Author Archives: admin

Elbow Pain Where Can’t Fully Extend – Posterior Olecranon Impingement

Have a couple cases where cannot fully extend elbow and in considerable pain posteriorly on olecreanon rim. Attempts to exercise it to extension just cause pain. Loose bodies and spurs can cause trouble but are often not visible on xrays. … Continue reading

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Straight MRI’s Useless in Fibromyalgia (FM)

There appears to be an association of chiari (“a hindbrain malformation characterized by downward anatomical extension of the cerebellar tonsils below the foramen magnum, and is thought to result from a developmentally small posterior fossa.”) and FM. This however, is … Continue reading

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Asymptomatic Rotator Cuff Tendon Tears More Common in Elderly Diabetics

In 70 year olds, incidence of major asymptomatic supraspinatus tears is 7.8% in elderly controls, and 15.8 in elderly diabetics

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Laparoscopic Radical Prostatectomy Not that Great

One would think minimally invasive prostatectomy would have fewer side effects – in the postop period they do, but not in the long term…

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So You Had Prostate Cancer Surgery and They Didn’t Get It All – What Does It Mean to You

Where there was a positive margin after prostate cancer surgery, time until PSA starts rising depends on how many margins, and what per cent of the prostate was cancerous.  Tables have been plotted for such.

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Persistent Groin Pain – Cut Adductors – Adductor Tenotomy

In 91% of severe persistent groin pains, adductor tenotomy was found beneficial

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Simple Measure Found to Prevent Dementia

Recent review encourages a positive optimism about dementia prevention. They point out that hip fracture rates have dropped 25% from 1995 to 2005,  and age-adjusted stroke rates have dropped 25%  in both USA and Australian studies as well. Dementia rates could do the … Continue reading

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Scary Aspect of Osteoporosis Meds – Hip Atypical Subtrochanteric Fractures

Recent analysis had put hip fracture rates with bisphosphonate osteoporosis meds at 1/1000 per year. This is way too common – I have a suggested treatment.

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Breast Reduction Surgery- Is It Worth It?

I have patients argue that the reduction of upper back pain would be an indication for breast reduction. What needs to be factored in, is the 11-49% chronic scar pain following surgery – and how to deal with that.

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Unilateral Plantar Fasciitis Might Be a Sign of a Longer Leg

Study found plantar fasciits was associated with leg length discrepancy and in the longer leg.

Posted in plantar fasciitis | 1 Comment

How Do Asymptomatic Shoulder Tendon Tears Become Symptomatic?

When partial tear became full, or when full tears spread by >5 mm – it was more likely to become symptomatic. It was suggested that “Further research is warranted to investigate the role of prophylactic treatment of asymptomatic shoulders to … Continue reading

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Self Treatment For Trigeminal Neuralgia

Case was presented where deep breathing was found to abort TN episodes with hope that others would try it and maybe report if it was effective.

Posted in Trigeminal Neuralgia | 1 Comment

Is Fibromyalgia(FM) an Anti-immune Disease?

Fibromyalgia rates are much higher in Hashimoto’s thyroiditis (HT) – about 31% and not higher in cases with subclinical hypothyroidism. This suggests a subgroup might be autoimmune.

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Fibromyalgia(FM) and Breathing Trouble – Alpha-1 – antitrypsin (AAT) deficiency

About 1-5% of FM might actually be an alpha-1-antitrypsin deficiency. This  condition causes run away inflammation that causes COPD but responds to AAT replacement therapy. Cases are presented.

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If DHEA and Androgens Help Then Why is Fibromyalgia(FM) Higher in Polycystic Ovaries(PCO)

DHEA and androgen levels are higher in PCO yet FM rates are 32.5% in PCO versus 7.7 in the general population.

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Hook Hamate Fractures Missed – New Test For

Missing a Hook of Hamate Fracture presents a medico-legal nightmare somewhat like missing a scaphoid fracture. It is often a “unbalanced loaded” racket sports related injury or direct blow.  Pain may not be severe and plain xrays are often normal. … Continue reading

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Trigeminal Neuralgia – Those With Constant Pain Component Do Poorly

There are two versions of Trigeminal Neuralgia – one version that just has episodic sharp pains, and another that has that and also a continuous pain component. Those with a continuous component do poorly.

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Erosive Hand Osteoarthritis – Can Do Better Than Arthritis Pills

Hand Osteoarthritis with progressive deformities, pain and  erosions on xray is not your typical osteoarthritis. It is coined “inflammatory osteoarthritis” and can lead to  increased disability.  Drugs like IM methylprednisolone, Hydroxychloroquine, Infliximab, and  Anakinra all help.

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Old and in Pain? Weight Loss Could Make the Difference

Recent study looking into factors involved in chronic pain in the elderly found subjects with central obesity were twice as likely to have pain problems.  Various factors contribute.

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New Hope For Severe Knee Arthritis – Burn Nerves to Joint (Radiofrequency Neurotomy of 3 out of 5 Genicular nerves)

Article referred in press describes how radiofrequency to 3/5 of Genicular nerves could induce  over 50% improvement in 59% of cases over the 3 months followup.

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Synthetic Cannabinoids And Fibromyalgia – Pain Aid and Now Sleeps

Two Canadian studies have been done on  Nabilone – One at University of Manitoba showing it improves pain, and a recent one from McGill showing it helps sleep.

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Post Stroke Hemiplegic Shoulder Pain – Plain Local Suprascapular Block as Good as Steroid Injection in Shoulder

Beefing up my contention that suprascapular nerve blocks have therapeutic shoulder effects, is a new article finding it works as well as steroid injections into shoulder – without having to use steroids.

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Isolated Posterior Wall Infarction – Are We Missing It and Using Posterior Chest Leads to Find

Only 38% of Doctors can diagnose a posterior MI (heart attack) because traditional leads do not pick it up. I have on occasion seen someone with vague chest pains but a previous history of heart disease. If ECG is normal … Continue reading

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Cranial Electrical Stimulation (CES) Helps Post Spinal Cord Injury(SCI) Pain

Skin surface CES therapy is usually 2 milliamp therapy with anode over motor cortex strip (C3) (on skin) with a cathode lead on forehead. In SCI patients it resulted in significant pain relief (P<0.03 versus sham). They found the effect … Continue reading

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MS Plaque Position Not Associated With Pain

13 MS cases with chronic pain versus 10 without pain did not show any associations with plaque in certain areas of the brain

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