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chronic pain

This category contains 17 posts

Livia isn’t a new off switch for period pain, it’s an expensive TENS unit

I’ve been asked so many times about Livia in the past month that I figured it’s time for me to just post on it. The makers of the device claim it is an “off switch for period pain” and that it is a “new device.” It’s neither. What Livia appears to be is a TENS … Continue reading

Whoopi Goldberg’s menstrual marijuana has lots of issues, a GYNO explains

My phone blew up this morning with health reporters asking about Whoopi Goldberg’s new health venture – medical marijuana for period pain. Why did the health reports ask me? Yes I’m a doctor on social media a lot, but I’am also board certified in OB/GYN as well as holding two different board certifications in pain … Continue reading

Stress and a bad diet can cause chronic pain, just ask my cat

As a pain medicine physician one of the hardest parts of my job is to get people to buy into the idea that addressing stress or anxiety or sleep or nutrition doesn’t mean I think their pain is “all in their head” or that I am not taking their pain seriously. Or both. Chronic pain … Continue reading

Vaginal marijuana for menstrual cramps: the grass isn’t always greener

Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD. Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible? THC and cannabidiol (CBD) are compounds found … Continue reading

Hysterectomy for chronic pelvic pain? Ask these 7 questions first

Chronic pelvic pain (CPP, pain in the pelvis that is present for more than 2 weeks a month and has been there for more than 6 months) affects 15% of women and accounts for upwards of $2 billion a year in direct medical costs. To say it is a significant health burden is a gross … Continue reading

Vaginal Valium is ineffective for pelvic floor muscle spasm

A common cause (possibly the most common cause) of both pelvic pain and pain with sex is spasm of the pelvic floor (the levator ani and obturator internus muscles). Some physicians have promoted vaginal Valium as a treatment. There is a retrospective study of 26 patients (which has all the inherent problems of small retrospective … Continue reading

To cut isn’t always to cure: knee surgery, health care, and our love affair with the scalpel

An article, just published in the NEJM, caught my attention not only for the study results, but because of what is says in a between-the-lines kind of way about the American health care system. The study looks at arthroscopic surgery for a torn meniscus in people over the age of 45 who also have arthritis … Continue reading

The FDA’s new restrictions on hydrocodone are unlikely to solve any problem.

America consumes 80% of the world opioid supply (99% of the world hydrocodone supply), but has about 5% of the world’s population. If you don’t think America has some kind of opioid problem, then move along because this rational, evidence-based, experience-laden way in which I’m going to discuss opioid use and misuse will not interest you. … Continue reading

Abortion, health care, HPV, chronic pain: what I’ve learned from my most popular posts of 2012

I published 97 posts in 2012 and during the year my blog was viewed approximately 970,000 times.  I’m humbled that anyone took the time to read anything that I wrote. Some posts were read by a couple of hundred people and some posts by a couple of hundred thousand. I don’t think the writing on … Continue reading

The low oxalate diet and vulvodynia: how a case report becomes snake oil

Restrictive diets, the most common being the low oxalate diet, are widely reported in the lay press and on-line for vulvodynia (a chronic pain condition of the vulva). In one study, 41% of women with chronic vulvar pain reported trying a low-oxalate diet. The only problem? The low oxalate diet doesn’t work. How this diet … Continue reading

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