Doubling of rate in North Carolina may mimic rest of nation
Posted February 10, 2009
By Carolyn Colwell
HealthDay Reporter
TUESDAY, Feb. 10 (HealthDay News) -- A North Carolina study finds that the rate of chronic low back pain has more than doubled in that state since the early 1990s -- a statistic the authors say might reflect what's happening in the country as a whole.
"We were actually surprised by what we found," said Dr. Timothy S. Carey, a professor of medicine at the University of North Carolina and the study's lead author.
He said his team knew that expenditures for medical services aimed at easing back pain have increased over the years. One theory for that rise has been that back pain sufferers are simply seeking more services.
But the researchers found another cause.
"A major reason for the increase in cost for back pain is not just that people are seeking a lot of care, but that there is a lot of back pain out there," Carey said. "We may need to rethink our way of dealing with this problem." More...
PainCareMD
Saturday, March 7, 2009
FDA Issues Warning on Osteoporosis Medication
Mireya Hernandez
February 4, 2009
Mireya Hernandez
The Food and Drug Administration came out with some important news on bisphosphonates last month. Bisphosphonates are a common treatment and prevention medication for osteoporosis, and are marketed through brands like Boniva, Fosamax, Actonel and Reclast.
The report warns physicians of the possibility of bone, joint and/or muscle pain connected to the use of these drugs. It can take anywhere from days to years after starting the medication for the pain to start. And it can be very severe.
The FDA report says in nearly all cases, the pain stopped when the medication was cut off. More...
PainCareMD
February 4, 2009
Mireya Hernandez
The Food and Drug Administration came out with some important news on bisphosphonates last month. Bisphosphonates are a common treatment and prevention medication for osteoporosis, and are marketed through brands like Boniva, Fosamax, Actonel and Reclast.
The report warns physicians of the possibility of bone, joint and/or muscle pain connected to the use of these drugs. It can take anywhere from days to years after starting the medication for the pain to start. And it can be very severe.
The FDA report says in nearly all cases, the pain stopped when the medication was cut off. More...
PainCareMD
AAPM: Spinal-Stretching Device Relieves Back Pain
This study, as pointed out by the author of the article, was prospective but uncontrolled, involving only a small patient sample. This study was funded by one of the makers of the device. A larger, controlled study should follow.
Larry Ho, MD
By John Gever, Senior Editor
MedPage Today
January 29, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
HONOLULU, Jan. 29 -- Stretching patients' spines gently with a noninvasive, computer-controlled traction device relieved back pain of different etiologies in a small study, a researcher said here.
Six weeks of treatment with the device reduced mean pain scores from 6.4 on a standard 10-point index to 0.8 (P0.0001), reported Charlotte Richmond, Ph.D., of NEMA Research in Miami Beach, at the American Academy of Pain Medicine meeting here. More...
PainCareMD
Larry Ho, MD
By John Gever, Senior Editor
MedPage Today
January 29, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
HONOLULU, Jan. 29 -- Stretching patients' spines gently with a noninvasive, computer-controlled traction device relieved back pain of different etiologies in a small study, a researcher said here.
Six weeks of treatment with the device reduced mean pain scores from 6.4 on a standard 10-point index to 0.8 (P0.0001), reported Charlotte Richmond, Ph.D., of NEMA Research in Miami Beach, at the American Academy of Pain Medicine meeting here. More...
PainCareMD
Why Sitting Up Straight May Get You A Better Ride, Too
Showing Some Backbone
By Alfonso Moretti
motorcyclecruiser.com
Sitting Up Straight Side View
Have you ever been at a rally and taken a really good look around? If you gazed long and hard, you probably realized the folks you're checking out aren't exactly the most stand-up group-literally. In other words, your motorcycling brethren are a bunch of slouches. The good news is that most of the general population has bad posture too, not just motorcyclists. The bad news is that the biggest cause of slouching is not laziness, but sitting.
