Dr Ilonka Meyer

07/04/2024

🌧️ So, here's how my Sunday kicked off - a run in the pouring rain. 🏃‍♂️ Did I feel up for it? Absolutely not! 🤷‍♂️ Did I enjoy it? Kinda. But hey, I did it and that's what counts, right?

🚀 Many of my long-term patients will know I've been on a personal health improvement journey for the past few years. 💪 I think the moment has finally arrived for me to focus on getting fit again. 📱 I've started using the Nike Run Club app (a tip from my awesome anaesthetist, Dr Kim Brown) and I have to say, I'm loving it.

🤩 It's my first time trying this app and three weeks in, I'm totally digging the guided runs. Today, I was scheduled to run for just 7 minutes and I was like, "Really?" 🤔 But then Coach Bennet's commentary made me understand the logic - it was all about just getting out there and doing it.

🏃‍♂️💨 Okay, so when I say I'm "running" again, let's put it in quotes, because it's more like a mix of walking, running, and trying not to die (me catastrophizing a little)! 🌟 I can already feel a difference from when I started three weeks ago. 🐢 I know I'm slow, but that's ok. I'm just trying not to push too hard, to pace myself, and stick with it.

📲 I've tried a few running apps and programs in the past and enjoyed them. Here are some pros and cons if you're interested:

👟 None to Run
Pros:
👶 Tailor-made for beginners. Even for walkers - you don't have to run when they say run, just pick up your pace a bit.
⏱️ A 12-week program focusing on time, not distance, making it user-friendly.
🏋️‍♂️ Includes strength and mobility workouts to keep injuries at bay.
🤗 Provides a supportive community through social media groups.
📱 Easy to use and compatible with gadgets like the Apple Watch.
Cons:
🍏 Mainly available for iOS, limiting access for Android users.

👟 Couch to 5K (C25K)
Pros:
🌟 Ideal for beginners, aimed at getting you to complete a 5K run in 9 weeks.
📋 Simple, clear-cut program with a well-defined structure.
🔄 Promotes rest days and cross-training for a balanced approach.
Cons:
🛠️ Limited customization of the training plan.
🏋️ Requires some level of fitness to start.

👟 Nike Running Club
Pros:
🎯 Provides personalized coaching plans aligned with your goals.
📊 Extensive tracking features to monitor progress.
💡 Motivational guidance from professional athletes. I'm personally a HUGE fan of the guided runs!
🌍 Available on both iOS and Android.
Cons:
💳 Some features require a premium subscription.
🆕 Might be a bit too advanced for absolute beginners.

06/04/2024

🤔 I often get questions from my patients about how they can keep moving even when they're dealing with chronic pain. I'm a big fan of making a conscious decision to move throughout the day, no matter what your situation is.

🚫 I deliberately avoid saying 'exercise' when I talk to my patients because it can be a scary word if you're living with a chronic illness or pain. I think we should start using the terminology 'intentional movement' instead.

🚶 Whether it's taking 10 minutes to stretch every day, working on a rehab program after an injury, or training for a half marathon, the idea is the same: regular daily intentional movement is crucial.

💡 It's well known that any type of movement program can boost our physical and mental health. It helps our brains release a bunch of neurotransmitters that make us function and think better.
For my chronic pain patients, the neurotransmitters released during intentional movement play significant roles in managing chronic pain:

💊 Endorphins: These natural painkillers bind to opioid receptors in the brain, similar to how pain medications work, helping to alleviate pain and produce a feeling of well-being.

😊 Dopamine: Increased levels of dopamine can help mitigate feelings of pain by enhancing mood and reward sensations, which may be particularly important for maintaining motivation and engagement in physical activity despite chronic pain.

🌈 Serotonin: By boosting serotonin levels, exercise can help regulate mood and reduce pain perception. Serotonin is known for its role in pain modulation, and higher levels can lead to decreased sensitivity to pain.

⚡ Norepinephrine: This neurotransmitter not only improves focus and energy, which can be diminished by chronic pain, but it also plays a role in pain modulation. Increased norepinephrine can reduce the perception of pain by influencing the pain pathways in the brain.

