Posts Tagged ‘back injuries’
Wednesday, February 16th, 2011
If you visit clinician be it orthopedic surgeon or a neuro-surgeon and complain of back ache you are more than likely to be advised to have a MRI.
Low back pain is a very common condition. The Need for diagnostic imaging for patients with low back pain has often been exaggerated. ‘Evidence indicates that routine imaging is not associated with clinically meaningful benefits but can lead to harms’, reports Annals of Internal Medicine.
Usually diagnostic imaging in this condition should be indicated only if low back pain is associated with progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. This evidence-based recommendations from the American College of Physicians(ACP) and the American Pain Society (APS) appear to be grossly neglected. Routine imaging does not seem to improve clinical outcomes and exposes patients to unnecessary harms.
Overuse of imaging imposes severe financial burden on patients who already suffer lower productivity due to the menacing low back pain. Reducing unnecessary tests or ineffective treatments decrease the costs associated with low back pain. In addition to the direct costs imaging also causes additional expenses by leading to additional tests, follow-up, and referrals. It may also result in an invasive procedure of limited or questionable benefit.
The appropriateness of many of the low back imaging studies obtained in clinical practice has long been questioned. The ACP/APS low back pain guideline recommends selective imaging for patients in whom it is clinically indicated.
There are numerous factors that explain why routine imaging does not seem beneficial. Most lumbar imaging abnormalities are common in persons without low back pain and are only loosely associated with back symptoms. Although advanced imaging can detect more and smaller abnormalities, these abnormalities are not necessarily clinically relevant. This means a rapid MRI need not always be of greater practical value than radiography for evaluating low back pain.
Many abnormalities detected with advanced imaging are so common in asymptomatic persons that they could be viewed as normal signs of aging. The presence of imaging abnormalities need not mean that the abnormalities are responsible for symptoms.
Acute low back pain has a favorable natural history and the expected yield of routine imaging is low. Most patients show significant improvements in pain and function in the first 4 weeks; routine imaging is unlikely to improve on this. Imaging results rarely affect treatment plans. Thus they often have a low impact on clinical outcomes.
Routine imaging is associated with potential harms:
- Lumbar radiography and CT contribute to cumulative low-level radiation exposure. They may promote the development of cancer.
- The use of iodinated contrast in lumbar CT is associated with hypersensitivity reactions and nephropathy (disease associated with the kidneys).
- The average radiation exposure from lumbar radiography is 75 times higher than for chest radiography. This is particularly harmful to young woman because of the proximity to the gonads (sex glands). The amount of female gonadal irradiation from lumbar radiography is supposed to tantamount to having chest radiography daily for several years.
Most clinicians routinely order imaging for all cases of lower back pain even in the absence of a clear clinical indication though ACP/APS guideline suggests a trial of management without imaging in adults with no risk factors other than older age. The use of advanced imaging modalities like MRI and CT scans is skyrocketing. A large number of clinicians hastily jump to these modalities irrespective of any guidelines.
Patient expectations and preferences about diagnostic testing also add to the cause. They expect a clear diagnosis for their low back pain. Some attach a clinician’s decision to not obtain imaging with low-quality care. There are patients who think that their pain is not legitimate or important if the clinician doesn’t order for imaging. Wanting diagnostic testing is a frequent reason for repeated office visits for chronic back pain. There are ones who insist that they need imaging even after the physician explains that it would be unnecessary.
The potential solutions include:
- Clinicians should adhere to the ACP/APS recommendations on use of imaging so as to reduce overuse. Most patients do not need immediate imaging, and an initial trial of therapy before imaging is warranted in many cases.
- Advanced imaging should be reserved for serious situations, i.e. only when the results are sure to influence clinical decision making. Conditions like major trauma, severe neurologic compromise, or vertebral infection qualify for being imaged using an MRI or CT scanner. In the absence of strong risk factors for cancer and lack of neurologic signs, initial imaging with lumbar radiography and evaluation of erythrocyte sedimentation rate (ESR) is a reasonable approach.
