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17 Articles in Volume 19, Issue #4
Analgesics of the Future: Inside the Potential of Nerve Growth Factor Antagonists
Best Practices Are Still Largely Undefined in Task Force Report
Brief Behavioral Interventions for Chronic Pain
Cervicogenic Headache: Diagnosis and Management
Chronic Headache and Central Pain Conditions
Considering Comorbidities When Selecting Medications for Pain (Part 4)
For APPs: How to Contribute to Clinical Research
Gabapentin and Suicidal Ideation: Is There a Link?
Intranasal Ketamine for the Relief of Cluster Headache
Letters: Slipping Rib Syndrome; Burning Leg Pain; CGRP Complications
Pain Assessment Tools for Malingering in Patients with Chronic Pain
Refractory Chronic Migraine: Mild, Moderate, or Severe
Should Probuphine be considered for MAT?
Special Report: The Abuse Potential of Gabapentin & Pregabalin
Tension-Type Headache: Evidence for Trigger Points
Treatment Alternatives for Migraine: Photobiomodulation and Sphenopalatine Ganglion Blocks
Trigeminal Neuralgia: Current Diagnosis and Treatment Options

Letters: Slipping Rib Syndrome; Burning Leg Pain; CGRP Complications

June 2019 Letters to the Editor from practitioner peers and patients.
Page 13

Patient Complications with CGRP Inhibitors

I started taking Aimovig injections last August [2018]. I began to experience knee pain almost immediately but also began to experience relief from almost daily migraine attacks, varying only in intensity. I continued the injections, hoping the knee pain would decrease. I advised both my doctor and pharmacist.

Unfortunately, the effectiveness of the injections declined and the knee pain escalated. In January 2019, I stopped the injections altogether, hoping the knee pain would stop as well. My pharmacist advised me that the shelf-life of Aimovig is four to five months. I am horrified to say the knee pain is still not gone, and I am now faced with debilitating knee pain causing difficulties standing or kneeling. The pain affects my sleeping and my daily activities. This is a far cry from the relief I hoped to achieve.

–P. Mastry

New CRPS Diagnosis

My husband was diagnosed with CRPS in early December. It has been exhausting. After a wrist injury and surgery, doctors have told us there really is not much more that can be done. His orthopedic surgeon transitioned us to a neuro-specialist who then sent us to a pain specialist. Yet, the only advice to date has been to take ibuprofen despite the constant debilitating pain. My husband can barely leave the house and I am fearful he will never go back to work. He is always in pain and getting angrier by the day, which I think stems from his pain and frustration. I have had to work two jobs and overtime to supplement income.


Any advice on CRPS, as this condition is fairly new to us, is welcome.

–K. Wendt

Chronic, Burning Leg Pain After Epidural

I’m a 27-year-old female who has had excruciating pain for over a year now. It has progressed to the point of being couch/bed bound, I have severe hesitancy with bladder and bowel, and “foot drop” of my right foot. My MRI from one year ago shows “normal” but I’m unable to get pain relief as I have no diagnosis.

My pain started within days of my epidural for childbirth and has just progressively gotten worse. My legs feel heavy, I get cramps in my legs, and I have an intense burning that never stops. Any advice would be appreciated…. I just don’t know what to do as I feel like everyone thinks it’s all in my head.

–A. Haney

Treating Slipping Rib and Other Rare Conditions

I had a slipping 10th rib, which was resected to my side but it took 4 years to be diagnosed. I was in constant pain and nobody believed me until a thoracic surgeon finally diagnosed me after an X-ray. Most of the doctors I had seen previously had never heard of slipping rib syndrome (as reported on in your case report in the November 2018 PPM issue).

I pity the patients that end up living in agony with this affliction… It is time for the pain management field to get its act together [and] pursue continuing education [on subjects such as these rare conditions].



We invite you to please share your experience with migraine, arachnoiditis, CRPS, slipping rib and other rare pain conditions. We welcome your response to the letters herein, as well as case studies, best practice tips, and literature reviews. Please send your thoughts and ideas to ppmeditorial@remedyhealthmedia.com.

Last updated on: August 3, 2021
Continue Reading:
Letters: Opioid Conversions; Scrambler Therapy for CRPS
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