Posts Tagged ‘study’

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.

Sitting will KILL YOU!

Thursday, January 21st, 2010

So, perhaps that is a slight exaggeration- but I am always so happy when a study comes out that confirms what my clinical experience has been telling me all along.

If you’ve ever seen or read an interview with me, I am pretty much always asked what I think are the major causes of back pain- and I always cite our propensity to sit too much as a major cause.

From an evolutionary standpoint, we simply were not designed to sit as much as we do. We are hunter-gatherers! We should be out doing rather than sitting. In fact, the lumbar flexion caused by sitting places high degrees of stress on the area of your vertebral discs most likely to herniate.

I’ve been saying this for years- and now a study in The British Journal of Sports Medicine which basically confirms it.

The study essentially states that sitting too long will cause a whole host of health problems, but did not elaborate on how much sitting constituted too much. According to the study, figures from a 2004 survey suggested that Americans spend more than half of their time sitting- between home, their commute, work, and back again- and that this sitting had detrimental effects on ones well being.

The take home point is this: GET OFF OF YOUR BUTT!!!!

Speaking of sitting too much…

That’s how I got into the situation which precipitated the Back Together Fitness Challenge.

Since the initial posting where I invited viewers to follow along with me as I get myself back into shape- I have received several stories from people who want to participate in the challenge. I will share some of the stories with you as they come in.

An interesting development is that there have been several companies that have stepped in to sweeten the pot for the person selected as a winner. Originally, I was going to give the winner a Back Together package including Books, DVDs, etc… Some of these companies have offered to contribute some additional prizes. I will work out which ones make sense, and will keep you updated.

Best,

Andy

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Midnight in the City That Never Sleeps…

Smoking and Back Pain, Eagles Disappointment

Monday, January 11th, 2010

Smoking and back pain:

As if I needed yet another reason to convince my patients to quit smoking- a new Finnish study finds a link between smoking and back pain. The study does not suggest that smoking causes back pain, but that it potentially exacerbates already existing pain. The study suggests that the pain-augmenting effect may have to do with decreasing the blood supply to the spine. It is also likely that there are some analogous functions shared by pain receptors in your nervous system and those receptors which respond to nicotine.

Long and short of it- if you have back pain, and you smoke, now you have more reasons than ever to quit.

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Philadelphia Eagles: When you cut the heart out of your team, you are left with a heartless team….

Saturday saw the Philadelphia Eagles’ painful loss to their arch-division-rivals, the Dallas Cowboys. Now it would be reasonable to think that the Eagles could lose 1 or 2 games to the Cowboys, but until now- 3 would have been unthinkable.

I have already elaborated on my thoughts on how the team did this to themselves. You can have a team full of competent players, but in the absence of locker room leadership, no amount of raw talent is likely to help. Sorry to harp on this, but allowing Brian Dawkins to finish his career in Denver was the leadership equivalent of cutting out your own heart. THEN to make matters worse, bringing in dog lover Michael Vick injected a hearty helping of bad Karma into the mix. Perhaps he can help secure a trade for a draft pick for a quarterback replacement for #5- but who’s really out there worthy of cultivation? Now we can look forward the team management rewarding quality play with allowing players to leave. Leonard Weaver was something the Eagles have needed for a long time- and he proved his worth again and again this season. I wonder who he will be playing for next season?

The Eagles management makes it so hard to be a fan…

As always, best to you and yours,

-Andy

Eagles Training Camp- Lehigh University, Lehigh Pennsylvania

Eagles Training Camp- Lehigh University, Lehigh Pennsylvania