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

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

When cause of death is opioid overdose is it murder or malpractice? The case of Dr. Tseng

Is a doctor guilty of malpractice or murder or is the patient responsible for his or her actions when there is a death by overdose? This is the question that a jury in Los Angeles will have to decide as they are presented the facts in the case of Dr. Lisa Tseng. The prosecution’s version […]

Vaginal Valium is ineffective for pelvic floor muscle spasm

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

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

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

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

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

Persistent pain after a c-section: when is it nerve pain and what can you do?

Persistent pelvic and/or abdominal pain post c-section often poses a diagnostic and treatment dilemma, because most OB/GYNs know very little about pain and most pain doctors know very little about the pelvis. But that’s where I come in, being both board certified in OB/GYN and Pain Medicine. It is hard to know how many women have […]

The risks of CT scans: what an informed patient should know

More than 60 million CT scans are performed every year in the United States. A CT scan uses a computer to assemble multiple x-rays taken in rapid sequence to produce a far more detailed image than a conventional x-ray. CT scans are helpful in the diagnosis and management of many medical conditions. All tests have […]