🧠 Brain-Derived Neurotrophic Factor (BDNF): Though not a neurotransmitter, the increase of BDNF through exercise supports neural health, which is crucial for chronic pain patients. BDNF can enhance brain function, aid in the recovery of damaged neurons, and is involved in the regulation of pain.

📲 I'm going to start sharing more online resources, apps, and tech that I recommend to my patients (and use myself) to keep your body and mind healthy.

🤸 So, I'm curious, what kind of intentional movement routines do you have in your day to help your body and mind stay healthy?

03/02/2024

https://www.facebook.com/share/v/Bs5av8zoYQjng9Rn/?mibextid=WC7FNe

28/01/2024

The Inquiry into Women’s Pain, spearheaded by the Victorian Government and informed by insights from the Women’s Health Survey Report, represents a significant turning point in the recognition and treatment of chronic female pain sufferers. As a specialist in chronic pain, I find this initiative especially salient, considering that 40% of the women surveyed report enduring chronic pain.

The inquiry zeroes in on a crucial issue: the vast majority of women—76.3%, according to the 2023 national Pain Survey—feel that their pain-related complaints are routinely dismissed. This revelation calls for rigorous academic and clinical exploration.

It dovetails with the pressing requirement for systemic healthcare reforms that guarantee compassionate and fair pain management for all. Furthermore, with 20.3% of survey participants disclosing experiences of sexism and bias within the healthcare system, the inquiry's commitment to embedding gender-sensitive methodologies into both pain research and treatment practices cannot be overstated.

Support for such investigative efforts is fundamental in enhancing our comprehension and ameliorating the treatment of chronic pain in women.

https://www.theguardian.com/australia-news/2024/jan/22/australia-first-womens-pain-inquiry-victoria-chronic-illness

27/01/2024

💡Exploring Nanotechnology Innovations: Could This Mark a New Era in Pain Management?💡

The realm of pain management is witnessing a transformative shift, thanks to groundbreaking advances in nanotechnology. This innovative approach is not just reshaping our understanding but could revolutionize the treatments available for chronic and acute pain conditions.

🔬 Tailored Drug Delivery Systems: The advent of nanotechnology has ushered in an era where medications can be precisely delivered to the distressed areas, ensuring enhanced efficacy. Zinc Oxide (ZnO) nanoparticles, for example, have shown remarkable potential in reducing pain by blocking NMDA receptors and activating the opioidergic system, thus providing a more targeted and effective treatment.

🌟 Personalized Treatment Plans: The precision of nanotechnology enables the creation of personalized treatment strategies. Magnesium Oxide (MgO) nanoparticles, known for their antinociceptive effects, have demonstrated enhanced analgesic effects in the central nervous system, highlighting the potential for customized pain relief solutions.

🌈 Innovative Nanoparticles: The exploration of Manganese Dioxide (MnO2) and Magnetite (Fe3O4) nanoparticles reveals their unique properties in modulating analgesia and pain perception through the dopaminergic system and reducing inflammation, respectively. These discoveries point towards a future where pain management can be both highly effective and minimally invasive.

The integration of nanotechnology in pain management is not just a glimpse into the future; it is a reality that is unfolding now. Embracing these advancements offers hope and new possibilities for individuals seeking relief from chronic pain.

Follow the link for an interesting article published in Nano Today - Nanotechnology for Pain Management: Current and Future Therapeutic Interventions. https://pubmed.ncbi.nlm.nih.gov/34899962/

Let's engage in a dialogue about how these nanotechnological advancements can shape the future of healthcare and pain management. What are your thoughts on the potential impact of these innovations?

24/11/2023

✍️ Just came across an intriguing research article titled "To tolerate weather and to tolerate pain: two sides of the same coin" by Granot M. et al., published in the PAIN journal, in May 2022. 📚

Here's a brief rundown:

📌 The study includes a large sample size of over 18,000 subjects aged 40 years or older, lending credibility to the findings. 🧑‍🤝‍🧑

📌 A unique approach was taken to gauge pain tolerance levels using cuff algometry pressure pain tolerance (PPT) and cold pain tolerance (CPT), tested with a cold pressor test. 🌡️

