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Category Archives: Back Pain
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
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
Posted in Back Pain, Drugs
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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
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.
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
Posted in Back Pain, Injection, Insurer issues, pain mechanisms
3 Comments
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
4 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.
Posted in Back Pain, Injection
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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
Posted in Back Pain, Injection
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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
Posted in Back Pain, Injection
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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
Posted in Back Pain, Injection
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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
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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
4 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
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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.
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
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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
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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
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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
7 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
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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
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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
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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
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