Microbiome. It is amazing the number of patients, especially those with fibro-myalgia, respond to the optimizing of their gut microbiome (see above). This is done by education about the microbiome and how it increases pain, and the repairing of the gut wall and re-inoculating the correct bacteria into the gut, and general care of the microbiome.
It is also impressive to what extent the optimizing of the microbiome improves anyone’s general wellbeing, wellness and quality of life. This is all accomplished here.
Medication appropriate for the patient’s condition. He can also administer certain drugs and therapies using intravenous drips.
PRP Platelet Rich Plasma both systemically or local injection instead of cortisone.
Some patients are admitted to hospital for intravenous pain control. The idea is to break the pain cycle and make the patient’s pain more manageable. Also to reduce the neuro-inflammation and to start the gut repair and microbiome optimization process.
Vacumed treatment (lower body negative pressure device) which also improves blood circulation to the lower limbs and helps with chronic wound healing.
Inject cortisone where indicated often with the aid of X-rays to determine exact placement of the injection.
Nerve blocks with indwelling catheters for 5 days where indicated for the patient’s problem. Not every problem can be or is treated with a nerve block.
NMS 460 – the application of Pulsed-RF electrical impulses to nerves through the skin in cases of neuropathic pain.
Radio Frequency (RF) ablation (heat destruction) OR treatment (non-ablation) of the nerve/s that supply the area where the pain is being experienced plays a big role in chronic pain management. Again, it is not indicated for every problem but only where indicated. This is done theatre in hospital often under general anaesthetic.
Releasing impinged nerves is another therapy offered.
In highly selected patient who qualify for it he implants a spinal cord stimulator or an intrathecal (spinal) morphine or lioresal pump . Neither of these are “first line” therapies so are never the first thing offered.