Engineers Conceive Disc Replacement To Treat Chronic Low Back Pain

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Main Category: Back Pain
Article Date: 15 Jun 2012 - 0:00 PDT Current ratings for:
Engineers Conceive Disc Replacement To Treat Chronic Low Back Pain

In between the vertebrae of the human spine are 23 Oreo-sized, cartilage-filled discs that hold the vertebrae together and allow for spine movement.

While the discs are critical for movement, they can become the source of back pain when they degenerate or herniate - a major health problem that affects 85% of Americans and drains the U.S. economy to the tune of $100 billion every year.

A new biomedical device to surgically treat chronic back pain - an artificial spinal disc that duplicates the natural motion of the spine - has been licensed from Brigham Young University to a Utah-based company.

The artificial disc was conceived by engineering professors Anton Bowden and Larry Howell and BYU alum Peter Halverson. It will be developed to market by Crocker Spinal Technologies, a company founded by BYU President's Leadership Council member Gary Crocker and headed by BYU MBA graduate David Hawkes.

The BYU researchers report on the mechanism's ability to facilitate natural spine movement in a study published in a forthcoming issue of the International Journal of Spine Surgery.

"Low back pain has been described as the most severe pain you can experience that won't kill you," said Bowden, a BYU biomechanics and spine expert. "This device has the potential to alleviate that pain and restore the natural motion of the spine - something current procedures can't replicate."

Currently, the most common surgical treatment for chronic low back pain is spinal fusion surgery. Fusion replaces the degenerative disc with bone in order to fuse the adjacent segments to prevent motion-generated pain.

Unfortunately, patient satisfaction with fusion surgery is less than 50 percent.

The solution researched by the BYU team, and now being developed by Crocker Spinal Technologies, consists of a compliant mechanism that facilitates natural spine movement and is aimed at restoring the function of a healthy spinal disc.

Compliant mechanisms are jointless, elastic structures that use flexibility to create movement. Examples include tweezers, fingernail clippers or a bow-and-arrow. Howell is a leading expert in compliant mechanism research.

"To mimic the response of the spine is very difficult because of the constrained space and the sophistication of the spine and its parts," Howell said. "A compliant mechanism is more human-like, more natural, and the one we've created behaves like a healthy disc."

Under Howell's and Bowden's tutelage, BYU student-engineers built prototypes, machine tested the disc and then tested the device in cadaveric spines. The test results show the artificial replacement disc behaves similarly to a healthy human disc.

"Putting it in a cadaver and having it do what we engineered it do was really rewarding," Howell said. "It has a lot of promise for eventually making a difference in a lot of people's lives."

Halverson, who was lead author on the International Journal of Spine Surgery study, has since earned his Ph.D. from BYU and taken a position at Crocker Spinal Technologies, which will likely begin international sales distribution as early as next year.

"Fusion, which is the current standard of care for back pain, leaves a lot to be desired," said Hawkes, president of Crocker Spinal Technologies. "Disc replacement is an emerging alternative to fusion that has the potential to make a significant difference in the lives of millions.

"BYU's innovation is a radical step forward in the advancement of disc replacement technology. It is exciting to be a part of this effort and a delight to work with such talented, wonderful people," he said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Although Back Pain Improves With Care, It Often Persists For A Year Or Longer

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Article Date: 15 May 2012 - 1:00 PDT Current ratings for:
Although Back Pain Improves With Care, It Often Persists For A Year Or Longer

For people receiving health care for acute and persistent low-back pain, symptoms will improve significantly in the first six weeks, but pain and disability may linger even after one year, states a large study published in CMAJ (Canadian Medical Association Journal).

Low-back pain is a common condition that results in significant health care costs, disability and absenteeism in workplaces. However, there are differing views on how quickly and completely people recover from this condition.

