Study of 2940 Obstructive sleep apnea subjects over 3 years found a 3.7 times risk of having IC/PBS.
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 injections of benzyl alcohol have found 0.071% benzyl alcohol does not cause retinal toxicity – easily achieve with IV Versed if given caudally in 15 mls dilutant that has some bicarbonate to ph balance the formulation. Even then, that does not consider that the solution will be diluted even more caudally.
Though results have varied, latest studies show little benefit of guided imagery in FM.
Recent article did not find orthotics by self made a difference, but when combined with dorsiflexion calf stretching night splint reduced pain by 50% in 8 weeks.
Article finds self massage can reduce pains potentially by 1/2. Massage instructions are free to anyone.
Analysis of 41 cases of juvenile widespread pain found “definite SFPN (small fiber polyneuropathy) in 59%, probable SFPN in 17%, and possible SFPN in 22%. Steroids or IV gamma globulin subjectively helped 80% of those that tried them.
Three cases of severe neck pain with radiation down arm, not helped by any other measure, were helped with mini-pulse therapy of betamethasone 4 mg twice daily for 4 days and decreasing doses subsequently. In those 3 cases, pain disappeared after 10 days. In a separate article, Lamotrigine, titrated to 200 mg in a case, reduced pain “from 100 to 20 mm during eight weeks of titration” for neck sciatica/radiculitis.
Over and over again Biphosphonates have been shown to help CRPS except one study that only bothered to give one infusion. A new agent not yet available in Canada, Neridronate, at 100 mg given FOUR times over 10 days was found to reduce pain over 50% in 73% cases versus 32% in placebo. The nature review article felt this was “estimated to be equivalent to pamidronate at 90 mg given FOUR times over 4–10 days”. As previously shown, the infusions have to be given repeatedly not like a previous stupid one infusion only study.
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 more likely to subsequently develop “Modic” end plate changes. A separate article also in press found following 100 days of antibiotics, chronic Back pain cases, with modic degenerative changes in the backbone improve. They have 1/2 the pain level, a year later, versus no change in control group. They toted this as substantially better than any established conservative treatment.This represents a huge shift in thinking about discogenic neck and back pain.
My wife’s PRS-600 sony reader crashed with a rectangular boxed area complaining of exception error – do you want to format? – and when you say yes (actually a bad idea) – it says cannot format. Information on this was so sketchy I felt I had to write down what worked for me.
Naltrexone is a partial pain site blocker/stimulant used primarily to help alcoholics get off drinking. It was found in a controlled pilot study some years ago to help with pain in Fibromyalgia. It was well tolerated. Present controlled unfortunately shows mediocre results like most agents used in FM.
Technique involves injecting ilioinguinal nerve (by anterior superior iliac spine) – with dye and local – if get GOOD temporarly relief – then go in right after and remove all dye stained areas including ilioinguinal nerve.
In selected cases (good relief with block) 27/28 cases had pain for relief for at least the year of study.
Despite the advent of the fear-avoidance and acceptance psychology, it is becoming abundantly clear that pain level determine disability. This is but the latest article in that regard.
Helicobacter pylori driven irritation is a prime cause of peptic/duodenal ulcers. Now in “functional dyspepsia” , particularly with stomach pain, it’s eradication shows benefit.
Injury to the Intercostobrachial nerve following breast cancer surgery helps trigger the persistent neuropathic pains after. Why don’t we hear much about it? Here is some info on it.
There is evidence that a small fiber neuropathy is responsible for a subset of FM cases – particluarly if there is more burning, numb feelings and severe pain (neuropathic symptoms). A group with these symptoms was biopsied but predicting who would have a small fiber neuropathy was not necessarily possible.
Substance abuse issues in chronic pain sufferers is always a concern – and doubly so, if there is an abuse history. Chance of abuse in high risk cases was 32%.
Brain EEG “imaging” study shows hyperarousal with just brushing of right arm – highlighting fact disease involves brain hypersensitivity
Both FM and CBP are thought to, in part, involve central sensitization and inoperative descending pain inhibition. Their histories are however different.
Mice who are not physically active develop “exercise-induced muscle pain by reducing phosphorylation of the NR1 subunit of the NMDA receptor in the central nervous system.” – ie the pain circuits are hyperacute (or less protected depending on which way you look at it). An inactive lifestyle, in susceptible people, may doom them to chronic pain.
For years, I have been working and injecting the muscles around the knee to promote relief from knee pains. Sometimes it makes a big difference; sometimes the joint line osteoarthritis is more important. Two studies hi-light muscle issues in patellofemoral pains but also cases waiting for knee replacement pains.
Chinese article claims sacral nerve stimulation cured 19/32 and improved 12/32 cases.
In the animal model of diabetic neuropathy, Coenzyme Q10 helps prevent nerve damage. Patients on cholesterol lower statins end up with no coenzyme Q10 in their system
Guidelines for gallbladder polyps are not readily available. Here at last are some – gallbaldder attacks suggest surgery. Chance of malignancy is slight unless polyps are over 10 mm size and in someone over 50.
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 be too great. However Clinically significant help of Duloxetine has been questioned.