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MedWorm: Back Pain



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Back Pain category.



Last Build Date: Tue, 22 Mar 2016 08:27:07 +0100

 



Occupational exposure and health problems among Polish denturists: a population‐based study in Łódź province

Tue, 22 Mar 2016 06:26:00 +0100

ConclusionsAnalyses of denturists’ occupational exposure in the Łódź province and epidemiological estimates of the health effects suggest the need for preventive measures. (Source: International Dental Journal)

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Complex regulation of the regulator of synaptic plasticity histone deacetylase 2 in the rodent dorsal horn after peripheral injury

Tue, 22 Mar 2016 02:43:31 +0100

This article is protected by copyright. All rights reserved. (Source: Journal of Neurochemistry)



Exploring the Benefits of Animal Physiotherapy

Mon, 21 Mar 2016 17:50:25 +0100

Animals have always been a part of my life, even before I took my first breath. Carrying me to full term was a difficult pregnancy for my mom, but it was her two Yorkies, Kirsch and Butch, who laid by her side and comforted her during the nine months that she was bed ridden. They could sense when my mom was in pain, and licked her face until the moment passed. They could feel when the baby was moving, and repositioned themselves next to her belly until the stirring soothed. And although they couldn't speak English, their message was loud and clear, they were there to protect the family using their senses to guide the way. It's uncanny how in tune pets become to the needs of their owners. We don't even have to say a word and they seem to instinctively read our minds, which is one of the ma...



Opioid Prescribing for Occupational Back Pain in the EDOpioid Prescribing for Occupational Back Pain in the ED

Mon, 21 Mar 2016 13:25:52 +0100

How often are opioids prescribed for work-related low back pain? Are these medications being prescribed in compliance with established guidelines? The Journal of Emergency Medicine (Source: Medscape Today Headlines)



Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial

Mon, 21 Mar 2016 00:00:00 +0100

Conclusions From a societal perspective, MTU was not cost-effective in comparison with PT in patients with sub-acute and chronic non-specific neck pain for perceived recovery, functional status, and QALYs. As no clear total societal cost and effect differences were found between MTU and PT, the decision about what intervention to administer, reimburse, and/or implement can be based on the preferences of the patient and the decision-maker at hand. Trial registration ClinicalTrials.gov Identifier: NCT00713843 (Source: European Spine Journal)



Melatonin reverses morphine tolerance by inhibiting microglia activation and HSP27 expression

Mon, 21 Mar 2016 00:00:00 +0100

In this study, we explored the possible mechanism of melatonin in diminishing morphine tolerance. Main methods Two intrathecal (i.t.) catheters were implanted in male Wistar rats for drug delivery. One was linked to a mini-osmotic pump for morphine or saline infusion. On the seventh day, 50μg of melatonin or vehicle was injected through the other catheter instantly after discontinuation of morphine or saline infusion; 3h later, 15μg of morphine or saline was injected. The antinociceptive response was then measured using the tail-flick test every 30min for 120min. Key findings The results showed that chronic morphine infusion elicited antinociceptive tolerance and upregulated heat shock protein 27 (HSP27) expression in the dorsal horn of the rat spinal cord. Melatonin pretreatment parti...

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Sensorimotor dysfunction after limb fracture – An exploratory study

Mon, 21 Mar 2016 00:00:00 +0100

ConclusionsLimb fracture is associated with changes in pain perceptions, motor planning, and disruption to body perception. Signs and symptoms of CRPS, ongoing pain and delayed recovery post‐fracture are common. What does this study add?In the immediate post‐fracture period: Body perception disturbance is reported in the fractured limb. Imagined movements of the fractured limb are less vivid and associated with painThis study contributes to the incidence literature on CRPS. (Source: European Journal of Pain)



Comparison of transforaminal and interlaminar epidural steroid injections for the treatment of chronic lumbar pain

Mon, 21 Mar 2016 00:00:00 +0100

Conclusions This study showed that interlaminar epidural steroid injections can be as effective as transforaminal epidural steroid injections when performed at the nearest level of lumbar pathology using fluoroscopy in 12-month intervals. (Source: Brazilian Journal of Anesthesiology)