Researchers from Australia and Brazil examined data from 33 studies (11 166 participants) to understand the clinical course of pain and disability in people receiving care for low-back pain. The study looked at more studies than previous reviews, which allowed more precise estimates of the clinical course of acute low-back pain as well as persistent low-back pain.

"Our review confirms the broad finding of previous reviews that the typical course of acute low-back pain is initially favourable: there is a marked reduction in mean pain and disability in the first six weeks," comments Dr. Christopher Maher, Director, Musculoskeletal Division, The George Institute for Global Health, The University of Sydney, Australia. "Beyond six weeks, improvement slows and thereafter only small reductions in mean pain and disability are apparent up to one year."

At one year, the patients who initially presented with acute low-back pain still experienced some pain and disability but it was minimal; the typical improvement in pain intensity was about 90%. In contrast, those who initially presented with persistent low-back pain experienced moderate levels of pain and disability at one year; the typical improvement in their pain was only about 50%.

Maher notes, "There is both good and bad news in our review. It is great that people improve with care, but arguably there is room to do better, particularly for people with persistent low-back pain. Generally, when people see results like this they want to blame the clinician, but I think that is short-sighted. One of the principal reasons we have not made more progress in the back pain field is that research agencies do not take back pain research seriously. Around the world, back pain research is hugely underfunded relative to the burden of the disease. It's time for that to change."

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Maison aérobie marche programme aussi efficace que la thérapie clinique dans le traitement des douleurs lombaires

Catégorie principale : Maux de dos
Également inclus dans : Réhabilitation / physiothérapie
L'article Date: 7 mars 2013 - 1:00 PST courants nominaux pour :
Maison aérobie marche programme aussi efficace que la thérapie clinique dans le traitement des douleurs lombaires

Douleurs lombaires sont une plainte fréquente, et souvent le traitement nécessite de nombreuses heures de physiothérapie au fil de plusieurs visites à la clinique hebdomadaire - un engagement coûteux. Dr Michal Katz-Leurer de l'Université de Tel Aviv Stanley Steyer école des Professions de la santé à la faculté de Sackler de médicament dit maintenant qu'un simple programme de marche aérobie est aussi efficace pour soulager les douleurs lombaires comme le renforcement des programmes qui nécessitent un équipement spécialisé dans les cliniques de réadaptation musculaire. Le programme comprend deux à trois fois par semaine pendant une période de 20 à 40 minutes de marche.

Dr Katz-Leurer et son collègue Ilana Shnayderman, étudiant de troisième cycle au département de physiothérapie et un physiothérapeute pratiquant au Maccabi Health Care, disent que leur option de traitement s'intègre facilement dans une routine quotidienne et permet à ceux qui ont des maux de dos plus responsables de leur propre santé.

Leur étude a été publiée dans la revue Clinical Rehabilitation.

Une solution simple

Selon le Dr Katz-Leurer, recherche a montré que lorsque les gens marchent activement, abdominaux et muscles du dos travaillent à peu près la même manière que lorsqu'ils complètent les exercices qui ciblent ces zones. Et contrairement aux programmes, qui souvent appellent à des équipements spécifiques et peuvent impliquer des exercices nécessitant une supervision d'experts, de renforcement musculaire, la marche est une activité simple qui peut être faite seul.

Pour l'étude, les chercheurs ont recruté des 52 patients ayant des douleurs lombaires pour participer à un essai contrôlé randomisé. Par le biais de questionnaires, ils ont été évalués initialement pour des niveaux de douleur, sentiments d'incapacité et l'évitement des activités quotidiennes, ainsi que musculaire et l'endurance à pied.

Ensuite, la moitié des participants complété un muscle typique en clinique, programme de renforcement, avec 02:58 séances par semaine pendant six semaines d'exercices. L'autre moitié achevé un programme de marche aérobie six semaines, deux à trois fois par semaine de marche. Les participants a commencé avec 20 minutes de marche, puis a progressé à 40 minutes en tant que leur endurance améliorée.

