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Category Archives: Back Pain
Making Methotrexate Work in Ankylosing Spondylitis/ Inflammatory Back Pain
Methotrexate is a fairly safe medication but studies of it solo have failed to help Ankylosing spondylitis. Chinese study found when used with methylprednisolone had a therapeutic effect and improved inflammatory markers.
Posted in Back Pain, Rheumatic
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What is Time Course of Vertebral Fracture 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.
Posted in Back Pain, osteoporosis
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What Mattress Works Best to Prevent Back Pain?
Review of multiple studies found no surprises: “a medium-firm mattress promotes comfort, sleep quality and rachis alignment.”
Posted in Back Pain
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Waistband Back Pain
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
Effectiveness of Sacroiliac (SI) Joint Steroid Injection
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
Posted in Back Pain, Injection, piriformis
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Gluteus Medius Tendonitis Injection Treatment and more
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
Posted in Back Pain, Hip Pains, Injection
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Back Pain -Easy Help -Slumping
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
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Some Fibromyalgias are Treatable Arthritis
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) -Stiffness Disease
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
Posted in Back Pain
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Resistant Piriformis Syndrome – Could We be Missing the Boat? – Obturator Internus
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
Posted in Back Pain, piriformis, Uncategorized
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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.
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
Posted in Back Pain, Depression, psychology
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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
Posted in Back Pain, Injection
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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.
Posted in Back Pain, Mechanical aids
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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.
Posted in Back Pain, Stimulation
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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.
Posted in arm, Back Pain, hand, wrist
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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.
Posted in Back Pain, Leg Pains
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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
Posted in Back Pain, Drugs
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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
Posted in arthritis, Back Pain
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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
Posted in Back Pain, Injection
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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
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.
Posted in Back Pain, neuropathic, pelvic
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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
Posted in Back Pain, Injection
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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
Posted in Back Pain, Drugs, Fibromyalgia, pain mechanisms, Uncategorized
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Sweet Epidural Caudal Sugar-Water Injections Cut Back Pain Longterm
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