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Tag: back pain

  • 6 Ways to Improve Your Back Pain

    6 Ways to Improve Your Back Pain

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    When Deanne Bhamgara took a tumble off her electric scooter on a pier in San Diego, she didn’t make much of it at first. The fall left her sore, but she felt only little pain.

    But over the next several days, she slowly began to hurt more and more.

    “What started as a tingling sensation in my thighs had soon become sensitive to touch,” says Bhamgara, 28. The San Francisco resident later learned that the fall affected her lower back, tailbone, pelvic areas, and her hip joints. In a few days, Bhamgara’s pain had radiated to the rest of her back and to the thighs as well.

    Almost all Americans get back problems at one time or another. You might sleep awkwardly or wrench your back while lifting something heavy. Or, like Bhamgara, you might hurt your back in an accident. But often, says physical therapist Eric Robertson, DPT, the culprit is too much sitting and not enough moving.

    “We’re largely a sedentary society, and so that sedentary lifestyle is the primary thing that we have to work on,” says Robertson, who also is a spokesperson for the American Physical Therapy Association (APTA). “So any sort of movement exercise, walking, working with a physical therapist to give you an individualized customized program is a great idea.”

    When Bhamgara went to doctors, physical therapists, and chiropractors about what to expect with her recovery, they gave her conflicting opinions. It might take 6-12 weeks, she heard, or it could take a full year before she was back to normal.

    “I was mostly in bed after the pain started,” Bhamgara says. She had inflammation on her thighs right up to behind the knees, groin, butt, lower back, and sometimes in her shoulders.

    Confused and worried, Bhamgara tried a host of treatments to ease her pain. She went to physical therapy twice a week. She got trigger point massage and acupuncture, which she said helped.

    Bhamgara is now on the mend. She understands it’ll take time and effort to fully heal and to keep her inflammation in check.

    Robertson of the APTA says feeling better with back pain doesn’t have to be complicated. Here are some effective steps:

    Avoid bed rest. Studies show that lying down too much can slow recovery and raise the pain.

    “Over the last 25 years or so, probably the one thing we’ve learned definitively about back pain and bed rest is that is not OK,” says William Lauretti, DC, an associate professor at New York Chiropractic College and a spokesperson for the American Chiropractic Association. Instead, “you want to be as active as you can be with your back pain.”

    Move. You may not want to move when you’re in pain, but it’s important to do as much as you can handle.

    Robertson says most back pain isn’t serious, even if it may be very painful. “So not being afraid of motion and continuing to move despite the pain is something that’s really important,” he says. Walking is a good choice you can do on your own. You also can work with a physical therapist to learn how to spot dangerous levels of pain and which moves are best for you.

    Keep good posture. Pay attention to the way you hold your back when you sit, stand, walk, sleep, or do day-to-day activities. Good posture is when all the bones in your spine are correctly aligned. Poor posture can leave your back stiff and tense. This often to leads to back pain.

    Lauretti offers these tips on posture:

    • Don’t sit up in your bed hunched over your laptop. That’s a surefire recipe for back pain over time.

    • If you must sit for a long time, use cushioned chairs. Hard seats won’t support your back and may prevent you from sitting up straight.

    • Use a comfortable desk and chair if you need them while working.

    Here are some general tips to maintain good posture:

    • Keep your feet shoulder-width apart.

    • Tuck your stomach in when you’re standing.

    • If you’re standing for too long, regularly shift your weight from one foot to the other and from your toes to heels.

    • Roll your shoulders back.

    • Let your arms hang naturally on the sides of your body.

    Sleep smart. The ideal bed, Lauretti says, is one that’s “comfortable for you.” As for the best sleep posture, he says on your side or back is easier on your back than sleeping on your belly. If you’re face down, your head will be turned all night so you can breathe, which can lead to neck pain.

    Bhamgara says tucking a pillow between her legs to help align her hips lessens her back pain.

