New Study on TENS therapy
A recent update to guidelines by the American Academy of Neurology based upon a study by the University of Kansas Medical Center suggested that a commonly used treatment modality, TENS, was not effective in the treatment of chronic low back pain.
TENS therapy has been in wide use for over 40 years, and many patients have reported benefit from it. The study implied that there was no clear benefit, but that the clinician should use their judgement to determine if it should be used on a particular patient.
Now, I do not use TENS in my office- however, pretty much all of the physical therapists I refer to do, and the patients I have spoken with frequently see benefit from the treatment. So what are we supposed to make of this study? Well, first of all- pain is a subjective issue. Unfortunately, there is really no way to objectively quantify pain. If a patient is telling me they are getting relief from a treatment that has no down side, I am ok with continuing it. The issue for you is going to be coverage. Up until now, it has been reasonably easy to obtain a TENS unit if you had a complaint of back pain. WIth these new guidelines, it will be harder to get a home unit, and I suspect physical therapist will cease to get paid when they perform it in the office. It will be interesting to see how this pans out.
A Quick Thought on Sneakers
A patient came in last week with complaints of low back pain which occurred when they were jogging. Now, there are lots of potential causes for back pain with exercise activities, but this patient’s pain developed over the course of several weeks without a change in their exercise regimen, and no injury or trauma.
As I went through his history, complaints, and physical exam- I eventually got to the topic of footwear. Was he wearing shoes appropriate to his sport? Yes. How old were his shoes? About 18 months….
Since he was running indoors on a treadmill, his shoes looked pretty much new- so he never thought to replace them.
Current shoe technology can do much to absorb the shock of sports activity- however, like all things, they can eventually wear out. Quality footwear, with good supportive arches, and shock absorption will prevent the impact of exercise from being transmitted up through your body and into your spine. If you work out regularly, it is probably a good idea to replace your sneaker every 6 months or so.
Feedback on Donna’s Piece Last Week
Thank you so much for your very kind thoughts on my wife Donna’s contribution last week- I forwarded all of your comments to her. She is already working on her next contribution. I cannot wait so see what she posts!
We are getting ready for more snow here in Philadelphia. Stay warm, and as always, be well.
-Andy
Philadelphia Flower Show- Every February, reminding us that the winter will end, eventually…
