The Back Pain Epidemic.

Low back and neck pain is an increasingly widespread and expensive condition worldwide, costing the US alone $88bn a year – the third highest bill for any health condition.

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Millions of people worldwide suffer from low back and neck pain, most of it unexplained, although some professionals think it may be worsened by sitting at desks all day, carrying bags and general bad posture. Episodes of acute pain are very common, but experts say that medical investigations only make things worse and the best cure is often to take painkillers, exercise gently and wait for the pain to pass. Continue reading The Back Pain Epidemic.

“A Placebo Conundrum” by Michael Brooks

beyond-imagination-marina-harrisIT SEEMED like a good idea until I saw the electrodes. Dr Luana Colloca’s white coat offered scant reassurance. “Do you mind receiving a series of electric shocks?” she asked.

I could hardly say no – after all, this was why I was here. Colloca’s colleague, Fabrizio Benedetti of the University of Turin in Italy, had invited me to come and experience their placebo research first hand. Colloca strapped an electrode to my forearm and sat me in a reclining chair in front of a computer screen. “Try to relax,” she said.

First, we established my pain scale by determining the mildest current I could feel, and the maximum amount I could bear. Then Colloca told me that, before I got another shock, a red or a green light would appear on the computer screen.

A green light meant I would receive a mild shock. A red light meant the shock would be more severe, like the jolt you get from an electric fence. All I had to do was rate the pain on a scale of 1 to 10, mild to severe. Continue reading “A Placebo Conundrum” by Michael Brooks

Acupuncture: East meets West

AcuA HAIR-THIN needle pricks the skin. What happens next depends on who you ask. A traditional Chinese practitioner will tell you that acupuncture manipulates the body’s vital energy, Qi (pronounced chee), balancing the opposing forces of Yin and Yang. When Yin and Yang are in harmony, Qi flows freely along pathways called meridians and you stay healthy, but when the Qi gets blocked you become ill. Inserting needles into points along a meridian unblocks Qi and restores the body’s healthy balance.

Western scientists explain it differently. They say inserting needles at acupuncture points stimulates the nervous system to release morphine-like substances that block pain signals. It may also trigger neurotransmitters and neurohormones, which influence such dynamic systems as circulation and the immune response.

Ever since acupuncture caught on in the West, we’ve been seeking to replace the Eastern mysticism with hard facts. But clinical trials so far have produced a disappointingly mixed bag of results that don’t seem to back up the anecdotal claims for the wonders of acupuncture. There might be a steadily building case for clinical relief of some types of pain and nausea. But the inconclusive studies still outweigh the positive ones. Continue reading Acupuncture: East meets West

Antibiotics could “Cure 40% of Chronic Low Back Pain”.

Up to half a million patients with chronic low back pain may be suffering from an infection that can be treated with antibiotics.

SpineIf proved true, the revolutionary theory about the cause of one of the commonest and most debilitating ailments should win its discoverer the Nobel Prize, one surgeon said today.

However, the paper describing the research based on just 162 patients was turned down by the leading medical journals such as the Lancet and BMJ. It was published today in the European Spine Journal.

Researchers claim the treatment could be suitable for up to 40% of patients with severe, long term pain for whom the only alternative is surgery.

However, it is not as simple as replacing the painkillers with antibiotics. The treatment requires an MRI scan to detect distinctive “Modic” changes in the spinal column – named after the doctor who first observed them in the late 1980s – which are indicative of bacterial infection. Continue reading Antibiotics could “Cure 40% of Chronic Low Back Pain”.

Let go of outdated paradigms and stop dwelling on Biomechanical tissue-based models when treating Back Pain.

Mick-ThackerThis was the message from CSP fellow Dr Mick Thacker, director of the ‘Pain: Science and Society’ MSc course at King’s College London.

Giving a keynote lecture, Dr Thacker advised delegates to move away from purely mechanical-based therapies for back pain patients, and become more aware of the role of neuro-immnunology in relation to pain.

“Traditional physiotherapy has based its management of back pain on anatomical, tissue-based principles and biomechanics”, said Dr Thacker. Continue reading Let go of outdated paradigms and stop dwelling on Biomechanical tissue-based models when treating Back Pain.

Yoga: A Cost-Effective Treatment for Back Pain Sufferers?

Specialised group Yoga Classes could provide a cost-effective way of treating patients with chronic or recurrent low back pain, according to the UK’s largest ever study of the benefits of Yoga.

Led by the University of York, and funded by Arthritis Research UK, the study provides an evaluation of a specially-developed 12-week group yoga intervention programme compared to conventional general practitioner (GP) care alone.

The results published in Spine, show that the Yoga intervention programme — “Yoga for Healthy Lower Backs” — is likely to be cost effective for both the UK National Health Service and wider society.

The cost assumed for yoga intervention is important in determining whether this is an efficient use of NHS resources. As Yoga classes are not currently available through the NHS, the researchers examined a range of possible costs.

They conclude that if the NHS was to offer specialist yoga and managed to maintain the cost below £300 per patient (for a cycle of 12 classes), there is a high probability (around 70 per cent) of the yoga intervention being cost effective.

Researchers also found that those taking part in the yoga programme had far fewer days off work than those in the control group. On average, a control group participant reported 12 days off due to back pain, whereas those in the yoga group had four days off.  Continue reading Yoga: A Cost-Effective Treatment for Back Pain Sufferers?