Thousands of Americans sustain winter-related back injuries every year, including many injuries directly related to holiday activities. But there are often simple things that can be done to reduce injury risk and minimize or eliminate back pain.
Most people experience additional stress and busier schedules during the winter holiday season that can lead to back pain, or worsen existing back pain. Increased activity such as completing year-end work projects, traveling, holiday shopping, carrying heavy packages, prolonged work in the kitchen, and hanging indoor or outdoor decorations can all wreak havoc on your back. The CDC estimates, in fact, that 5,800 Americans go to emergency rooms every year due to injuries, including back injuries, sustained from holiday decorating related falls.
Excess weight gained during the holidays can also place strain on the spine. According to one survey, 69% of Americans estimate that they gain up to eight pounds during the winter holiday season. Excess weight increases the likelihood of back injury, can aggravate existing injuries and can make it more difficult to recover.
Leading neurosurgeon and spine specialist William J. Sonstein, MD, FACS, of Neurological Surgery, P.C., has developed tips to help keep readers' backs safe and healthy during this season:
Minimize or Avoid Travel-Related Pain
-- Wear comfortable shoes with good arch supports to help you walk long distances, and comfortable, loose-fitting clothes to help you stay comfortable throughout your trip.
-- Give yourself extra time. When you rush, you are less aware of your body movements, which can cause stress and strain on your back.
-- Don't overpack. Take two smaller bags rather than one heavier big suitcase.
-- Be careful when lifting bags or luggage bend at the knee, and don't try to lift with your back. Ask for help when necessary.
Keep Shopping Safe
-- Shop during the off-peak hours to avoid having to stand on long lines and walk through crowded areas.
-- Make several small trips, rather that one large trip, to avoid stress and fatigue.
-- Distribute the weight of shopping bags evenly, and avoid carrying bags for too long. Remember to ask a store clerk for assistance with heavy or bulky items.
-- Sit down and rest if you start to feel fatigued.
-- Take Care When Preparing Meals
-- Prepare meals on a work surface that is most comfortable for you, or at elbow level.
-- Stand on a cushioned mat or non-slip rug to avoid muscle fatigue and back ache.
-- When taking heavy pans from the oven, lift from the knees, not the waist.
Decorate Your Home Safely
-- Take your time, mind your posture, and watch your step as you bend, stoop and stretch to retrieve items from your basement, shed or attic. Don't lift heavy boxes alone; ask a family member or friend to help you.
-- Use a sturdy stool or ladder for reaching high places.
Acute low back pain is the fifth most common reason for all physician visits in the U.S. Nine out of ten adults experience back pain at some point in their lives, and five out of ten working adults have back pain every year.
Dr. Sonstein is a partner in Neurological Surgery, P.C., a private practice of leading neurosurgeons, and Chief of Neurosurgery at North Shore-LIJ Hospital at Plainview, New York. He is a diplomate of the American Board of Neurosurgery. He
has a special interest in complex spine surgery and has extensive experience with a range of minimally invasive and open surgical techniques.
Source: Neurological Surgery, P.C.
суббота, 30 апреля 2011 г.
пятница, 29 апреля 2011 г.
Workers' Compensation Ratings Don't Accurately Predict Disabilities
A study of settlement decisions in workers' compensation claims for low back pain has found almost no relationship between the rating of the disability's severity when the claim was settled and reported pain and disability 21 months later.
Findings were counterintuitive: Claimants with higher disability ratings, which suggest higher severity and less ability to work, fared better than those with lower ratings.
The study shows that "administrative decisions made at the end of the workers' compensation claim process about the ability of someone to work after back injury has very little predictive validity," said Dr. Norton Hadler, a professor of medicine and microbiology/immunology in the University of North Carolina at Chapel Hill's School of Medicine.
Hadler is a co-author of the paper, which was published in the December issue of the Journal of Pain, with colleagues from St. Louis University and the University of Florida. It was based on administrative records in Missouri of workers' compensation claims for low back pain.
Workers' compensation is an important part of America's health-care system, accounting for 3 percent of an employer's gross income, Hadler said.
"Clearly, the rating schemes for workers' compensation are inconsistent, and that fact is stirring enormous pots across the country," Hadler said. "If the outcomes from Missouri generalize, then there is a need to reform how disability is determined."
Another paradoxical finding showed that white claimants faired no better than blacks, even though previous reviews found that blacks were much less likely than whites to be diagnosed with a herniated disk or to have back surgery, had less money spent on their care and received lower disability ratings and smaller settlements.
"It's one of the more perverse observations in our study," said Hadler. "African-Americans were much less likely to be operated on, but the care that the whites got, even though it looks like more care, because it's surgery and it's more expensive, didn't do anything for them."
For their study, the researchers interviewed 580 black and 892 white workers' compensation claimants an average of 21 months after claim settlement to assess how well they were functioning and to determine the contribution of impairment, race and socioeconomic status to their disability ratings.
Hadler said that workers' compensation claims for low back pain represent only 20 to 30 percent of all claims filed but consume a majority of the workers' compensation budget.
The article concludes that "the pattern of results suggests that race/ethnicity and other sociodemographic factors influence medical decision making and … the outcomes of medical care." Furthermore, the flaws in the system "are not distributed evenly" but "are visited disproportionately" on minorities and persons of lower socioeconomic status.
Study collaborators were Drs. John T. Chibnall and Raymond C. Tait from Saint Louis University School of Medicine and Dr. Elena M. Andresen of the University of Florida. Tait was the study's principal investigator and lead author of the article. It is the fifth article that the quartet have published over the last two years.
University of North Carolina at Chapel Hill
210 Pittsboro St. Campus Box 6210
Chapel Hill, NC 27514
United States
unc/
Findings were counterintuitive: Claimants with higher disability ratings, which suggest higher severity and less ability to work, fared better than those with lower ratings.
The study shows that "administrative decisions made at the end of the workers' compensation claim process about the ability of someone to work after back injury has very little predictive validity," said Dr. Norton Hadler, a professor of medicine and microbiology/immunology in the University of North Carolina at Chapel Hill's School of Medicine.
Hadler is a co-author of the paper, which was published in the December issue of the Journal of Pain, with colleagues from St. Louis University and the University of Florida. It was based on administrative records in Missouri of workers' compensation claims for low back pain.
Workers' compensation is an important part of America's health-care system, accounting for 3 percent of an employer's gross income, Hadler said.
"Clearly, the rating schemes for workers' compensation are inconsistent, and that fact is stirring enormous pots across the country," Hadler said. "If the outcomes from Missouri generalize, then there is a need to reform how disability is determined."
Another paradoxical finding showed that white claimants faired no better than blacks, even though previous reviews found that blacks were much less likely than whites to be diagnosed with a herniated disk or to have back surgery, had less money spent on their care and received lower disability ratings and smaller settlements.
"It's one of the more perverse observations in our study," said Hadler. "African-Americans were much less likely to be operated on, but the care that the whites got, even though it looks like more care, because it's surgery and it's more expensive, didn't do anything for them."
For their study, the researchers interviewed 580 black and 892 white workers' compensation claimants an average of 21 months after claim settlement to assess how well they were functioning and to determine the contribution of impairment, race and socioeconomic status to their disability ratings.
Hadler said that workers' compensation claims for low back pain represent only 20 to 30 percent of all claims filed but consume a majority of the workers' compensation budget.
The article concludes that "the pattern of results suggests that race/ethnicity and other sociodemographic factors influence medical decision making and … the outcomes of medical care." Furthermore, the flaws in the system "are not distributed evenly" but "are visited disproportionately" on minorities and persons of lower socioeconomic status.
Study collaborators were Drs. John T. Chibnall and Raymond C. Tait from Saint Louis University School of Medicine and Dr. Elena M. Andresen of the University of Florida. Tait was the study's principal investigator and lead author of the article. It is the fifth article that the quartet have published over the last two years.
University of North Carolina at Chapel Hill
210 Pittsboro St. Campus Box 6210
Chapel Hill, NC 27514
United States
unc/
четверг, 28 апреля 2011 г.
David Beckham Has One Leg Shorter Than The Other
England's football captain, David Beckham, has said that one of his legs is much shorter than the other.
According to some experts, this is not unusual. Very few of us are symmetrical down the midline (completely symmetrical). Everyone probably has one leg shorter than the other.
There seems to be disagreement among experts whether this has an effect on posture and back pain.
Some people say that we do get back pain as the body compensates for the discrepancy (it puts the back under stress). Others say that the difference in leg length would have to be huge for any back pain or other complaints to emerge.
(UK - Football. USA - Soccer).
According to some experts, this is not unusual. Very few of us are symmetrical down the midline (completely symmetrical). Everyone probably has one leg shorter than the other.
There seems to be disagreement among experts whether this has an effect on posture and back pain.
Some people say that we do get back pain as the body compensates for the discrepancy (it puts the back under stress). Others say that the difference in leg length would have to be huge for any back pain or other complaints to emerge.
(UK - Football. USA - Soccer).
среда, 27 апреля 2011 г.
Degenerative Disk Disease
Back pain can interfere with normal activities. One of the most common causes is degenerative disk disease. Fortunately, there is help. For most people, the pain improves within one to four weeks and can be managed with conservative treatments.
The June issue of Mayo Clinic Women's HealthSource describes causes and treatment for this condition.
Small disks act as shock absorbers between the vertebrae in the spine. With age, the disks are more prone to trauma and tearing that results from twisting and turning, a fall or a blow to the back. When a tear occurs in the outer portion of the disk, adjacent nerve endings are irritated and sensitive to pain. The pain is usually intermittent and worsens with longer periods of sitting, or with bending, twisting or lifting. Degenerative disk disease is most common among people in their 30s, 40s and 50s.
To diagnose the condition, a doctor will perform a physical exam and verify which movements cause pain. Imaging tests may be used to assess spinal changes.
Treatment usually consists of self-care measures such as applying cold or heat, pain medication, physical therapy and lifestyle changes. Losing weight may be advised to reduce stress on the back. Stopping smoking could be recommended to improve blood circulation and aid in healing. Other back-friendly measures include proper lifting, good posture, ergonomic furniture and supportive footwear.
Surgery is performed when other treatments haven't eased the pain. Options are spinal fusion to permanently fuse two or more vertebrae, or disk replacement where the damaged disk is replaced with a prosthetic one.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
mayoclinic
The June issue of Mayo Clinic Women's HealthSource describes causes and treatment for this condition.
Small disks act as shock absorbers between the vertebrae in the spine. With age, the disks are more prone to trauma and tearing that results from twisting and turning, a fall or a blow to the back. When a tear occurs in the outer portion of the disk, adjacent nerve endings are irritated and sensitive to pain. The pain is usually intermittent and worsens with longer periods of sitting, or with bending, twisting or lifting. Degenerative disk disease is most common among people in their 30s, 40s and 50s.
To diagnose the condition, a doctor will perform a physical exam and verify which movements cause pain. Imaging tests may be used to assess spinal changes.
Treatment usually consists of self-care measures such as applying cold or heat, pain medication, physical therapy and lifestyle changes. Losing weight may be advised to reduce stress on the back. Stopping smoking could be recommended to improve blood circulation and aid in healing. Other back-friendly measures include proper lifting, good posture, ergonomic furniture and supportive footwear.
Surgery is performed when other treatments haven't eased the pain. Options are spinal fusion to permanently fuse two or more vertebrae, or disk replacement where the damaged disk is replaced with a prosthetic one.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
mayoclinic
вторник, 26 апреля 2011 г.
Back Pain Permanently Sidelines Soldiers At War
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. Cohen, M.D., associate professor of anesthesiology at the Johns Hopkins University School of Medicine and a colonel in the U.S. Army Reserves. "If you have only a 13 percent success rate, this is a failure. There's a systemic problem."
Cohen and his team looked at data from 1,410 soldiers who were medically evacuated out of war zones complaining chiefly of back pain from 2004 through 2007. More than 95 percent of the service members were taken to the U.S. military's treatment facility in Landstuhl, Germany. Researchers assessed how many were returned to their stationed units within two weeks and how many were sent to the United States unable to perform their duties.
A previous study done by Cohen showed that when soldiers with back pain were taken to a pain clinic in Iraq, all patients returned to their units. When they were sent to pain clinics in Germany or in Washington, fewer than 2 percent did. Both this previous study and the new research suggest that the further away the evacuee is treated, the less likely they are to return to that unit. Cohen notes that it can be difficult for certain soldiers to return to their jobs, particularly those in physically demanding combat-related roles. "It's the rule in war: People will have back pain because you have to go on these long road marches and carry heavy equipment, wear body armor," he says. "The roads are not paved. Riding in these vehicles while wearing body armor, it hurts your back."
Cohen explains that the reasons why few military personnel return to their units after leaving with back pain may simply be a reflection of the outcomes for back pain in civilian life. "Back pain has notoriously low success rates for treatment," he says. The biggest predictors of a poor outcome, he said, are psychosocial factors. People who are depressed or anxious, who cope poorly with stress, who are unhappy in their jobs, and those with other psychological issues are more likely to remain disabled by back pain. Cohen, who is also director of chronic pain research at Walter Reed Army Medical Center, said those with back pain who remain in the country where they are deployed may be more motivated to stay on the job or are more satisfied with their role in the military.
The military needs to find a way to get soldiers with back pain back to their units wherever possible, Cohen says. He suggests that could be accomplished if there were more pain management options in Iraq or Afghanistan, following the model used for soldiers with symptoms of combat stress. When those symptoms are treated at mental health clinics on base, approximately 95 percent of service members returned to their units. When treated in a transitional unit in nearby Kuwait, the figure was around 50 percent. When sent to Germany, fewer than 10 percent returned.
Other researchers on the study include Shruti G. Kapoor, M.D., M.P.H., a resident in the Department of Anesthesiology at Johns Hopkins University School of Medicine; Maj. Conner Nguyen, M.D., chief of physical medicine and rehabilitation at Landstuhl Regional Medical Center in Germany; and Col. Leslie Foster, D.O., and Maj. Anthony Plunkett, M.D., both of Walter Reed Medical Center.
The research was funded in part by a congressional grant from the John P. Murtha Neuroscience and Pain Institute, Johnstown, Pa., the U.S. Army and the Army Regional Anesthesia & Pain Medicine Initiative, Washington, D.C.
Source: Johns Hopkins Medicine
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. Cohen, M.D., associate professor of anesthesiology at the Johns Hopkins University School of Medicine and a colonel in the U.S. Army Reserves. "If you have only a 13 percent success rate, this is a failure. There's a systemic problem."
Cohen and his team looked at data from 1,410 soldiers who were medically evacuated out of war zones complaining chiefly of back pain from 2004 through 2007. More than 95 percent of the service members were taken to the U.S. military's treatment facility in Landstuhl, Germany. Researchers assessed how many were returned to their stationed units within two weeks and how many were sent to the United States unable to perform their duties.
A previous study done by Cohen showed that when soldiers with back pain were taken to a pain clinic in Iraq, all patients returned to their units. When they were sent to pain clinics in Germany or in Washington, fewer than 2 percent did. Both this previous study and the new research suggest that the further away the evacuee is treated, the less likely they are to return to that unit. Cohen notes that it can be difficult for certain soldiers to return to their jobs, particularly those in physically demanding combat-related roles. "It's the rule in war: People will have back pain because you have to go on these long road marches and carry heavy equipment, wear body armor," he says. "The roads are not paved. Riding in these vehicles while wearing body armor, it hurts your back."
Cohen explains that the reasons why few military personnel return to their units after leaving with back pain may simply be a reflection of the outcomes for back pain in civilian life. "Back pain has notoriously low success rates for treatment," he says. The biggest predictors of a poor outcome, he said, are psychosocial factors. People who are depressed or anxious, who cope poorly with stress, who are unhappy in their jobs, and those with other psychological issues are more likely to remain disabled by back pain. Cohen, who is also director of chronic pain research at Walter Reed Army Medical Center, said those with back pain who remain in the country where they are deployed may be more motivated to stay on the job or are more satisfied with their role in the military.
The military needs to find a way to get soldiers with back pain back to their units wherever possible, Cohen says. He suggests that could be accomplished if there were more pain management options in Iraq or Afghanistan, following the model used for soldiers with symptoms of combat stress. When those symptoms are treated at mental health clinics on base, approximately 95 percent of service members returned to their units. When treated in a transitional unit in nearby Kuwait, the figure was around 50 percent. When sent to Germany, fewer than 10 percent returned.
Other researchers on the study include Shruti G. Kapoor, M.D., M.P.H., a resident in the Department of Anesthesiology at Johns Hopkins University School of Medicine; Maj. Conner Nguyen, M.D., chief of physical medicine and rehabilitation at Landstuhl Regional Medical Center in Germany; and Col. Leslie Foster, D.O., and Maj. Anthony Plunkett, M.D., both of Walter Reed Medical Center.
The research was funded in part by a congressional grant from the John P. Murtha Neuroscience and Pain Institute, Johnstown, Pa., the U.S. Army and the Army Regional Anesthesia & Pain Medicine Initiative, Washington, D.C.
Source: Johns Hopkins Medicine
понедельник, 25 апреля 2011 г.