- Patients should be educated about the pros and cons of imaging. Face-to-face information with patient hand outs, self-care education books, online materials, mass media educational campaigns help.
Source: ‘Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care from the American College of Physicians’: Annals of Internal Medicine.
Source-Medindi
by Dr. Nithin Jayan
Read more: Does Routine Imaging in Low Back Pain – Do More Harm Than Good? http://www.medindia.net/news/healthwatch/Does-Routine-Imaging-in-Low-Back-Pain-Do-More-Harm-Than-Good-80842-1.htm#ixzz1Dylv7n6r
Tags: back injuries, back pain, back surgery, healing, herniated disc, Imaging, Lower Back Pain, pain
Posted in Reposted from another source | No Comments »
Monday, December 13th, 2010
The following article is a repost from Newsmax.com. You can read the original post here.
There are many myths about back pain including:
Myth 1: The spine can be easily injured.
Fact: One of the most common back pain myths is that compared with the rest of the body, the spine – being extremely delicate – is more prone to injury and can be easily injured. The truth is, that the spine is not delicate, as the muscles, tendons, and ligaments that support and surround the spine render it a very well designed and sturdy structure that is both supportive and flexible.
Myth 2: Lower back pain increases with age and becomes debilitating.
Fact: One myth is that lower back pain at a younger age gradually gets worse as we grow older. Research suggests that, on average, lower back pain reaches its peak between the ages of 35 and 55. After the age of 55, back pain treatment may be required to treat the problem of disc degeneration that occurs as part of the aging process as a natural phenomenon. Spinal paralysis is not genetic and lower back pain is not among its symptoms. However, spinal tumors, spinal infections, and unstable spine fractures do increase the risk of spinal paralysis.
Myth 3: Causes of back pain are hereditary.
Fact: You cannot assume that your lower back pain is due to a genetic predisposition. Parents play absolutely no role in passing their lower back pain on to you.
Myth 4: Causes of back pain can only be discovered by expensive MRI scans.
Fact: High-end diagnostic tests like MRI are not the only way to diagnose the underlying causes of back pain. This is one of those back pain myths that have no scientific basis whatsoever. While a good physical examination and a thorough analysis of a person’s medical history usually suffice in understanding the causes of back pain, only a few specific cases need diagnostic tests. This usually happens when the patient does not respond to any appropriate common back pain treatments. While the results of an MRI scan may suggest certain spinal abnormalities, there is enough medical evidence to prove that people with no lower back pain can sometimes have more serious problems and abnormalities like a herniated disc or a degenerative disc as revealed by their MRI results. In addition, lower back pain cannot be assumed to be a good indicator of the severity of spinal damage.
Myth 5: Active people don’t need back pain treatment.
Fact: Athletes, sportspersons, and home makers who lead an active life assume that they will never need back pain treatment. While a good amount of physical activity provides quicker back pain relief if the body is well-conditioned, there is no hard and fast rule that states that active individuals are less prone to lower back pain compared to sedentary individuals. Irrespective of the level of activity, an individual may need back pain treatment. In fact, some sports such as golf, volleyball, and gymnastics can sometimes lead to back pain.
Tags: back injuries, back pain, herniated disc, Lower Back Pain, pain
Posted in Reposted from another source | 2 Comments »
Friday, October 29th, 2010
If you were to do a search online for the “SR 500” you would likely come up with some links to a Yamaha motorcycle. You would also find the SR 500 is the given product name for a certain type of back brace, however, the SR 500 is no normal brace. Normal braces—or braces that are “common” on the market—are constriction braces. This means exactly what the term implies…they constrict. They are designed to cinch tight around the abdomen to immobilize the area. The theory is less movement less pain.
This simple logic has been the “backbone” of back bracing theory for hundreds of years. Then in the mid 1980s a new kind of treatment started to take hold in America—spinal decompression. By the late 1990s decompression therapy had made significant advances in technology and popularity. It was about that time that a Korean Medical company asked the question: Why can’t there be a brace that produces some of the same effects as decompression therapy?