📌 The results show a clear seasonal variation in CPT, with the rate of withdrawal in the cold pressor test being up to 75% higher in warmer months. ☀️❄️

📌 However, it's important to note that the study involved a one-time assessment of the participants, so it provides just a snapshot in time. Also, individual differences in pain sensitivity and other potential confounding factors were not considered. 🔄

👉 Despite these limitations, the study offers valuable insights into the field of pain management. It suggests that weather conditions could potentially influence pain management strategies, opening up new avenues for research. This could lead to more personalized and effective pain management strategies based on weather conditions. 🌳💡

I believe it's an exciting time in the field of pain management, as we continue to uncover new ways to enhance patient care. 👩‍⚕️💼

Source: https://bit.ly/3sHiAVc?utm_source=facebook&utm_medium=social&utm_campaign&utm_content=ap_kiamacwqlv

12/08/2023

Read our latest patient article on the utility of pulsed radiofrequency for the treatment of meralgia paraesthetica - neuropathic pain in the distribution of the lateral cutaneous nerve of the thigh.

Follow the link below for the full article:

https://mbpain.com.au/pulsed-radiofrequency-for-the-treatment-of-meralgia-paraesthetica-lateral-cutaneous-nerve-of-the-thigh-pain/

11/08/2023

I have been adding the saphenous nerve as a fairly standard part of an approach to treating knee osteoarthritis with genicular radiofrequency ablation due to improved postprocedural pain relief for patients. 👩‍⚕️

This article, published in Pain Medicine, Volume 24, Issue 7, July 2023, compares a 3-nerve protocol to a 5-nerve protocol for treatment of genicular nerves:

"Ultrasound-guided genicular nerve radiofrequency treatment: prospective randomized comparative trial of a 3-nerve protocol versus a 5-nerve protocol" by Selin Guven Kose, MD et al. 📖

You can find the complete article at this link: https://academic.oup.com/painmedicine/article-abstract/24/7/758/7068803?redirectedFrom=fulltext

➖ Methodologies:

The study conducted a prospective, randomized comparative trial to compare the effectiveness of a traditional 3-nerve protocol versus a 5-nerve protocol in ultrasound-guided genicular nerve radiofrequency treatment for chronic knee osteoarthritis pain. 📋 📈

➖ Findings and clinical implications:

The results showed that 5-nerve protocol ((adding the recurrent fibular and infrapatellar branches of the saphenous nerve) had improved effectiveness compared to the 3-nerve protocol. The addition of two sensory nerves led to better pain relief outcomes for patients with knee osteoarthritis. 🎯

This approach may offer a more effective treatment option for individuals suffering from knee osteoarthritis. 🧑‍⚕️

➖ Further Research and clinical recommendations:

Further research is needed to validate the findings and explore the long-term effects of the 5-nerve protocol.

I am also interested in the different clinical outcomes in patients with osteoarthritis limited to the medial compartment vs medial/patellofemoral compartment vs medial/ patellofemoral/ lateral compartment disease - in my experience isolated medial compartment osteoarthritis has the best results from genicular radiofrequency ablation and when there is significant lateral compartment disease, the outcomes are often not as good. 🧪🔬

Pain medicine specialists can consider incorporating the 5-nerve protocol into their clinical practice. However, individual patient assessment and consultation are essential. ✔️👩‍⚕️

➖ Conclusion:

Through the comparative study presented, it's apparent that the 5-nerve protocol holds promise for enhancing pain relief outcomes in patients with knee osteoarthritis. The addition of the recurrent fibular and infrapatellar branches of the saphenous nerve to the traditional 3-nerve protocol seemed to offer improved results.

However, given that individual patient conditions can greatly vary, it is crucial to pair these findings with personalized patient assessments and consultations. Future research should focus on exploring the long-term effects of the 5-nerve protocol and discerning the varying outcomes in cases of osteoarthritis limited to specific knee compartments. 🙌🔬

AbstractObjectives. Genicular nerve radiofrequency procedures increasingly are being performed to treat chronic pain due to knee osteoarthritis. Targeting addit

07/08/2023

🔬📚 Interesting Article: "Sympathetic Blocks as a Predictor for Response to Ketamine Infusion in Patients with Complex Regional Pain Syndrome: A Multicenter Study" published in Pain Medicine, October 2022.

