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Showing posts from September, 2016

The Knee Bone's Connected To The Leg Bone....

Two recent studies have brought a not-so-novel concept into the limelight-the concept being that people who present with knee pain often develop pain in other parts of their bodies.  These studies, known as the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), were assessed by a Clinical Epidemiology Team as Boston University School of Medicine in an effort to find preventive strategies to combat this trend.




The authors suggest that knee pain may cause individuals to alter their gait in an effort to compensate for their discomfort. In doing so, the alignment of other body joints is altered, and this may be the cause of secondary joint pain, especially hips and ankles. The authors go on to say that the pain in these secondary sites is not necessarily osteoarthritis--perhaps bursitis or some other injury.

Osteoarthritis is a result of wear and tear in the joints.  We may not be able to completely eliminate osteoarthritis from occurring, but some common se…

Food Fight! New Evidence Based Scales Rank Foods Abilities In The War On Depression

It's long been established that many folks with chronic pain suffer from depression.  This is largely due to the limitations on activity, the constant discomfort, the isolation, and loss of independence suffered by this population.




It's not unusual for a chronic pain patient to be prescribed an antidepressant. But there are other ways to battle the blues.  Introduced at this year's American Psychiatric Association,  a "brain food scale" rates nutrients and foods in their ability to help people to battle depression and perhaps dementia as well. According to Dr. Drew Ramsey, who presented on the topic, data suggests that foods have a very critical role to play in brain health.

Plant based foods rate vary highly in this ability, according to the newly described Brain Essential Nutrients Scale (BEN).  Leafy green vegetables are high on the list, but also included are game meats, organ meats, nuts, clams and other bivalves, and fish such as salmon. According to the s…

Do You Take Lyrica? Here's The Latest...

Lately I've seen a lot of television spots for prescription medications...for products that treat diabetes, psoriasis, and of course, chronic pain. While think it's generally good for patients to know about pharmaceutical options available to them, sometimes I wonder if patients consider all the pros and cons of each medication before visiting their doctors asking for prescriptions for this or that.



Case in point--one product I see quite often is a prescription product known as Lyrica®. The generic name is pregabalin and it's indicated for chronic pain. The general mechanism of action for this drug is that it dampens the nervous impulses (including pain signals from body to brain) as they travel along the neurons in the human bodies.  While this drug is categorized as a controlled substance, it's not really habit forming and does not pose risk of addiction like the opioids do. This product is widely used and does offer some relief to patients...but there are new studi…

The ABCs of Pain Management: What You Should Know About NSAIDs

The topic for today is NSAIDS.  I hope you know what this acronym stands for, and I hope you know even more about the topic after you read this post!



First off, NSAID is an acronym that stands for Non Steroidal Anti-Inflammatory Drug.  This class of drugs has flooded the marketplace in the last twenty or thirty years.  If you don't know the term NSAID, you might be aware of some of the brand or generic names of these drugs, including Aleve®, Naprosyn®, Motrin®, naproxen, and ibuprofen.  But there are many more. These drugs are very effective at reducing fever, pain and inflammation.  But there is more to the story...

I came across a survey in recent news...in a poster session at the recent PAINWEEK conference in Las Vegas, authors cited survey results that were truly shocking.  Forty-seven percent of a responders to a small online survey did not know what an NSAID was, including forty percent of responders who reported that they had taken pain medication in the last twelve months…

Effectiveness Of Ozone Injections Is No Longer Up In The Air

Most of us know someone who has osteoarthritis, if we don't have it ourselves.  Joint replacement surgery is a pretty common remedy when the joint becomes severely damaged and the patient is in a lot of pain.  With risk of complications from such a surgery, perhaps an alternative treatment should be tried first.






One such remedy is the injection of a synthetic version of collagen(e.g. Synvisc®) into the affected joint.  This procedure restores the cushioning to a joint that has degenerated over the years. It can diminish the pain substantially and help put off joint replacement surgery for months to years.  The biggest drawback is that these products are expensive.  GoodRX, a web site that can be used to estimate the cost of medications, estimates the cost of these products to be over $1,000 each.

Here's another example--and I am not sure how widely accepted this protocol has become since study authors introduced it in November 2015.  Are you ready for this? Injecting ozone g…

Thinking Out Loud: Getting To The Root of The Problem Is a High Priority

In the modern era of pain management, it has become of utmost importance to pinpoint the source of pain. This really offers someone who is experiencing pain the best hope of a speedy, permanent resolution to their discomfort.  If pain medications are ordered, they may be effective, but will only cover up the pain instead of fixing it.




