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Auto Draft

Recent Study Confirms Confusion Caused by Lower Back MRI

Radicular leg pain from sciatica needs no MRI to diagnose or treat it. MRI has been repeatedly found to FAIL to identify the cause of lower back pain or sciatica.

Epidural steroids often provide pain relief from the typical “sciatica” leg pain symptoms. MRI study BEFORE the epidural does nothing to improve diagnosis, speed recovery or give better long-lasting relief. Action: Without specific indications for an MRI — Routine lower back MRI study does not improve the success of epidural steroid injections for lower back pain.

See the report – http://www.medicalnewstoday.com/articles/239128.php

Auto Draft

How to Tell When Shoulder Problems Masquerade As Cervical Spine Problem

Patients referred for neck disc surgery may easily be incorrectly diagnosed when the shoulder is the real culprit.

With sophisticated MRI scans for neck pain – How can this happen so often?

Simple. MRI scans are generally non-specific in findings. It’s a little known fact that MRI results do NOT show the cause of pain radiating down from the neck to the forearm.

Recent reports highlight the problem of shoulder arthritis and rotator cuff problems that look like a herniated disc in the cervical spine. If you get to the wrong doctor (one with “nothing scheduled on Tuesday”) you just might end up with an unnecessary neck fusion surgery.

How to Tell the Difference Between Neck and Shoulder Pain

Shoulder problems will typically limit the motion of the shoulder in flexion and abduction – moving your arm up overhead in front of your body and lifting it out to the side. Especially if you feel any painful popping inside your shoulder or can’t sleep on that side – think shoulder-sourced pain from rotator cuff problems. A feeling of weakness in the arm when lifting it is also common.

A simple injection and some therapy (for the shoulder, not the neck) may help a lot.

Also, arthritis in the little joint at the end of your collarbone (clavicle) can be very painful – all the way from the neck and down into the arm, too. In that case, reaching that arm across your body towards the other side will often provoke the AC joint arthritic pain. Sometimes all you need is a cortisone shot in that little joint to get good relief. But – If your doctor doesn’t think to check the shoulder – and if the MRI shows a bulging or herniated cervical disc – you may be headed for unnecessary neck surgery.

Action: ALWAYS get your shoulder checked out before you sign up for any neck surgery. The burning, aching neck and arm pain just might be from your shoulder. As non-specific as a neck MRI is at identifying the cause of neck pain, an MRI of the shoulder is very accurate at pinning down the cause of shoulder and arm pain.

Plus, chiropractic for neck pain when the shoulder is the real cause not only wastes time, but can delay healing and cost hundreds unless you can tell the difference.

Yoga Training Most-effective Long-term Back Pain Relief

Back Pain Management Yoga Training Actually Gives Better Relief Than Chiropractic

Study from the U.K. reports that a 12-week basic yoga group training program improves back function more than exercise and manipulation, cognitive-behavior treatment and six sessions of 1-to-1 Alexander technique.

All of these simple, practical treatments are more effective than chiropractic treatment – and much less expensive. Prior research has supported education as one of the most important things you can do to get faster back pain relief.

Findings published in the November, 2011 Annals of Internal Medicine journal show that many people with chronic back pain could get effective pain relief – NOT with surgery or injection therapy – BUT with yoga. Check out the abstract at http://annals.org/content/155/9/569.abstract

Common Practice to Avoid Lifting With Bad Back is WRONG!

Common Practice to Avoid Lifting With Bad Back is WRONG!

New research demonstrates that healthy discs require lifting to maintain the proper flow of nutrients. So exercise is what actually keeps discs healthy and happy.

If you STOP exercising and using your back, the discs deteriorate faster, potentially increasing your back pain. One more reason why the very best treatments for back pain involve strategic exercises to maintain more balanced and healthy function.

The clinical study results found in a recent paper on back pain from disc degeneration published in PLoS Computational Biology, cited researchers at the Institute for Bioengineering of Catalonia. They reported that normal loading allows healthy transportation of nutrients and solutes into the disc tissues.

Degenerative disc changes appear to slow-down or block the transport of nutrients and oxygen into the discs. Movement and loading help the transport process.

Tip for Back Pain: Don’t do Nothing, Do Something – Exercise. And the best exercises for your low back pain? Pattern-recognition based exercises are up to 10.85 times more effective at cutting pain than the “usual medical approach” – pain pills, muscle relaxers, physical therapy/’feel-good’ treatments like ultrasound, electrical stim and traction machines.

Auto Draft

2 Characteristics May Mean Your Pain Is Likely To Stick Around

A recent study in the Journal of Pain showed that 2 factors in Acute or Subacute Back Pain are more likely to be found in Chronic Back Pain patients.

  1. Greater pain severity and
  2. Bilateral lower back pain

Is there a connection between the presence of these symptoms in acute back pain and increased onset of chronic lower back pain?

Researchers are not sure just yet. But, If your back pain seems more severe than other people you’ve talked to with lower back pain for less than 3 months, you may be in for some trouble getting over your pain.

Also, pain limited to one side or one buttock/leg seems less likely to turn chronic. Bilateral lower back pain – rather than one-sided back pain – is a very common characteristic of chronic back pain patients.

So it IS critical to take your shorter term back pain very seriously and take steps to cut the pain ASAP.

Chiropractic Tested -

Chiropractic – “No Better Than Placebo”
6,000 Patients Tested – 26 Clinical Studies

no back pain relief with chiropracticIf you have chronic lower back pain – Don’t waste your time on chiropractic spinal manipulation therapy. New review finds it of “no clinical significance.”

