Pain physician & PhD statistician
Patients struggling with chronic pain find it difficult to engage in exercises. Yet research shows that physical activities is one of the most effective treatments for many pain conditions. It is important for patients to be strategic about exercise, & invest the limited time & energy on sustainable, beneficial forms of exercises. Walking & Nordic walking…
Pain around the vagina, penis, anus, & buttock are often experienced by patients but seldom reported. Patients should know that this is a common problem that can often respond to comprehensive pain treatments by pelvic pain specialists. Pelvic pain Pelvic pain is experienced around the vagina, penis, scrotum, anus, & buttock. It can be worsened…
For chronic pain conditions, gabapentinoids (gabapentin & pregabalin) are often first-line treatments because of their effectiveness & safety. They bind to a2d which alters activity of calcium channels on nerves, thereby modulating pain signals before they reach the brain. Pharmacology of gabapentinoids The absorption of gabapentin & pregabalin differ. Gabapentin absorption is slow. Beyond a…
While spinal nerve impingement can cause shooting arm or leg pain, many patients have instead pain from nerve entrapments. Common entrapments include Alcock canal, carpal & tarsal tunnels, meralgia paresthetica, and more than 50 others. Treatment starts with accurate diagnosis by specialist physicians familiar with the complex nerve anatomy and ultrasound visualization of the nerves.…
The medical specialty of Pain treats chronic pain using interventions & interdisciplinary care.
Patients with fibromyalgia experience chronic, diffuse pain across the body, due to exquisitely sensitivity of the brain & spinal cord (“central sensitization”). The keys to relief are prompt diagnosis, interdisciplinary pain care, & not overlooking co-existing pain conditions. Total body pain The best way to describe the experience of fibromyalgia is total body pain including a…
Small sensory nerves throughout the body gather information & interact with the body directly. This nerve-body interface underlies many diseases. In chronic pain, nerves cause “neurogenic inflammation” by activating blood vessels, skin, & immune cells. This is the site of action of many pain treatments. Key nerve-body interfaces Neural-vascular: Sensory nerves open blood vessels. This…
Patients with pain often feel that pain causes more pain. Pain is persistent and many treatments that seem at first effective stop working. Research shows Medications alone cannot break the pain cycles Injections alone cannot break the pain cycles Direct brain and nerve treatments are promising Interdisciplinary treatment is the only reliable treatment for chronic…
Pain signals converge in the core of the brainstem where they deeply influence behavior. For checks & balances, the brainstem uses “descending inhibition” as a volume control to reduce pain. Pain physicians leverage this for treatment, via antidepressants, acupuncture, & meditation. Descending inhibition systems To keep pain signals from running out of control, the brainstem…