This process can be very frustrating. It's not unusual for someone to have pain but no source can be identified. But it's really better to be relentless in the search.  Here's a story that sort of illustrates my point:

Mrs. A. is a healthy woman in her later 50s. She lives in the country and raises chickens...she always has fresh eggs on hand!  She has never smoked and does not really consume alcohol too often.  She is a regular exerciser and loves to garden. She has been happily married for almost forty years. One day Mrs. A. notices some shoulder pain so she visits her local ER. The physician there tells her that she probably pulled a mus…

The Nuts and Bolts Of Patient/Provider Agreements

In the wake of opioid and heroin addiction, you may be hearing more about patient/provider agreements when it's determined that opioid therapy is in the patient's best interest.  Today's post will provide you with a brief overview of what a patient/provider agreement is, and what you might see in one if opioid therapy is in your future

A patient/provider agreement is simply a contract that these two parties make with each other at the onset of treatment.  This type of contract spells out in detail all of the responsibilities of the health care provider as well as those of the patient.  The contract also spells out what will happen if the terms of the contract are violated by either party.



What are some of the things you might see in a patient/provider agreement? Each provider may be a little bit different, but in general you can expect to see at least some of the following:

Patient Responsibilities:


Patient agrees to take medication only as prescribed.Patient agrees to keep…

Living in Spite of Chronic Pain

My message for today is simple but very important.  My message today is that a positive attitude about ANY situation--chronic pain being a prime example--is the most important weapon you can have.  Case in point: Barby Ingle.  Click here for a link to a column she wrote for her the Pain News Network.  Her story is not unusual; her attitude is priceless!

Sources: Flickr; Pain News Network

The Wurn Technique: A Novel Approach to Pelvic Adhesions That Cause Pain And Infertility

One of the most baffling pain conditions women experience is chronic pelvic pain. This unfortunate problem is not only uncomfortable, but can be a cause of infertility in women. Some of the usual causes are fibroids, endometriosis and pelvic adhesions. Typically, these problems are addressed by standard modalities--surgery, medications, psychotherapy, and physical therapy among them.




Recently, I came across a newer idea for treatment of pelvic pain caused by adhesions.  It's known as the Wurn Technique, and it's really a quite interesting approach.  Similar to a deep tissue massage, this method can be used to break the adhesions in the pelvic area.  This helps to reduce the pelvic pain and can even restore fertility in some cases!  The best part is that it's all drug free!

For more information about the Wurn Technique, you can click here to reach the ClearPassages website. This site explains in more detail about how the technique is used and also the story of how this ama

Daith Piercing: An Alternative Medical Practice For Chronic Migraine

Piercing is a form of self expression these days, along with tattoos of every shape and size. I try not to judge--and here is one good reason why.

Have you ever seen someone with a piercing like the one above?  This is known as Daith piercing.  It is not just someone trying to be stylish! This is actually an acupuncture practice that has been in existence for thousands of years.  There is no scientific evidence to support this practice, but many migraine sufferers who have this piercing report a reduced frequency in migraine attacks.

Migraine headaches are a complex neurological event. More than 3 million persons in the US experience a migraine attack every year. The pain can be so severe as to cause nausea and vomiting, and can incapacitate a person for hours to days.  If you experience severe headache, typically a throbbing on one side of the head, accompanied by sensitivity to light and/or nausea/vomiting, it just might be a migraine.  There are many pharmacological and non-pharma…

September is Pain Awareness Month!

My thoughts exactly!


Sources: Flickr.com

Ehlers-Danlos Syndrome: A Rare But Painful Disorder

Do you know anyone who is extremely flexible--in the physical sense?  As it turns out, a small number of these individuals actually have a connective tissue disorder.  Known as Ehlers-Danlos syndrome, this inherited disorder of connective tissue results in overly flexible joints and stretchy, fragile skin.  A more severe version of this disorder also affects the walls of the blood vessels.

How does one know this might be a problem? Firstly, the joints are much more flexible than the average person because the connective tissue that holds the joints together is very loose.  Secondly, the skin of affected individuals is very "stretchy...it can be pulled away from the body more than normal, but goes right back into place when released.  The skin is also very fragile, to the point where wounds do not heal well. Those who have the vascular form of this disorder have distinctive facial features( thin nose and upper lip, small earlobes, and prominent eyes), and the heart can be affecte…

Control Or Catastrophe? That Is The Question....

Back in March 2015 I wrote a post about pain catastrophizing.  You can read that post by clicking this link, but I will try to explain it to you briefly: Pain catastrophizing simply means that physical pain that is amplified by negative emotions that coincide with the physical pain.  Many people might think that this is just part of a personality, that it cannot be changed, etc. etc.



But today I am here to share some good news--that is to say, that some of that factors associated with pain catastrophizing CAN be controlled.  In the next paragraph or two, you'll get my drift.

First, let me tell you about an article I read about this topic that was completed at Emory University.
The study authors investigated 300 chronic pain patients at clinics in rural Alabama. The study revealed that a very key factor common to pain catastrophe is low health literacy. These patients simply did not understand much about health and/or medicine, so they had very poor understanding of their health…