Patients suffering from back pain, sciatica, or a herniated disc, sometimes find relief with epidural steroid injections (ESI). Recent research has found that needle electromyography (EMG) can reliably predict, among other factors, the patient's potential pain relief from these injections. A prospective study was conducted at the North Texas Veterans Administration Medical Center in Dallas, TX to determine whether needle EMG findings could predict pain relief in patients who had sciatica and underwent ESI. Eighty-eight subjects were found to meet the following criteria for lumbar radiculopathy: symptoms of leg pain, abnormal lumbar magnetic resonance imaging, and positive physical examination findings. Each subject then underwent needle EMG examination of the back and lower extremities. The needle EMG tracings were then reviewed by two blinded experts, both certified by the American Board of Electrodiagnostic Medicine. Membrane instability was the criterion for abnormality because this is the most clear-cut indicator of abnormality in lumbar radiculopathy.
Research published on bmj.com today reports that over a third (35 percent) of patients will recover from chronic low back pain within nine months and four out of 10 (41 percent) will do so within a year. This groundbreaking study reveals findings that are contrary to the broad theory that recovery from an episode of chronic low back pain is doubtful. Dr Luciola Menezes Costa, from the University of Sydney is the lead author. She reports that individuals were more likely to have delayed recovery it they had a prior sick leave due to low back pain, high disability levels, low levels of education and were born overseas. The authors explain that chronic low back pain is a major health problem. It places an enormous social and economic burden on society. In addition, they argue that there is presently significant doubt associated with recovery rates. The participants came from a larger group of 973 patients. They all attended primary care clinics in Sydney with a new episode of low back pain.
Over a third (35%) of patients will recover from chronic low back pain within nine months and four out of 10 (41%) will do so within a year, according to research published on BMJ.com. This is the first study of its kind and the results go against the common view that recovery from an episode of chronic low back pain is unlikely. The lead author, Dr Luciola Menezes Costa, from the University of Sydney, says individuals with previous sick leave due to low back pain, high disability levels, low levels of education and being born overseas were more likely to have delayed recovery. Chronic low back pain is a major health problem, say the authors, and places a huge social and economic burden on society. They also argue that there is currently considerable uncertainty associated with recovery rates. The participants were drawn from a larger group of 973 patients who attended primary care clinics in Sydney with a new episode of low back pain. These patients had visited their health care provider with acute low back pain (ie.
Patients reporting new low-back pain are more likely to undergo surgery if treated in an area with a higher-than-average concentration of magnetic resonance imaging machines, according to research from the Stanford University School of Medicine. This may be bad news for patients, since previous studies have found that increased surgery rates don't improve patient outcomes. "The worry is that many people will not benefit from the surgery, so heading in this direction is concerning, " said senior author Laurence Baker, PhD, professor of health research and policy. In their new study, to be published online Oct. 14 in Health Affairs, Baker and first author Jacqueline Baras correlate areas with high numbers of MRI machines to an increased likelihood that MRIs will be performed on new low-back pain patients. In turn, high local MRI availability correlates with increased rates of low-back surgery. "It is important that policymakers recognize that infrastructure matters, and that the number of MRI machines in any particular area may affect the volume and quality of health care that patients receive, " said Baras, a Stanford medical student with a master's degree in health services research.
On World Osteoporosis Day, October 20, centenarian Helen Daniels of Poughkeepsie, NY, has a good reason to smile; she's able to comfortably walk again following minimally invasive spine surgery. After suffering two spinal fractures caused by osteoporosis, Mrs. Daniels had debilitating back pain. After being treated with a minimally invasive spinal procedure, called balloon kyphoplasty, she no longer suffers from back pain and is able to walk with the aid of a walker or cane. Osteoporosis is a disease that leads to fragile bones and an increased susceptibility to fractures of the spine, hip or wrist. The degenerative disease is the main cause of the estimated 1.4 million vertebral compression fractures (VCFs) of the spine suffered annually worldwide that need the attention of a physician.i The International Osteoporosis Foundation is sponsoring World Osteoporosis Day on October 20 with the goal of informing and educating the patients and policy makers about osteoporosis prevention.
