Recent content by kstarm

I agree with some of the comments. I do think the shift to financially favor interventional medicine including pain procedures has been a detriment, especially for chronic pain patients. If the finances favored comprehensive pain mgmt and especially more robust coordination with social work...

That is why I am asking the question. What do you tell patients when the ask about activity restrictions?

I am curious what if any restrictions you give patients with the following and if so for how long: acute/sub acute non-surgical disc herniation with mild to moderate radicular symptoms. Mild symptoms or asymptomatic severe central spinal stenosis: Lumbar or cervical. Thanks

So AP of the sacrum (with sacrum lined up (typically caudal tilt)) or AP just no tilt and whatever you see under there you go for. If the picture doesn't look like what you posted do you start tilting until you see the joints separated

Can you post pics of depth? Edit: I used my amazing art skills instead. Feel free to create your own, but I am curious how deep on lateral you think the needles should be A, b, or C? Or something else?:

I got done reading the first one and was feeling no thanks, and then I read the 2nd option....What is option 3 any other private practice options, hospital based options or VA? 50min commute sucks in a major metro area, plus it sound like you are going to have to bust it to make bank without...

If patients meet criteria for CRPS I find that I usually can help them with all the various multimodal treatments. Most still have pain, or sensitivity but they are in a better place, and some homeruns. You need to address the elephants in the room e.g. If there was something traumatic that...

Are people doing anything for lumbar in these cases or just going ahead without clearance

Our clinic is currently working on creating a guideline for compression fracture management. Currently there is a plan to make bracing part of that management plan. Our neurosurgeons routinely requests this as well. Up-to-date says that bracing really does not do anything, citing a number of...

I have thought about this and think doing pain management for the ultra-wealthy/celebrity types could be a nightmare despite the improved income and shedding most of the current work headaches. I think the pressure to do something in these concierge type practices could easily lead to...

I think this article does bring up a good question. I have taken the stance with these referrals that it is bupe or taper off which has worked well for me. I do now have a number of geriatric patients and legacy patients on bupe. If I retire in 10 years what do I do with them. In the current...

I guess maybe some overlap with symptoms but fibro vs menopause seem different enough to me. I agree that their is more and more compelling evidence that immune interactions with the nervous system leads to fibro et al symptoms and there is likely some role for immune modulation for that group...

Why?

Why do you believe this is a placebo effect?

I am not sure if a tegaderm would help underneath, kind of a tricky area. I wonder if a shot of flonase on your skin before you wear it might prevent some of the irritation.