June – 2011 Issue – Spine: Lead author – Sidney M. Rubinstein of VU University Medical Center, Amsterdam says improvement with manipulation therapy was only 4 percent overall and less over time.

Last year, chiropractic literature reported that only 19 percent of those with acute back pain got lasting relief. Most people get recurrent pain within a few months after chiropractic SMT treatment.

Chiropractic professionals will most-likely be critical of this report, but the researchers describe the results as “high quality.”

See more information on the clinical research of back pain relief with chiropractic here.

Most Dentists & Hygienists Suffer Neck Pain

Correct Posture Helps Relieve Neck and Back Pain

Better ergonomics the key to long-term neck and back pain relief says University of Maryland.

Citing statistics that show two-thirds of dentists suffer chronic back and neck pain, new classes and ergonomic training are now “Required” classwork for all dental students.

Bad ergonomics from a simple car commute can cause back and neck pain, so it is easy to see that your own ergonomics at work, in the car and in the home office are important, too.

“Proper posture is the key element in a long-term solution (and prevention).” Read more on back and neck pain relief with ergonomics.

Doctors Should Choose Drugs Less Frequently For Back Pain Problems

Meds For Back Pain? Doctors Should Say “No” More Often According to New Approach From Harvard

Gordon D. Schiff, M.D. (Harvard Med School – Boston) with associates from the University of Illinois at Chicago advise M.D.s to:

  • Think beyond drugs such as narcotics. Would other interventions help?
  • Does the pain med merely cover-up pain – but with no real treatment or cure of the underlying source or cause of the pain?
  • Patients do not need to leave the office with a new or added prescription after each visit.

That’s why I like the principle of compound benefits. 3 different treatments proven to give partial relief – when combined – can result in 80-90 percent pain relief.

Ask your doctor: What’s the clinical proof that my treatment for back (or neck) pain actually gives relief? Are there 2 or 3 or 4 treatments that can work together to help cut my pain? Could that be safer and give me fewer side-effects than a strong narcotic or muscle relaxer?

Especially for chronic pain, this is a better-informed way to get your life back. Read more of the Harvard expert’s opinions on drugs as primary treatment here: http://www.medicalnewstoday.com/releases/228187.php

New Brain Neurons - a (Secret) Benefit of Cymbalta Treatment?

Cymbalta Appears to Stimulate Development of New Brain Cells

New research (April, 2011) from the U.K. (Britain) shows that duloxetine stimulates and speeds the growth of brain nerve stem cells, a process that is normally stunted by chronic pain and depression.

Brain Researcher Reports “New Stem Cells” With Cymbalta

“For the first time in a clinically relevant model, we were able to show that antidepressants produce more stem cells and also accelerate their development into adult brain cells,” said Professor Anacker – a doctor on the research team at the Institute of Psychiatry in London (King’s College) regarding their results.

They found that “the glucocorticoid receptor, is essential for this to take place,” (that’s a specific protein in the cell). “The antidepressants activate this protein which switches on particular genes that turn immature stem cells into adult brain cells.”

Action: Too soon to be sure…but appears promising. More research required.

Does that mean that those who take Cymbalta will be smarter? That would be a great combo – less pain + smarter, to boot!

Duloxetine - Effective Back Pain Relief Med

Duloxetine – Effective Back Pain Relief

New FDA approval was granted in November, 2010 for once-a-day oral treatment of chronic pain in the bones, joints and muscles – including the lower back. F.D.A. panel-members appeared most impressed with the results of several double-blind, randomized clinical studies demonstrating effective low back pain relief.

Cymbalta – Not the Best Stand-Alone Treatment For Osteoarthritis

Duloxetine delayed-release capsules (Cymbalta) are one of several of a moderately-effective and newer class of antidepressants known as serotonin and norepinephrine reuptake inhibitors (SNRIs). Results showed the medication was less effective at treating osteoarthritis pain, but Cymbalta was “not inferior” to other available treatments. Use of 60 mg per day is the current maximum dose as the 120 mg per day dosing results were not strong enough to warrant approval.

New Med Approved For Back PainGood For Fibromyalgia and Neuropathic Pain, Too

Previously approved by the United States F.D.A. for treatment of the conditions: major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, and fibromyalgia. In 4 double-blind, randomized clinical trials showing that duloxetine was significantly more effective than placebo for decreasing pain in patients with those conditions. The recommended dose is 60 mg daily.

Unpleasant Side-Effects May Occur

Gradually weaning off of prior anti-depressants and also gradually starting on duloxetine a good idea. These “Brain Chemicals” can have quite a potent effect, so gradual changes are typically safer, and better tolerated.

Adverse events or ‘side-effects’ that most people with musculoskeletal pain in the trials reported were nausea, dry mouth, insomnia, sleepiness, constipation, dizziness, and fatigue. (5% or more)

Uncommon events (less than 1%) include liver damage, allergic/hypersensitivity reactions, pneumonia, and suicidal tendencies.

Action Steps: If you have chronic pain – especially chronic back pain, this medication may be of help. Many can cut their use of narcotic pain meds by adding an anti-depressant like Cymbalta. Clinically, some doctors report that their patients with more neuropathic-type symptoms like paresthesias, burning pain, non-specific aches and fatigue respond best.

  1. Discuss transition to Cymbalta as part of your medication plan with your treatment team.
  2. Make gradual changes.
  3. Don’t forget the positive role and benefits of exercise.