That's right-simply resting back on your glutes can wreak havoc on your spine. It can shorten your hamstrings, abdominals and chest muscles and lengthen your upper back, lower back and quadriceps muscles. All those little disruptions add up to bad posture, which can also result in back pain. I can't tell you how many people I ride with have complained to me about lower back pain, neck issues, numb hands and so forth. And you've probably heard the complaints, too, or may have uttered one yourself. I'm not saying motorcycling is responsible for back issues, but it certainly doesn't help-in fact it will likely aggravate most acute conditions. With over 50 percent of the population suffering some sort of back trouble, there is a good chance you know exactly what I'm talking about. More...
PainCareMD
By Alfonso Moretti
motorcyclecruiser.com
Sitting Up Straight Side View
Have you ever been at a rally and taken a really good look around? If you gazed long and hard, you probably realized the folks you're checking out aren't exactly the most stand-up group-literally. In other words, your motorcycling brethren are a bunch of slouches. The good news is that most of the general population has bad posture too, not just motorcyclists. The bad news is that the biggest cause of slouching is not laziness, but sitting.
That's right-simply resting back on your glutes can wreak havoc on your spine. It can shorten your hamstrings, abdominals and chest muscles and lengthen your upper back, lower back and quadriceps muscles. All those little disruptions add up to bad posture, which can also result in back pain. I can't tell you how many people I ride with have complained to me about lower back pain, neck issues, numb hands and so forth. And you've probably heard the complaints, too, or may have uttered one yourself. I'm not saying motorcycling is responsible for back issues, but it certainly doesn't help-in fact it will likely aggravate most acute conditions. With over 50 percent of the population suffering some sort of back trouble, there is a good chance you know exactly what I'm talking about. More...
PainCareMD
FDA Warns of Potential of Serious Side Effects with Topical Numbing Agents
By Todd Neale, Staff Writer
MedPage Today
ROCKVILLE, Md., Jan. 16 -- The FDA has issued a second warning about the potential dangers of using topical anesthetics for relieving pain from medical tests and conditions.
The latest advisory was prompted by a report last summer on the results of a randomized trial evaluating the use of lidocaine for the pain and discomfort of mammography...
The agency said that some of the topical medication can pass into the blood stream upon application.
Under certain circumstances -- if a large area of skin is covered, the drug is applied to broken skin, or skin temperature increases -- the amount of medication entering the blood stream may be toxic, causing irregular heartbeat, seizures, breathing difficulties, coma, and death, the agency said.
This latest warning repeats the concerns of an advisory issued in February 2007 following the deaths of two women, ages 22 and 25, who applied topical anesthetics to their legs and covered them in plastic wrap to numb the anticipated pain of laser hair removal.
Both women had seizures, fell into a coma, and subsequently died because of the drugs' toxic effects.
The drugs involved were lidocaine and tetracaine.
The FDA advised physicians to determine whether a topical anesthetic would create the necessary pain relief when considering its use for any purpose and whether an alternate treatment would be as effective.
If a topical anesthetic is determined to be the best choice, the agency recommended using the lowest amounts possible, applying the medications as sparingly as possible, avoiding broken or irritated skin, and being aware that wrapping or applying heat to the areas treated with the medications can increase the risk of serious side effects. More...
PainCareMD
MedPage Today
ROCKVILLE, Md., Jan. 16 -- The FDA has issued a second warning about the potential dangers of using topical anesthetics for relieving pain from medical tests and conditions.
The latest advisory was prompted by a report last summer on the results of a randomized trial evaluating the use of lidocaine for the pain and discomfort of mammography...
The agency said that some of the topical medication can pass into the blood stream upon application.
Under certain circumstances -- if a large area of skin is covered, the drug is applied to broken skin, or skin temperature increases -- the amount of medication entering the blood stream may be toxic, causing irregular heartbeat, seizures, breathing difficulties, coma, and death, the agency said.
This latest warning repeats the concerns of an advisory issued in February 2007 following the deaths of two women, ages 22 and 25, who applied topical anesthetics to their legs and covered them in plastic wrap to numb the anticipated pain of laser hair removal.
