Pain disorder characterize by pain in the distribution of a nerve or nerves
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In this episode of The Healers Café, Manon Bolliger, FCAH, RBHT (facilitator and retired naturopath with 30+ years of practice) speaks to Mike who emphasized the importance of accurate pain assessment and the potential impact of psychological factors like placebo effect. Tony's injury from swimming surprisingly reduced his chronic pain, suggesting a link between acute and chronic pain management. Mike suggested alternative pain-inducing activities to potentially aid healing. For the transcript and full story go to: https://www.drmanonbolliger.com/mike-sententia2 Highlights from today's episode include: Mike and the importance of honest feedback from clients—encouraging them to report truthfully even when a technique doesn't work, as this helps practitioners refine and improve their healing methods. Mike explains the shift from using the term “suppress” to “neutralize” or “cancel out” energy signatures, to better describe his pain reduction technique and avoid negative connotations. Manon explains the need for thorough, transparent assessment and follow-up of pain intensity and frequency, so practitioners and clients have accurate benchmarks to measure healing progress. ABOUT MIKE SENTENTIA: I'm Mike. After studying and practicing energy healing 20+ years, I've developed a unique system of energy healing, specifically designed for chronic pain conditions. I'm truly so grateful for every client who's placed their faith in me and who I've been able to help get back to doing what they love most over the past two decades. They're the reason I do this work! In addition to being an energy healer for chronic pain, I'm also a science geek and love reading research. My books cover holistic care techniques that actually work, and the evidence behind them. Core purpose/passion: The mission of Healing Lab is to see Energy Healing integrated into mainstream medical practice and to see it covered by insurance in the same way that acupuncture is becoming. We know there is modern science behind energy healing even if we don't fully understand all the mechanisms yet. Website | LinkedIn | Instagram | YouTube | Facebook | TikTok | ABOUT MANON BOLLIGER, FCAH, RBHT As a de-registered (2021) board-certified naturopathic physician & in practice since 1992, I've seen an average of 150 patients per week and have helped people ranging from rural farmers in Nova Scotia to stressed out CEOs in Toronto to tri-athletes here in Vancouver. My resolve to educate, empower and engage people to take charge of their own health is evident in my best-selling books: 'What Patients Don't Say if Doctors Don't Ask: The Mindful Patient-Doctor Relationship' and 'A Healer in Every Household: Simple Solutions for Stress'. I also teach BowenFirst™ Therapy through and hold transformational workshops to achieve these goals. So, when I share with you that LISTENING to Your body is a game changer in the healing process, I am speaking from expertise and direct experience". Manon's Mission: A Healer in Every Household! For more great information to go to her weekly blog: http://bowencollege.com/blog. For tips on health & healing go to: https://www.drmanonbolliger.com/tips Follow Manon on Social – Facebook | Instagram | LinkedIn | YouTube | Twitter | Linktr.ee | Rumble ABOUT THE HEALERS CAFÉ: Manon's show is the #1 show for medical practitioners and holistic healers to have heart to heart conversations about their day to day lives. Subscribe and review on your favourite platform: iTunes | Google Play | Spotify | Libsyn | iHeartRadio | Gaana | The Healers Cafe | Radio.com | Medioq | Follow The Healers Café on FB: https://www.facebook.com/thehealerscafe Remember to subscribe if you like our videos. Click the bell if you want to be one of the first people notified of a new release. * De-Registered, revoked & retired naturopathic physician after 30 years of practice in healthcare. Now resourceful & resolved to share with you all the tools to take care of your health & vitality!
He's Back! I had the pleasure of interviewing Bill Taylor a little while ago - ostensibly to talk about pudendal neuralgia...except we got sidetracked into an extensive discussion about male pelvic health. However, we did promise to re-convene and discuss Pudendal Neuralgia and here we are!In this conversation we talked about all the angles and our joint consensus is that most of the problems that are attributed to pudendal neuralgia are actually...not thatIn this conversation:we talked about the potential for misdiagnosis (and gaslighting)how the other nerves in the pelvis are often overlooked the importance of considering the whole person, including an assessment of their movement, their sciatic mobility, nutrition and sleep; we also explored the importance of a nuanced pelvic floor approach, taking things like constipation, breathing and inflammation into accountwe paid respects to the complexity of persistent pelvic pain, and how systems are dynamic and interconnected - and the importance of listening to what's really important to the person in front of us, and giving them knowledge, agency and support This is NOT a short conversation - but no apologies as we really wanted to give a comprehensive overview of assessment and treatment strategies for this often intimidating diagnosis - hopefully you'll think we did a good job!Bill is an absolute superstar and one of my favourite colleagues and friends - I love the way he thinks and his openness to lateral thinking and exploration - Bill is doing a post-con at Pelvicon and you can find all his info at billtaylor.com
Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep Ultrasound Training REGISTER TODAY! Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures. Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023 Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology. He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more! Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office. For an appointment go to AABPpain.com or call Brooklyn 718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.
Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep Ultrasound Training REGISTER TODAY! Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care. As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures. Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023 Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology. He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures. He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more! Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques. Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office. For an appointment go to AABPpain.com or call Brooklyn 718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.
Post-herpetic neuralgia (PHN) is the most common complication following an episode of shingles and can affect up to one in five people. Pain is typically described as burning or like an electric shock and is often associated with allodynia and hyperalgesia. It can have significant effects on both physical and psychological well-being, with sleep disturbance and depression being frequently described. PHN is notoriously difficult to treat, with a significant number of patients achieving only a modest reduction in their symptoms despite combinations of analgesic agents. In this episode, Dr Kate Chesterman explores the treatment options available in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-161-post-herpetic-neuralgiaDid you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
Entenda as causas e os tratamentos da neuralgia do trigêmeo.
