Category Archives: Back Pain

Sedentary Lifestyle Only Weakly related to Chronic Back Pain – and Only in Women – Twin Study

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):933-942. doi: 10.1016/j.spinee.2017.02.004. Does sedentary behavior increase the … Continue reading

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Depression in Chronic Back Pain? – Twin Study Suggests More Familial Than Related to Pain

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

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Epidural Steroid Injection – Pain on Lumbar Extension Determines Extent of Benefit

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

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Do Pelvic Belts Help Back Pain? – Yes

Study on SI belts for pregnancy back pain found it reduced pain by 2/10.

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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.

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Does Job Rotation Reduce Illness?

Job Rotation reduces wrist and hand pains but doesn’t do much else according to a review.

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Sacroiliac Joint – Leg symptoms

SI joints generate significant amount of lateral thigh and inguinal area pains.  About 1/3 will complain of lateral thigh numbness as well.

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Antidepressants Don’t Necessarily Help that Much Re Back Pain

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

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Back Pain in Crohn’s Colitis is a Spondyloarthritis

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

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Epidural For Back – Particulate Steroids Work Better than Soluble

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

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MRI Back Pain Sciatica Interpretation So Variable Could Effect Patient Outcome

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

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Chronic Rectal Perineal Pain Helped by Simple Caudal Block

80 year old with sharp, intermittent, burning pain worsened on sitting down relieved by simple steroid caudal block when all other measures failed.

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Vertebroplasty Does Work For Vertebral Back Compression Fractures

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

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Reasons Why Vit D Helps Chronic Pain Coming Clearer – Vit D Genes

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

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Sweet Epidural Caudal Sugar-Water Injections Cut Back Pain Longterm

Re back  pain and scioatica – 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

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Gabapentin Fails to Help Back Pain With or Without Sciatica

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

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Does Etanercept Nerve Irritation Limit Use?

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

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Missed Back Pains Especially in Elderly – Kissing Spinous Processes – Baastrup’s Disease

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

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Sacroiliac Joint Injection Proposal

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.

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Chronic Back Pain Is a Painful Vertebral Body Problem

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

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Vitamin D – Could High Doses Help Pains?

4000 u/d vitamin D  lessening  Chronic Musculoskeletal Pains

Posted in Back Pain, Deficits, Drugs, Fibromyalgia, myofascial pain, pain mechanisms | 3 Comments

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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