Category Archives: neuropathic

Capsaicin 8% Patch in Peripheral Neuropathy Not Diabetic but at a Cost…

Capsaicin 8% patch was compared to pregabalin (lyrica) for effects on non-diabetic peripheral neuropathy.  A treatment with Capsaicin can cut skin sensitivity (dynamic mechanical allodynia) in half and render 29% free of sensitivity. Was embarrassed to publish this once I … Continue reading

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Upper Facial Pain Treatment- Home Based Sphenopalatine Block

About eye, forehead, and temple pains from headache source, or surgery can be disabling yet responsive to blocks of the back of nose. The description is laid out in an online article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545953/ or you can read my version.

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Post Craniotomy Headache Local Treatments

Post-Craniotomy Headaches are annoyingly common – “Headaches following craniotomies are reported in up to 91% of neurosurgical cases”.  Injecting craniotomy edge defect triggers,  scar neuromas, and botulinum to temporalis muscle are local treatment options.

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What can One Do For Severe Limb Pain? Epidural Motor Cortex Stimulation

Severe limb pain unresponsive to treatment ends up a surgical problem with spinal or ganglion stimulation becoming more common. A pain pump is an option. Motor cortex stimulation is as well, if pain is localized.  This is technically more difficult … Continue reading

Posted in complex regional pain, neuropathic, Stimulation | Leave a comment

What are the Causes of Polyneuropathy?

Recent study gave a breakdown of what they found re cause. Frank diabetes was eliminated from selection as the cause would be obvious? Top 4 were Idiopathic 47%, Chronic Demyelinating Inflammatory Polyneuropathy(CIDP) 38%, Pre-diabetes 16%, and Charcot Marie Tooth syndrome … Continue reading

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Does Small Fiber Neuropathy Progress?

Approximately 40% of “Fibromyagia” cases are actually small fiber neuropathy (SFN). There is now evidence of how this type of neuropathy progresses. 75% remain stable and 25% progress into large fibers.

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Nasal Neuralgias – What to Do

A Nose pain issue with pain out of control could represent a nasal neuralgia with  a treatable injection regimen.

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Lateral to Upper Eyelid Lacrimal Neuralgia

Poorly known pain condition affecting outer eyelid and temple area. Such conditions I thought no one would care about but have had thank you’s in past so here it is.

Posted in eyes, neuropathic | 1 Comment

Cheek Pain – New Zygomaticofacial Neuralgia

The  Zygomaticofacial Foramen  is 2 cm lateral and 2 cm inferior to the lateral canthus  (edge)  of the eye. A case of neuropathic pain from there that responded well to injection is documented.

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New Test for Neck Radiculitis

I have now seen 2 cases of idiopathic cervical “sciatica”/radiculitis with stickingly bad pains in triceps. This arm muscle pains can help distinguish this from intrinsic shoulder pains and one author some years ago came up with the arm “squeeze” … Continue reading

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Want Do You Do For Desperate Neuropathy? – Implantable Pain Pump

Some years ago, Neuropathic study demonstrated meaningful reduction in neuropathic pain occurred in only 23.7% of cases. Severe Neuropathic Pain – Only 1/4 Respond to Standard Drug Protocols – What Else Is There?   http://painmuse.org/?p=2640 Subject of present article was case … Continue reading

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Chronic Severer Abdominal Pain – Why Has It taken So Long To Realize it’s Partly the Abdominal Wall and Treatable?

Early last year I wrote about my experience chronic severe abdominal pain as it being from the abdominal wall: Chronic Severe Abdominal Pain is a Skin Nerve Pain http://painmuse.org/?p=4840 Now, someone has taken it a step further by doing a … Continue reading

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Median Nerve Flossing for Neck- Arm Pains

Several years ago I listened to a talk on using nerve “flossing” mobilizations to help victim with hypermobility issues. This would stretch the nerve in their “tracts” and help reduce pain. They were taught to do a routine -repeated like … Continue reading

Posted in arm, Neck, neuropathic, radiculitis | 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

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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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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

Peripheral Neuropathy Pain Unresponsive to Creams – Try 5% Doxepin

Child cancer case where chemotherapy induced peripheral neuropathy pain was not helped by usual topicals was helped by 5% doxepin cream

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Buttock-Posterior Thigh Neuropathic Pain – Posterior Femoral Cutaneous Nerve Injury and Treatment

Pain in butt and hamstring is not uncommon and usually involves hamstring. However, neuropathic level pain in areas can happen after surgery or injection suggesting nerve damage to Posterior Femoral Cutaneous Nerve. Present article used cryoablation successfully to treat.

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Refractory Burning Mouth – Try Clonazepam and Venlafaxine

Venlafaxine (300 mg/d) and Clonazepam (5 mg/d) in Refractory Burning mouth – All responded with a reduction in pain from 8.6/10 to 3.2/10 after 3 months

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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 | 3 Comments

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

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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 … Continue reading

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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

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