Humira(R) (adalimumab) Receives FDA Approval For Treatment Of Ankylosing Spondylitis
Abbott announced that the U.S. Food and Drug Administration (FDA) approved HUMIRA(R) (adalimumab) for reducing signs and symptoms in patients with active ankylosing spondylitis (AS). AS is an autoimmune disease affecting the spine and large peripheral joints that causes inflammatory back pain and stiffness and also can be associated with other inflammatory diseases of the skin, eyes and intestines. In its severe form, AS over time can result in complete spinal fusion, causing extreme physical limitation and reduction in health-related quality of life.
AS is the third of six autoimmune diseases targeted for HUMIRA therapy that has received FDA approval. HUMIRA also is approved by the FDA to treat rheumatoid arthritis (RA) and psoriatic arthritis (PsA) and clinical trials are currently under way evaluating the potential of HUMIRA in other autoimmune diseases. HUMIRA received European approval to treat patients with severe, active AS on June 1, 2006.
"Medications like HUMIRA represent another option in the way we treat ankylosing spondylitis, a painful and potentially disabling disease that tends to strike mostly young adults," said Jane Bruckel, BSN, RN, Spondylitis Association of America co-founder and executive director.
AS affects young adults and commonly develops during the second and third decades of life. Because the pain and stiffness of AS are hard to distinguish from other common causes of back pain, patients may go undiagnosed for many years from the onset of their symptoms. AS is one of the most overlooked causes of persistent back pain in young adults.
The recommended dose of HUMIRA for AS is 40 mg every other week, by subcutaneous injection (a shot beneath the skin), the usual dose recommended for HUMIRA in the treatment of moderate to severe RA and PsA. HUMIRA is available to patients with AS in the United States in a pre-filled syringe. Beginning in August, patients will be able to take advantage of the HUMIRA Pen, a new delivery device for the self-administration of HUMIRA. Approved by the FDA on June 23, 2006, the HUMIRA Pen offers improved ease of use and a less painful experience compared to the HUMIRA pre-filled syringe.
Clinical Trial Results
The approval of HUMIRA for the treatment of patients with active AS is based on data from the ATLAS (Adalimumab Trial Evaluating Long-Term Efficacy and Safety in AS) trial.
ATLAS was a randomized, placebo-controlled, double-blind, Phase III study conducted in Europe and the United States. Results showed that HUMIRA was successful in reducing pain and inflammation in patients with AS after 12 weeks of treatment, the study's primary endpoint. Other findings demonstrated significant improvement in measures of disease activity for many patients treated with HUMIRA that were first observed at week two and maintained through 24 weeks.
ATLAS also explored the impact of HUMIRA on enthesitis, a condition in AS characterized by inflammation of the ligaments that attach to the bone. At week 24, the mean change in the enthesitis symptom score as measured by Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) in patients treated with HUMIRA showed significant reduction. MASES is an index that assesses enthesitis in certain locations, such as the rib cage, lower back, and Achilles tendons.
"The approval of HUMIRA in the treatment of ankylosing spondylitis marks an important milestone for Abbott," said Rebecca Hoffman, M.D., divisional vice president, Immunology Development, Abbott. "HUMIRA is now approved to treat three forms of autoimmune rheumatic diseases - all of them chronic, progressive, debilitating diseases where patients have limited treatment options. With its proven efficacy and established safety profile and the convenience of every other week self-administered dosing, HUMIRA offers an outstanding treatment option for the diverse patient populations who suffer from these conditions."
In the ATLAS trial, a similar rate of treatment-emergent adverse events leading to discontinuation of study drug was observed among placebo-treated (1.9 percent) and HUMIRA-treated (1.4 percent) patients. The overall incidence of adverse events reported by patients treated with HUMIRA was higher than the placebo-treated patients. The most common adverse events included nasopharyngitis, injection site reactions and headache.
About Ankylosing Spondylitis
Ankylosing spondylitis, or arthritis of the spine, is an autoimmune disorder in which a human protein, tumor necrosis factor-alpha, has been suggested to play a role in the disease development. AS is a form of arthritis known as spondyloarthritis, which is a group of closely linked rheumatic diseases that can cause pain in the spine and joints as well as ligaments and tendons. A chronic disease, AS primarily affects the spine causing back stiffness and potential deformity over time.
AS is associated with a number of other conditions including peripheral arthritis and enthesitis (inflammation of the muscle-bone insertion). Other associated affected organ systems may include the eyes, intestines and skin.
Important Safety Information
Cases of tuberculosis (TB) have been observed in patients receiving HUMIRA. Serious infections and sepsis, including fatalities, have been reported with the use of TNF-blocking agents, including HUMIRA. Many of these infections occurred in patients also taking other immunosuppressive agents that in addition to their underlying disease could predispose them to infections. Treatment with HUMIRA should not be initiated in patients with active infections. TNF-blocking agents, including HUMIRA, have been associated with reactivation of hepatitis B (HBV) in patients who are chronic carriers of this virus. Some cases have been fatal. Patients at risk for HBV infections should be evaluated for prior evidence of HBV infections before initiating HUMIRA. The combination of HUMIRA and anakinra is not recommended.
TNF-blocking agents, including HUMIRA, have been associated in rare cases with demyelinating disease and severe allergic reactions. Infrequent reports of serious blood disorders have been reported with TNF-blocking agents. More cases of malignancies have been observed among patients receiving TNF blockers, including HUMIRA, compared to control patients in clinical trials. These malignancies, other than lymphoma and non-melanoma skin cancer, were similar in type and number to what would be expected in the general population. There was an approximately four- fold higher rate of lymphoma in combined controlled and uncontrolled open label portions of HUMIRA clinical trials. The potential role of TNF-blocking therapy in the development of malignancies is not known.
The most frequent adverse events seen in the placebo-controlled clinical trials in rheumatoid arthritis (HUMIRA vs. placebo) were injection site reactions (20 percent vs. 14 percent), upper respiratory infection (17 percent vs. 13 percent), injection site pain (12 percent vs. 12 percent), headache (12 percent vs. 8 percent), rash (12 percent vs. 6 percent) and sinusitis (11 percent vs. 9 percent). Discontinuations due to adverse events were 7 percent for HUMIRA and 4 percent for placebo. As with any treatment program, the benefits and risks of HUMIRA should be carefully considered before initiating therapy.
In HUMIRA clinical trials for ankylosing spondylitis and psoriatic arthritis, the safety profile for patients treated with HUMIRA was similar to the safety profile seen in patients with rheumatoid arthritis.
About HUMIRA
HUMIRA is the only fully human monoclonal antibody approved by the FDA for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active RA. HUMIRA can be used alone or in combination with methotrexate or other disease-modifying anti-rheumatic drugs (DMARDs).
HUMIRA is indicated for reducing the signs and symptoms of active arthritis in patients with psoriatic arthritis. HUMIRA can be used alone or in combination with DMARDs.
HUMIRA is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
Abbott's Commitment to Immunology
Abbott is focused on the discovery and development of innovative treatments for immunologic diseases. The Abbott Bioresearch Center, founded in 1989 in Worcester, Massachusetts, United States, is a world-class discovery and basic research facility committed to finding new treatments for autoimmune diseases. More information about HUMIRA, including full prescribing information, is available on the Web site rxabbott or in the United States by calling Abbott Medical Information at 1-800-633-9110.
About Abbott
Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs 65,000 people and markets its products in more than 130 countries.
abbott
View drug information on Humira.
AS is the third of six autoimmune diseases targeted for HUMIRA therapy that has received FDA approval. HUMIRA also is approved by the FDA to treat rheumatoid arthritis (RA) and psoriatic arthritis (PsA) and clinical trials are currently under way evaluating the potential of HUMIRA in other autoimmune diseases. HUMIRA received European approval to treat patients with severe, active AS on June 1, 2006.
"Medications like HUMIRA represent another option in the way we treat ankylosing spondylitis, a painful and potentially disabling disease that tends to strike mostly young adults," said Jane Bruckel, BSN, RN, Spondylitis Association of America co-founder and executive director.
AS affects young adults and commonly develops during the second and third decades of life. Because the pain and stiffness of AS are hard to distinguish from other common causes of back pain, patients may go undiagnosed for many years from the onset of their symptoms. AS is one of the most overlooked causes of persistent back pain in young adults.
The recommended dose of HUMIRA for AS is 40 mg every other week, by subcutaneous injection (a shot beneath the skin), the usual dose recommended for HUMIRA in the treatment of moderate to severe RA and PsA. HUMIRA is available to patients with AS in the United States in a pre-filled syringe. Beginning in August, patients will be able to take advantage of the HUMIRA Pen, a new delivery device for the self-administration of HUMIRA. Approved by the FDA on June 23, 2006, the HUMIRA Pen offers improved ease of use and a less painful experience compared to the HUMIRA pre-filled syringe.
Clinical Trial Results
The approval of HUMIRA for the treatment of patients with active AS is based on data from the ATLAS (Adalimumab Trial Evaluating Long-Term Efficacy and Safety in AS) trial.
ATLAS was a randomized, placebo-controlled, double-blind, Phase III study conducted in Europe and the United States. Results showed that HUMIRA was successful in reducing pain and inflammation in patients with AS after 12 weeks of treatment, the study's primary endpoint. Other findings demonstrated significant improvement in measures of disease activity for many patients treated with HUMIRA that were first observed at week two and maintained through 24 weeks.
ATLAS also explored the impact of HUMIRA on enthesitis, a condition in AS characterized by inflammation of the ligaments that attach to the bone. At week 24, the mean change in the enthesitis symptom score as measured by Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) in patients treated with HUMIRA showed significant reduction. MASES is an index that assesses enthesitis in certain locations, such as the rib cage, lower back, and Achilles tendons.
"The approval of HUMIRA in the treatment of ankylosing spondylitis marks an important milestone for Abbott," said Rebecca Hoffman, M.D., divisional vice president, Immunology Development, Abbott. "HUMIRA is now approved to treat three forms of autoimmune rheumatic diseases - all of them chronic, progressive, debilitating diseases where patients have limited treatment options. With its proven efficacy and established safety profile and the convenience of every other week self-administered dosing, HUMIRA offers an outstanding treatment option for the diverse patient populations who suffer from these conditions."
In the ATLAS trial, a similar rate of treatment-emergent adverse events leading to discontinuation of study drug was observed among placebo-treated (1.9 percent) and HUMIRA-treated (1.4 percent) patients. The overall incidence of adverse events reported by patients treated with HUMIRA was higher than the placebo-treated patients. The most common adverse events included nasopharyngitis, injection site reactions and headache.
About Ankylosing Spondylitis
Ankylosing spondylitis, or arthritis of the spine, is an autoimmune disorder in which a human protein, tumor necrosis factor-alpha, has been suggested to play a role in the disease development. AS is a form of arthritis known as spondyloarthritis, which is a group of closely linked rheumatic diseases that can cause pain in the spine and joints as well as ligaments and tendons. A chronic disease, AS primarily affects the spine causing back stiffness and potential deformity over time.
AS is associated with a number of other conditions including peripheral arthritis and enthesitis (inflammation of the muscle-bone insertion). Other associated affected organ systems may include the eyes, intestines and skin.
Important Safety Information
Cases of tuberculosis (TB) have been observed in patients receiving HUMIRA. Serious infections and sepsis, including fatalities, have been reported with the use of TNF-blocking agents, including HUMIRA. Many of these infections occurred in patients also taking other immunosuppressive agents that in addition to their underlying disease could predispose them to infections. Treatment with HUMIRA should not be initiated in patients with active infections. TNF-blocking agents, including HUMIRA, have been associated with reactivation of hepatitis B (HBV) in patients who are chronic carriers of this virus. Some cases have been fatal. Patients at risk for HBV infections should be evaluated for prior evidence of HBV infections before initiating HUMIRA. The combination of HUMIRA and anakinra is not recommended.
TNF-blocking agents, including HUMIRA, have been associated in rare cases with demyelinating disease and severe allergic reactions. Infrequent reports of serious blood disorders have been reported with TNF-blocking agents. More cases of malignancies have been observed among patients receiving TNF blockers, including HUMIRA, compared to control patients in clinical trials. These malignancies, other than lymphoma and non-melanoma skin cancer, were similar in type and number to what would be expected in the general population. There was an approximately four- fold higher rate of lymphoma in combined controlled and uncontrolled open label portions of HUMIRA clinical trials. The potential role of TNF-blocking therapy in the development of malignancies is not known.
The most frequent adverse events seen in the placebo-controlled clinical trials in rheumatoid arthritis (HUMIRA vs. placebo) were injection site reactions (20 percent vs. 14 percent), upper respiratory infection (17 percent vs. 13 percent), injection site pain (12 percent vs. 12 percent), headache (12 percent vs. 8 percent), rash (12 percent vs. 6 percent) and sinusitis (11 percent vs. 9 percent). Discontinuations due to adverse events were 7 percent for HUMIRA and 4 percent for placebo. As with any treatment program, the benefits and risks of HUMIRA should be carefully considered before initiating therapy.
In HUMIRA clinical trials for ankylosing spondylitis and psoriatic arthritis, the safety profile for patients treated with HUMIRA was similar to the safety profile seen in patients with rheumatoid arthritis.
About HUMIRA
HUMIRA is the only fully human monoclonal antibody approved by the FDA for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active RA. HUMIRA can be used alone or in combination with methotrexate or other disease-modifying anti-rheumatic drugs (DMARDs).
HUMIRA is indicated for reducing the signs and symptoms of active arthritis in patients with psoriatic arthritis. HUMIRA can be used alone or in combination with DMARDs.
HUMIRA is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
Abbott's Commitment to Immunology
Abbott is focused on the discovery and development of innovative treatments for immunologic diseases. The Abbott Bioresearch Center, founded in 1989 in Worcester, Massachusetts, United States, is a world-class discovery and basic research facility committed to finding new treatments for autoimmune diseases. More information about HUMIRA, including full prescribing information, is available on the Web site rxabbott or in the United States by calling Abbott Medical Information at 1-800-633-9110.
About Abbott
Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs 65,000 people and markets its products in more than 130 countries.
abbott
View drug information on Humira.
воскресенье, 24 апреля 2011 г.
Lumbar Fusion Has Long-Term Benefits
Lumbar fusion is becoming an increasingly common treatment for low-back pain, but its long-term effects are relatively unknown. A doctoral thesis from the Swedish medical university Karolinska Institutet now shows that the long-term effects are superior to those of physiotherapy.
Chronic low-back pain is treated increasingly often with lumbar fusion, by which several lower back vertebrae are fused in a way that has little impact on the back's overall mobility. Lumbar fusion has been shown to relieve pain in the short term, but no studies have examined the long-term effects of the operation and compared them with alternative, non-surgical treatments like physiotherapy.
Per Ekman is a surgeon at Stockholm South General Hospital (Södersjukhuset), and has shown in his doctoral thesis that patients who have undergone lumbar fusion also improve in the longer term. His results are based on an evaluation of 111 patients, randomly assigned treatment with lumbar fusion or physiotherapy. On a follow-up nine years later, 76 per cent of the surgical group stated that they felt better than before the operation, compared with only 50 per cent of the physiotherapy group.
"Whether lumbar fusion should be used at all for this type of back pain has long been the subject of much debate," says Dr Ekman. "My studies suggest that most patients who have undergone lumbar fusion actually feel better, and that the operation carries no great risk. However, long-term improvements are often relatively modest, and the operation should also continue to be used as a complement to physiotherapy when this treatment doesn't help."
His thesis shows that men, the physically active and the gainfully employed have somewhat higher chances of benefitting from the operation than others.
"This tells us something, but unfortunately there are still no good methods for finding those with the best chances of responding well to the operation," says Dr Ekman.
Thesis: Lumbar fusion for chronic low-back pain in isthmic spondylolisthesis, Per Ekman, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet.
Karolinska Institutet is one of the leading medical universities in Europe. Through research, education and information, Karolinska Institutet contributes to improving human health. Each year, the Nobel Assembly at Karolinska Institutet awards the Nobel Prize in Physiology or Medicine.
Karolinska Institutet
Chronic low-back pain is treated increasingly often with lumbar fusion, by which several lower back vertebrae are fused in a way that has little impact on the back's overall mobility. Lumbar fusion has been shown to relieve pain in the short term, but no studies have examined the long-term effects of the operation and compared them with alternative, non-surgical treatments like physiotherapy.
Per Ekman is a surgeon at Stockholm South General Hospital (Södersjukhuset), and has shown in his doctoral thesis that patients who have undergone lumbar fusion also improve in the longer term. His results are based on an evaluation of 111 patients, randomly assigned treatment with lumbar fusion or physiotherapy. On a follow-up nine years later, 76 per cent of the surgical group stated that they felt better than before the operation, compared with only 50 per cent of the physiotherapy group.
"Whether lumbar fusion should be used at all for this type of back pain has long been the subject of much debate," says Dr Ekman. "My studies suggest that most patients who have undergone lumbar fusion actually feel better, and that the operation carries no great risk. However, long-term improvements are often relatively modest, and the operation should also continue to be used as a complement to physiotherapy when this treatment doesn't help."
His thesis shows that men, the physically active and the gainfully employed have somewhat higher chances of benefitting from the operation than others.
"This tells us something, but unfortunately there are still no good methods for finding those with the best chances of responding well to the operation," says Dr Ekman.
Thesis: Lumbar fusion for chronic low-back pain in isthmic spondylolisthesis, Per Ekman, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet.
Karolinska Institutet is one of the leading medical universities in Europe. Through research, education and information, Karolinska Institutet contributes to improving human health. Each year, the Nobel Assembly at Karolinska Institutet awards the Nobel Prize in Physiology or Medicine.