Carolyn McMakin, MA, DC - contact@frequencyspecific.com 00:59 Seminar Stories: A Week of Learning and Healing 02:32 Case Study: Herniated Disc and Muscle Recovery 10:08 Treating Ehlers-Danlos Syndrome 14:35 Exploring Charcot-Marie-Tooth Disease 22:46 Understanding Myasthenia Gravis 24:57 Breakthrough in Scleroderma Research 27:52 Encouraging vs. Harassing: A Gentle Approach 28:01 Diagnosing and Treating Ehlers-Danlos Syndrome 30:21 Understanding TMJ and Its Treatment 33:42 Benign Prostatic Hypertrophy and Root Canals 35:34 Pudendal Neuralgia and Pelvic Floor Issues 41:42 Detoxifying from Airborne Toxins 46:11 Root Canals: Risks and Solutions 50:33 Upcoming Events and Reflections Herniated Discs: A Path to Healing A herniated disc can be a painful and debilitating condition. One case involved a patient with a herniated disc impacting the S1 nerve root. The patient experienced muscle weakness and numbness in the foot. Through FSM, we used a frequency combination tailored specifically for this condition, which led to remarkable recovery. The treatment helped the muscles regain strength and improved the patient's foot sensation. This case highlights FSM's potential in restoring nerve functionality and relieving symptoms of herniated discs. Ehlers-Danlos Syndrome: Managing the Challenges Ehlers-Danlos Syndrome (EDS) presents unique challenges due to its impact on connective tissues. Patients often suffer from joint pain and hypermobility. Through FSM, we address these challenges by focusing on balancing the autonomic nervous system and improving connective tissue function. For instance, a patient with EDS experienced significant relief by treating both nerve dysfunction and connective tissue issues. This holistic approach can substantially enhance quality of life for those with EDS. Genital Neuralgia: Finding Relief Genital neuralgia, often misunderstood and misdiagnosed, can be extremely distressing. FSM can offer relief by targeting the nerve roots and reducing inflammation. In a case involving pudendal neuralgia, the patient benefited from specific frequencies that eased nerve pain and muscle tension. Proper diagnosis and a targeted FSM approach can help alleviate symptoms and improve daily functioning. Addressing Autoimmune Conditions FSM also shows promise in treating autoimmune conditions like scleroderma and myasthenia gravis. By modulating the immune response and reducing inflammation, FSM can help manage these complex disorders. Understanding the triggers and underlying causes of autoimmune dysfunction is crucial in tailoring effective treatment strategies. The Importance of a Tailored Approach One of the key takeaways in applying FSM is the importance of a personalized treatment plan. Each condition and patient requires a unique combination of frequencies and a thorough understanding of their specific challenges. The ability to adapt and modify treatment protocols is what makes FSM a valuable tool in integrative medicine. Continuous Learning and Innovation FSM training is vital for practitioners eager to expand their treatment options. As our understanding of frequency-specific applications grows, so does the potential to provide relief for patients with challenging conditions. Staying informed and embracing new techniques is crucial for practitioners dedicated to offering holistic care solutions.
Pudendal neuralgia is one of the most intimidating diagnoses we treat.It's complex, frustrating, and often misunderstood—even among pelvic health providers.In this Missing Piece episode from the Rising Vault, we're breaking down a key factor that's often overlooked in pudendal neuralgia treatment:
“Health starts in the mouth”. It's truer than people know. When oral issues can be correlated to about 80% of chronic disease, it may be the most critical area of health neglected by the public and misunderstood by professionals. Which is why Dr Michelle is the voice we need in the world of oral health. Her pain to purpose story combined with a passion for science and her patient's wellbeing, I wish dentists around the world heard her message and also became health based dentists. PRE-ORDER her NEW book now: https://www.amazon.com/Living-Well-Dr-Michelle-Comprehensive/dp/1637746784Dr. Michelle Jorgensen is an author, speaker, teacher, biologic/holistic dentist, and health and wellness provider. After practicing traditional dentistry for 10 years, Michelle became very sick. Through her own path to return to health, she discovered she had mercury poisoning from drilling out mercury fillings for her patients.This path led her to discover ways to improve her family's and her own health in all facets of life. She found answers in the kitchen, in the garden, and at home. She has found what it takes to Live Well, in today's world, and now with Living Well with Dr. Michelle, she wants to share those ways to Live Well with you.Join us as we explore:A health based dentist, why between 60% and 80% of chronic disease are correlated to issues of oral health. Why Utah became the first American state to ban fluoride from public drinking water.Mercury poisoning, how Dr Michelle got it, her painful treatment process and why it remains a problem in the world of oral health.What to ask for when you need a filling. The root canal controversy, cavitations and why the documentary “Root Cause” was banned on Netflix. What actually causes cavities and tooth decay, and how to remineralize. Neuralgia inducting cavitation osteonecrosis and fatty degenerative osteonecrotic jawbone, what they are, how serious are they and what Dr Michelle tells everybody about this process.Contact: Website - www.livingwellwithdrmichelle.comMentions:Person - Hal Huggins, https://pmc.ncbi.nlm.nih.gov/articles/PMC4566458/Directory - IAOMT, www.iaomt.orgSupport the showFollow Steve's socials: Instagram | LinkedIn | YouTube | Facebook | Twitter | TikTokSupport the show on Patreon:As much as we love doing it, there are costs involved and any contribution will allow us to keep going and keep finding the best guests in the world to share their health expertise with you. I'd be grateful and feel so blessed by your support: https://www.patreon.com/MadeToThriveShowSend me a WhatsApp to +27 64 871 0308. Disclaimer: Please see the link for our disclaimer policy for all of our content: https://madetothrive.co.za/terms-and-conditions-and-privacy-policy/
Código Sagrado 613 Para Aliviar la neuralgia (nervio trigemino)Los Códigos Sagrados son herramientas energéticas basadas en una matemática misteriosa que conecta con dimensiones superiores. Al activarlos con fe y desapego, abrimos el camino a la manifestación de nuestros deseos.
Olá Bom Dia ALEGRIA! Munson here with the Good Morning Portugal! show, livestream & podcast... We start the show with the all-new 'Bom Dia Daily' - 20 minutes of news, weather, language, culture & wellbeing in Portugal, by way of an introduction today to...John Heimbach AKA 'João Do Norte' with a Northern Portugal update who, with wife Pam, has made a beautiful, home in Ponte De Lima.Find John at www.theportugalclub.comAntónio Barbosa of real estate agents, Infinite Solutions with us too for some new year 'Tony Time'. The 'Man in The Minho' returns with his 2025 forecast.Contact Tony via his website - https://www.infinite-solutions.pt/Comments in the chat, pics & vids to WhatsApp (00 351) 913 590 303Get more at www.goodmorningportugal.com / Support the show and join the Portugal Club at www.gmpvip.comBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-good-morning-portugal-podcast-with-carl-munson--2903992/support.
Chronic pain is pain that lasts for more than 3 months, and it can be primary (with no underlying cause identified) or secondary (with an underlying cause identified). In this episode, the MIMS Learning editors look at the diagnosis and management of chronic pain in primary care. They review what NICE says about assessing chronic pain, the possible causes of chronic pain, and management options. Educational objectivesAfter listening to this podcast, healthcare professionals should be more aware of:The definition of chronic primary pain and when to consider it as a diagnosis The different types of neuropathic pain, including postherpetic neuralgia Non-pharmacological and pharmacological options for managing chronic painThe relationship between chronic pain and mental healthYou can access the website version of this podcast on MIMS Learning to make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.Useful linksGuidance update: NICE guidelines on chronic pain in over 16sBest use of neuropathic pain medicationUnderstanding painful diabetic neuropathyDepression and anxiety in people with chronic painPost-herpetic neuralgia and herpes zoster vaccinesAcute pelvic pain - red flag symptomsRegister for a free MIMS Learning healthcare professional accountwww.mimslearning.co.uk/register Hosted on Acast. See acast.com/privacy for more information.
What can I take instead of antibiotics or ibuprofen? How can I prevent cognitive decline? On this episode of Vitality Radio, Jared introduces four new natural products at Vitality Nutrition that address these questions. You'll learn about propolis extract and its many uses and benefits, and a PEA formula as an alternative to opiates and OTC drugs like Advil and Tylenol. You'll also hear how Red Ginseng and Greek Mountain Tea with Bacopa are so useful for cognitive support, neuroprotection, and energy!Terry Naturally Products:Propolis ExtractGreek Mountain Tea + BacopaRed GinsengPEAVisit the podcast website here: VitalityRadio.comYou can follow @vitalityradio and @vitalitynutritionbountiful on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Please also join us on the Dearly Discarded Podcast with Jared St. Clair.Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.
