Thanks for your post. I would recommend going into the appointment with an open mind. Your goals are pain relief and the medications may not be the best or only way to get there depending on the pathology. There are a number of treatments that can be used to treat neck pain. It all depends on what your symptoms are, your exam, and how it all correlates with the findings on imaging. Good luck.View Thread
Thank you for your post. A careful history and exam are always important. The treatment of Fibromyalgia normally consist of patient education, specific medications, cardiovascular exercise, cognitive behavioral therapy (CBT) and other psychological therapies. These all been shown to results in some short and long term benefit. Opioids are typically not used for the treatment of pain from Fibromyalgia. In addition, with your GI issues - the role of opioids can be even more problematic. You should discuss all if the issues with your doctor. I hope that helps. Good luck.View Thread
Thank you for your post. I would agree with what others have suggested thus far. I second opinion sounds like a good next step. I hope you are able to find a solution. If you have further questions please let us know. Good luck.View Thread
Thank you for your post. Excellent question - There is good evidence that the immune system plays an important role in chronic pain, but as you elude to, there is no data that it results in weakening of the immune system.View Thread
There is some data to suggest that opioids may effect wound healing - particularly in animal models. My experience with prolotherapy is limited and thus I cannot give you an opinion as it relates to that treatment. I do however believe if you are able to wean down on the opioids or perhaps off for a period a time (opioid holiday) that it may provide benefit. Good luck.View Thread
Thank you for your post. I would suggest discussing these issues with a foot and ankle specialist. They will likely be able to assist you with the shoe modifications and spectrum of treatment for this. The treatment normally consist of proper foot wear w/ a metatarsal bar or pad placed beneath the involved bone and limiting activity for several weeks. In severe cases consideration for immobilizing the foot can be made as well. There may be a role for surgery if conservative treatment fails but again this is a discussion you should have with the orthopedic specialist. I hope that helps. Good luck.View Thread
Joel - Thank you for your post. This sounds like an incredibly difficult situation. I would suggest you seek the opinion of a pain specialist who is focused on the interventional side of things. There are a number of treatments from a non pharmacologic perspective that could provide you relief. Specifically - there may be a role for spinal cord stimulation. Have you tried any topical medications to treat the pain? This would also be worth a discussion with your pain doctor. Please let me know if you have any other questions. Good luck.View Thread
I am sorry to hear you are struggling. the treatment of neuropathic pain is very challenging. Opioids are generally a last line treatment as side effects often will outweigh clinical benefit. Neuromodulators (anti-convulsants, anti-depressants) are often utilized first. Have you ever sought any non pharmacologic treatments? You may be a candidate for spinal cord stimulation or other alternative treatment. I would discuss with your provider. Good luck.View Thread
Costochondritis (costo-sternal pain) is diagnosed purely based on exam and the ability to reproduce pain on palpation of tender areas. The natural history if poorly understood. The treatment normally consist of stretching exercises (physician directed), heat (applied a few times a day), and anti-inflammatories /Tylenol (anti-inflammatory creams can also be helpful). This does normally resolve over time but again the history is very poorly documented in the literature. A variety of rheumatologic conditions can be associated with this and an evaluation from that standpoint is sometimes warranted. You should discuss this with your doctor. Good luckView Thread
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