Les résultats ont montré que les deux groupes améliorée sensiblement dans tous les domaines d'évaluation, ce qui démontre que le programme de marche était « aussi efficace que le traitement qui pourrait avoir été reçu à la clinique, » dit le Dr Katz-Leurer.

Le chemin vers une vie plus saine

Dr Katz-Leurer affirme que le programme de marche a l'avantage supplémentaire d'encourageants les patients à suivre un mode de vie sain global. En termes de condition physique, ceux du groupe de marche ont été capables de marcher en moyenne de 0,05 km plus loin lors d'un test de marche de six minutes à la fin du programme par rapport aux évaluations préalables.

Elle note également que régulièrement des personnes actives sont moins susceptibles de souffrir de la typique des douleurs au cours de leur vie. Marche, une activité à faible impact, aussi, abaisse la tension artérielle, stimule cerveau et système immunitaire fonctionne et réduit le stress, dit-elle.

Article adapté par Medical News Today de communiqué de presse original. Cliquez sur « références » onglet ci-dessus pour la source.
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Physical Therapy - A Quick Fix For Sacroiliac Joint Pain In Many Children And Adolescents

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Main Category: Back Pain
Also Included In: Pediatrics / Children's Health;  Rehabilitation / Physical Therapy
Article Date: 24 May 2012 - 0:00 PDT Current ratings for:
Physical Therapy - A Quick Fix For Sacroiliac Joint Pain In Many Children And Adolescents

Investigators report that a simple bedside manual therapy to correct a painful misaligned sacroiliac joint was highly successful in a group of 45 patients 10 to 20 years of age. Thirty-six patients (80 percent) obtained significant pain relief, whereas nine patients (20 percent) experienced minimal to no relief. In 24 patients (53 percent) complete resolution of pain was experienced immediately upon treatment. Only two patients required a second treatment because of symptom recurrence. These findings are reported in a new article, "Sacroiliac joint pain in the pediatric population. Clinical article," by Stoev and colleagues, published in the June 2012 issue of the Journal of Neurosurgery: Pediatrics, now online.

Investigators at Washington University in St. Louis and St. Louis Children's Hospital conducted a retrospective analysis of patient records in children and adolescents with low back pain who had been referred to a single neurosurgeon, Jeffrey R. Leonard, M.D., between 2005 and 2011. At the initial consultation, the patients performed a variety of physical maneuvers designed to evaluate whether their pain stemmed from misalignment of the sacroiliac joint. In 48 patients pain was attributed to this misalignment. There were 37 female and 11 male patients with a mean age of 15.7 years (range 10 to 20.6 years). The average duration of symptoms was 7 months (range 0.25 to 48 months). Before treatment the patients' mean pain score was 5.7 (range 3 to 9.5) on a 10-point visual analog scale ranging from 0 = no pain to 10 = most extreme pain. Three patient files were incomplete, and therefore the investigators could only report results on pain relief in the 45 pediatric patients in whom complete follow-up data were accessible.

Treatment consisted of sacroiliac joint manipulation accomplished by performing isometric hip contraction and extension. Physical therapists call this procedure the "muscle energy technique." The patient flexes and extends the hip while the physical therapist provides resistance to the move. This forces the sacroiliac joint back into proper alignment. Most patients experienced improvement in their symptoms, and more than half of the patients had immediate pain relief following treatment.

When asked whether the investigators were surprised to find that such a simple technique could bring about pain relief in so many patients, Dr. Leonard said, "No we were not surprised. We were surprised by the number of patients who actually presented with this problem. These children have had prior imaging studies, procedures, or been in back pain for over a year."

Following treatment, patients were given instructions for at-home exercises to strengthen muscles in the region to ensure that sacroiliac joint alignment would be maintained. Dr. Leonard believes that patients were compliant with these exercises "because a large number of patients were in significant debilitating pain which kept them out of activities. This simple manipulation allowed them to potentially leave clinic pain free." In this study only two patients needed repeated treatment.