Television viewing time, physical activity and low back pain in community-based adults: Results from a prospective cohort study

Sun, 20 Mar 2016 18:07:33 +0100

Purpose: Low back pain (LBP) has an enormous negative economic impact on individuals, families, communities, industries and governments. As such, understanding the aetiology and risk factors for LBP is important in reducing the significant burden of this condition. In an effort to achieve this, epidemiological studies have examined a number of factors, including demographic (age and gender), obesity, and lifestyle factors (physical activity and sedentary lifestyle). The role of lifestyle factors on LBP has become a particular area of importance as they can be modified. (Source: Osteoarthritis and Cartilage)



Healthcare service use after lumbar spine MRI in general practice

Sun, 20 Mar 2016 18:07:33 +0100

The objective of the study was to investigate the association between patient characteristics, back pain characteristics and MRI abnormalities (including lumbar degeneration) with subsequent specialist consultation and/or surgery in low back pain patients presenting for lumbar MRI as referred by their general practitioners. (Source: Osteoarthritis and Cartilage)



Relationships between weight, physical activity and back pain in young adult women

Sun, 20 Mar 2016 18:07:33 +0100

Purpose: Back pain is a major global health problem, causing greater disability worldwide than any other condition. It is associated with a significant economic burden and major disability, as therapeutic options have limited efficacy. Given limited treatment options, clarifying predictors of back pain is important in order to optimize preventive strategies. Furthermore, as previous episodes of back pain are predictive of future recurrence, understanding risk factors associated with back pain in early adulthood is particularly important. (Source: Osteoarthritis and Cartilage)

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NGF selective inhibition therapy on facet joint pain

Sun, 20 Mar 2016 18:07:33 +0100

Purpose: The lifetime prevalence of low back pain (LBP) is about 70-85%, with 10-20% experience experiencing chronic low back pain (LBP). Facet joint degeneration (FJD) by osteoarthritic changes is a common cause of LBP with an incidence of 15–45% among patients with chronic LBP. The overall objectives are to test the pharmacological efficacy of allosteric small molecule inhibitor of the TrkA pathway in FJD-induced chronic back pain, and to understand the underlying molecular pain pathways. (Source: Osteoarthritis and Cartilage)



Development of a complex group self-management intervention and feasibility trial for osteoarthritis and chronic low back pain

Sun, 20 Mar 2016 18:07:31 +0100

Purpose: Self-management (SM) is consistently endorsed by clinical practice guidelines and policy makers for osteoarthritis (OA) and chronic low back pain (CLBP), but health service commissioners require robust evidence of its clinical and cost effectiveness prior to widespread implementation, which is currently lacking. The multifaceted nature of SM interventions with several interacting components that need to be tailored to the individual, and underpinned by a collaborative relationship between the patient and health-care professional within the local health service constitutes a complex intervention, notwithstanding the additional challenges of consistently delivering such an intervention in a group format if preferred, across a diverse range of health service settings with varying res...



Older adults with low back pain who meet a clinical cluster for hip osteoarthritis have ultrasound joint morphological findings consistent with hip osteoarthritis

Sun, 20 Mar 2016 18:07:30 +0100

Purpose: The primary objective was to determine whether or not hip joints that meet a clinical cluster for hip osteoarthritis (OA), in older adults with low back pain (LBP), have joint morphological findings consistent with hip OA, as obtained with ultrasound imaging (USI). We also sought to determine the sensitivity and specificity of a clinical cluster in predicting USI joint morphological findings consistent with hip OA. (Source: Osteoarthritis and Cartilage)



Systematic review of costs and effects of self-management interventions for chronic musculoskeletal pain: Spotlight on analytic perspective and outcomes assessment

Sun, 20 Mar 2016 18:07:30 +0100

Purpose: Chronic musculoskeletal pain (CMP) conditions, particularly low back pain (LBP), are common and disabling conditions frequently requiring long-term management. Enabling individuals to self-manage (SM) their condition is widely endorsed within clinical practice guidelines and health policy recommendations internationally. However, the current evidence for the cost-effectiveness of SM is limited with little consensus. The outcome of economic evaluations is highly dependent on which costs and effects are included in the economic analysis. (Source: Osteoarthritis and Cartilage)