Karolinska Institutet
Biovail Receives Canadian Approval For Ralivia™ For The Treatment Of Moderately Severe Pain
Biovail Corporation (NYSE:BVF)(TSX:BVF) announced that it has received an expanded indication for once-daily Ralivia™ - to include the treatment of moderately severe pain in addition to moderate pain - from the Therapeutic Products Directorate (TPD) in Canada. Ralivia™ is now indicated for the management of moderate to moderately severe pain in adults who require continuous treatment for several days or more.
"This revised indication for moderately severe pain underscores the effectiveness of Ralivia™ in patients with moderate to moderately severe pain," said Biovail Chief Executive Officer Bill Wells. "Ralivia™ provides an analgesic option for patients with moderate to moderately severe pain without the risk of long-term cardiovascular and gastrointestinal risks that are associated with non-steroidal anti-inflammatory drugs and COX-2 inhibitors."
The new indication is based on the results of four 12-week, randomized, double-blind, parallel-group, placebo-controlled trials with Ralivia™ in more than 3,000 patients with persistent, moderate-to-severe pain due to osteoarthritis of the knee and/or hip, and low back pain. An additional study confirmed the safety and efficacy of Ralivia™ administered for up to 58 weeks.
Ralivia™ has been shown to produce significant reductions in pain intensity relative to placebo as early as the first day of treatment, with analgesic efficacy increasing throughout the first four weeks of treatment. Ralivia™ has also been shown to produce significant improvements in sleep, including improvements in sleep quality, trouble falling asleep, and awakening by pain at night and in the morning.
Ralivia™ is the only once-daily tramadol formulation that has also been approved by the United States Food and Drug Administration (FDA), and the only one with over 2.5 years of U.S. patient experience, during which time approximately 2.6 million prescriptions have been written.
Dosage Regimen
Ralivia™ should normally be started at a dose of 100mg once daily, and may gradually be increased in 100mg increments every five days, as necessary, and depending upon tolerability, to the relief of pain. The maximum dose of Ralivia™ is 300mg once daily.
Safety Precautions
Patients who are prescribed Ralivia™ may experience side effects, including dizziness, nausea, constipation and headache. These side effects are most likely to present shortly after the commencement of treatment. Patients in whom these side effects persist should contact their doctor.
Tramadol has a potential to cause psychic and physical dependence. Tramadol should not be used in opioid-dependent patients. In patients with a tendency to abuse drugs or a history of drug dependence, and in patients who are chronically abusing opioids, treatment with tramadol is not recommended. Withdrawal symptoms may occur following abrupt discontinuation of therapy. Patients on prolonged therapy should be withdrawn gradually from tramadol if it is no longer required for pain control.
Patients and health-care professionals who wish to obtain more information about Ralivia™ are encouraged to visit the Products subdirectory on the Company's Web site at biovail or to call Biovail Medical Information at 1-866-825-8120.
Caution Regarding Forward-Looking Information and "Safe Harbor" Statement
To the extent any statements made in this press release contain information that is not historical, these statements are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and may be forward-looking information under applicable Canadian provincial securities legislation (collectively, "forward-looking statements"). These forward-looking statements relate to, among other things, our objectives, goals, strategies, intentions, plans, beliefs, estimates and outlook, including, without limitation, statements concerning Ralivia™, the expanded indication and the safety precautions associated therewith, and can generally be identified by the use of words such as "believe", "anticipate", "expect", "intend", "plan", "will", "may" and other similar expressions. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances are forward-looking statements.
Although Biovail believes that the expectations reflected in such forward-looking statements are reasonable, such statements involve risks and uncertainties, and undue reliance should not be placed on such statements. Certain material factors or assumptions are applied in making forward-looking statements, and actual results may differ materially from those expressed or implied in such statements. Important factors that could cause actual results to differ materially from these expectations include, among other things: the results of continuing safety and efficacy studies by industry and government agencies; the patient's dosage regime; the particular attributes, traits and health of the patient; the regulatory environment; acceptance and demand for new pharmaceutical products and new indications for existing products; the impact of competitive products and pricing; regulatory matters including compliance with pharmaceutical regulations; and other risks detailed from time to time in the Company's filings with the U.S. Securities and Exchange Commission and the Canadian Securities Administrators, as well as the Company's ability to anticipate and manage the risks associated with the foregoing. Additional information about these factors and about the material factors or assumptions underlying such forward-looking statements may be found in the body of this news release, as well as under the heading "Risk Factors" contained in Item 3(D) of Biovail's most recent Annual Report on Form 20-F.
Biovail cautions that the foregoing list of important factors that may affect future results is not exhaustive. When relying on our forward-looking statements to make decisions with respect to the Company, investors and others should carefully consider the foregoing factors and other uncertainties and potential events. We undertake no obligation to update or revise any forward-looking statement.
About Biovail Corporation
Biovail Corporation is a specialty pharmaceutical company engaged in the formulation, clinical testing, registration, manufacture, and commercialization of pharmaceutical products. The Company is focused on the development and commercialization of medicines that address unmet medical needs in niche specialty central nervous system (CNS) markets. For more information about Biovail, visit the Company's Web site at biovail.
Biovail Corporation
What is pain?
For more information on what pain is and possible treatments, please see:
What is Pain? What Causes Pain?
"This revised indication for moderately severe pain underscores the effectiveness of Ralivia™ in patients with moderate to moderately severe pain," said Biovail Chief Executive Officer Bill Wells. "Ralivia™ provides an analgesic option for patients with moderate to moderately severe pain without the risk of long-term cardiovascular and gastrointestinal risks that are associated with non-steroidal anti-inflammatory drugs and COX-2 inhibitors."
The new indication is based on the results of four 12-week, randomized, double-blind, parallel-group, placebo-controlled trials with Ralivia™ in more than 3,000 patients with persistent, moderate-to-severe pain due to osteoarthritis of the knee and/or hip, and low back pain. An additional study confirmed the safety and efficacy of Ralivia™ administered for up to 58 weeks.
Ralivia™ has been shown to produce significant reductions in pain intensity relative to placebo as early as the first day of treatment, with analgesic efficacy increasing throughout the first four weeks of treatment. Ralivia™ has also been shown to produce significant improvements in sleep, including improvements in sleep quality, trouble falling asleep, and awakening by pain at night and in the morning.
Ralivia™ is the only once-daily tramadol formulation that has also been approved by the United States Food and Drug Administration (FDA), and the only one with over 2.5 years of U.S. patient experience, during which time approximately 2.6 million prescriptions have been written.
Dosage Regimen
Ralivia™ should normally be started at a dose of 100mg once daily, and may gradually be increased in 100mg increments every five days, as necessary, and depending upon tolerability, to the relief of pain. The maximum dose of Ralivia™ is 300mg once daily.
Safety Precautions
Patients who are prescribed Ralivia™ may experience side effects, including dizziness, nausea, constipation and headache. These side effects are most likely to present shortly after the commencement of treatment. Patients in whom these side effects persist should contact their doctor.
Tramadol has a potential to cause psychic and physical dependence. Tramadol should not be used in opioid-dependent patients. In patients with a tendency to abuse drugs or a history of drug dependence, and in patients who are chronically abusing opioids, treatment with tramadol is not recommended. Withdrawal symptoms may occur following abrupt discontinuation of therapy. Patients on prolonged therapy should be withdrawn gradually from tramadol if it is no longer required for pain control.
Patients and health-care professionals who wish to obtain more information about Ralivia™ are encouraged to visit the Products subdirectory on the Company's Web site at biovail or to call Biovail Medical Information at 1-866-825-8120.
Caution Regarding Forward-Looking Information and "Safe Harbor" Statement
To the extent any statements made in this press release contain information that is not historical, these statements are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and may be forward-looking information under applicable Canadian provincial securities legislation (collectively, "forward-looking statements"). These forward-looking statements relate to, among other things, our objectives, goals, strategies, intentions, plans, beliefs, estimates and outlook, including, without limitation, statements concerning Ralivia™, the expanded indication and the safety precautions associated therewith, and can generally be identified by the use of words such as "believe", "anticipate", "expect", "intend", "plan", "will", "may" and other similar expressions. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances are forward-looking statements.
Although Biovail believes that the expectations reflected in such forward-looking statements are reasonable, such statements involve risks and uncertainties, and undue reliance should not be placed on such statements. Certain material factors or assumptions are applied in making forward-looking statements, and actual results may differ materially from those expressed or implied in such statements. Important factors that could cause actual results to differ materially from these expectations include, among other things: the results of continuing safety and efficacy studies by industry and government agencies; the patient's dosage regime; the particular attributes, traits and health of the patient; the regulatory environment; acceptance and demand for new pharmaceutical products and new indications for existing products; the impact of competitive products and pricing; regulatory matters including compliance with pharmaceutical regulations; and other risks detailed from time to time in the Company's filings with the U.S. Securities and Exchange Commission and the Canadian Securities Administrators, as well as the Company's ability to anticipate and manage the risks associated with the foregoing. Additional information about these factors and about the material factors or assumptions underlying such forward-looking statements may be found in the body of this news release, as well as under the heading "Risk Factors" contained in Item 3(D) of Biovail's most recent Annual Report on Form 20-F.
Biovail cautions that the foregoing list of important factors that may affect future results is not exhaustive. When relying on our forward-looking statements to make decisions with respect to the Company, investors and others should carefully consider the foregoing factors and other uncertainties and potential events. We undertake no obligation to update or revise any forward-looking statement.
About Biovail Corporation
Biovail Corporation is a specialty pharmaceutical company engaged in the formulation, clinical testing, registration, manufacture, and commercialization of pharmaceutical products. The Company is focused on the development and commercialization of medicines that address unmet medical needs in niche specialty central nervous system (CNS) markets. For more information about Biovail, visit the Company's Web site at biovail.
Biovail Corporation
What is pain?
For more information on what pain is and possible treatments, please see:
What is Pain? What Causes Pain?
Special Report On Nonsurgical Spinal Decompression To Treat Chronic Low Back Pain Now In The January Issue Of Pain Medicine News
In most industrialized countries, chronic low back pain is recognized as a widespread condition. However, a Special Report supported through a grant from Axiom Worldwide is now featured in the January issue of Pain Medicine News. The Special Report was first featured in the December 2007 issue of Anesthesiology News and was then presented on-line at: painmedicinenews in early January.
The article has since become the most read article on this website. The Special Report highlights exciting research on a medical device that offers patients a non-surgical treatment option in treating chronic low back pain. The device is called the DRX9000™ and is manufactured by Axiom Worldwide of Tampa, FL. The authors of this Special Report are from the prestigious institutions of Duke University School of Medicine, Mayo Clinic, and Johns Hopkins University School of Medicine. They conclude their Special Report by stating, "The DRX9000™ computerized nonsurgical spinal decompression systems were designed to provide maximum patient benefits with the use of a noninvasive approach that may help minimize health care resources and offer a potentially optimal therapeutic approach to the treatment of LBP (low back pain)."
Axiom Worldwide manufactures and distributes its flagship products, the DRX9000 True Non-surgical Spinal Decompression System™, DRX9000C™, and DRX9500™ in medical markets around the globe. Axiom also manufactures a digital electroceutical device, the EPS8000™, for use in relieving pain and for use in muscular rehabilitation. Axiom prides itself on providing safe, non-surgical alternatives that patients should consider prior to undergoing surgery.
AxiomWorldwide.
The article has since become the most read article on this website. The Special Report highlights exciting research on a medical device that offers patients a non-surgical treatment option in treating chronic low back pain. The device is called the DRX9000™ and is manufactured by Axiom Worldwide of Tampa, FL. The authors of this Special Report are from the prestigious institutions of Duke University School of Medicine, Mayo Clinic, and Johns Hopkins University School of Medicine. They conclude their Special Report by stating, "The DRX9000™ computerized nonsurgical spinal decompression systems were designed to provide maximum patient benefits with the use of a noninvasive approach that may help minimize health care resources and offer a potentially optimal therapeutic approach to the treatment of LBP (low back pain)."
Axiom Worldwide manufactures and distributes its flagship products, the DRX9000 True Non-surgical Spinal Decompression System™, DRX9000C™, and DRX9500™ in medical markets around the globe. Axiom also manufactures a digital electroceutical device, the EPS8000™, for use in relieving pain and for use in muscular rehabilitation. Axiom prides itself on providing safe, non-surgical alternatives that patients should consider prior to undergoing surgery.
AxiomWorldwide.
PainEaze - Natural Pain Relief Solution Launched For Sports & Exercise Injuries, UK
Troublesome sports injuries are the target of PainEaze Sport, a new roll-on and spray range launched by the company behind the already popular original pain relief formula - PainEaze.
With more than 10 million recreational sports injuries occurring every year, the products have been created to aid sufferers, by calming inflammation in damaged muscles and joints whilst providing fast acting pain relief through its blend of 100 per cent natural ingredients. The topical application can reduce recovery time, aid pain and reduce swelling, without the side-effects associated with some alternatives.
The new invigorating citrus scented formula combines two highly effective anti-inflammatory agents, which work to reduce inflammation and swelling. Native Indian plant frankincense (boswellia serrata) has proven anti-inflammatory effects and is widely used in the treatment of back pain and rheumatism. Peppermint oil is an anti-inflammatory and natural muscle relaxant.
The rapid, comfort-restoring powers come from dimethylsulfone (MSM), sometimes referred to as the 'magic bullet' of pain relief and from eucalyptus. Eucalyptus increases blood flow and promotes optimum tissue health, essential for soothing tender or sore areas. Menthol is the main coolant in the formulation, providing a pleasant tingling sensation on the skin.
PainEaze Sport is an ideal first aid for those suffering from spontaneous, accidental injuries perhaps caused by a bad tackle, swing of an arm, or a slip or fall which can cause bruising or temporary damage to the joints or ligaments. Other sports-related conditions such as back ache, muscular pains that often happen more gradually through prolonged use of improper gear, poor technique or just being out of shape can be effectively eased with PainEaze Sport while further medical solutions are sought.
"One in twenty of all people treated at UK hospital A&E departments have sport and exercise related injuries, but many more minor, yet still painful incidents are treated at home by those who take part in regular exercise or sport," says PainEaze founder Ron Milross. "No matter which sport you play, injuries are inevitable but normally healthy fit people often prefer not to resort to oral medication. Topical pain relief goes directly to where you need it."
Available in both a spray for large or hard to reach areas and a unique, easy-to-use roll-on for targeting smaller areas, PainEaze Sport penetrates quickly and directly to the source of the pain, without the need for rubbing or massaging in.
PainEaze Sport, priced at ВЈ9.95 rrp is approved by the Medicines & Healthcare Products Regulatory Agency as an over-the-counter remedy and is initially available on-line at paineaze. The original range is also available from independent pharmacies and selected Waitrose stores.
With more than 10 million recreational sports injuries occurring every year, the products have been created to aid sufferers, by calming inflammation in damaged muscles and joints whilst providing fast acting pain relief through its blend of 100 per cent natural ingredients. The topical application can reduce recovery time, aid pain and reduce swelling, without the side-effects associated with some alternatives.
The new invigorating citrus scented formula combines two highly effective anti-inflammatory agents, which work to reduce inflammation and swelling. Native Indian plant frankincense (boswellia serrata) has proven anti-inflammatory effects and is widely used in the treatment of back pain and rheumatism. Peppermint oil is an anti-inflammatory and natural muscle relaxant.
The rapid, comfort-restoring powers come from dimethylsulfone (MSM), sometimes referred to as the 'magic bullet' of pain relief and from eucalyptus. Eucalyptus increases blood flow and promotes optimum tissue health, essential for soothing tender or sore areas. Menthol is the main coolant in the formulation, providing a pleasant tingling sensation on the skin.
PainEaze Sport is an ideal first aid for those suffering from spontaneous, accidental injuries perhaps caused by a bad tackle, swing of an arm, or a slip or fall which can cause bruising or temporary damage to the joints or ligaments. Other sports-related conditions such as back ache, muscular pains that often happen more gradually through prolonged use of improper gear, poor technique or just being out of shape can be effectively eased with PainEaze Sport while further medical solutions are sought.
"One in twenty of all people treated at UK hospital A&E departments have sport and exercise related injuries, but many more minor, yet still painful incidents are treated at home by those who take part in regular exercise or sport," says PainEaze founder Ron Milross. "No matter which sport you play, injuries are inevitable but normally healthy fit people often prefer not to resort to oral medication. Topical pain relief goes directly to where you need it."
Available in both a spray for large or hard to reach areas and a unique, easy-to-use roll-on for targeting smaller areas, PainEaze Sport penetrates quickly and directly to the source of the pain, without the need for rubbing or massaging in.
PainEaze Sport, priced at ВЈ9.95 rrp is approved by the Medicines & Healthcare Products Regulatory Agency as an over-the-counter remedy and is initially available on-line at paineaze. The original range is also available from independent pharmacies and selected Waitrose stores.
New Survey Reveals Mums Blame Back Pain On Children And Buggies
Children are a pain in the back!
New survey reveals that 83% of Mums suffer back pain directly related to caring for young children
A new survey* conducted by Maclaren Buggys and BackCare, 'The Charity for Healthier Backs', has revealed that 83% of Mums suffering from back pain believe it has been caused or exacerbated by their children. Mums cite pregnancy as well as the day-to-day lifting and carrying of their children as the main reasons but the survey highlighted a significant proportion of these mums (73%) also link back pain to pushing, folding or lifting pushchairs. Sash Newman, Chief Executive for BackCare comments "A pushchair is one of the most important pieces of baby equipment a parent buys - they will be using it constantly for years, not just months. If you choose one that has the wrong handle height for you, is too heavy, or is difficult to fold and lift then you could be storing up some real problems for the future."
