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Author Archives: admin
Segmental Colitis Associated with Diverticulosis (SCAD syndrome)
Diverticulosis can exist with segmental colitis – have an older patient who had bad diarrhea on a trip and was diagnosed with such. Not something I was aware of.
Posted in Abdominal pain
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Achilles Tendonitis – New Eccentric Program
Achilles Tendonitis is one condition I hate and any treatment program is welcome. This is an upgraded eccentric program that does not involve dorsiflexion (foot pushed up from normal)
Posted in Leg Pains
3 Comments
I wish I Had Fibromyaglia – Then I Couldn’t Have Anything Else…
I hate the term Fibromyaglia (FM) – not because it doesn’t exist but because it stops people looking for potentially treatable issues as well. “It’s all just Fibromyalgia” is just too convenient. Here is an example of a subject with … Continue reading
Posted in Fibromyalgia
1 Comment
Rehab – Forget Fear-Avoidance – Give Them Opioids
I have a picture that portrays my view of fear-avoidance:My perspective is that, in a good many of cases, everything is controlled by pain intensity. Some articles try to avoid the issue by saying “they just thought they were in … Continue reading
Posted in Insurer issues, psychology
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Zinc and Magnesium Deficiency Common in Fibromyaglia- and What are Zn and Mg Good For?
A recent article found a relationship of low zinc levels and tender point counts, and low magnesium and fatigue
Posted in Deficits, Fibromyalgia
3 Comments
Optimal Fentanyl Patch Use
There is alot of confusion of what amounts to optimal fentanyl patch use. Many patients contend it only lasts 2 days. How does one adjust the dosage?
Posted in Drugs
4 Comments
Hope For Failed Backs – Spinal Cord Stimulation
Given there is little evidence medications work well for chronic radiculitis, It is encouraging to note that Spinal Cord Stimulation might give 50% relief in failed back patients.
Posted in Back Pain, Mechanical aids
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Angiogenesis (new blood vessel growth) the root of all pain?
Angiogensis and its accompanying nerves are evident in disc disease with the formation of neurovascular growth in the High Intensity Zone facing the spinal cord. Similarly, I have written how chronic tendonitis is associated with neurovascular growth. Now it appears … Continue reading
Posted in Pathophysiology
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Is Facet Injection Better Than Medial Branch Block?
Facet injection appeared to be superior to medial branch block of SPECT scan positive facet joints
Posted in Back Pain, Injection
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New Treatment For Vulvodynia – 6% Gabapentin in Lipoderm
6% Gapapentin in Lipoderm is helpful in vulodynia. Interesting how they made it up.
Dorsal Wrist Impingement – How to Diagnose
Dorsal wrist impingement is pincing of dorsal wrist capsule between the extensor carpi radialis brevis and the dorsal ridge of the scaphoid. It’s diagnosis is strictly clinical.
Posted in wrist
3 Comments
Acute Nerve Injury – Try Gabapentin and Tramadol
After a sciatic nerve as accidentally injected, gabapentin and tramadol helped the pain until some recovery came about.
Posted in Drugs, neuropathic
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Want a Cheap Nerve Stimulator needle? -Look No More…
Disposable insulated needles are not readily available but a 20 gauge cannula is easy enough to find…
Posted in Mechanical aids
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Child in Pain & Distressed – Healing Potential of Massage + some techniques
Children in a chronic pain clinic respond significantly to massage. The laying on of the hands also has a significant effect on distress. This is an under-utilized resource that needs to be taught to parents.
Posted in children, Fibromyalgia
2 Comments
New Treatment for Chronic Daily Headaches – Mexiletine
Chronic daily headahces has to be the bane of most doctors frustrated by fact use of painkillers will potentially only make things worse. Now it looks like Mexiletine may help but …the patient has to be prepared to accept side … Continue reading
Posted in Drugs, Headaches
6 Comments
Diabetic Peripheral Neuropathy – Pregabalin to 600mg or bust
I am used to 75-150 mg doses of pregabalin but doses of 300 mg BID are being used for diabetic peripheral neuropathy.
Posted in Drugs, neuropathic
1 Comment
Tennis elbow and desperate – try Duloxetine
Two cases resistant to any treatment responded to Duloxetine suggesting complex origin.
Posted in Drugs, Tennis elbow
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Neuropathic Pain More Spinal and there are potentially better treatments
Recent Japanese article hilights spinal sensitization in neuropathic pain suggesting lidocaine and ketamine maybe should play bigger role
Posted in neuropathic, Pathophysiology
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Hypnosis in Chronic Pain
Hypnosis helps chronic pain and should be part of a chronic pain program, if not managed by mindfulness meditation.
Posted in psychology
3 Comments
NSAID’s and Gastritis – new help
Arthritis pills longterm, particularly in the elderly, is a risky business. Stomach bleed have been reported to cause more deaths than car accidents and other injuries. These stats are now relatively old and comments from doctors has been that they … Continue reading
Posted in Abdominal pain, Drugs
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Polymyalgia Rheumatica – Back and Neck Pains
http://ard.bmj.com/cgi/content/full/67/6/758 “Cervical interspinous bursae lie anteriorly in C6–C7 interspinous spaces (arrows). B. Median sagittal section through L3–L5 of the vertebral column. Lumbar interspinous bursae lie posteriorly in L3–L5 interspinous spaces (arrows).” These are inflamed bursas between the posterior neck (and … Continue reading
Posted in arthritis
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For MS Sake, Give Vitamin D to Your Kids
In 2006, a US military study did a GOOD perspective study on MS that involved taking blood samples some 4-5 years prior to the start of their MS. In subjects under 20, high vitamin D levels offered a high rate … Continue reading
Fast Fix for Shingles Pain – and Doctors: For God’s Sake – Give a Block!
Nerve blocks combined with tricyclic antidepressants gave rapid relief of pain in 80% cases in one Japanese report. I feel nerve blocks or epidural blocks are manditory for any cases of shingles in which the current acutely infected pain would … Continue reading
Posted in neuropathic
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Immorality of Canadian Agency for Drugs and Technologies in Health
The Common Drug Review is part of the Canadian Agency for Drugs and Technologies in Health. It is a national program that determines what drugs are worth putting on formularies in the province. They decided that Lyrica should not be … Continue reading
Posted in Regina Pain News
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Want to See a Pain Expert? – See a Vet, not a Doctor
A Canadian Pain Society Survey found medical students only get on average 11 hours training in pain education. A vet, however, gets on average 98 hours education. This might explain why patients are treated poorly by some doctors.
Posted in Insurer issues
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