Factors affecting physiology of intraosseous pressure measurement

Sun, 20 Mar 2016 18:07:29 +0100

Purpose: Intraosseous pressure (IOP) has been studied for 50 or more years and is of interest in diseases such as osteoarthritis and osteonecrosis and in bone pain. IOP in cancellous bone has usually been thought to have a static value due to venous back pressure or tissue turgor. We measured IOP in patients before surgery but the results varied. We therefore set out to assess factors which might influence the physiology of IOP at rest in healthy subchondral cancellous bone in a standardized animal model. (Source: Osteoarthritis and Cartilage)

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Regenerative medicine of nucleus pulposus niche through biomaterial-assisted transplantation of adipose stromal cell-derived nucleopulpocytes: preliminary experiments in sheep

Sun, 20 Mar 2016 18:07:28 +0100

Purpose: Intervertebral disc (IVD) degeneration is one of the major causes of low back pain (LBP). IVD degeneration is conceptualized as the consequence of the nucleus pulposus (NP) cell inability to maintain IVD extracellular matrix homeostasis. Regenerating the NP niche through biomaterial-assisted transplantation of regenerative cells could thus be a promising strategy to address LBP. Interestingly, we recently demonstrated the ability of human adipose derived-stromal cells (ASC) to give rise to nucleus pulposus cells namely the nucleopulpocytes (NPCy) and the ability of ASC-derived NPCy to support the neo-formation of a NP-like tissue when transplanted with a silanized hydroxypropylmethylcellulose (Si-HPMC) hydrogel in nude mice subcutis. (Source: Osteoarthritis and Cartilage)



The relationship between obesity and low back pain and disability is affected by mood disorders–a population-based, cross-sectional study of men

Sun, 20 Mar 2016 18:07:28 +0100

Purpose: Low back pain and obesity are both major public health problems. Known risk factors for back pain include age, female gender, lower educational attainment, strenuous physical activity and mood disorders. Obesity has also been linked with low back pain and recent studies have reported that increased fat but not lean tissue mass has been associated with back pain, however previous studies predominantly examined women. The relationship between body composition and low back pain in men is unknown. (Source: Osteoarthritis and Cartilage)



Co-existing hip symptoms are associated with self-efficacy and pain-related fear in older adults with a primary complaint of low back pain: the Delaware spine studies

Sun, 20 Mar 2016 18:07:28 +0100

Purpose: Low back pain (LBP) is the most common musculoskeletal complaint among the geriatric population. Musculoskeletal clinicians have often proposed a link between the hip and lumbar spine in older adults. Offierski and McNab originally described hip-spine syndrome as the presence of lumbar symptoms due to an abnormal biomechanical relationship between the hip joint and spine likely related to degenerative pathology in one or both joints; but, little work has been done to understand whether the additional burden of co-existing hip symptoms might impact pain-related psychologic factors in an individual with LBP. (Source: Osteoarthritis and Cartilage)



Association between body composition and low back pain intensity and disability

Sun, 20 Mar 2016 18:07:28 +0100

Purpose: Understanding the aetiology and risk factors for low back pain (LBP) is important in reducing the significant burden of this condition. There are evidence that demonstrate that like other musculoskeletal disease, LBP is associated with overweight and obesity. Evidence supporting an association between body size and risk of LBP currently relies mostly on BMI, waist circumference which does not account for body composition and cannot discriminate adipose from non-adipose body mass. Clarifying the role of body composition on the risk of LBP is important as it will help in the understanding of likely pathological mechanisms. (Source: Osteoarthritis and Cartilage)



Hip symptoms contribute to low back pain-related disability in older adults with a primary complaint of low back pain: the Delaware spine studies

Sun, 20 Mar 2016 18:07:28 +0100

Purpose: Low back pain (LBP) is the most frequently reported musculoskeletal problem among older adults. Clinicians specializing in the care of musculoskeletal conditions have often proposed a link between hip dysfunction and LBP among older adults. Offierski and McNab originally described hip-spine syndrome as the presence of symptoms due to an abnormal biomechanical relationship between the hip joint and spine likely related to degenerative pathology in one or both joints; but, little work has been done to elucidate this relationship. (Source: Osteoarthritis and Cartilage)

