Traumeel Facet Injections??

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mid|ine

Interventional Spine
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OK, has anyone heard of this? Looks like quackary to me.

http://ohiopainmanagement.com/index.shtml

http://ohiopainmanagement.com/for_doctors.shtml

What types of medications do you use?
We use non-steroidal anti-inflammatory medicines, including the most commonly used NSAID called traumeel, but we are testing others. Available worldwide for use as an anti-inflammatory, traumeel has been used in the United States since 1986 and in Germany since 1937. It’s listed in the Physicians’ Desk Reference and is indicated to have no known side effects or contraindications. There’s also no evidence of a rebound effect (inflammation returning at a greater degree than prior to treatment) that’s often experienced when using steroids.

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Traumeel- "It's the new Sarapin"

They came around when I was a fellow and gave us free topicals to dispense. They also offered to sell us injectable versions. We were not interested in a proprietary blend of herbs and spices for human injection. Chicken- yes. Mom- no.
 
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i've used traumeel mainly for diabetics who could use a little relief but sugars elevate too much with steroid. it works okay. some people prefer it actually. i think its a nice option to provide people. there is a practice around here that uses only traumeel, but its like an ob-gyn and general surgeon doing FJI and SJI and its like wtf.
 
Traumeel is literally a homeopathic preparation for MSK injuries and pain. There are really no detectable levels of herbs and spices in it. Traumeel has a huge name recognition and brand loyalty amongst the alternative medicine crowd...you can be 99% certain that Traumeel is recognized by almost any alternative medicine patient....
 
Looking at the ingredients it appears as though it is injectable Jagermeister

" rendering the vessels impervious " love it!
 
If it walks like a duck...
 
did you see the credentials of the pain doctor???
 
it seems the must make their money on the Traumeel itself. Its the only thing they inject? and are facets the only thing they inject?
 
looking at the site it looks like yes to both, traumeel is the only thing she injects and only into the facets, at least best I can tell...
 
looking at the site it looks like yes to both, traumeel is the only thing she injects and only into the facets, at least best I can tell...


i mean that seems perfectly logical and legit...uggh.
 
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AZ Pain Centers treats these joints bilaterally and in multiple levels plus potential trigger points, successfully reducing many types of debilitating pain.

Sounds like they really rack up the $$$$$

Seems like they do mostly facets, though they also mention:

• Steroidal Epidural

An epidural steroid injection is an injection of a long lasting steroid combined with a local anesthetic into the epidural space. The medication travels up and down the epidural space to coat the spinal nerves and the facet joints near the area of the injection.

• Satellite Ganglion Blocks

A satellite ganglion block is a test to diagnose and treat sympathetic dependent pain in your hand, arm or shoulder. The pain may come from the nerves in your neck near the spine. These nerves control sweating, heart rate, blood vessels, pupil dilatation, movement of food through the intestines and many other body functions. Sometimes these nerves do not work right and cause pain. It can be on either side of your body. Learning more about the cause of your pain helps your doctor decide on the best treatment for you.

• Large and Small Joint Injections

Joint Injections are injections of long lasting steroids ("cortisone") in the facet joints - which are located in the back area the spinal bony structure. These joints are actual joints with joint capsule that contains lubricating fluids. Facet joints are paired (one on each side) and are present from the top of the cervical spine in the neck all the way down and through the lumbar spine in the lower back. Common causes of facet joint pain include arthritis, degenerative disease of the spine, and trauma. In the absence of injury or accident, the most common cause for facet mediated pain is degenerative disease of the spine or arthritis. Therefore, older patients are more commonly afflicted with facet joint pain. In whiplash injuries of the neck, commonly seen in motor vehicle accidents and other traumatic events, the cervical facet joints can be traumatized, and this can lead to chronic neck pain and headaches.

• Tendon and Ligament Injections
 
Did you see this on the same website?!

"Comfort Technology ™
Comfort Technology™ was designed by our Doctors to help make advanced pain intervention procedures more comfortable for even the most sensitive patients. The medications and the techniques used by AZ Pain Centers were developed to eliminate pain, not cause more.
The Physicians at AZ Pain Centers searched the globe to find advanced methods for eliminating pain. During our research we discovered exciting new techniques and devices that we incorporate into our regular treatment protocols to add both safety and comfort.
As an added benefit we use these techniques for every procedure we do, which is why many of our patients describe our procedures as “just a little pressure” or “nothing at all”. This amazing benefit you’ll find only at AZ Pain Centers."

What the hell are they talking about?
 
"Reiner Kremer, NMD, MPH
Dr. Reiner Kremer received his premedical training at Rutgers University and the National University of Health Sciences. He graduated from naturopathic medical school in 2001 from the American University of Integrative Medicine. While there, he was initially trained in interventional pain management at the Arizona Surgical Hospital by Drew Collins, ND. "

Say Whaaaaaat??? :(
 
Wow, what an informative website! They Understand your Pain!

Just not the anatomy of the SATELLITE ganglion.
Is it named the SATELLITE GANGLION because it orbits around your body? If this is the case I need to make sure I keep my SGBs scheduled for the morning for fear of missing it in when it orbits around uranus in the evening?
Just a thought.

Unreal. I 100% agree with the hyphenated sentiment.
 
"Reiner Kremer, NMD, MPH
Dr. Reiner Kremer received his premedical training at Rutgers University and the National University of Health Sciences. He graduated from naturopathic medical school in 2001 from the American University of Integrative Medicine. While there, he was initially trained in interventional pain management at the Arizona Surgical Hospital by Drew Collins, ND. "

Say Whaaaaaat??? :(

Professional memberships include the Naturopathic Academy of Therapeutic Injection and the American Society of Interventional Pain Physicians.