🔗 Read the full study here: https://academic.oup.com/painmedicine/article/24/3/316/6767822

💡 In this study by Steven P Cohen et al., they explore the potential of sympathetic blocks to predict response to ketamine infusion in patients with Complex Regional Pain Syndrome (CRPS). Here's a brief overview of the methodologies used, key findings, and clinical implications discussed in the article:

🔬 Methodologies:
🔺The study utilized a multicenter design, enhancing the generalizability of the findings.
🔺Demographic and clinical factors, technical characteristics of sympathetic blocks, and psychophysical assessments were examined as predictors of response to ketamine infusion.
🔺A significant number of participants were included, increasing the study's statistical power.

📊 Findings:
👉The study revealed a correlation between the effectiveness of sympathetic blocks and subsequent response to ketamine infusion in patients with CRPS.
👉Specific demographic and clinical factors, along with certain characteristics of the sympathetic blocks, were identified as potential predictors of response to ketamine treatment.

💼 Clinical Implications:
📌Performing sympathetic blocks before ketamine infusion could aid in identifying patients who are more likely to benefit from this treatment approach in managing CRPS.
📌Further research should focus on conducting randomized controlled trials to establish a causal relationship between sympathetic blocks and response to ketamine infusion.
📌Collaboration between pain medicine specialists and researchers will help refine treatment algorithms and develop personalized approaches for CRPS management.

🔍 Areas for Further Research:
➖While the study establishes a link between sympathetic blocks and response to ketamine infusion, further research is needed to validate and refine these findings.
➖Future studies could explore the optimal timing, dosage, and frequency of ketamine infusions following sympathetic blocks to maximize therapeutic efficacy.

AbstractBackground. Ketamine infusions are frequently employed for refractory complex regional pain syndrome (CRPS), but there are limited data on factors assoc

09/05/2023

At MindBodyPainSpecialists we have an exciting opportunity for someone to join our team.

We are advertising two flexible, part-time Medical Administration positions. The role will see you managing a variety of booking & billing tasks, with a focus on delivering an exceptional patient experience.

The position is 2-3 days a week on a 12-month contract with potential to extend.

Please share with any contacts in your network who might be interested in applying for this position.

https://www.seek.com.au/job/67159560

The position is 2-3 days a week on a 12-month contract with potential to extend.

28/10/2022

We published this study BMC anaesthesiology earlier this year, reflecting our postoperative use of Buprenorphine. Our change of practice from use of Oxycodone to Sublingual Buprenorphine as primary transition opioid from patient-controlled analgesia delivered full opioid agonists was associated with a clinically significant decrease in 24-hourly post-parenteral opioid transition OMEDDs (oral morphine equivalent daily dose) and improved NRS-11 pain scores on movement, but without an association with hospital length of stay after major abdominal surgery.

The increased use of low dose sublingual Buprenorphine has resulted in easier transition to oral route once gut function returns and due to the decrease OMEDDs after initial transition from PCA to sublingual Buprenorphine, the resultant OMEDDs when changing from sublingual route to oral route is also lower.

Our study was a retrospective cohort study and further prospective randomised studies are needed.

https://lnkd.in/gZ6dEMxx

24/07/2022

National Pain Week is Australia's annual awareness event for chronic pain. National Pain Week takes place in the last week of July each year, and in 2022 it will take place from 25th-31st July.

The event is organised by Chronic Pain Australia, and this year the organisation is advocating to ensure that all Australians living with chronic pain receive Triple A standards of care: Awareness, Accessibility and Affordability.

Chronic pain is a major health problem worldwide, and its prevalence is increasing as global populations age. In Australia, it is estimated that 3.2 million people suffer from chronic pain, and this number is projected to increase to 5 million by 2050.

Chronic pain can have a significant negative impact on quality of life, and it imposes a significant economic burden on individuals, families and society as a whole. National Pain Week provides an important opportunity to raise awareness of this condition and its impact on those affected by it.

It also highlights the need for improved access to pain management services and for greater investment in research to develop new and improved treatments for chronic pain.

👉 https://chronicpainaustralia.org.au/nationalpainweek2022/