The authors state that there are no clear estimates on how many children and adolescents suffer pain from misaligned sacroiliac joints, but low back pain is fairly common. Unlike adults whose sacroiliac joint-related pain is usually related to disc deterioration or joint disease, children and adolescents are more likely to experience pain due to repeated stress from athletic activities. Girls are more susceptible (77% in this study) because of the laxity of the female developing pelvic girdle.

As the authors point out, the source of low back pain is often difficult to identify, which can make patients face long periods of painful symptoms, drug dependency, and/or unnecessary surgical procedures. The take-away message from this study is that simple manual manipulation should be tried in children and adolescents whose low back pain is suspected to be caused by a misaligned sacroiliac joint. The therapy described in this paper is cost-effective, takes little time, and poses no negative consequences to the patient. The authors found that this simple manipulation procedure can provide sustained relief in most patients.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our back pain section for the latest news on this subject. Stoev I, Powers AK, Puglisi JA, Munro R, Leonard JR. Sacroiliac joint pain in the pediatric population. Clinical Article. J Neurosurg: Pediatrics 9:602-607, 2012; DOI: 10.3171/2012.2.PEDS11220.
Disclosure: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
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posted by Sarah on 31 May 2012 at 8:18 am

Very excited to see a report like this come out. After 3 years of not one doctor being able to figure out my one-sided low back pain, I figured it out myself via online research for months. Then I had to try about 5 physiotherapists before one finally could help me via the manual movement that this report speaks of. I'm over 40 but the therapy and exercises for this, do work. Family doctors should learn about this simple technique so they can recommend their patients go to a PT. Not just throw drugs at us.

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Stanford Researchers Report Progress In Quest To Create Objective Method Of Detecting Pain

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Also Included In: Medical Devices / Diagnostics;  Back Pain
Article Date: 24 Dec 2012 - 0:00 PST Current ratings for:
Stanford Researchers Report Progress In Quest To Create Objective Method Of Detecting Pain

A method of analyzing brain structure using advanced computer algorithms accurately predicted 76 percent of the time whether a patient had lower back pain in a new study by researchers from the Stanford University School of Medicine.

The study, which was published online Dec. 17 in Cerebral Cortex, reported that using these algorithms to read brain scans may be an early step toward providing an objective method for diagnosing chronic pain.

"People have been looking for an objective pain detector - a 'pain scanner' - for a long time," said Sean Mackey, MD, PhD, chief of the Division of Pain Medicine and professor of anesthesiology, pain and perioperative medicine, and of neurosciences and neurology. "We're still a long way from that, but this method may someday augment self-reporting as the primary way of determining whether a patient is in chronic pain."

The need for a better way to objectively measure pain instead of relying solely on self-reporting has long been acknowledged. But the highly subjective nature of pain has made this an elusive goal. Advances in neuroimaging techniques have initiated a debate over whether this may be possible. Such a tool would be particularly useful in treating very young or very old patients or others who have difficulty communicating, Mackey said.

In a study published last year in PLoS ONE, Mackey and colleagues used computer algorithms to analyze magnetic resonance imaging scans of the brain to accurately measure thermal pain in research subjects 81 percent of the time. But the question remained whether this could be a successful method for measuring chronic pain.

The goal of the new study was to accurately identify patients with lower back pain vs. healthy individuals on the basis of structural changes to the brain, and also to investigate possible pathological differences across the brain.

Researchers conducted MRI scans of 47 subjects who had lower back pain and 47 healthy subjects. Both groups were screened for medication use and mood disorders. The average age was 37.

The idea was to "train" a linear support vector machine - a computer algorithm invented in 1995 - on one set of individuals, and then use that computer model to accurately read the brain scans and classify pain in a completely new set of individuals.

The method successfully predicted the patients with lower back pain 76 percent of the time.

