Greetings!
My esteemed Steemians.
It has been a while since I last wrote on my blog. Last week was the busiest week yet for this year 2018. For anybody who knew me, they could have guessed what made me so busy. However, I have taken binge-reply and comment whenever I got the chance. I would not want to miss steemit for long now. My mind has always been on steemit.
For more than a couple of years, I have always take the opportunity to talk about how to get rid of chronic pain, effectively and permanently.
Introduction.
Chronic pain is widely defined as any pain that lasting more than 12 weeks. Chronic pain can persist for months or even longer.
Every a patient comes to see a doctor complaining of pain, we would normally ask several questions. The usual questions would be
- Where is the pain?
- When did it start?
- Does it getting worse?
- Does it moves to other places?
- Any other symptoms associated with it?
- Anything that you do may relieve the pain?
- Does the pain comes and go or is it consistent with severity?
- If you could give grades for this pain being 0 as no pain at all and 10 the worst pain you ever felt, which would it be?
- Does it disturb your sleeping pattern?
- Does it stop you from doing your work or something that you like?
The list can be very long.
The reasons why we asked so many questions are basically to locate as accurate as possible the system that involved.
The type of chronic pain that I am going to concentrate is Peripheral Neuropathic Pain. What it basically meant is that pain originates from the nervous system.
**Peripheral Neuropathic Pain
I put up this picture to show you the part of the nervous, more accurately sensory system that responsible for neuropathic pain. The part that responsible for neuropathic pain is the first-order neurons.
I have difficulties trying to memorise this picture when I was a medical student 20 years ago.
If we look at the picture, the location of the neurons involved in neuropathic pain is at the periphery. It causes us pain because the neurons got inflamed. The term for this condition is called neurogenic inflammation.
Before I continue, let me summarize all the information that we got so far.
Chronic pain is a pain that lasts more than 12 weeks and may persist even for years. One type of chronic pain that we know is coming from the nervous system which we call SomatoSensory System, specifically coming from the first-order neurons. It causes pain because this part of the neurons got inflamed. This neurogenic inflammation which causes us pain is associated with Neuropathic Pain.
We call it Peripheral Neuropathic Pain because most of the receptors that pick up the pain are located at the peripheries. i.e joints, underneath the skin and etc.
I know, by this time, most of your family doctor or physician will disagree on the origin of pain once you share this information. I hope that I can explain everything in this one posting. However, I may need another posting or Part 2.
How do we treat Peripheral Neuropathic Pain?
Let me start sharing with you a book edited by Lawrence Kruger and John C Liebaskind, titled Advances in Pain Research and Therapy Vol. 6, Chapter 1 written by John J Bonica MD, Pain Research and Therapy: Recent Advances and Future Needs, which was written in 1984.
- Prevalence of chronic pain (neuropathic pain) in the USA is estimated at 20% - 40%.
- In 1982, chronic pain cost the American people a total of $65 - $70 billion for health - care services; loss of work productivity; compensation and related factors, representing 10% of the American national budget.
Nothing has changed since 1984, pain management is ineffective and has become more expensive. Current US national budget is $3.9 trillion. US healthcare cost in 2013 were 17.9% of GDP = $612 trillion. Today, chronic pain could cost an estimated $390 billion. BUT A CHANGE IN PAIN VIEWS IS HAPPENING - John Lyftogt MD, 2014.
I quoted Dr John Lyftogt MD because he had pioneered a treatment for chronic pain that may reduce the cost by hundreds of fold and even get rid of it effectively and permanently!
The treatment that he had introduced is called Lyftogt Perineural Injection TreatmentR or Lyftogt PITR.
Currently, I am using this method to treat most my patients who suffered from chronic pain, mainly neuropathic pain.
**How does it work?
We are using a low glucose/dextrose concentration in our treatment. At first, I wasn't really convinced that a glucose or dextrose can be used to get rid of chronic pain effectively and literally permanently.
After learning from Dr John Lyftogt, I carefully picked my patient that may get benefit from this method.
