Drug Combos Do Not Work In Back Pain -But what you might try

It is commonly taught that drug combinations should be used in chronic pain – the most common pain being chronic back pain. Now it has been shown that little is gained from that. Only combo worth mentioning was buprenorphine plus pregabalin – the former is difficult if insurers won’t cover. There are other options that require actually treating the patient.

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Ankylosing Spondylitis with Hypermobility Syndrome – Impossible to diagnose

I once wrote that ankylosing spondylitis (AK) was impossible to diagnose in women:
The Pain Diagnosis that Cannot be Made in Women – Spine Arthritis – Ankylosing Spondylitis
http://painmuse.org/?p=77
Blood work is rarely positive including ESR, CRP, and HLA B27; MRI imaging takes at least 10 years to show positive and radiologist are not very good at reading them. Finally, women have hypermobile SI joints by necessity re pregnancy and rarely show much stiffness. To make things worse, are those cases that have AK and hypermobility syndrome – their chances of diagnosis are low. 4 cases were diagnosed mostly because they were HLA B27 positive (unusual finding) and they had a family history of rheumatic disease

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