Monthly Archives: September 2008

Knee Mensicus Tears – Accelerate Osteoarthrtis or Bistander?

A Recent Framingham study has demonstrated on MRI: By age 69, 50% have meniscial tears; it is more common in women 61% of these tears were asymptomatic In cases of Osteoarthritis, those with symptoms 63% had cartilage tears, without symptoms … Continue reading

Posted in arthritis, Knee | 1 Comment

Manitoba Family Practice Snubs Physiotherapy

Recently, there was a workshop on muscle energy techniques. I know the name sounds corny but it is a gentle postitional push- release-stretch technique that has become one of the principle manual spinal techniques now taught to physiotherapists and besides … Continue reading

Posted in Regina Pain News | Leave a comment

Segmental Colitis Associated with Diverticulosis (SCAD syndrome)

Diverticulosis can exist with segmental colitis – have an older patient who had bad diarrhea on a trip and was diagnosed with such. Not something I was aware of.

Posted in Abdominal pain | Leave a comment

Achilles Tendonitis – New Eccentric Program

Achilles Tendonitis is one condition I hate and any treatment program is welcome. This is an upgraded eccentric program that does not involve dorsiflexion (foot pushed up from normal)

Posted in Leg Pains | 3 Comments

I wish I Had Fibromyaglia – Then I Couldn’t Have Anything Else…

I hate the term Fibromyaglia (FM) – not because it doesn’t exist but because it stops people looking for potentially treatable issues as well. “It’s all just Fibromyalgia” is just too convenient. Here is an example of a subject with … Continue reading

Posted in Fibromyalgia | 1 Comment

Rehab – Forget Fear-Avoidance – Give Them Opioids

I have a picture that portrays my view of fear-avoidance:My perspective is that, in a good many of cases, everything is controlled by pain intensity. Some articles try to avoid the issue by saying “they just thought they were in … Continue reading

Posted in Insurer issues, psychology | Leave a comment

Zinc and Magnesium Deficiency Common in Fibromyaglia- and What are Zn and Mg Good For?

A recent article found a relationship of low zinc levels and tender point counts, and low magnesium and fatigue

Posted in Deficits, Fibromyalgia | 3 Comments

Optimal Fentanyl Patch Use

There is alot of confusion of what amounts to optimal fentanyl patch use. Many patients contend it only lasts 2 days. How does one adjust the dosage?

Posted in Drugs | 4 Comments

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 | Leave a comment

Angiogenesis (new blood vessel growth) the root of all pain?

Angiogensis and its accompanying nerves are evident in disc disease with the formation of neurovascular growth in the High Intensity Zone facing the spinal cord. Similarly, I have written how chronic tendonitis is associated with neurovascular growth. Now it appears … Continue reading

Posted in Pathophysiology | 1 Comment

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 | Leave a comment

New Treatment For Vulvodynia – 6% Gabapentin in Lipoderm

6% Gapapentin in Lipoderm is helpful in vulodynia. Interesting how they made it up.

Posted in gynecologic, Interstial Cystitis/Gynecologic, Topical Pain Treatments | 4 Comments

Dorsal Wrist Impingement – How to Diagnose

Dorsal wrist impingement is pincing of dorsal wrist capsule between the extensor carpi radialis brevis and the dorsal ridge of the scaphoid. It’s diagnosis is strictly clinical.

Posted in wrist | 3 Comments

Acute Nerve Injury – Try Gabapentin and Tramadol

After a sciatic nerve as accidentally injected, gabapentin and tramadol helped the pain until some recovery came about.

Posted in Drugs, neuropathic | Leave a comment

Want a Cheap Nerve Stimulator needle? -Look No More…

Disposable insulated needles are not readily available but a 20 gauge cannula is easy enough to find…

Posted in Mechanical aids | Leave a comment

Child in Pain & Distressed – Healing Potential of Massage + some techniques

Children in a chronic pain clinic respond significantly to massage. The laying on of the hands also has a significant effect on distress. This is an under-utilized resource that needs to be taught to parents.

Posted in children, Fibromyalgia | 2 Comments

New Treatment for Chronic Daily Headaches – Mexiletine

Chronic daily headahces has to be the bane of most doctors frustrated by fact use of painkillers will potentially only make things worse. Now it looks like Mexiletine may help but …the patient has to be prepared to accept side … Continue reading

Posted in Drugs, Headaches | 6 Comments

Diabetic Peripheral Neuropathy – Pregabalin to 600mg or bust

I am used to 75-150 mg doses of pregabalin but doses of 300 mg BID are being used for diabetic peripheral neuropathy.

Posted in Drugs, neuropathic | 1 Comment

Tennis elbow and desperate – try Duloxetine

Two cases resistant to any treatment responded to Duloxetine suggesting complex origin.

Posted in Drugs, Tennis elbow | Leave a comment

Neuropathic Pain More Spinal and there are potentially better treatments

Recent Japanese article hilights spinal sensitization in neuropathic pain suggesting lidocaine and ketamine maybe should play bigger role

Posted in neuropathic, Pathophysiology | Leave a comment

Hypnosis in Chronic Pain

Hypnosis helps chronic pain and should be part of a chronic pain program, if not managed by mindfulness meditation.

Posted in psychology | 3 Comments

NSAID’s and Gastritis – new help

Arthritis pills longterm, particularly in the elderly, is a risky business. Stomach bleed have been reported to cause more deaths than car accidents and other injuries. These stats are now relatively old and comments from doctors has been that they … Continue reading

Posted in Abdominal pain, Drugs | Leave a comment