Are migraines getting on your nerves? They quite literally could be—or they could be stemming from a condition called Occipital Neuralgia (ON). ON is caused by irritated or damaged occipital nerves, which run from the top of your spine, up your neck, and into your scalp. When you suffer from ON, you experience intense head pain that can be mistaken for migraines. In this episode, we're unraveling the truth about the occipital nerve so you can determine if your head pain is truly from migraines or if you have ON to blame. In this episode, you'll hear: What the occipital nerve is, and where it causes pain The many symptoms of ON that often get mistaken for migraines How to tell the difference between ON and migraines Common ON triggers Why inflammation is the #1 cause of head pain associated with ON and migraines How to treat ON Last week, our discussion focused on the trigeminal nerve. If you haven't checked out that, I highly recommend listening to episode 36 before tuning in today. Resources: Complete the Migraine Sensitivity Scorecard to determine your migraine sensitivity. Once you receive your results, email us at debbie@debbiewaidl.com to access the training that accompanies your score! Connect with Debbie: Instagram: https://www.instagram.com/debbiewaidl.migrainefree/ Women's Migraine Freedom Facebook Group: https://www.facebook.com/groups/womensmigrainefreedom LinkedIn: https://www.linkedin.com/in/debbie-waidl Website: https://debbiewaidl.com/ Disclaimer: The Migraine Freedom Your Way Podcast and information provided by Debbie Waidl and guests in this podcast is presented solely to provide helpful information, education, and entertainment on the subjects discussed. The use of information or resources mentioned on or linked from this podcast is at the user's own risk and discretion. This podcast is not intended to diagnose or treat any medical condition. For diagnosis or treatment of any medical problem, consult your own physician. Debbie Waidl and In The Balance Health Coaching LLC are not responsible for any medical conditions or liable for any damages or negative consequences from any treatment, action, application, or preparation to any person reading or following the information presented on this podcast. References are provided for informational purposes only and do not constitute an endorsement of any websites or other sources.
Pain isn't nice, but there are times when it's necessary - If you don't feel the pain you should, you're at risk of doing yourself greater damage. If you feel pain you shouldn't, that could the first signs of a deeper issue. Professor Rayaz Malik and Dr Ioannis Petropolous talk about their work on a new, non-invasive, inexpensive way of detecting early stages of neurodegeneration that could be as easy as an opticians appointment. Read their original research: https://doi.org/10.2337/dc20-2012
Consultório do Rádio Livre: O Consultório do Rádio Livre hoje vai tratar sobre a doença que causa a maior dor do mundo. Você conhece essa doença?
In this podcast Dr. Zahra Figueredo explains the difference between Neuropathy and Neuralgia. How does Peripheral Neuropathy manifest and how this conditions can be treated with stem cell therapy. What would be the deployment method and more. _____________________________________________________________ Could Dr. Zahra's Natural and Unique Stem Cell Therapy Transform Your Life? "My heart and soul sing when we see what an incredible impact we can make on the lives of our patients and their families with our natural and comprehensive stem cell therapies." Dr. Zahra Figueredo. Canadian Dr. Zahra Figueredo has successfully treated 1,000+ patients from the USA and Canada suffering with hundreds of different health problems in her Stem Cell Healing Institute in Guatemala - 'the land of eternal Spring' - with her safe, comprehensive, non-surgical and innovative stem cell therapies. It's important to note that Dr. Zahra's powerful stem cell combination therapy is NOT available anywhere in the USA or Canada. What To Do Now? New Patient? - Learn how Dr. Zahra's combined stem cell healing could transform your life. Please send us an email. info@stemcellhealinginstitute.com For more information on stem cell treatment please visit our website
Welcome back, dear listeners. On this episode, I sat down for a chat with Andrew. Andrew is someone I met through Instagram — it's funny that how that happens. Once you start sharing your own story, it's like you become a lighthouse and when other people who see the light you're shining resonate with your story or with the work you're doing, they will seek you out. And if you relate to their story too, you can wind up months later feeling like you know this person just from exchanging messages about a common experience that you share. And that was the case with Andrew. He first reached out to me when he was quite a bit earlier along in his journey, struggling with pelvic pain that was diagnosed as pudendal neuralgia, often known as cyclist syndrome, which was fitting in his case, because Andrew is an avid cyclist. So, you can imagine how much this type of pain interfered not only with his life in general, but also more specifically with cycling, an activity that he's passionate about. So, when Andrew reached a stage in his process where he's now sharing his recovery story with others to give them hope and direction, I really wanted to get him on this podcast to share his experience with you! And without further introduction, here is our conversation. You can find Andrew at: https://www.instagram.com/andrewmbcyclist/ And you can find me at: Instagram: @anna_holtzman Email: anna@annaholtzman.com Website: www.annaholtzman.com --- Support this podcast: https://podcasters.spotify.com/pod/show/from-chronic-pain-to-pass/support
Federico y el Dr. Enrique de la Morena hablan con José María Serratosa, especialista en Neurología.
Marie's road to developing pudendal neuralgia is long and complicated. Pudendal neuralgia is a chronic pain condition involving damage to the pudendal nerve, which is the main nerve that branches to the genitals. Marie now lives with constant pain that is worsened by sitting, so she is forced to either […]
Chronic headaches are extremely debilitating conditions which significantly impact the quality of life. Dr Giorgio Pietramaggiori and Dr Saja Scherer of Global Medical Institute, Switzerland employ minimally invasive treatments such as targeted Botox injections, surgical release of nerves, and fat transfer, which aim to offer relief for people suffering from chronic headaches when pharmacological alternatives fail. Read more in Research Features: doi.org/10.26904/RF-149-5161384107Read the original research: doi.org/10.1097/prs.0000000000009777
In this episode Susan and Erica welcome a Tough To Treat listener, Megan Barclay. Megan brings a case of a patient who continues to suffer neuralgia after a bout of shingles, along with persistent neck pain. Listen to the client's history, significant findings, and differentials as we navigate this client's journey and discuss relevant findings. There is also a rich discussion on possible interventions targeting many points of the trigeminal system and cranial region. A glance at this episode: [1:25] Neck pain and potential causes and drivers [8:39] Post-shingles symptoms and treatment [16:32] Patient's neck and shoulder pain, possible causes and treatments [24:38] Treating a patient with neck and head issues [28:55] Pain perception and treatment for cervical and lumbar issues [30:16] Improving balance and reducing trigeminal symptoms through exercises [33:31] Treating neck and back issues with physical therapy and nutrition [41:09] Treating a patient with shingles [43:28] Shingles treatment and empowerment [46:12] Exercise and posture for chronic pain management Related links: Tough To Treat Website Erica's Course: Decoding the Complex Patient Susan's Pelvic Health Education Subscription Access the Transcript Megan's Instagram Megan's Website
Based on the availability of new literature, the current article is a minor update only that does not result in modification of the prior recommendations: Clinicians may use ONS as a treatment option for patients with medically refractory ON. J. Bradley Elder, MD Michael D. Staudt, MD, MSc Jorge Ahmed, MD
Pelvic Pain Podcast|The Real Story About Chronic Pelvic Pain
Diagnosing muscle-based pelvic pain, including: pelvic floor dysfunction, a bacterial prostatitis, non-bacterial prostatitis, Prostatitis/CPPS, chronic pelvic pain syndrome, levator ani syndrome, pudendal, neuralgia, and coccydynia.