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Silica nanocarrier as a sustained delivery system of GDF5 for intervertebral disc regenerative medicine

Sun, 20 Mar 2016 18:07:27 +0100

Purpose: Intervertebral disc (IVD) degeneration, and notably its central part the nucleus pulposus (NP), is one of the leading causes of low back pain (LBP). Currently, LBP is mainly managed by pharmacological treatments and for advanced cases by invasive surgical procedures. (Source: Osteoarthritis and Cartilage)



Degenerated intervertebral discs contain increased proportion of α-smooth muscle actin positive cells

Sun, 20 Mar 2016 18:07:27 +0100

Purpose: Low back pain (LBP) is a common disease which affects 80% of people around the world for at least once in their life time. Our previous study based on Hong Kong cohort demonstrated that intervertebral disc (IVD) degenerates with aging and is a major contribution to LBP. To date, the molecular changes in the IVD during degeneration progress is not fully illustrated. Previously, Melrose et al reported that a proportion of NP (the inner compartment of IVD) and AF (the surrounding lamella tissue surrounding NP) cells expressed α-smooth muscle actin (α-SMA). (Source: Osteoarthritis and Cartilage)



Characterization of age- and gender-specific trabecular bone structural parameters and mesenchymal stromal cells of osteoarthritic facet joints in lumbar spinal stenosis

Sun, 20 Mar 2016 18:07:27 +0100

Purpose: Facet joint osteoarthritis may be a cause of low back pain in degenerative spine diseases such as lumbar spinal stenosis. While increased bone remodeling is a clinical hallmark of osteoarthritis, the trabecular bone structural parameters of osteoarthritic lumbar facet joints have not been characterized thus far. Interestingly, an age- and gender-specific decrease of trabecular number, thickness and volume fraction has been previously described for lumbar 4/5 facet joints of healthy individuals. (Source: Osteoarthritis and Cartilage)



Predictors of back pain in middle aged women: data from the Australian longitudinal study on women’s health

Sun, 20 Mar 2016 18:07:27 +0100

Purpose: Back pain is a major public health issue, causing greater disability worldwide than any other condition. Given the limited treatment options available, an understanding of the predictors of back pain is vital to optimize preventive strategies. Women are not only more likely to suffer from back pain, they are also more likely to utilise health care services to a greater extent than men. However, few studies to date have examined modifiable predictors of back pain in middle-aged women, with exposure and outcome measures assessed at multiple time points and major inconsistency and knowledge gaps persist in this area. (Source: Osteoarthritis and Cartilage)



Intradiscal injection of a slow release formulation of celecoxib for the treatment of dogs with low back pain

Sun, 20 Mar 2016 18:07:27 +0100

Purpose: Intervertebral disc (IVD) disease characterized by low back pain is common in both humans and large breed dogs. Inflammatory mediators such as prostaglandin E2 (PGE2) play a key role in IVD degeneration, causing structural changes of the IVD and low back pain. The current conservative and surgical treatment modalities do not reverse IVD degeneration and have certain drawbacks. Long term systemic administration of non-steroidal anti-inflammatory drugs can cause gastro-intestinal side effects. (Source: Osteoarthritis and Cartilage)

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The effect of bone morphogenetic protein-2 on chondrocyte-like cells derived from degenerated human and canine intervertebral discs

Sun, 20 Mar 2016 18:07:27 +0100

Purpose: Both humans and dogs experience low back pain, which is related to intervertebral disc (IVD) degeneration. Biologic repair of the degenerated IVD is mainly based on growth factors that exert anabolic matrix effects, and mesenchymal stromal cells (MSCs) to replenish the cell population of the degenerated IVD. Thus far, the anabolic effects of different growth factors have not been compared. The aim of this study was to study the effect of the frequently used growth factors transforming growth factor beta 1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2) on canine and human chondrocyte-like cells (CLCs) from degenerated IVDs alone and in combination with MSCs. (Source: Osteoarthritis and Cartilage)