"Lower back pain is the most common chronic condition we deal with," Mackey said. "In many cases, we don't understand the cause. What we have learned is that the problem may not be in the back, but in the amplification coming from the back to the brain and nervous system. In this study, we did identify brain regions we think are playing a role in this phenomena."

An estimated 100 million Americans suffer from chronic pain, and chronic low back pain, in particular, is the most common cause for activity limitation in those younger than 45, according to the study. The prevalence of lower back pain among the U.S. population has also risen significantly, from 3.9 percent in 1992 to 10.2 percent in 2006.

"Previous studies have shown that there are functional changes in the brain of a chronic pain patient, and we show that structural changes may be used to differentiate between those with chronic lower back pain and those without," said former research assistant Hoameng Ung, the first author of the study who is now an MD/PhD student at the University of Pennsylvania School of Medicine. "This observation also suggests a role of the central nervous system in chronic pain, and that some types of chronic low back pain may reflect pathology not within the back, but instead within the brain."

Study results suggested that lower back pain is characterized by a pattern of structural changes in the gray matter, the nervous tissue of the brain, showing indication of disease.

"Our investigation ... suggests that the pathology of lower back pain involves changes in gray matter that are present throughout a distributed system of pain processing and pain-associated areas within the brain," the study stated.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pain / anesthetics section for the latest news on this subject. This work was supported by a grant from the National Institutes of Health (DA026092, DA029262, DA023609), an International Association for the Study of Pain collaborative research grant and the Redlich Pain Research Endowment.

Other Stanford authors included former graduate student Justin Brown, PhD; postdoctoral scholar Kevin Johnson, PhD; and Jarred Younger, PhD, assistant professor of anesthesiology, pain and perioperative medicine.

Stanford University Medical Center

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posted by Sarah on 12 Jan 2013 at 5:55 am

This is interesting. I have had chronic pain for 25 years. In the last 3 I have made significant recovery. Part of it was due to 'retraining' my brain to reduce the over active pain messages locking my body up with paralysing spasms. This was achieved by learning the Alexander Technique - it reset my body. Therefore the indication of 'disease' must be viewed in that it can be reversible - is disease the right term?

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Symptômes du SSPT mis au point par un cinquième des Patients en chirurgie vertébrale

Catégorie principale : Maux de dos
Également inclus dans : L'anxiété et du Stress ;  Psychologie / psychiatrie
Article Date: 2 octobre 2012 - 0:00 PDT courants nominaux pour :
Symptômes du SSPT mis au point par un cinquième des Patients en chirurgie vertébrale

Presque 20 pour cent des personnes ayant subi une fusion dos bas chirurgie développée stress post-traumatique trouble symptômes associés à cette chirurgie, selon une récente étude de l'Université de l'Oregon Health Sciences & publié dans le journal de colonne vertébrale.

Des études antérieures ont noté des symptômes du SSPT dans certains traumatismes, le cancer et organes transplant. Mais c'est la première étude, les auteurs estiment, de surveiller les symptômes du SSPT chez les patients subissant une intervention médicale au choix.

« Il n'est peut-être pas surprenant que des interventions chirurgicales importantes ont psychologique ainsi que des impacts physiques, » a dit Robert Hart, M.D., un chirurgien orthopédiste, le professeur d'orthopédie et de réadaptation au OHSU et principal auteur de l'étude. « Je pense que cela signifie que nous dans la communauté médicale ont besoin de surveiller ces effets chez nos patients et de les gérer lorsqu'elles surviennent. »

L'étude a conclu que le facteur le plus fort pour déterminer si un patient de chirurgie du rachis ont souffert de symptômes du SSPT après que la chirurgie si le patient avait un trouble psychiatrique - dépression ou l'anxiété troubles, par exemple - avant la chirurgie. Mais certains patients qui n'avaient aucun tel diagnostic préopératoire a souffert également symptômes du SSPT après la chirurgie de la colonne vertébrale, l'étude a révélé.