In response to the survey, Backcare has joined forces with Maclaren to create a 'Top Ten Tips' providing advice on what to look for when choosing the right pushchair plus general tips on how to care for your back when looking after young children. These 'tips' are below and are on the Maclaren website at: maclarenbaby/gb/backcare
The survey reveals just how often women are using their pushchairs:
- 84% of women are using their pushchairs up to 3 times a day
- 91% are folding or unfolding them up to 3 times a day
- 87% are pushing them between three and ten miles a week.
- 47% are frequently lifting them in and out of the car
Adds Sash, "With such high usage all parents should consider the effects of a pushchair on their back and look for features that promote good back health - not just one that looks good or is used by a celebrity and hopefully our 'Top Ten Tips' will help women make the right choice for them." She continues, "When choosing a pushchair women should be looking for good handle height - too short and you'll be bending your back. The frame design should allow you to take a full stride, it should also be light to lift and easy to fold. We have found all these elements in Maclaren Buggys."
Jo Ebdon, Marketing Manager at Maclaren comments, "87% of parents push their buggies between 3-10 miles per week. That's a lot of regular use so it's important for parents to be comfortable. All our buggies have ergonomically optimised handles that keep parents' arms in a good pushing position and therefore their head, neck and back in correct alignment. Our unique angled A-frame design also ensures parents can take nice large steps without the risk of kicking the back of the buggy when walking." She continues, "The survey also highlighted the importance of handle height to Mums. Maclaren buggies have a good range of handle heights at 104 - 114 cm (41-45"). Plus our Techno XT and XLR models also have height adjustable handles, for increased flexibility and comfort."
This care for women is rooted in the Maclaren design. Back in 1965, Owen Maclaren, a former test pilot and aeronautical engineer, saw his daughter struggling with her bulky, cumbersome pram and was inspired to design something more user-friendly. He created a portable, lightweight (just 3kg/6lbs) yet sturdy buggy for her with a unique umbrella-fold mechanism. Thus the first Maclaren buggy was born and went onto revolutionise baby transport and become an iconic design.
The company has continued in this innovative vein and today each buggy is ergonomically optimised to promote comfort and good posture. Jo adds "We make our frames from strong, but lightweight aluminium and we have the lightest buggy on the market - the Volo, weighing in at just 4.0kg. In addition all our buggies have a 5-second one-hand fold for ease of use and what's more we're so confident in the design and quality, every one is now eligible for our unique Sovereign Lifetime WarrantyTM.
Top Ten Tips For Mums On How To Look After Their Backs
1. Look for a buggy with good handle height to keep yours arms in a good pushing position - this will help keep your head, neck and back in the correct alignment.
2. When pushing your buggy you should keep your shoulders down and relaxed and your elbows in.
3. Make sure the buggy you choose has a frame that allows you to swing your legs fully in front when walking.
4. Opt for a lightweight buggy, especially if you are always lifting it in and out of the car.
5. Make sure your buggy is easy to fold/unfold.
6. When lifting your child try not to bend over, instead bend at the knees and squat next to your baby. Hold your baby close to you and straighten up from the knees. 'Bend your knees, not your back' is the key to lifting small children.
7. If you are picking up a toddler, put one foot in front of the other, bend at your knees and encourage them to 'walk' up your front leg.
8. Avoid carrying your child on one hip - instead carry them in front of your body with their legs around your hips.
9. Exercise your back regularly - many exercises and activities can help you keep your back fit and healthy. Yoga, walking and swimming are particularly popular.
10. Use a well-designed backpack, such as the one BackCare has available** that spreads the weight evenly over your shoulders to carry your baby equipment - not a single sling bag.
Please note the aforementioned tips do not constitute medical advice and information displayed on maclarenbaby should not be used to replace medical advice received from qualified (healthcare) professionals, Maclaren is not in a position to recommend any specific treatment, product or therapy.
Sources:
* Conducted on babyexpert, thinkbaby and babyworld in January 2009, among 1206 volunteer women respondents.
** BackCare has designed a range of back packs to help you protect your back and make a difference to your posture and performance. More information on this unique back pack can be found at backcare.uk or by calling 0208 977 5474.
Notes
Maclaren Buggys are eligible for Maclaren Sovereign Lifetime Warranty™, the world's first global lifetime warranty, when parents register online at maclarenbaby within 45 days of purchase.
Maclaren is committed to safeguarding the environment by acting in a socially responsible manner and by adhering to the principles of: reduce, reuse and recycle.
Source
BackCare
New survey reveals that 83% of Mums suffer back pain directly related to caring for young children
A new survey* conducted by Maclaren Buggys and BackCare, 'The Charity for Healthier Backs', has revealed that 83% of Mums suffering from back pain believe it has been caused or exacerbated by their children. Mums cite pregnancy as well as the day-to-day lifting and carrying of their children as the main reasons but the survey highlighted a significant proportion of these mums (73%) also link back pain to pushing, folding or lifting pushchairs. Sash Newman, Chief Executive for BackCare comments "A pushchair is one of the most important pieces of baby equipment a parent buys - they will be using it constantly for years, not just months. If you choose one that has the wrong handle height for you, is too heavy, or is difficult to fold and lift then you could be storing up some real problems for the future."
In response to the survey, Backcare has joined forces with Maclaren to create a 'Top Ten Tips' providing advice on what to look for when choosing the right pushchair plus general tips on how to care for your back when looking after young children. These 'tips' are below and are on the Maclaren website at: maclarenbaby/gb/backcare
The survey reveals just how often women are using their pushchairs:
- 84% of women are using their pushchairs up to 3 times a day
- 91% are folding or unfolding them up to 3 times a day
- 87% are pushing them between three and ten miles a week.
- 47% are frequently lifting them in and out of the car
Adds Sash, "With such high usage all parents should consider the effects of a pushchair on their back and look for features that promote good back health - not just one that looks good or is used by a celebrity and hopefully our 'Top Ten Tips' will help women make the right choice for them." She continues, "When choosing a pushchair women should be looking for good handle height - too short and you'll be bending your back. The frame design should allow you to take a full stride, it should also be light to lift and easy to fold. We have found all these elements in Maclaren Buggys."
Jo Ebdon, Marketing Manager at Maclaren comments, "87% of parents push their buggies between 3-10 miles per week. That's a lot of regular use so it's important for parents to be comfortable. All our buggies have ergonomically optimised handles that keep parents' arms in a good pushing position and therefore their head, neck and back in correct alignment. Our unique angled A-frame design also ensures parents can take nice large steps without the risk of kicking the back of the buggy when walking." She continues, "The survey also highlighted the importance of handle height to Mums. Maclaren buggies have a good range of handle heights at 104 - 114 cm (41-45"). Plus our Techno XT and XLR models also have height adjustable handles, for increased flexibility and comfort."
This care for women is rooted in the Maclaren design. Back in 1965, Owen Maclaren, a former test pilot and aeronautical engineer, saw his daughter struggling with her bulky, cumbersome pram and was inspired to design something more user-friendly. He created a portable, lightweight (just 3kg/6lbs) yet sturdy buggy for her with a unique umbrella-fold mechanism. Thus the first Maclaren buggy was born and went onto revolutionise baby transport and become an iconic design.
The company has continued in this innovative vein and today each buggy is ergonomically optimised to promote comfort and good posture. Jo adds "We make our frames from strong, but lightweight aluminium and we have the lightest buggy on the market - the Volo, weighing in at just 4.0kg. In addition all our buggies have a 5-second one-hand fold for ease of use and what's more we're so confident in the design and quality, every one is now eligible for our unique Sovereign Lifetime WarrantyTM.
Top Ten Tips For Mums On How To Look After Their Backs
1. Look for a buggy with good handle height to keep yours arms in a good pushing position - this will help keep your head, neck and back in the correct alignment.
2. When pushing your buggy you should keep your shoulders down and relaxed and your elbows in.
3. Make sure the buggy you choose has a frame that allows you to swing your legs fully in front when walking.
4. Opt for a lightweight buggy, especially if you are always lifting it in and out of the car.
5. Make sure your buggy is easy to fold/unfold.
6. When lifting your child try not to bend over, instead bend at the knees and squat next to your baby. Hold your baby close to you and straighten up from the knees. 'Bend your knees, not your back' is the key to lifting small children.
7. If you are picking up a toddler, put one foot in front of the other, bend at your knees and encourage them to 'walk' up your front leg.
8. Avoid carrying your child on one hip - instead carry them in front of your body with their legs around your hips.
9. Exercise your back regularly - many exercises and activities can help you keep your back fit and healthy. Yoga, walking and swimming are particularly popular.
10. Use a well-designed backpack, such as the one BackCare has available** that spreads the weight evenly over your shoulders to carry your baby equipment - not a single sling bag.
Please note the aforementioned tips do not constitute medical advice and information displayed on maclarenbaby should not be used to replace medical advice received from qualified (healthcare) professionals, Maclaren is not in a position to recommend any specific treatment, product or therapy.
Sources:
* Conducted on babyexpert, thinkbaby and babyworld in January 2009, among 1206 volunteer women respondents.
** BackCare has designed a range of back packs to help you protect your back and make a difference to your posture and performance. More information on this unique back pack can be found at backcare.uk or by calling 0208 977 5474.
Notes
Maclaren Buggys are eligible for Maclaren Sovereign Lifetime Warranty™, the world's first global lifetime warranty, when parents register online at maclarenbaby within 45 days of purchase.
Maclaren is committed to safeguarding the environment by acting in a socially responsible manner and by adhering to the principles of: reduce, reuse and recycle.
Source
BackCare
Exercise Programme As Beneficial As Spinal Surgery In Treating Lower Back Pain, MRC Study
The largest ever clinical trial of surgery versus exercise treatments for chronic low back pain has found that patients
may obtain as much benefit from an intense physical exercise programme as from spinal surgery.
The results of the MRC Spine Stabilisation trial, led by Mr. Jeremy Fairbank of the Nuffield Orthopaedic Centre, Oxford were
published online in today's BMJ.
Chronic low back pain (LBP) is one of the most common ailments that GPs and consultants have to treat. For nearly 90 years
the same method of spinal surgery has been used to treat low back pain. There has however, been little evidence to support
the assumption that surgery is more effective than the best exercise treatments.
The study, funded by the Medical Research Council (MRC), was carried out in 15 hospitals in England and Scotland. A total of
349 patients aged 18-55 years, suffering with chronic low back pain for at least a year, were randomly selected to groups for
spinal surgery or for a three-week intensive physical exercise programme. Half of the patients were assigned to each
treatment.
The type of surgery chosen was that considered best for the particular patient. The rehabilitation included cognitive
behavioural therapy as well as the three-week programme of exercise.
The researchers, found that, although a few of the patients that underwent surgery had slightly more relief of symptoms
compared to patients who were given the exercise programme and cognitive behavioural therapy, the results were not clinically
significant enough to suggest that surgery was more beneficial.
Patients in both groups reported improvement in the two year follow-up, with less pain and disability and more mobility. In
the absence of an untreated control group it cannot be claimed that this longer-term benefit is due to these treatments,
though other studies suggest that this group of patients do not normally improve with time without treatment. A control group
of observational or usual treatment was not deemed acceptable to patients with chronic pain unresponsive to physiotherapy,
analgesics or chiropractic treatment.
Mr. Jeremy Fairbank, Consultant Orthopaedic Surgeon at the Nuffield Orthopaedic Centre, Oxford, and principal investigator
for the MRC Stabilisation Trial, said: "Our results suggest that patients eligible for surgery should be offered this type of
rehabilitation programme first, with strong support from the surgeon. We believe it is safer and cheaper than using surgery
as the first line of treatment, when conventional physiotherapy and alternative therapy have failed. This type of
rehabilitation is well within the capacity of ordinary physiotherapy departments to deliver".
A concurrent study of the economics of the two treatment programmes suggests that a strategy of intensive rehabilitation in
the first instance was half the price of a surgical strategy, even though 28% of those allocated to rehabilitation eventually
went to have surgery. This part of the study was directed by Dr Alistair Gray of the Institute of Health Sciences.
mrc.ac.uk
may obtain as much benefit from an intense physical exercise programme as from spinal surgery.
The results of the MRC Spine Stabilisation trial, led by Mr. Jeremy Fairbank of the Nuffield Orthopaedic Centre, Oxford were
published online in today's BMJ.
Chronic low back pain (LBP) is one of the most common ailments that GPs and consultants have to treat. For nearly 90 years
the same method of spinal surgery has been used to treat low back pain. There has however, been little evidence to support
the assumption that surgery is more effective than the best exercise treatments.
The study, funded by the Medical Research Council (MRC), was carried out in 15 hospitals in England and Scotland. A total of
349 patients aged 18-55 years, suffering with chronic low back pain for at least a year, were randomly selected to groups for
spinal surgery or for a three-week intensive physical exercise programme. Half of the patients were assigned to each
treatment.
The type of surgery chosen was that considered best for the particular patient. The rehabilitation included cognitive
behavioural therapy as well as the three-week programme of exercise.
The researchers, found that, although a few of the patients that underwent surgery had slightly more relief of symptoms
compared to patients who were given the exercise programme and cognitive behavioural therapy, the results were not clinically
significant enough to suggest that surgery was more beneficial.
Patients in both groups reported improvement in the two year follow-up, with less pain and disability and more mobility. In
the absence of an untreated control group it cannot be claimed that this longer-term benefit is due to these treatments,
though other studies suggest that this group of patients do not normally improve with time without treatment. A control group
of observational or usual treatment was not deemed acceptable to patients with chronic pain unresponsive to physiotherapy,
analgesics or chiropractic treatment.
Mr. Jeremy Fairbank, Consultant Orthopaedic Surgeon at the Nuffield Orthopaedic Centre, Oxford, and principal investigator
for the MRC Stabilisation Trial, said: "Our results suggest that patients eligible for surgery should be offered this type of
rehabilitation programme first, with strong support from the surgeon. We believe it is safer and cheaper than using surgery
as the first line of treatment, when conventional physiotherapy and alternative therapy have failed. This type of
rehabilitation is well within the capacity of ordinary physiotherapy departments to deliver".
A concurrent study of the economics of the two treatment programmes suggests that a strategy of intensive rehabilitation in
the first instance was half the price of a surgical strategy, even though 28% of those allocated to rehabilitation eventually
went to have surgery. This part of the study was directed by Dr Alistair Gray of the Institute of Health Sciences.
mrc.ac.uk
Linemen Are Back In Game After Disc Surgery, Encouraging Average People To Resume Active Lives
If NFL linemen can recover from back surgery and return to their spine-bruising careers, so can you get back into your "game" of horsing around with your kids or working out at the gym after back surgery.
That's the good news from a new Northwestern Medicine study that found 80 percent of NFL lineman - whose spines are especially vulnerable to degeneration - were able to return to play many more games after the surgery. These elite athletes spend a lot of time in a squatting stance that puts tremendous stress on their spine.
The study is encouraging to average people who are often fearful of becoming physically active after disc surgery, said lead study author Joseph Weistroffer, M.D., assistant professor of orthopaedic and of neurological surgery at Northwestern University Feinberg School of Medicine and a spine surgeon at Northwestern Memorial Hospital.
"Many times after the surgery, people are afraid to go back and live their lives,"Weistroffer said. "They don't want to hurt themselves and have another herniation. If a football player can get back to playing football again, you, too, can resume normal life. Just because you had disc surgery doesn't mean you are going to be broken for life."
The study will be published in the March issue of the Journal of American Sports Medicine. The coauthor is Wellington Hsu, M.D., assistant professor of orthopaedic and of neurological surgery at Feinberg and a spine surgeon at Northwestern Memorial.
For the study, Northwestern researchers scoured two decades of public records to determine the career outcomes of 52 NFL offensive and defensive linemen who had had herniated disc surgery during their active careers. Not only did 80 percent of the players return to the game, they also played an average of 33 games during three years after the surgery. More than half of them attained the prestigious distinction as starter at their position.
"The numbers show they were able to get back to the extreme and sustained activity of playing football on an NFL level," Weistroffer said. "That's significant." There is a paucity of evidence showing clinical outcomes for high-end athletes after herniated disc surgery, he noted.
Discs, disk-shaped tissue that separates the bones of the spinal column, start to wear out as people age, Weistroffer said. The sidewall of the disc may tear, but usually heals on its own. Occasionally disc material will squirt out through the tear and pin the nerve root against the bone, causing extreme back and leg pain. Most of the time the body can heal itself within six to 12 weeks. If healing doesn't occur, surgery can relieve the pressure on the nerve root and in many cases, relieve the pain, Weistroffer said.
Post-surgery, patients need to take it easy for up to three months and not lift more than 10 pounds to enable the body to heal. It is also usually beneficial to develop good muscle tone in the back and abdomen to help support the spine.
Source:
Marla Paul
Northwestern University
That's the good news from a new Northwestern Medicine study that found 80 percent of NFL lineman - whose spines are especially vulnerable to degeneration - were able to return to play many more games after the surgery. These elite athletes spend a lot of time in a squatting stance that puts tremendous stress on their spine.
