Debilitating Headache Unresponsive To Therapy

BT is a 36y/o nurse s/p MVA with a five-year history of right upper neck and headache pain which was constant in duration, 6/10 in severity, exclusively right-sided localized principally at the base of her skull with radiations into the back of ther head and forehead.  Pain was sharp, stabbing and aching in character and aggravated by extension and stress.  BT was a restrained driver of a mini-van when a 18 wheeler truck struck the driver’s side of her vehicle.  Treatment to date had included physical therapy, massage, cervical traction, trigger point injects,  TENS unit, Botox injections complicated by cervical weakness and radiofrequency ablation of the right C2-4 joints without significant relief.  BT was no longer able to work due to her unrelenting pain.

Physical examination was significant for sensitivity to light, balance disturbance preventing her from walking heel to toe, extreme tenderness over the right C0/C1 and C1/2 joint with marked restriction in extension and rotation secondary to pain.

Upper cervical joints are common sources of pain following motor vehicle accidents.  The atlanto-occipital joint ( C0/C1) is compromised of the atlas of the vertebral column and the occipital bone (base of skull).  The atlas is the topmost (first) cervical vertebra and forms the joint that connect the skull to the spine.

Injection of the right atlanto occipital joint provided 90% reduction in pain.  The C0/C1 joint should always be considered as a possible pain generator when evaluating patients with headache pain following motor vehicle accidents.  Dreyfuss has mapped the referral patterns. Ogoke was detailed the anatomy, clinical presentation and various treatment modalities.

Stem Cell Glossary

Ever wonder what the difference is between multipotent and pluripotent stem cells?   Is a VSE some type of battery?  These and other terms are showing up in increasing frequency. The terms can be confusing and misunderstood.  ICMS has created a comprehensive glossary of stem cells with links to the latest research and news.

 The International Cellular Medicine Society is an independent nonprofit organization dedicated to the advancement of safe and effective adult stem cell therapies through  research, education and oversight.

 

 

 

Off Shore Stem Cell Report Card

The International Cellular Medicine Society is an independent nonprofit organization dedicated to the advancement of safe and effective adult stem cell therapies through research, education and oversight.

The ICMS  publication is a first of its kind report on off shore stem cells clinics. The report provides a summary of cells used, diseases treated and treatments costs of nearly a dozen non-US based stem cells clinics. The report also details the specific procedures, methods and practices of each clinic and evaluates them against the ICMS clinical and lab practice guidelines.

Testicle Pain: Next Step Amputation

DS is a 40y/o patient with 7 month history of right testicle pain which is constant in duration, 5/10 in severity, progressive in nature, throbbing in character and principally localized in the right testicle with intermittent radiations into the groin, anterior thigh and third right toe.  Patient denies any traumatic injury.  Treatment to date had included antibiotics, MRI, ultrasound evaluation of the testicle,ultrasound of the inguinal area to rule out hernia and anesthetic block performed by the urologist which provided 3 hours of pain relief.  All studies were normal.  Patient underwent surgical removal of the an appendage of the testicle (epididymis) with no reduction in pain.  Patient has a 3 year history of intermittent lower back  and right leg pain.

Physical examination was most significant for an abnormal neurologic and musculoskeletal examination.  Specifically patient had decreased sensation to light touch and temperature along the right big toe and lateral aspect of right foot, profound muscle banding with multiple trigger points in the lower back and most importantly along the inner right thigh.

A thin gauge needle was inserted in the adductor magnus at the most tender trigger point.  This simple therapy provided DS with 40 % reduction in his testicular pain.

DS has a classic example of myofascial pain syndrome.  A dysfunctional muscle caused referred pain.  In DS’s case, his adductor magnus was responsible for some his testicular pain.  He has just started therapy.  He may also has some referred pain from lumbar disc.

The adductor magnus is a large fan like muscle that attaches on the pelvis and femur. It’s referral pattern is typically into the groin and testicle.  There are other muscles with similar referral patterns.

A thorough musculoskeletal examination is essential in the evaluation of pain.  This is the standard of care at The Centeno-Schultz Clinic.