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Category Archives: Drugs
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
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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
Posted in Drugs, neuropathic
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Vitamin D – Could High Doses Help Pains?
4000 u/d vitamin D lessening Chronic Musculoskeletal Pains
Posted in Back Pain, Deficits, Drugs, Fibromyalgia, myofascial pain, pain mechanisms
4 Comments
Neuropathic Pain 2015 and…
Mayo clinic has a review but lacks imagination
Posted in Botox, Drugs, Fibromyalgia, neuropathic
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Donepezil reduces stress induced widespread pain in mice so…
Donepezil (aricept) is used as an anticholinergic to help dementia. In the animal model repeated use can “cure” “ICS[Intermittent Cold Stress]-induced hyperalgesia [increased pain] and allodynia[touch pain] even after the cessation of drug treatments”
Posted in Drugs, elderly, Fibromyalgia
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Breathtaking Option for Treatment Resistant Fibromyalgia
A Water pill, Spironolactone 100-200 mg/day, can dramatically relieve pain in potentially 1/2 of Fibromyalgia cases and reduce morphine needs.
Posted in Drugs, Fibromyalgia, neuropathic
2 Comments
Opioids Affect Immunity
Opioids can lower resistance to infections. Had on lady get couple of pneumonias which made me reconsider which types of opioids to use in these cases.
Posted in Drugs
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Pamidronate in Severe Knee Pain
Filling in my contention that pamidronate is very useful in Complex Regional Pain Syndrome, is an older article using it for CRP of the kneecap.
Posted in complex regional pain, Drugs, Knee
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Desimpramine For Neuropathic Pain a Myth
Use of Tricyclic antidepressants (TCA)’s for neuropathic pain was based on an article for diabetic neuropathy where, through frequent phoning and support, authors were able to get patients up to 150 mg. No one has succeeded in getting people up … Continue reading
Posted in Drugs, neuropathic
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Acetaminophen (paracetamol) does not work in acute Back Pain
Double blind study found Paracetamol (acetaminophen) at average dose of 3500 mg/day in week 1 and 2800 mg/day in week 2 for the regular group was not better than placebo. It had `no eff ect on pain, disability, function, global … Continue reading
Case of Wrist Complex Regional Pain (CRPS) Helped by Dextroamphetamine
While dealing with infertility with dextramphetamine, patient’s wrist CRPS pains issues subsided
Posted in complex regional pain, Drugs
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Methotrexate for Knee Osteoarthritis
On methotrexate up to 25 mg/week orally, 53% had over a VAS drop of 2.0/10 while only 24% had in control group.
Posted in arthritis, Drugs
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Osteoarthritis – Does Sierrasil Work? – No
One of my patients started on Sierrasil and said there was literature on its effectiveness – it does not say that it helps pain though..
Posted in Drugs, Knee
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Cytokine Storm – Treatment with Etanercept – Could it Stop Influenza Death?
Mild cytokine reactions give you a flu like situation where achy all over and malaise. Cytokine storm occurs with certain viral infections and can kill. Etanercept (Enbrel) can block that effect some in the mouse model infected with H1N1.
High Dose Metoclopramide (20 mg IV over 15 min) Beats Subcut Sumitriptan (Imetrix) 6mg For Acute Headache
Metoclopramide 20 gm IV was VAS pain score 0.55/10 better on VAS than Sumitriptan injectable 6 mg. However, the later needed starting an IV and slow infusion over 15 minutes to avoid extrapyramidal oculogyric crisis (0.2% incidence with the 10 … Continue reading
Posted in Drugs, Headaches
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In Unilateral Chronic Episodic Headaches – Should Prolactin Levels Be Done?
Recently a series of patients with Prolactinomas (a pituitary prolactin – secreting tumor in brain) was published. They found they often presented with either one sided migraines (often orbital) or SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing). … Continue reading
Posted in Drugs, Headaches
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New Daily Persistent Headache Lasting Over 1 Year Responding to Nimodipine (Nimotop)
Case of thunderclap (severe sudden onset) headache associated with inability to do calculations (acalculia) that persisted for 13 months despite interventions. Nimodipine 30 mg, initially bid, then od, relieve headache. It was felt that cytokines and vasospasms persisted the headaches. … Continue reading
Posted in Drugs, Headaches
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Unresectable Painful Bone Cysts – IV Zoledronic acid For Adults and IV Pamidronate For Children Gives Rapid Relief
Painful large and unresectable bone cysts responded rapidly to IV biphosphonate therapy within first cycle in 88% of cases. Adults received 4 mg of Zoledronic acid (Zometa®, Novartis), and children got IV pamidronate 1mg/kg. Zoledronic acid, if more than one … Continue reading
Posted in Back Pain, children, Drugs, Hip Pains, IV therapy
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Reaching “Critical Mass” to Achieving Pain Control – Procedure Pearls
I have recently achieved (previously unattainable) control in some of my chronic pain subjects using recent innovations – but to acheive this required use of multiple modalities at once.
Carpal Tunnel Syndrome and Vitamin B6
For years, it was suggested that people with carpal tunnel should take B6, but it fell out of favour ( in my mind) when excessive B6 was found to be neurotoxic. Now a recent study has confirmed use of B6 … Continue reading
Posted in Drugs, hand, neuropathic
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Is Nortriptyline Any Good? – Maybe – but Maybe Only a Bit
Recently, nortriptyline has been touted as good anti-neuropathic drug but thoughts of its use have extended into use for chronic pain in general. Well, it doesn’t work for back pain, sciatica or migraines so that might need reanalysis.
Posted in Back Pain, Drugs, neuropathic
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What Have We Really Learnt About Opioid Overuse – Part is Over-Reliance on Pills to Treat Chronic Pain
Over-reliance on opioids is due to poor training of physicians in manual medicine and injection techniques. What techniques? – look at my blog and at the proliferation of chiropractors. Most of chronic pain has a major myofascial component that is … Continue reading
Posted in Drugs, Manual Med
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Could Statins Help Prevent or Treat Neuropathy?
After classic sciatic nerve constriction in rats, spinal/nerve elevations of Tumor Necrosis Factor (TNF), matrix metalloproteases (MMP-2) and nerve growth factor (NGF) were some ameliorated by Atorvastatin. In a human case report, atorvastatin reduced neuropathic pain.
Posted in Drugs, neuropathic
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Antidepressants Just Don’t Work on Descending Inhibition
Neurobiol Dis. 2013 Dec;60:39-50.Antidepressants suppress neuropathic pain by a peripheral β2-adrenoceptor mediated anti-TNFα mechanism. Bohren Y, Tessier LH, Megat S, Petitjean H, Hugel S, Daniel D, Kremer M, Fournel S, Hein L, Schlichter R, Freund-Mercier MJ, Yalcin I, Barrot M. … Continue reading
Posted in Drugs, neuropathic, Uncategorized
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Both Subcutaneous and Perineural Botulinum Treatments Advocated
Review has concluded both subcutaneous and perineural treatments are effective in neuropathic pains.
Posted in Botox, Drugs, neuropathic
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