Modern Palliative Treatments for Metastatic Bone Disease: Awareness of Advantages, Disadvantages, and Guidance

Sun, 20 Mar 2016 06:07:24 +0100

This article aims to present these palliative treatments for the patients with bone metastases, summarize the clinical applications, and review the techniques and results. Methods: It gives an extensive overview of the possibilities of palliation in patients with metastatic cancer to the bone. Results and Discussion: Currently, modern treatments are available for the palliative management of patients with metastatic bone disease. These include modern radiation therapy, chemotherapy, embolization, electrochemotherapy, radiofrequency ablation, and high-intensity focused ultrasound. As such it is of interest for all physicians with no experience with these developments to make palliative procedures safer and more reliable. (Source: The Clinical Journal of Pain)



Follicularly-based papules on the thigh of a young woman.

Sun, 20 Mar 2016 01:46:01 +0100

We present a case of a 29-year-old woman who presented with an atypical follicularly-based eruption localized to her inner thigh with an associated pain in her lower back and inner thigh prior to the papular eruption. She was successfully treated with valacyclovir 1,000 mg three times daily with no complications. PMID: 26990477 [PubMed - in process] (Source: Dermatol Online J)



8 Ways Resilient People Approach Life, Love and Success.

Sat, 19 Mar 2016 13:55:55 +0100

Resilient people have a sense of grit at their core. They are persistent and tough-minded in the face of failure, loss, heartbreak, success and challenge. They are committed. Whatever they pursue is met with their full attention and nothing less. There is no amount of hard work they will shy away from if it means losing an opportunity to improve themselves or their lives. Because of this commitment they are able to resist the temptation to slack. They are able to stay focused, determined and resolute in the pursuit of their goals. They also know when to let go. 1. Past history is a wisdom teacher. Resilient individuals see their past as the most valuable teacher. Past mistakes allow them to learn what not to repeat in their future. Once they have the lesson they do not harbor it and contin...



Anterior lumbar inter-body fusion with instrumentation compared with posterolateral fusion for low grade isthmic-spondylolisthesis.

Sat, 19 Mar 2016 07:00:03 +0100

CONCLUSIONS: ALIF with posterior instrumentation in low grade isthmic spondylolisthesis provides satisfactory outcome in patients requiring surgical treatment. The results of pain relief and disability index are comparable to time tested posterolateral fusion. ALIF shows a tendency to faster pain relief and return to activity with less intraoperative blood requirement in low grade isthmic spondylolisthesis. PMID: 26984651 [PubMed - in process] (Source: Acta Orthopaedica Belgica)

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Pars injuries in athletes - Oren J, Gallina J.

Sat, 19 Mar 2016 06:34:46 +0100

Pars injuries are common causes of low back pain in adolescent athletes. Workup traditionally has included lumbar radiographs with oblique views and single-photon emission computed tomography (SPECT). However, recent literature has demonstrated the accurac... (Source: SafetyLit)



OsseoFix Spinal Fracture Reduction System—a safe and effective alternative for kyphoplasty in vertebral compression fractures

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Vertebral compression fractures (VCFs) are the most common fragility fractures and are a significant cause of pain, deformity and morbidity. In recent years expandable titanium mesh cages, such as the OsseoFix Spinal Fracture Reduction System (Alphatec Spine Inc, CA), have come into use with promising initial results. (Source: The Spine Journal)



Vertebral augmentation for vertebral fractures in the “older-old” person: experience from a tertiary UK spinal unit

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Vertebral augmentation has been shown to improve pain associated with osteoporotic vertebral fractures (VF). Its benefit in the ‘older-old’ is less certain. (Source: The Spine Journal)



Sacropelvic fixation using S2 alar-iliac (S2AI) screws—analysis of clinical and radiological outcomes with minimum 1-year follow-up

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Sacropelvic fixation with iliac screws requires transverse connectors and is associated with risks of prominent metalwork, pelvic pain, pressure necrosis and construct failure. Significant lateral dissection leads to greater risk of bleeding and infection. The S2 alar-iliac (S2AI) screw has been suggested as an alternative to reduce these risks. (Source: The Spine Journal)



