Chronic pain

Chronic Pain Programs Rise from the Ashes: This Was Silly in the ’90s and It’s Still Silly Today

Back in the ’90s, when I was a young physician, we had many “chronic pain programs” in town. These were made up of an interdisciplinary team of physicians and therapists who would be the court of last resort for patients in pain for whom traditional medicine couldn’t help. The problem was that patients would graduate…read more

RIP Radiofrequency Ablation Treatment for Low Back Pain

When Radiofrequency Ablation (RFA) became popular in the late 90s, it seemed like a miracle for many patients with chronic neck pain. At the same time, while this therapy seemed to work reliably to provide pain relief in the neck, it was always hit or miss as a treatment for low back pain. Perhaps that’s…read more

Why Is My Big Toe Numb?

On this page: Pinched nerve and toe numbness Other issues that can cause big toe numbness If your big toe is numb or you’re having on-again, off-again episodes of numbness, consider this a warning sign of something bigger — like a pinched or irritated nerve in your low back. Big toe numbness can also be…read more

Epidural Steroid Side Effects: Repeated Injections Cause Diminishing Relief

On the surface, as a nonsurgical way to relieve pain and inflammation, epidural steroid injections seem like a great idea. However, when we dive beneath the surface, we find that epidural steroid side effects are pretty awful. I’ve observed many times, that for some patients, that while that first shot seems nothing short of miraculous,…read more

NSAIDs and Opioids May Not Work for Pain!

As if we needed yet another reason to just say no to NSAIDs and opioids, it seems that some of them just aren’t working. So while you may be getting a lot with these drugs—the risk of sudden-death heart attacks and strokes and GI bleeding with NSAIDS, and addiction and more pain with opioids, for…read more

Confounding and the Biopsychosocial Model

As I blogged a few days ago, the biopsychosocialists are back. We dealt with these theories in pain management and orthopedic injuries a decade or more ago, but advances in pain research made these theories go away or at least fade into the background. Now, they have again surfaced in a new physical therapy viral…read more

You May Have a Pinched Low Back Nerve Despite What Your Doctor Thinks

The first day of medical school, our head honcho got up and was brave enough to say that about half of what they would teach us would probably be proven wrong. Yikes, was he ever right. This also applies to what your doctor thinks he or she knows about back pain. For example, we have…read more

A Great Regenexx Provider: Dr. Fenton in Vermont

How do we choose Regenexx providers? First, they have to have a certain amount of training in imaging-guided injections. Second, they have to have a willingness to learn a new way of treating and approaching patients. Finally, they need to be willing to leave much of a traditional practice behind and focus more and more…read more