The result of that question led to the world’s first ever decompression brace. I’ll spare you the details of exactly how it evolved, but evolve it did to what is now known as the SR 500. So let’s take an inside-out look at the SR 500. What makes it unique? What makes it a “decompression” brace?
First of all, the SR 500 is not a constriction brace. It does not immobilize the spine. When properly adorned, it actually promotes healthy movement. This helps avoid muscle atrophy which is a known side effect of the constriction back brace.
What the SR 500 does is expand vertically. In order to obtain a decompression effect, the designers created unique air chambers or cells made of a rubber bladder-like material that, when filled with air, expand upward. As they expand they cause the overall profile of the belt to grow from just 4 inches in height to over 7 inches in vertical height. As it does it lodges up under the rib cage pushing upwards and down against the pelvic girdle pushing downwards. The result is an unloading of the lumbar spine as the weight-bearing forces are offset. As this occurs, something quite magical takes place inside the spine. Discs that have been “compressed” due to an injury (such as a herniated or bulging disc) or due to a long life of poor health and poor posture (results are disc degeneration) can now “decompress.” That means they can distract or facilitate back into their original space and shape. As they do they reabsorb any lost fluids and begin to heal.
The decompression effect achieved by the SR 500 is a scaled down version of the decompression achieved on a decompression table at a qualified chiropractor’s office. Decompression tables use computer guided micro movements to target and adjust specific discs for short periods of time while the patient is on the table. This pinpointed effect has produced thousands of positive results for chronic back pain sufferers. The SR 500 offers the chance to continue decompression into the home between visits or after the therapy ends. It serves as a perfect supplement to the table treatments and it has helped speed the recovery of many patients. It has even allowed many patients freedom from pain killers and the elimination of the possibility of spinal surgery.
Included with the SR 500 is a hand pump that has a built in pressure gauge to insure proper inflation, a owner’s manual and a laundry bag. The SR 500 is 100% machine washable. The brace also comes with a rigid front and rear panel for those individuals who need more spinal stability in the initial stages of healing.
The design behind the SR 500 is patent protected and is available by prescription only. Medicare and private insurance companies reimburse for the brace. Visit your doctor, chiropractor, physical therapist or other care provider to inquire about obtaining your own SR 500. You may want to visit www.spinalrehabsolutions.com first and print off some information to show your provider in case he/she is not familiar with this type of brace.
Tags: back brace, back injuries, back pain, back surgery, chiropractics, decompression, discs, distraction, Durable Medical Equipment, healing, herniated disc, Lower Back Pain, pain, spinal brace, spinal decompression, Spinal Rehab Solutions, spine, sr 500
Posted in Articles by Michael Harris | 10 Comments »
Thursday, October 14th, 2010
If only there were a study done regarding how effective back surgery is in relation to not having back surgery. I wonder what the results would be? Maybe some day someone will conduct such a study.
Well, that someday is today! In a very thought provoking article, MSNBC contributor Linda Carroll reports on just such a study. It is a great article that tells the story of a Scottsdale, AZ woman who has endured two back surgeries only to find her pain increasing.
The article also reports on what researchers found when they combed through over 1400 patients in the Ohio Bureau of Worker’s Comp database. The results regarding back pain sufferers who went under the knife vs. those who did not are nothing less that shocking!
Read the entire article here.
Tags: back brace, back injuries, back pain, back surgery, discs, DME, Durable Medical Equipment, HME, Home Medical Equipment, Lower Back Pain, MSNBC, pain, spinal brace, spinal decompression, spine, sr 500
Posted in Uncategorized | 1 Comment »
Friday, September 3rd, 2010
According to the American Chiropractic Association (ACA), 60 percent of children toting heavy backpacks to school had suffered from back pain; studies conducted in France have shown that the longer a child wears a backpack, the longer it takes for the spine to correct itself from a curvature or deformity; and Magnetic Resonance Imaging (MRI) conducted by researchers at the University of California, San Diego, concluded that the heavier the bags, the more there was compression of the discs in the spine and increased curvature of the lower spine in kids.
