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- Monika Theresia Geier on WCB troubles – What Needs to Be Done?
- Louise B. Andrew MD on Remarkable New Treatment – Injecting Over Tenderized Skin Nerves With Plain 5% Dextrose
- Margreet Hogenbirk on Sore Pubic Joint – Osteitis Pubis How Does One Treat It?
- John Waters on Accurate Piriformis Injection
- Blurge on Vitamin B12 Injections For Chronic Pain
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Differential Diagnosis of Neurogenic Thoracic Outlet Syndrome (NTOS)
Tenderness is supraclavicular fossa, numbness patterns, tinel’s sign either supraclavicular, axillary or elbow cubital areas all point to NTOS. Triggers in trapezuis, rhomboids and levator scap are common in NTOS as well.
Posted in thoracic outlet syn
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Prevent Chemotherapy Neuropathy With L-Acetyl Carnitine (LAC) – Please Take
Peripheral Neuropathy can limit the extent of chemotherapy and hence have a direct effect on survival; L-Acetyl Carnitine at a dose of 3-5 gm/day can prevent that.
Posted in breast cancer, Drugs, neuropathic
2 Comments
Fibromyalgia Helped by Music Therapy – Confirmed
1 hour/day of classic music mixed with salsa music resulted in a 24% reduction of pain over placebo. this is a confirmation of a different study finding relief with regular music listening: Music Therapy in Chronic Pain May Drop Pains … Continue reading
Posted in Fibromyalgia
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Trigeminal Neuralgia – New Treatment For Drug Resistant Cases
A simple infusion of lidocaine 100 mg and Magnesium sulphate 1.2 gm over 1 hour – weekly for 3 weeks, gave good results in 9 trigeminal neuralgia resistant cases.
Posted in Trigeminal Neuralgia
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What Causes Hand Tingling in Computer Terminal Operators – More Myofascial Than You Would Think
The causes of hand tingling in computer operators were : myofascial pain syndrome, 68%; cervical radiculopathy (arm sciatica), 27%; shoulder rotator cuff syndrome, 11%; forearm tenosynovitis, 8%; and carpal tunnel syndrome, 5%.
Posted in arm, myofascial pain, Thoracic
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Bolulinum Works as Well as Steroid in Frozen Shoulder – Isn’t it About Time We Think About Combining The Two?
A recent article shows that botulinum and steroid have similar durations of action in adhesive capsulitis – ie Frozen Shoulder. I have given both triamcinolone and botulinum (at separate times) into knee joints and noticed the combination can cause a profound … Continue reading
Posted in Botox, Injection, shoulder
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Severe Neuropathic Pain – Only 1/4 Respond to Standard Drug Protocols – What Else Is There?
Presentation at Canadian Pain Society Winnipeg 2013 found only 23.7% of severe neuropathic pain victims responded to Canadian Pain Society drug protocols for neuropathic pain. It is time to look outside the box for treatment measures.
Posted in Drugs, Fibromyalgia, Injection, IV therapy, Manual Med, myofascial pain, neuropathic, Pain Dystrophy, piriformis
9 Comments
Unilateral Interscapular Pains – Dorsal Scapular Nerve Entrapment – Forgotten and Now Rediscovered
About 30 years ago, I attended a course given by Drs. Travell and Simon. Dr. Simon was discussing interscapular pains and Dr. Travell mentioned – don’t forget the scalenes – something that Dr. Simon replied he was getting … Continue reading
Posted in Back Pain, myofascial pain, Neck, Thoracic, thoracic outlet syn
7 Comments
Varizig – Zoster Immune Globulin – Forgotten in Severe Zoster
An older study found zoster immune globulin single early infusion could reduce shingles symptoms by 50% at day 42 but this appears to be forgotten. It appears in Canada to be readily available through public health as Varizig – manufactured in Winnipeg … Continue reading
Posted in post herpetic neuralgia
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Hip Blocks Help Pain For Up to 3 Months – But Used Steroid So More Likely That Effect – And How to Block a Hip
Injecting articular branches femoral nerve and obturator nerve can give some relief for up to 3 months. However, results are more likely from the steroid used.
Posted in Hip Pains
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Alcohol Blocks Versus Radiofrequency Thermocoagulation For Post-Herpetic Neuralgia
Given that Post shingles pain is restricted to certain nerve root Level(s), nerve destructive measures could be an option. Cure rates for both were about 85% but thermocoagulation had more adverse events.