The study is encouraging to average people who are often fearful of becoming physically active after disc surgery, said lead study author Joseph Weistroffer, M.D., assistant professor of orthopaedic and of neurological surgery at Northwestern University Feinberg School of Medicine and a spine surgeon at Northwestern Memorial Hospital.
"Many times after the surgery, people are afraid to go back and live their lives,"Weistroffer said. "They don't want to hurt themselves and have another herniation. If a football player can get back to playing football again, you, too, can resume normal life. Just because you had disc surgery doesn't mean you are going to be broken for life."
The study will be published in the March issue of the Journal of American Sports Medicine. The coauthor is Wellington Hsu, M.D., assistant professor of orthopaedic and of neurological surgery at Feinberg and a spine surgeon at Northwestern Memorial.
For the study, Northwestern researchers scoured two decades of public records to determine the career outcomes of 52 NFL offensive and defensive linemen who had had herniated disc surgery during their active careers. Not only did 80 percent of the players return to the game, they also played an average of 33 games during three years after the surgery. More than half of them attained the prestigious distinction as starter at their position.
"The numbers show they were able to get back to the extreme and sustained activity of playing football on an NFL level," Weistroffer said. "That's significant." There is a paucity of evidence showing clinical outcomes for high-end athletes after herniated disc surgery, he noted.
Discs, disk-shaped tissue that separates the bones of the spinal column, start to wear out as people age, Weistroffer said. The sidewall of the disc may tear, but usually heals on its own. Occasionally disc material will squirt out through the tear and pin the nerve root against the bone, causing extreme back and leg pain. Most of the time the body can heal itself within six to 12 weeks. If healing doesn't occur, surgery can relieve the pressure on the nerve root and in many cases, relieve the pain, Weistroffer said.
Post-surgery, patients need to take it easy for up to three months and not lift more than 10 pounds to enable the body to heal. It is also usually beneficial to develop good muscle tone in the back and abdomen to help support the spine.
Source:
Marla Paul
Northwestern University
Back Pain? Insoles Won't Help, Review Insists
The advertisements are vague but alluring: Wear insoles and you will be relaxed and stand with proper posture. You will be comfortable, even blissful all day. However, when researchers actually probed scientific studies, they found no evidence that shoe insoles prevent or treat back pain.
"Doctors and other health professionals should not recommend insoles for prevention of back pain or even for back pain treatment," said Tali Sahar, Ph.D., lead author of a new systematic review. "Insoles might be beneficial for prevention or treatment of other disorders, but this was not the topic of our review," said Sahar, with the department of family medicine at Hebrew University in Jerusalem
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
The new review looked at three studies involving 2,061 participants, which focused on the use of customized and standard insoles versus either no treatment or sham inserts for back pain prevention. Another three studies comprising 256 participants examined the use of insoles for either prevention or treatment of existing back pain.
The three larger studies looked at back pain prevention among male military recruits in Israel, Denmark and South Africa. The interventions lasted five to 14 weeks and data showed no significant difference in the prevention of back pain between the participants using insoles and those who did not.
The smaller studies focused on civilians. One comprised 96 women, all of whom worked in laboratories or in patient reception and were required to stand for 75 percent of their working hours. Back pain decreased with insole use, the original study reported. However, Sahar and her colleagues wrote that analysis of the data was inadequate.
Still another study focused on 100 nursing students "standing three days a week for eight hours a day." In that case, some back pain sufferers wearing insoles reported that the pain shifted to lower extremity pain.
The final study involved 60 postal workers, all of whom experienced back pain and were required to walk long distances. In that study, 81 percent preferred the real insoles to placebo insoles. However, the study itself had a "major methodological flaw," Cochrane reviewers found, and while participants reported a decrease in pain with real insoles, the results were not clinically significant, the team said.
Researchers encountered several obstacles while studying insoles, including participants complaining of discomfort. In a study involving 404 Israeli recruits wearing standard military footgear boots with leather uppers and rubber soles about half of the men dropped out. In another study, 25 of 96 women refused to participate because the insoles felt unpleasant and tight.
The study also noted that most of the trials involved younger people. The average age of the nurses was 23. Military recruits were 19 in South Africa and Israel, and 18 to 24 in Denmark. Older participants were included in two other studies still, the average age in both cases was only 39. Therefore, questions remain about the use of insoles for prevention and treatment of back pain in senior populations.
Still, there is probably no need for further research regarding prevention of back pain with insoles, "because there is strong evidence that they don't help," Sahar said. "Further research is needed to assess if insoles are useful for treatment or secondary prevention (preventing backache in people who have already had back problems). Such trials should be of higher quality of methodology and reporting than those we have found."
Another doctor says the findings did not surprise him. Many attributes are assigned to insoles, said Paul Hecht, M.D., an orthopedic surgeon at Dartmouth Hitchcock Medical Center. "I personally think they are over-prescribed."
Hecht, whose training is in foot and ankle surgery, prescribes insoles to cushion the foot. "I will use them for certain indications, but not for back pain," he said. "Do they help some people? Yes. Do they help everybody? No."
Estimates indicate that 60 percent to 85 percent of us will experience back pain at some point in our lives. Every year, back disorders in North America cost an estimated $100 billion in treatment and lost time from work.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane for more information.
Sahar T, et al. Insoles for prevention and treatment of back pain (Review). Cochrane Database of Systematic Reviews 2007, Issue 4.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
"Doctors and other health professionals should not recommend insoles for prevention of back pain or even for back pain treatment," said Tali Sahar, Ph.D., lead author of a new systematic review. "Insoles might be beneficial for prevention or treatment of other disorders, but this was not the topic of our review," said Sahar, with the department of family medicine at Hebrew University in Jerusalem
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
The new review looked at three studies involving 2,061 participants, which focused on the use of customized and standard insoles versus either no treatment or sham inserts for back pain prevention. Another three studies comprising 256 participants examined the use of insoles for either prevention or treatment of existing back pain.
The three larger studies looked at back pain prevention among male military recruits in Israel, Denmark and South Africa. The interventions lasted five to 14 weeks and data showed no significant difference in the prevention of back pain between the participants using insoles and those who did not.
The smaller studies focused on civilians. One comprised 96 women, all of whom worked in laboratories or in patient reception and were required to stand for 75 percent of their working hours. Back pain decreased with insole use, the original study reported. However, Sahar and her colleagues wrote that analysis of the data was inadequate.
Still another study focused on 100 nursing students "standing three days a week for eight hours a day." In that case, some back pain sufferers wearing insoles reported that the pain shifted to lower extremity pain.
The final study involved 60 postal workers, all of whom experienced back pain and were required to walk long distances. In that study, 81 percent preferred the real insoles to placebo insoles. However, the study itself had a "major methodological flaw," Cochrane reviewers found, and while participants reported a decrease in pain with real insoles, the results were not clinically significant, the team said.
Researchers encountered several obstacles while studying insoles, including participants complaining of discomfort. In a study involving 404 Israeli recruits wearing standard military footgear boots with leather uppers and rubber soles about half of the men dropped out. In another study, 25 of 96 women refused to participate because the insoles felt unpleasant and tight.
The study also noted that most of the trials involved younger people. The average age of the nurses was 23. Military recruits were 19 in South Africa and Israel, and 18 to 24 in Denmark. Older participants were included in two other studies still, the average age in both cases was only 39. Therefore, questions remain about the use of insoles for prevention and treatment of back pain in senior populations.
Still, there is probably no need for further research regarding prevention of back pain with insoles, "because there is strong evidence that they don't help," Sahar said. "Further research is needed to assess if insoles are useful for treatment or secondary prevention (preventing backache in people who have already had back problems). Such trials should be of higher quality of methodology and reporting than those we have found."
Another doctor says the findings did not surprise him. Many attributes are assigned to insoles, said Paul Hecht, M.D., an orthopedic surgeon at Dartmouth Hitchcock Medical Center. "I personally think they are over-prescribed."
Hecht, whose training is in foot and ankle surgery, prescribes insoles to cushion the foot. "I will use them for certain indications, but not for back pain," he said. "Do they help some people? Yes. Do they help everybody? No."
Estimates indicate that 60 percent to 85 percent of us will experience back pain at some point in our lives. Every year, back disorders in North America cost an estimated $100 billion in treatment and lost time from work.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane for more information.
Sahar T, et al. Insoles for prevention and treatment of back pain (Review). Cochrane Database of Systematic Reviews 2007, Issue 4.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
Short And Long-Term Efficacy Of Spinal Stabilisation System Investigated In Patients With Lower Back Pain
A new study announced today by Medtronic will investigate the short and long-term benefits of adding a spinal stabilisation system to a standard herniectomy procedure in patients with spinal disc herniation. The study is the first randomised control trial to assess the clinical benefit and patient perception of the relief of lower back pain in patients with spinal disc herniation, comparing a standard herniectomy versus a herniectomy supplemented with the DIAMпїЅ Spinal Stabilisation System.
"This new study is crucial to determine whether a spinal stabilisation system can help offer faster recovery time and reduce postoperative pain to patients with lower back pain undertaking a herniectomy and hence prevent or delay the need for spinal fusion," stated Dr. Ferdinand Krappel, an orthopaedic surgeon with Medizinisches Zentrum Kreis Hospital in Aachen, Germany, and a leading investigator of the DIAM study. "Compared to spinal fusion, this procedure is minimally invasive and it maintains the surgical site for future procedures if and when required."
It is estimated that more than 22 million people age 20 and older suffer from chronic back pain in Western Europe. One-third of these adults show evidence of herniated disc. Spinal disc herniation is also known as a slipped, ruptured or torn disc, and consists in a rupture of the spinal disc often occurring as a result of aging.
This multi-centre study expects to enroll 268 patients at 20 centres in six countries, including Belgium, Germany, Italy, Spain, Switzerland, and the United Kingdom. The study is the third of three planned randomised control trials investigating the benefits of the DIAM Spinal Stabilisation System in more than 1,000 patients in the United States and in Europe. The European trial endpoints include back pain relief at six months and reduction of disability at 12 months.
The herniectomy procedure takes approximately one hour and usually requires two to three days of hospitalisation. During the operation, the spinal stabilisation system is placed between the spinous processes (the visible ridges of the back) and is designed to act as a shock absorber that reduces loads on the surrounding vertebrae. The core of the DIAM System is made of silicone, while the outer mesh and tethers are made of medical-grade polyester. The flexible properties of the DIAM materials may also protect the integrity of the spinous process.
According to Lionel Hadjadjeba, vice president of the Spinal, Biologics and Navigation business at Medtronic, "Medtronic plays a leading role in the research on new device therapy for patients with chronic back pain, and learning more about the DIAM Spinal Stabilisation System will enable us to continue bringing therapies to market."
Back pain is one of the most common reasons for chronic disability and incapacity in the Western world.
About the Spinal Business at Medtronic
Medtronic's spinal business, based in Memphis, Tenn., is the global leader in today's spine market and is committed to advancing the treatment of spinal conditions. The spinal business collaborates with world-renowned surgeons, researchers and innovative partners to offer state-of-the-art products and technologies for neurological, orthopedic and spinal conditions. Medtronic is committed to developing affordable, minimally invasive procedures that provide lifestyle friendly surgical therapies. More information about the company and its spinal treatments can be found at medtronicspinal and its patient-education Web sites, back, iscoliosis, maturespine and necksurgery.
About Medtronic
Medtronic, Inc. (medtronic), headquartered in Minneapolis, is the global leader in medical technology - alleviating pain, restoring health, and extending life for millions of people around the world.
Medtronic
medtronic
"This new study is crucial to determine whether a spinal stabilisation system can help offer faster recovery time and reduce postoperative pain to patients with lower back pain undertaking a herniectomy and hence prevent or delay the need for spinal fusion," stated Dr. Ferdinand Krappel, an orthopaedic surgeon with Medizinisches Zentrum Kreis Hospital in Aachen, Germany, and a leading investigator of the DIAM study. "Compared to spinal fusion, this procedure is minimally invasive and it maintains the surgical site for future procedures if and when required."
It is estimated that more than 22 million people age 20 and older suffer from chronic back pain in Western Europe. One-third of these adults show evidence of herniated disc. Spinal disc herniation is also known as a slipped, ruptured or torn disc, and consists in a rupture of the spinal disc often occurring as a result of aging.
This multi-centre study expects to enroll 268 patients at 20 centres in six countries, including Belgium, Germany, Italy, Spain, Switzerland, and the United Kingdom. The study is the third of three planned randomised control trials investigating the benefits of the DIAM Spinal Stabilisation System in more than 1,000 patients in the United States and in Europe. The European trial endpoints include back pain relief at six months and reduction of disability at 12 months.
The herniectomy procedure takes approximately one hour and usually requires two to three days of hospitalisation. During the operation, the spinal stabilisation system is placed between the spinous processes (the visible ridges of the back) and is designed to act as a shock absorber that reduces loads on the surrounding vertebrae. The core of the DIAM System is made of silicone, while the outer mesh and tethers are made of medical-grade polyester. The flexible properties of the DIAM materials may also protect the integrity of the spinous process.
According to Lionel Hadjadjeba, vice president of the Spinal, Biologics and Navigation business at Medtronic, "Medtronic plays a leading role in the research on new device therapy for patients with chronic back pain, and learning more about the DIAM Spinal Stabilisation System will enable us to continue bringing therapies to market."
Back pain is one of the most common reasons for chronic disability and incapacity in the Western world.
About the Spinal Business at Medtronic
Medtronic's spinal business, based in Memphis, Tenn., is the global leader in today's spine market and is committed to advancing the treatment of spinal conditions. The spinal business collaborates with world-renowned surgeons, researchers and innovative partners to offer state-of-the-art products and technologies for neurological, orthopedic and spinal conditions. Medtronic is committed to developing affordable, minimally invasive procedures that provide lifestyle friendly surgical therapies. More information about the company and its spinal treatments can be found at medtronicspinal and its patient-education Web sites, back, iscoliosis, maturespine and necksurgery.
About Medtronic
Medtronic, Inc. (medtronic), headquartered in Minneapolis, is the global leader in medical technology - alleviating pain, restoring health, and extending life for millions of people around the world.
Medtronic
medtronic
Physiotherapy No Better Than Advice For Back Pain
Routine physiotherapy for mild to moderate low back pain is no more effective than a single advice session with a physiotherapist, finds a study in this week's BMJ (British Medical Journal).
Physiotherapists in the British NHS treat around 1.3 million people for low back pain each year, but there is very little evidence for its effectiveness. International guidelines vary but generally recommend advice to remain active.
The study involved 286 patients with low back pain of more than six weeks' duration; 144 received therapy and 142 received advice only. Level of disability was measured at two, six, and 12 months. Patient perceived benefit of treatment was also assessed.
Patients in the therapy group were more likely to report benefits from treatment, but there was no evidence of a long term effect of physiotherapy. There were no differences in disability scores between the groups at 12 months.
Routine physiotherapy seems to be no more effective than one session of assessment and advice from a physiotherapist, conclude the authors.
Contact:
Sarah Stewart-Brown, Professor of Public Health, University of Warwick, UK
(Randomised controlled trial of physiotherapy compared with advice for low back pain)
bmj/cgi/content/full/329/7468/708
(Editorial: Back pain and physiotherapy)
bmj/cgi/content/full/329/7468/694
Physiotherapists in the British NHS treat around 1.3 million people for low back pain each year, but there is very little evidence for its effectiveness. International guidelines vary but generally recommend advice to remain active.
The study involved 286 patients with low back pain of more than six weeks' duration; 144 received therapy and 142 received advice only. Level of disability was measured at two, six, and 12 months. Patient perceived benefit of treatment was also assessed.
Patients in the therapy group were more likely to report benefits from treatment, but there was no evidence of a long term effect of physiotherapy. There were no differences in disability scores between the groups at 12 months.
Routine physiotherapy seems to be no more effective than one session of assessment and advice from a physiotherapist, conclude the authors.
Contact:
Sarah Stewart-Brown, Professor of Public Health, University of Warwick, UK
(Randomised controlled trial of physiotherapy compared with advice for low back pain)
bmj/cgi/content/full/329/7468/708
(Editorial: Back pain and physiotherapy)
bmj/cgi/content/full/329/7468/694
Bone Pain Can Be A Sign Of Myeloma - Patients And Doctors Join Forces To Raise Awareness Of Early Myeloma Diagnosis
Myeloma Euronet, the European Network of Myeloma Patient Groups, and EFORT, the European Federation of National Associations of Orthopaedics and Traumatology, have joined efforts to highlight the importance of early myeloma diagnosis.
A recent international survey1 conducted by Myeloma Euronet among patients and physicians has revealed that advanced disease stage due to late diagnosis constitutes one of the greatest barriers to myeloma treatment and care. A study published last year in the Quarterly Journal of Medicine has confirmed that a prolonged delay in the diagnosis of myeloma does have a significant impact on disease-free survival.2
Bone pain is one of the most frequent symptoms of multiple myeloma, an increasingly common form of bone marrow cancer that is incurable but treatable. Myeloma affects around 80,000 people in Europe at any one time. "It can happen that myeloma patients go undiagnosed for years and sometimes they receive treatment for their bone pain that actually makes matters worse. This is why it is so important to check for myeloma whenever there is bone pain," says Anita Waldmann, President of Myeloma Euronet.
"This is an unprecedented partnership of cancer patients and orthopaedic surgeons and traumatologists across Europe and we are very excited that EFORT has agreed to inform its members of the need to routinely check for myeloma when seeing patients who report pain in the bone or in the back," Ms. Waldmann concludes.