In this solo episode Colette continues her series on the srotas or channels of the body and focuses on majja vaha srotas, which is the channel carrying nutrition for the bone marrow and nerve tissue. The passage of this channel is the nervous system (the central, peripheral, sympathetic and parasympathetic nervous system), the brain and the cavities of the bone e.g. spinal column. The limbic system is the part of the brain involved in our behavioural and emotional responses and these responses occur through majja vaha srotas along with communication, coordination, sensation, learning and memory. Some of the signs and symptoms of aggravation of majja vaha srotas are: Neurological symptoms Tingling, numbness, tremors, tics, spasms Ringing in the ears Feeling of darkness in front of the eyes Dizziness, lack of stability and equilibrium, vertigo Memory loss Bell's palsy Convulsions, seizures Alzheimer's, Parkinson's disease Multiple sclerosis Neuralgia Neuropathy * Thanks to Kerala Academy for sponsoring this episode. Kerala Ayurveda's annual Skin and Beauty workshop is coming this June 24-25 and is open to all levels. You'll explore the definition of beauty from a holistic perspective, learning lifestyle recommendations for radiant face, hair, skin and body. Visit keralaayurveda.us/courses to sign up and use code BEAUTYELEMENTS for $30 off. * Visit Colette's website www.elementshealingandwellbeing.com Online consultations Private at-home Digestive Reset Cleanse tailored to you Educational programs - Daily Habits for Holistic Health Have questions before you book? Book a FREE 15 min online Services Enquiry Call * Join the Elements of Ayurveda Community! * Stay connected on the Elements Instagram and Facebook pages. * Thanks for listening!
What's something that's misunderstood or overlooked when treating complex patients with pudendal neuralgia? This is often one of the most intimidating diagnoses we work with.It's easy to hyperfocus on the path of the pudendal nerve, but a missing piece is actually the posterior cutaneous femoral nerve.In fact, it's almost impossible for 'pudendal neuralgia' to only involve the pudendal nerve! This is why nerve blocks often don't address all symptoms or symptoms spread beyond the immediate pathway of the pudendal.Medical Procedures MasterclassIf you'd like to learn more about medical procedures to help our patients with pelvic pain, check out the Medical Procedures Masterclass! At only $47, you'll learn about nerve blocks, trigger point injections, Botox to the pelvic floor, and more! Find it at www.pelvicptrising.com/procedures.Pelvic Business Accelerator!More details dropping soon, but head to www.pelvicptrising.com/accelerator for details and access to the wait list! You won't want to miss this program, wherever you are in your business.About UsNicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped nearly 200 pelvic practices start and grow through the Pelvic PT Rising Mentorship Program (www.pelvicptrising.com/business) and business courses to change the way pelvic health is administered. Get in Touch!Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!
Listen as Dr. London Smith (.com) and his producer Cameron discuss Postherpetic Neuralgia with special guests Mr and Misses Beautiful (Schune Fu & Susan Teixeira). Sponsored by Caldera + Lab (use code "jockdoc" to get 20% off!). Not so boring! https://calderalab.com/pages/podcast-special-offer?show=Jock+Doc&utm_medium=podcast&utm_source=JocDoc https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Guests: Schune Fu, Susan Teixeira. Produced by: Dylan Walker Created by: London Smith
In this episode Dr. Taves explains the diagnosis of Occipital Neuralgia, a sharp/burning/stabbing pain in the backside of your head and top part of your neck. He provides next steps, stretches and tools for taking control of your health and healing if you have been diagnosed with Occipital Neuralgia. Novera: Headache Center
Comedian and writer Morgan Murphy joins Steph to discuss the hellscape that is social media and how their therapists have it really hard these days. Morgan also details the ways in which she coped and recovered from a very rare Neuralgia during the height of the pandemic.
How hip pain, toe pain and hand pain all direct us to the same emotional healing found in the gut-brain axis. This physical energetic and emotional read will show you how the energetic and emotional body reveals its stagnation in the form of physical ailments. Listen and learn how to heal your body by healing your thoughts, heart and mind. 2:30- right hip pain 4:00- Morton's neuroma- foot pain 6:22- I could not find a link to the workbook. But this is a great book to help you define the emotions based on physical ailments - You can heal your body. https://www.amazon.com/Heal-Your-Body-Physical-Metaphysical/dp/B0043O36L4/ref=sr_1_1?crid=10WFL37HZMQOP&keywords=illness+and+ailment+workbook+psychological+meaning&qid=1678601639&sprefix=illness+and+ailment+workbook+psycologcal+meaning%2Caps%2C196&sr=8-1 7:09- Pain in the right hip- fear of moving forward in life 11:40- Great message about being honest about our healing 12:20- How the childhood message of "being an misfit" applies to the continual pain and how it could alleviate it through inner child meditation 15:00- Intimacy limitation causing hip pain and how it affects the pain- emotional and physical 17:00- Arthritis- No one was ever there for them and felt no one deserved to be there for them because everything was their fault. 18:50- foot pain- fear of the future. afraid to move forward 19:20- nerve pain- worried about stepping over the line. Keep them around the homestead programming 20:05- Chinese culture education on how important family is for everyone. 23:00- Nerve problem- expression suppression 25:17- Neuralgia- no self-forgiveness or no self-trust 29:28- Difficulty on getting a grip on grounding 31:10- https://www.youtube.com/eringaray 39:00- Solar plexus & Crown chakra and the gut-brain axis correlation 42:26- How the eyes, feet, legs, and stomach are all connected to the forced will 44:00 - Gut-Brain axis and how it's all connected 45:50- Meditation to heal the gut 46:15- How energy reads are challenging for people close to us 50:30- 7- 14 remedying the communication challenges of the hips and toes and healing the seat of the emotions 55:00- Message planted during 7-14 but the foot pain presented by 28-35 57:50- Morton's neuroma- fear of the future, afraid to step forward in life. 1:00:45- Childhood wounds meditation- https://youtu.be/amLEfa7prfo 1:03.00- Acupuncture point- Union Valley- Great eliminator - clears head and intestines - https://mendacupuncture.com/li4-our-great-eliminator 1:04.00- If energy isn't weak, the body won't injure Podcast Edited by Lindsay Curtis
Claim CME The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/tn70Yk Dr. Rosenblum discuss a challenging case and reviews the pathology, treatment and evidence for interventional pain in the the treatment of Post Herpetic Neuralgia. Discussed in this podcast: Intrathecal injection of methylprednisolone Dorsal Root Ganglion Paraveterbral Nerve Block Stellate Ganglion Block Spinal Cord Stimulation Botulinum Toxin Injection And more! Course Calendar Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Puerto Rico- Feb. 10, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine Tamarindo, Costa Rica- Feb. 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- March 11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- April 22, 2023 Regenerative Pain Medicine Course NYC- May 13 Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 References Lin, Chia-Shiang, et al. "Interventional treatments for postherpetic neuralgia: a systematic review." Pain physician22.3 (2019): 209. https://www.painphysicianjournal.com/current/pdf?article=NjMwMg%3D%3D&journal=120
Although the symptoms associated with shingles can be distressing, the pain that persists after the rash resolves, known as postherpetic neuralgia (PHN) is the most worrisome. Traveling, shopping, cooking, and even dressing may all come to a halt. Hacky Clark, a successful estate attorney explains firsthand how PHN has affected his life and PHN expert Dr. […]
I get the opportunity to chat with my friend and colleague Suzy Shutt about her experience as a women's health Physio. We talk about Pudendal neuralgia and menopause - what they are, why they happen and how they affect those of us with hip dysplasia. It was a brilliant conversation that I personally learnt a lot from. I hope you find it interesting too. You can find Suzy @themwordphysio on socials.