It's no wonder that many people feel extra soreness and aches in their backs during winter months -- they're often not getting enough vitamin D. The body makes vitamin D from the sun's ultraviolet rays, so it's known as the sunshine vitamin. However, even in the sunniest parts of America, this essential vitamin for keeping bones healthy is in short supply during late fall and winter. Up to 8 out of 10 persons will have back pain in their lifetimes. In many cases, there is no evidence of any injury, disease, or bone problem like a slipped disk. An extensive review of clinical research in a report from Pain Treatment Topics found that help may be available from a surprising champion of pain relief Vitamin D. According to Stewart B. Leavitt, MA, PhD, Executive Director of Pain Treatment Topics and author of the report, "our examination of the research, which included numerous clinical studies, found that patients with chronic back pain usually had inadequate levels of vitamin D.
The discovery of a multi-level arteriovenous malformation (AVM) in the thoracic epidural space can now bring relief to potentially thousands of suffers of chronic thoracic pain and progressive myelopothy. Identified as thoracic epidural arteriovenous malformation (T.E.A.M.), this particular AMV primarily affects younger women ages 20 to 40. While AVMs are rare, affecting approximately 300, 000 people, according to the National Institutes of Health, AVMs in this particular multi-level location have previously not been documented in medical literature. Symptoms of this condition include severe pain in the middle back area extending to the chest, loss of function and coordination of the lower extremities, hyperreflexia, muscle spasms and severe pain at night. The discovery was made by neurological spine surgeon Dr. Robert S. Bray Jr., the CEO and founder of D.I.S.C. Sports and Spine Center. He will present his initial findings at the annual Congress of Neurological Surgeons in New Orleans on Oct.
The NHS Institute for Innovation and Improvement has launched a new publication to support the NHS in improving community-based access to specialist services for patients suffering from musculoskeletal (MSK) conditions such as chronic back pain, osteoporosis and other bone, joint, spinal and muscular diseases. The publication, Focus On: Musculoskeletal Interface Services, highlights the key characteristics of best practice for MSK interface services and is aimed at commissioner and provider organisations aiming to set up an MSK interface service or develop an existing service. The improvements in MSK interface services detailed in the document have the potential to allow services to be redesigned to provide more care in the community and free up significant capacity in secondary care. Sophie Cowley, the lead Associate from the NHS Institute said: "Musculoskeletal conditions frequently have an adverse influence on health and quality of life for many individuals and can limit daily activities.
Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center found that yoga may be more effective than standard treatment for reducing chronic low back pain in minority populations. This study appears in the November issue of Alternative Therapies in Health and Medicine. Low back pain is common in the United States, resulting in substantial disability and cost to society. Individuals from low-income, minority backgrounds with chronic low back pain (CLBP) may be more affected due to disparities in access to treatment. Although many CLBP patients seek relief from complementary therapies such as yoga, use of these approaches are less common among minorities and individuals with lower incomes or less education. BUSM researchers recruited adults with CLBP from two community health centers that serve racially diverse, low-income neighborhoods of Boston. They were randomly assigned to either a standardized 12-week series of hatha yoga classes or standard treatment including doctor's visits and medications.
Military personnel evacuated out of Iraq and Afghanistan because of back pain are unlikely to return to the line of duty regardless of the treatment they receive, according to research led by a Johns Hopkins pain management specialist. In a study published in the Nov. 9 Archives of Internal Medicine, researchers found that just 13 percent of service members who left their units with back pain as their primary diagnosis eventually returned to duty in the field. Women, officers, those deployed in Afghanistan and those with previous back pain had better outcomes, but only marginally. Aside from combat injuries sustained during battle, the return-to-duty rate for spinal pain and other musculoskeletal disorders is lower than for any other disease or non-combat injury category except for psychiatric illness, the researchers said. "The whole mission of the medical corps for the military is to preserve unit strength, to keep people doing what they're doing, " says study leader Steven P.