Both women had seizures, fell into a coma, and subsequently died because of the drugs' toxic effects.
The drugs involved were lidocaine and tetracaine.
The FDA advised physicians to determine whether a topical anesthetic would create the necessary pain relief when considering its use for any purpose and whether an alternate treatment would be as effective.
If a topical anesthetic is determined to be the best choice, the agency recommended using the lowest amounts possible, applying the medications as sparingly as possible, avoiding broken or irritated skin, and being aware that wrapping or applying heat to the areas treated with the medications can increase the risk of serious side effects. More...
PainCareMD
FDA OKs Fibromyalgia Drug Savella
Savella Joins Cymbalta and Lyrica as Drugs Approved for Fibromyalgia Patients
By Miranda Hitti
WebMD Health News
Reviewed by Louise Chang, MD
Jan. 15, 2009 -- The FDA has approved a new drug called Savella for the management of fibromyalgia.
Savella belongs to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs), which include some antidepressants.
The drug companies behind Savella -- Forest Laboratories Inc. and Cypress Bioscience Inc. -- report that the FDA approved Savella based on two clinical trials that together included 2,084 fibromyalgia patients who took Savella or a placebo for three months or six months.
Savella trumped the placebo in the percentage of patients of who reported at least a 30% reduction in pain and also rated themselves as being "very much improved" or "much improved" in terms of their fibromyalgia, according to a joint news release from Forest Laboratories and Cypress Biosciences. More...
PainCareMD
By Miranda Hitti
WebMD Health News
Reviewed by Louise Chang, MD
Jan. 15, 2009 -- The FDA has approved a new drug called Savella for the management of fibromyalgia.
Savella belongs to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs), which include some antidepressants.
The drug companies behind Savella -- Forest Laboratories Inc. and Cypress Bioscience Inc. -- report that the FDA approved Savella based on two clinical trials that together included 2,084 fibromyalgia patients who took Savella or a placebo for three months or six months.
Savella trumped the placebo in the percentage of patients of who reported at least a 30% reduction in pain and also rated themselves as being "very much improved" or "much improved" in terms of their fibromyalgia, according to a joint news release from Forest Laboratories and Cypress Biosciences. More...
PainCareMD
Back: Deterioration is natural, but it can be slowed
Mar. 01, 2009
By Sam McManis
The Sacramento Bee
The problem, arguably, began when we started walking upright. Our spines just aren't constructed to take such vertical force. Something's got to give and, most often, it's a disc, a muscle, a nerve.
Back pain, elusive to diagnosis and tricky to treat, affects 80 percent of the U.S. population at some point in life, according to the North America Spine Society. Cost of treatment has exceeded $86 billion per year, a rise of 65 percent in a decade, according to the Journal of the American Medical Association.
And yet pain alleviation is hard to come by. More people than ever are seeking back-pain relief, through a combination of physical therapy, opioids and other pain-management techniques or surgery. U.S. doctors perform 1.2 million spinal operations yearly, the highest among developed nations.
Maybe, it has been posited, we will always battle back pain. It's the way we were built.
"If you believe that we once were quadrupeds, then it makes sense why the back tends to deteriorate," says Dr. Brian Davis, a UC Davis Medical Center physician specializing in spine and musculoskeletal disorders. "There's no question that the mechanical stuff that we put our back through is probably not what we were truly designed for. The people who believe in evolution will agree with that. The people who believe in creationism will say, 'That's a bunch of baloney.' "
Speaking to the evolution crowd, Davis explained.
"When we were walking on all fours, if you believe that, we didn't put pressure on those small parts of the back at all," he says. "The pressure was on the arms. Then, as we stood up, we're meant to put most of the pressure on the front parts of the bones in the discs, which tend to fall apart with aging. And as we go more backward into what we call extension, we're putting more pressure on even those small joints. They can't tolerate it." More...
