Author Archives: admin

Does Musculoskeletal Pain Cause Stress or Stress Cause the Pain -Studying People over time

A longitudinal – study – studying people before and subsequent to pains is the most reliable study format for figuring out what is going on.. What this study found was that it was the Musculosketal pain that caused the stress … Continue reading

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Metformin is Mitochondrial Enhancer and Helps Bipolar Depression

A 25 yr old bipolar patient of mine was put on metformin and a weight loss program prior to hip surgery. Her mood was more stable and she noticed particularly fewer manic episodes. There is evidence in literature for metformin helping bipolar … Continue reading

Posted in Depression, Drugs | 2 Comments

Hives with Nonspecific Gut symptoms – Consider Blastocystis

Blastocystis is a protozoan thought commensal (normal flora) but actually shown to cause disease in humans. Now a particular subtype is linked to urticaria/hives.

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Endometriosis – Continuous Birth Control Pills- Does it Help?

Review article covered recent literature and found what one would expect – of course.

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Fibromyalgia (FM) – Mitochondrial Dysfunction Helped by Metformin and Weight Loss

Adenosine Monophosphate activated Protein Kinase (AMPK) regulates cell metabolism  i.e “AMPK has a central regulatory role in cell metabolism, mitochondrial biogenesis and oxidative stress response”. Recent study of FM fibroblasts found AMPK downregulated.”AMPK down-regulation [is] at least in part responsible … Continue reading

Posted in Depression, Drugs, Fibromyalgia | 1 Comment

Topical B12 helps Canker Sore Pain and what this means for Shingles –

Triamcinolone 0.1% topical oral ointment with 500ug B12/2 mg ointment outperformed plain triamcinolone adding credulance that frequent B12 injections into active shingles area helps. Question is whether it needs to be methylcobalamin  – B12 bioactive form for best topical effect.

Posted in ENT, post herpetic neuralgia | Leave a comment

Pine Bark for Migraine?

Only study on Pine bark for migraine I could find used 1200 mg/day and did get impressive results on resistant migraines. But the best price I could get for that was $4/day..

Posted in Drugs, Headaches | Leave a comment

Migraine in Adolescence – Abortive Treatment -But in Canada you’ll Need a Pill Splitter

In the US, a drug combination for treatment of migraines has been released called  Treximet – sumatriptan (Imetrix) 10 mg and Aleve (Sodium Naproxen) 25  mg. It has been approved for use in adolescents 12-17. In Canada you’d have to … Continue reading

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Diabetic Neuropathy – B12 Helps While Vegan Diet Minimal Effects

Though 20 week vegan diet touted as helping diabetic neuropathy, its pain levels were no different than the B12 control and the foot skin conductance was not different. Only diffence was in McGill Pain questionnaire in the sensory fields. Unfortunately, … Continue reading

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Neck Pains From Atlanto-Occipital Joints

Top joint C0-1 refers to upper neck, face and upper shoulder tips. Exam requires you to grip c1 transverse processes and nod neck sideways. Certain manual techniques might help.

Posted in Headaches, Injection, Manual Med, Neck | Leave a comment

Diabetic Neuropathy: Duloxetine Mediocre Results

For Diabetic Neuropathy – Recent study in China showed statistical significant drop of pain on Duloxetine but not clinically significant. – Have a look.

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Coccygodynia = Tender Coccyx – Inject Ganglion Impar

One Ganglion Impar injection achieved over 50% improvement for 82% of cases that lasted an average of 6 months.

