Facial Ramsay-Hunt Shingles -Paralysis Maybe Adverted by Stellate Ganglion Block

Posted on April 9, 2015 by admin

Ramsay Hunt syndrome shingles affects ear canal and associated area about ear, and is very painful and can be associated with facial nerve damage. Two stellate ganglion blocks with “local anesthetic 0.25% bupivacaine and triamcinolone 40 mg were given daily for two sittings. Next five sittings of block were done with 0.25% bupivacaine only” – pain subsided after 2-3 days.

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Posted in post herpetic neuralgia | Leave a comment

Donepezil reduces stress induced widespread pain in mice so…

Posted on April 6, 2015 by admin

Donepezil (aricept) is used as an anticholinergic to help dementia. In the animal model repeated use can “cure” “ICS[Intermittent Cold Stress]-induced hyperalgesia [increased pain] and allodynia[touch pain] even after the cessation of drug treatments”

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Posted in Drugs, elderly, Fibromyalgia | Leave a comment

Breathtaking Option for Treatment Resistant Fibromyalgia

Posted on April 3, 2015 by admin

A Water pill, Spironolactone 100-200 mg/day, can dramatically relieve pain in potentially 1/2 of Fibromyalgia cases and reduce morphine needs. -NOT CONFIRMED

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Posted in Drugs, Fibromyalgia, neuropathic | 2 Comments

Opioids Affect Immunity

Posted on February 13, 2015 by admin

Opioids can lower resistance to infections. Had on lady get couple of pneumonias which  made me reconsider which types of opioids to use in these cases.

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Smart Phones Not So Smart

Posted on January 13, 2015 by admin

Leaning over reading smart phones linked to neck problems.

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Posted in Neck | Leave a comment

Nocturnal Calf Cramps – Trigger Injections Help

Posted on January 12, 2015 by admin

Injections into gastrocnemius not only helped nocturnal calf cramps – they helped the insomnia as well

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Posted in Injection, Leg Pains, myofascial pain | Leave a comment

Low Vitamin D associated with Osteoarthritis

Posted on January 11, 2015 by admin

This is not necessarily new – Framingham study found that low vitamin D was associated with with “an increased risk for progression of osteoarthritis of the knee” back in 1996. This seems to have been forgotten.  Now a new study found “Participants with adequate 25(OH)D levels reported significantly less knee osteoarthritis pain compared to participants with deficient or insufficient levels, regardless of obesity status”.

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Posted in arthritis, Knee | 1 Comment

New Treatment for Scabies – and even bad Rosacea, Blepharitis, and Scalp Folliculitis

Posted on December 4, 2014 by admin

Scabies has become increasingly resistant to Nix and Kwelleda leaving people with attempts to get Ivermectin orally by emergency release from the US (not easy – they kept sending me repeated letters with more questions to answer). It is easy for animals as it is a de-worming agent though. A work around is the finding that topical ivermectin 1% has real potential to work. It is now clear that some Roseacea, Blepharitis, and scalp folliculitis is actually an infestation of Dermodex “mange” mites that are ubiquitous in humans but excessive in some.

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Pamidronate in Severe Knee Pain

Posted on November 16, 2014 by admin

Filling in my contention that pamidronate is very useful in Complex Regional Pain Syndrome, is an older article using it for CRP of the kneecap.

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Posted in complex regional pain, Drugs, Knee | Leave a comment

Inflammatory Back Pain (IBP) – MRI’s Use depends on when you do it.

Posted on September 28, 2014 by admin

In IBP – MRI could be negative or positive at one point and then the opposite later on. Make MRI imaging more dubious than people think.

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Posted in arthritis, Back Pain | Leave a comment

Are You Sick of Health Web Sites?

Posted on September 27, 2014 by admin

I am sick of health websites that:
– don’t give links to what they discuss
– are filled with commercial ads
– make you go though multiple pages, each with various ads
– just repeat what you see elsewhere.

It is thought that health sites will be filled with commercial interests and I am seeing that already.
see:
Health websites could be overrun by commercial interests, experts fear
http://www.cbc.ca/news/health/health-websites-could-be-overrun-by-commercial-interests-experts-fear-1.2779128?cmp=rss

Everything on this site is referenced and on one page. I have no ads nor commercial interests.

I think people should tell some of these sites that they are not worth scrolling through…

opinions?

Posted in Uncategorized | Leave a comment

Desimpramine For Neuropathic Pain a Myth

Posted on September 27, 2014 by admin

Use of  Tricyclic antidepressants (TCA)’s for neuropathic pain was based on an article for diabetic neuropathy where, through frequent phoning and support, authors were able to get patients up to 150 mg. No one has succeeded in getting people up to these doses since and success with TCA has been less. Now, in the case of desipramine, Cochrane has come out and said it – “This review found little evidence to support the use of desipramine to treat neuropathic pain. There was very low quality evidence of benefit and harm, but this came from studies that were methodologically flawed and potentially subject to major bias. Effective medicines with much greater supportive evidence are available.”
I have written how Nortriptyline is of little use in Neuropathic pains:
Is Nortriptyline Any Good? – Maybe – but Maybe Only a Bit
http://painmuse.org/?p=3316

neuropathicp

I wish speakers would stop extolling the virtues of TCA’s when their effects are poor at best. – use better drugs.

