This Web Server is designed to promote discussion on pain topics. It is hosted by Dr. Michael Montbriand MD CCFP, a Family Physician, who has a special training and interest in chronic pain. The idea is to propose understanding and treatments for chronic pain.
Recent Comments
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- Margreet Hogenbirk on Sore Pubic Joint – Osteitis Pubis How Does One Treat It?
- John Waters on Accurate Piriformis Injection
- Blurge on Vitamin B12 Injections For Chronic Pain
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Thank you for the article on chronic pain after hernia repair. Since I had the surgery two
years ago, I have been in constant pain. Some nights I’ve only slept 30 minutes. A few months ago a pain management specialist diagnosed nerve entrapment. He has been giving me injections into my abdomen, but today told me that I may have reached max improvement because I couldn’t tell a difference after the last injection. I won’t accept that what I feel now is an indicator of what I can expect for the rest of my life. While I really like my pain management doctor, I’ll find someone who’ll try the tens on me. One more thing: Last month I started using Tiger Balm and it has given some relief. It’s worth a try to anyone who reads this who is having pain–especially in the thigh area.
Thank you for such an incredible resource for pain related issues. I’m new to your site but I don’t think there’s anything like this on the internet. This is the first place I’ll peruse when I have that difficult and unusual case to see if you have anything to say about the issue. By the way, I see you have some prolotherapy references. I know you don’t know me, so whatever it’s worth, I’ve been doing prolo on patients for the last 11 out of the 20 years I’ve been in my pain practice and it is the real deal. For the last three years I have performed prolo on about 30 football players at LSU (currently the #1 football team in the US). You can believe that if prolo is a sham the LSU athletic trainers would not waste their time on this treatment approach. There’s too much at stake with these players. There are several reasons, economically, politically and otherwise why prolo isn’t mainstream yet, but most of these have little to do with does it actually work. If you put aside the economic/political issues the technical issues have to do with:
1) It is virtually impossible to have a reasonable placebo in prolo studies since the needling alone causes an injury/inflammatory response thus invalidating the placebo arm of the studies. Indeed, the prolo research otherwise appropriately done are plagued by high placebo responses. (Just because normal saline is injected doesn’t mean it is an adequate sham treatment)
2) Unlike with corticosteroid treatment, prolo only works in an extremely localized fashion necessitating very precise needling technique. Additionally, despite what the orthopaedic paradigm presumes, referred pain is fairly common and with prolo as with many other treatments, injecting an area of referred pain will not work.
3) Probably the biggest barrier to prolo becoming mainstream is that there are no possibilities of any patents in the present form of the technology. No patents – No research money. We have witnessed several competing technologies lately; e.g. Platelet rich plasma, whole blood, various growth factor injections and recently in Europe bone marrow aspirate injections. However, someone needs to compare all of these to the gold standard in proliferative therapies– prolotherapy. Other than having various patents associated with these “newer” technologies, they all may offer only slight or no advantages over the patent-less prolotherapy.
Your thoughts would be appreciated. Thanks again for the incredible site.
Paul Kramm MD
Baton Rouge, La. USA
Yes, prolotherapy is helpful – I prolotherapied my own thumbs when they became too hyper-extensibile from manual work I did… Came back from a CAOM conference where they are using testosterone instead of sugar and am eager to try it. – admin
My brothers Mother-In Law, only needed 1 prolotherapy session, and her knee condition dramatically improved. This is no sham treatment, however, it does not cure everything.
Hi Michael,
Welcome back! I really enjoy reading your pain hacking ideas.
Glad to hear that they special pain codes now. We have something similar starting in BC in the near decade.
Keep up the good work.
Cheers,
Dr. Jan Venter
Functional Medicine, Family Medicine, Neurofeedback and Neuromodulation
Vancouver, BC
Pain, especially the chronic type can be so very debilitating. I believe that mine is mostly spine and perhaps spinal cord related but there are so many who suffer from fibro, CRPS, etc.. and on and on. It seems to me that so many would be thrilled with a reasonable return to function from even moderate pain relief that this would be a top priority world wide. But, there is a hesitancy from the established medical industry and I don’t understand why?
This is an interesting video on Chronic Fatigue Syndrome from an international conference on autoimmunity. I thought that I would share it.
http://autoimmunityresearch.org/resources/