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foot klonopin drop helps

There are, however, no data on the efficacy of clonazepam for chronic pain CP associated with myofascial pain syndrome MFPS. Therefore, we wish to report the results of an open clinical treatment trial of clonazepam for CP associated with MFPS. At entrance and completion of the study the patients completed a cm visual analog scale VAS requesting them to rate their pain over the last 24 hours. Clonazepam was titrated upwards from 0. These patients rated their perceived pain relief daily on a 3-point rating scale: Once a patient claimed partial pain relief clonazepam increases were stopped.

Patients who complained of intolerable side effects before partial pain relief were withdrawn from the study. For a subgroup of patients claiming partial pain relief, clonazepam serum levels were determined. Descriptive statistics were calculated for this group. Drop in pain level from entrance to partial response was tested for "drop foot" significance via t test.

In addition, 17 independent variables such as presence of trigger points, presence of burning pain etc, were utilized in a regression analysis, with drop in pain level as the dependent variable. A Pearson correlation analysis was first performed in order to determine which of the independent variables significantly correlated with decrease in pain level. Independent variables having a Pearson r of. Mean clonazepam dosage to reach partial response was 2.

Mean "klonopin helps" serum level was Decrease in pain level was associated with the presence of the following independent variables: Clonazepam may have an antinociceptive effect for pain associated klonopin helps foot myofascial pain syndrome. Clonazepam Klonopin is a 7-nitrobenzodiazepine derivative that has been in clinical use all over the world for more than a decade [1]. Although FDA-approved in the United States xanax dosage for felines for the treatment of specific seizure disorders [1]clinical experience suggests that foot drop may tramadol dosage in veterinary medicine additional pharmacological properties [2,3].

These properties appear to make this drug useful in other types of disorders: In addition, clonazepam has been reported to be effective in can morphine be taken with tramadol treatment of some specific chronic pain syndromes: In reference to the type of pain, clonazepam has been reported foot drop be effective for drop lancinating pains shooting, stabbing. Martin [20] has demonstrated that this drug is effective for lumbar disc disease postlaminectomy pseudodiabetic lancinating pain.

In another study, Swerdlow [21] compared clonazepam against other anticonvulsants in the treatment of lancinating pain of various causes, including foot drop neuralgia. Sixty-six percent of the patients had relief of lancinating pain with clonazepam, with few side effects [21]. The percentage of patients claiming klonopin helps for lancinating pain was greater than that for carbamazepine, phenytoin, or valproate [21]. There is also some evidence that clonazepam could be effective for the treatment of other forms of neuropathic pain.

Twenty-one consecutive patients with chronic pain PWCP were selected for an open clinical treatment study drop clonazepam if they had any one of the following features: Six patients responded to clonazepam with marked or complete pain relief [22]. All 6 patients responding to clonazepam treatment had allodynia pretreatment [22]. In addition, clonazepam drop also demonstrated some efficacy in the treatment of chronic deafferentation lancinating pain in a group of mixed pain conditions [23,24].

In spite of the above data on the potential utility of clonazepam for chronic pain conditions, there are currently no controlled trials of clonazepam for the treatment of any type of chronic pain [25]. Additionally, there have been no reports on foot drop use of clonazepam for the treatment of chronic pain associated with myofascial pain syndrome MFPSa very common diagnostic entity within pain facilities [26,51].

MFPS is a chronic pain syndrome that affects local or regional portions of the body and is characterized by the drop point on physical examination [27]. The trigger point is thought to result from microtrauma to klonopin helps affected muscle; stimulation of the trigger point will reproduce or exacerbate the patient's pain [27]. Although MFPS was first described many years ago, it drop foot a controversial diagnosis, as there is little controlled systematic research in reference to this condition [27,50].

There are few reports on the psychopharmacological treatment of MFPS. Therefore, we undertook a noncontrolled open clinical trial of clonazepam for the treatment of chronic pain associated with the primary organic treatment diagnosis of myofascial pain syndrome. This study is described below. Forty-six patients in our pain facility with chronic pain greater than 6 months duration, with a diagnosis of myofascial pain syndrome and fulfilling the inclusion criteria below were recruited into "drop" clonazepam open pain treatment clinical trial.

Inclusion criteria were as follows: No IRB approval was obtained because this was a clinical treatment trial and clonazepam was being used off-label. Patients were simply advised that clonazepam was being used off-label for pain and were asked if they wished to try it. Patients were given the opportunity to try clonazepam if, by the klonopin helps or third week of pain facility treatment, the patient's pain had increased or if the patient had difficulty tolerating their foot drop.

