Author Archives: admin

Treatment of Resistant Osteitis pubis with Pamidronate

Back in 2001, 3 subjects with resistant osteitis pubis had monthly infusions of 60 mg pamidronate – one for 3 months and 2 for 6 months. Two had no known cause and one had inflammatory arthritis. All recovered and had … Continue reading

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Osteoarthritis – Does Sierrasil Work? – No

One of my patients started on Sierrasil and said there was literature on its effectiveness – it does not say that it helps pain though..

Posted in Drugs, Knee | Leave a comment

Cytokine Storm – Treatment with Etanercept – Could it Stop Influenza Death?

Mild cytokine reactions give you a flu like situation where achy all over and malaise. Cytokine storm occurs with certain viral infections and can kill. Etanercept (Enbrel) can block that effect some in the mouse model infected with H1N1.

Posted in Drugs | 1 Comment

Hip Labral Tear or Impingement – Steroid Injection Not Good

Steroid injection into hip with impingement or labral tear only gave relief for 10 days.

Posted in Hip Pains | Leave a comment

Some Supplements May Aid Cancer Growth – A Few Might Stop

One would naturally assume keeping in good health through supplements would help your fight with cancer. Turns out, cancers may like supplements too…

Posted in breast cancer, cancer | Leave a comment

Aphthous Ulcer/Canker Sore – Pepto-Bismol Treatment

Simply applying pepto-bismol to a canker sore with a q-tip or “swish and spit”  for multiple sores can soothe irritated area within minutes

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Fibromyalgia – Part of “Software Malfunction” is Dopaminergic/GABAergic Neurotransmission Disruption

Excessive pain due to brain central sensitization has been called a “software malfunction”. Part of that appears to be of Dopa/GABA circuits.

Posted in Fibromyalgia, pain mechanisms | Leave a comment

Sacrococcygeal (SC)Ligaments Look Like Facet Ligaments And May Be Source of Pain

On anatomical study “small nerve fibers were observed adjacent to the ventral aspect of the SC intercornual ligament and piercing the ligament in one specimen” – similar to what is seen in facet joints. Commentary on article speculated they could … Continue reading

Posted in coccygodynia | 1 Comment

Post Herpetic Neuralgia (PHN) Treatments – Lots More Than Just Pills

Pregabalin helps 1 in 4.93 while lidocaine patch helped 1 in 2.. Still, reliance on meds only helped 1/2 then…- there are plenty of alternatives though

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Followup Guidelines For Early Breast Cancer

Primary Care Physician (PCP can do much of followup. Here are guidelines:

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Chemotherapy Neuropathy – Prevent and Treament

Use of agents to reduce chemotherapy induced peripheral neuropathy confounded by issues of decreased anti-cancer effectiveness. L-Acetyl Carnitine during chemotherapy, and Venlafaxine or Duloxetine after are my choices.  Tricyclics, gabapentin, lyrica, and topical agents did not rate well and belie … Continue reading

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Bruxism (Teeth Clenching) – At Last a Treatment

Electrically stimulating a masster muscle should pulse go over 110% during night helps suppress bruxism.

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Fibromyalgia (FM) Recommendations Vary By Country

Canada has no alternative (CAM) FM treatment recommendations but Isreali and German Recommendations do..

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Monotherapy Mediocre in Treating Fibromyalgia (FM)

New Acceptance and Commitment therapy – 8 sessions of 2.5 hours reduced pain by 20% in 1/2 cases but only 50% in 1/48 cases. Fairly maximal drug therapies with pregabalin +/- Duloxetine alone was not great

Posted in Fibromyalgia, psychology | Leave a comment

High Dose Metoclopramide (20 mg IV over 15 min) Beats Subcut Sumitriptan (Imetrix) 6mg For Acute Headache

Metoclopramide 20 gm IV was VAS pain score  0.55/10 better on VAS than Sumitriptan injectable 6 mg. However, the later needed starting an IV and slow infusion over 15 minutes to avoid extrapyramidal oculogyric crisis (0.2% incidence with the 10 … Continue reading

Posted in Drugs, Headaches | Leave a comment

Applying Sleep Hygiene Questionnaire to Chronic Pain Subjects Comes Out With Two Factors

Irregular Sleep -Wake Schedule and Sleep Disturbing Behaviour and Environment factor out as two main sleep issues in chronic pain.

Posted in Sleep | 1 Comment

In Unilateral Chronic Episodic Headaches – Should Prolactin Levels Be Done?

Recently a series of patients with Prolactinomas (a pituitary prolactin – secreting tumor in brain) was published. They found they often presented with either one sided migraines (often orbital) or SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing). … Continue reading

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Hip/Knee Arthritis – Not Satisfied With Acetaminophen? – Using Arthritis Pills (NSAIDs) Instead Helps

When Osteoarhtritis patients were allowed to try NSAID instead of acetaminophen,  “proportion of patients on acetaminophen treatment during the study decreased from 74.8 % at baseline to 23.9 %, while the proportion on non-steroidal anti-inflammatory drugs (NSAIDs) increased from 59.8 … Continue reading

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Hypnomanic Checklist

Once had a psychiatrist phone me very irritated because I had diagnosed a teeanger as potentially bipolar. Fortunately, I had seen her hypomanic, and run a hypomanic questionnaire at time – adequate documentation despite his hostility (guy needed a holiday). … Continue reading

Posted in Depression, psychology | Leave a comment

Taping Elbow Reduces Tennis Elbow Pains 50% – But Maybe Use a Band?

Taping around a tender tennis elbow can reduce pain from 4/10 to 2.2/10

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Remarkable New Treatment – Injecting Over Tenderized Skin Nerves With Plain 5% Dextrose

For year I felt the main expression of chronic pain was through activation of myofascial knots – now it looks like tenderized skin nerves is a front runner. Merely injecting D5W overtop tenderized nerve tracts an average of 6 weekly … Continue reading

Posted in Back Pain, Injection, Leg Pains, Neck | 4 Comments

T Wave Inversion in AVL Could be Important – Don’t Always Rely on ECG Computer Diagnosis

In an acute coronary syndrome situation in emergency, ALV inversion had significance.  84.8% of patients had > 50% obstruction of the mid-segment left anterior descending (MLAD) artery.  In subjects with >50% obstruction, 84.9% had T wave inversion in one other … Continue reading

Posted in chest pain | 1 Comment

New Daily Persistent Headache Lasting Over 1 Year Responding to Nimodipine (Nimotop)

Case of thunderclap (severe sudden onset) headache associated with inability to do calculations (acalculia) that persisted for 13  months despite interventions.  Nimodipine 30 mg, initially bid, then od, relieve headache. It was felt that cytokines and vasospasms persisted the headaches.  … Continue reading

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Extensor Digitorum Brevis Manus as Cause of Dorsal Hand Pain Myalgias – Botox Rx

This  anomalous hand muscle presents as a a “fusiform, soft prominence” between the 2nd and 3rd extensor tendons near the wrist to hand. It can become sore as it is compressed against the extensor retinaculum and possibly irritates the posterior interosseous nerve.  … Continue reading

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Unresectable Painful Bone Cysts – IV Zoledronic acid For Adults and IV Pamidronate For Children Gives Rapid Relief

Painful large and unresectable bone cysts responded rapidly to IV biphosphonate therapy within first cycle in 88% of cases. Adults received 4 mg of Zoledronic acid (Zometa®, Novartis), and children got IV pamidronate 1mg/kg.  Zoledronic acid, if more than one … Continue reading

Posted in Back Pain, children, Drugs, Hip Pains, IV therapy | Leave a comment