Author Archives: admin

Quadratus Lumborum Post IsometricTreatment

Techniques involving post isometric relation stretching of Quadratus Lumborum clinic use.                                                            (Travell & Simon)

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Gabapentin Fails Again – Does Not Work in Chronic Pelvic Pains

While gabapentin might work in post herpetic neuralgia and diabetic neuropathy, it does not work well in spinal pains/sciaticas and so forth. Now it has been shown not to work in chronic pelvic pains as well.

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Bruxism with Antidepressant SSRI’s -Quetiapine Helps

Usually when subjects brux (teeth clench) of antidepressants, one has to stop antidepressants as the alternative is higher dose clonazepam (1 mg) Bruxism – How do You Treat Besides Splints http://painmuse.org/?p=4547 Quetiapine 25-50 mg helps considerably as well.

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Chronic Pain – Doing One Thing at a Time to See What Works is Silly – Need For Critical Mass

Even Opioids, if placebo is removed, can only give you 1/10 reduction in pain. Want to push it for more?  Well, I suspect some opioid deaths are included here. From what I have seen, various approaches ( Tai Chi, acupuncture, … Continue reading

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Phantom Rectal Pain

This is such a trying condition that when I came across this poster abstract I felt I needed to post it here.

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New Opioid “Guidelines” Not Always Work And What do with Opioid Induced Hyperalgesia

Would opioid guidelines always work on cancer patients?The answer is NO. –  13.7% do not respond to usual doses and only half of those will get any benefit from increasing the dose. If one were to extrapolate, this would mean … Continue reading

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Waistband Back Pain

I see often older men wearing belts who solemnly come in with nerve-like pain level at low back and flank level. I tell them I can treat this – but they are going to laugh – because what is a … Continue reading

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Skin Nerve treatment in CRPS

Injecting skin nerves where constricted in the skin can significantly relieve pain in Complex Regional Pain Syndrome – a secret as is only published as a letter

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Vitamin B12 Injections For Chronic Pain

Below is a study poster presented to the Canadian Pain Society showing benefits of frequent B12 Injections. Unfortunately, a study found men with smoking history have a 3 times lung cancer rate so I have now restricted B12 injection use … Continue reading

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Beta-adrenergics Prevent Post Thoracotomy Pains

Post-thoracotomy pains are the worst post-operative pains, occurring in high frequency and can be severe. Surprisingly, asthma beta-adrenergic stimulants greatly reduce any neuropathic pain, though not muscular pains, postsurgery. It suggest beta-adrenergic circuits, thought to be involved in descending inhibition, … Continue reading

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Medial Knee Pains – in Adductors – What Can You Do?

Pain and spasm on the inside of the knee in adductors is not uncommon – – especially in the heavy set with stairs. A brutal stretch massage can relieve but takes effort and willingness of subject to deal with the … Continue reading

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Kinesio Taping May Reduce Post Thoracotomy Pain

Post thoracotomy pains have to be one of the banes of chest surgery occurring in high frequency. Now simple taping might reduce it.

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Postural Orthostatic Tachycardia Syndrome (POTS) – More Complex in Chronic Pain

POT’s is a syndrome where one is unable to maintain blood pressure standing and so often faint –  and is often associated with attacks of tachycardia. Finding this situation in a chronic pain patient, greatly complicates the situation, and makes … Continue reading

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DHEA – for Depression in Elderly – Seemed Like a Good Idea..

Antidepressants are poorly tolerated in elderly and DHEA, found to be low in elderly, has been found to help with depression. I suspect part of its effect is through androgen stimulation as some is converted to such.  I have patients … Continue reading

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Is It Worth Checking For Anxiety – Depression in Osteoarthritis?

Cost-utility Analysis suggests not. I am not a big fan of attributing chronic pain to anxiety-depression – (sorry Dr. Sarno)… Recent analysis suggests in osteoarthritis it is not cost -effective to spend special time on anxiety depression

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Botulinum For Joint Pains

Study did meta-analysis of multiple article and found at 1 or 2 months will drop pain by 1.1/10 with no difference between 100 or 200 units. Often there is significant inflammation around the knee – anserine bursa being an obvious … Continue reading

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Lateral Patellar Knee Injection Technique Best

I’ve always liked the anterior knee injection using a 2 inch needle but have had to accept the recent statistics put forth by Durolane injectable lubricant that lateral injection mid patellar is better

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Refractory Migraine Eliminated by Pulse Radiofrequency to Superior Cervical Ganglion -Good for Chronic Neck Pain as well

Awe inspiring case of chronic migraine headaches eliminated by pulsed radiofrequency (low burn) to a neck sympathetic ganglion.

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Confirmed Again – Local + Steroid Injections Help Post Herpetic Neuralgia

Local steroid/local injections can greatly attenuate shingles and post shingles pain yet has received very little notice. I wrote about it in a couple blog notes: Alternate Approaches to Post-Herpetic Neuralgia (PHN) http://painmuse.org/?p=346 Early Fix For Herpetic Zoster/Shingles – Inject … Continue reading

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CRPS – Why Are Doctor Too Dumb to Use Prednisone Steroids?

The most successful treatment for CRPS especially early is Prednisone. It is even used in wrist fracture situation. Yet this fact seems not all that well known as is the fact one should continue the course for 8 weeks. Needless … Continue reading

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Effectiveness of Sacroiliac (SI) Joint Steroid Injection

Steroid injection of SI joints can be very helpful. It is more common than one would think as is seen in post-traumatic cases, in celiac disease, in various colitis, and in certain Fibromyalgia misdiagnosed subgroups. I highlight this study so … Continue reading

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Opioid Death Fueled by Illegal Chinese Fentanyl NOT Prescriptions

Recent Article diagrammatically demonstrates where  opioid deaths have been coming from https://aapsonline.org/opioid-overdose-crisis-is-from-illicit-fentanyl/ So spend less time looking at medical opioid prescriptions and more at illicit fentanyl trade. All doctors are now under tremendous pressure to cut their dose of  opioids … Continue reading

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Elderly with Resistant Post Herpetic Neuralgia – What do You Do?

Not a new study but the benefits  mandated that I include it. Study presented were 2 cases in their 80’s with severe Post Herpetic Neuralgia – one on face, other T8-10 that tried everything including spinal stimulator without effect. Pain … Continue reading

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Capsaicin 8% Patch in Peripheral Neuropathy Not Diabetic but at a Cost…

Capsaicin 8% patch was compared to pregabalin (lyrica) for effects on non-diabetic peripheral neuropathy.  A treatment with Capsaicin can cut skin sensitivity (dynamic mechanical allodynia) in half and render 29% free of sensitivity. Was embarrassed to publish this once I … Continue reading

Posted in neuropathic, Topical Pain Treatments | 1 Comment

Trigeminal Neuralgia (TN) Botulinum -Updated Treatment

When I first started Botulinum injections I just just injecting intradermally the areas where they felt the pain. Then it became clear the trigger zone needed special treatment and subcut was more done. I used to have a researcher repeatedly … Continue reading

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