Back pain is very common. In fact, it has been estimated that up to 80% of people will suffer from back pain in their lifetime. It is easy to search for that stat on the web but finding a solution for back pain has proven much more difficult.
For a long time, rest was the "treatment" of choice. In many cases, bed rest. In recent years, experts have prescribed a more active approach.
Physical therapy and specific therapeutic exercises came to the forefront of many back pain treatments. Now, results from new research are hinting at a different approach, an approach where both (rest and exercise) are right… and wrong.
Here's what this is all about: A study published February 29, 2012 in BMC Medicine compared rest vs. active treatment with low back patients with modic changes (MC). Modic changes have been described as early disk degenerative changes only seen on an MRI.
Results: In total, 100 patients were included in the study. Data was available on 87 patients at 10 weeks and 96 patients at one-year follow-up and used in the intention-to-treat analysis.
Conclusions: No statistically significant differences were found between the two treatment approaches (rest vs. active treatment) in patients with persistent LBP and modic changes.
What does all this mean? According to the study's lead author, Rikke K. Jensen, MSc, "The results do not suggest that patients with MCs should not exercise... But I think clinicians should be careful; when patients come back and say this treatment didn't work, it's not because they did it the wrong way or they didn't do it enough. It's very possible that this treatment is just not very effective for this group of patients."
In other words – THERE IS NO ONE APPROACH THAT WORKS BEST FOR ALL PATIENTS WITH LOW BACK PAIN.
It is estimated that 40% of low back pain sufferers have modic changes. This means exercise may not be the best treatment protocol for 4 out of 10 sufferers.
The cause of modic changes is unknown. Jensen said, "We know that they are part of the degeneration process but we still don't know what causes them."
It is theorized they may be caused by mechanical stress. Mechanical stress can cause excessive loading, micro fractures and inflammation of the vertebral endplate and bone marrow.
"When you're jumping up and down on micro fractures, they tend not to get better," said Jensen. "It was important for us to test the hypothesis that people don't improve with exercise if they have these MCs, and there are other treatment options that could prove to be more effective."
Here's something interesting: One Chiropractic theory is that malfunctioning spinal joints cause abnormal mechanical stress. Over time, this can cause degenerative changes.
So, is it possible that exercising on a spine with malfunctioning joints is doing more harm than good?
Some Chiropractors have theorized that these spinal malfunctions should be corrected BEFORE an exercise program is started.
More research needs to be done but it seems like there is no one answer when it comes to helping back pain sufferers. Every case is individual and no one way is the ultimate solution.
Is the best way to treat back pain to first correct the mechanical malfunctions of the spine and then use exercise to regain strength and flexibility?
This and other questions still need to be answered. Up-to-date doctors will see each case of low back pain as individual and devise a unique treatment plan. They will also know when to adjust the treatment plan if it is not working.
Drug To Joint Failure
Pharmaceutical company Pfizer thought they had a great new painkiller. As it turns out, The Food and Drug Administration (FDA) says there is a clear association between the nerve-blocking medication and incidences of joint failure that led the agency to halt studies.
According to USA Today, "Problems with the [drug] began to emerge in the summer of 2010. Beginning in June, Pfizer halted studies of its experimental injection tanezumab in patients with osteoarthritis, low back pain and diabetic nerve pain. The action was requested by the Food and Drug Administration, after researchers reported that osteoarthritis actually worsened in some patients, causing joint failure in some cases."
TV doctor gets "schooled" about Chiropractors.
Chiropractic has been through a lot. Its founder, Daniel D. Palmer, was put in jail for practicing medicine without a license. Many other Chiropractors were jailed for the same offense.
Times have changed. Chiropractic has been licensed in every state for many decades and is accepted by mainstream medicine. In fact, chiropractors and medical doctors work together every day in clinics around the world.
But, some ignorance still exists, such as this example taken from an ABCNews4 story:
It's Wellness Wednesday and that means our very own back expert, Dr. Ellen Rhame of the Southeastern Spine Institute, stopped by to answer today's viewer question.
Anita from West Ashley wrote in, "I have chronic back pain. Should I be seen at Southeastern Spine prior to getting regular adjustments from a chiropractor?"
Dr. Ellen says there is nothing wrong with chiropractors. The only issue is she wants to make sure that people are getting evaluated properly before they look for alternate means of medicine. At the Institute, they can show you what's wrong with your back and give you some ideas on what your next steps should be. Dr. Ellen says that she is just concerned that some people will go without being treated properly and do more harm than good.
Here is a comment posted by a reader on the program's website: "Dr. Ellen is not well-versed about chiropractic physicians. By law, they are required to be able to differentially diagnose conditions that could mask as back pain. For example, chiropractors must take multiple tests at the state and federal levels to show proficiency in the ability to diagnose neurological, urinary, gynecological, intestinal, hormonal, cardiovascular, pediatric and other non-musculoskeletal conditions. You can be confident your chiropractic physician has the training to send you to the proper medical provider if your back pain is caused from some other condition."
And don’t forget, if you ever have any questions or concerns about your health talk to us. Contact us with your questions. We’re here to help and don’t enjoy anything more than participating in providing you natural pain relief.
