Archive for the ‘Studies & Research’ Category

Sharp Rise in Complex Back Surgeries.

Monday, April 26th, 2010

A new study on back surgeries has shown that there has been a significant increase in spinal surgeries between the years of 2002 and 2007. In this study, conducted by physicians at the Oregon Health and Science University in Portland and published in the Journal of the American Medical Association showed that the increase went from 1.3 to 19.9 surgeries per 100,00 medicare patients. Complex surgeries were defined as procedures in which 3 or more vertebrae were fused.

Now they didn’t draw any conclusions from this study, but certainly there are a couple of things we need to consider here.

As spinal surgery is the last option for most patients, what conservative options did they try before surgery? The statistical outcomes for these types of surgeries are still not that great- so surgeons typically don’t perform them unless there is a very good reason.

Are there lifestyle factors which increase the likelihood that we are damaging our spines to the point that surgery is necessary? Does the fact that Americans seem to be less active contribute to this? Is their a correlation to the rate of obesity?

These questions will probably be addressed in another study, but it would be hard to imagine that lifestyle and preventive considerations would not have affected these increases in a significant way. As I said, spinal surgery is a last option for most patients, and I know that there are things we can all do to decrease the likelihood that we will get to that point.

Thanks for tuning in.

-Andy

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Study: Cognitive Behavioral Therapy & Back Pain

Tuesday, April 13th, 2010

A study out of the University of Warwick, published in the Lancet suggests that cognitive therapy may be a useful tool for combatting back pain.

For those unfamiliar with cognitive therapy, here is a description from the Encyclopedia of Mental Disorders:

Cognitive therapy is a psychosocial (both psychological and social) therapy that assumes that faulty thought patterns (called cognitive patterns) cause maladaptive behavior and emotional responses. The treatment focuses on changing thoughts in order to solve psychological and personality problems.

In this study, focused around 701 patients pulled from family practices, people with ongoing back pain were given cognitive therapy in the form of ‘Back Skills Training,’ Those who had the therapy were then compared to those who had not, utilizing a subjective measure of pain pain known as the Roland Morris scale.

Those patients who participated in the cognitive therapy group had significantly less pain than those who did not. The bigger issue, as with any lifestyle modification, is compliance. The study found that only 63 percent of those patients inserted into the therapy group were compliant with the therapy.

Again, I can’t stress strongly enough, the link between mind and body. How you perceive and experience pain is every bit as important as the physiological issues which caused it in the first place. If you are someone who has been  dealing with back or neck pain for a long time, you already know the psychological burden it can be. Perhaps this additional modality could be a benefit to you.

If you have had cognitive therapy for your back pain, or another psychological modality, please share your experience here on BackWords. I look forwards to hearing from you.

Be well!

-Andy

Bringing a partner into the healing cycle can have significant benefit to a person in pain.

Bringing a partner into the healing cycle can have significant benefit to a person in pain.

Genetic Link to Pain Tolerance- Why does your back hurt more than theirs??

Monday, March 22nd, 2010

If you have been dealing with back pain, have you ever spoken with someone who has a similar condition? If you have met with people with similar spinal issues, you may have noticed that many people experience pain in different ways, and that different folks have different pain tolerances.

An article in the Proceedings of the National Academy of Sciences describes a gene which has been identified as SCN9A which plays a role in how you tolerate pain. Researchers found this gene was ‘underrepresented’ in patients suffering from rare conditions where patients don’t sense pain, and that it was over active in patients who had hypersensitivity to pain.

Now this news is probably not real comfort to you if you are hurting at this very moment. But clearly, there need to be other factors which can influence how you experience pain, otherwise you wouldn’t have ‘good days’ and ‘bad days.’

Here are just a few thoughts on getting more ‘better days.’…

-If you stick around this blog long enough, you will know what a big role I feel psychology has in how you feel. More and more studies cite the importance of the mind-body connection. Knowing this, take a few minutes out of each day to improve your psychology- this can come from meditation, a hobby, reading- doesn’t matter what- JUST DO IT!

-Regular exercise will keep your body ‘lubricated’ and as close to peak as possible. Take a few moments out of your day to work on your fitness.

-Maximize the quality of your sleep. Good sleep gives your body a chance to recharge and recuperate- both physically and mentally.

-Give yourself time for good social interactions- both with your partner/spouse and with friends. These interactions help solidify your feelings of worth and participation in community- key positive emotions.

