Did you miss me?

It’s been a while since I last posted on my blog, as I’ve had other projects on the go this summer. Over this time I’ve been pondering, as I usually do, why pain management/rehabilitation has so many problems. Conceptually, I can understand that pain is a complex experience that we’re a long way from understanding. I get that it’s a philosophically challenging subject. That because it’s subjective (like love, disgust, fatigue or hunger) it’s difficult to examine dispassionately. I also get that it’s big business. Pain is one aspect of being human that captures the entrepreneur’s imagination. People don’t like pain (on the whole), and even those who seek pain (I’m not thinking fetishes – just sports people!) aren’t inclined to want it to hang around. There’s a ready market for anything that helps “get rid of” pain – even though it’s impossible to fully “get rid of” pain without simultaneously creating other problems! Some of us clinicians focus almost exclusively on finding a presumed cause. The search can go on for weeks, months, years. Professionals will use tests, investigations, even treatments to see whether they’re on the right track to find what’s initiating the experience. And clinicians can believe, because a treatment was followed by a reduction in pain, that they’ve found it! Happy customer, happy therapist. Huge argum...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Low back pain Pain conditions Professional topics Science in practice Source Type: blogs

Related Links:

Abstract INTRODUCTION: The treatment of chronic low back pain (cLBP) often involves multimodal pharmacologic and non-pharmacologic strategies. There remain shortcomings with these tools with regards to both effect size and side effects. AREAS COVERED: In an effort to better address cLBP, anti-nerve growth factor (NGF) monoclonal antibodies (mAbs) are nearing marketing approval. This class of medications has been primarily evaluated for osteoarthritis, but are being examined at higher doses for use in cLBP. We review the efficacy of this class in treating LBP as well as their potential side effects based on ni...
Source: Pharmacological Reviews - Category: Drugs & Pharmacology Authors: Tags: Expert Rev Clin Pharmacol Source Type: research
CONCLUSIONS: This updated Cochrane Review included 32 trials to evaluate the efficacy of NSAIDs in people with acute LBP. The quality of the evidence ranged from high to very low, thus further research is (very) likely to have an important impact on our confidence in the estimates of effect, and may change the estimates. NSAIDs seemed slightly more effective than placebo for short-term pain reduction (moderate certainty), disability (high certainty), and global improvement (low certainty), but the magnitude of the effects is small and probably not clinically relevant. There was no clear difference in short-term pain reduct...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
gze N, Bereczki D Abstract Inflammation contributes to the pathogenesis of low back pain and sciatica. Growing evidence suggests that elevated levels of some inflammatory biomarkers are associated with these conditions. Much of the research evaluating the association between pro- and anti-inflammatory cytokines, chemokines, other regulatory molecules, and low back pain and sciatica, focused on patients with chronic low back pain, while fewer studies addressed the issue of detectable biomarkers in the acute phase. Previous studies suggest that pro-inflammatory cytokines such as TNF-α, IL-6, and IL-8 and anti-...
Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
Patients with radicular low back pain (radicular LBP, sciatica) frequently describe their pain as “shooting” or “radiating.” The dictionary meaning of these words implies rapid movement, and indeed, many sufferers report feeling pain moving rapidly from the lower back or buttock into the leg. But, others do not. Moreover, the sensation of movement is paradoxical; it is neither predicted nor accounted for by current ideas about the pathophysiology of radicular LBP. We have used a structured questionnaire to evaluate the sensory qualities associated with “shooting” and “radiating&rdq...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Several interactive pelvic axes occur during activities of weight-bearing and ambulation. Flexion and extension of the symmetrical innominates occur on the sacral x-axis with weight-bearing. Normal asymmetric innominate rotation occurs on the innominate axis at the pubic symphysis during weight-bearing with normal ambulation. Oblique sacral movement occurs on an oblique sacral axis concurrent with asymmetric innominate movement. Acute and chronic low back pain is commonly caused by a bilateral symmetrical or oblique anterior innominate rotation on the sacrum on an acetabular axis, usually while lifting, bending, lowering, ...
Source: Topics in Geriatric Rehabilitation - Category: Geriatrics Tags: Thieves' Market Source Type: research
Conclusions: The present study evaluated the anti-inflammatory and regenerative efficiencies of Nar and NG in degenerated human NP cells. Altered gene expressions of cytokines, metalloproteases, extracellular proteins, apoptotic genes were dose responsive. The molecular docking (in silico) studies showed effective binding of these native ligands (Nar and NG) with genes identified as potent inhibitors of inflammation. Thus, these natural flavonoids could serve as anti-inflammatory agents in the treatment of low back pain and sciatica. PMID: 31575107 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Study Design. Prospective research in middle-aged and elderly people. Objective. To investigate low back pain (LBP) and neuropathic pain (NeP); spinal alignment and range of motion (ROM); spinal degenerative changes in plain radiography; osteoporosis; muscle strength; and physical ability as possible risk factors for poor quality of life (QOL). Summary of Background Data. The aging of society has led to an increase in elderly people with chronic pain, including LBP and NeP. However, there has been no analysis of NeP and spinal sagittal alignment as potential risk factors for decreased QOL in the healthy general pop...
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
ConclusionsThis incidence of SD sustained by Granulicatella adiances could be underestimated due to their particular microbiological conditions requested for their cultures. However, this infection should be suspected in cases of culture-negative SD, especially when associated with endocarditis.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
This is a long…… readooops, sorry, not. Low back pain is, we know, the greatest contributor to days lived with disability (Rice, Smith &Blyth, 2016). And no-one anywhere in the world has found a good mix of services to reduce the number of days lived with disability as a result of this problem. And yet billions of dollars are used to fund research into the many contributors to a shift from acute low back pain to ongoing disability associated with low back pain. At the same time, treatments that directly target disability, rather than pain (a target considered the most important outcome by Sullivan a...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Low back pain Pain conditions Research Science in practice health funding health systems models of care Source Type: blogs
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; &AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regio...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
More News: Anesthesiology | Back Pain | Blogging | Cardiology | Chronic Pain | Databases & Libraries | General Practices | Heart | Low Back Pain | Pain | Pain Management | Primary Care | Rehabilitation | Sciatica | Science | Sports Medicine | UK Health