Author Archives: admin

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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Does Goodlife Fitness Want you to clean Off their chairs?

As my message to them was too long, I’m posting it here: I am a practicing physician. I am very careful to clean off any areas I touch. However, I was accosted by a member who insisted I clean off … Continue reading

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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

Posted in complex regional pain, Deficits, Depression, Fibromyalgia, mast cell disease | Leave a comment

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

Posted in Depression, Drugs | Leave a comment

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

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

Posted in Injection, Knee | Leave a comment

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.

Posted in Headaches, Neck | Leave a comment

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

Posted in complex regional pain | Leave a comment

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

Posted in Back Pain, Injection, piriformis | Leave a comment

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

Posted in Drugs, post herpetic neuralgia | Leave a comment

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 | Leave a 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

Posted in Injection, Trigeminal Neuralgia | Leave a comment

Nonspecific pain in the Little Finger Hypothenar Eminence Hand – Pisiform Instability

Pisiform instability can cause nondescript pain over lateral hand eminence, and in some cases present with ulnar nerve damage. It is little recognized.

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Colitis Flare-ups Might be Temporary Sensitivity to Gluten Foods

Growing evidence that some gluten sensitivity is actually sensitivity to the carbrohydrates in Gluten Foods rather than to gluten. None the less, avoiding gluten foods during colitis flareups, helps suggesting a temporary sensitivity.

Posted in Abdominal pain | 1 Comment

Poor Pain Treatment – Here We Go Again

Back in the 1984, I listened to Dr. John Bonica admonishing Doctors over the poor treatment of cancer pain. I felt ashamed. Now, with the war of Chinese based Fentanyl washing over all use of opioids, cancer patients are again … Continue reading

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Upper Facial Pain Treatment- Home Based Sphenopalatine Block

About eye, forehead, and temple pains from headache source, or surgery can be disabling yet responsive to blocks of the back of nose. The description is laid out in an online article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545953/ or you can read my version.

Posted in ENT, neuropathic | Leave a comment

Post Craniotomy Headache Local Treatments

Post-Craniotomy Headaches are annoyingly common – “Headaches following craniotomies are reported in up to 91% of neurosurgical cases”.  Injecting craniotomy edge defect triggers,  scar neuromas, and botulinum to temporalis muscle are local treatment options.

Posted in Headaches, neuropathic | Leave a comment

What can One Do For Severe Limb Pain? Epidural Motor Cortex Stimulation

Severe limb pain unresponsive to treatment ends up a surgical problem with spinal or ganglion stimulation becoming more common. A pain pump is an option. Motor cortex stimulation is as well, if pain is localized.  This is technically more difficult … Continue reading

Posted in complex regional pain, neuropathic, Stimulation | Leave a comment

Using the Pain System to Treat Depression – Buprenorphine

I have published on the use of ketamine to treat pain/depression/suicidality. Now a weak painkiller / partial painkiller blocker has been shown to help depression, not with one study, but with findings from twelve studies.

Posted in Depression, Drugs, pain mechanisms | 1 Comment

Dental Nerve Injury

Yanking out a 3rd molar can damage the associated nerve, but done inferiorly, this just seems to create a numb chin most of the time. Dental implants however, can damage the nerve and leave persistent pain. Article found that early … Continue reading

Posted in ENT | Leave a comment

Does Gargling with Probiotic Align Help Persistent Sore Throat – and what else you can do.

Had one patient with persistent sore throat gargle with Align Probiotic with rapid improvement in pain – just used it once/day, Would be interested in anyone with similar response.

Posted in ENT | Leave a comment

Fibromyalgia and Going For Surgery Advice.

This advice is being circulated and I’m putting it here so it won’t be lost in ensuing weeks.

Posted in Fibromyalgia | Leave a comment