The Brains Drain System

The brain drain is real. There is a network of previously unrecognised vessels that rid the brain of unwanted extracellular fluids and other substances, including amyloid-beta – a peptide that accumulates in the brain of people with Alzheimer’s. The new discovery looks set to add to our understanding of the disease.

Jeffrey Iliff at the University of Rochester Medical Centre, New York, and his colleagues, were intrigued by the fact that there are no obvious lymphatic vessels in the brain. Among other things, the lymphatic system removes waste interstitial fluids from body tissue.

“It seemed strange that such an important and active organ wouldn’t have a specialised waste-removal system,” says Iliff.

When the researchers added fluorescent and radioactive tracers to the cerebrospinal fluid of live mice, the tracers quickly spread throughout the rodents’ brains. Using two-photon microscopy to visualise the movement in real-time, the team saw cerebrospinal fluid permeating the entire brain through ‘pipes’ surrounding blood vessels, similar to the lymphatic system that services all other organs.

The pipes work on hydraulic principles, though, and so the system breaks upon opening, making it hard to identify it outside living organisms. Continue reading The Brains Drain System

Whiplash Injuries & Trigger Points

Persistent muscle pain following whiplash is commonly considered the result of poor psychosocial status, illness behaviour, or failing coping skills. However, there is much evidence that this persistent  pain may be due to neurophysiologic mechanisms involving peripheral and central nerve sensitisation. Myofascial trigger points may play a crucial role in maintaing this sensitisation. Recent research suggests that the chemical environment of myofascial trigger points is an important factor. Several consequences are reviewed when central pain mechanisms and myofascial trigger points are included in the differential diagnosis and in the management of patients with persistent pain following whiplash. Continue reading Whiplash Injuries & Trigger Points

Pain really is “All in the Mind”

Doctors and nurses have known for many years that some people are more sensitive to pain than others. Now brain scans of people experiencing the same painful stimulus have provided the first proof that this is so. But the scans also suggest that how much something hurts really is “all in the mind”.

“We saw a huge variation between responses to the same stimulus,” says project leader Bob Coghill of the Wake Forest University School of Medicine in Winston-Salem, North Carolina. “The message is: trust what patients are telling you.” Continue reading Pain really is “All in the Mind”

Back Pain linked to shrinking Brain

BACK pain has a mysterious link with brain damage. Brain scans have shown that patients with chronic lower back pain have lost grey matter from two brain areas. Scientists are not yet sure whether this is the cause of back pain or the result, but the finding could lead to new drug treatments for backache that target the brain rather than the back or spine.

The discovery was made by Vania Apkarian of Northwestern University in Chicago, when he and his colleagues scanned the brains of 26 patients who had suffered lower back pain for at least a year. Some had damage to their sciatic nerve, which emerges at the base of the spine, while the others had no known injury. The team found that all the patients had lost grey matter in two brain regions known to be important in pain perception. Continue reading Back Pain linked to shrinking Brain

Treating Chronic Muscle Pain by Robert Gerwin

Chronic muscle pain (myalgia) is a common problem throughout the world.

Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain.

The two common muscle pain conditions are Fibromyalgia and Myofascial Pain Syndrome.

Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis.

Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle.

The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying causes of persistent or chronic muscle pain in order to develop a specific treatment plan.

Chronic myalgia may not improve until the underlying precipitating or perpetuating factors are themselves managed.

Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypo-mobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency.

Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition. Continue reading Treating Chronic Muscle Pain by Robert Gerwin

Bad Posture can “Switch Off” Back Muscles

Slumping in front of the television or computer could deactivate muscles that support and protect your spine, triggering many otherwise inexplicable cases of lower back pain.

A European Space Agency study in Berlin, Germany, in which young men spent eight weeks in bed, showed that an absence of load on spinal support muscles can sometimes be just as debilitating as a physical injury.

Ultrasound studies have shown that in most cases of lower-back pain, either the lumbar multifidus muscles, which keep the vertebrae in place, or the transversus abdominis, which holds the pelvis together, or both, are inactive. Normally the muscles work continuously to support and protect the lower back.

Heavy lifting, whiplash or other injuries can damage and inactivate these support muscles. This increases the risk of long-term back pain, as people are then more likely to suffer sprains, or damage to the discs or other tissue in the back. However, only between 10 and 15 per cent of cases of back pain begin with such an injury. For the rest, the cause is often a mystery. Continue reading Bad Posture can “Switch Off” Back Muscles

Smartphone users ‘risking health’ with overuse of devices

People are risking their health by working on smartphones, tablets and laptops after they have left the office, according to the Chartered Society of Physiotherapy.

It says people have become “screen slaves” and are often working while commuting or after they get home.

The society said poor posture in these environments could lead to back and neck pain.

Unions said people needed to learn to switch off their devices.

An online survey, of 2,010 office workers by the Society found that nearly two-thirds of those questioned continued working outside office hours.

The organisation said people were topping up their working day with more than two hours of extra screen – time, on average, every day.

The data suggested that having too much work and easing pressure during the day were the two main reasons for the extra workload. Continue reading Smartphone users ‘risking health’ with overuse of devices