Author Archives: admin

Alternate Cause of Thumb MCP Joint Pain – Sesamoiditis – With Tests

There are small bones surrounding certain joints called sesamoids. In the thumb, they can get inflamed at the thumb MCP joint and respond to 10 mg triamcinolone injection or rarely to surgical removal.

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Resistant Piriformis Syndrome – Could We be Missing the Boat? – Obturator Internus

I have a case of long term piriformis syndrome that I have been whittling away for some time. To be fair, she has seen multiple specialists and is some better but not enough to improve quality of life, (old sad … Continue reading

Posted in Back Pain, piriformis, Uncategorized | Leave a comment

Resistant Tennis Elbow – Open Release or Radiofrequency Microtenotomy – and More

Randomized trial of open release (OR) or radiofrequency microtenotomy (RFMT) for tennis elbow. Article suggests: “As a result of the extra expense of RFMT, we therefore recommend that OR is offered as the standard surgical management.”

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AC Joint Treatments

Recent article defines treatments as steroid injection or distal clavicle excision. It found little evidence of persistent benefits of AC steroid injection and found arthroscopic distal clavicular excision satisfactory in 92.5% of cases on average.

Posted in shoulder | Leave a comment

New Ion Channel Abnormality Found in Diabetic Neuropathy

Hyperpolarization-activated cyclic nucleotide-gated (HCN2) channels have been found to cause issues in animal models of diabetic neuropathy and the rush is on to find a drug safe to use to block them. An Ion Channel That Perpetuates Pain in Diabetic … Continue reading

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Neuropathic Treatment Failure -The Greatest Issue In Treatment of Chronic Pain

I was asked to put a letter in a time capsule for my great nephew. I reflected over the near 40 years I have been working on chronic pain and my wishes for 2034. The treatment of neuropathic pain is … Continue reading

Posted in neuropathic | 1 Comment

Imipramine and Pregabalin – Little correlation Effect with plasma concentration

Imipramine drops polyneuropathy pain by one and has no increasing effect with dosage suggesting most effect is placebo. Pregabalin drops pain by 0.4 and marginal/not significant drug dosing effects suggesting neither is much use alone.

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Magnesium Oxide Better Absorbed Than Citrate

Magnesium oxide is (surprisingly) better absorbed than citrate –

Posted in Uncategorized | Leave a comment

Complex Grief or PTSD – New Treatment – Mirror Neuron Network Activation

It is proposed that PTSD and abnormal grief reactions are due to mal-wired brain connections that loop painful recollections. In phantom limb, abnormal circuit changes potentiate the pain. Some of these connections can be over-written by “mirror therapy” where a … Continue reading

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Supratrochlear Neuralgia

            This is a newly described condition. Ignored as a possible cause of head pain (astoundingly, 6/15 had a prior supraorbital nerve block but not trochlear). Tip off is it’s near midline location. Pressing or … Continue reading

Posted in Headaches, neuropathic | 1 Comment

Persistent Hiccups in Cancer – 0.1 ml Vinegar Squirted Into Nose and What Else

Using vinager for hiccups is a Japanese folk medicine treatment. After testing in regular subjects for safety, 0.1 ml; of vinerger (4.2% acetic acid) was used in a cancer patient with persistent hiccups with effect.

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Diabetic Medication Aids

Putting together info on using newer agents. Note: DPP4 and SGLT2 combo not allowed by EDS. Lectures from Dr. Sue Petersen 2017

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Cervical Radiculitis Without a Cause ? Chickenpox Zoster Virus History High

If you take cases of cervical radiculitis – if imaging shows possible reason for it, they give a history of having had shingles at about 18.4%. In cases with normal imaging, the prior incidence jumps to 81.6%  (p<0.01) – most of … Continue reading

Posted in Neck, radiculitis, shoulder, Uncategorized | Leave a comment

Mucositis Help by Zinc Sulphate 220 mg /day

Patients were followed during various stages of chemotherapy. and had 1/4 or less significant mucositis compared to control if took Zinc  Sufate 220 mg/day

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A Multisystem Disease Problem Case

Below is a recent email of someone with multisystem undiagnosed problems that would be daunting to say the least;

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On Methotrexate? – Take Vitamin C

In rat model, vitamin C prevents oxidative stress on liver and kidney

Posted in Drugs, Rheumatic | Leave a comment

Acute Neck Pain and Pain on Swallowing – Longus Colli Tendonitis

Though often confused with an abscess, acute  anterior neck pain and stiffness associated with swallowing pain or globus, can be longus colli tendonitis. Calcificatrions might be seen on xray. Fortunately it last only a couple weeks on average

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In Sleep Deprived? Naps and Caffeine Might Help Pain

in the Animal model if animal sleep deprived ( Not fragmented sleep though) , they animals become more sensitive to noxious stimuli.  Yet sleep would restore things and Caffeine would also reduce pain reaction.

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How Can You Tell If Duloxetine (Cymbalta) or Pregabalin (Lyrica) will Work?

Both duloxetine and pregabalin work by restoring brain down pain inhibition. Hence the work in people who have deficits in this system. There is a simple test to confirm functioning.

Posted in Drugs, Fibromyalgia, pain mechanisms | Leave a comment

Friedrich Nietzsche – What I got out of his Sayings

Friedrich Nietzsche  – What I got out of his Sayings

Posted in Uncategorized | Leave a comment

Office Factors Related to Chronic Neck Pain

Keyboard too close, too long in one job position, and muscle tension are 3 factors found in one study

Posted in myofascial pain, Neck | Leave a comment

Sedentary Lifestyle Only Weakly related to Chronic Back Pain – and Only in Women – Twin Study

Twin study found only a weak relationship between sedentary lifestyle and chronic back pain – and found it only in women and when corrected for genetics -was only weak.

Posted in Back Pain | 1 Comment

Ibuprofen an Alternative For Preventing High Altitude Sickness

“Severe high altitude headache  occurred in 3% treated with ibuprofen and 10% with placebo”

Posted in Drugs, Headaches | Leave a comment

Fibromyalgia Common in Thyroid Disease

In Hashimoto’s thyroiditis, quoted FM rate is 30-40% ; present study found 62%.  Thyroid antibodies, abdominal girth, and duration disease among other things, contribute to FM possibility.

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Chemotherapy Induced Sore Mouth Mucositis – Cut Pain in Half with Topical Ketamine

Must be horrible to have a sore mouth with chemotherapy – ketamine  20 mg/5ml used four times daily reduced pain from 6 to 3 within days.

Posted in ENT | 1 Comment