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Category Archives: Injection
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
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.
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
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
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
Injections into gastrocnemius not only helped nocturnal calf cramps – they helped the insomnia as well
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
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.
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.
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
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
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…
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
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.
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
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.
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
Steroid Epidurals Results Might Be Minimized By Fact Steroid Mineralcorticoid Effects are Pro-Inflammatory and Nociceptive
Steroids effect two processes/receptors – a glucocorticoid pathway, and a mineralcorticoid one. The glucocorticoid pathway has strong anti-inflammatory and immunosuppressive effects. The mineralcorticoid pathway works more on retaining salt. The latter has been found to have pro-inflammatory effects which might have … Continue reading
Rather than using a nerve probe to see if needle is in right position to refer to painful area, ultasound was done. In only 1 case was the right nerve area hit by injecting ilioinguinal and iliohypogastric nerves seen so they assumed nerve … Continue reading
I got a question on what could be done for Glossopharyngeal neuralgia and came across this article on repeated bilateral intraoral glossopharyngeal nerve injections and amitriptyline as an alternative.
Chronic sciatica /buttock pain – I recently received a request for help…
Repeated OnabotulinumtoxinA shots can reduce chronic migraine headache frequency from 20 headaches/month to 10/month.
Previously for ganglion injection, , injection through the sacrococcygeal joint has been suggested. Recent information has found the ganglion is actually lower in the first intracoccygeal joint level. Injection of this ganglion is an important treatment for coccydynia.
Intradermal injections of local and subcutaneous injections of steroid have been used for scar pain. This study compared intradermal dexamethosone and botox and got 25% and 30% relief repectively lasting 4 and 8 weeks respectively.
Both whole blood and platelet rich plasma work in resistent tennis elbow – but it takes 3 month for most improvement. There is no statistical difference between the 2 therapies.