Prof. Karl-Göran Thorngren, President of EFORT, agrees and adds: "We know that back pain can be a symptom of various cancer types, including pancreatic cancer, colon cancer and multiple myeloma, and we realise that a diagnosis as early as possible is extremely important. This issue has to be addressed across medical disciplines and we are more than happy to take steps in that direction, for example, by means of our Newsletter going out to more than 30,000 orthopaedic surgeons and traumatologists across Europe."
Myeloma Euronet and EFORT have also jointly issued a poster entitled "Back Pain - Could be Myeloma!" that can be downloaded from the Myeloma Euronet Web site at myeloma-euronet, and EFORT has granted Myeloma Euronet a free booth space at the upcoming 9th EFORT congress where the patient network can inform the participants about this issue. The congress will be held from 29 May - 1 June in Nice, France, and the President of Myeloma Euronet will also be available for interviews at the congress press conference to be held on 30th May at 9:30 a.m. in the Acropolis Convention Centre.
Myeloma can have various other non-specific symptoms, including but not limited to, anaemia and renal failure, and patients therefore present to a range of medical professionals, such as general practitioners or nephrologists. For this reason, the European section of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), have invited Myeloma Euronet to their European congress in September this year, to raise awareness of the importance of an early myeloma diagnosis, and Myeloma Euronet will also approach the European Renal Association.
Myeloma Euronet is a Belgian-registered international non-profit organisation of multiple myeloma patient groups in 18 European countries dedicated to raising the awareness of multiple myeloma. Myeloma Euronet also provides information on myeloma diagnosis, treatment and care and advocates the cause of myeloma at the European level.
EFORT works on behalf of the European Orthopaedic and Traumatology community, to secure mobility, musculoskeletal health and quality of life. EFORT unites European national orthopaedics societies from 36 European countries with about 35,000 members.
References
1 A full survey report is available for download at myeloma-euronet
2 Kariyawasan CC, Hughes DA, Jayatillake MM, Mehta AB: Multiple myeloma: causes and consequences of delay in diagnosis. QJM. 2007 Oct;100(10):635-40. Epub 2007 Sep 10.
Myeloma Euronet AISBL
A recent international survey1 conducted by Myeloma Euronet among patients and physicians has revealed that advanced disease stage due to late diagnosis constitutes one of the greatest barriers to myeloma treatment and care. A study published last year in the Quarterly Journal of Medicine has confirmed that a prolonged delay in the diagnosis of myeloma does have a significant impact on disease-free survival.2
Bone pain is one of the most frequent symptoms of multiple myeloma, an increasingly common form of bone marrow cancer that is incurable but treatable. Myeloma affects around 80,000 people in Europe at any one time. "It can happen that myeloma patients go undiagnosed for years and sometimes they receive treatment for their bone pain that actually makes matters worse. This is why it is so important to check for myeloma whenever there is bone pain," says Anita Waldmann, President of Myeloma Euronet.
"This is an unprecedented partnership of cancer patients and orthopaedic surgeons and traumatologists across Europe and we are very excited that EFORT has agreed to inform its members of the need to routinely check for myeloma when seeing patients who report pain in the bone or in the back," Ms. Waldmann concludes.
Prof. Karl-Göran Thorngren, President of EFORT, agrees and adds: "We know that back pain can be a symptom of various cancer types, including pancreatic cancer, colon cancer and multiple myeloma, and we realise that a diagnosis as early as possible is extremely important. This issue has to be addressed across medical disciplines and we are more than happy to take steps in that direction, for example, by means of our Newsletter going out to more than 30,000 orthopaedic surgeons and traumatologists across Europe."
Myeloma Euronet and EFORT have also jointly issued a poster entitled "Back Pain - Could be Myeloma!" that can be downloaded from the Myeloma Euronet Web site at myeloma-euronet, and EFORT has granted Myeloma Euronet a free booth space at the upcoming 9th EFORT congress where the patient network can inform the participants about this issue. The congress will be held from 29 May - 1 June in Nice, France, and the President of Myeloma Euronet will also be available for interviews at the congress press conference to be held on 30th May at 9:30 a.m. in the Acropolis Convention Centre.
Myeloma can have various other non-specific symptoms, including but not limited to, anaemia and renal failure, and patients therefore present to a range of medical professionals, such as general practitioners or nephrologists. For this reason, the European section of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), have invited Myeloma Euronet to their European congress in September this year, to raise awareness of the importance of an early myeloma diagnosis, and Myeloma Euronet will also approach the European Renal Association.
Myeloma Euronet is a Belgian-registered international non-profit organisation of multiple myeloma patient groups in 18 European countries dedicated to raising the awareness of multiple myeloma. Myeloma Euronet also provides information on myeloma diagnosis, treatment and care and advocates the cause of myeloma at the European level.
EFORT works on behalf of the European Orthopaedic and Traumatology community, to secure mobility, musculoskeletal health and quality of life. EFORT unites European national orthopaedics societies from 36 European countries with about 35,000 members.
References
1 A full survey report is available for download at myeloma-euronet
2 Kariyawasan CC, Hughes DA, Jayatillake MM, Mehta AB: Multiple myeloma: causes and consequences of delay in diagnosis. QJM. 2007 Oct;100(10):635-40. Epub 2007 Sep 10.
Myeloma Euronet AISBL
Low-Level Heat Wrap Therapy Can Significantly Reduce Acute Low Back Pain, Study
A new study released today supports
that continuous low-level heat wrap therapy (CLHT) can significantly reduce
acute low back pain and improve functional outcomes in patients who use CLHT
with exercise as compared to those who do not. The results of the study were
presented today at the 2005 Annual Meeting of the International Society for
the Study of the Lumbar Spine.
Restorative exercise and physical therapy are common modalities for
treating acute low back pain. But little is known about the additive effects
of a combination treatment of palliative processes such as CLHT with exercise
in acute low back pain. However, earlier clinical studies have shown that CLHT
can reduce muscle and joint pain better than the oral analgesics,
acetaminophen and ibuprofen.
"This is the first time we found that subjects who exercised with CLHT had
70% less lower back pain, 139% greater reduction in disability and 95%
improvement in functional ability as compared to subjects who exercised
without CLHT.," said John Mayer, Ph.D., Director of Research at U.S. Spine &
Sport Foundation. "Simply wearing a portable heat wrap in conjunction with
exercise cut pain and disability approximately in half."
About the Study
In the study one hundred patients (age 31.2+/-10.6 years) with
non-specific low back pain of less than three months duration were randomized
to one of four groups: CLHT alone (ThermaCare Heatwraps, n=25); directional
preference-based exercise alone (Exercise, n=25); combination of CLHT and
exercise (CLHT+Exer, n=24); or control (Instructional Booklet, n=26).
Treatment was administered for five consecutive days and included four visits
to the study center over one week. Outcome measures were functional ability
assessed by the Multidimensional Task Ability Profile, disability assessed by
the Roland-Morris Disability Questionnaire, and pain relief assessed by a 6-
point verbal rating scale.
About US Spine and Sport Foundation
U.S. Spine & Sport Foundation is a non-profit research and education
organization that was founded in 1994 by Vert Mooney, M.D., a world-renowned
orthopedic surgeon. The Foundation is dedicated to conduct clinical research
to: 1) Assess products, services, and interventions that have the potential
to enhance musculoskeletal function, expedite recovery from injury, or prevent
functional loss, and 2) Develop and assess novel measurement systems for
musculoskeletal function.
Please visit
spineandsport/foundation for more
information about the
Foundation.
U.S. Spine & Sport Foundation
spineandsport/foundation
that continuous low-level heat wrap therapy (CLHT) can significantly reduce
acute low back pain and improve functional outcomes in patients who use CLHT
with exercise as compared to those who do not. The results of the study were
presented today at the 2005 Annual Meeting of the International Society for
the Study of the Lumbar Spine.
Restorative exercise and physical therapy are common modalities for
treating acute low back pain. But little is known about the additive effects
of a combination treatment of palliative processes such as CLHT with exercise
in acute low back pain. However, earlier clinical studies have shown that CLHT
can reduce muscle and joint pain better than the oral analgesics,
acetaminophen and ibuprofen.
"This is the first time we found that subjects who exercised with CLHT had
70% less lower back pain, 139% greater reduction in disability and 95%
improvement in functional ability as compared to subjects who exercised
without CLHT.," said John Mayer, Ph.D., Director of Research at U.S. Spine &
Sport Foundation. "Simply wearing a portable heat wrap in conjunction with
exercise cut pain and disability approximately in half."
About the Study
In the study one hundred patients (age 31.2+/-10.6 years) with
non-specific low back pain of less than three months duration were randomized
to one of four groups: CLHT alone (ThermaCare Heatwraps, n=25); directional
preference-based exercise alone (Exercise, n=25); combination of CLHT and
exercise (CLHT+Exer, n=24); or control (Instructional Booklet, n=26).
Treatment was administered for five consecutive days and included four visits
to the study center over one week. Outcome measures were functional ability
assessed by the Multidimensional Task Ability Profile, disability assessed by
the Roland-Morris Disability Questionnaire, and pain relief assessed by a 6-
point verbal rating scale.
About US Spine and Sport Foundation
U.S. Spine & Sport Foundation is a non-profit research and education
organization that was founded in 1994 by Vert Mooney, M.D., a world-renowned
orthopedic surgeon. The Foundation is dedicated to conduct clinical research
to: 1) Assess products, services, and interventions that have the potential
to enhance musculoskeletal function, expedite recovery from injury, or prevent
functional loss, and 2) Develop and assess novel measurement systems for
musculoskeletal function.
Please visit
spineandsport/foundation for more
information about the
Foundation.
U.S. Spine & Sport Foundation
spineandsport/foundation
Chronic Back Pain Can Shrink Your Brain
US researchers have found that back pain can shrink the thalamus, this is a part of the brain that helps you make
decisions and interact with other people. The scientists, from Northwestern University, USA, found that people with back
pain had less activity in the thalamus.
You can read about this study in the Journal of Neuroscience.
Team leader, Dr Vania Apkarian, stressed that they will need to carry out more research. However, they reckon that some of
the shrinkage might be permanent.
Dr Vania Apkarian said we may have to treat pain earlier and more aggressively to prevent any shrinkage.
52 people took part in this trial. 26 volunteers suffered from chronic back pain, while the other 26 were healthy.
Those with chronic pain had experienced shrinkage of up to 11%. The human loses that amount of brain after ten to twenty
years of ageing. The longer the pain, the more the patients lost - about 1.3 cubic centimetres per year (for patients with
chronic pain).
Dr Vania Apkarian stressed that they are not completely sure whether the loss is permanent - they need to carry out more
studies. "It is possible that some of the observed decreased gray matter shown in this study reflects tissue shrinkage
without substantial neuronal loss, suggesting that proper treatment would reverse this portion of the decreased brain
matter."
decisions and interact with other people. The scientists, from Northwestern University, USA, found that people with back
pain had less activity in the thalamus.
You can read about this study in the Journal of Neuroscience.
Team leader, Dr Vania Apkarian, stressed that they will need to carry out more research. However, they reckon that some of
the shrinkage might be permanent.
Dr Vania Apkarian said we may have to treat pain earlier and more aggressively to prevent any shrinkage.
52 people took part in this trial. 26 volunteers suffered from chronic back pain, while the other 26 were healthy.
Those with chronic pain had experienced shrinkage of up to 11%. The human loses that amount of brain after ten to twenty
years of ageing. The longer the pain, the more the patients lost - about 1.3 cubic centimetres per year (for patients with
chronic pain).
Dr Vania Apkarian stressed that they are not completely sure whether the loss is permanent - they need to carry out more
studies. "It is possible that some of the observed decreased gray matter shown in this study reflects tissue shrinkage
without substantial neuronal loss, suggesting that proper treatment would reverse this portion of the decreased brain
matter."
Back And Neck Pain Remedy DVD Available Free To Public
The Pro-Care Spine Center in Austin, Texas recently created the Back and Neck Pain Remedy DVD and made it available free to the general public. This DVD includes 16 stretches and exercises that can be done at work or at home to help alleviate back and neck pain. In addition to the stretches and exercises, this DVD includes suggestions for controlling inflammation and how to know when the time is right to seek professional help.
"The patients we see typically fall into two categories: the patients that completely ignore the symptoms until they can't move and the patients that try to help the problem but end up hurting themselves worse," said Dr. Neil Boecking, D.C., Clinic Director. "We think the DVD does a better job than most books and pamphlets because it shows each of the activities in-detail and is very easy to follow. This DVD should be easy enough to get the average Joe to at least take some pro-active steps and get the others to do the activities in such as manner to help the pain instead of hurt."
The DVD is split into two parts, 6 neck pain activities and 10 low-back pain activities. Each of these sections can be played separately depending on the problem area. To get your free Back and Neck Pain Remedy DVD, just go to procarespine or call our office at 512-371-7478.
"We picked the most common and effective activities that we use in our office on a daily basis to put on this DVD," said Dr. Chad Walding DPT. "These activities will help most, but won't work for everybody. In the case where they need help beyond the DVD, offices such as ours can tailor simple and effective treatment plans to get them back up and active again quickly."
About Pro-Care Spine Center
The Pro-Care Spine Center is transforming the way physical medicine is combined to effectively combat back and neck pain. By combining physical therapy (with a Dr. of physical therapy), chiropractic, non-surgical spinal decompression, massage therapy, nutritional counseling, and other adjunct modalities, better results have been achieved than with any single therapy. The Pro-Care Spine Center is also advancing the severity of back conditions in which physical medicine can address. Using non-surgical spinal decompression, many serious conditions such as herniated/bulging disc(s) and degenerative disc disease can be treated non-surgically in the clinic. The Pro-Care Spine Center is located in Austin, Texas and began operations in 2004.
procarespine
"The patients we see typically fall into two categories: the patients that completely ignore the symptoms until they can't move and the patients that try to help the problem but end up hurting themselves worse," said Dr. Neil Boecking, D.C., Clinic Director. "We think the DVD does a better job than most books and pamphlets because it shows each of the activities in-detail and is very easy to follow. This DVD should be easy enough to get the average Joe to at least take some pro-active steps and get the others to do the activities in such as manner to help the pain instead of hurt."
The DVD is split into two parts, 6 neck pain activities and 10 low-back pain activities. Each of these sections can be played separately depending on the problem area. To get your free Back and Neck Pain Remedy DVD, just go to procarespine or call our office at 512-371-7478.
"We picked the most common and effective activities that we use in our office on a daily basis to put on this DVD," said Dr. Chad Walding DPT. "These activities will help most, but won't work for everybody. In the case where they need help beyond the DVD, offices such as ours can tailor simple and effective treatment plans to get them back up and active again quickly."
About Pro-Care Spine Center
The Pro-Care Spine Center is transforming the way physical medicine is combined to effectively combat back and neck pain. By combining physical therapy (with a Dr. of physical therapy), chiropractic, non-surgical spinal decompression, massage therapy, nutritional counseling, and other adjunct modalities, better results have been achieved than with any single therapy. The Pro-Care Spine Center is also advancing the severity of back conditions in which physical medicine can address. Using non-surgical spinal decompression, many serious conditions such as herniated/bulging disc(s) and degenerative disc disease can be treated non-surgically in the clinic. The Pro-Care Spine Center is located in Austin, Texas and began operations in 2004.
procarespine
High Health And Productivity Impact Of Pain In The Workforce
Approximately 30 percent of corporate employees have problems with pain, which are linked to reductions in health, work performance, and productivity, reports a study in the July Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).
Led by Harris Allen, Ph.D., of The Harris Allen Group, Brookline, Mass., the researchers performed an Internet survey of more than 1,000 employees of a major U.S. business services company. The study was designed to examine the frequency of pain in the workforce and its impact on employees' health and productivity.
Overall, 29 percent of workers reported ongoing problems with pain. Employees with pain scored more than 45 percent lower on an overall rating of physical health, compared to those without pain. Pain was also linked to a 23 percent reduction in mental health score.
Pain was related to reductions in nearly every aspect of productivity measured-the more severe the pain, the greater its effect on productivity. Workers with pain were five times more likely to report health-related limitations in job performance. On a measure combining absenteeism and "presenteeism"-defined as health problems that are not severe enough to cause absence but still affect work performance-employees with pain lost an average of three and two-thirds work days per month.
Additional questions suggested "considerable room for improvement" in the way employees' pain was being managed. Despite frequent use of pain medications and health care visits, many workers reported dissatisfaction with their current pain treatment.
Pain's impact on health and productivity was particularly extensive for workers with musculoskeletal conditions. Three of the five most common health problems-neck pain, back pain, and arthritis-fell into this category. (Allergies and depression were the other problems in the top five.)
Companies are increasingly aware of the financial impact of employee health-not just direct costs such as health insurance, but also indirect costs such as reduced productivity. Pain reduction has become a useful target for employers seeking ways to increase the health and productivity of their workforce.
The new results suggest that pain is common-reported by nearly one in three employees-and has a major impact on health and productivity. In designing programs to identify and help employees with pain, a focus on musculoskeletal conditions such as spinal pain and arthritis would offer the biggest "bang for the buck," the researchers write. Interventions to target and reduce the burden of pain could provide companies with a chance to create a "win-win" situation: "nurturing a better quality of life for many employees while at the same time promoting a more productive workforce."
