Neuroinflammation of Patients with Sciatica

A study by Massachusetts General Hospital (MGH) investigators has found, for the first time in humans, that patients with chronic sciatica - back pain that shoots down the leg - have evidence of inflammation in key areas of the nervous system. In their paper published in the May issue of the journal Pain, the research team reports finding that average levels of a marker of neuroinflammation were elevated in both the spinal cord and the nerve roots of patients with chronic sciatica. Additionally, the study showed an association between neuroinflammation and response to anti-inflammatory steroid injections, with levels of neuroinflammation differing…
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TMS Protocol May Be Effective in CRPS

The use of a novel frequency pairing for transcranial magnetic stimulation (TMS) may effectively relieve upper and lower extremity pain associated with complex regional pain syndrome (CRPS), according to a study published in Neuromodulation. The TMS protocol used in this study consisted of initial intermittent theta bursts (ie, burst of three 50-Hz pulses every 200 ms, 2 second-long trains repeated every 10 s, total of 600 pulses, delivered at 70% of the resting motor threshold [RMT]). This was followed by a 10-Hz stimulation (duration, 10 s; intertrain interval, 30 s; total pulses, 2000; delivered at 80% of RMT). Muscle activity was monitored throughout…
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Dr. Castillo: The Opioid Crisis

When you look at the “Opioid Epidemic” in America it is like an elephant everyone looks at it from their point of view and uses their facts the way they want the elephant viewed. The Federal Government passed a Law, as did the State of Arizona stating that the maximum level of opioids should be ninety morphine milligram equivalents (90MME). They based this more on politics and the storyline of opioid crisis with people dying. The facts are right, but is the interpretation correct. The opioid is killing people. The first thing is some people have severe pain. The Laws…
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Neck Pain a Migraine Symptom

Contrary to previous studies, neck pain is a symptom of migraine only, not the result of an underlying muscle dysfunction that triggers migraine attacks, according to a recent article published in The Journal of Headache and Pain. The study sought to weigh in on the scientific debate regarding neck pain in migraineurs, and whether neck muscle dysfunction could be a trigger for migraine attacks or is merely a symptom. Investigators recruited 102 participants (43 episodic migraine, 31 chronic migraine, and 28 healthy controls) and used surface electromyography to record muscle tension of the trapezius during 15 blocks of stressful experimental conditions alternated with…
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