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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
Posted in ankle
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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
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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
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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
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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
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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
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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
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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
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