Spine Treatments Little Help In Fibromyalgia

Year after meningitis outbreak, pain still persists

GAN HLTH MENINGITIS ANNIV 091613

Previous research has suggested that poor response is associated with young age, use of opioids, previous spine surgery, and lengthy duration of symptoms, as well as somatization and depression. It also has become clear that certain chronic pain conditions, most notably fibromyalgia, are characterized by alterations in centralized CNS pain processing, implying that local treatments are less likely to be successful. “Injections and peripherally targeted analgesics would be expected to provide less benefit in a patient with altered central pain processing than in those with predominantly peripheral pathology,” the researchers noted. Patients with fibromyalgia also typically have reduced levels of pain-inhibiting neurotransmitters such as serotonin and high levels of transmitters such as glutamate that can increase pain sensations. To explore whether this centralized pain phenotype was common among spine patients and might help aid in patient selection for localized treatments, Brummett’s group enrolled 443 patients with complaints ranging from neck pain to lumbago and lumbar spinal stenosis. Fibromyalgia was diagnosed according to the ACR 2010 criteria, which was based on a widespread pain index and a symptom severity scale and no longer included the original tender point criteria. A continuous fibromyalgia score consisted of the sum of the pain index and severity scale score. Other diagnostic evaluations included the Brief Pain Inventory, which measures pain severity and interference, PainDETECT for neuropathic pain, the Hospital Anxiety and Depression Scale, and physical function according to the Oswestry Disability Index. On univariate analysis, patients who met the criteria for fibromyalgia were more often younger, not employed, and to have financial compensation. They also had higher scores for chiropractor bayview village pain severity and interference, neuropathic pain, anxiety and depression, and worse physical function, which represented “profound phenotypic differences” compared with non-fibromyalgia patients, the researchers observed.
For the original version including any supplementary images or video, visit http://www.everydayhealth.com/fibromyalgia/0916/spine-treatments-little-help-in-fibromyalgia.aspx

Study suggests brain is hard-wired for chronic pain

Three died in the hospital and several were seen in the clinic there but not hospitalized, said Vanderbilt spokesman Craig Boerner. “We are still following six patients and do have at least one patient who is still taking antifungal medications,” he added. Looser regulations Efforts to place tighter regulatory control over drug compounders have stalled in Congress, although a new proposal surfaced last week in the U.S. House. The Tennessee General Assembly reacted by approving a new law that actually loosens control over drug compounders by eliminating a requirement that patient-specific prescriptions be issued for each drug compounded. Carol Wetton died April 16, 2013, after receiving a steroid shot for her back pain on Sept. 17, 2012. (Photo: Provided photo via The Tennessean) The outbreak is blamed on Massachusetts-based New England Compounding Center, the source of the tainted methylprednisolone acetate steroid injections. Michael A. Carome of Public Citizen said the new Tennessee law “undermines patient safety in Tennessee and represents a substantial step in the wrong direction.” Carome has been equally critical of the proposals now before Congress, including a measure backed by U.S. Sen.
For the original version including any supplementary images or video, visit http://www.usatoday.com/story/news/nation/2013/09/17/fungal-meningitis-outbreak-anniversary/2824263/

They also showed that brain activity could be used to predict whether a subject recovered or experienced persistent pain. In this study, the researchers used a scanning technique called diffusion tensor imaging (DTI) which measures the structure of white matter , the nerve cell wires, or axons, which connect brain cells in different parts of the brain. They found a consistent difference in white matter between the subjects who recovered and the subjects who experienced pain throughout the year. “Our results suggest that the structure of a person’s brain may predispose one to chronic pain,” said Dr. Apkarian. In agreement with this idea, the researchers also found that the white matter of subjects who had persistent pain looked similar to a third group of subjects known to suffer from chronic pain. In contrast, the white matter of the subjects who recovered looked similar to that of healthy control subjects. To test this idea further, the researchers asked whether the white matter differences they saw during the initial brain scans predicted whether the subjects would recover or continue to experience pain. They found white matter brain scans predicted at least 80 percent of the outcomes. “We were surprised how robust the results were and amazed at how well the brain scans predicted persistence of low back pain,” said Dr. Apkarian. “Prediction is the name of the game for treating chronic pain.” The nucleus accumbens and the medial prefrontal cortex are two brain regions thought to be involved with pain. Further examination of the brain scans suggests that the white matter structure connecting these brains regions is different between the subjects who recovered and those who had persistent pain.
For the original version including any supplementary images or video, visit http://medicalxpress.com/news/2013-09-brain-hard-wired-chronic-pain.html