Most of the patients that I picked had been complaining of pain for more than 3 months. I purposely picked those with knee pain only because it was relatively easier to treat and those who are willing to test it out. Surprisingly, most of the patients that I encountered, are more than willing to take part using the new method.
After a comprehensive history and physical examination together with an explanation on how I was going to treat them, I started by withdrawing glucose/dextrose into my syringe.
I just cannot hide how happy I am to start injecting may patient. Because I know, it will put a smile on their face most of the time, after treatment.
(I will be treating 3 patients on this coming Saturday and I hope I can update you all with new pictures or video by Saturday on how I do the injection. )
Most of the nerves are palpable to a trained doctor using light palpation on the affected side. The rule of thumb is, any points that exerting pain sensation on light palpation/touch is basically the inflammed neuron.
Once we have located these points, we will inject the dextrose just underneath the skin. Every time we completed injecting in one area, eg. the knee, we will check out by asking the patient to move the treated knee. We will continue injecting until the patient is satisfied with the treatment on that day itself without having to go for surgery.
Why are we injecting the nerve that runs just beneath the skin?
It means that we only need to treat the most superficial nerves that are affected in order to get a good outcome.
**Why Lyftogt PITR?
On May 24th, 2013, Canadian Pain Society did a presentation in Winnipeg on the effectiveness of Standard Drug Protocols on treating severe Neuropathic Pain. They found out that _*only 23.7% of severe neuropathic pain victims responded to Canadian Pain Society drug treatment guidelines for neuropathic pain.
Their conclusion was, "It is time to look outside the box for treatment measures".
This method has been practised by Dr John Lyftogt for more than 17 years. Although there were studies on the effectiveness of dextrose/glucose on treating Neuropathic Pain, it was not enough for this treatment to be regarded as a gold standard treatment. It needs larger-scale studies.
Every treatment aims to extinguish the pain, which at the first treatment may initially last for a period of four hours to four days. Repeated treatments (usually 6-8 sessions) usually done weekly, result in a gradual reduction of the overall pain, with the aim of complete resolution - a zero pain score - and allow the return of full function. Success rates vary between 80-100% depending on the condition. For most conditions recurrence is unlikely unless re-injury occurs.
** Conclusion.
There is a new method on how to treat Chronic Pain effectively and most doctor are not aware of it. It is my wish to extend this message to other people outside the clinic where I practices, especially my fellow steemians. I'm sure they are a lot of steemians, somehow or another suffered some form of pain.
Once you met your GP, the usual painkiller would normally be prescribed. However, if your pain extended for more than 3 months, it is not advisable for us to keep taking the painkiller, as one of the most common side effects are gastritis and it may compromise our kidney function.
Please ask your GP about Perineural Injection Therapy using buffered Dextrose/Glucose.
There are also many medical or surgical conditions that may get benefit from using the above treatment. Some surgical conditions such as Carpal Tunnel Syndrome or de Quervain's Tenosynovitis can be treated using Lyftogt PITR method. Which means you don't have to go under the surgeon's knives. The cost of this treatment may be much lesser than the usual method.
I hope that this posting will help you or any of your loved one who is in pain right now and gives them hope that their pain can effectively be treated.
Let me share one story about my patient who had suffered both shoulder pain for the past 20 years. She has been seeing a lot of doctors for the past 20 years. After careful history taking and physical examination, I diagnosed her to have Neuropathic Pain.
On the 1st visit, I treated her shoulder. She was very happy at the end of the treatment because the pain had almost gone. On the 2nd visit, which was 2 weeks from the 1st treatment, she claimed to have the best pain-free sleep ever for a very long time. At this moment, I advised her to come when necessary because she was roughly 90% pain-free.
She came to visit me for the 3rd time after 3 months from the 2nd treatment. After careful examination, I decided that she only needs a minimal amount of treatment as she was almost 100% pain-free.
That was 3 years ago. She is still pain-free.
Thank you for reading and for giving your support.
Please don't forget to leave a comment or two. Questions are most welcome.
Always pursue the idea that the chemical and physical phenomena are controlled by the nervous system.
Claude Bernard, "Father of Physiology", 1860. (12th July 1813 - 10th February 1878)