PainCare
By Sam McManis
The Sacramento Bee
The problem, arguably, began when we started walking upright. Our spines just aren't constructed to take such vertical force. Something's got to give and, most often, it's a disc, a muscle, a nerve.
Back pain, elusive to diagnosis and tricky to treat, affects 80 percent of the U.S. population at some point in life, according to the North America Spine Society. Cost of treatment has exceeded $86 billion per year, a rise of 65 percent in a decade, according to the Journal of the American Medical Association.
And yet pain alleviation is hard to come by. More people than ever are seeking back-pain relief, through a combination of physical therapy, opioids and other pain-management techniques or surgery. U.S. doctors perform 1.2 million spinal operations yearly, the highest among developed nations.
Maybe, it has been posited, we will always battle back pain. It's the way we were built.
"If you believe that we once were quadrupeds, then it makes sense why the back tends to deteriorate," says Dr. Brian Davis, a UC Davis Medical Center physician specializing in spine and musculoskeletal disorders. "There's no question that the mechanical stuff that we put our back through is probably not what we were truly designed for. The people who believe in evolution will agree with that. The people who believe in creationism will say, 'That's a bunch of baloney.' "
Speaking to the evolution crowd, Davis explained.
"When we were walking on all fours, if you believe that, we didn't put pressure on those small parts of the back at all," he says. "The pressure was on the arms. Then, as we stood up, we're meant to put most of the pressure on the front parts of the bones in the discs, which tend to fall apart with aging. And as we go more backward into what we call extension, we're putting more pressure on even those small joints. They can't tolerate it." More...
PainCare
Talk Therapy for Kids' Pain: Better than Pills?
Tuesday, Mar. 03, 2009
By John Cloud
TIME
Some children, like some adults, have chronic, unexplainable pain. They have backaches every day or their legs and feet hurt every day or their necks throb constantly — and no one is sure why. Doctors call this pain idiopathic, a medical term for "we have no clue." Idiopathic pain arises spontaneously and without a known cause.
How best to treat idiopathic pain is one of medicine's great mysteries. You can anesthetize patients with painkillers, but that's not a great long-term solution, since patients become habituated (and in some cases addicted) to pain meds. In children, the situation is even more dire, since they may face decades of swallowing drugs. (See nine kid foods to avoid.)
That's why a study just published in the journal Pain is so encouraging. According to the study, clinicians who used a particular form of behavior therapy called acceptance and commitment therapy (ACT) with a group of 16 chronic-pain patients ages 10 to 18 saw remarkable results: after just 10 weeks of ACT sessions, during which patients were taught strategies for accepting chronic pain so they could pursue important goals, those kids suffered less intensely and functioned significantly better day to day than did a control group of 16 chronic-pain kids who had been treated the way kids with persistent aches are normally treated — with drugs and standard talk therapy. Both groups improved, but the children in the ACT group, who got no drugs, improved more than those who took pills. More...
PainCareMD
By John Cloud
TIME
Some children, like some adults, have chronic, unexplainable pain. They have backaches every day or their legs and feet hurt every day or their necks throb constantly — and no one is sure why. Doctors call this pain idiopathic, a medical term for "we have no clue." Idiopathic pain arises spontaneously and without a known cause.
How best to treat idiopathic pain is one of medicine's great mysteries. You can anesthetize patients with painkillers, but that's not a great long-term solution, since patients become habituated (and in some cases addicted) to pain meds. In children, the situation is even more dire, since they may face decades of swallowing drugs. (See nine kid foods to avoid.)
That's why a study just published in the journal Pain is so encouraging. According to the study, clinicians who used a particular form of behavior therapy called acceptance and commitment therapy (ACT) with a group of 16 chronic-pain patients ages 10 to 18 saw remarkable results: after just 10 weeks of ACT sessions, during which patients were taught strategies for accepting chronic pain so they could pursue important goals, those kids suffered less intensely and functioned significantly better day to day than did a control group of 16 chronic-pain kids who had been treated the way kids with persistent aches are normally treated — with drugs and standard talk therapy. Both groups improved, but the children in the ACT group, who got no drugs, improved more than those who took pills. More...
