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.
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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/
I had 2 Prolo treatments with Dr. Cenaiko in Wakaw Sask; The first was 144 needles, I was placed on a demerol drip, before he started. It was quite different from anything I’ve ever received. The Demerol drip put me in lulla land, I even dreamt about Nanuk the Great White polar bear.. But I was coherent and could hear him and his assistant “Especially when he asked for the 6″ needle” which I didn’t feel anything other than Squish, Squish,Squish as Dr. Cenaiko plunged the needle into my body. “I didn’t feel a darn thing” Until he hit a very troubling muscle spasm / knot that has plagued me since my severe workplace injury. WOW that hurt. +8 out of 10. at least. He started on one shoulder went across the collar bone up into the soft tissue of the head around the top part of my neck, down the other side, and down my spine. I think i faded asleep for part of the procedure, but it only would have been for a few minutes at most.. When Dr. Cenaiko was done i was asked to stand and moved under my own power to a recovery bed. It took 1 1/2 hrs to 2 hrs. to gain my full senses, the demerol drip had done it’s job nicely. However I don’t like the feeling of being dead drunk, heavily medicated but it was Very Necessary, as I returned for a 2nd treatment believing I was tough enough I did not need such a large demerol infusion, “BOY was I wrong” I had to beg Dr. Cenaiko to stop after 80 needles, I could not tolerate the pain. “Did it HELP? Definitely, No Question. However, I suffered another injury in physiotherapy which of course WCB refused to accept, further refusing to investigate. I cannot WARN injured workers enough, “DO NOT” trust WCB or anything they say. These people are literally Psychopathic Perverts who “DENY, LIE, FALSIFY”…. Hope You DIE. In 2014 I was alerted to more of the Tricks WCB uses to “TERMINATE” benefits of medical care, wage replacement. WCB likes to take other injured workers “Medical Information” build a file, which they send to treating physicians so when you get there, that physician will think that injury has already been investigated, when it has NOT. WCB also receives the assessment report which they “Rewrite” dropping recommendations made to protect the injured from further “HARM” .. In my case I believe WCB actually “FALSIFIED” the Doctor report, which they then used to “TORTURE” me .. When I entered the physiotherapy program I was able to walk 3.5 Kilometers per hr. within 1-2 months I could only walk .5 k’s per hr for 15 minutes before ungodly horrific pain forced me to stop. This was already with very strong opioids, which became useless. The Pain got so bad, sleep was unattainable, all night I would use Hot Showers, to try to drop the pain which only offered minimal relief. I pity anyone who has WCB direct their medical care. They say WCB does not direct injured workers medical care, but I have counted around 80 refusals of physicians / specialists who have tried to help me. Many Gave Up, stating they didn’t have time for the WCB *Bull Crap* Well Doc I’m 68, it’s been over 20 yrs since I suffered severe workplace injury. In the last 3 months I’ve been transferred by ambulance 3 times from my local hospital to one in S’toon. Instead of receiving treatments I’ve been prescribed handfuls of more pills, which really don’t help much. I can sense the end is near, I think of “MAID” every day, as these pain flares are extremely difficult. Peace Out