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Category Archives: Back Pain
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
2 Comments
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
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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
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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
Treatment Plan For Fresh Osteoporotoc Compression Fractures
Now that Kyphoplasty has become widespread, these techniques might be outdated. However, there are cases where you cannot do kyphoplasty, and these techniques would apply – they involve caudal or epidural catheter blocks, intercostal nerve blocks, trigger injections, and near infrared radiation … Continue reading
Posted in Back Pain, Injection, Mechanical aids, neuropathic, osteoporosis, Stimulation
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Bad Thoracic Back Pain and Desperate? -Early Case of Peripheral Nerve Field Stimulation
Some cases of thoracic back pains can get horrendous – partially because there are pain generators coming form both thoracic spine and neck, and because postural and instability effects are rampant there as well. It seems that measures may only … Continue reading
Posted in Back Pain, Mechanical aids, Stimulation, Thoracic
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Accurate Piriformis Injection
ºAlthough I have been happy with Rectal Coupled Piriformis Injections, Ultrasound Guided injections are becomeing more popular. Combined with Botulinum, the results can last 6 months or more.
Posted in Back Pain, Botox, Injection, piriformis
3 Comments
Epidural Primarily Work on Side Needle Tip is Closer To
At the IASP congress in Montreal, it was stated metanalysis show epidural steroid block do not work. I mentioned the fact putting the bad side down can near double its effectiveness: Steroid Epidurals – Why Some Work And Some Not … Continue reading
People With Longstanding Lumbar Nerve Root Problems Have “MRI Invisible” Lesions
Radiculopathy (sciatica) cases were categorized by their pain diagrams and physical findings. Only 16- 37% of cases showed MRI findings. If there is an MRI-visible issues – only 22-78 % cases have symptoms (positive predictive values of MRI-visible nerve involvement). … Continue reading
Posted in Back Pain, Insurer issues, Neck, radiculitis
3 Comments
Subcutaneous (Under Skin) Electrical Stimulation For Chronic Back Pain
Back Spinal leads – Spinal cord stimulation (SCS) is useful for leg pains where you can elicit Funny feeling “paresthesias” with implanted leads. Obtaining the same for back pain has been more difficult. In cases where they were unable to … Continue reading
Posted in Back Pain, Stimulation
1 Comment
Sacral Nerve Root Stimulation Helps Coccygodynia
Sacral Nerve Root Stimulation (SNS) was compared with Peripheral Subcutaneous Field Stimulation (PSFS). SNS attenuated pain 50 – 60% at low stimulation with good patient satisfaction.
Posted in Back Pain, coccygodynia, Stimulation
1 Comment
Perineural “Tarlov” Spinal Nerve Outlet Cyst Pains – Overlooked and Treatable
I have a patient with multiple level cysts where the nerves exit the spine in the neck. He also has some mild foraminal stenosis. He is symptomatic with arm and referred upper back pain. Getting his problem taken seriously has … Continue reading
Posted in Abdominal pain, Back Pain, Neck, pelvic
1 Comment
Lumbar Radiculopathy Paraspinous Blocks Simple and Effective
Author devised a 3.5 cm out for L4-5, 3.5 cm down from there, for L5-S1 – 2 mm down for each model for injections. Injected 60 mg Depomedrol each level needed for radiculopathy. Got excellent results without image intensifier in 100 … Continue reading
Confirmed – Intrathecal (Spinal) Midazolam Gives 1-3 Months Relief in Chronic and Failed Back Pain
Those who have epidural steroid injections for back pain know they are limited often to injections every 3 months (except for initial 3 shots). When the pain comes back in 3-6 weeks – what can one do? Now it looks … Continue reading
Posted in Back Pain, Injection
3 Comments
Sacral Insufficiency Fractures – Hard to Make – a Possible Examination Technique
One elderly lady, I recently saw, fell and multiple fractured her left humerus. Was seen, put in a sling, kept briefly in hospital and discharged. Because she could not walk, she was reassessed and found to have a pubic ramus … Continue reading
Posted in Back Pain, osteoporosis
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Midazolam Augmentation of Lumbar Steroid Injections – Use, in Just Mechanical Back Pain
Recent article demonstrated that a combination of steroid and midazolam worked well for post herpetic neuralgia: Miracle Treatment – Low Back Post Herpetic (Post Shingles)Neuralgia Treated With Epidural Steroid and Spinal Midazolam Without Local Can Give Significant Relief For Over … Continue reading
Actonel Improves Osteoporosis Back Pain Without Fracture – on 5 mg/day
In Osteoporosis, not only did Risedronate 5 mg/day cut back pain to 1/3 in 4 months, it cut the disability rating in half – despite the fact there were no fractures.
Posted in Back Pain, osteoporosis
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Smokers 1.5 times More Back Pain – Does Quitting Become An Effective Treatment?
This was a large Canadian study and results demonstrated “this association remained significant after controlling for sociodemographics and any lifetime anxiety or mood disorder.” If smokers back pain dropped to normal after quitting, this would result in a 33% improvement. … Continue reading
Posted in Back Pain, TMJ
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Steroid Epidurals – Why Some Work And Some Not So Well
Recent findings demonstrate lying patient with bad side down for 15 minutes can almost double its effectiveness.
Posted in Back Pain, Injection
2 Comments