Posted in Uncategorized
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Quick Questionnaire For Cluster Headache
Three simple questions have a sensitivity of 53.8% and a specificity of 88.9% for cluster headache.
Posted in Headaches
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Intercostal Nerve Blocks For Shingles / Herpes Zoster
I have written extensively on how nerve root blocks are a necessary part of treatment of shingles. Came across two Chinese articles stating effectiveness – one stating you can get “markedly effective” results in 75% of cases.
Posted in post herpetic neuralgia
1 Comment
Post-Herpetic /Shingles Neuralgia – Benefits of Local B12 Injections
Two separate chinese articles discuss use of B12 in the period immediately after shingles and also, in a separate study, later. Each shows benefit. Note should be made that they used methylcobalamin – the bioactive form of B12
Posted in Injection, post herpetic neuralgia
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Early Fix For Herpetic Zoster/Shingles – Inject the Spots With Local and Steroid
Injecting shingles lesion in acute stage with local and steroid reduces pain, improves sleep and purportedly reduces post-herpetic neuralgia. NOTE TO MY CHINESE VIEWERS – I only have access to the chinese abstract translation – if you could fill in gaps … Continue reading
Posted in post herpetic neuralgia
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The Missing Aspects of Tennis Elbow Treatment – Axillary and Scapular Triggers to Treat Segmental Hypersensitivity
Chinese article claims adding injections to “dorsal scapula” triggers and sore spot in axilla can allow lateral epicondyle injections to work 100% of time.
Posted in elbow, Injection
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Post Herpetic Neuralgia / Shingles – Micro-knifing Tender Areas (Acupotomy) Reduces Pain 60% and Persists over Course of 6 – 12 Months
Previously, there was a technique involved producing 2nd degree frost burns in tender post-herpetic neuralgia areas – as a means to reduce pains. Suzuki H, Ogawa S, Nakagawa H, et al. Cryocautery of sensitized skin areas for the relief of … Continue reading
Posted in Injection, post herpetic neuralgia
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Vertebral Compression Fracture Pain And Nothing Helped – Other Option
Effectiveness of Kyphoplasty has been disputed, and other are left without it; this leave a proportion wondering what to do. Medial branch rhizotomy (like a facet rhizotomy) has been found helpful.
Posted in Back Pain, osteoporosis
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Herpes Zoster/Shingles – Can You Tell What Nerve Level Affected?
The back can have a wide distribution in shingles; and according to a study, is not relable at determining nerve level, as is the front distribution. I will inject dorsal nerve roots in order to shut the back distribution off; often I … Continue reading
Posted in post herpetic neuralgia
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Neuropathic Features Seen In Osteoarthritis
Neuropathic feature – electric shocks pain, burning pain,, radiating pain with increased touch sensitivity to an area were commonly seen in joints.
Posted in Knee, neuropathic
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Steroid Epidurals Results Might Be Minimized By Fact Steroid Mineralcorticoid Effects are Pro-Inflammatory and Nociceptive
Steroids effect two processes/receptors – a glucocorticoid pathway, and a mineralcorticoid one. The glucocorticoid pathway has strong anti-inflammatory and immunosuppressive effects. The mineralcorticoid pathway works more on retaining salt. The latter has been found to have pro-inflammatory effects which might have … Continue reading
Posted in Back Pain, Injection
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Is TMJ Issues a Problem of Same Side Chewing?
Subjects with TMJ were asked to chew almonds to see how a splint worked – 16/20 chewed on affected side leading author to dub it the “Habitual Chewing Side Syndrome”
Might Anxiety Be A Form of Pain?
Recently, a dose of Acetaminophen (Tylenol) has been shown to reduce anxiety responses to a surrealistic film. Previously, it had been shown to reduce MRI evidence of the effects of social rejection. Together, it suggests anixety/social rejection is another form of pain.
Posted in Uncategorized
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Top 10 Pain Web Sites
Recent article scanned the web and catalogued the best pain sites. I’m not on it but I’m not bitter (much)…
Posted in Uncategorized
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Endometriosis and Painful Bladder Syndrome: Evil Twins in Regard to Chronic Pelvic Pain
In chronic pelvic pain, 61% will have painful bladder syndrome, 70% will have endometriosis, and 48% will have both. They do indeed seem to be evil twins often operating together.