L'étude OHSU comprenait 73 des patients de chirurgie de Hart qui a subi une opération de fusion spinale lombaire, une procédure dans laquelle deux ou plusieurs vertèbres lombaires dans le dos sont fusionnés ensemble, habituellement y compris implantation des tiges et des vis à métaux dans le cadre de la procédure.

Chirurgiens au OHSU Spine Center toujours chercher de nouvelles façons de faire face à des maux de dos avant la chirurgie. Mais parfois, la chirurgie est la seule option. Et la fusion spinale est souvent une intervention chirurgicale majeure qui peut entraîner des complications et implique souvent une période de temps de récupération. La majorité des patients de l'étude a signalé une bonne expérience et avait important soulagement de leur douleur préopératoire.

Hart a indiqué que les résultats de l'étude pourraient offrir des conseils aux médecins et aux chirurgiens pour conseiller les patients en chirurgie colonne vertébrale potentiels au sujet de la chirurgie. Pour les patients à haut risque, les résultats suggèrent médecins et chirurgiens pourraient offrir leur traitement avant l'opération, a dit m. Hart.

"À la fin de la journée, j'espère que cela apportera des modifications dans la façon dont nous préparons des gens pour la chirurgie, pour réduire ces impacts psychologiques. Ceci est analogue à la façon dont nous optimisons actuellement l'état physique des patients avant une intervention chirurgicale majeure,"a déclaré m. Hart.

Hart a dit qu'il veut étudier cette question ensuite - et mesurer quelles interventions préopératoire pourraient fonctionner mieux pour réduire ou éliminer les effets de PTSD.

Article adapté de nouvelles médicales aujourd'hui du communiqué de presse original. Cliquez sur « Références » onglet ci-dessus pour source.
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Parc national de « Symptômes du SSPT mis au point par un cinquième des Patients de chirurgie vertébrale. » Nouvelles médicales aujourd'hui. MediLexicon, aéroport international, 2 octobre 2012. Web.
18 Novembre 2012. APA

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Posté par bert Kummel sur 3 octobre 2012 à 10:36

Des essais de Waddell non-organiques statut fait pré-opératoire ? Sinon, Eh bien, dois-je dire plus ?

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Back Pain - Genetically Engineered Drug Less Effective

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Main Category: Back Pain
Also Included In: Pain / Anesthetics
Article Date: 18 Apr 2012 - 0:00 PDT Current ratings for:
Back Pain - Genetically Engineered Drug Less Effective

It appears that spinal injections of etanercept, a new type of anti-inflammatory genetically engineered drug, are not as effective in relieving the severe leg and lower back pain of sciatica, as steroid injections into the spine, the current standard of care, according to a new study reported in the 17 April issue of the Annals of Internal Medicine.

Dr Steven P Cohen, an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine in Baltimore, Maryland led the study.

He told the press pain experts have long been looking for a, safe, reliable alternative to steroids as a way to treat sciatica. The current treatment, where steroids are injected into the spine, often has mixed results and only temporarily relieves pain. It also has the potential for "catastrophic complications".

Etanercept is a genetically-engineered tumor necrosis factor inhibitor (TNF) that is currently used to treat rheumatoid arthritis and other autoimmune disorders, where the patient's own immune system attacks healthy tissue, causing damage, pain and swelling.

Cohen said research interest in etanercept, sold under the brand-name Enbrel, arose from attempts to prevent or limit the pain produced by herniated discs pressing on nerve roots in the lower back or neck.

The drug works by blocking TNF, a naturally produced substance that causes inflammation. Unlike steroids that combat inflammation generally, TNF inhibitors target the specific inflammation molecules that cause the pain from sciatica and other conditions. They do this by stopping them being able to bind to nerve cell receptors, which should in theory prevent pain altogether.

However, Cohen said while this new treatment shows a lot of promise, "at least in the doses we gave it - the dose known to be safe - steroids still work better".

