EDS: Analysis of Current Treatment Options

Ehlers-Danlos Syndrome: An Analysis of the Current Treatment Options – Pain Physician – 2020

Background: Ehlers-Danlos syndrome (EDS) is a multifaceted disease that can present with a variety of types of pain.

Unfortunately, both the mechanisms and treatments for pain are poorly understood. The proposed treatments for the various musculoskeletal pain syndromes in EDS have had variable success, and it becomes much more imperative to better define and evaluate the current treatment modalities in treating this debilitating disease.

Objectives: The purpose of this study was to investigate the currently available treatment modalities for patients with EDS and their efficacies in pain and symptom relief. 

Low-Dose Radiation for Viruses like COVID

Interest grows in low-dose radiation for Covid-19, but experts are divided – By Juliet Isselbacher – July 2020

Back in 2013, toxicologist Edward Calabrese and a colleague at the University of Massachusetts, Amherst, were combing over a cache of century-old data on low-dose radiation therapy, hunting for evidence on the scientific idea that small doses of certain poisons might actually be beneficial.

They found small amounts of radiation were surprisingly successful in combating pneumonia. Again and again, doctors reported symptoms subsided within hours of a single X-ray.

The use of “micro-doses” of radiation as therapy for various aliments has come up before here: The Radioactive Remedy.

How to Talk to Your Doctor About Pain

How to Talk to Your Doctor About Pain – Health Essentials from Cleveland Clinic – June 2020

This article contains an excellent list of many descriptive words to help us describe very specific aspects of our pain.

There are many causes and types of pain, and everyone experiences it differently. Effective communication with your doctor is a key piece of the pain management puzzle.

“While most people think pain is all the same, there are actually several different types of pain,” explains pain management specialist Robert Bolash, MD.  

It seems most scientists, researchers, and even doctors assume that chronic pain is some generic entity, and that’s a ridiculous assumption. 

Profit Motive as Cause of Previous Over-Prescribing

I keep reading about studies that show opioids to be no more effective for pain than non-opioid medications or other therapies. I still cannot believe that.

At first, I was convinced the studies had been corrupted, then I thought that the statistics were improperly manipulated, then I thought the patients had been poorly selected, but now I’m running out of excuses to insist those studies are wrong.

Still, it makes no sense to me that the only medication or treatment or therapy that has reliably reduced my pain for decades can be “proven” to be no better than drugstore pills (NSAIDs). 

FDA Clears OTC Electromagnetic Pulse Therapy

FDA Clears OTC Electromagnetic Pulse Therapy – Steve Duffy – Feb 2020

I haven’t tried this because my pain’s location is constantly changing, but for less than $30 on Amazon, it might be worth a try for localized pain.

The over-the-counter (OTC), drug-free medical device, ActiPatch®, has obtained a new 510(k) clearance from the Food and Drug Administration (FDA) for the adjunctive treatment of musculoskeletal pain.

The topical device is a wearable version of pulsed shortwave therapy that consists of low voltage (3V) digital/analog electronics that produce a therapeutic radiofrequency field.

The electromagnetic signal pulses to stimulate neuromodulation of the afferent nerves to reduce pain and inflammation. 

Diagnosis Codes Index – Opioid related disorders

Diagnosis Codes Index – Opioid related disorders (F11)

In the new ICD-10 system for medical billing codes, there’s a specific code for anything and everything to do with opioids. There’s even a code for “opioid use, unspecified, uncomplicated“, which seems to indicate that any “use” of opioids is a medical problem in itself. 

We can see how “the medical system” is organized by looking at how healthcare services are billed. Looking at the hierarchy of categories in this billing scheme, we can discover how they see us, pain patients, using opioids.

The problems start at the top level: our “code” is listed under the category of “Mental disorders”:

Mental and behavioural disorders (F00–F99)   

Diagnosing Hyperalgesia to Limit Care

Misuse of Hyperalgesia to Limit Care | Practical Pain Mgmt | By Donald C. Harper, MD, BSc – March 2011

John (not his real name) is a 51-year-old chronic pain patient that I have been seeing since 2003. I had begun carefully titrating him on oxycodone, Oxycontin® and Dilaudid®, which had been started by another doctor and, ultimately, settled on a dose of Oxycontin 640mg B.I.D., 32mg hydromorphone q 4 hrs prn breakthrough pain and Xanax® 1 to 1.5mg q.i.d. prn muscle spasms and anxiety. On these medicines, he was content and functional and denied any deficits or side-effects due to his medicine.

His insurance company was concerned about the expenses of his medicine and asked me to arrange for a second opinion. Given the complicating factor of his end-stage lung cancer, I arranged for an evaluation by the pain clinic of a major cancer center.  

Artificial Intelligence, Back Pain, and the Cleveland Clinic

Artificial Intelligence, Lower Back Pain, and the Cleveland Clinic  – By Chuck Dinerstein — December 20, 2018

Two physicians from Cleveland Clinic write almost breathlessly about how artificial intelligence will revolutionize the treatment of back pain – a highly remunerative area to physicians that has no one ascendant, best treatment regimen.

What is so troubling, at least to me, about the vaporware they are peddling is both their confidence in its application, and the way cost pervades their view.

I’m glad someone else is pointing out what I’ve observed as well: all aspects of healthcare are more and more beholden to financial interests instead of medical ones.  

The Nuts and Bolts of Low-level Laser (Light) Therapy

Here are my annotations of five studies showing the efficacy of photobiomodulation (PBM), also called LLLT, for pain, depression, and muscle function. (as of 2/9/2018)

The Nuts and Bolts of Low-level Laser (Light) Therapy – Ann Biomed Eng. 2012 Feb;  /PMC3288797/

This full-text article explains how LLLT works.

Soon after the discovery of lasers in the 1960s it was realized that laser therapy had the potential to improve wound healing and reduce pain, inflammation and swelling.

In recent years the field sometimes known as photobiomodulation has broadened to include light-emitting diodes and other light sources, and the range of wavelengths used now includes many in the red and near infrared  

High-Intensity Laser Therapy Improves Chronic Pain

High-Intensity Laser Therapy Improves Chronic Pain, Reduces Opioid Dependence – Pain Medicine News – DECEMBER 26, 2017

Scientific evidence has been accumulating over the last 10 years regarding the usefulness of high-intensity laser therapy (HILT) for the treatment of a variety of acute and chronic pain syndromes.

Devices used for HILT operate at wavelengths between 660 and 1,275 nm and at power levels from 1 to 75 watts (Table).

Compared with low-level laser devices (<1 watt), these HILT devices can penetrate tissue to depths ranging from 5 to 15 cm while producing only low levels of thermal accumulation in the tissue.