Category Archives: neuropathic

Nerve Pain? – 21st Century Gene Therapy

Since the early 2000’s experiments gene therapy experiments have been done on rodents using a non-replicating (Not growing) version of Herpesvirus (cold sore virus). The virus’s genetic machinery has been altered so it makes ingredients for enkephalins (spine cord morphine-like … Continue reading

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Ounce of Prevention is a Pound of Cure For Neuropathic Pain

Chronic administration of minocycline (a tetracycline antibiotic) started 7 days prior to nerve injury prevented neuropathic pain in the animal model – This offers exciting possibilities for preventing post surgical pain conditions.

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Post-mastectomy Neuropathic Pain Cure – Lymph Node Transplants

Pain post mastectomy can be an important issue. Associated with the pain is swelling called lymphedema. Now it appears transplanting lymph nodes from the groin can resolve the pain and lymphedema

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IV Magnesium Studies

There was recent mention on using IV Magnsium in acute migraines in a previous blog note. I had used it in combination 1-2 gms Magnesium sulphate with lidocaine 100 – 200mg IV for migraines but was not impressed that it … Continue reading

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New Hopes for Leg Phantom Limbs

Phantom limb pain is suprizingly resistant to treatment and some articles on the subject have concluded “put them on opioids – perhaps methadone”. Now come two different approaches to treating the leg version of this – memantine and pulsed radioifrequency.

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Acute Nerve Injury – Try Gabapentin and Tramadol

After a sciatic nerve as accidentally injected, gabapentin and tramadol helped the pain until some recovery came about.

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Diabetic Peripheral Neuropathy – Pregabalin to 600mg or bust

I am used to 75-150 mg doses of pregabalin but doses of 300 mg BID are being used for diabetic peripheral neuropathy.

Posted in Drugs, neuropathic | 1 Comment

Neuropathic Pain More Spinal and there are potentially better treatments

Recent Japanese article hilights spinal sensitization in neuropathic pain suggesting lidocaine and ketamine maybe should play bigger role

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Fast Fix for Shingles Pain – and Doctors: For God’s Sake – Give a Block!

Nerve blocks combined with tricyclic antidepressants gave rapid relief of pain in 80% cases in one Japanese report. I feel nerve blocks or epidural blocks are manditory for any cases of shingles in which the current acutely infected pain would … Continue reading

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Super Capsaicin for Neuropathic Pain Control Looks Promising

The use of a SINGLE application of a 8% (vs 0.025 – 0.075 usually used) capsaicin patch (NGX-4010) resulted in significant relief for over 12 weeks in HIV neuropathic pain. Given the old technique (4 X/day gel application for two … Continue reading

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Microglia Key to Neuropathic Pain

While much is written about gimped NMDA receptors in chronic pain, the innocuous support tissues in the spinal cord, the “glial cells”, turn out to be a big player. An inhibitor of these cells, clopidogrel – known as Plavix – … Continue reading

Posted in neuropathic, Pathophysiology | 2 Comments

Post Hernia Surgery Helped by TENS and Should Surgeons be Doing Hernia Repairs if They do Not Know How to Deal with the Persistent Pain Afterwards?

Pain after hernia surgery is common. Transcutaneous nerve stimulation (TNS) seems to help post operatively and one wonders if it might have lasting effects. I was always taught that one should not do a procedure unless one can deal with … Continue reading

Posted in neuropathic, Post Hernia | 40 Comments

Pamidronate and Clodronate – hope for CRPS and Back Pain

Pamidronate can significantly help over 3/4 of RSD and reduce chronic back pain through a series of simple infusions. It is expensive and because of a poorly designed negative study, has not reached full acceptance for the good it can … Continue reading

Posted in complex regional pain, IV therapy, neuropathic | 12 Comments

Etanercept (Enbrel) for Radiculitis (Sciatica)

The common and disabiling pain condition is chronic lumbar radiculopathy (chronic back pain/Sciatica). Despite the widespread promotion of treatments of neuropathic pain a recent analysis of neuropathic pain treatments has concluded the following: “To date, no medications have demonstrated efficacy … Continue reading

Posted in Back Pain, Drugs, Neck, neuropathic, radiculitis | 35 Comments

Varicella shots for shingles but tests ?useless

In 2005, a super-potent varicella-zoster vaccine established a 50% reduction in shingles over a 3 year period but left disturbing issues over whether the increased strength was necessary or a marketing ploy. Recent Zoster immunity testing locally cast doubt on … Continue reading

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