Author: Brendan
-
Understanding Lumbar Epidural Steroid Injections. A Patient Guide for Sciatica and Low Back Nerve Pain
A lumbar epidural steroid injection, or LESI, is used to treat low back pain and nerve pain that travels into the hips, buttocks, or legs. This type of radiating pain is often called sciatica. The pain is commonly related to a lumbar disc herniation or spinal stenosis. When a disc sprains, tears, or bulges, it […]
-
Low-Dose Naltrexone for Chronic Pain. Why It Is Prescribed Off-Label and What Patients Should Understand
Low-dose naltrexone, often called LDN, is one of the most discussed medications in chronic pain, autoimmune, and complex illness communities. Many patients ask about it. Many providers hesitate because it is prescribed off-label. The reality is that LDN is not a magic bullet, but for the right patient, it can be a useful tool, especially […]
-
The 4 Categories of Chronic Pain Treatment Why Most Patients Only Ever Get One
Many chronic pain patients arrive exhausted from years of fragmented care. They may have been given medications, sent to physical therapy, offered a steroid injection, or told there is nothing else to do. The problem is not always that these treatments were wrong. The problem is that they were often used in isolation. Complex chronic […]
-
What Spinal Cord Stimulation Can and Cannot Do An Honest Assessment for Chronic Pain Patients
When patients hear about spinal cord stimulation or dorsal root ganglion stimulation, they often have one of two reactions. Some are frightened by the idea of implanted hardware. Others have been led to believe that a device will be a cure-all. The reality is more careful. Neuromodulation can be a powerful tool for chronic, difficult-to-treat […]
-
Why Pelvic Pain Is Not Just a Gynecology Problem When the Pelvis Is Painful, but the Organs Look Normal
Many patients with chronic pelvic pain spend years moving between gynecology, urology, colorectal surgery, and other specialists. They may have normal imaging, negative testing, and procedures that do not explain why the pain continues. This can be deeply frustrating. The organs may look healthy, but the pain is still real. The key is understanding that […]
-
The Sympathetic Nervous System and Chronic Pain Why Fight-or-Flight Pain Is Often Missed
When a patient has diffuse, burning, unrelenting pain that does not match a clean line on an MRI, the pain is often misunderstood. Some patients are told they have fibromyalgia, anxiety, or pain that is “psychological.” One important piece that is often missed is sympathetically maintained pain. The sympathetic nervous system is best known for […]
-
Ketamine Infusions for Chronic Pain Separating the Evidence From the Hype
Ketamine clinics are increasingly common, and many patients now hear about ketamine as a potential treatment for chronic pain. Online, it is sometimes described as a miracle cure. The reality is more nuanced. Ketamine can be a powerful tool for the right patient, but it is not a solution for every type of pain. What […]
-
Prolotherapy vs. PRP vs. Steroid Injections Why the Right Injection Depends on the Diagnosis
Many patients are told they need an “injection” for pain, but not all injections do the same thing. One of the biggest mistakes in musculoskeletal and pain medicine is treating injections as interchangeable “pain shots.” Prolotherapy, PRP, and steroid injections each work differently. They have different goals, different risks, and different roles in a treatment […]
-
What Pudendal Neuralgia Actually Is And Why It Can Take 7 Years to Diagnose
For many patients, the journey to a pudendal neuralgia diagnosis is long, frustrating, and often filled with misdiagnoses of incomplete diagnoses. They may see multiple specialists, receive antibiotics for “phantom UTIs,” try pelvic floor therapy, and be told their symptoms are anxiety, fibromyalgia, or isolated pelvic floor dysfunction. The pain is real. The problem is […]
-
The EDS-MCAS-POTS Connection Many Providers Miss. When Separate Symptoms May Be Part of the Same Pattern
A patient may arrive with years of records and several separate diagnoses. Cardiology is treating tachycardia. Gastroenterology is treating IBS-like symptoms or gastroparesis. Allergy is treating hives, flushing, or unexplained reactions. Psychiatry may have labeled the patient with anxiety. Rheumatology may have called the pain fibromyalgia. Each label may describe one part of the experience. […]