- Finger Bruising – Recurrent Spontaneous on
- Coccygodynia = Tender Coccyx – Inject Ganglion Impar on
- Reaching “Critical Mass” to Achieving Pain Control – Procedure Pearls on
- The Intercostobrachial Nerve(ICBN) -What is it and Why Can’t Breast Cancer Surgeons Deal Better With It? – and What Can You Do With It After. on
- ECG Evidence of Acute MI with Left Bundle Branch Block on
Category Archives: pain mechanisms
I have published on the use of ketamine to treat pain/depression/suicidality. Now a weak painkiller / partial painkiller blocker has been shown to help depression, not with one study, but with findings from twelve studies.
NSAID/arthritis pills have painkilling action centrally and this now appears to be related to its effect on opioid system. Unfortunately it means you can develop tolerance either because you are on an opioid or because its effects on descending inhibitory … Continue reading
I have a patient with psoriatic arthritis that had widespread pains. His rheumatologist told him it was “fibromyalgia” He developed such bad bronchitis I had to put him on steroids – at which point his “fibromyaglia” pains went away. He … Continue reading
Both duloxetine and pregabalin work by restoring brain down pain inhibition. Hence the work in people who have deficits in this system. There is a simple test to confirm functioning.
This was the title of a recent article in British Journal of Sports Medicine. It is what my blog is all about – recognizing that there are new things coming out every week that make a difference –
One Reason Osteoarthritis Bad in Canadian Prairies – Persistent Low Vitamin D Levels – and Supplements Prevent
I do vitamin D levels on all my patients coming in for physical – they are almost always low. – Recently demonstrated that persistently low levels of Vitamin D associated with accelerated osteoarthritis and helping that helps. …
A Fokl DNA gene polymorphism in the Vitamin D receptor would reduce its sensitivity to vitamin D. Vitamin D supports many metabolic processes beyond calcium and gene variations are even associated with certain cancers. In athletes, the FF Fokl genotype … Continue reading
Twin study shows low Epiandrosterone, a metabolite of dehydroepiandrosterone (DHEA). Could supplementation help?
A longitudinal – study – studying people before and subsequent to pains is the most reliable study format for figuring out what is going on.. What this study found was that it was the Musculosketal pain that caused the stress … Continue reading
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
4000 u/d vitamin D lessening Chronic Musculoskeletal Pains
Pain and Depression – Consider Brain Inflammation With Tumor Necrosis Factor (TNF) – and What About Brain Aging
Prior, I published a belief that depression in some cases was a manifestation of chronic pain for which ketamine could temporarily block. In this 21 page article they make clear connections between brain cytokine inflammation especially TNF (Tumor Necrosis … Continue reading
Fibromyalgia – Part of “Software Malfunction” is Dopaminergic/GABAergic Neurotransmission Disruption
Excessive pain due to brain central sensitization has been called a “software malfunction”. Part of that appears to be of Dopa/GABA circuits.
Fibromyalgia(FM) – Quetiapine XR (Seroquel) Reduces Pain Similar to Others and Reduces Depression – But Drowsiness High
FM could be considered a neurodegenerate disorder with certain degrees of brain loss and cognitive impairment evident. Some years ago I was at a presentation in which the brain damage evident in Fibromyalgia was bemoaned by speaker. Having dealt with … Continue reading
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
Chronic Back Pain May Be a Pamidronate Infusion Treatable Disease – And Why Did It take 10 Years to Replicate That?
For Chronic back pain – Pamidronate 90 mg diluted in 250 mls saline and given over 4 hours – initially and in 4 weeks resulted in 85% getting 100% relief at 6 months versus very little response in the placebo … Continue reading
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
What Determines Severity of Neuropathic Pain – The Neuropathicity, Not the Mood – and Good-Bye Fear Avoidance Model(FAM)
Factors such as pain on light touch (allodynia) and excessive pain on pinprick (hyperpathia) were strong indicators of pain severity. “Female gender, age, and history of serious mental disorders were found to be weaker indicators.” Psychological factors are played up … Continue reading
Recent study looking into factors involved in chronic pain in the elderly found subjects with central obesity were twice as likely to have pain problems. Various factors contribute.
In rodents were either afflicted with either: – peripheral nerve injury – string tied about sciatic nerve – sciatica / radiculitis – string tied about a lumbar nerve Botox injections into paw cut senstivity by 50% in the peripheral injury … Continue reading
Pain Hyperalgesia is a condition where “allegedly” you become more sensitive to pain once on opioids. This is used by opioid-haters that tell of doom to those on opioids. A Stanford associated study couldn’t find any and another failed to … Continue reading
Proteases are inflammatory chemicals like cytokines. They were first described in 1991 and have become a target for therapy. Now they are connected to chronic prostatitis.
The endorphin system in the brain and its counterpart enkephalin system in the spine help to shut down pain awareness in acute situations. Had a bad headache that suddenly disappeared? That is that system kicking in. This system is called … 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.
Cytokine (Immune chemical) diseases will become more clear in the ensuing years. Recently Tension headache was associated with higher Interleukin-6 levels.