ACOEM, an international society of 6,000 occupational physicians and other healthcare professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
Lippincott Williams & Wilkins
530 Walnut St.
Philadelphia, PA 19106
United States
lww
Led by Harris Allen, Ph.D., of The Harris Allen Group, Brookline, Mass., the researchers performed an Internet survey of more than 1,000 employees of a major U.S. business services company. The study was designed to examine the frequency of pain in the workforce and its impact on employees' health and productivity.
Overall, 29 percent of workers reported ongoing problems with pain. Employees with pain scored more than 45 percent lower on an overall rating of physical health, compared to those without pain. Pain was also linked to a 23 percent reduction in mental health score.
Pain was related to reductions in nearly every aspect of productivity measured-the more severe the pain, the greater its effect on productivity. Workers with pain were five times more likely to report health-related limitations in job performance. On a measure combining absenteeism and "presenteeism"-defined as health problems that are not severe enough to cause absence but still affect work performance-employees with pain lost an average of three and two-thirds work days per month.
Additional questions suggested "considerable room for improvement" in the way employees' pain was being managed. Despite frequent use of pain medications and health care visits, many workers reported dissatisfaction with their current pain treatment.
Pain's impact on health and productivity was particularly extensive for workers with musculoskeletal conditions. Three of the five most common health problems-neck pain, back pain, and arthritis-fell into this category. (Allergies and depression were the other problems in the top five.)
Companies are increasingly aware of the financial impact of employee health-not just direct costs such as health insurance, but also indirect costs such as reduced productivity. Pain reduction has become a useful target for employers seeking ways to increase the health and productivity of their workforce.
The new results suggest that pain is common-reported by nearly one in three employees-and has a major impact on health and productivity. In designing programs to identify and help employees with pain, a focus on musculoskeletal conditions such as spinal pain and arthritis would offer the biggest "bang for the buck," the researchers write. Interventions to target and reduce the burden of pain could provide companies with a chance to create a "win-win" situation: "nurturing a better quality of life for many employees while at the same time promoting a more productive workforce."
ACOEM, an international society of 6,000 occupational physicians and other healthcare professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
Lippincott Williams & Wilkins
530 Walnut St.
Philadelphia, PA 19106
United States
lww
Benefit Of Adipose-Derived Regenerative Cells In Spinal Disc Model Reported By Cytori
Cytori Therapeutics, Inc. (NASDAQ: CYTX) reported preclinical study results, which demonstrate the potential benefit of adipose-derived stem and regenerative cells (ADRCs) for the treatment of damaged intervertebral discs, evidenced by significantly increased disc tissue density and disc-specific extracellular matrix components at 12-months post treatment in a large animal model. The data were presented at the 2008 Tissue Engineering and Regenerative Medicine International Society meeting.
This study demonstrates the potential of a patient's own ADRCs to repair the spinal disc. While this study relied upon the traditional glassware methodology for ADRC isolation, the Celution® System could increase the efficiency and cost-effectiveness of the procedure. The Celution® System is an automated, bedside device that isolates autologous ADRCs in a real-time fashion, thus representing a potential novel therapeutic for more than 300,000 patients undergoing spinal surgery annually.
12 months following treatment, discs that received ADRCs in hyaluronic acid (HA) carrier compared to discs treated with HA only demonstrated significantly greater levels of the disc specific extracellular matrix proteins, aggrecan and type II collagen. Viable ADRCs were identified within the discs by histological examination identifying a potential link between the durability of these transplanted cells and improved condition of the discs. "This histologic data shows that ADRCs may contribute to the regeneration of the spinal disc and form a healthier, more natural inner-disc space than HA alone," said Jörg Meisel, M.D., Ph.D., the Director of Neurosurgery at the Bergmannstrost Klinik in Germany."
In addition, in this preclinical study at 12 months post therapy, injured discs that were treated with ADRCs in HA showed significantly greater disc density. This finding is based on independent assessments of T2 weighted MRI, compared to injured discs that received no treatment.
As part of the study design, 12 large animals (6 for each time point), underwent injury of three lumbar discs. Six weeks following the injury, the three discs were randomly assigned to receive autologous ADRCs suspended in HA, HA only (control) or no treatment. The discs were then assessed at 6 and 12 months after treatment for matrix hydration and morphology, which both showed significant improvement in the ADRC treated discs. All ADRC treatments were well tolerated, evidenced by the lack of inflammation within the disc space. The reported results are a subset of top-line findings which will be reported in full in the Spring of 2009.
About Cytori
Cytori's (NASDAQ: CYTX) goal is to be the global leader in regenerative medicine. The company is dedicated to providing patients with new options for reconstructive surgery, developing treatments for cardiovascular disease, and banking patients' adult stem and regenerative cells. The Celution(R) 800 System is being introduced in Europe into the reconstructive surgery market while the Celution(R) 900 System is being commercialized globally for cryopreserving a patient's own stem and regenerative cells. Clinical trials are ongoing in cardiovascular disease and planned for spinal disc degeneration, gastrointestinal disorders, and other unmet medical needs. cytoritx
Cautionary Statement Regarding Forward-Looking Statements
This press release includes forward-looking statements regarding events, trends and business prospects, which may affect our future operating results and financial position. Such statements are subject to risks and uncertainties that could cause our actual results and financial position to differ materially. Some of these risks and uncertainties include our history of operating losses, the need for further financing, regulatory uncertainties regarding the collection and results of, clinical data, dependence on third party performance, and other risks and uncertainties described under the "Risk Factors" in Cytori's Securities and Exchange Commission Filings. We assume no responsibility to update or revise any forward-looking statements to reflect events, trends or circumstances after the date they are made.
Source: Megan McCormick
Cytori Therapeutics
This study demonstrates the potential of a patient's own ADRCs to repair the spinal disc. While this study relied upon the traditional glassware methodology for ADRC isolation, the Celution® System could increase the efficiency and cost-effectiveness of the procedure. The Celution® System is an automated, bedside device that isolates autologous ADRCs in a real-time fashion, thus representing a potential novel therapeutic for more than 300,000 patients undergoing spinal surgery annually.
12 months following treatment, discs that received ADRCs in hyaluronic acid (HA) carrier compared to discs treated with HA only demonstrated significantly greater levels of the disc specific extracellular matrix proteins, aggrecan and type II collagen. Viable ADRCs were identified within the discs by histological examination identifying a potential link between the durability of these transplanted cells and improved condition of the discs. "This histologic data shows that ADRCs may contribute to the regeneration of the spinal disc and form a healthier, more natural inner-disc space than HA alone," said Jörg Meisel, M.D., Ph.D., the Director of Neurosurgery at the Bergmannstrost Klinik in Germany."
In addition, in this preclinical study at 12 months post therapy, injured discs that were treated with ADRCs in HA showed significantly greater disc density. This finding is based on independent assessments of T2 weighted MRI, compared to injured discs that received no treatment.
As part of the study design, 12 large animals (6 for each time point), underwent injury of three lumbar discs. Six weeks following the injury, the three discs were randomly assigned to receive autologous ADRCs suspended in HA, HA only (control) or no treatment. The discs were then assessed at 6 and 12 months after treatment for matrix hydration and morphology, which both showed significant improvement in the ADRC treated discs. All ADRC treatments were well tolerated, evidenced by the lack of inflammation within the disc space. The reported results are a subset of top-line findings which will be reported in full in the Spring of 2009.
About Cytori
Cytori's (NASDAQ: CYTX) goal is to be the global leader in regenerative medicine. The company is dedicated to providing patients with new options for reconstructive surgery, developing treatments for cardiovascular disease, and banking patients' adult stem and regenerative cells. The Celution(R) 800 System is being introduced in Europe into the reconstructive surgery market while the Celution(R) 900 System is being commercialized globally for cryopreserving a patient's own stem and regenerative cells. Clinical trials are ongoing in cardiovascular disease and planned for spinal disc degeneration, gastrointestinal disorders, and other unmet medical needs. cytoritx
Cautionary Statement Regarding Forward-Looking Statements
This press release includes forward-looking statements regarding events, trends and business prospects, which may affect our future operating results and financial position. Such statements are subject to risks and uncertainties that could cause our actual results and financial position to differ materially. Some of these risks and uncertainties include our history of operating losses, the need for further financing, regulatory uncertainties regarding the collection and results of, clinical data, dependence on third party performance, and other risks and uncertainties described under the "Risk Factors" in Cytori's Securities and Exchange Commission Filings. We assume no responsibility to update or revise any forward-looking statements to reflect events, trends or circumstances after the date they are made.
Source: Megan McCormick
Cytori Therapeutics
Treating Back Pain In Blood Marrow Cancer Patients
Treating non-osteoporotic compression fractures in patients with multiple myeloma, a blood cancer, shows that the use of vertebroplasty - a minimally invasive treatment performed by interventional radiologists using imaging guidance that stabilizes collapsed vertebrae with the injection of medical-grade bone cement into the spine - results in a reduction of pain, medication usage and disability, according to researchers in the largest study of its kind at the Society of Interventional Radiology's 35th Annual Scientific Meeting in Tampa, Fla.
"The minimally invasive, image-guided treatment of vertebroplasty is an integral component to the complicated treatment of multiple myeloma, an incurable (yet treatable) cancer of the bone marrow that causes destructive lesions in bones and makes them more susceptible to fracture. By reducing pain and improving mobility, vertebroplasty helps patients become better equipped to continue with their rigorous treatment for multiple myeloma," said Eren Erdem, M.D., associate professor of radiology and neurosurgery and chief of interventional neuroradiology at the University of Arkansas for Medical Sciences in Little Rock. "There are many studies reporting the effectiveness of vertebroplasty in treating osteoporotic vertebral compression fractures. With 792 patients, this is the largest study to date in the treatment of compression fractures in multiple myeloma patients," he added.
"Vertebral compression fractures are very common in patients with multiple myeloma and cause severe pain and debilitation. Patients can experience compression of abdominal contents and a decrease in lung capacity, resulting in weight loss, anorexia and a reduced ability to perform normal daily functions," Erdem noted. "In our study, patients' pain from their spinal fractures was significantly reduced following vertebroplasty, resulting in about a 40 percent reduction in the use of narcotics for pain control," said Erdem, with half of the patients also reporting an improvement in their activity level following treatment.
About 20,000 Americans are diagnosed with multiple myeloma each year, making it the second most common blood cancer in the United States. Most patients are in their early sixties when diagnosed, and the disease is more common in men and African-Americans. Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells are part of the immune system, which helps protect the body from germs and other harmful substances. In time, myeloma cells collect in the bone marrow and in the solid parts of bone - causing painful bone deterioration, typically in the drum-shaped bones of the spine, the vertebrae. Vertebral compression fractures occur when the internal scaffolding - bone marrow - is weakened due to the cancer, explained the co-author of "Vertebral Augmentation in the Treatment of Non-osteoporotic Vertebral Compression Fractures in 792 Patients With Multiple Myeloma."
Researchers at the University of Arkansas for Medical Sciences treated 2,715 non-osteoporotic vertebral compression fractures in 792 patients with multiple myeloma (45 percent women; average age, 63) over a six-year period. Of 2,715 non-osteoporotic vertebral compression fractures, 2,258 were treated by vertebroplasty and 457 were treated by kyphoplasty, a procedure in which a balloon is placed in the vertebrae (then inflated) and bone cement is applied.
In the study, the average pain intensity score for patients based on the 11-point visual analog scale dropped significantly from 7.0 to 2.7. In the study, 37 percent of patients reported a decrease in medication usage; 62 percent had no change; and 1 percent reported an increase in medication usage. Also, 48 percent of patients reported an improvement in their post-procedural activity level, and 83 percent would consider vertebroplasty or kyphoplasty again, if needed.
Abstract 17: "Vertebral Augmentation in the Treatment of Non-osteoporotic Vertebral Compression Fractures in 792 Patients With Multiple Myeloma," S.F. Malak, M. Atherton, C. Wood, M. Yousaf, P. Ajit, W.C. Culp, E. Erdem, all at the University of Arkansas for Medical Sciences, Little Rock, Ark., SIR 35th Annual Scientific Meeting March 13, 2010, Tampa, Fla.
Source:
Maryann Verrillo
Society of Interventional Radiology
"The minimally invasive, image-guided treatment of vertebroplasty is an integral component to the complicated treatment of multiple myeloma, an incurable (yet treatable) cancer of the bone marrow that causes destructive lesions in bones and makes them more susceptible to fracture. By reducing pain and improving mobility, vertebroplasty helps patients become better equipped to continue with their rigorous treatment for multiple myeloma," said Eren Erdem, M.D., associate professor of radiology and neurosurgery and chief of interventional neuroradiology at the University of Arkansas for Medical Sciences in Little Rock. "There are many studies reporting the effectiveness of vertebroplasty in treating osteoporotic vertebral compression fractures. With 792 patients, this is the largest study to date in the treatment of compression fractures in multiple myeloma patients," he added.
"Vertebral compression fractures are very common in patients with multiple myeloma and cause severe pain and debilitation. Patients can experience compression of abdominal contents and a decrease in lung capacity, resulting in weight loss, anorexia and a reduced ability to perform normal daily functions," Erdem noted. "In our study, patients' pain from their spinal fractures was significantly reduced following vertebroplasty, resulting in about a 40 percent reduction in the use of narcotics for pain control," said Erdem, with half of the patients also reporting an improvement in their activity level following treatment.
About 20,000 Americans are diagnosed with multiple myeloma each year, making it the second most common blood cancer in the United States. Most patients are in their early sixties when diagnosed, and the disease is more common in men and African-Americans. Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells are part of the immune system, which helps protect the body from germs and other harmful substances. In time, myeloma cells collect in the bone marrow and in the solid parts of bone - causing painful bone deterioration, typically in the drum-shaped bones of the spine, the vertebrae. Vertebral compression fractures occur when the internal scaffolding - bone marrow - is weakened due to the cancer, explained the co-author of "Vertebral Augmentation in the Treatment of Non-osteoporotic Vertebral Compression Fractures in 792 Patients With Multiple Myeloma."
Researchers at the University of Arkansas for Medical Sciences treated 2,715 non-osteoporotic vertebral compression fractures in 792 patients with multiple myeloma (45 percent women; average age, 63) over a six-year period. Of 2,715 non-osteoporotic vertebral compression fractures, 2,258 were treated by vertebroplasty and 457 were treated by kyphoplasty, a procedure in which a balloon is placed in the vertebrae (then inflated) and bone cement is applied.
In the study, the average pain intensity score for patients based on the 11-point visual analog scale dropped significantly from 7.0 to 2.7. In the study, 37 percent of patients reported a decrease in medication usage; 62 percent had no change; and 1 percent reported an increase in medication usage. Also, 48 percent of patients reported an improvement in their post-procedural activity level, and 83 percent would consider vertebroplasty or kyphoplasty again, if needed.
Abstract 17: "Vertebral Augmentation in the Treatment of Non-osteoporotic Vertebral Compression Fractures in 792 Patients With Multiple Myeloma," S.F. Malak, M. Atherton, C. Wood, M. Yousaf, P. Ajit, W.C. Culp, E. Erdem, all at the University of Arkansas for Medical Sciences, Little Rock, Ark., SIR 35th Annual Scientific Meeting March 13, 2010, Tampa, Fla.
Source:
Maryann Verrillo
Society of Interventional Radiology
For Back Pain, Spinal Manipulation Holds Its Own
If you're suffering from chronic lower back pain, a new review of existing research finds that spinal manipulation the kind of hands-on regimen that a chiropractor might perform on you is as helpful as other common treatments like painkillers.
Spinal manipulation is also safe, researchers found. Ultimately, "the decision to refer for manipulation should be based upon costs, preferences of the patient and providers, and relative safety of all treatment options," said review lead author Sidney Rubinstein, a chiropractor in private practice and a postdoctoral researcher at the VU University Medical Center in Amsterdam.
Surveys suggest that half of working Americans suffer from back pain each year. An estimated 25 percent of American adults reported that they suffered from back pain for at least a day within the last three months, according to a 2006 Centers for Disease Control and Prevention report, and lower back pain is the fifth most common reason that people go to the doctor.
Patients frequently turn to painkillers, which can cause side effects and be addictive, or to physical therapy, which is time-consuming and expensive. The new review looks at a third option spinal manipulation.
In North America, Rubinstein said, chiropractors perform most spinal manipulation. Practitioners move their hands around a patient's spine and joints, often producing an audible crack.
"The effectiveness of this therapy has long been controversial," Rubinstein said. "Some proponents are slowly starting to view it as effective for chronic low-back pain. The results of this review will support that view."
The review authors looked for randomized controlled studies, which are researchers consider as the most reliable forms of medical research. They found 26 studies with 6,070 participants that met their criteria for inclusion in their review, but deemed only nine studies to be of high quality.
The findings appear in the latest issue of The Cochrane Library. The journal is a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The researchers found that spinal manipulation worked about as well as the other treatments. It appears to work well in particular for certain kinds of patients, Rubinstein said, including those with restricted movement in the back, those without psychological issues, and those without symptoms below the knee related to the sciatic nerve.
Spinal manipulation "appears to be no better or worse than other existing therapies for patients with chronic low-back pain," the review says.
There is one small caveat, however. In medical research, scientists often compare a treatment to a placebo, which is difficult when you are talking about something that's difficult to fake like spinal manipulation.