Does ASIPP let naturopaths join? I did not know that they were licensed to do interventional procedures.
 
on a flight 5 years ago i was sitting next to a guy reading a medical textbook... i asked him what he did - he responded that he was an interventional pain specialist... I said: "no way, so am I... where do you practice"... He back-tracked "i am really a naturopath who does interventions"

This ND (based in Utah) had a completely interventional pain practice (injections only, and some vitamins, no other co-management) - all cash based.... NO fluoroscopy... facets, epidurals, botox... and stated he was quite successful because the next closest pain doc was 120 miles away....

yikes
 
so, I stumbled across this discussion, so though I'd rant.

This place in AZ, where I am located and a practicing interventional pain specialist, is a total scam. The only really qualified provider they recently had just left to open his own place here in scottsdale. unfortunately, he also does this Traumeel stuff, so the scam continues. I have patients coming to me all the time complaining about how that had a ton of injections and only relief for a few weeks at best. But that's ok...because we'll just do it again! Seriously, 6-8 level "facet" injections (if they are even in the facet) with Traumeel done weekly for 3-4 weeks and repeat as necessary? This is absolutely raping the system and has already triggered a Noridian (Medicare) response to pull in the reigns. This gal on the link above came from this same system, and no offense, but primary care docs, or anyone else should not be doing interventional pain procedures without the residency or fellowship training to support it. Not the 'weekend warriors'.

If this stuff was so great, we'd all be doing it. Better off with RFA, if you have the right diagnosis and give someone a chance for months/year + relief. These folks and many like them are straight out killing this specialty for the years to come.
 
Anyone have any new thoughts on this stuff? This AZ Pain Centers has a massive marketing machine and a ton of people who have received these injections. Most of them have no relief and go elsewhere but one patient, whom I know socially and is very level headed said she got relief for over a year when traummel was injected into her hands. She does not want "steroid injections" and asked if I could do this. I said OK I'll order a bottle for you. I would never use this stuff around the spine but in the hands I'll give it a try. What do you think guys? Would you do it or not?
 
Anyone have any new thoughts on this stuff? This AZ Pain Centers has a massive marketing machine and a ton of people who have received these injections. Most of them have no relief and go elsewhere but one patient, whom I know socially and is very level headed said she got relief for over a year when traummel was injected into her hands. She does not want "steroid injections" and asked if I could do this. I said OK I'll order a bottle for you. I would never use this stuff around the spine but in the hands I'll give it a try. What do you think guys? Would you do it or not?

Tell her to go back to the other guy. This way you do no harm and also don't give the impression some quack is better at giving injections than you. It was good timing or placebo effect.
 
Tell her to go back to the other guy. This way you do no harm and also don't give the impression some quack is better at giving injections than you. It was good timing or placebo effect.

Ditto...33% chance of working...
 
Anyone have any new thoughts on this stuff? This AZ Pain Centers has a massive marketing machine and a ton of people who have received these injections. Most of them have no relief and go elsewhere but one patient, whom I know socially and is very level headed said she got relief for over a year when traummel was injected into her hands. She does not want "steroid injections" and asked if I could do this. I said OK I'll order a bottle for you. I would never use this stuff around the spine but in the hands I'll give it a try. What do you think guys? Would you do it or not?

It seems to be fairly benign. I have a few folks who want only this so I have it and it works well enough. No problems after facet injections. No problems after peripheral joint/tendon injections. I saw records from a different place here that injected it epidurally as well and the patient had no negative sequellae from it. No way I would do that though.
 
Anyone have any new thoughts on this stuff? This AZ Pain Centers has a massive marketing machine and a ton of people who have received these injections. Most of them have no relief and go elsewhere but one patient, whom I know socially and is very level headed said she got relief for over a year when traummel was injected into her hands. She does not want "steroid injections" and asked if I could do this. I said OK I'll order a bottle for you. I would never use this stuff around the spine but in the hands I'll give it a try. What do you think guys? Would you do it or not?

AZ pain centers does indeed have a massive marketing machine. A pain doc here in WA state is buddys with them and is implementing the same model. Subscribe the narcs whether appropriate or not, inject, kick them out if they don't want injections. Never meet the actual physician until they are in the procedure room. NPs run all the clinic visits and consults. Its a travesty.
 
AZ pain centers does indeed have a massive marketing machine. A pain doc here in WA state is buddys with them and is implementing the same model. Subscribe the narcs whether appropriate or not, inject, kick them out if they don't want injections. Never meet the actual physician until they are in the procedure room. NPs run all the clinic visits and consults. Its a travesty.

Unfortunately, this is going to be the downfall of pain. I wonder what is going to happen when ACO's start to come into play? It is unfortunate because these kinds of practices are all to common in pain.
 
Unfortunately, this is going to be the downfall of pain. I wonder what is going to happen when ACO's start to come into play? It is unfortunate because these kinds of practices are all to common in pain.

I tend to agree with the ACO comment. If a group of PCPs are going to lose some of their share of the check if they have to refer out to specialists I think pain physicians will be one of the first ones that take a hit. Right now, they think of pain physicians as opiate refillers that happen to do some "shots" to make some money on the side. Unless properly educated, they will send the pts to back surgeons when things get really bad. They simply don't want to deal with the headache of opiate prescribing right now but when their money is on the line they will likely have a newfound tolerance for prescribing.
 
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