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Category Archives: Back Pain
Twin study found only a weak relationship between sedentary lifestyle and chronic back pain – and found it only in women and when corrected for genetics -was only weak.
Spine J. 2017 Jul;17(7):905-912. doi: 10.1016/j.spinee.2017.02.009. Chronic low back pain and the risk of depression or anxiety symptoms: insights from a longitudinal twin study. Fernandez M https://www.ncbi.nlm.nih.gov/pubmed/28267634 “The relationship between chronic LBP and the future development of depression or anxiety … Continue reading
In Chronic Low Back Pain and Radiculopathy (sciatica) epidurals are used with varying success. “The mean length of relief duration is 38.37 weeks for individuals without painful lumbar extension and 14.68 weeks for individuals with painful lumbar extension.” CONCLUSIONS:: The … Continue reading
Study on SI belts for pregnancy back pain found it reduced pain by 2/10.
Failure Back Surgery Post Laminectomy Pain Treatment- New High Frequency or Burst Mode Spinal Stimulation
Spinal stimulation is primarily for the sciatica -only 1/2 of back pains respond.. This leave a subgroup, with predominately back pain, with a need for options. High 10 Kz frequency stimulation and Burst stimulation are two options.
Job Rotation reduces wrist and hand pains but doesn’t do much else according to a review.
SI joints generate significant amount of lateral thigh and inguinal area pains. About 1/3 will complain of lateral thigh numbness as well.
I contend antidepressants help very little in back pain and waiting for it to work before starting painkillers is an unethical abomination. Studies showing any benefit in the last century are laughable because dosages used would not be achievable today. … Continue reading
Imaging spine in Crohn’s Colitis found evidence of spondyloarthritis (active spine arthritis) in 1/2 of cases. Have a case of “arrested” crohn’s disease (there is usually evidence of continued activity in stool secretion – see http://painmuse.org/?p=374 re that) with chronic … Continue reading
For Sciatica & spinal stenosis steroid epidurals are used but controversy exists over whether there is any benefit of particulate over soluble steroids. It would seem obvious that a steroid that last weeks would be better than one that last … Continue reading
The MRI GOD is struck another blow – interpretation is so variable, the authors states “As a result, the authors conclude that where a patient obtains his or her MRI examination and which radiologist interprets the examination may have a … Continue reading
80 year old with sharp, intermittent, burning pain worsened on sitting down relieved by simple steroid caudal block when all other measures failed.
Clin Cases Miner Bone Metab. 2016 Sep-Dec;13(3):234-236. doi:10.11138/ccmbm/2016.13.3.234 Safety and efficacy of vertebroplasty in the treatment of osteoporotic vertebral compression fractures: a prospective multicenter international randomized controlled study. Leali PT, Solla F, Maestretti G, Balsano M, Doria C https://www.ncbi.nlm.nih.gov/pubmed/28228788 200 … Continue reading
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
Re back pain and sciatica – Astoundingly, you can get 50% back pain reduction short term and 30% relief long term with repeated simple injection of D5W sugar water given caudally. Caudal injection has been dumbed down to a simple … Continue reading
Not all that long ago, Canadian Indian Affairs mandated that native pain sufferers had to try gabapentin/cymbalta like drugs first before certain opioids. I wrote about how poorly cymbalta worked: http://painmuse.org/?p=2179 Now even gabapentin failed to help back pain with … Continue reading
Many years ago I was injecting enbrel paraspinously near the nerve exit of sciatica nerve location. I was using a full 25 mg and found it had minimal effects. I wrote E. Tobinick at times and wondered if it was … Continue reading
Touching spinous processes in back can elicit pain, and may coexist with other problems so be easily missed. Cortisone injection is the first line treatment. I might have seen one lately that was puzzling that it was so localized – … Continue reading
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.
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
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