The Glossopharyngeal Nerve Revisited- The CE experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/VOw8zH Glossopharyngeal Neuralgia, Anatomy, Pathophysiology, Diagnosis, and Treatment- Dr. Rosenblum reviews Neuralgia and Compression of CN IX pathology, discusses the management, treatment and more. David Rosenblum MD, pain physician in Great Neck, Long Island discusses the different approaches to treating patients with medications and interventional pain procedures such as nerve blocks, neurolysis and radiofrequency lesioning... Upcoming Events... Want to view the complete events agenda? Click Here Now! IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYNJ-PS 2022 Annual Symposium- Nov. 3rd-6th, 2022! NYSIPP/ NJSIPP's Annual Pain Medicine Symposium Come and join us in New Jersey in November | NYNJ-PS 2022 Save the Date! Nov. 3rd-6th, 2022 Get Your Tickets Today! Register Now! Dominican Republic: Regional Anesthesia & Pain Ultrasound CME Workshop, Nov 12th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Physician Networking Event- NYC Nov. 17th, 2022 Physician Networking Event- Nov. 17th, NYC Join us for our a cool session of networking with your colleagues. Our last event hit the mark, and our docs left happy and excited for the next one. So we've planned it. As always, there will be food and drinks served. Come prepared to speak to others about medicine, healthcare. side gigs, new opportunities for career growth, innovation, fun activities, and more. Lock in Your Spot Today! Register Now! NYC Ultrasound Guided Chronic Pain/Regional Anesthesia Training Workshop- Dec. 3rd, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYC Regenerative Pain Medicine Workshop- Jan. 28th, 2023 Regenerative Pain Medicine Training Workshop! Lock in Your Spot Today! Register Now! IPA Costa Rica: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Feb. 19, 2023 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Pain Management Board Review & Refresher Workshop June 10-12, 2023 - TBA Annual NRAP/IPA/ Pain Management Board Review Workshop! Registration Set to Open Soon... Email to Reserve a Spot! Podcast Resources: https://europepmc.org/article/nbk/nbk541041 https://en.wikipedia.org/wiki/Glossopharyngeal_nerve Subscribe to PainExam mailing list * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos
The Glossopharyngeal Nerve Revisited- The CME experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/VOw8zH Glossopharyngeal Neuralgia, Anatomy, Pathophysiology, Diagnosis, and Treatment- Dr. Rosenblum reviews Neuralgia and Compression of CN IX pathology, discusses the management, treatment and more. David Rosenblum MD, pain physician in Great Neck, Long Island discusses the different approaches to treating patients with medications and interventional pain procedures such as nerve blocks, neurolysis and radiofrequency lesioning... Upcoming Events... Want to view the complete events agenda? Click Here Now! IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYNJ-PS 2022 Annual Symposium- Nov. 3rd-6th, 2022! NYSIPP/ NJSIPP's Annual Pain Medicine Symposium Come and join us in New Jersey in November | NYNJ-PS 2022 Save the Date! Nov. 3rd-6th, 2022 Get Your Tickets Today! Register Now! Dominican Republic: Regional Anesthesia & Pain Ultrasound CME Workshop, Nov 12th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Physician Networking Event- NYC Nov. 17th, 2022 Physician Networking Event- Nov. 17th, NYC Join us for our a cool session of networking with your colleagues. Our last event hit the mark, and our docs left happy and excited for the next one. So we've planned it. As always, there will be food and drinks served. Come prepared to speak to others about medicine, healthcare. side gigs, new opportunities for career growth, innovation, fun activities, and more. Lock in Your Spot Today! Register Now! NYC Ultrasound Guided Chronic Pain/Regional Anesthesia Training Workshop- Dec. 3rd, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYC Regenerative Pain Medicine Workshop- Jan. 28th, 2023 Regenerative Pain Medicine Training Workshop! Lock in Your Spot Today! Register Now! IPA Costa Rica: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Feb. 19, 2023 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Pain Management Board Review & Refresher Workshop June 10-12, 2023 - TBA Annual NRAP/IPA/ Pain Management Board Review Workshop! Registration Set to Open Soon... Email to Reserve a Spot! Podcast Resources: https://europepmc.org/article/nbk/nbk541041 https://en.wikipedia.org/wiki/Glossopharyngeal_nerve Subscribe to the AnesthesiaExam mailing list * indicates required Email Address * Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos
The Glossopharyngeal Nerve Revisited- The CE experience for this Podcast is powered by CMEfy - click here to reflect and unlock credits & more: https://earnc.me/VOw8zH Glossopharyngeal Neuralgia, Anatomy, Pathophysiology, Diagnosis, and Treatment- Dr. Rosenblum reviews Neuralgia and Compression of CN IX pathology, discusses the management, treatment and more. David Rosenblum MD, pain physician in Great Neck, Long Island discusses the different approaches to treating patients with medications and interventional pain procedures such as nerve blocks, neurolysis and radiofrequency lesioning... Upcoming Events... Want to view the complete events agenda? Click Here Now! IPA Israel: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Oct 30, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYNJ-PS 2022 Annual Symposium- Nov. 3rd-6th, 2022! NYSIPP/ NJSIPP's Annual Pain Medicine Symposium Come and join us in New Jersey in November | NYNJ-PS 2022 Save the Date! Nov. 3rd-6th, 2022 Get Your Tickets Today! Register Now! Dominican Republic: Regional Anesthesia & Pain Ultrasound CME Workshop, Nov 12th, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Physician Networking Event- NYC Nov. 17th, 2022 Physician Networking Event- Nov. 17th, NYC Join us for our a cool session of networking with your colleagues. Our last event hit the mark, and our docs left happy and excited for the next one. So we've planned it. As always, there will be food and drinks served. Come prepared to speak to others about medicine, healthcare. side gigs, new opportunities for career growth, innovation, fun activities, and more. Lock in Your Spot Today! Register Now! NYC Ultrasound Guided Chronic Pain/Regional Anesthesia Training Workshop- Dec. 3rd, 2022 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! NYC Regenerative Pain Medicine Workshop- Jan. 28th, 2023 Regenerative Pain Medicine Training Workshop! Lock in Your Spot Today! Register Now! IPA Costa Rica: Ultrasound Guided Chronic Pain and Regional Anesthesia Course, Feb. 19, 2023 Advanced Ultrasound Guided Injection Training Workshop! Lock in Your Spot Today! Register Now! Pain Management Board Review & Refresher Workshop June 10-12, 2023 - TBA Annual NRAP/IPA/ Pain Management Board Review Workshop! Registration Set to Open Soon... Email to Reserve a Spot! Podcast Resources: https://europepmc.org/article/nbk/nbk541041 https://en.wikipedia.org/wiki/Glossopharyngeal_nerve Subscribe to the PMRExam mailing list for Free Board Prep Material & More! * indicates required Email Address * Email Format html text Download the PainExam Official Apps for Android and IOS Devices! https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US https://apps.apple.com/us/app/the-pain-management-review/id997396714 Follow PainExam- https://painexam.com/blog/ https://www.facebook.com/PainExam/ https://twitter.com/painexams https://www.instagram.com/painexam/ https://www.linkedin.com/company/painexam https://www.pinterest.com/painexam https://www.youtube.com/user/DocRosenblum/videos