The effect of fluid flow on intervertebral disc cells

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Spinal exercises are recommended by National Institute of Clinical Excellence (NICE) guidelines for the treatment of low back pain, but research surrounding which exercises are most beneficial has been inconclusive. Spinal movement creates pressure change and fluid flow, which are essential for disc health. (Source: The Spine Journal)

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Management of paediatric pars oedema without fracture

Sat, 19 Mar 2016 01:34:48 +0100

We present the clinical features, management and outcome of this disorder. (Source: The Spine Journal)



Fusion rates following distraction interference arthrodesis of the sacroiliac joint. A retrospective study of post-operative computerized tomography (CT) scans

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Sacroiliac joint pain, often overlooked yet significantly debilitating, may present as a primary source of pain or secondary to previous lumbar spine fusion similar to adjacent segment wear. Minimally invasive techniques with their perceived advantages of less operating time, blood loss, morbidity and inpatient stay are now described and utilised. However, little radiologic evidence exists to support the use of such techniques for sacroiliac joint fusion. Our centre performs distraction arthrodesis for recalcitrant pain. (Source: The Spine Journal)



Lumbar spine angles in subjects with a history of flexion-related back pain when performing a typing task

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Lower back pain is a highly prevalent musculoskeletal condition with high economic costs to governments and individuals. A classification approach that subgroups individuals based on the movement activities that aggravate their back pain will specifically target treatment. Prolonged sitting is a common aggravating activity for many back pain sufferers. Further understanding of the sitting behaviours of the subgroup of individuals with flexion-aggravated back pain could help guide intervention. (Source: The Spine Journal)



Comparison of intrathecal diamorphine with conventional methods of analgesia following transforaminal lumbar interbody fusion (TLIF) surgery

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Unrelieved postoperative pain following lumbar surgery can lead to severe complications. Intrathecal opioids (morphine) following spinal surgery have been described but can be associated with an increased incidence of late respiratory depression. (Source: The Spine Journal)



Sacroiliac minimal invasive fusion compared to physical therapy: six-month outcome from a multicentre randomised controlled trial

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Sacroiliac (SI) joint dysfunction is a common cause of chronic, unremitting lower back or buttocks pain. (Source: The Spine Journal)

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Midterm results for coflex interspinous dynamic stabilisation device in degenerative lumbar stenosis. The good, the bad and the ugly

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: The concept of ‘dynamic stabilisation’ or ‘soft stabilisation’ was introduced with the aim to provide a solution to problems related with spinal fusion. In theory, dynamic stabilisation system should provide sufficient support at the inserted level, allowing for load transmission of a spinal motion segment, without major restriction to motion at the affected segment, allowing to relieve pain and avoiding adjacent level disease encountered with spinal fusion. (Source: The Spine Journal)



Lumbar spine curvature varies with modic changes and disc degeneration in asymptomatic individuals

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Degenerative lumbar disc disease (DLDD) is significantly associated with signs of lumbar disc (LDD) and vertebral degeneration (modic change or MC) and symptoms of recurrent low back pain. An association between spinal curvature and DLDD in asymptomatic individuals has not been previously considered. (Source: The Spine Journal)



Single-level versus multiple-level lumbar disc arthroplasty: a prospective study with 24-months follow-up

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Low back pain is one of the most prevalent spinal problems in the Western world and is only set to increase as the population ages. Degenerative disc disease is a significant contributor. Lumbar disc replacement (LDR) aims to preserve motion and avoid fusion-related complications. (Source: The Spine Journal)



Outcome and health-related quality of life after surgery for spinal metastases

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Spinal metastases is a common condition that may lead to neurological compromise, spinal instability and incapacitating pain. Surgical treatment has been shown to improve pain, function and neurological outcome. (Source: The Spine Journal)



Computational models for characterisation and design of patient-specific spinal implant