Kids’ schoolbags should not weigh more than 10 to 15 percent of their own weight (i.e. if a child weights 65 pounds, their backpack should weigh no more than 13 pounds). Concerned parents only need to see their children leaning in one direction, breathing heavily while lugging their backpacks, or holding their straps to ease achy shoulders to realize they are carrying too much weight. Here are some tips to get your kids’ minds off their backs and back into their studies:
Be Picky About Your Pack
Children naturally migrate toward backpacks that display their favorite television characters. Examine these carefully. The right carryall for their school supplies can be fun and safe. An appropriate-sized backpack will end just a few inches above the waist. Also look for a backpack that has soft, padded straps to maximize comfort and different compartments that help distribute the weight. Packs with waist straps are an added bonus.
Proper Pack Packing
Have your child sort through their backpack and leave any books home that aren’t needed. Place the heaviest items in first so they are closer to your child’s back and put less strain on those muscles. Encourage your child to stop at his or her locker frequently to drop off books that aren’t needed the rest of the day. If the choice is available, advise your child to select a paperback textbook over the heavier hardcovers
Read more: http://blogcritics.org/culture/article/back-to-school-backpacking/#ixzz0yVHwRTtI
Tags: back brace, back injuries, back pack, back pain, back to school, discs, herniated disc, Lower Back Pain, spinal decompression
Posted in Reposted from another source | 2 Comments »
Monday, August 30th, 2010
Give your back a break! Treat it with respect and it will support you your entire life. Ignore it; neglect it or even abuse it and you will become one of the 80 percent of Americans who suffer from severe to moderate chronic back pain.
Here are seven sins that can spell pain and suffering to back health if not avoided.
Sin 1-Lifting with your back
The muscles in your legs work synergistically to be the most powerful group in your body. Your back muscles on the other hand are spread out and work more independently responding to which way you need to twist or bend. Therefore, when it comes to lifting heavy objects, you are much more likely to isolate, strain and pull a back muscle than you are a leg muscle. Plus, your spine consists of many individual bones (vertebrae) that house and protect nerves that are connected by many delicate micro tendons, tissues and muscle. Your legs on the other hand have three main, large bones supported by large muscles. Logically thinking, the legs are where it’s at when you need to lift.
Sin 2-Poor Posture
Slouching: Yes, it is a sin. Your mom knew what she was talking about all those years. Over time it and other poor posture positions wear the ligaments down, squish the discs into degenerative oblivion and can even cause the vertebrae to rub, grow spurs and fall out of alignment.
Sin 3-Wreckless Abandon
While we are young many of us feel indestructible and we engage in risky activities that can lead to back injury. For example, my brother once got a little too big for his britches while jumping his dirt bike at our local sand dunes. Too much speed led to too much height which led to landing too hard which led to a broken back. Luckily no damage occurred to his spinal column, but now that he is older the location of his breaks are turning into sources of pain, and the prognosis is for it to worsen. Moral of the story: We all get old and injuries incurred when we were young though careless actions can come back with a haunting vengeance.
Sin 4-Poor Health
We’ve all seen the guy with a belly so large he has to lean way back to maintain a center of balance. The strain such a posture puts on the spine is one thing, the wearing effects of the excess weight is another. Additionally such a person is likely not in the habit of keeping his core muscles in shape. They are your abdominal muscles and all the back muscles surrounding your spine. If kept strong they minimize the deteriorating effects gravity can have on your discs and vertebrae. When weak you run a significant risk of degenerative disc disease and a drove of other malicious ailments. Add the burden of excess weight or obesity and you are sure to be hurting as early as your mid 30s, depending on factors such as genetics and the previously-mentioned sins.
Sin 5-Genetics
It may not be fair to call genetics a sin…but just as inheriting a predisposition for cancer or heart problems, genetics can dictate your back’s susceptibility to such things as arthritis and other diseases. Sin or not, genetics can play a very significant role.
Sin 6-Injury
Accidents happen. Whether you slip on some ice; lose your footing on your stairs; get in an automobile accident or land wrong when skydiving; one accident can cause a lifetime of pain. It doesn’t matter if you are the cause of the accident or a victim, the sentence is the same…damage to key locations of your back.