PainCareMD
J. D. Drew Encouraged After Injection to Relieve Back Discomfort
J.D. Drew plays professional baseball for the Boston Red Sox. This is a good example of the procedure, facet injections, from a patient's perspective.
Thursday, March 5, 2009
By JOE McDONALD
Journal Sports Writer
The Providence Journal
FORT MYERS, Fla. -- The four injections Red Sox outfielder J.D. Drew received on Monday in Boston contained a combination of cortisone and litacane. Dr. Bill Palmer administered the procedure.
Drew took batting practice Thursday morning and is expected to play against the Marlins on Friday at City of Palms Park.
Drew missed a total of 33 games late last season after he suffered a herniated disk. He received a couple of epidural shots to help alleviate the discomfort in his lower back, and that procedure was more invasive than the recent injections. Drew explained the epidural shot is injected directly into the spinal area, while the injection he received on Monday was into the facet joints on each side of the spine.
"I feel good," said Drew. "More than anything, I talked about residual stiffness I had throughout the offseason that I really wished I could get rid of. I started working with a chiropractor and we started talking about the facet tightness that I had, and he thought that might be the main cause -- some of that residual stiffness from sitting around and riding on the airplanes, sitting around the house and things like that. Really the only way to know if this would work or not was to go ahead and try the injection. If it works, then great, and we could get it freed up. If we didn't, then we would try something different. It's felt really good the last couple of days." More...
PainCareMD
Thursday, March 5, 2009
By JOE McDONALD
Journal Sports Writer
The Providence Journal
FORT MYERS, Fla. -- The four injections Red Sox outfielder J.D. Drew received on Monday in Boston contained a combination of cortisone and litacane. Dr. Bill Palmer administered the procedure.
Drew took batting practice Thursday morning and is expected to play against the Marlins on Friday at City of Palms Park.
Drew missed a total of 33 games late last season after he suffered a herniated disk. He received a couple of epidural shots to help alleviate the discomfort in his lower back, and that procedure was more invasive than the recent injections. Drew explained the epidural shot is injected directly into the spinal area, while the injection he received on Monday was into the facet joints on each side of the spine.
"I feel good," said Drew. "More than anything, I talked about residual stiffness I had throughout the offseason that I really wished I could get rid of. I started working with a chiropractor and we started talking about the facet tightness that I had, and he thought that might be the main cause -- some of that residual stiffness from sitting around and riding on the airplanes, sitting around the house and things like that. Really the only way to know if this would work or not was to go ahead and try the injection. If it works, then great, and we could get it freed up. If we didn't, then we would try something different. It's felt really good the last couple of days." More...
PainCareMD
The National Pain Care Policy Act of 2009
How Organizations & Support Groups Can Expand Congressional Sponsorship
by American Pain Foundation
March 5, 2009
“This bill will make pain care and pain management a public health priority.”
The American Pain Foundation applauds the United States House of Representatives’ Energy and Commerce Committee for adopting The National Pain Care Policy Act of 2009 (H.R.756)* on March 4, 2009.
The legislation will now move to the full House for consideration and then to the United States Senate. The National Pain Care Policy Act of 2009 would combat pain by:
• Authorizing a Pain Consortium at the National Institutes of Health (NIH) to expand research on causes and treatments for pain;
• Providing comprehensive pain care education and training for healthcare professionals;
• Creating a national public awareness campaign on pain management;
• And authorizing an Institute of Medicine conference on pain management.
“This bill will make pain care and pain management a public health priority for the 76.5 million Americans who are suffering with persistent chronic pain and will improve the understanding, assessment and treatment of their pain. It is critical that this important legislation be heard and approved by both the House and the Senate during this Congressional session.” More...
PainCareMD
by American Pain Foundation
March 5, 2009
“This bill will make pain care and pain management a public health priority.”
