Category Archives: Pathophysiology
Increased Connection Of Medial Prefrontal Cortex to Nucleus Accumbens(pleasure center) Predicts Chronic Pain
Saw recent talk by Dr. Apkarian where he noted overactivity of nucleus accumbens (pleasure center) in chronic pain – he called it “addicted to pain” (no relation to painkillers). Now this appears to be driven by increased white matter circuitry from … Continue reading
Minocycline is an IV tetracycline antibiotic known to inhibit glial cell changes at spinal cord level post injury and hence reduce post-injury nerve pain. In the rat model it reduces post burn pains.
Angiogensis and its accompanying nerves are evident in disc disease with the formation of neurovascular growth in the High Intensity Zone facing the spinal cord. Similarly, I have written how chronic tendonitis is associated with neurovascular growth. Now it appears … Continue reading
Recent Japanese article hilights spinal sensitization in neuropathic pain suggesting lidocaine and ketamine maybe should play bigger role
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
Quoted article starts by saying: “Many painful conditions occur more frequently in women, and estrogen is a predisposing factor. Estrogen may contribute to some pain syndromes by enhancing axon outgrowth by sensory dorsal root ganglion (DRG) neurons.” This effect may … Continue reading
Carbamazepine and Valproic acid have been found to be effective in bronchial asthma begging the question whether asthma involves neurological mechanisms similar to migraines or Trigeminal Neuralgia
NMDA receptors play a vital role in memory NMDA dysfunction is of course key to chronic pain, though there are non-NMDA pathways though the thalamus in mice…. NMDA blockage 2 days in a row with ketamine will cause temporary remission … Continue reading
Presentation at Canadian Association of Rehabilitation Professionals June 2007. Summation (version 1) here: Power points are here. 1) Disc disease(especially chronic) can often not be imaged and the worst chronic cases just show disc bulges. Disc disease and sciatica is … Continue reading
Does sudden withdrawal of Estrogen cause a “aromatase inhibitor pain syndrome” leading to increased musculoskeletal pain? One author thinks so.
Ever have a patient with a chronic cough unresponsive to anti-reflux, allergic rhinitis, and asthma treatment? Sensory Neuropathy might be the problem and Amitriptyline the answer.
Studies on Achilles, Patellar and Lateral epicondylar (tennis elbow)tendonitis have demonstrated the ultrasound demonstrable appearance of a “vasculo-neural growth” that corresponds to the site of pain. In long-term resistant cases, treating these lesions with sclerosing agent, polidocanol, under ultrasound guidance; … Continue reading
Sodiums channels are important in central and peripheral neuropathic pains. Morphine has no effect but Fentanyl (in Duragesic), Tramadol (in Tramacet), and Sufentanil (10 more potent fentanyl) do. This highlights there is a rationale for switching to a different opioid.
Transcendental Meditation can reduce thalamic response to pain by 40-50% – highlighting how relaxation training needs to be an integral part of chronic pain treatment