Category Archives: Injection

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 | 4 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.

Posted in Botox, Injection, Knee, shoulder | Leave a comment

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 | 7 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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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

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Post Hernia Surgery Pain Nerve Blocks No Help In Moron Study

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

Posted in Injection, neuropathic, Post Hernia | Leave a comment

Glossopharyngeal Neuralgia – Treated by Steroid Injection and Amitriptyline

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.

Posted in Injection, neuropathic, Trigeminal Neuralgia | 1 Comment

Sciaitica, Bone Cyst in Ilium, and Gluteal Tight Muscles – down right leg – needs help

Chronic sciatica /buttock pain  – I recently received a request for help…

Posted in Back Pain, Hip Pains, Injection, myofascial pain, neuropathic, piriformis, radiculitis | 1 Comment

Chronic Migraines – Botulinum Helps

Repeated OnabotulinumtoxinA shots can reduce chronic migraine headache frequency from 20 headaches/month to 10/month.

Posted in Botox, Headaches, Injection | Leave a comment

Ganglion Impar Injection For Tailbone Coccydynia

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.

Posted in coccygodynia, Injection | 4 Comments

Injecting Painful Scars

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.

Posted in Injection, neuropathic, Post Hernia | 1 Comment

Resistent Tennis Elbow – Platelet Rich Plasma May be No Better Than Whole Blood Injection

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.

Posted in elbow, Injection, Uncategorized | 4 Comments