Category Archives: Back Pain

Inflammatory Back Pain (IBP) – MRI’s Use depends on when you do it.

In IBP – MRI could be negative or positive at one point and then the opposite later on. Make MRI imaging more dubious than people think.

Posted in arthritis, Back Pain | Leave a comment

Remarkable New Treatment – Injecting Over Tenderized Skin Nerves With Plain 5% Dextrose

For year I felt the main expression of chronic pain was through activation of myofascial knots – now it looks like tenderized skin nerves is a front runner. Merely injecting D5W overtop tenderized nerve tracts an average of 6 weekly … Continue reading

Posted in Back Pain, Injection, Leg Pains, Neck | 3 Comments

Unresectable Painful Bone Cysts – IV Zoledronic acid For Adults and IV Pamidronate For Children Gives Rapid Relief

Painful large and unresectable bone cysts responded rapidly to IV biphosphonate therapy within first cycle in 88% of cases. Adults received 4 mg of Zoledronic acid (Zometa®, Novartis), and children got IV pamidronate 1mg/kg.  Zoledronic acid, if more than one … Continue reading

Posted in Back Pain, children, Drugs, Hip Pains, IV therapy | Leave a comment

Reaching “Critical Mass” to Achieving Pain Control – Procedure Pearls

I have recently achieved (previously unattainable) control in some of my chronic pain subjects using recent innovations – but to acheive this required use of multiple modalities at once.

Posted in arm, Back Pain, Botox, complex regional pain, Drugs, Fibromyalgia, Headaches, Injection, IV therapy, Leg Pains, Manual Med, myofascial pain, Neck, neuropathic, Pain Dystrophy, piriformis, post herpetic neuralgia, radiculitis, shoulder, Uncategorized | 4 Comments

Is Nortriptyline Any Good? – Maybe – but Maybe Only a Bit

Recently, nortriptyline has been touted as good anti-neuropathic drug but thoughts of its use have extended into use for chronic pain in general.  Well, it doesn’t work for back pain, sciatica or migraines so that might need reanalysis.

Posted in Back Pain, Drugs, neuropathic | Leave a comment

Effect Of Cushioning Insoles on Workplace Back, Foot and Knee Pains

Use of sorbothane insoles cut  back pains by 38%, foot pains by 37% and knee pains by 38%. Relief in back pain did not mean relief in another areas. Wonder if antifatigue covers would help more.

Posted in Back Pain, Knee, Leg Pains, Mechanical aids | Leave a comment

Obscure Groin Pain Could Be Lumbar Disc Even if Back Not Painful

Five  cases of groin pain that refused deliniation  and had NO back pains. They all turned out to be L4/5 or L5/S1 disc pain found on discogram/discoblock.  They all got relief with anterior intrabody fusion.

Posted in Back Pain, central & spinal, neuropathic | Leave a comment

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

Posted in Back Pain, Drugs, IV therapy, pain mechanisms, Sask Pain Advice | 1 Comment

Back Pain Worsening? – Look For Back Pain Multipliers – They Are Treatable.

I had a recent personal experience of back pain that showed me conditions that would multiply pain several times or more.  I have patients on opioids that have complained their meds no longer “cuts it” – and I have been able … Continue reading

Posted in Back Pain, Botox, neuropathic | 3 Comments

Unilateral Interscapular Pains – Dorsal Scapular Nerve Entrapment – Forgotten and Now Rediscovered

    About 30 years ago, I attended a course given by Drs. Travell and Simon.  Dr. Simon was discussing interscapular pains and Dr. Travell mentioned – don’t forget the scalenes – something that Dr. Simon replied he was getting … Continue reading

Posted in Back Pain, myofascial pain, Neck, Thoracic, thoracic outlet syn | 6 Comments

Vertebral Compression Fracture Pain And Nothing Helped – Other Option

Effectiveness of Kyphoplasty has been disputed, and other are left without it; this leave a proportion wondering what to do.  Medial branch rhizotomy (like a facet rhizotomy) has been found helpful.

Posted in Back Pain, osteoporosis | Leave a comment

Steroid Epidurals Results Might Be Minimized By Fact Steroid Mineralcorticoid Effects are Pro-Inflammatory and Nociceptive

Steroids effect two processes/receptors – a glucocorticoid pathway, and a mineralcorticoid one. The glucocorticoid pathway has strong anti-inflammatory and immunosuppressive effects. The mineralcorticoid pathway works more on retaining salt. The latter has been found to have pro-inflammatory effects which might have … Continue reading

Posted in Back Pain, Injection | Leave a comment

Midazolam Effective For Back Pain – Safe as Kenalog Because Same Benzyl Alcohol Perservative – As Long as Ph Balanced and Benzyl Alcohol Diluted to 0.07%