Posted in coccygodynia, Injection | 3 Comments

DN4 Outperforms In Diagnosis of Cancer Neuropathy

Douleur Neuropathique in 4 Questions (DN4) proved more sensitive to neuropathic pain in cancer than the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) – 87.5% for DN4 versus 68.1% for LANSS in sensitivity. However LANSS had slightly better specificity … Continue reading

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Widespread Pain and Dizzy – Ear Canalithiasis? (rocks) and Repositioning Them Helps Whiplash, TMJ, and Fibromylagia

Study suggests dizzy whiplash and widespread pain cases could respond well to middle ear grit repositioning measure.  This is being able to see way outside the box…

Posted in Fibromyalgia, Manual Med, Neck, TMJ | Leave a comment

Benign Positional Vertigo? – Modified Canalith Repositioning Maneuver (CRP)

Effectiveness of Treatments for Benign Paroxysmal Positional Vertigo of the Posterior Canal Helen S. Cohen, Kay T. Kimball Otol Neurotol  26: 1034–1040, 2005 Modified  Canalith  Repositioning  Maneuver  (CRP)  technique: The head was held in each position as follows: The subject … Continue reading

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Duloxetine For Fibromyalgia – Mixed Results

Initial study showed benefit only in first 6 weeks more than placebo and not after: Study glowingly mentions early effects but fails to mention lack of lasting effects Comment – I recently reviewed a back study that cleverly disguised their … Continue reading

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Fibromyalgia – Responses to Methotrexate and Steroids

Old McGill study found initial impressions of doctors and rheumatologist were wrong 2/3 of time and in particular inflammatory arthritis cases are missed. Fitzcharles, M‐A et al. “Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals.” Rheumatology 42.2 (2003): … Continue reading

Posted in Fibromyalgia | 2 Comments

Amitriptyline – Not Much For Neuropathy Really

The initial study of use of Amitriptyline was a study with diabetic neuropathy where patients were subject to impressive coaching (calls from nurse and pharmacist) . That way doses of 75-150 mg were obtained. They were able to show benefits. … Continue reading

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New Help for Some Fibromyalgia (FM) – Gluten Sensitivity Management

Over the past couple years there is growing evidence that maybe 1/3 of Fibromyalgia patients with IBS actually suffer from non-celiac gluten sensitivity and respond to gluten free diet – some within a few month, and some “gradually… over many … Continue reading

Posted in Fibromyalgia | 3 Comments

Algorithm For Post Hernia Pains

Concise choice selections for what to do with nerve damage level post hernia pains. I love algorithms – they are so practical.

Posted in neuropathic, Post Hernia | Leave a comment

Uncontrolled Post-Herpetic Neuralgia (PHN) in Elderly subject – New Measures

Using 6% gabapentin, 4% amitriptyline,  ketoprofen 10%,  lidocaine 5%, and ketamine 10% probably in Lipoderm could give some relief topically.  Ketamine 100 mg/ml with 0.1 ml spray nasally could give additional relief.  30% mannitol might be good here.

Posted in Drugs, Pain Dystrophy, post herpetic neuralgia, Topical Pain Treatments | Leave a comment

Patellofemoral (PF) pain – New Hope – Femoral Nerve Stretching Helps Half

Another looking out of the box study. Supposed part of PF pain is neurologic and stretched femoral nerves. In cases that tested as having “tight” femoral nerves (positive femoral slump test) which was about 1/2 of cases, treatment resulted in … Continue reading

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Needling Lower Trapezius Helps Unilateral Neck Pains

Needling the lower trapezius muscle was found beneficial in chronic neck pain. I was so taken with the approach then had to injecting lower trap(with muscle relaxed rather than stretched) that I had to include a pic of actual treatment … Continue reading

Posted in Manual Med, Mechanical aids, myofascial pain, Neck, Thoracic | Leave a comment

Resistent Post Herpetic Neuralgia Treatments – IV Magnesium for Neuropathic Pains

Three IV Magnesium  1mg /k in 100 mls saline  infusions over 1 hour – one every other day or Three 1 mg/kg Ketamine in 100 mls saline infused in over 1 hour ketamine  one EOD resulted in 7/15 magnesium and … Continue reading

Posted in central & spinal, complex regional pain, Drugs, IV therapy, neuropathic, Pain Dystrophy, post herpetic neuralgia, radiculitis | 1 Comment

Fibromyalgia Hypervigilance May Exist – and My Model

With help of  EEG (scalp)sensors, one can measure a brain response to a stimulus- often auditory.  Often the brain reaction diminishes with a repeat stimulus – called sensory gating. If one were hypervigilant, you would expect the brain response to … Continue reading

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