Trigeminal Neuralgia is commonly known as Suicide Disease because it causes painful nervous sensations in the head. At their most desperate moments, they are pushed to think about the unthinkable to free themselves from their suffering. Dr. Jeff Scott, a Blair upper cervical doctor at Montclair Upper Cervical, joins Dr. Kevin Pecca to talk about the primary causes of this dreadful disease, which are usually little habits that accumulate over time. Dr. Kevin explains how Trigeminal Neuralgia can be carefully treated through upper cervical care and chiropractic methods. He also discusses Occipital Neuralgia, another type of Neuralgia that runs around the back of the skull and results in an equally painful experience.Love the show? Subscribe, rate, review, and share!Here's How »Join Expect Miracles community today:drkevinpecca.comMontclair Upper Cervical Chiropractic FacebookDr. Kevin Pecca InstagramEmail Dr. Kevin Pecca
Dr. Ellison Melrose // #PPPonICE // www.ptonice.com
In today's episode, we will be talking about Tic Douloureux or Trigeminal neuralgia. As our guest will show us, it has many different names, but only one cause. We will be discussing the neurology as well as the proper approach for correcting this problem and bringing relief to the patients who suffer with it. This is an episode you will not want to miss! --- Support this podcast: https://anchor.fm/david-fowler/support
Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks… Afaf: Greetings, Could you kindly answer an inquiry for my dad who was diagnosed with a prostate cancer? He is 78 years old, 5'10 and weighs 150 lbs. The conclusion of the biopsy shows: - Right prostatic biopsy: adenocarcinoma prostatic grade 4 of ISUP, Score of Gleason at 8 (4+4), infiltrating 80% of the examined sample - Left prostatic biopsy: foyer of 2mm of an adenocarcinoma prostatic grade 4 of ISUP, Score of Gleason at 8 (4+4) The test results from the CT scan showed no other organ is damaged along with his bones. His doctor advised to start radio therapy and hormone-therapy. My inquiry is related to the Prostate Support supplementation as I would like to know if it is compatible with the treatment he is about to start. Can he take the supplements while he is ongoing treatment? Otherwise, should these supplements be taken prior to the start of treatment or after? When and what is the best timeframe to take these? Many thanks for your precious advice. Siomara: Hi Dr. Cabral I am a 47 year old female. I've had sleeping issues for years now. I use to take the generic brand of ambien and that didn't make my sleeping issue any better. Every night when I put my head on my pillow the back of my head and neck hurts to the point where I can't sleep. My head feels restless, if that even makes sense. I saw a neurologist and she said I have occipital neuralgia and she poked me with a needle to block the nerve on the back of my head, It didn't work for me. I also went to a pain management doctor and he told me it was stress and prescribed noretriptilyne to relax me at night, that didn't work either. I stopped taking every medication given to me for this problem and I just bare the pain. I've also purchased every pillow imaginable for the head and neck and nothing seems to work. I've changed my lifestyle by eating healthy for the past two years. I am gluten free and eat clean. I've eliminated processed foods and sugar from my diet. I was thinking of going to a chiropractor. Please let me know what you think. I am always so tired because I do not get any sleep. Thanks in advance for your help! Amy: Hello Dr. Cabral, Thank you for all that you do. My husband has had consistently low HDL levels (often in the low 30 mg/dl) despite being of normal weight and without other known risk factors. His father (deceased from a heart attack) and his sister have also both had consistently low HDL (although both were/are overweight). The doctor would advise him to exercise more, which is ironic since my husband runs quite a bit. Having said that my questions are : In an otherwise healthy individual is low HDL something to be concerned about? If it is something of concern, other than increasing exercise might there be some natural ways of raising HDL levels despite a possible genetic connection? Thank you for all you do. Summer: Hi doc! Question regarding EBV. I'm 32 & had mono around age 15. My health tanked after that until about 5 years ago. My white blood cell count, absolute neutrophils, & absolute monocytes are all low. EBV early antigen D AB (IGG) is 29.4 u/mL, EBV viral capsid AG (VCA) AB (IGG) is 297 U/mL, & EBV nuclear AG (EBNA) AB (IGG) is 191 U/mL. I'm told all the EBV levels are high & that these labs point to chronic active EBV. I've been working diligently for at least 5 years on my health. I've overcome PCOS, PMD, endometriosis, H Pylori, depression, arthritis, migraines, exercise intolerance, regained energy & drive, but still having gut & thyroid issues. I've been overdosed on Bioidentical T3 for a number of years & have recently weaned off & my thyroid has improved dramatically. By the time you answer this I'll be about half done with the CBO protocol. I guess I'm wondering how do I know that the EBV is causing my residual health issues? Should I have addressed the EBV first instead of the gut? I've already been doing most of the things listed in ep. 760 so curious why my levels would still show a problem with EBV. I've worked so hard & feel like I just can't quite get all the way there. I'm struggling with the right order to attack these remaining problems. Thanks so much! Chelsea: Hi Dr. Cabral - question about coffee enemas. Does caffeine get absorbed into the bloodstream when doing a coffee enema? Or can they be done later in the day without caffeine affecting sleep? Isabella: Where does exercise fit in when you're under extreme mental & emotional stress and not getting enough sleep (4-6 hrs) and still have to manage a household with kids and a spouse? I try to eat well, at least 5-7 cups of veggies per day, lean proteins, supplement with Daily Foundation Protocol 2 plus Zinc. I usually do HIIT classes but worry that it may just be adding more stress to my current situation. Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes & Resources: http://StephenCabral.com/2277 - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Stress, Sleep & Hormones Test (Run your adrenal & hormone levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels)
