Monthly Archives: October 2008

Ounce of Prevention is a Pound of Cure For Neuropathic Pain

Chronic administration of minocycline (a tetracycline antibiotic) started 7 days prior to nerve injury prevented neuropathic pain in the animal model – This offers exciting possibilities for preventing post surgical pain conditions.

Posted in neuropathic | 3 Comments

New Arthritis Pain Option – Botox It

For some years, they were finding Botox into ankle, shoulder and hip joints was giving pain relief. Now injecting Botox 25 u into a thumb Metacarpal-phalangeal and 50 – 100 units into cervical facet joints gives a similar result.

Posted in arthritis | 2 Comments

Irritable Bowel – Possible Missed Protozoan Disease With Treatment

It has been known for some time that bacterial overgrowth is a common cause/aggravation of irritable bowel. Now further concern Blastocystis Hominis and Dientamoeba fragilis infections are not being reported because labs are restricting their search for Amoebiasis and Giardiasis … Continue reading

Posted in Abdominal pain | Leave a comment

Polymyalgia Rheumatica (PR) – What can Help?

Prednisone dosage for the PR is a major concern. Initial dosages can be 20 mg daily, decreased 50% at 21 weeks. The accumulative dose is dangerous for osteoporosis, weight gain, hypertension and heart disease. Methotrexate at 7.5 mg weekly failed … Continue reading

Posted in arthritis | 5 Comments

Possible Cure for Parkinson and Central Pains – Gamma Knife the Thalamus

Gamma knife (GK) thalamotomy was used in cases of pain with Parkinson disease and other central pains.”A clinical success rate of approximately 80% with negligible complications” was achieved.

Posted in central & spinal | Leave a comment

Got a Sinus Infection? Try a Migraine Triptan.

Cases with “sinus headaches” but negative workup were found to respond to tripans used for migraines 82% of time. 31% cases didn’t by into idea migraine and refused to be part of the study from the start – maybe, however, … Continue reading

Posted in Headaches | Leave a comment

Bacterial Overgrowth causing Chronic Pancreatitis and Rosacea – New treatment? And, for elderly, a quick way to get rid of lactose intolerance

Chronic pancreatitis is a disease associated with recurrent abdominal pains, and malabsorption with possible steatorhea (fatty looking stools), bloating, intermittent diarrhea. A recent study found Small Intestine bacterial overgrowth (SIBO) in 14/15 cases and suggested treatment would help those symptoms. … Continue reading

Posted in Abdominal pain | 2 Comments

Hamstring Syndrome of Tethered Sciatic Nerve – Newer Entity With Surgical Treatment

This syndrome comprises of pain in the gluteal region radiating down thigh to the posterior knee popliteal fossa. It is associated with hamstring weakness. A series of 43 cases were found in athletes and surgically rectified. This resulted in a … Continue reading

Posted in Leg Pains, piriformis, radiculitis | 12 Comments

Irritable Bowel (IBS) Involves Excessive Permeability of Gut Membranes

For years, IBS has been known as a “psychological disease”, an intestinal spastic disease, and a segmental hypersensitivity syndrome (nerves hyperirritable). Now there is increased gut permeability, particluarly in the diarrhea predominant form. This “leaky gut” creates an immune reaction … Continue reading

Posted in Abdominal pain | 1 Comment

Post-mastectomy Neuropathic Pain Cure – Lymph Node Transplants

Pain post mastectomy can be an important issue. Associated with the pain is swelling called lymphedema. Now it appears transplanting lymph nodes from the groin can resolve the pain and lymphedema

Posted in neuropathic | 2 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.

Posted in Back Pain | 1 Comment

Posterior Acromial Injections Need 2″+ Needles

Recent Study did injection by anterior, lateral and posterior portals and checked subacromial penetration arthroscopically. “RESULTS: The mean distance with anterior needle placement was 2.9 +/- 0.6 cm. The mean distance with lateral needle placement was 2.9 +/- 0.7 cm. … Continue reading

Posted in Injection, shoulder | Leave a comment

Older Celiacs With Iron Deficiency Anemia Missed

20% of missed celiac cases are found after age 60 and present with iron deficiency anemia. The gold standard is duodenal scope and biopsy but this might not be the best place to be.

Posted in Abdominal pain | 1 Comment

IV Magnesium Studies

There was recent mention on using IV Magnsium in acute migraines in a previous blog note. I had used it in combination 1-2 gms Magnesium sulphate with lidocaine 100 – 200mg IV for migraines but was not impressed that it … Continue reading

Posted in IV therapy, neuropathic | Leave a comment

Neck Cheap Home Cervical Traction

I have found inflatable neck traction very useful for neck radiculopathy cases. A cheap source is available on ebay

Posted in Neck | 2 Comments

Where Can You Get Inexpensive Support Bras?

I recommend good support bras for some of my female patients but have had complaints about $200-300 dollar price tags on some of them. One of my patients, suggested I give this link for decently priced bras. They do have … Continue reading

Posted in Mechanical aids | 2 Comments

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.

Posted in Back Pain | 1 Comment

TMJ Osteoarthritis(OA) – Diclofenac and Splints Work

Study finds in cases that meet the criteria for actual osteoarthritis in TMJ responded equally as well to Diclofenac and splint althought the former worked faster

Posted in TMJ | 1 Comment

Chronic Mouth Yeast Infection? – Nuke Your Dentures..

Candida-related denture stomatitis is an annoying chronic concern. Comparison of “topical application of miconazole three times per day for 30 days” versus “upper denture microwaved IN WATER (650 W per 6 min) three times per week for 30 days”. The … Continue reading

Posted in ENT | Leave a comment

Botox For Thrombosed Piles

A blood clot in a hemorrhoid can cause extreme pain. Caught early, it can be surgically evacuated. Once several days old, there is no advantage in doing so. Now it looks like an intrasphincteric injection of 0.6 ml of a … Continue reading

Posted in Abdominal pain, Botox | Leave a comment

New Relief For Chronic One Sided Headaches

A new wonder of technology has created a new suboccipital stimulator at 1/12th the size of previous! It has been found useful for chronic one sided headache called chronic hemicrania for which indomethacin has been the mainstay of treatment

Posted in Headaches, Mechanical aids | 1 Comment

IV meds For Migraine and Approach For Resistant Cases

Recent article found both regimens below equal efficacy: prochlorperazine 10 mg and diphenhydranate 25 mg intravenously metoclopramide 20 mg and diphenhydranate 25 mg intravenously “Three quarters of subjects in both arms would want the same medication for their next migraine.”

Posted in Headaches, IV therapy | 1 Comment

Sleep Disurbance and Pain Severity Predict Chronic Pain

In Burn Cases, both Pain and Sleep Onset Insomnia predicted pain chronicity and their model suggested that the sleep problem was beyond what one would expect from the pain

Posted in Sleep | 1 Comment

Whiplash – When Does “Give It Time” No Longer Apply

Recent metanalysis of studies suggests recovery is not great after 3 months

Posted in Neck | Leave a comment