Author Archives: admin

Knitting as Treatment For Hand Osteoarthritis

Case was recorded that got 75% improvement in hand OA condition by frequent knitting

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Chronic Tennis Elbow Might Be an Instability Issue

Chronic tennis elbow might involve instability in elbow joint. I remember being taught to always inject the radio-humeral joint and I can see why if much of the time pathology exists there. Might explain recurrence rates.

Posted in elbow | 1 Comment

Topical NSAID Ketophen or Diclofenac – Poor Showing

Topical anti-inflammatory drug would be the safest way to go in knee arthritis for example. Yet the number of patients needed to treat to help one case was Ketoprofen – one in 6.9 cases Diclofenac (Voltaren) – one in 9.8 … Continue reading

Posted in Drugs, Knee, Topical Pain Treatments | Leave a comment

Burning Mouth Syndrome – Could a Subgroup With Elevated B6 Levels be Helped by Stopping B6?

Recent study paradoxically found elevated B6 levels – up to 4 times normal in 1/6 of burning mouth cases and stopping B6 seemed to help in a case. Could this be of help in others?

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MRI God Fails Again – Peroneal Neuropathy

Peroneal neuropathy is a symptom complex of shin weakness, atrophy and foot drop, and knee pain. A common cause is a cyst in the nerve as it wraps around fibula. However, this will be missed in 64% of MRI negative … Continue reading

Posted in Knee, Leg Pains, neuropathic | Leave a comment

Pramipexole Stops MS in Animal Model – Helps Restless Legs, Fibromyalgia, and May Help Resistant Depression

In the mouse model of Multiple Sclerosis, Pramipexole, a antiparkinson drug, stops the brain neuroinflammation and that form of MS called “Experimental Autoimmune Encephalomyelitis”. This agent is used extensively for restless legs – Got MS and restless legs? – I … Continue reading

Posted in central & spinal, Drugs, Leg Pains, Uncategorized | 1 Comment

A Serious Version of Migraine with Aura – CADASIL

An heriditary version of migraine with aura could be cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Early on, nothing is evident even on MRI; but later, damage can be seen on MRI from this vasculopathy. Clinical features … Continue reading

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Maxillary Sinus Mucocele – Cause of Cheek Pain and Treatment

Patients with chronic allergies and chronic sinus conditions can end up with cysts in cheek sinus – the cyst does expand and causes remodeling pressure on bony margins and give pain with it. Sinus issues and pain in cheek? – … Continue reading

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Chronic Rectal Perineal Pain Helped by Simple Caudal Block

80 year old with sharp, intermittent, burning pain worsened on sitting down relieved by simple steroid caudal block when all other measures failed.

Posted in Back Pain, neuropathic, pelvic | 2 Comments

Post Herpetic Neuralgia (PHN) – Repeat Case – Pulse Radiofrequency (PRF) To Dorsal Root Ganglion Again Works

Case T7 PHN helped by PRF to dorsal root ganglion

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Post Dural Headache Treatments

Came across a wonderful list of drugs available for post-dural headaches: https://www.asra.com/content/documents/aug-14.pdf p13-14,23 If you can’t reach it, here is the list and more

Posted in Drugs, Headaches, Injection | Leave a comment

Instructions for Dealing With Calcific Tendonitis Shoulder

It has always been vague on the fine points of this techique. A beautiful account for this procedure is available in this newsletter: http://www.asra.com/content/documents/nov-13_asra_news.pdf on pages 14-17 I have included a summary for those who can’t reach it.