Sin 7-Disregard
Should you have the misfortune of sustaining a back injury or if you are hurting as a result of one of sins 1-5 you are likely going to end up talking with a doctor, a chiropractor, a physical therapist or some other practitioner as you seek relief from the pain. And you are likely to hear all sorts of advice. The worst thing you can do is permanently ignore what you hear. However, some of the advice may be conflicting so it is important that you do your own research…and of course opt for the less evasive therapies before agreeing to back surgery. And if your doctor asks you to take it easy, wear a back brace or do some specific core-strengthening exercises, follow his suggestions! For to disregard them would be…a sin.
Tags: back brace, back injuries, back pain, back surgery, Lower Back Pain, spine, sr 500
Posted in Articles by Michael Harris | 4 Comments »
Wednesday, August 25th, 2010
If you are one of the millions of Americans suffering from disc-related back pain it is important for you to understand the difference between the three major types of disc dysfunction and how to treat them.
A disc can suffer damage from an isolated incident such as a fall or a car accident, or it can gradually weaken with age. Either way, the result is most likely severe pain.
This is because discs are in such close proximity to a slew of delicate nerves. One slip, bulge, break or squeeze from the adjacent disc and you can experience pain that will stop you in your tracks, most likely in the form of sciatica pain (the nerve that goes through your buttocks and down your legs).
Here’s a summary of everything you ever needed to know about your discs but never knew you needed to ask:
- A healthy disc has a fibrous outer shell with a jelly-like, squishy substance in the middle called the nucleus. It is that center substance that gives the disc its shock absorbing traits and keeps the vertebrae from rubbing against each other.
- A bulging disc is when, most likely through an injury, the disc is over compacted (squished) between the two vertebrae it protects, forcing the nucleus to push against the fibrous shell with such force that it actually bulges the wall of the shell.
- A herniated disc is when the nucleus actually penetrates the fibrous wall spilling out into the inter-vertebra cavity. This is also called a ruptured disc.
- Disc degeneration is not necessarily caused by injury although an earlier injury may be the partial cause. Degeneration is a much slower onset and is due to age, poor health and poor posture. All these combined gradually wear the disc down. The disc loses its height and elasticity. As it loses height it begins to allow the vertebra to touch and rub. This in itself can be painful and will likely result in osteophyte formations (bone spurs on the outer rim of the vertebrae). Signs of early disc degeneration are referred to as disc thinning.
No matter your disc ailment, believe it or not there is something you can do. Discs can heal if given the opportunity. That opportunity is in the form of added space. All of the above ailments are caused by either a onetime violent squeeze on the disc or a life time of squeezing from gravitational effects. Either way the disc’s natural residing area was compromised forcing it to flatten. With no room to spare in the inter-vertebral disc space, the disc, or parts of it, is forced out. Or in the case of degeneration, cell by cell, over time the disc dissipates.
Give the disc back its original space and the disc will reassume its original shape…and heal! Well, most likely. Extremity of the injury or the advancement of the degeneration may be deterring factors…as will age and patient’s overall health.
How do you give a disc more space? Depends on who you ask. A spinal surgeon is likely to tell you it can be done through surgery (by cutting off the herniation or carving into the vertebra to create more room) or not at all (in which case they may recommend a spinal fusion of the two vertebrae in question thus totally eliminating the need for the disc).
A chiropractor will tell you otherwise—particularly a chiro who specializes in decompression therapy. Modern decompression therapy involves computer guided micro adjustments that can target the specific disc in question. The adjustments expand or stretch the two vertebrae thus creating more inter-vertebral disc space. The result is the disc distracts back into its place and begins the healing process. Full distraction is accomplished over the course of 15 to 30 sessions. These sessions may be augmented with a decompression brace.
Of course, it should go without saying that exercise and good health can make a huge difference in both preventing disc problems in the first place, and in helping them heal. This is especially true with degenerative disc disease. If your core muscles, (the ones responsible for lower spine support) are kept strong, natural weight-bearing forces are kept off the discs to begin with thereby sparing your discs the wear and tear that promotes degeneration.
