I have a case of axillary neuritis with excessive pain. Below can be used to demonstrate deltoid weakness.

Since 1994, signs of deltoid dysfunction have been put forward and modified. below are the tests.

Continue reading “Signs of Deltoid Dysfunction From Axillary Nerve Palsy”

The question of diet and chronic pain has been only answered well by one randomized trial of 17 subjects showing benefit and another of 19 cases with statistical but not clinical pain reduction. The idea is that an anti-inflammatory diet might help but I wonder if it is beef related…

I have included all studies so you can decide…

Continue reading “What About Diet and Pain?”

The Pneumococcal vaccine can reduce chance of heart attack and stroke in cases over 60, and the shingles vaccine reduces stroke over 60 for 10 years.  Another study found reduced heart attack rates in those having a flu shot.  After all the bad press, this is a new view of benefits for vaccinations.

Continue reading “Vaccinations Help In Elderly in More Ways than One”

Years ago, though they injected local in shoulder bursa, they injected the cortisone in the buttock and got the same results as injecting it it bursa. This study was ignored by people who wanted ultrasound to be better. Now, a randomized control trial did not find ultrasound versus landmark shoulder injection made any difference. Using US could be a lengthy procedure and I’m glad it is put to rest.
Continue reading “Using Ultrasound Does Not Improve Shoulder Injection Results”

I see bras causing a problem in some patients but don’t know what to say. A recent blog article highlights the problem: Underwire Bra Pain: How to Avoid It https://whenwomeninspire.com/2019/01/11/underwire-bra-pain-solutions/ Their first comment coincides with my suspicion: 80% of bras don’t fit – (Yet getting a fitted one can be an expensive undertaking…) The need […]

Codeine and hydromorphone need to be converted to an active form in the liver.  Anidepressants use the cytochrome CYP2D6 system in the liver and may cut down conversion and hence opioid effectiveness. This has been determined in post-operative pains in people on SSRI anti-depressants. However common antidepressants used in chronic pain –  amitriptyline, venlafaxine and duloxetine – all use the CYP2D6 system as well.

Continue reading “Antidepressants May Lessen Benefits of Codeine or Hydromorphone”

I once went to a talk on treatment of neuropathic pain and much to speaker’s surprise I told him I hated that term.  Reason being, neuropathic pain with considerable peripheral sensitization (coming from the skin tissues) will respond nicely to neuropathic pain drugs like gabapentin but nerve pain syndromes coming from brain, spine of nerve root near spine ( sciatica) do not. Then comes along a study that lumps them all together – most probably spinally related and the notice no benefits from topical meds.  That is nothing nerve shattering – most neuropathies respond poorly to the same drugs orally – a study using drug combinations orally only got 23.7% significant response rate: I wrote about it here:
Severe Neuropathic Pain – Only 1/4 Respond to Standard Drug Protocols – What Else Is There?
http://painmuse.org/?p=2640

based on article:
Moulin, Dwight E., et al. .
Long-term outcome of the management of chronic neuropathic pain: a prospective observational study.
The Journal of Pain 16.9 (2015): 852-861.
https://www.jpain.org/article/S1526-5900(15)00703-8/fulltext

Continue reading “Topicals For Pain Fair Poorly So Selection May be Key”