The American Pain Foundation applauds the United States House of Representatives’ Energy and Commerce Committee for adopting The National Pain Care Policy Act of 2009 (H.R.756)* on March 4, 2009.
The legislation will now move to the full House for consideration and then to the United States Senate. The National Pain Care Policy Act of 2009 would combat pain by:
• Authorizing a Pain Consortium at the National Institutes of Health (NIH) to expand research on causes and treatments for pain;
• Providing comprehensive pain care education and training for healthcare professionals;
• Creating a national public awareness campaign on pain management;
• And authorizing an Institute of Medicine conference on pain management.
“This bill will make pain care and pain management a public health priority for the 76.5 million Americans who are suffering with persistent chronic pain and will improve the understanding, assessment and treatment of their pain. It is critical that this important legislation be heard and approved by both the House and the Senate during this Congressional session.” More...
PainCareMD
M.R.I.’s May Burn Patients Who Wear Drug Patches
March 6, 2009
By GARDINER HARRIS
The New York Times
WASHINGTON — Federal health officials warned Thursday that patients who wear nicotine or other drug patches during M.R.I. scans risk burns, because some patches contain tiny metal elements that can be heated by the device’s huge magnet.
“Some, but not all, of these patches contain a little bit of aluminum, just enough that the patch could overheat if worn during an M.R.I. scan,” said Dr. Sandra Kweder, deputy director of the Food and Drug Administration’s new-drug office.
The F.D.A. has received reports of as many as five patients wearing patches who experienced a skin burn similar to a bad sunburn during screening, Dr. Kweder said. Federal health officials are generally alerted to only a fraction of the injuries associated with drug and device use.
About 60 kinds of drug patches are sold in the United States, and about 20 contain the tiny metal fragments, Dr. Kweder said. Some of these metal-containing products do not warn patients of their contents. And since few people consult the box anyway after donning a patch, the F.D.A. will soon require that all such products carry a warning on the patch itself.
“Our proposal is to start with something like ‘Remove Before M.R.I.,’ ” Dr. Kweder said, though the precise wording is still under discussion.
Patients should consult their doctors on whether to replace or reuse patches after removal for scans, she said. More...
PainCareMD
By GARDINER HARRIS
The New York Times
WASHINGTON — Federal health officials warned Thursday that patients who wear nicotine or other drug patches during M.R.I. scans risk burns, because some patches contain tiny metal elements that can be heated by the device’s huge magnet.
“Some, but not all, of these patches contain a little bit of aluminum, just enough that the patch could overheat if worn during an M.R.I. scan,” said Dr. Sandra Kweder, deputy director of the Food and Drug Administration’s new-drug office.
The F.D.A. has received reports of as many as five patients wearing patches who experienced a skin burn similar to a bad sunburn during screening, Dr. Kweder said. Federal health officials are generally alerted to only a fraction of the injuries associated with drug and device use.
About 60 kinds of drug patches are sold in the United States, and about 20 contain the tiny metal fragments, Dr. Kweder said. Some of these metal-containing products do not warn patients of their contents. And since few people consult the box anyway after donning a patch, the F.D.A. will soon require that all such products carry a warning on the patch itself.
“Our proposal is to start with something like ‘Remove Before M.R.I.,’ ” Dr. Kweder said, though the precise wording is still under discussion.
Patients should consult their doctors on whether to replace or reuse patches after removal for scans, she said. More...
PainCareMD
Wednesday, March 4, 2009
Physical Therapy is Effective for Management of Low-Back Pain
A new review article published in the Journal of the American Academy of Orthopaedic Surgeons should help convince many patients with low back pain to consider physical therapy as a first line of treatment for their condition, according to the American Physical Therapy Association (APTA). The review, published in February 2009, recommends that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective treatment is physical therapy combined with anti-inflammatory medications. Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes. More...
Source: American Physical Therapy Association
Pain Care MD
Source: American Physical Therapy Association
Pain Care MD
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