Drugs, neuropathic | Leave a comment

Irritable Bowel – Hypnosis helps

Hypnosis is a useful adjunct to IBS treatment.

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Posted in Abdominal pain, psychology | Leave a comment

Chronic Scrotal Pain Algorithm

Chronic scrotal pain can be an enigma – this new article gives detailed options for investigation and treatment. I have spent a great deal of time trying to give a clear view for people -  let me know if you find it helpful…

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Posted in groin pain, prostatitis / prostatism, Uncategorized | Leave a comment

Fibromyalgia Look Alike – Myotonia Congenita

Myotonia Congenita is a rare neuromuscular disease manifest by “painful muscle cramps or myalgia as well as transient muscle weakness following myotonic stiffness”. Article describes 2 cases – one that got worse with pregnancy which is what Fibromyalgia also does. The transient weakness after cramping can be easily missed though EMG does pick up the problem.

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Vitamin D – Could High Doses Help Pains?

4000 u/d vitamin D  lessening  Chronic Musculoskeletal Pains

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Posted in Back Pain, Deficits, Drugs, Fibromyalgia, myofascial pain, pain mechanisms | Leave a comment

Post Herpetic Neuralgia – Peripheral Nerve Stimulators

I have heard of peripheral nerve stimulators used in cases before but this additional one makes it more mainstream. This one captured control with high frequency

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Posted in Mechanical aids, neuropathic, post herpetic neuralgia | Leave a comment

Burning Mouth Syndrome – Early? – Get treated For Herpesvirus

Case  Burning Mouth Syndrome under 6 month old was found to have high herpesvirus DNA in saliva, and improved with herpesvirus treatment (which also cleared the DNA from saliva)

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Posted in ENT, neuropathic | Leave a comment

Lumbar Spinal Stenosis – German View

With a recent negative American view, it is nice to have a more encouraging German perspective. Though 2/3 go to surgery, 1/3 can be managed with physiotherapy, cycling exercise, psychotherapy, and injections – epidural, paraspinal, facet and sacroiliac.

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Posted in Back Pain, Injection | Leave a comment

Neuropathic Pain 2015 and…

Mayo clinic has a review but lacks imagination

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Posted in Botox, Drugs, Fibromyalgia, neuropathic | Leave a comment

Pain and Depression – Consider Brain Inflammation With Tumor Necrosis Factor (TNF) – and What About Brain Aging


Prior, I published a belief that depression in some cases was a manifestation of chronic pain for which ketamine could temporarily block.


In this 21 page article they make clear connections between brain cytokine inflammation especially TNF (Tumor Necrosis Factor), chronic pain, and depression. The Hippocampus seems to be the center of much of this. Treatments directed against brain inflammation include antidepressants and interspinal entanercept. Poor sleep prevents clearance of inflammatory compounds from brain. Exercise is an anti-inflammatory. Sensitized Glial cell in the hippocampus generate these chamicals.

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Posted in Depression, pain mechanisms, Uncategorized | Leave a comment

Chest Wall Cancer Treatments

Very clearly defined treatments for chest wall cancer makes it easy to know what to do.

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Posted in cancer, Thoracic | Leave a comment

Fibromyalgia (FM) Falls – Stiff Ankles Contribute

A study found falls in FM related to reduced dorsiflexion (bringing toes and foot up). The question is how does one fix that. Continue reading

Posted in ankle, Fibromyalgia, Leg Pains, Manual Med, myofascial pain | 1 Comment

Use of Bio Skin Q Brace in Patellofemoral Arthritis

Bio Skin® Q Brace™ reduced pain in knee patellofemoral OA and reduced bone marrow edema seen









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Simple Neck Treatment For Headaches

The neck gets involved in headaches and can make them worse. You can tell neck may be involved because end rotation is restricted. A simple technique to encourage rotation has benefits.

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Posted in Headaches, Mechanical aids, Neck | Leave a comment

Caudal Block- Just Going Thru Sacrococcygeal Ligament only Works 68% of Time But…

It has been suggested just going thru sacrococcygeal ligament is enough to get into epidural space. Imaging shows it works 68% of time, while advancing up 1 cm works 95.8% of time. However, intravascular injection occurred 25% of time where advanced into canal while 0% when not.

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Posted in Back Pain, Injection | Leave a comment

Phantom Limb -tDCS Scalp Stimulation Reduced it 40% -Immediate and Sustained

A sustained 40% improvement was obtained from direct current 1.5 milliamp voltage – about what a 9 volt battery hooked up with a 10 k potentiometer resistor could furnish.

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Posted in Mechanical aids, neuropathic, Pain Dystrophy | Leave a comment

Methylene Blue Disc injection for Chronic Disc disease

Methylene blue injections were an exciting option after a Chinese article was published in PAIN glowingly detailed great responses to intradisc injections. Dr. N. Bogduk, at time, wrote an editorial suspicious that Chinese patients might be reluctant to admit they were not better. Since that time, there has not been much positive. Now it looks like at 3 months time, 47% will be at least 30% better.

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Posted in Back Pain, Injection | Leave a comment