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Category Archives: Back Pain
Sciatica Pain Is Different and Does NOT Respond Much to Pregabalin (Lyrica)
Recent guidelines for treating Neuropathic pain have drawn extensively from results with Diabetic and Post Herpetic Neuropathy. I have written about how those results cannot be generalized to treatment of Radiculopathy (sciatica either of back or neck). see here: Etanercept … Continue reading
Posted in Back Pain, radiculitis
3 Comments
Sacroiliits Totally Unthought of Treatment – Filter Out White Blood Cells – Filtration Leukocytapheresis
Lady with ulcerative colitis and sacroiliitis improved after leukocytapheresis (LCAP).
Posted in Back Pain, Rheumatic
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What Concerns People on Work Disability With Low Back Pain
Recent Article takes a survey of concerns of low back pain patients sent for rehab. The results are no surprise.
Posted in Back Pain, Insurer issues
2 Comments
Vitamin C in Press Again – Low Contributes to Disc Disease?
Recent Hypothesis forwarded that low Vitamin C sets the stage for disc disease and once disc degeneration started, it is a self fueling inflammatory disease.
Posted in Back Pain, Drugs
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Localized Cause of Back Pain – Inter-Spinous Process Bursitis “Baastrup’s Disease”
An MRI found intraspinous processes bursitis in 8.2% of individuals which could be causing segmental back pain.
Posted in Back Pain
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Chronic “Back” Pain Missed in Elderly – the Costo-Iliac Impingment Syndrome
With the loss of height from osteoporosis in the elderly, the lowermost side ribs can rub on the side wing of the hip crest, resulting in was patients describe as back pain. To make things worse, this rubbing restricts walking, … Continue reading
Posted in Back Pain, Mechanical aids
6 Comments
Determining If Veretbral Compression Fracture
Various new approaches help define vertebral compression fracture so can be earlier diagnosed.
Posted in Back Pain
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Yes, Virginia, Steroid Caudal Blocks Are Effective (At least For Spinal Stenosis)- and So Older People With Back Pain After Two Blocks Walking Are Better.
Article in Press Finds Caudal Epidural Steroid injection work for degenerative lumbar spinal stenosis. This condition is the bane of older individuals that can’t walk more than a 2-3 blocks without getting back – leg pain. The pain remits with … Continue reading
Posted in Back Pain, Injection
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? Sciatica Option – Drug For Pulmonary Hypertension Gives Relief
Case study of patient on Sitaxsentan, a selective endothelin-A antagonist used in pulmonary hypertension, found his sciatica got better while on the drug and worse when off.
Posted in Back Pain, radiculitis
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New Painkiller for Back & Knee Pains – Raloxifene (Evista) – a drug for Osteoporosis
There is a connection between osteoporosis and arthritis with arthritis settling in more in osteoporotic joints. Now an osteoporotic drug can not only help that but seems to have analgesic properties to back and knee pains if used regularly.
Posted in Back Pain, Drugs, Knee, osteoporosis
2 Comments
Groundbreaking News – A “Cure” For Chronic Discogenic Back Pain??
A simple procedure injecting 1 ml of 1% methylene blue followed by 1 ml 2% lidocaine into damaged disc has achieved unprecedented results
Ultrasound and TENS for Back Pain
I have found home ultrasound helpful in chronic back pain but there has been little research in its effectivenesss. Now there is a study in low back pain combining it with exercise that found it useful. TENS worked well to … Continue reading
Part of Failed Back is Overactivity of Sympathetic Nervous System
Failed back sydrome – post-laminectomy syndrome has multiple origins. Now it appears some sympathetic overload is present as well.
Posted in Back Pain
2 Comments
Advanced Disc Degeneration Still Very Painful
Article states “there has been a belief that DD initially causes pain because of the penetration of fluid nuclear material through annular fissures, and that pain eventually resolves as the nucleus becomes fibrotic and can no longer penetrate the fissures”. … Continue reading
Posted in Back Pain, Neck
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Got Crohn’s? – May Have Spine Arthritis Too
Recent MRI study of crohn’s colitis patients found 17/44 cases had evidence to sacroiliitis and 11 of these had back pain. HLA B27 is seen in 10% of the population. If present in any of the crohn’s patients (were in … Continue reading
Posted in Abdominal pain, Back Pain, Rheumatic
3 Comments
Costovertebral Joint Pain Referrals
Costovertebral (rib) joints are just starting to be recognized as a source of pain. A recent provocative study demonstrated their referral patterns
Posted in Back Pain, Thoracic
3 Comments
Lumbar Facet Osteoarthritis Not Associated With LBP
I was always bemused by “specialists” that point out facet OA changes and claim to patients these old age changes are responsible for their pains. Now the Framingham study has put a nail in the coffin for that attitude.
Sacroiliitis Tests Not Great
Testing MRI/CT imaged Sacroilitis versus clinical testing and comparing it to positivity of tests with Low back pain came up with low sensitivities and specificities.
Hope For Failed Backs – Spinal Cord Stimulation
Given there is little evidence medications work well for chronic radiculitis, It is encouraging to note that Spinal Cord Stimulation might give 50% relief in failed back patients.
Posted in Back Pain, Mechanical aids
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Is Facet Injection Better Than Medial Branch Block?
Facet injection appeared to be superior to medial branch block of SPECT scan positive facet joints
Posted in Back Pain, Injection
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Pulsed Radiofrequency – New Hope for “Sciatica”/radiculitis of Neck and Back – but where available?
Traditional treatments for referred nerve pain of neck and back have been inadequate. As mentioned previously, opioids and other pain modifying medications work poorly in radiculitis, leading to an American summation that there is no proved drug treatment for radiculopathy. … Continue reading
Posted in Back Pain, Mechanical aids, Thoracic
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Post Vertebral Fracture Pain – Balloon Kyphoplasty Resources – Miraculous Results
Post vertebral fracture pain can be disabling and longstanding and spell the beginning of the end for some cases. Almost immediate relief can be obtained by tunneling a balloon into the vertebral body and pumping it up with hot plastic. … Continue reading
Posted in Back Pain, Mechanical aids
5 Comments
How Should One Investigate Chronic Back Pain and What about the Back Muscles?
Exercise programs and biopsychosocial fear-avoidance perspectives abound but what workup should be involved prior to such processes? Despite attempts to talk about “nonspecific chronic back pain”, research has demonstrated that in most many cases, a specific diagnosis can be made … Continue reading
Posted in Back Pain
11 Comments
Etanercept (Enbrel) for Radiculitis (Sciatica)
The common and disabiling pain condition is chronic lumbar radiculopathy (chronic back pain/Sciatica). Despite the widespread promotion of treatments of neuropathic pain a recent analysis of neuropathic pain treatments has concluded the following: “To date, no medications have demonstrated efficacy … Continue reading
Posted in Back Pain, Drugs, Neck, neuropathic, radiculitis
35 Comments
Big disc protrusions gimps facets
I have a patient who had a large disc protrusion. These have been shown to have a good chance of recovery (vs disc bulges which very few with sciatica were better a year later). This patient did not improve until … Continue reading
Posted in Back Pain
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