Recent Comments
- Monika Theresia Geier on WCB troubles – What Needs to Be Done?
- Louise B. Andrew MD on Remarkable New Treatment – Injecting Over Tenderized Skin Nerves With Plain 5% Dextrose
- Margreet Hogenbirk on Sore Pubic Joint – Osteitis Pubis How Does One Treat It?
- John Waters on Accurate Piriformis Injection
- Blurge on Vitamin B12 Injections For Chronic Pain
Author Archives: admin
WCB ISSUES
I have received various concerns about WCB, many angry. There are some precedent judgements passed that may help.
Posted in Insurer issues
6 Comments
WCB troubles – What Needs to Be Done?
I have received a variety of letters condemning high handed techniques by WCB. I read the letter below with a sense of sadness. I can’t imagine the desolation involved in living with chronic pain and dealing with the system. I … Continue reading
Posted in Insurer issues
12 Comments
Exercise Rehab Programs by Themselves Worthless? – Evidence Snuffed?? and How does One Get an Unbiased Appraisal of Disability?
Cochrane reviews withdrew a review on rehab programs that questioned any validity to programs that do not have full multidisciplinary approaches. One wonders if this was pressure from Functional restoration business – who would not like that presented
Posted in Insurer issues
6 Comments
New Option For Interstitial Cystitis
Pentosan Polysulfate, i.e. Elmiron, is used orally for IC but can take 3 – 6 months to gain effect with 35-40% of subjects having marked improvement of symptoms. as per here Now it appears it can be given intravesically (into … Continue reading
Restless Legs and Interstitial Cystitis Related to Gut Bacterial Overgrowth?
In those patients with Irritable bowel and restless leg syndrome, significant benefits can occur if therapy to treat bacterial overgrowth is undertaken
Is Asthma a form of Pain?
Carbamazepine and Valproic acid have been found to be effective in bronchial asthma begging the question whether asthma involves neurological mechanisms similar to migraines or Trigeminal Neuralgia
Posted in Pathophysiology
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Finger pressure can relieve many migraine headaches
Over three minute pressure to occipital arteries can greatly relieve migraine pain in over 1/2 of cases; almost sounds too good to be true.
Posted in Headaches
11 Comments
Mast Cells Implicated in Migraines
Recent findings that mast cells may trigger migraines has significant implications on cause and treatment. Mast cells play a key role in Peripheral Sensitization – Neurogenic Inflammation where tissues become overly tender and swollen. They are, however, a cornerstone of … Continue reading
Posted in Headaches
5 Comments
Big disc protrusions gimps facets
I have a patient who had a large disc protrusion. These have been shown to have a good chance of recovery (vs disc bulges which very few with sciatica were better a year later). This patient did not improve until … Continue reading
Posted in Back Pain
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Functional Capacity Accessment for Neck Risky and Unverified
In May 2007, was published a review of FCE of the neck. Their analysis found: “At this moment, however, no validated performance based instrument has been described in literature.” They also found various necks tests were not without danger.
Posted in Insurer issues
2 Comments
Transformed Dural Leak Headaches – Undiagnosable Here
Dural leaks can be following an epidural injection gone subarachnoid, but can occur spontaneously primarily in the Thoracic Spine. The headaches are usually better at night when lying down and worse when one gets up. If the dural leak is … Continue reading
Posted in Headaches
3 Comments
NMDA receptors are king
NMDA receptors play a vital role in memory NMDA dysfunction is of course key to chronic pain, though there are non-NMDA pathways though the thalamus in mice…. NMDA blockage 2 days in a row with ketamine will cause temporary remission … Continue reading
Posted in Pathophysiology
2 Comments
WCB Report Files
I made a presentation to the Saskatchwan Workmans Compensation Review Panel. Their report left out much of what I had to say so I am putting it here: 1) Case workers make patients worse and obstruct medical care: dangerous.doc One … Continue reading
Posted in Insurer issues
88 Comments
CARP Conference Slides
Presentation at Canadian Association of Rehabilitation Professionals June 2007. Summation (version 1) here: Power points are here. 1) Disc disease(especially chronic) can often not be imaged and the worst chronic cases just show disc bulges. Disc disease and sciatica is … Continue reading
Posted in Insurer issues, Pathophysiology
5 Comments
Simple Opioid Risk Tool
A talk by Dr. Pam Squire recommended a simple opioid risk tool called the ORT
Posted in Drugs
2 Comments
Rotator Cuff of hip causes Greater Trochanter pains
Trochanteric side of hip pain is common yet rarely properly diagnosed. Actual Gluteal tears can be a cause and by age 60, 10% of people have them. Twenty Percent of chronic back pains (average age of 54 yrs) have trochanteric … Continue reading
Posted in Hip Pains
4 Comments
Does Abrupt Estrogen Withdrawal trigger Pain?
Does sudden withdrawal of Estrogen cause a “aromatase inhibitor pain syndrome” leading to increased musculoskeletal pain? One author thinks so.
Posted in Drugs, Pathophysiology
3 Comments
Surface DC Electrode Stim helps Fibromyalgia
Skin DC CES (Cranial Electrical Stimulation) has been shown to help central spinal pain (see other post). Now, 5 days of 20 minute daily treatment can drop pain scores from 8.5/10 to 5/10. Placebo effect? – not likely because stim … Continue reading
Posted in Fibromyalgia, Mechanical aids
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Is Crushed Vertebrae a RSD? – New RX
It is not unusual to find asymptomatic compression fractures in the spine, while it has also been demonstrated that the same can cause disabling persistent pain. Now, with evidence of rapid pain response to IV Pamidronate, a drug found helpful … Continue reading
Posted in Back Pain, complex regional pain, IV therapy
2 Comments
Bah to Lyme? – Check out Lichen Sclerosis RX
Lichen Sclerosis and its male equivalent balanitis xerotica obliterans can be disabling conditions. It can cause disabling pain, burning, pruritis, and genital lesions. Lyme disease Borrelia burgdorferi have been detected in cases of this, so a recent study used Lyme … Continue reading
CRPS – Peripheral endothelial dysfunction player
Evidence of microcirculatory endothelial dysfunction was documented in Complex Regional Pain Syndrome aka RSD. The peripheral changes could help trigger the central sensitization process.
Posted in complex regional pain, Pain Dystrophy
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Chronic cough might be sensory neuropathy
Ever have a patient with a chronic cough unresponsive to anti-reflux, allergic rhinitis, and asthma treatment? Sensory Neuropathy might be the problem and Amitriptyline the answer.
Posted in Pathophysiology
35 Comments
Fibromyalgia no more poor copers than ill public
The finding that all ill people can “symptom intensify” and persons with Fibromyalgia(FM) don’t do it any more than any other illness is another nail in the coffin for FM being psychological. There will be a subgroup in FM that … Continue reading
Posted in Fibromyalgia
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Does Pain “Grow” at Tendon injury sites? -and Treatment tennis elbow
Studies on Achilles, Patellar and Lateral epicondylar (tennis elbow)tendonitis have demonstrated the ultrasound demonstrable appearance of a “vasculo-neural growth” that corresponds to the site of pain. In long-term resistant cases, treating these lesions with sclerosing agent, polidocanol, under ultrasound guidance; … Continue reading
Posted in Pathophysiology, tendonitis
12 Comments
Microscopic Colitis – Undiagnosable Pain Generator?
There is a growing awareness that colitis can occur without any observable lesions on colonoscopy. Microscopic colitis is occasionally associated with spondylitis and may be associated with myofascial back pain by activating psoas and abdominal wall spasms. How then does … Continue reading
Posted in Abdominal pain
1 Comment