Author Archives: admin
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
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
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
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
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
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
Post thoracotomy pains have to be one of the banes of chest surgery occurring in high frequency. Now simple taping might reduce it.
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
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
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
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
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
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.
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
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
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
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
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
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
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
Pisiform instability can cause nondescript pain over lateral hand eminence, and in some cases present with ulnar nerve damage. It is little recognized.
Growing evidence that some gluten sensitivity is actually sensitivity to the carbohydrates in Gluten Foods rather than to gluten. None the less, avoiding gluten foods during colitis flareups, helps suggesting a temporary sensitivity.
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
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.
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.