Author Archives: admin

Malassezia Fungus Makes News Again With Peptic Ulcers

Malassezia seen in brains of Alzheimer’s: Front Aging Neurosci. 2018 May 24;10:159. doi: 10.3389/fnagi.2018.00159 Infection of Fungi and Bacteria in Brain Tissue From Elderly Persons and Patients With Alzheimer’s Disease. Alonso R et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976758/ “the fungal genera more prevalent … Continue reading

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Why is Metformin’s Magical Effects on Chronic Pain a Secret?

Selecting people with mildly abnormal hemoglobin A1C (prediabetic), authors found the introduction of Metformin 500 mg twice daily could dramatically relieve widespread pains. Article had to be pulled because consents were iffy and they didn’t have enough in “control group” … Continue reading

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What is Time Course of Vertebral Fracture Pain?

At least in low back, it looks like after 3 months, it gets as good as it gets.. Almost 1/3 might end up poorly so thoughts of IV pamidronate or vertebro/kypho plasty might need consideration.

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Failed Post-Cervical Laminectomy Fusion Pains -What can you do?

Failed cervical laminectomy/fusions are considered a difficult situation. Epidurals are difficult. and rhizotomies might fail. Usually a cervical spinal cord stimulator is considered impossible due to scarring. However, in this case. a cervical spinal cord stimulator was much easier placed … Continue reading

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New Genetic Determinant of Neuropathic Pain – Chromosome 12q23.1

We are all faced with patients that have pain are above what they should have and have pondered genetic causes.  Genetic Variant at Chromosome 12q23.1 increases chances by odds ratio 1.68 of neuropathic pain. Is a mitochondrial phosphate carrier and … Continue reading

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What Mattress Works Best to Prevent Back Pain?

Review of multiple studies found no surprises: “a medium-firm mattress promotes comfort, sleep quality and rachis alignment.”

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Methadone – Is It Better Than Morphine?

Brazilian study compared morphine 47.4 +/-  57.6 to methadone 62.1 */- 15.5 and suggested methadone was 20% better. However, there are some problems with study.

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Treating Tooth Infection Early

I have had my share of tooth infections and this is what I have learned so far: 1) Once it’s abscessed nothing works but a root canal or extraction 2) early on, regular dosed antibiotics do nothing. There are options … Continue reading

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Evista / Raloxifen For Fibromyalgia Pain and Fatigue – Why Has No One Confirmed It?

Raloxifen is a estrogen look alike used for osteoporosis. Is is similar to tamoxifen so helps to prevent breast cancer. Like birth control pills, has a slight stroke risk. I have a relative who had been on raloxifen for Osteoporosis. … Continue reading

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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

Posted in psychology, Uncategorized | 1 Comment

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

Posted in Botox, Injection, Knee | Leave a comment