Author Archives: admin

Epicrania fugax – Like a Trigeminal Neuralgia of the Scalp

Have a case of lancinating severe jabs to right top of head. She had them before but they have recently returned. There was no trigger zone, no tenderness, and occipital, temporal and supraorbital nerve trunks were nontender. Write up on subject … Continue reading

Posted in Headaches, neuropathic, Trigeminal Neuralgia | Leave a comment

Chronic Migraines – Botulinum Helps

Repeated OnabotulinumtoxinA shots can reduce chronic migraine headache frequency from 20 headaches/month to 10/month.

Posted in Botox, Headaches, Injection | Leave a comment

Glossopharyngeal Neuralgia (GN) Relief Manouver

GN causes sharp sudden pain in one side of pharynx (anterior neck) and lower jaw. It can be initiated by drinking cold drinks and food and by yawning. Enclosed is a case who found relief by “earlobe hyperextension and ear … Continue reading

Posted in ENT, Neck, neuropathic, Trigeminal Neuralgia | 2 Comments

Pain Post Carpal Tunnel Surgery – Not So Simple

Recent study found an 8.3% incidence of regional pain following carpal tunnel surgery regardless of anesthetic technique.

Posted in complex regional pain, neuropathic, wrist | Leave a comment

Benefits of Group Laughter – Endophins and Social Bonding

Recent study suggests social laughter stimulates endophins and encourages social bonding. This makes a case for Laughter Yoga

Posted in psychology | Leave a comment

No Need to Fear Suicidality – Rapid Relief of Suicide Intent With Ketamine

A “single i.v. bolus of ketamine (0.2 mg/kg) over 1–2 min will rapidly dissolve suicidal ideation” and its effect will last aat least 10 days. I find this an exciting innovation that could prevent a big unnecessary killer. This is just … Continue reading

Posted in Depression | 2 Comments

Intra-bladder Alkalized Lidocaine in Interstitial Cystitis – Popular – Easy Preparation Technique

Mixing Lidocaine and 8.4% sodium bicarbonate to ph 8 can be a puzzler and difficult given the propensity of lidocaine to precipitate at neutral ph’s. Putting in spinal lidocaine (5% lidocaine in 5% dextrose) first and then an equal volume … Continue reading

Posted in Uncategorized | 2 Comments

Depression is a Form of Pain and Ketamine May be a Cure if One Can Make It Last

Recent studies has demonstrated short infusions of ketamine can quickly and perhaps completely remove depression for up to 1 week (who says there is no happy pill?). Infusions for neuropathic pain can give significant improvements for time periods as well. … Continue reading

Posted in complex regional pain, Depression, Drugs, neuropathic | 3 Comments

Cheap Treatments For Sleep Apnea

My daughter, Janice Montbriand, and I did a sleep study on selected cases of chronic pain and found a high incidence of sleep apnea. In Fibromylagia, disordered breathing (a dumbed down version of sleep apnea),is very common. Though the CPAP … Continue reading

Posted in Fibromyalgia, Mechanical aids, Sleep | Leave a comment

Statin (Cholesterol lower drug) Muscle Pains – Some Due to Low Vitamin D.

Prior case examples have hilighted how low vitamin D might cause leg pains etc. with statin drugs. Now a group analysis has confirmed it and shown supplementation helps.

Posted in Drugs | Leave a comment

New Fibromyalgia Scoring Self – Questionnaire

The new Fibromyalgia criteria are confusing and so I put together a self- questionnaire that might simplify things for people.

Posted in Fibromyalgia | 1 Comment

Ganglion Impar Injection For Tailbone Coccydynia

Previously for ganglion injection, , injection through the sacrococcygeal joint has been suggested.  Recent information has found the ganglion is actually lower in the first intracoccygeal joint level.  Injection of this ganglion is an important treatment for coccydynia.    

Posted in coccygodynia, Injection | 6 Comments

Primary Care Back and Leg Neuropathic Pain (thought sciatic) common. – MRI, and Straight Leg Raise Useless.