These are just a sampling of the things you can do. Check back here often for more tips, and if you have specific questions or comments about your personal situation send ‘em in- as always, your contributions are what keep this place interesting!

Be well!

-Andy

My father & I with the late, great Oscar Peterson- the greatest jazz pianist ever.

My father & I with the late, great Oscar Peterson- the greatest jazz pianist ever.

Updates: Football injuries, back pain & pregnancy study & more…

Tuesday, February 2nd, 2010

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Good Morning!

Another way too cold day here in Philadelphia- I am literally counting the days until Spring. Yesterday I received a stack of movie reviews of Avatar, both from people who thought it was the best movie ever made, and those who really hated it. As I said in the last post- I really enjoyed it a lot. What I hope is that James Cameron doesn’t try to make a sequel.

Today’s video:

This weeks video update includes a thank you for your comments on my daughter’s first blog post, a note on the Time magazine cover story regarding football injuries, a comment about a study regarding manual medicine for the treatment of pregnancy related back pain, and an update on the fitness challenge. Bear with me while I try to find the best way to ‘banner’ Back Together for the other sources displaying my videos.

Best, and be well,

-Andy

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New study on integrated movement, follow up on the comfortable sex piece from yesterday, and a brief note about Back Together…

Wednesday, January 27th, 2010

Study on Integrated Movement from University of Gothenburg, Sweden:

A new study from the university discussed the concept of integrated movement- a process where patients are encouraged to have more body awareness in an effort to reduce their pain. I touched upon this concept in my book, Back Together, in the chapter discussing the learned neurologic response.

It is widely known that injured patients will subconsciously limit their range of motion on certain movements following an injury in an effort to find less painful ways to accomplish various tasks and activities. Unfortunately, these self imposed modifications become learned, and the altered body mechanics remain even after the injury has resolved. This can lead to further problems down the road because of irregular wear & tear on joints, as well as a higher likelihood of being re-injured.

This study focused on the use of Sensory Motor Learning, which is an extension of the concepts of the Feldenkrais Method (A widely utilized modality which encourages body awareness, and focuses on postural stability.) Basically, they found that patients who focused on these body skills had better control over their back pain and improved their mechanics.

Again, I love it when a study reinforces what I see clinically. When I have patients recovering from back or neck injury, I often have them address the learned neurological response as part of their recovery. Basically, if a patient has pain performing a specific movement, I will ask them to look at their daily activities and try to identify and analogous, or mechanically similar movement which does not cause them pain. I will encourage them to take time from their day to do repetitions of the non-pain inducing movements followed by a few repetitions of the pain inducing movement- paying attention to the mechanical similarities and differences between them. Over the course of days or sometimes weeks, they will gradually shift the balance towards the movement which was originally causing them pain- but with progressively less discomfort, undoing the altered, damaged body mechanics established following their injury.

Follow up on the sex furniture piece from yesterday…

Thank you so much for all of the great feedback on yesterday’s piece on products to help  find comfortable positions for sexual activity. As happened with the previous post on this topic, I received several emails where people shared their successes and failures in this regard. Some folks were very grateful for the information, and were also glad to find that they were not alone with this difficulty. As I suspected, this is a really neglected issue for back pain sufferers.

A quick note about Back Together:

I created Back Together in an effort to provide a useful resource for people and their partners or spouses whose lives have been adversely affected by back pain. I hope to help as many people as I can to rid their lives of back pain. You may have noticed that I go to great lengths to use egalitarian language wherever possible, and I do this to underscore that back together is here for EVERYONE. In the past month I have received about ten emails from individuals asking me to refrain from using the word ‘partner’ in addition to spouse. Again, Back Together is for EVERYONE- And I want to be very clear that I do not and will not discriminate against anyone based on race, religion, sexual orientation, age- or anything else for that matter.

My wish is to slowly develop a community of people who are finding ways to lead pain-free lives- and that everyone is included and welcome, so you really don’t need to send me any more of these emails. Thanks.

Coming up:

-A new ‘One Thing’ segment with Pilates instructor, Amanda Mitchell.

-Some thoughts on preventing back injuries relating to falls.

-Reviews of two new studies regarding back pain and medications.

-As always, new Tips o’ the Day.

- And a whole lot more.

Thanks for visiting. Be well!

-Andy

Cynwyd Elementary participating in Treats for Troops- sending care packages to U.S. troops stationed in Afghanistan.

Cynwyd Elementary participating in Treats for Troops- sending care packages to U.S. troops stationed in Afghanistan.