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Dying in Long Term Care Facility (LTC) Issues

Some LTC facilities are reluctant to be involved in end stage care as they already have a reputation as the place the old go to die. Those that embrace it, require more staff, as the dying have rights to increased … Continue reading

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ECG Evidence of Acute MI with Left Bundle Branch Block

A modified Sgarbossa criteria can be used to suggested and Myocardial infarct in the presence of a LBBB. Additionally, it has been suggested to look for “Wellen’s signs” in V1-6: Wellens’  Type A – biphasic pattern of T waves in … Continue reading

Posted in chest pain | 1 Comment

Chronic Migraines – Repeated Occipital Nerve Blocks Cut pain in 1/2 in 3 Months

Earlier I wrote about Nerve blocks controlling headaches. Quick Fix For Headaches – Repeated Nerve Supraorbital, Infraorbital, and Occipital Nerve Blocks – and What To Do For The Very Bad http://painmuse.org/?p=2886 Several protocols had been made up. This present one, … Continue reading

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New Treatment for Uncontrollable headaches New RX for Nummular Headache Underlying

Had one case where I treated unrelenting headache with repeated IV Dihydroergotamine and metoclopramide just to find, as patient settled, that headache originated from a painful patch on the scalp called nummular headache. This is often due to a crushed nerve … Continue reading

Posted in Drugs, Headaches | 1 Comment

Getting Carpal Tunnel Surgery? – Take Alpha-Lipoic Acid

Taking Alpha-Lipoic acid 800 mg/day for 40 days reduced pain and increased 2 point discrimination.  Some nerve operations are fought with problems (nerve transfer in cubital tunnel syndrome); now there is a help.

Posted in post-surgery persistent | Leave a comment

Achilles Mid-belly Tendonitis Could Be Plantaris Muscle Rupture

Pain in midportion achilles tendon medially could be a Plantaris muscle rupture. Eccentric exercises for Achilles tendonitis will not help.

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New -Mab Cuts Sickle cell crises in Half

Antibody biologic administered 14 infusions cut sickle cell crises from 2.98/yr to 1.63/year.

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Hopeless Case Of Lower Leg CRPS Helped by Pulsed Radiofrequency of Sciatic Nerve at Knee

Pulsed radiofrequency to dumb down treated nerve is becoming a useful adjunct to treating untenable pain CRPS states. Post hip fracture leg painv pain state left patient with VAS 6-7/10 with breakthru of 9/10.  Following dropped to 3/10 – after … Continue reading

Posted in complex regional pain, foot, Leg Pains, neuropathic | Tagged | Leave a comment

Good Cane Use

In Dr. Travell and D. Simon’s book they talk about proper cane position: – on opposite side to leg pain (it become good leg when you lift good leg)-shoulder horizontal with cane held out 15 degrees from body Now additionally, … Continue reading

Posted in Knee, Mechanical aids | Leave a comment

Vertebroplasty Does Work For Vertebral Back Compression Fractures

Clin Cases Miner Bone Metab. 2016 Sep-Dec;13(3):234-236. doi:10.11138/ccmbm/2016.13.3.234 Safety and efficacy of vertebroplasty in the treatment of osteoporotic vertebral compression fractures: a prospective multicenter international randomized controlled study. Leali PT, Solla F, Maestretti G, Balsano M, Doria C https://www.ncbi.nlm.nih.gov/pubmed/28228788 200 … Continue reading

Posted in Back Pain, Injection | Leave a comment

Kidney Stone – Renal Colic – Ketoralac and Nifedipine Superior to Ketoralac and Tamsulosin

Spanish journal which I do not get but results seem clear enough – ketoralac 60 mg ?IM and Nifedipine XL 30 mg by mouth give best results.

Posted in Abdominal pain, Drugs | Tagged | Leave a comment

Bacterial Overgrowth and Irritable Bowel Syndrome (IBS) – What is the Hypothyroid/Levothyroxine Connection?

Hypothyroid victims on Levothyroxime have a 3 times relative risk to having bacterial overgrowth and the IBS connection that goes with it.

Posted in Abdominal pain | 1 Comment

New Effective Treatment for Intractable Sore Mouth Mucositis

0.05% Methylene Blue oral rinse therapy was cheap and effective treatment for mucositis from chemotherapy or radiotherapy. Amazing result could be big help.

Posted in Abdominal pain, Drugs, ENT, Injection, neuropathic, skin | 2 Comments