    Relax. Back pain can be linked to stress, tension, and other non-physical problems, Robertson says. Massages and acupuncture may help loosen muscles. Yoga, meditation, and other mindfulness practices may help lift your mood, stretch your muscles, and make you relax so you can better manage your back pain.

    Bhamgara says mediation made her feel alive, especially when her back pain made it painful to move freely.

    “I would think about healing every inch of my body,” she says. “There were times I would imagine myself walking in a park with my headphones on and just dancing! That brought me life.”

    Call your doctor. If your back pain doesn’t go away after 4 weeks or if you have long-term pain that lasts beyond 12 weeks and keeps you from carrying on with your daily activities, see your doctor. They can help pinpoint the cause of your pain and may suggest new therapies. Get medical attention right away if your legs tingle, feel numb, or weak.

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  • Nerve ‘Pulse’ Therapy May Help Ease Sciatica

    Nerve ‘Pulse’ Therapy May Help Ease Sciatica

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    By Dennis Thompson 

    HealthDay Reporter

    WEDNESDAY, March 29, 2023 (HealthDay News) — People suffering from sciatica gain lasting relief from a procedure that uses a fine needle to heat nerve roots near the spine, a new clinical trial shows.

    The minimally invasive procedure, called pulsed radiofrequency (RF), provided superior pain reduction and disability improvement out to one year for patients with sciatica, according to findings published March 28 in the journal Radiology.

    The procedure could help people with sciatica avoid or delay back surgery, said lead researcher Dr. Alessandro Napoli, an associate professor of radiology with the Policlinico Umberto I – Sapienza University of Rome in Italy.

    “Pulsed radiofrequency with this method can relieve pain in 10 minutes, with no surgery, no hospitalization, and faster recovery and return to daily activities. It is an important card to play,” Napoli said.

    People with sciatica have a sharp pain that shoots through their hips and buttocks and down one leg. The condition is typically caused by a herniated or slipped spinal disc that’s putting pressure on the sciatic nerve, the largest nerve on the body.

    The standard of care is a steroid injection aimed at calming the nerve down, said Dr. Jack Jennings, a professor of radiology and orthopedic surgery at the Washington University School of Medicine in St. Louis.

    “The steroids are basically to fool the nerve, to say nothing’s wrong,” said Jennings, who wrote an editorial accompanying the new study.

    The clinical trial added pulsed RF to the standard steroid injection to see if it would provide better, longer-lasting pain relief.

    In pulsed RF, doctors use CT scans to slide a fine needle precisely into the nerves that are causing sciatic pain.

    The needle is then heated using pulses of radio waves. The heat disrupts the nerve, preventing it from sending pain signals to the brain.

    “It is similar to a reset of an operating system,” Napoli said.

    The procedure takes about 10 minutes and is performed on an outpatient basis without general anesthesia, researchers said in background notes.

    Napoli said he thinks the two treatments, pulsed RF and steroids, work together, adding to the steroids’ anti-inflammatory activity and pulsed RF’s nerve signal disruption.

    About 350 people with sciatica were randomly assigned in the clinical trial to receive either steroids alone or steroids combined with pulsed RF. Everyone was followed for up to a year to see how well the treatments lasted.

    By the end of the year, 96% of the pulsed RF group had experienced an improvement in pain compared with 69% of those who only received steroids, results showed.

    About 68% of the pulsed RF group experienced complete pain relief, compared with 13% of the steroid group.

    On the other hand, twice as many people treated with steroids alone (25 versus 12) had intractable pain that required further treatment, up to and including surgery.

    The patients who received pulsed RF treatment also experienced less disability, researchers said.

    “To me, the most impressive part of this was the durability out to one year and the number of people that had complete response,” Jennings said of the results. “These numbers are very good in our world of pain.”

