I have recently attended the annual Canadian Association of Orthopaedic Medicine conference, this year held in the big TO. As usual there were some excellent presentations and workshops, and I left feeling inspired and privileged to be working in musculoskeletal pain management. There was a lot of focus on nutrition: so much of pain can be attributed to the foods we eat! Also there was an excellent talk on genetic testing - knowing one's genome can help tailor treatment very specifically and even prevent certain problems/diseases from occurring. I presented a workshop on the hydrodissection of peripheral nerves using 5% dextrose under ultrasound guidance, along with a colleague, Dr Jag Gupta. This was well-attended, showing the interest in treating neuropathic pain without using drugs which have many side effects (aka brain fog). Dr Gordon Ko organised a terrific conference and I hope to incorporate new pearls of wisdom into my practice!
An interesting study was published recently. Having a knee arthroscopy (a surgical procedure with a "telescope" looking into the knee, and cleaning out any part that is rough or loose) does not improve pain. Many, many people suffer from knee arthritis and so this is helpful in deciding on a course of action. Having a knee replacement may be the eventual answer, but in the mean time regenerative injections (perineural injecting of dextrose, or prolotherapy, or PRP) can be a big help in reducing symptoms, and may even prevent the "kneed" to do surgery at all.
The University of BC regularly sends out articles by physicians who have found some aspect of medicine has changed the way they practice. I have been meaning to send them my views on the subject and here they are! Thank you to the many patients over the years who have taught me so much about the treatment of pain.
In March 2015, David and I travelled to Honduras, to the village of Tela, to spend 2 weeks at a medical mission for people with chronic pain. We gave prolotherapy injections to many needy and willing recipients. The people of Honduras are so gracious: first the support team to run these clinics is second to none, and the patients who have so little (and line up for long hours and often travel many miles to come) are so grateful for anything we can do to help relieve their pain. We treated many people with arthritis, injuries, and poorly healing conditions and also benefited ourselves by being surrounded by other fantastic volunteering physicians, including a first rate teaching team. We are all better injectors as a result of these experiences. We salute the Hackett Hemwall Foundation who has been running humanitarian relief work in Honduras (prolotherapy, vein clinics and an ear, nose and throat team) for many, many years. We had the privilege of working under Dr Carl Osborn from Oregon, who celebrated his 20th year of this volunteer work. He is an excellent teacher! (see photo below - Carl is in the brown scrub top below). OK, so we had a bit of time to relax too...
Jannice is a family physician with an interest in the treatment of pain. Anything to help the process is added to this blog.