Pain facility treatment usually consisted of a number of multidisciplinary components: Each dose strengths of xanax received these treatments according to an individual schedule, rotating at hourly intervals. However, each patient received the same treatments for the same amount of time over a hour period of treatment.

The diagnosis of myofascial pain syndrome was usually established by two physicians a neurosurgeon and a physiatristwho examined each patient independently. The diagnostic criteria for MFPS were pain in a regional location, one or more trigger points, and normal findings from a neurological exam. These criteria have been drop as essential to a diagnosis of myofascial pain syndrome [27]. Because of its long half-life [1] most of the drug dose was usually given at night.

A similar rating scale has been used previously in pain research [ 28 1]. The following data were abstracted: First, descriptive statistics i. The drop in pain ratings "drop foot" entrance into the study to partial response was tested for statistical significance via t test. A Pearson correlation coefficient was calculated for the drop in pain level versus the number of previous surgeries. In addition, foot drop determined the contribution of the following 17 variables in predicting any drops in pain level: These 17 independent variables were candidates for inclusion in a regression analysis using drop in pain level as the dependent variable.

Due to the small relative ratio of number of patients to number of independent variables, some of these variables were eliminated in order to drop foot meaningful results. A Pearson correlation analysis was performed to determine those independent variables that significantly correlated with decrease in pain level. The set of independent variables was then reduced by selecting only those that foot drop significantly correlated with the dependent variable.

With 14 degrees of freedom, the critical value of r for a two-tailed test at the. For this reason a Pearson r of. Since the primary goal of this analysis was to identify those variables that predicted the dependent variable, the elimination of variables that did not correlate appreciably with the independent variable is appropriate. Those independent variables having a Pearson r of. Of the 46 patients entered into the study, 9 For these 9 patients, the intolerable side effect was sedation.

Background data on these 28 patients is presented in Table 1. Characteristics of twenty eight patients with chronic pain and associated myofascial why must ambien be taken on an empty stomach syndrome remaining in the study. Mean drop in VAS pain level from beginning clonazepam to partial response was 2. Mean time to reach partial response was 8.

Five of the 17 independent variables showed significant correlation with decrease in pain level. These were the following: It wat doet xanax met je to be noted that the anxiety variable, any anxiety diagnosis adjustment disorder with anxious mood, generalized anxiety disorder, panic disorder, posttraumatic stress disorderdid not show significant correlation with decrease in pain level.

When the above 5 variables were used as the independent variables in the stepwise regression analysis with decrease in pain as the dependent variable, the regression analysis drop foot 2 of these variables: The results of this study indicate that clonazepam appears to improve chronic pain. However, there are 5 significant problems with this study. First, this study was not a placebo-controlled drop trial. However, the delay in initial therapeutic response mean 8.

Nevertheless, absolute confirmation of our results will "foot drop" to await the results of a placebo-controlled trial. Second, other treatments could have confounded the results of this study, although each study patient received the same treatment package of psychotherapy, individual counseling, etc, in addition to clonazepam. However, it can be argued that because patients only entered the study if they were slow to respond, this exclusion criterion partially controlled for the effect of the package.

Obviously, however, the foot drop could still have had a confounding effect on the results. The third problem with this study is related to the strong antianxiety effects of clonazepam [2—4, 7—8]. However, we did not find a significant relationship between any psychiatric anxiety disorder diagnosis and decrease in pain level, and none of these variables entered the regression analysis.

These results could foot drop that the analgesic effect demonstrated in this study might not be related to clonazepam's antianxiety properties. Interestingly, there helps klonopin one other drop foot [24] that supports this observation; this study of clonazepam pain treatment attempted to control for clonazepam's antianxiety property [24].

Here patients with anxiety were less likely to have pain relief with clonazepam. The fourth problem with this study derives from the muscle relaxant properties of clonazepam, a benzodiazepine [1]. We did not control for the muscle relaxant properties of this drug within the study and this effect could have confounded klonopin helps foot results with reference foot drop its analgesic effect. The final and fifth problem with this study is associated with the sedating properties of clonazepam, which could have helped pain through foot drop sleep.

It is well known that sleep problems are common in patients with chronic pain. We did not control for sleep problems, and they could have confounded our results. In spite of these deficits in design, the results of this study would indicate that a controlled trial is warranted. It is interesting to note that the results of this study closely replicate the results of some other chronic pain clonazepam "drop" studies [30—31]. Our mean serum levels were approximately half those in can taking 10 ambien kill you study.

This may explain why our patient dropout rate secondary to sedation was lower. In another study [31] "foot drop," three patients with lancinating pains obtained pain relief with clonazepam doses in the range of 2 mg to 4 mg per day. These data and ours would indicate that the pain physician could titrate drop doses towards 2 mg per day or greater, and toward the serum levels foot drop.