Three of the studies reviewed the kind of spinal manipulation that produces a crack sound and tried to fool some patients into not realizing they were getting a sham treatment. However, it is unclear if they succeeded, Rubinstein said. One study appeared to show that patients could distinguish whether they were getting the real thing.
So how well do the treatments spinal manipulation and the other examined in the review work overall? Rubinstein said studies have shown that they help about two-thirds of patients. Sti other researchers say they have a modest impact at best.
In general, most treatments for lower-back pain "aren't all that effective, even the ones we think that work, but some people respond better than others," said Dr. Roger Chou, a physician and researcher with Oregon Health & Science University who has studied back pain.
"Right now the best we can say is that clinicians and patients have a number of moderately effective treatment options to consider, including exercise, manipulation, acupuncture, yoga, massage, cognitive behavioral therapy and some of the analgesic medications, and that it should be a decision between the clinician and patient," Chou said. "In general, I think exercise is a preferred option since it has a lot of other health benefits."
Dr. Tim Carey, director of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, said that many patients try several treatments, of which spinal manipulation is just one approach.
"We do not have a good sense of how manual therapy fits in an exercise regimen in a patient who is also taking medication, just as an example," said Carey, who studies back pain. "While manual therapy seems to be an option for chronic low back pain, the evidence at present does not support a role as a preferred option."
Source: Health Behavior News Service
Spinal manipulation is also safe, researchers found. Ultimately, "the decision to refer for manipulation should be based upon costs, preferences of the patient and providers, and relative safety of all treatment options," said review lead author Sidney Rubinstein, a chiropractor in private practice and a postdoctoral researcher at the VU University Medical Center in Amsterdam.
Surveys suggest that half of working Americans suffer from back pain each year. An estimated 25 percent of American adults reported that they suffered from back pain for at least a day within the last three months, according to a 2006 Centers for Disease Control and Prevention report, and lower back pain is the fifth most common reason that people go to the doctor.
Patients frequently turn to painkillers, which can cause side effects and be addictive, or to physical therapy, which is time-consuming and expensive. The new review looks at a third option spinal manipulation.
In North America, Rubinstein said, chiropractors perform most spinal manipulation. Practitioners move their hands around a patient's spine and joints, often producing an audible crack.
"The effectiveness of this therapy has long been controversial," Rubinstein said. "Some proponents are slowly starting to view it as effective for chronic low-back pain. The results of this review will support that view."
The review authors looked for randomized controlled studies, which are researchers consider as the most reliable forms of medical research. They found 26 studies with 6,070 participants that met their criteria for inclusion in their review, but deemed only nine studies to be of high quality.
The findings appear in the latest issue of The Cochrane Library. The journal is a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The researchers found that spinal manipulation worked about as well as the other treatments. It appears to work well in particular for certain kinds of patients, Rubinstein said, including those with restricted movement in the back, those without psychological issues, and those without symptoms below the knee related to the sciatic nerve.
Spinal manipulation "appears to be no better or worse than other existing therapies for patients with chronic low-back pain," the review says.
There is one small caveat, however. In medical research, scientists often compare a treatment to a placebo, which is difficult when you are talking about something that's difficult to fake like spinal manipulation.
Three of the studies reviewed the kind of spinal manipulation that produces a crack sound and tried to fool some patients into not realizing they were getting a sham treatment. However, it is unclear if they succeeded, Rubinstein said. One study appeared to show that patients could distinguish whether they were getting the real thing.
So how well do the treatments spinal manipulation and the other examined in the review work overall? Rubinstein said studies have shown that they help about two-thirds of patients. Sti other researchers say they have a modest impact at best.
In general, most treatments for lower-back pain "aren't all that effective, even the ones we think that work, but some people respond better than others," said Dr. Roger Chou, a physician and researcher with Oregon Health & Science University who has studied back pain.
"Right now the best we can say is that clinicians and patients have a number of moderately effective treatment options to consider, including exercise, manipulation, acupuncture, yoga, massage, cognitive behavioral therapy and some of the analgesic medications, and that it should be a decision between the clinician and patient," Chou said. "In general, I think exercise is a preferred option since it has a lot of other health benefits."
Dr. Tim Carey, director of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, said that many patients try several treatments, of which spinal manipulation is just one approach.
"We do not have a good sense of how manual therapy fits in an exercise regimen in a patient who is also taking medication, just as an example," said Carey, who studies back pain. "While manual therapy seems to be an option for chronic low back pain, the evidence at present does not support a role as a preferred option."
Source: Health Behavior News Service
Survey Finds Smokers Suffer More Back Pain
Smokers suffer more chronic back pain. This was the result of the analysis of a questionnaire performed by Monique Zimmermann-Stenzel and her colleagues and published in the current edition of Deutsches Arzteblatt International (Dtsch Arztebl Int, 2008; 105[24]: 441-8). aerzteblatt/v4/archiv/pdf.asp?id=60552
In 2003, the Robert Koch Institute interviewed more than 8000 private persons in the course of a telephone health survey (GsTel03). This included questions on social and demographic themes, as well as health and life style. On the basis of the collected data, the authors examined whether there was an association between smoking and chronic back pain.
Their evaluation showed that smokers or former smokers suffer chronic back pain much more often than do non-smokers. The number of years the subjects had been smoking or had smoked was decisive. Subjects who had consumed tobacco for more than 16 years had a two-fold greater probability of suffering chronic back pain than subjects who had smoked for less than 10 years. The probability of back pain was further multiplied for subjects who had smoked for longer than 26 years. On the other hand, the frequency with which the subjects consumed tobacco and the quantities smoked did not play a role.
However, the authors pointed out that tobacco consumption does not necessarily cause chronic back pain. It is just as possible that people with chronic back pain smoke to alleviate the pain. The exact association between smoking and back pain will have to be clarified in appropriate studies. These could offer additional possibilities to prevent chronic back pain or smoking motivated by this.
Source: Elke Bartholomäus
Deutsches Aerzteblatt International
In 2003, the Robert Koch Institute interviewed more than 8000 private persons in the course of a telephone health survey (GsTel03). This included questions on social and demographic themes, as well as health and life style. On the basis of the collected data, the authors examined whether there was an association between smoking and chronic back pain.
Their evaluation showed that smokers or former smokers suffer chronic back pain much more often than do non-smokers. The number of years the subjects had been smoking or had smoked was decisive. Subjects who had consumed tobacco for more than 16 years had a two-fold greater probability of suffering chronic back pain than subjects who had smoked for less than 10 years. The probability of back pain was further multiplied for subjects who had smoked for longer than 26 years. On the other hand, the frequency with which the subjects consumed tobacco and the quantities smoked did not play a role.
However, the authors pointed out that tobacco consumption does not necessarily cause chronic back pain. It is just as possible that people with chronic back pain smoke to alleviate the pain. The exact association between smoking and back pain will have to be clarified in appropriate studies. These could offer additional possibilities to prevent chronic back pain or smoking motivated by this.
Source: Elke Bartholomäus
Deutsches Aerzteblatt International
Clinical Review Of Minimally Invasive IDET(TM) Procedure Demonstrates Significant Decrease In Lower Back Pain
A meta-analysis of
the Intradiscal ELECTROTHERMAL(TM) Therapy (IDET(TM)) procedure examining
outcomes of 17 clinical studies demonstrates that patients suffering from
chronic disc-related low back pain experience a significant decrease in
pain and improvement in physical function, as well as a low incidence of
complications. The study is published in the July/August issue of Pain
Medicine, the peer-reviewed journal of the American Academy of Pain
Medicine.
Study authors Dr. Gunnar B.J. Andersson, professor and chairman of
orthopedic surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago,
and Dr. Michael Totta, physiatrist of the Spine Center at Orthopedic
Associates of Portland in Portland, Maine, systematically synthesized all
peer-reviewed published literature describing outcomes following the IDET
procedure involving more than 500 patients. The majority of clinical
studies reported outcomes assessed from six to 24-months post-treatment.
"The collective study results provide compelling evidence that the IDET
procedure can significantly improve the quality of life for patients who
suffer from chronic disc-related low back pain and are seeking relief,"
said Dr. Andersson.
Meta-Analysis Results of IDET Procedure
Meta-analytic techniques applied to measurement tools, such as the
Visual Analog Scale (VAS) and Bodily Pain (BP) and Physical Functioning
(PF) subscales of the SF-36 and the Oswestry Disability Index (ODI), were
used to examine the overall treatment effects of the IDET procedure. The
most frequently reported efficacy outcomes were the improvements in the VAS
assessment of pain, and the BP and the PF subscales of the SF-36 health
survey and ODI. The safety of the IDET procedure was evaluated by pooling
the incidence of complications among the published literature.
Based on the meta-analysis, the review concludes that a statistically
significant decrease in pain is reported post-treatment. These authors
found a mean improvement of 2.9 points on the VAS and a mean improvement of
21 points on the BP subscale of the SF 36. Statistically significant
improvements in physical function were also recorded. These improvements
following the IDET procedure were accompanied by a low incidence of
complications.
"By gathering the results from all the studies on the IDET procedure,
we have reinforced that the entire body of evidence supports the
effectiveness of the procedure," said Dr. Totta. "A meta-analysis is a
statistical method that combines the results of several independent
clinical trials. By integrating the body of evidence for a procedure, a
meta-analysis allows for a more objective appraisal of the data and can
also contribute to considerations about the consistency of the study
results."
About the IDET Procedure
Intradiscal ELECTROTHERMAL(TM) Therapy (IDET) is a minimally invasive
outpatient surgical procedure for patients suffering from chronic
disc-related lower back pain who have failed a program of aggressive
non-operative therapy. During the procedure, controlled levels of thermal
heat are applied directly to the affected disc. The heat contracts and
thickens the collagen fibers within the disc wall, cauterizing the tiny
nerve endings that cause the pain and potentially closing the cracks and
tears.
The IDET procedure can be performed in less than one hour, is safe and
has a low incidence of complications. Since 1998, over 60 peer-reviewed
articles have been published on the IDET procedure supporting the
procedure's efficacy and safety.
For more information about the IDET procedure, please visit
IDETprocedure.
About Smith & Nephew
Smith & Nephew (NYSE: SNN, LSE: SN) (smith-nephew) is a
global medical technology business, specializing in Endoscopy, Orthopaedic
Reconstruction, Orthopaedic Trauma and Clinical Therapies, and Advanced
Wound Management products. Smith & Nephew is a global leader in arthroscopy
and advanced wound management and is one of the leading global orthopaedics
companies.
Smith & Nephew is dedicated to helping improve people's lives. The
company prides itself on the strength of its relationships with its surgeon
and professional healthcare customers, with whom its name is synonymous
with the highest standards of performance, innovation and trust. The
company has more than 8,500 employees and operates in 33 countries around
the world and generated sales of nearly $2.6 billion.
Forward Looking Statements
This press release contains certain "forward-looking statements" within
the meaning of the US Private Securities Litigation Reform Act of 1995. In
particular, statements regarding expected revenue growth and operating
margins discussed under "Outlook" are forward-looking statements as are
discussions of our product pipeline. These statements, as well as the
phrases "aim", "plan", "intend", "anticipate", "well-placed", "believe",
"estimate", "expect", "target", "consider" and similar expressions, are
generally intended to identify forward-looking statements. Such
forward-looking statements involve known and unknown risks, uncertainties
and other important factors (including, but not limited to, the outcome of
litigation, claims and regulatory approvals) that could cause the actual
results, performance or achievements of Smith & Nephew, or industry
results, to differ materially from any future results, performance or
achievements expressed or implied by such forward-looking statements.
Please refer to the documents that Smith & Nephew has filed with the U.S.
Securities and Exchange Commission under the U.S. Securities Exchange Act
of 1934, as amended, including Smith & Nephew's most recent annual report
on Form 20F, for a discussion of certain of these factors.
All forward-looking statements in this press release are based on
information available to Smith & Nephew as of the date hereof. All written
or oral forward-looking statements attributable to Smith & Nephew or any
person acting on behalf of Smith & Nephew are expressly qualified in their
entirety by the foregoing. Smith & Nephew does not undertake any obligation
to update or revise any forward-looking statement contained herein to
reflect any change in Smith & Nephew's expectation with regard thereto or
any change in events, conditions or circumstances on which any such
statement is based.
Smith & Nephew
smith-nephew
the Intradiscal ELECTROTHERMAL(TM) Therapy (IDET(TM)) procedure examining
outcomes of 17 clinical studies demonstrates that patients suffering from
chronic disc-related low back pain experience a significant decrease in
pain and improvement in physical function, as well as a low incidence of
complications. The study is published in the July/August issue of Pain
Medicine, the peer-reviewed journal of the American Academy of Pain
Medicine.
Study authors Dr. Gunnar B.J. Andersson, professor and chairman of
orthopedic surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago,
and Dr. Michael Totta, physiatrist of the Spine Center at Orthopedic
Associates of Portland in Portland, Maine, systematically synthesized all
peer-reviewed published literature describing outcomes following the IDET
procedure involving more than 500 patients. The majority of clinical
studies reported outcomes assessed from six to 24-months post-treatment.
"The collective study results provide compelling evidence that the IDET
procedure can significantly improve the quality of life for patients who
suffer from chronic disc-related low back pain and are seeking relief,"
said Dr. Andersson.
Meta-Analysis Results of IDET Procedure
Meta-analytic techniques applied to measurement tools, such as the
Visual Analog Scale (VAS) and Bodily Pain (BP) and Physical Functioning
(PF) subscales of the SF-36 and the Oswestry Disability Index (ODI), were
used to examine the overall treatment effects of the IDET procedure. The
most frequently reported efficacy outcomes were the improvements in the VAS
assessment of pain, and the BP and the PF subscales of the SF-36 health
survey and ODI. The safety of the IDET procedure was evaluated by pooling
the incidence of complications among the published literature.
Based on the meta-analysis, the review concludes that a statistically
significant decrease in pain is reported post-treatment. These authors
found a mean improvement of 2.9 points on the VAS and a mean improvement of
21 points on the BP subscale of the SF 36. Statistically significant
improvements in physical function were also recorded. These improvements
following the IDET procedure were accompanied by a low incidence of
complications.
"By gathering the results from all the studies on the IDET procedure,
we have reinforced that the entire body of evidence supports the
effectiveness of the procedure," said Dr. Totta. "A meta-analysis is a
statistical method that combines the results of several independent
clinical trials. By integrating the body of evidence for a procedure, a
meta-analysis allows for a more objective appraisal of the data and can
also contribute to considerations about the consistency of the study
results."
About the IDET Procedure
Intradiscal ELECTROTHERMAL(TM) Therapy (IDET) is a minimally invasive
outpatient surgical procedure for patients suffering from chronic
disc-related lower back pain who have failed a program of aggressive
non-operative therapy. During the procedure, controlled levels of thermal
heat are applied directly to the affected disc. The heat contracts and
thickens the collagen fibers within the disc wall, cauterizing the tiny
nerve endings that cause the pain and potentially closing the cracks and
tears.
The IDET procedure can be performed in less than one hour, is safe and
has a low incidence of complications. Since 1998, over 60 peer-reviewed
articles have been published on the IDET procedure supporting the
procedure's efficacy and safety.
For more information about the IDET procedure, please visit
IDETprocedure.
About Smith & Nephew
Smith & Nephew (NYSE: SNN, LSE: SN) (smith-nephew) is a
global medical technology business, specializing in Endoscopy, Orthopaedic
Reconstruction, Orthopaedic Trauma and Clinical Therapies, and Advanced
Wound Management products. Smith & Nephew is a global leader in arthroscopy
and advanced wound management and is one of the leading global orthopaedics
companies.
Smith & Nephew is dedicated to helping improve people's lives. The
company prides itself on the strength of its relationships with its surgeon
and professional healthcare customers, with whom its name is synonymous
with the highest standards of performance, innovation and trust. The
company has more than 8,500 employees and operates in 33 countries around
the world and generated sales of nearly $2.6 billion.
Forward Looking Statements
This press release contains certain "forward-looking statements" within
the meaning of the US Private Securities Litigation Reform Act of 1995. In
particular, statements regarding expected revenue growth and operating
margins discussed under "Outlook" are forward-looking statements as are
discussions of our product pipeline. These statements, as well as the
phrases "aim", "plan", "intend", "anticipate", "well-placed", "believe",
"estimate", "expect", "target", "consider" and similar expressions, are
generally intended to identify forward-looking statements. Such
forward-looking statements involve known and unknown risks, uncertainties
and other important factors (including, but not limited to, the outcome of
litigation, claims and regulatory approvals) that could cause the actual
results, performance or achievements of Smith & Nephew, or industry
results, to differ materially from any future results, performance or
achievements expressed or implied by such forward-looking statements.
Please refer to the documents that Smith & Nephew has filed with the U.S.
Securities and Exchange Commission under the U.S. Securities Exchange Act
of 1934, as amended, including Smith & Nephew's most recent annual report
on Form 20F, for a discussion of certain of these factors.
All forward-looking statements in this press release are based on
information available to Smith & Nephew as of the date hereof. All written
or oral forward-looking statements attributable to Smith & Nephew or any
person acting on behalf of Smith & Nephew are expressly qualified in their
entirety by the foregoing. Smith & Nephew does not undertake any obligation
to update or revise any forward-looking statement contained herein to
reflect any change in Smith & Nephew's expectation with regard thereto or
any change in events, conditions or circumstances on which any such
statement is based.
Smith & Nephew
smith-nephew
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