Category Archives: Back Pain
At least in low back, it looks like after 3 months, it gets as good as it gets.. Almost 1/3 might end up poorly so thoughts of IV pamidronate or vertebro/kypho plasty might need consideration.
Review of multiple studies found no surprises: “a medium-firm mattress promotes comfort, sleep quality and rachis alignment.”
I see often older men wearing belts who solemnly come in with nerve-like pain level at low back and flank level. I tell them I can treat this – but they are going to laugh – because what is a … Continue reading
Steroid injection of SI joints can be very helpful. It is more common than one would think as is seen in post-traumatic cases, in celiac disease, in various colitis, and in certain Fibromyalgia misdiagnosed subgroups. I highlight this study so … Continue reading
Although the question of whether one is dealing with hip bursitis or is this referred from back is important, I wanted to clarify what steroid injection would do for seemingly glutues medius bursitis. One study suggests it was good in … Continue reading
Looking for cheap and easy techniques to treat pain, I came across a treatment for back pain using the slump test. Sitting with legs out straight and your feet flat against a wall, you slump forward and put your head … 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
Diffuse idiopathic skeletal hyperostosis (DISH) is were you get extensive ossification of ligaments and entheses(endings of tendons and ligaments). It is relatively common (10% of people over 50). If you get boney bridging of vertebrae you can get a very … Continue reading
I have a case of long term piriformis syndrome that I have been whittling away for some time. To be fair, she has seen multiple specialists and is some better but not enough to improve quality of life, (old sad … Continue reading
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