Category Archives: neuropathic

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

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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 | 1 Comment

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

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

Vulvodynia or Pudental Neuralgia -Simple Repeated Injection Breakthrough Treatment

A simple perivulvar way to do pudental like blocks, if repeated, can lead to astounding improvement in pain in perineal areas – either vulvodynia or pudental neuralgia. I have achieved control in one case of either but don’t know yet … Continue reading

Posted in gynecologic, neuropathic, pelvic | Leave a comment

Shooting Trigeminal Neuralgia – Facial Epicrania Fugax – and a New Treatment

6-8 years ago a brief neuralgic pain in the scalp that radiated to front or back of head was described. I wrote about it here: http://painmuse.org/?p=1516 Now a facially originated version has been defined and sounds very much like trigeminal … Continue reading

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Topical Clonidine or Capsaicin For Diabetic Neuropathy and Mannitol

Both clonidine 0.1% gel and capsaicin 0.75% cream three times daily can drop pain by 40% in 12 weeks though clonidine causes less skin irritation.

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Celiac is More Painful Than Thought – and What Does That Mean?

In seeing new pain patients, I became painfully aware that Celiac or at least gluten sensitivity has a definite presence- so much so that I always looked for it. Now, it looks like “anybody is fair game” now that even … Continue reading

Posted in Abdominal pain, celiac, Fibromyalgia, Leg Pains, neuropathic | 1 Comment

Severe or Neuropathic Groin Pain – Obturator Neuropathy

Have and elderly fellow that just persevered with severe left groin pain as was just something he should put up with. He had not been sleeping and daughter noted cognitive decline with it. Exam of hip was a bit sore … Continue reading

Posted in groin pain, Hip Pains, Injection, neuropathic | 1 Comment

Diabetic Neuropathy – B12 Helps While Vegan Diet Minimal Effects

Though 20 week vegan diet touted as helping diabetic neuropathy, its pain levels were no different than the B12 control and the foot skin conductance was not different. Only diffence was in McGill Pain questionnaire in the sensory fields. Unfortunately, … Continue reading

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Diabetic Neuropathy: Duloxetine Mediocre Results

For Diabetic Neuropathy – Recent study in China showed statistical significant drop of pain on Duloxetine but not clinically significant. – Have a look.

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DN4 Outperforms In Diagnosis of Cancer Neuropathy

Douleur Neuropathique in 4 Questions (DN4) proved more sensitive to neuropathic pain in cancer than the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) – 87.5% for DN4 versus 68.1% for LANSS in sensitivity. However LANSS had slightly better specificity … Continue reading

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Amitriptyline – Not Much For Neuropathy Really

The initial study of use of Amitriptyline was a study with diabetic neuropathy where patients were subject to impressive coaching (calls from nurse and pharmacist) . That way doses of 75-150 mg were obtained. They were able to show benefits. … Continue reading

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Algorithm For Post Hernia Pains

Concise choice selections for what to do with nerve damage level post hernia pains. I love algorithms – they are so practical.

Posted in neuropathic, Post Hernia | Leave a comment

Resistent Post Herpetic Neuralgia Treatments – IV Magnesium for Neuropathic Pains

Three IV Magnesium  1mg /k in 100 mls saline  infusions over 1 hour – one every other day or Three 1 mg/kg Ketamine in 100 mls saline infused in over 1 hour ketamine  one EOD resulted in 7/15 magnesium and … Continue reading

Posted in central & spinal, complex regional pain, Drugs, IV therapy, neuropathic, Pain Dystrophy, post herpetic neuralgia, radiculitis | 1 Comment

Is Sensitive Skin Neuropathic?

Study in Dermatology journal suggests 1/5 of subjects test positive with quiz DN4  for neuropathy

Posted in mast cell disease, neuropathic | Leave a comment

Complex Regional Pain Syndrome (CRPS) – Finding Immune Mechanims Offers New Treatments

Finding high levels of  beta2 adrenergic receptor autoantibodies in CRPS cases might explain why steroids, tumour necrosis factor (TNF)-alpha antagonist Adalimumab, IV Immmunoglobulins, and in present article Plasmapheresis can help in selected cases. In present study, these antibody titres fell … Continue reading

Posted in Botox, complex regional pain, Drugs, Injection, IV therapy, neuropathic, Pain Dystrophy, Stimulation | 1 Comment

Low Dose Neuropathic Pain Drugs Only Work in Combo – and then only a Bit

Neuropathic pain drugs by self have mediocre effects – often dropping pain by </= 2/10 points. At low dose Imipramine 75 mg/day and Pregabalin 300/day did not have significant benefit but the combo dropped VAS by One more than placebo … Continue reading

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