Midazolam has been shown to have powerful effects similar to steroid epidurally, but there are concerns about its perservative. However, it is the same Benzyl alcohol preservative seen in Kenalog which is widely used in epidural injections. Recent animal vitreous … Continue reading

Posted in Back Pain, Drugs, radiculitis | 1 Comment

Chronic Neck and Back Pain Might Be a Treatable Infection

Since 2001, there have been case studies showing you can grow low grade anaerobes out of damaged discs; these ignored as contamination or incidental because some studies did not find any infection. Now it appears that those with positive cultures are 5.6 times … Continue reading

Posted in Back Pain, Neck | 2 Comments

Back Pain – Is Duloxetine (Cymbalta) Really a Contender?-And What About Knee?

In a Quebec analysis (if one looks is actually the drug company’s), it has been suggested that Duloxetine might be more cost effective for patients over 65 where the heart disease and stomach bleed risks of NSAID arthrtis pill might … Continue reading

Posted in Back Pain, Depression | Leave a comment

Will MRI Localize the Site of Back Pain? – Epiduroscopic Study Suggests No – What this means for Insurers

Cases of chronic back pain with or without non-radicular leg referrals (in leg but not classic sciatica) were examine clinically, with MRI and by using a “keyhole” scope instrument in the spine called an Epiduroscope.  Scoping and probing area during … Continue reading

Posted in Back Pain, Insurer issues, Neck | 1 Comment

Low Vitamin D and Chronic Pain – What is the Evidence?

In 2006, My Daughter, Janice Montbriand, published a poster called Commonly Missed Factors in Chronic Pain. Vitamin D deficiency was one of them. Since the there have been a variety of confirmatory studies – with some negative ones as well. I … Continue reading

Posted in Back Pain, Deficits, Fibromyalgia, myofascial pain, osteoporosis, Rheumatic | 1 Comment

Enbrel Failure – So What Else Can You Do For Chronic Back Sciatica?

Got a recent enquiry of what to do if you are an enbrel failure. I will go over what I can.

Posted in Back Pain, neuropathic, piriformis, radiculitis | 7 Comments

Lithium Reduces Spinal Cord Damage Pain by 35% in 6 Weeks

Case reports have found lithium carbonate an effective in chronic pain but these results have been ignored because of lack of a reliable study, Now a a double-blind, randomized, placebo-controlled clinical trial was done and showed benefit in Chronic  Spinal … Continue reading

Posted in Back Pain, central & spinal, Drugs, neuropathic, radiculitis | Leave a comment

Simple Sciatic Leg Pain Relief – Repeated Simple Knee level Peroneal Blocks

  Repeated peroneal nerve blocks can remarkably control sciatica leg pains in most cases and avoid the necessity of surgery .

Posted in Back Pain, Leg Pains, neuropathic, radiculitis | 3 Comments

Sciaitica, Bone Cyst in Ilium, and Gluteal Tight Muscles – down right leg – needs help

Chronic sciatica /buttock pain  – I recently received a request for help…

Posted in Back Pain, Hip Pains, Injection, myofascial pain, neuropathic, piriformis, radiculitis | 1 Comment

Chronic Back Pain Help – Forgotten B12 Injections and What Else Good For…

Double blind, randomised, placebo – controlled trial of daily 1000U IM/day B12 for 14 days found significant benefit for people with chronic Low Back Pain. Cochrane review thought it was not high quality but sounded good to me; and for … Continue reading

Posted in Back Pain, Deficits, Drugs | 7 Comments

Primary Care Back and Leg Neuropathic Pain (thought sciatic) common. – MRI, and Straight Leg Raise Useless.

Recent study of neuropathic pain in leg associated with back pain, in a primary care setting, found MRI evidence of nerve root impingement unlikely and straight leg testing useless. Their conclusion:  “[the] neuropathic pain may be caused by irritation of nervous … Continue reading

Posted in Back Pain, Insurer issues, radiculitis | Leave a comment

Chronic Low Back Pain Injection Spot

Lumbar paraspinous muslces and sacroiliac ligaments all attach to sacrum making it a vulnerable site. Dr. Breck McKay has found injection of these ligments (and the sacrospinous ligament) can give significant results. Poster at IASP congress found a sweet spot … Continue reading

Posted in Back Pain, Injection | 2 Comments

Several Scoliosis Operations and Still Pain – Spinal Cord Stimulation May Help

I have one gentleman with multiple surgical procedures including fusions and Harrington rod placements who is left with chronic pain. He has to stand up most of the time. I’m presuming there is a pseudoarthrosis at one level but there … Continue reading

Posted in Back Pain, Mechanical aids, Stimulation | 1 Comment