Category Archives: Injection

Post Breast Surgery Pains – Nerve Blocks Help

Post breast cancer surgery Pains are often do to injury to the Intercostobrachial nerve. Up to now, there has been little literature on whether blocking nerve actually helps – now a pilot study suggests pain can be cut in half.

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Frozen Shoulder – Just a Little Cortisone But More Blocks Help

Study found 20 mg Kenalog worked as well as 40 mg and another found you don’t even need to hit the joint. I supplement suprascapular and quadrilateral space blocks as well as subscapularis working out.

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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

Neck Pains From Atlanto-Occipital Joints

Top joint C0-1 refers to upper neck, face and upper shoulder tips. Exam requires you to grip c1 transverse processes and nod neck sideways. Certain manual techniques might help.

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Coccygodynia = Tender Coccyx – Inject Ganglion Impar

One Ganglion Impar injection achieved over 50% improvement for 82% of cases that lasted an average of 6 months.

Posted in coccygodynia, Injection | 3 Comments

Post-Herpetic Neuralgia – Transforaminal Epidural Steroid Injection Might “Cure” And New Injection Rules

Several case studies have shown that transforaminal steroids could relieve Post Herpetic neuralgia (PHN) but that procedure is under heavy scrutiny because of rare strokes, paralysis and death so use of soluble dexamethasone has been edicted.

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Sacroiliac Joint Injection Proposal

Given that I do not have Ultrasound (got rid of old one – filled a room), I have developed a SI joint technique and would like opinion re such. Also I will refer to article using SI injections.

Posted in Back Pain, Injection | 1 Comment

Chronic Back Pain Is a Painful Vertebral Body Problem

One study demonstrates that chronic back pain is associated not so much with plain disc degeneration but with disc degeneration combined with end plate or vertebral body schmorl nodes. Another study found that people with back pain and modic type … Continue reading

Posted in Back Pain, Injection, Insurer issues, pain mechanisms | 3 Comments

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

Lumbar Spinal Stenosis – German View

With a recent negative American view, it is nice to have a more encouraging German perspective. Though 2/3 go to surgery, 1/3 can be managed with physiotherapy, cycling exercise, psychotherapy, and injections – epidural, paraspinal, facet and sacroiliac.

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Caudal Block- Just Going Thru Sacrococcygeal Ligament only Works 68% of Time But…

It has been suggested just going thru sacrococcygeal ligament is enough to get into epidural space. Imaging shows it works 68% of time, while advancing up 1 cm works 95.8% of time. However, intravascular injection occurred 25% of time where … Continue reading

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Methylene Blue Disc injection for Chronic Disc disease

Methylene blue injections were an exciting option after a Chinese article was published in PAIN glowingly detailed great responses to intradisc injections. Dr. N. Bogduk, at time, wrote an editorial suspicious that Chinese patients might be reluctant to admit they … Continue reading

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Spinal Stenosis – Biased Report Ignores Benefits of Epidurals

Epidural injections can reduce pain from spinal stenosis but fact is, very little of the effect is from the steroid. It can reduce pain from 6.6-6.7 to lower 4’s in 3 and 6 weeks – this is a drop of … Continue reading

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Nocturnal Calf Cramps – Trigger Injections Help

Injections into gastrocnemius not only helped nocturnal calf cramps – they helped the insomnia as well

Posted in Injection, Leg Pains, myofascial pain | Leave a comment

Remarkable New Treatment – Injecting Over Tenderized Skin Nerves With Plain 5% Dextrose

For year I felt the main expression of chronic pain was through activation of myofascial knots – now it looks like tenderized skin nerves is a front runner. Merely injecting D5W overtop tenderized nerve tracts an average of 6 weekly … Continue reading

Posted in Back Pain, Injection, Leg Pains, Neck | 3 Comments

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.

Posted in arm, Back Pain, Botox, complex regional pain, Drugs, Fibromyalgia, Headaches, Injection, IV therapy, Leg Pains, Manual Med, myofascial pain, Neck, neuropathic, Pain Dystrophy, piriformis, post herpetic neuralgia, radiculitis, shoulder, Uncategorized | 7 Comments

Failed Knee or Shoulder Arthroplasty? – Intra-articular Botox Injections Help

50% reduction of pain was reported in about 1/2 of post shoulder and knee arthroplasty pain cases with Botox injections. This was sustained by repeated injections.

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Human Chorionic Gonadotrophin (HCG) Touted as Only Curative Agent For Pain That Has Centralized

When pain becomes severe, constant, and unremitting –  chances are high the pain has imprinted on the brain and centralized. This is a tragic disease with poor treatment options. In those that persisted with treatment (failures may have dropped out?) … Continue reading

Posted in central & spinal, complex regional pain, Fibromyalgia, Injection, neuropathic, pain mechanisms | 1 Comment

New Rx For Chronic Abdominal Pain – Pulse Radiofrequency to Bilateral T10-T11

Patient with abdominal wall pain and no distinct triggers had bilateral pulse radiofrequency to T10 and 11. This brought pain levels down from 6/10 to 1/10 at 10 weeks by procedure and still relief after 10 months. Though their case … Continue reading

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Quick Fix For Headaches – Repeated Nerve Supraorbital, Infraorbital, and Occipital Nerve Blocks – and What To Do For The Very Bad

Series of 3 simple eyebrow, just below eye and bottom of skull posterior injections can give long-lasting relief of headaches. Now, just to get family doctors to pick up a syringe…

Posted in Headaches, Injection | 2 Comments

Bolulinum Works as Well as Steroid in Frozen Shoulder – Isn’t it About Time We Think About Combining The Two?

A recent article shows that botulinum  and steroid have similar durations of action in adhesive capsulitis – ie Frozen Shoulder. I have given both triamcinolone and botulinum (at separate times) into knee joints and noticed the combination can cause a profound … Continue reading

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Severe Neuropathic Pain – Only 1/4 Respond to Standard Drug Protocols – What Else Is There?

Presentation at Canadian Pain Society Winnipeg 2013 found only 23.7%  of severe neuropathic pain victims responded to Canadian Pain Society drug protocols for neuropathic pain. It is time to look outside the box for treatment measures.

Posted in Drugs, Fibromyalgia, Injection, IV therapy, Manual Med, myofascial pain, neuropathic, Pain Dystrophy, piriformis | 9 Comments

Post-Herpetic /Shingles Neuralgia – Benefits of Local B12 Injections

Two separate chinese articles discuss use of B12 in the period immediately after shingles  and also, in a separate study, later. Each shows benefit. Note should be made that they used methylcobalamin – the bioactive form of B12

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The Missing Aspects of Tennis Elbow Treatment – Axillary and Scapular Triggers to Treat Segmental Hypersensitivity

Chinese article claims adding injections to “dorsal scapula” triggers and sore spot in axilla can allow lateral epicondyle injections to work 100% of time.

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Post Herpetic Neuralgia / Shingles – Micro-knifing Tender Areas (Acupotomy) Reduces Pain 60% and Persists over Course of 6 – 12 Months

Previously, there was a technique involved producing 2nd degree frost burns in tender post-herpetic neuralgia areas –  as a means to reduce pains. Suzuki H, Ogawa S, Nakagawa H, et al. Cryocautery of sensitized skin areas for the relief of … Continue reading

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