In this episode, we chat with Gary M. Heri, DMD. An internationally recognized expert in orofacial pain and temporomandibular disorders. He is the director of the Center for Temporomandibular Disorders and Orofacial Pain in the Department of Diagnostic Sciences at Rutgers School of Dental Medicine, which performs research and teaches this advanced field of dentistry focusing on the assessment, diagnosis and treatment of complex chronic orofacial pain disorders. Gary Heir has recently been appointed to the Robert and Susan Carmel Chair in Algesiology at the Rutgers School of Dental Medicine. Over the past decade, Heir played a significant role alongside a committee of national orofacial pain program directors and the American Academy of Orofacial Pain to get orofacial pain recognized as the 12th specialty in dentistry by the American Dental Association in March 2020. He is also the signatory on the application to the National Commission on Recognition of Dental Specialties and Certifying Boards for recognition of the American Board of Orofacial Pain as the official certifying board for the specialty. Currently, Heir directs the center at the dental school, one of only 12 postgraduate orofacial pain programs in the country accredited by the Commission on Dental Accreditation (CODA). He stressed the need for more accredited programs, citing the millions of patients who require treatment but have difficulty finding specialists. In addition to his work at Rutgers, Heir is a highly sought-after lecturer, having delivered nearly 300 presentations on orofacial pain and related subjects in the region, in the country and throughout the world. He has served on the boards of many professional organizations, including as the president of the American Academy of Orofacial Pain and the American Board of Orofacial Pain and as a member of CODA and the Council on Dental Education and Licensure. He was appointed by three of New Jersey's governors for three consecutive terms as a member of New Jersey Governor's Lyme Disease Commission. Heir has published more than 100 peer-reviewed articles, chapters and abstracts on orofacial pain and TMJ disorders. He also serves as the section editor for Orofacial Pain Neuroscience of The Journal of the American Dental Association. (Bio credit, Rutgers.edu) Highlights of this podcast include: Orofacial Pain Musculoskeletal pain Neuropathic pain Neuralgia and palsy Nerve damage and neuropathy Trigeminal neuralgia Migraines Categories of Pain Fear and Pain - psychogenic Placebo and nocebo effects Pain Management / Control Emotional component of pain Diagnosis And So Much More! To learn more about Dr. Heir, please visit rutgershealth.org. This episode is brought to you by Therasage. Use code: STOPCHASINGPAIN at checkout.
This week, the topic of discussion was: Myth Busting Hernia Surgery Mesh Complications Mesh Reaction Mesh Allergy MRI Scar Tissue Adhesions Intestinal Obstruction Hernia Recurrence Tissue Repair Misinformation Neurectomy Neuralgia Neuroma Nerve Ablation CRPS (Complex Regional Pain Syndrome) CBT (Cognitive Behavioral Therapy)HerniaTalk LIVE is a Q&A hosted by Dr. Shirin Towfigh, hernia and laparoscopic surgery specialist who practices at the Beverly Hills Hernia Center. This is the only Q&A of its kind, aimed at educating and empowering patients about all things related to hernias and hernia-related complications. For a personal consultation with Dr. Towfigh: +1-310-358-5020, info@beverlyhillsherniacenter.com. If you find this content informative, please LIKE, SHARE, and SUBSCRIBE to the HerniaTalk Live channel and visit us on www.HerniaTalk.com.Follow Dr. Towfigh on the following platforms:Youtube | Facebook | Instagram | Twitter
Have you been diagnosed with Trigeminal or Occipital Neuralgia? We discuss these 2 diagnoses and provide you with a better understanding of what they truly mean. We also discuss from a physical therapy perspective why we feel like it's most appropriate to go down the avenue of looking at the neck and how we as PTs can reduce stress to the nerve - versus the traditional route and what patients are currently getting for treatment options. We also discuss what you can do about it so you feel empowered to move forward.
In this episode, Dr. K and Dr. P focus on pudendal neuralgia including its etymology, surprising symptoms, diagnosis methods, and possible treatment options.Earn AMA PRA Category 1 CME for listening to this podcast!Click Below:Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/QAhIjd
Peters PG, Adams SB Jr, Schon LC. Interdigital neuralgia. Foot Ankle Clin. 2011 Jun;16(2):305-15. doi: 10.1016/j.fcl.2011.01.010. Interdigital neuralgia affects a significant number of individuals, with an average age of presentation in the sixth decade and a 4- to 15-fold increased prevalence in women. Historical descriptions date back to the 19th century. Nonoperative treatment with shoe modifications, metatarsal pads, and injections provides relief for most, but long term, 60% to 70% of patients eventually elect to have surgery. Although excision can be performed through a dorsal or plantar approach, we prefer the dorsal incision to prevent scar formation on the plantar aspect of the foot. Satisfactory results are common but not certain with reports of excellent or good ranging from 51% to 93%.
You are the unfortunate recipient of an injury that caused whiplash, concussion, and persistent concussion symptoms (PCS). You do all the physical, vestibular, and vision therapy but the symptoms persist. You experience a constant headache with zapping pain that goes from the back to the front of your head. You've tried migraine treatments, you've seen specialist after specialist, but nothing helps. Sound like you? Join us in this episode as we learn more about occipital neuralgia (ON) from the founder of the Occipital Neuralgia Foundation, Kayla Smock! Learn more, and find hope and support at http://www.onfsupport.org (www.ONFsupport.org); on facebook at Occipital Neuralgia Foundation; and on Instagram at Occipital.neuralgia. Covered in this episode: Occipital Neuralgia Foundation: The mission is to raise awareness in the medical community and public about ON and to foster research on ON. The foundation focuses on providing an online community to support and educate. They are working on establishing connections in the medical community to pursue research. Social media accounts and the website focus on sharing resources, survivor stories, education, and most importantly providing light and positivity to those with ON. 3 in 100,000 people have Occipital Neuralgia diagnosed, likely there are many more but it is not readily diagnosed or broadly known about in the medical community Symptoms: People with ON have constant headaches that do not improve with treatment characterized by a zapping pain from the back of the head to front of the head. They may also have pain down the arms, blurry vision, and eye fatigue Treatment: headache medications, injections: botox, nerve blocks, or trigger point; nerve decompression surgery, radio frequency ablation, nerve excision, neuro-stimulator implant Advice to those going through ON: connect with others who have what you do (see links below), keep advocating for yourself and find a provider who will listen. Doctors are humans, not every doctor knows everything; it's ok to find one that knows about what you're going through. Have a support person to help you advocate. The Foundation is IN SEARCH OF medical providers and researchers interested in finding a cure. Please contact the Occipital Neuralgia Foundation at ONFsupport.org Links to resources: http://www.onfsuppport.org (www.ONFsuppport.org) Facebook: Occipital Neuralgia Foundation Instagram: @occipital.neuralgia HELP US SPREAD THE WORD! If you dug this episode head on over to Apple Podcasts and kindlyhttps://podcasts.apple.com/us/podcast/making-headway/id1534964037 ( leave us a rating, a review and subscribe!) Ways to subscribe to the Making Headway Podcast: https://podcasts.apple.com/us/podcast/making-headway/id1534964037 (Click here to subscribe via Apple Podcasts) https://open.spotify.com/show/4Ishnxgh8xbJfV8BtbCtZw (Click here to subscribe via Spotify) https://making-headway.captivate.fm/listen (Click here to subscribe via RSS) https://www.stitcher.com/podcast/making-headway (You can also subscribe via Stitcher) https://www.makingheadwaypodcast.com/ (Visit the Making Headway Podcast website) to learn more about Eryn and Mariah and our journey to podcasting. Follow us onhttps://www.instagram.com/makingheadwaypodcast/ ( Instagram) orhttps://www.facebook.com/makingheadwaypodcast ( Facebook).