Tags: back injuries, back surgery, healing, herniated disc, Lower Back Pain, pain, spinal decompression, spine
Posted in Articles by Michael Harris | 17 Comments »
Thursday, June 24th, 2010
Sprained ankles are common, but what about a sprained back? Is it possible? Yes it is. Use this quick question and answer article below to learn what a sprained back is and how it can be healed.
Q: What is a sprain anyway?
A: A sprain is a microscopic tear of ligaments, tendons or muscles.
Q: How do I know if I have a sprained back muscle?
A: You will feel pain. But making sure the pain you feel is from a sprain and not a damaged disc or other problem is critical. Generally you will have stiffness, pain that may radiate into the buttocks but does not go into the legs, pain that persists more than two weeks and muscle spasms.
Q: Will my sprained back heal?
A: Yes. Statistics show that well over 90 percent of all sprained back sufferers experience a full recovery.
Q: How long will it take my sprained back to heal?
A: This depends on severity of the sprain, your age and health, and on how well you are able to put yourself into healing-conducive situations. But a sprain can take up to a year to heal. Don’t worry though; it is most likely that you will be able to lead a normal active life after the initial healing period.
Q: Initial healing period? What’s that?
A: There are four stages of healing after a sprain.
Stage 1 is referred to the Active Swelling stage and occurs during the initial 12-72 hours after the injury.
Stage 2 is called the Passive Congestion stage and begins by day 2 or 3. This is the stage where most of the swelling occurs.
Stage 3 is the Tissue Repair stage. It begins by day 4 or 5. During this stage the body infiltrates the damaged area with scar tissue which is laid down in criss-cross matrix of fibers and is not conducive to normal function.
Stage 4 is the remodeling stage. It starts about six weeks after the Tissue Repair stage begins. In this stage, scar tissue fibers are realigned to a parallel orientation. It generally lasts 3-6 months but can last up to a year. It is during this stage that you can return to an increasingly normal routine.
Q: Is there anything I can do to speed my recovery?
A: Yes there is. During stage 1 stay down and keep movement to an extreme minimum. During stage 2, as pain levels allow, start to become somewhat mobile. But don’t push it. During stage 3 increase movement and functionality. You should be able to begin to cautiously return to some normal function albeit slower, and guarded. Avoid lifting or any sudden movement. Then, during stage 4, under your doctor’s or physical therapist’s guidance, you can engage in stretches and exercise to aid the body in realigning the scar tissue.
In the initial stages anti inflammatory drugs will greatly aid in the reduction of swelling which will allow for quicker healing. Electro therapy devices are also highly recommended. There is a great article I wrote on the various devices called TENS, EMS, IF, HVPC! Oh My! The DME Providers’ Ultimate Guide. http://www.goarticles.com/cgi-bin/showa.cgi?C=2965593 It was written for those who sell this equipment, but any reader will find it quite informative.
Q: Should I wear a back brace? If so, when and for how long?
A: A back brace, (a.k.a. a spinal brace) can be very helpful in immobilizing your sprained muscles while allowing you to remain active. In the initial stages, a restrictive or “cinch-tight” brace is ideal. However, especially as you enter the remodeling stage, a flexible brace such as Spinal Rehab Solutions’ SR 500 brace is a better choice. I mention the product by name because while restrictive braces are common and can be found almost everywhere, the newness of the flexible brace makes them harder to locate.
In general, braces should be worn no more than 4 hours a day to avoid muscle atrophy, and they can be worn at your most challenging times whether that be while lying, sitting or standing.
Tags: back brace, back injuries, back sprain, Lower Back Pain, spinal brace
Posted in Articles by Michael Harris | 3 Comments »
Wednesday, June 16th, 2010
Lower Back Pain is regarded as the most common cause of job-related disability, resulting in significant societal burden. Indirect costs related to lower back pain total $30 billion annually, with approximately 2 percent of the U.S. workforce compensated for back injuries. (Source: Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999; 354:581-585)
Tags: back injuries, disability, Lower Back Pain, U.S. Workforce
Posted in Quick Facts | No Comments »
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