For the blinded, placebo-controlled study, 84 adult patients with sciatica (lumbosacral radiculopathy) of less than 6 months' duration received epidural injections. The patients were randomly assigned to receive either 60 milligrams of a steroid, 4 milligrams of etanercept, or 2 milliliters of saline.

The idea behind giving sciatica patients an epidural injection is to provide better pain relief at lower doses, and fewer side effects compared with giving drugs by mouth or intravenously, because the spinal nerve roots are bathed directly in the medication designed to reduce inflammation (and pain).

The trial ran from 200 to 2011 and took place at several military and civilian treatment centers. Pharmacists prepared the epidural syringes, while neither the physicians who administered the injections, nor the nurses who assessed the outcomes, knew which patient received which treatment.

The results showed that one month after receiving the second of two injections, the patients who received steroids reported less pain and disability than the patients who received etanercept or the saline placebo.

However, Cohen and colleagues found that while the steroids worked, their effect did not last.

Cohen comments that another study published last month, where patients received more than twice the dose of etanercept used in their study, found one and two weeks after injection, the etanercept patients felt better than the patients given steroids, but not four weeks after.

It could be that in lower doses, "etanercept may not be the drug everyone's hoping it is", says Cohen, noting that "There's still a lot more work to be done".

He suggests there is a need to investigate the safety and effectiveness of higher doses of etanercept and other drugs that block pain receptors.

Most of the funds for the study came from the John P. Murtha Neuroscience and Pain Institute, the International Spinal Intervention Society and the Center for Rehabilitation Sciences Research.

Written by Catharine Paddock PhD

View drug information on Enbrel.
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today Visit our back pain section for the latest news on this subject. "Epidural Steroids, Etanercept, or Saline in Subacute Sciatica: A Multicenter, Randomized Trial"/b>; Steven P. Cohen, Ronald L. White, Connie Kurihara, Thomas M. Larkin, Audrey Chang, Scott R. Griffith, Christopher Gilligan, Ralph Larkin, Benny Morlando, Paul F. Pasquina, Tony L. Yaksh, and Conner Nguyen; Ann Intern Med 17 April 2012, 156:551-559; Link to Abstract.
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posted by Greg Cowart with Back Pain on 19 Apr 2012 at 9:48 am

As someone who suffered from back pain and has had surgery on my L5-S1 disc, I had residual post-opt scare tissue build up that caused pain after my surgery. A year after my surgery I had two cortisone steroid shots that ended up greatly reducing my back pain, allowing me the time to strengthen my core muscle groups so that I have little to no pain now.

I also have chrons and have looked seriously at several TNF type inhibitor drugs to combat my autoimmune disorders. I do not think that the use of this type of drug would be effective due to the fact that TNFs are used to treat autoimmune disorders not inflammation just in a specific area.

The inflammation that causes back pain is not caused by the body attacking itself unless its rheumatoid arthritis. So I think using TNFs for back pain is misguided. Cortisone and steroids I think are a more proven pain reliever than TNFs will be. Not to take take away from TNFs because they do have their place.

A great place to get a second opinion on MRI or CT scan is http://www.backpainrelief.net/
Greg Cowart

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Charges lourdes sur les épaules peuvent causer des lésions nerveuses dans les mains et les doigts

Catégorie principale : Bones / orthopédie
Également inclus dans : Lombalgie ;  Neurologie / neurosciences
L'article Date: 25 février 2013 - 1:00 PST courants nominaux pour :
Charges lourdes sur les épaules peuvent causer des lésions nerveuses dans les mains et les doigts

Chemine d'un endroit à l'autre avec des poids lourds sur notre dos est une réalité quotidienne, des écoliers toting manuels dans les sacs à dos aux pompiers et soldats transportant l'équipement professionnel. Muscle et problèmes osseux sont des préoccupations très réelles. Maintenant les chercheurs de l'Université de Tel Aviv dire que des lésions nerveuses, plus précisément sur les nerfs qui traversent le cou et les épaules pour animer nos mains et les doigts, estégalement également un risque sérieux.