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Posted in Drugs, neuropathic | Leave a comment

Autosomal Dominant Polycystic kidneys – avoid or keep Estrogens to low dose

Posted on September 26, 2014 by admin

Recent review of Polycystic Kidneys states “Because of the proliferative effect of estrogen on hepatic cysts, oral contraceptives containing estrogen and menopausal estrogen therapy should be administered at the lowest effective dose or avoided in patients with ADPKD (autosomal dominant polycystic kidney disease)“

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Posted in Uncategorized | Leave a comment

Acetaminophen (paracetamol) does not work in acute Back Pain

Posted on September 26, 2014 by admin

Double blind study found Paracetamol (acetaminophen) at average dose of 3500 mg/day in week 1 and 2800 mg/day in week 2 for the regular group was not better than placebo.  It had `no eff ect on pain, disability, function, global symptom change, sleep, or quality of life.`

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Posted in Drugs | 1 Comment

No Evidence of Hypervigilance in Fibromylagia (FM)

Posted on September 26, 2014 by admin

Implications have been made that victims of FM are nuts and think too much of their pain. Now it seems that subjects with FM are no better in awareness of changes in tactile stimulation – suggesting hypervigilance is not present.

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Serum Lipase Should Be Test For Pancreatitis

Posted on September 26, 2014 by admin

Serum lipase has a sensitivity of 91% while amylase had sensitivity of 61%. Specificity was 92% for lipase and 93% for amylase.  Testing lipase and amylase together changed sensitivity very little – was 93%.

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Bell’s Palsy Treatment Algorithm

Posted on September 12, 2014 by admin

Latest algorithm suggests you make sure of diagnosis

Use of antivirals doesn’t work

Prednisone 1 mg/k x 7 days (why does one need to taper though?) useful

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Posted in Uncategorized | Leave a comment

Stellate Radiofrequency Neurolysis for upper limb CRPS

Posted on August 22, 2014 by admin

Severe pains in various locations in arms can respond to burning the stellate ganglion in the neck.  67.6% of radiofrequency destruction  cases obtained  >50 % pain inprovement for over 2 years while those with just anesthetic block got 21.2% for 2 year results.  Anaesthetic block lasted average or 40.5 days only.

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Posted in complex regional pain | Leave a comment

Case of Wrist Complex Regional Pain (CRPS) Helped by Dextroamphetamine

Posted on August 22, 2014 by admin

While dealing with infertility with dextramphetamine, patient’s wrist CRPS pains issues subsided

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Posted in complex regional pain, Drugs | Leave a comment

Methotrexate for Knee Osteoarthritis

Posted on August 22, 2014 by admin

On methotrexate up to 25 mg/week orally, 53% had over a VAS drop of  2.0/10 while only 24% had in control group.

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Posted in arthritis, Drugs | Leave a comment

Venous Leg Ulcer? – Simvastatin 40 mg/day Speeds Healing

Posted on August 17, 2014 by admin

With  leg ulcers less that 5 cm size, all healed in simvastatin group versus 50% control. With ulcers over 5 cm, 67% of simvastatin group closed versus none of control group.

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Posted in Leg Pains | Leave a comment

Drugs for Diabetic Neuropathy

Posted on June 14, 2014 by admin

Should we believe these results?  A study on treatment for diabetic neuropathy pretends one treatment is better than onother because on group starts with more severe pain than the other then claims each treatment can virtually eliminate pains with 7 months of continued use. No one else got these results.

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Posted in neuropathic, Uncategorized | Leave a comment

Welcome to Painmuse

Posted on May 2, 2014 by admin

ALTHOUGH I WILL NOW UPDATE THIS SITE, FOR PAST 6 MONTHS, BLOG NOTES (about 50) WERE PUBLISHED AT :
newpainmuse.org

visit me there!

I have a program that tracks where users are from – pain is worldwide:

Thanks admin

Hit     CTRL  +   to make things larger

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Treatment of Resistant Osteitis pubis with Pamidronate

Posted on March 20, 2014 by admin

Back in 2001, 3 subjects with resistant osteitis pubis had monthly infusions of 60 mg pamidronate – one for 3 months and 2 for 6 months. Two had no known cause and one had inflammatory arthritis. All recovered and had no recurrence of symptoms and in the 2 with bone scan changes- these changes resolved. Now this study has be replicated – cases with bone marrow edema were infused with 60 mg over 60 kg size and 30 mg under 60 kg size. Sadly, they were given one infusion initially and maybe a repeat at 3 months – a study I call “one shot wonders” – hardly sufficient to work well. Nonetheless, 5/8 were significantly improved and returned to sports and 1/8 was some improved. This confirms in my mind that it should be used in resistant osteitis pubis.

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Posted in groin pain | Leave a comment

Osteoarthritis – Does Sierrasil Work? – No

Posted on February 11, 2014 by admin

One of my patients started on Sierrasil and said there was literature on its effectiveness – it does not say that it helps pain though.. Continue reading →

Posted in Drugs, Knee | Leave a comment