Author Archives: admin

Vulvodynia Treatments 2017

New approaches include topical neuromodulation which means “Podophyllotoxin (5 mg/mL) applied locally to tender points of vestibule after 5% acetic acid application. Treated area was covered with a mild estrogen cream and covered with gauze pads until the next day” … Continue reading

Posted in Drugs, gynecologic, Interstial Cystitis/Gynecologic | Leave a comment

SSRI Antidepressants Work Better Than older TCA Antidepressants in Irritable Bowel

Traditionally, an old antidepressant, amitriptyline, has been used for irritable bowel at doses far lower than its antidepressant level, as an aid to stimulating endophin system etc. Now it appears that more up to date SSRI’s work better. This was … Continue reading

Posted in Abdominal pain, Drugs | Leave a comment

Persistent Plantar Fasciitis – TENS Like Stimulation of Low Impedance Spots Helps Resolve

Point stimulation has been found helpful in nummular headaches: Small Spot Body Pain Treatment – Pen like Electrical Skin Stimulation http://painmuse.org/?p=704 This case, involved treatment of persistent plantar fasciitis. Using a point probe (like an acupuncture point locator), Spots of … Continue reading

Posted in foot, Stimulation | Leave a comment

Pain and Swollen Arm? – Upper Arm DVT Protocol

Upper arm pain and swollen and no other likely cause? – combinations of D-dimer testing and compression ultrasounds seem to be the approach.

Posted in arm | Leave a comment

Do Pelvic Belts Help Back Pain? – Yes

Study on SI belts for pregnancy back pain found it reduced pain by 2/10.

Posted in Back Pain, Mechanical aids | Leave a comment

Osteoarthritis (OA) Knee Suffers Should Limit Walking to 30 min at a Time

 

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One Reason Osteoarthritis Bad in Canadian Prairies – Persistent Low Vitamin D Levels – and Supplements Prevent

I do vitamin D levels on all my patients coming in for physical – they are almost always low. – Recently demonstrated that persistently low levels of Vitamin D associated with accelerated osteoarthritis and helping that helps. …

Posted in Deficits, Knee, pain mechanisms | Leave a comment

Failure Back Surgery Post Laminectomy Pain Treatment- New High Frequency or Burst Mode Spinal Stimulation

Spinal stimulation is primarily for the sciatica -only 1/2 of back pains respond.. This leave a subgroup, with predominately back pain, with a need for options. High 10 Kz frequency stimulation and Burst stimulation are two options.

Posted in Back Pain, Stimulation | Leave a comment

Office Ketamine For Chronic Pain Poster

here is poster in pdf format:   Poster CPS 2017 ketaminefinal (2)

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Confirmed – Resistant Ulcerative Colitis – Fecal Transplant Works 1/2 Time

70%  showed clinical response, and “13 of the 30 (43.3%) patients achieved clinical and endoscopic remission.”

Posted in Abdominal pain | Leave a comment

Stabbing Headaches

Rather new entity is the stabbing headache – primary stabbing headache (PSH) – often in occipital area, happening 2-100 times a day and more occipital (back of head) in location.  Treatment is not all what you’d think – its indomethacin, … Continue reading

Posted in Headaches | 1 Comment

Does Job Rotation Reduce Illness?

Job Rotation reduces wrist and hand pains but doesn’t do much else according to a review.

Posted in arm, Back Pain, hand, wrist | Leave a comment

Sacroiliac Joint – Leg symptoms

SI joints generate significant amount of lateral thigh and inguinal area pains.  About 1/3 will complain of lateral thigh numbness as well.

Posted in Back Pain, Leg Pains | Leave a comment

Recurrent Aphthous Ulcers – Minocycline 0.5% Mouth Rinse Treatment

Canker sores respond to tetracycline/minocycline rinses – 0.5% minocycline works best

Posted in ENT, Topical Pain Treatments | Leave a comment

Burning Mouth Syndrome – Remarkable Improvement with Botulinum Injections

“16 units of incobotulinumtoxinA (100 units diluted in 2 mL of saline), 4 units into each side of the lower lip and 4 units into each anterolateral side of the tongue” – “The beneficial effects lasted up to 16 weeks … Continue reading

Posted in Botox, ENT, neuropathic | 3 Comments

Antidepressants Don’t Necessarily Help that Much Re Back Pain

I contend antidepressants help very little in back pain and waiting for it to work before starting painkillers is an unethical abomination. Studies showing any benefit in the last century are laughable because dosages used would not be achievable today. … Continue reading

Posted in Back Pain, Drugs | Leave a comment

Please suggest help for this case of post back and post hip back-hip pain

A case in desperate need of help wrote and I have put it in a patient discussion forum: http://painmuse.org/?topic=post-laminectomy-post-hip-pains/

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Greater Occipital Nerve Blocks Help Triptan Overuse Headaches

Triptan overuse can exacerbate and well as signify uncontrolled headaches. Use of Occipital nerve blocks can make transition of limiting triptans easier.

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Advanced Gallbladder Testing Can Miss Disease

Two approaches to gallbladder advanced testing – use of fatty meal (FM) as a substitute for cholecystokinin (CCK) in pain reproduction during hepato-imino-diacetic acid (HIDA) scan in functional gallbladder disorder. – will miss 1/2 of cases

Posted in Abdominal pain, Drugs | Leave a comment

Back Pain in Crohn’s Colitis is a Spondyloarthritis

Imaging spine in Crohn’s Colitis found evidence of spondyloarthritis (active spine arthritis) in 1/2 of cases. Have a case of “arrested” crohn’s disease (there is usually evidence of continued activity in stool secretion – see http://painmuse.org/?p=374 re that) with chronic … Continue reading

Posted in arthritis, Back Pain | Leave a comment

Metformin May Augment Painkillers

Previously I wrote how metformin helps Fibromyalgia and Bipolar. It has anti-cancer properties and diabetics, just on it, live longer. Now in animal model it it cut analgesic needs by 56-73% in regard to ibuprofen, ASA, tramadol, and pregabalin in … Continue reading

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Serotonin Syndrome May be Reversed by Famoditine (Pepcid)

Operative case serotonin syndrome induced by Merperidine caused “hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex.”  Incidentally, patient was given famotidine, in this case IV, to prevent aspiration pneumonia. Within 15 … Continue reading

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Neuropathic Pain – Phenytoin Topical Augments Ketamine or Baclofen

It is all very well to say a drug works topically. However it is easy to assume they work on similar mechanisms so one does not add to the other. Phenytoin (Dilantin) augmented both ketamine or Baclofen so might be … Continue reading

Posted in neuropathic, Topical Pain Treatments, Trigeminal Neuralgia | Leave a comment

Dysphonia Hoarseness Could be a Myofascial Pain Syndrome

Amazing discovery. While getting  Diagnostic Electrodiagnostic EMG needles stuck in dysphonic vocal cords,  some experienced a sharp pain (like one hitting a muscle trigger point). Subsequently, those that experience that, noted their dysphonia was better. Looking into it deeper, some … Continue reading

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Do Estrogen Creams Help Vulvodynia? – Maybe…

Estrogens, in 18-45 age group daily application, reduced dyspareunia 27% versus 3% in placebo though that was not considered statistically better due to small sample size – so answer is maybe…

Posted in gynecologic | Leave a comment