Prof. Amit Gefen de département de génie biomédical de TAU et Prof. Yoram Epstein de Sackler Faculté de TAU de médecine, ainsi que le doctorant Amir Hadid et Dr. Nogah Shabshin de l'Institut d'imagerie du centre médical Assuta, ont déterminé que la pression des charges lourdes, porté sur le dos ont le potentiel d'endommager les tissus mous de l'épaule, causant des dommages aux nerfs microstructurales.

Le résultat pourrait être quelque chose de simple irritation à capacité diminuée de nerf, finalement limitant les muscles de réagir aux signaux du cerveau, inhibition de la mobilité de la main et la dextérité des doigts. Dans la pratique, cela pourrait avoir un impact fonctionnalité, réduction de la capacité du travailleur à faire fonctionner des machines, de compromettre un soldat tir des temps de réponse, ou limiter l'écriture de l'enfant ou le dessin de capacité.

La recherche a été publiée dans le Journal of Applied Physiology et partiellement financée par une subvention de TAU Nicholas et Elizabeth Slezak Super centre de recherche cardiaque et de génie biomédical.

Modélisation réduite des fonctions nerveuses

Mise au point de leur étude sur les unités de combat dans lequel soldats doivent porter de lourds sacs à dos, les chercheurs ont découvert que, en plus de se plaindre de l'inconfort ou de douleur dans les épaules, soldats signalé aussi des sensations de chatouillement ou un engourdissement des doigts.

Explorer ce problème de manière non invasive, ils ont utilisé des méthodes d'analyse biomécanique développés à l'origine pour enquêter sur les plaies chroniques. Les analyses montrent comment mécaniques charges, définie comme la quantité de force ou de déformation, placé sur une zone particulière du corps, ont été transférées sous la peau provoque des dommages aux tissus et les organes internes.

Selon les données recueillies par l'IRM, Profs. Gefen et Epstein élaboré des modèles d'ordinateur anatomique des épaules. Ceux-ci ont montré comment la pression générée par le poids d'une charge de sac à dos est distribuée sous la peau et transférés aux nerfs du plexus brachial. Les modèles représentent également des propriétés mécaniques, tels que la rigidité des tissus de l'épaule et l'emplacement des vaisseaux sanguins et les nerfs dans les zones sensibles qui ont tendance à endommager.

Chargement mécanique approfondie a semblé avoir un fort impact physiologique. « La charge de sac à dos s'applique tension de ces nerfs, » explique le Prof. Gefen. Il fait remarquer que les dommages qui en résultent « conduit à une réduction de la vitesse de conduction - c'est-à-dire la vitesse par lequel les signaux électriques sont transférés par les nerfs. » Avec un retard ou une réduction de l'amplitude ou l'intensité des signaux, communication nerveuse ne peut pas fonctionner correctement, dit-il.

Un danger pour les adultes et les enfants

Ces résultats s'appliquent aux personnes de tous horizons, dit le Prof. Gefen. Beaucoup de professions et d'activités de loisirs, telles que la randonnée ou en voyage, impliquent transportant du matériel lourd sur le dos. Les chercheurs prévoient d'élargir cette étude dans deux directions : Premièrement, pour étudier les effets de la charge sur la conductivité nerveuse et, deuxièmement, d'examiner l'impact de ces charges lourdes sur l'anatomie de l'enfant.

Sacs d'école sont une préoccupation majeure, prévient-il. On ne peut présumer que les corps des enfants réagissent pour assumer le stress en exactement de la même manière que les adultes. Différences dans la physiologie pourraient conduire à des conséquences différentes, la tolérance et des niveaux de dégâts.

Article adapté par Medical News Today de communiqué de presse original. Cliquez sur « références » onglet ci-dessus pour la source.
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