NIH-funded study suggests brain is hard-wired for chronic pain

For the new study, Dr. Bruce Landon from the Harvard Medical School in Boston and his colleagues tracked nationally-representative data on outpatient visits for back and neck pain collected between 1999 and 2010. The researchers had information on about 24,000 visits, which represented a total of 440 million appointments across the U.S. During that span, they found the proportion of patients prescribed Tylenol and NSAIDs dropped from 37 percent to 25 percent. At the same time, the proportion given narcotics rose from 19 percent to 29 percent. About 11 percent of people with back pain had a CT or MRI scan in 2009 and 2010, compared to seven percent in 1999 and 2000. Finally, although the rate of referrals to physical therapy held steady during the study period, the proportion of patients referred to another doctor – likely for surgery or other treatments – doubled from seven to 14 percent, the researchers reported Monday in JAMA Internal Medicine. “Physicians want to offer patients treatments that are going to work sooner and patients are demanding them and sometimes it’s just easier to order the MRI or order the referral,” Landon said. But, he added, “They often lead to things that are unnecessary and expensive and maybe not better in the long run and maybe even worse,” such as surgery or injections that haven’t proven to be effective. According to the National Institutes of Health, eight out of ten people have back pain at some point in their lives.
For the original version including any supplementary images or video, visit http://www.reuters.com/article/2013/07/29/us-back-pain-treatment-idUSBRE96S0Z720130729

Back pain treatment often not in line with guidelines

Lastly, back pain can be the result of same everyday activity or poor posture. Poor posture is the common culprit for back pain. When our muscles are not balanced and equally working together then our posture declines. Once we start losing proper posture then our back muscles lose the ability to work efficiently. This creates pain in the back and overtime overall body pain. Luckily, posture can be improved and doing Egoscue exercises can give you great results. Egoscue is a revolutionary method for stopping chronic pain and is beneficial for everyone. Egoscue was founded by Pete Egoscue, and the program uses gentle exercises to help correct misalignments. It helps to reintroduce proper body mechanics. The picture included in this article is an example of an Egoscue exercise to help reduce low back pain. It is called Static Back and can be done everyday. This exercise relaxes the hip flexor muscles and hamstrings which are both often too tight. Placing the hip flexors in this position forces the back to be in its neutral position rather than arched or slouched.
For the original version including any supplementary images or video, visit http://www.examiner.com/article/low-back-pain-relief-exercise-by-egoscue

Low back pain relief using the Egoscue Method

About half of the subjects recovered at some time during the year; the other half had pain throughout, which the researchers categorized as persistent. Previously, the Apkarian laboratory showed that the volume of grey matter in the brains of the same subjects who had persistent pain decreased over the same year. Grey matter describes the area of the brain where the central bodies and branched antennae, or dendrites, of nerve cells reside. They also showed that brain activity could be used to predict whether a subject recovered or experienced persistent pain. In this study, the researchers used a scanning technique called diffusion tensor imaging (DTI) which measures the structure of white matter, the nerve cell wires, or axons, which connect brain cells in different parts of the brain. They found a consistent difference in white matter between the subjects who recovered and the subjects who experienced pain throughout the year. “Our results suggest that the structure of a person’s brain may predispose one to chronic pain,” said Dr. Apkarian. In agreement with this idea, the researchers also found that the white matter of subjects who had persistent pain looked similar to a third group of subjects known to suffer from chronic pain. In contrast, the white matter of the subjects who recovered looked similar to that of healthy control subjects. To test this idea further, the researchers asked whether the white matter differences they saw during the initial brain scans predicted whether the subjects would recover or continue to experience pain. They found white matter brain scans predicted at least 80 percent of the outcomes. “We were surprised how robust the results were and amazed at how well the brain scans predicted persistence of low back pain,” said Dr.
For the original version including any supplementary images or video, visit http://www.sciencecodex.com/nihfunded_study_suggests_brain_is_hardwired_for_chronic_pain-119485

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