    The study replicates the results of a 2017 clinical trial that showed pulsed RF plus steroids could be used to treat pain caused by pinched nerves, said Dr. Jianguo Cheng, director of the Cleveland Clinic’s Multidisciplinary Pain Medicine Fellowship Program.

    “The results of the current study are strikingly consistent with what we reported,” Cheng said. “A significant strength of this study is that it has a much larger sample size and it is a multicenter study, providing stronger evidence supporting the combination therapy.”

    Pulsed RF is used more often in Europe than in the United States to treat sciatica, Jennings said, even though the procedure has been long approved by the U.S. Food and Drug Administration.

    Steroid injections can damage the body, and the effects wear off over time, Jennings noted.

    “They have a shelf life with the person. You can’t just inject them every three or four months for the rest of their life. They ultimately stop working. So to me, if you can increase the durability and get a year or more relief from [pulsed RF], that’s incredible,” Jennings said.

    “I hope this study does increase knowledge and broader adoption of the procedure, and I do think it will,” he added.

    Jennings hopes that a follow-up clinical trial will test pulsed RF alone against steroids, to see if the therapy would work on its own.

    More information

    The Cleveland Clinic has more about sciatica and radiofrequency therapy.

     

    SOURCES: Alessandro Napoli, MD, PhD, associate professor, radiology, Policlinico Umberto I – Sapienza University of Rome, Italy; Jack Jennings, MD, PhD, professor, radiology and orthopedic surgery, Washington University School of Medicine in St. Louis, Mallinckrodt Institute of Radiology; Jianguo Cheng, MD, PhD, director, Cleveland Clinic Multidisciplinary Pain Medicine Fellowship Program; Radiology, March 28, 2023

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  • Simple Solutions for Lower Back Pain Work Best

    Simple Solutions for Lower Back Pain Work Best

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    Feb. 3, 2023 – Good news for those of us with lower back pain: Muscle relaxants and common pain relievers provided relief from low back pain after a week of treatment, according to a new study of more than 3,000 people.

    Acute lower back pain is a common cause of disability worldwide, and often interferes with daily living. the study authors wrote. However, concerns about opioids have prompted more research into other options for pain management. 

    In an analysis published in the Journal of Orthopaedic Research, a team of investigators from Germany examined which non-opioid drugs are best for treating it.

    The researchers found 18 studies totaling 3,478 patients with acute low back pain that lasted less than 12 weeks. The average age of the patients across all the studies was 42.5 years, and 54% were women. The average length of symptoms before treatment was 15.1 days.

    Overall, muscle relaxants and common pain relievers, known as non-steroidal anti-inflammatory drugs – or NSAIDs — helped reduce pain and disability after about 1 week of use. 

    Ibuprofen, aspirin and naproxen are all NSAIDs.

    In addition, studies of a combination of these drugs and acetaminophen showed more improvement than NSAIDs alone, but acetaminophen alone had no significant impact on LBP. 

    Most patients with acute lower back pain recover on their own, so it is difficult to tell how effective the medications are, the researchers wrote 

    However, it is important that other therapies that don’t include medication, are tried first, the researchers said. 

    More research is needed to see if the drugs help prevent back from returning, they said. 

    Study Supports Opioid Alternatives

    The study highlights effective alternatives to opioids for back pain management, Suman Pal, specialist in hospital medicine at the University of New Mexico, says. 

    Pal says he was not surprised by the results. “The findings of the study mirror prior studies,” he says. “However, the lack of benefit of paracetamol (acetaminophen) alone needs to be highlighted as important to clinical practice.”  

    The main message from the study, says Pal, is that “patients with low back pain should talk to their doctors about the best approach to treatment. 

    During those conversations, patients should discuss their symptoms, previous medical conditions, and medications they are currently taking, Pal says. “These factors should guide the choice of pharmacological therapy, if needed.” 

    However, more research is needed to better identify which patients would get the  most benefit from NSAIDs and muscle relaxants to manage their pain since chronic NSAID use carries its own potential for side effects, Pal says. 

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