When I meet a person whose life and career seem to keep them in the physical realm (personal trainers, physical therapists, kinesiologists) I am tempted to worry that they will not be open to mind/body work. That makes it even better and more gratifying when I come across someone like Kate Murphy. Kate is successfully coaching people in Foundational Training as well as other fitness philosophies, while fully embracing TMS and mind/body medicine in her practice and her life. Join Kate and I as we discuss her own story - both painful and triumphant - and see the ways in which she totally understands that without emotional health, physical health is almost impossible. Lots of wise gems in this one! Hoping this finds you well today. OX, n. PLEASE RATE AND REVIEW THE PODCAST HERE TO HELP OTHERS FIND IT! My next VIRTUAL FULL WEEKEND RETREAT is live and on sale! With the cancellation of OMEGA, my guest instructors have rallied and we will be coming together to bring you an incredible weekend of connection, guidance and love on September 18-20 2020. Click here for all the info! **INCLUDED IN YOUR RETREAT FEE IS A COMPLIMENTARY DOWNLOAD OF MY ONLINE COURSE AS WELL AS ALL 4 OF MY ORIGINAL GUIDED MEDITATIONS** ANNOUCEMENTS: CANCELLED: My retreat at 1440 Multiversity has sadly been cancelled for October 18-23, 2020. I hope to reschedule for 2021. 1440 Multiversity in Santa Cruz, CA. The Art of Living Retreat Center in Boone, NC will be hosting my work in the coming year. We had a fall date, but are moving it to Spring 2021 in light of current circumstances. Click here to learn more about their beautiful space. If you are interested in supporting the many free resources I offer to get this message to the global community, please consider donating to my cause on my website, www.thecureforchronicpain.com. Look for the DONATE button on the home page. Thank you so much! ALL MY RESOURCES: Instagram: Follow me on insta @nicolesachslcsw for tons of new content Website: The Cure for Chronic Pain YouTube: The Cure for Chronic Pain with Nicole Sachs, LCSW Book: The Meaning of Truth Online Course: FREEDOM FROM CHRONIC PAIN FB Closed Group:JournalSpeak with Nicole Sachs, LCSW OMEGA General info: OMEGA INSTITUTE Subscribe Apple Podcasts Deezer iHeart RadioPublic RSS Spotify
What a joy to sit down with the amazing and resilient Angie Firmalino to discuss her journey through medical trauma (implanted with the device Essure which she has now successfully gotten removed from the market after a ten year advocacy battle) and her myriad symptoms which had confounded her for years. She knew that all of the trauma and debilitating conditions in her body must be related, but she had no idea how... until she found my work. One day, scrolling through podcasts, she found the story of our own lovely Scarlett Murray. This began her incredible journey of hope and healing. Join us today as we share some deep and beautiful knowledge, and wisdom. Recovery is possible, when you have a roadmap. Angie's story is proof of that. Sending big love. XO n. My Chicago Workshop retreat with Dr. John Stracks is coming up next month - Feb 22-23rd in Chicago. Come spend the weekend with us and let it change your life. XO Click here: https://www.drstracks.com/freedom-from-chronic-pain/freedom-from-chronic-pain-a-mind-body-approach Don't forget that our sponsor for this podcast, The Curable App, is offering my listeners 50% off their yearly membership when you visit: www.getcurable.com/nicole. Don't delay, as this amazing deal won't last forever! XOOX CLICK HERE TO SPEND THE WEEKEND WITH DR. JOHN STRACKS AND ME IN CHICAGO FEB 22-23! Join me on April 5-10, 2020 at 1440 Multiversity in Santa Cruz, CA. Click here to join me for this amazing experience on their stunning campus. This 5 day retreat will be the Omega of the West Coast! And of course, my second annual 5 day OMEGA Retreat is LIVE AND ON SALEfor August 9-14, 2020 in beautiful Rhinebeck, NY. To see the moving video of last year's retreat, go to www.thecureforchronicpain.com/resources. Learn more about all of my work: Website: The Cure for Chronic Pain YouTube: The Cure for Chronic Pain with Nicole Sachs, LCSW Book: The Meaning of Truth Online Course: FREEDOM FROM CHRONIC PAIN FB Closed Group:JournalSpeak with Nicole Sachs, LCSW OMEGA General info: OMEGA INSTITUTE Subscribe Apple Podcasts Deezer iHeart RadioPublic RSS Spotify
Today you are in for a special treat. This interview with Julie is my one of my favorites ever. She has come through a grueling battle with Occipital Neuralgia to complete freedom, and she is articulate and wise in her telling of it. This is Julie's unedited original email to me: Nicole, I wanted to thank you. Make sure to add: occipitial neuralgia to your list because you helped me be cured of that! :) Thank you for helping me finally thrive, the way I should've been for years and years and years. I know you don't even know me, but your program and book completely saved my life...and my soul!!! I can't ever thank you enough. All my love, Julie :) The spirit of this email is what you will hear in this interview. Enjoy, and be inspired to take back your life, and your soul. XO If you'd like to support my work and enhance your recovery with more original content from me, or even direct interaction between us, I have established a Patreon page. You will help continue my life saving efforts, and receive some real guidance in your personal journey. Please learn more about this at www.patreon.com/NicoleSachsLCSW OR CLICK HERE! NOTE: I have been invited to do a second 5 day retreat: April 5-10, 2020 at 1440 Multiversity in Santa Cruz, CA. Save the Date! The retreat will go on sale soon with the release their Spring Catalog. And of course, my second annual 5 day OMEGA Retreat is LIVE AND ON SALE for August 9-14, 2020 in beautiful Rhinebeck, NY. To see the moving video my wife Tiff made on last year's retreat, go to www.thecureforchronicpain.com/resources. CLICK HERE TO SPEND THE WEEKEND WITH DR. JOHN STRACKS AND ME IN CHICAGO FEB 22-23! Learn more about all of my work: OMEGA 2020 is LIVE and ON SALE! CLICK HERE TO SPEND THE WEEKEND WITH DR. JOHN STRACKS AND ME IN CHICAGO FEB 22-23! April 5-10, 2020: 1440 Multiversity General Info Website: The Cure for Chronic Pain YouTube: The Cure for Chronic Pain with Nicole Sachs, LCSW Book: The Meaning of Truth Online Course: FREEDOM FROM CHRONIC PAIN FB Closed Group:JournalSpeak with Nicole Sachs, LCSW OMEGA General info: OMEGA INSTITUTE
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