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Confirmed – Resistant Ulcerative Colitis – Fecal Transplant Works 1/2 Time
70% showed clinical response, and “13 of the 30 (43.3%) patients achieved clinical and endoscopic remission.”
Posted in Abdominal pain
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Stabbing Headaches
Rather new entity is the stabbing headache – primary stabbing headache (PSH) – often in occipital area, happening 2-100 times a day and more occipital (back of head) in location. Treatment is not all what you’d think – its indomethacin, … Continue reading
Does Job Rotation Reduce Illness?
Job Rotation reduces wrist and hand pains but doesn’t do much else according to a review.
Posted in arm, Back Pain, hand, wrist
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Sacroiliac Joint – Leg symptoms
SI joints generate significant amount of lateral thigh and inguinal area pains. About 1/3 will complain of lateral thigh numbness as well.
Posted in Back Pain, Leg Pains
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Recurrent Aphthous Ulcers – Minocycline 0.5% Mouth Rinse Treatment
Canker sores respond to tetracycline/minocycline rinses – 0.5% minocycline works best
Posted in ENT, Topical Pain Treatments
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Burning Mouth Syndrome – Remarkable Improvement with Botulinum Injections
“16 units of incobotulinumtoxinA (100 units diluted in 2 mL of saline), 4 units into each side of the lower lip and 4 units into each anterolateral side of the tongue” – “The beneficial effects lasted up to 16 weeks … Continue reading
Posted in Botox, ENT, neuropathic
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Antidepressants Don’t Necessarily Help that Much Re Back Pain
I contend antidepressants help very little in back pain and waiting for it to work before starting painkillers is an unethical abomination. Studies showing any benefit in the last century are laughable because dosages used would not be achievable today. … Continue reading
Posted in Back Pain, Drugs
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Greater Occipital Nerve Blocks Help Triptan Overuse Headaches
Triptan overuse can exacerbate and well as signify uncontrolled headaches. Use of Occipital nerve blocks can make transition of limiting triptans easier.
Posted in Headaches, Injection
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Advanced Gallbladder Testing Can Miss Disease
Two approaches to gallbladder advanced testing – use of fatty meal (FM) as a substitute for cholecystokinin (CCK) in pain reproduction during hepato-imino-diacetic acid (HIDA) scan in functional gallbladder disorder. – will miss 1/2 of cases
Posted in Abdominal pain, Drugs
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Back Pain in Crohn’s Colitis is a Spondyloarthritis
Imaging spine in Crohn’s Colitis found evidence of spondyloarthritis (active spine arthritis) in 1/2 of cases. Have a case of “arrested” crohn’s disease (there is usually evidence of continued activity in stool secretion – see http://painmuse.org/?p=374 re that) with chronic … Continue reading
Posted in arthritis, Back Pain
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Metformin May Augment Painkillers
Previously I wrote how metformin helps Fibromyalgia and Bipolar. It has anti-cancer properties and diabetics, just on it, live longer. Now in animal model it it cut analgesic needs by 56-73% in regard to ibuprofen, ASA, tramadol, and pregabalin in … Continue reading
Posted in Drugs
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Serotonin Syndrome May be Reversed by Famoditine (Pepcid)
Operative case serotonin syndrome induced by Merperidine caused “hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex.” Incidentally, patient was given famotidine, in this case IV, to prevent aspiration pneumonia. Within 15 … Continue reading
Posted in Drugs
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Neuropathic Pain – Phenytoin Topical Augments Ketamine or Baclofen
It is all very well to say a drug works topically. However it is easy to assume they work on similar mechanisms so one does not add to the other. Phenytoin (Dilantin) augmented both ketamine or Baclofen so might be … Continue reading
Dysphonia Hoarseness Could be a Myofascial Pain Syndrome
Amazing discovery. While getting Diagnostic Electrodiagnostic EMG needles stuck in dysphonic vocal cords, some experienced a sharp pain (like one hitting a muscle trigger point). Subsequently, those that experience that, noted their dysphonia was better. Looking into it deeper, some … Continue reading
Posted in ENT
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Do Estrogen Creams Help Vulvodynia? – Maybe…
Estrogens, in 18-45 age group daily application, reduced dyspareunia 27% versus 3% in placebo though that was not considered statistically better due to small sample size – so answer is maybe…
Posted in gynecologic
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Epidural For Back – Particulate Steroids Work Better than Soluble
For Sciatica & spinal stenosis steroid epidurals are used but controversy exists over whether there is any benefit of particulate over soluble steroids. It would seem obvious that a steroid that last weeks would be better than one that last … Continue reading
Posted in Back Pain, Injection
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Subtle Cervical Dystonia
Diagnosing early cervical dystonia and using botulinum toxin has been one of the major advances I have seen in my treatment. Sidebend or Rotation to one side can be subtle but very important as one can now get drug coverage … Continue reading
Posted in Botox, Neck
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Improvements in functioning are dependent or pain relieving measures not mental health – hip and knee replacements
Fear avoidance model makes one consider cause of disability is in the psyche. Normalization of physical functioning despite mental health status with knee replacement belies that contention and further suggests those with mental health issues can have joint replacements.
Posted in Knee
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What Determines Depression – A Bad Diagnosis or the Pain? – the Pain of Course
Study did not find a history of cancer affected depression scores – what did was “a painful somatic symptom”. I have always contented that pain was the prime driver in chronic pain where the fear avoidance crowd like to put … Continue reading
Posted in psychology
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MRI Back Pain Sciatica Interpretation So Variable Could Effect Patient Outcome
The MRI GOD is struck another blow – interpretation is so variable, the authors states “As a result, the authors conclude that where a patient obtains his or her MRI examination and which radiologist interprets the examination may have a … Continue reading
Urinary Catheterization Pain – Cut in 1/2 by Attempted Voiding While Implementing
Always feel sorry for male patient being catheterized. Now brilliantly simple maneuver can cut pain in 1/2.
Posted in Urinary
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On Oxaliplatin Chemotherapy for Colon Cancer? Would taking Melatonin Reduce Peripheral Neuropathy?
In rodents, Melatonin helps prevent peripheral nerve damage from Oxaliplatin for colon cancer without reducing its cyotoxic effects on cancer. Doses were large, but I would give it a try..
Posted in cancer, Drugs
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Protocol for Treating Polycystic Kidney Disease Pain
Autosomal dominant polycystic kidney disease (ADPKD) can end up with such severe pain that they wish nephrectomy. I’m hoping this protocol reaches kidney societies that can lobby for aggressive pain treatment to keep things under control.
Posted in Abdominal pain, Injection
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Multiple Sclerosis (MS) Pain Treatment Options
I have an MS patient who was in bad shape when I started to see her – was using a walker. With various measures, she was much better. What worked? Vit D2 50,000 u weekly, B12 injections 1000 mcg subcut … Continue reading
Tip of Medial Malleolus- Possible Posterior Tibialis Tendonitis -Treatable Option – Os Subtibiale Bone Ossicle
Posterior Tibialis Tendonitis with medial ankle pain below medial malleolus is a difficult issue. The tendon is usually in process of tearing and so cortisone injection in not usually an option. On occcasion, a bone ossicle just below the medial … Continue reading
Posted in foot
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