Recent study of neuropathic pain in leg associated with back pain, in a primary care setting, found MRI evidence of nerve root impingement unlikely and straight leg testing useless. Their conclusion:  “[the] neuropathic pain may be caused by irritation of nervous … Continue reading

Posted in Back Pain, Insurer issues, radiculitis | Leave a comment

Injecting Painful Scars

Intradermal injections of local and subcutaneous injections of steroid have been used for scar pain. This study compared intradermal dexamethosone and botox and got 25%  and 30% relief repectively lasting 4 and 8 weeks respectively.

Posted in Injection, neuropathic, Post Hernia | 1 Comment

Topical Lidocaine for Coccydynia

I hate tailbone pains and failure to respond to steroid injections happens. One approach I noticed recently was use of a topical patch.  

Posted in coccygodynia, Topical Pain Treatments | 4 Comments

Curable Chronic Posterior Ankle Pains – the os trigonum syndrome

There is a bone at the back side of the ankle joint that normally goes into the rest of the boses but can either remain separate or break off. Either way, repeated or traumatic toe down (Plantar flexion) positioning can … Continue reading

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Persistent Heartburn Despite Meds – A Hypersenstive Esophagus Helped by Antidepressants

Persistent esophageal symptoms (heartburn, chest pain, and regurgitation) despite ulcer meds –  could be the results of a spastic oversenstive esophagus that may respond to serotonergic agents – like antidepressant citalopram or Duoxetine

Posted in Abdominal pain | Leave a comment

Celiac – Hard to Diagnose

Recent talk at CAOM meeting clarified how difficult diagnosis celiac disease is – with an average diagnostic delay of 11.7 years – and some approaches that could help

Posted in Abdominal pain, celiac | Leave a comment

Fibromyalgia Is Only Induced by Motor Vehicle Trauma ?Whiplash Disease

A prospective trial (follow people before injury to after injury – a very good trial approach) found Widespread Pains developed only after Road traffic accidents – not after any other injury. This highlights howPost Traumatic Fibromyalgia coould be a neck disease … Continue reading

Posted in Fibromyalgia, Neck | 4 Comments

Low Serotonin Levels in Fibromyalgia – A False Picture Created by Antidepressant Therapy

Serum Serotonin levels are not low in Fibromyalgia; they are only low in FM subjects on antidepressants. This would explain why antidepressants do not have a major effect on FM.

Posted in Uncategorized | Leave a comment

Resistent Tennis Elbow – Platelet Rich Plasma May be No Better Than Whole Blood Injection

Both whole blood and platelet rich plasma work in resistent tennis elbow – but it takes 3 month for most improvement. There is no statistical difference between the 2 therapies.

Posted in elbow, Injection, Uncategorized | 4 Comments

Unlearning Fibromylagia Pain

Quite some years ago, John Sarno, an orthopedic surgeon wrote book on how chronic widespread pain might be a manifestation of emotional pain – people whose bodies are on overdrive and knotted up with body armour. He called it Tension … Continue reading

Posted in Fibromyalgia, psychology | Leave a comment

Mindfulness Therapy Not So Great in Fibromyalgia -Possible Reasons

Though an earlier uncontrolled study suggested Mindfulness medication could be helpful in FM, a randomized trial did not.  Maybe becoming aware of surroundings, some of which you don’t like, is not helpful?

Posted in Fibromyalgia, psychology | Leave a comment

Physical Activity and Fibromylagia -Is it Good or Is It Hype?

Only 1/2 of studies show pain benefits in FM from exercise. Most exercise trails are short term (12-20 weeks) and a recent long term study failed to show benefits on followup. Is the idea “all you need is exercise” just hype?

Posted in Fibromyalgia | Leave a comment

Easy Control For Bad Menstrual Cramps, Restless Legs in Fibromyalgia, and Occipital Migraines – Using Ivory Scent Oil

Ivory Scent oil patches were found to give quick relief for menstrual cramps and when applied to leg, for restless legs My Daughter and I are doing a survey of women with Fibromylagia. If you have Fibromyalgia, could you be … Continue reading

Posted in gynecologic, Headaches, Leg Pains, Topical Pain Treatments | Leave a comment