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Spinal fusion is designed to reduce movements between vertebrae and therefore pain. The most used devices for this procedure are mainly made of titanium or polyether ether ketone (PEEK). However, the mismatch between devices, with standard shapes and materials, and the surrounding bones can lead to suboptimal outcomes. Computational models, namely, Finite Element Analyses (FEA), can be employed to optimise existing device and design more effective solutions. (Source: The Spine Journal)

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A systematic review of pain and disability outcomes of pain neuroscience education (PNE) in the management of chronic low back pain

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Pain neuroscience education is employed in patients with chronic low back pain (CLBP) to reduce pain-related behaviours. However, its efficacy has not been systematically evaluated. (Source: The Spine Journal)



‘I think positivity breeds positivity’: a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: It is proposed that ‘significant others’ (spouses/partners/close family members) are important sources of support in helping those with chronic musculoskeletal pain to remain at work, but the phenomenon remains largely unexplored. (Source: The Spine Journal)



Therapeutic efficacy of particulate versus non-particulate steroids for cervical and lumbar radiculopathy

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Selective nerve root blocks (SNRB) by transforaminal epidural steroid infiltration (TFESI) is used in non-operative management of cervical and lumbar radiculopathy(C&LR). Particulate steroids (PS) are perceived to be more effective providing long-lasting pain relief in comparison to non-particulate steroids (NPS). (Source: The Spine Journal)



The effect of classification-based cognitive functional therapy on spinal kinematics and function in subgroups of chronic low back pain

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Chronic low back pain (CLBP) is a global problem with effective treatments unknown. Heterogeneity is thought responsible for lack of success. Classification-based cognitive functional therapy (CB-CFT) targeting person's pain mechanisms demonstrated efficacy. CB-CFT effect on spinal movement and function has not been studied. (Source: The Spine Journal)



Predictors of self-management in patients with chronic low back pain: study protocol

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Self-management (SM) can be defined as individual's ‘ability to manage the symptoms, treatment, physical and psychological consequences and life-style modifications’. SM programmes for patients with chronic low back pain (CLBP) have failed to show clinically meaningful improvement in pain and disability, which potentially reflects difficulty in treatment matching in absence of extensive research on predictors of SM. (Source: The Spine Journal)

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The surgical treatment of severe Scheuermann kyphosis

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Scheuermann kyphosis is a structural deformity of the thoracic or thoracolumbar spine that can produce severe pain resistant to conservative measures, neurological compromise or unacceptable cosmetic deformity. Modern techniques allow better correction of the deformity through posterior-only or anteroposterior surgery but carry significant risks of major complications. (Source: The Spine Journal)



Percutaneous correction of scoliosis in Duchenne muscular dystrophy: a new technique

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Scoliosis is common in Duchenne muscular dystrophy (DMD). It leads to impaired respiratory function, poor sitting balance and pain. Surgical correction of scoliosis improves sitting balance and prevents deterioration of respiratory function. However, conventional surgery in these patients is associated with significant intraoperative bleeding and risk of infection; percutaneous surgical techniques have the advantage of reducing this. (Source: The Spine Journal)



Observed changes with intraoperative spinal cord monitoring during kyphosis correction with 3 column osteotomies

Sat, 19 Mar 2016 01:34:48 +0100

BACKGROUND CONTEXT: Kyphosis and junctional kyphosis associated with previous surgery commonly present with worsening pain and neurological deficits. The indications for surgery are increasing axial back pain, pseudoarthrosis or malunion that fails to respond to non-operative treatment, and progressive neurological deterioration. Spinal deformity corrections are associated with iatrogenic neurological injuries. Intraoperative monitoring (IOM) is mandatory during spinal deformity correction to alert the surgeon during critical times in these high-risk procedures, allowing modification of surgical technique. (Source: The Spine Journal)



Measuring spinal surgical success: the proportion achieving acceptable symptoms

Sat, 19 Mar 2016 01:34:47 +0100

Commentary On: Fekete TF, Haschtmann D, Kleinstück FS, Porchet F, Jeszenszky D, Mannion AF. What level of pain are patients happy to live with after surgery for lumbar degenerative disorders? Spine J 2016:16:S12–18 (in this issue). (Source: The Spine Journal)



Rib-sparing minimally invasive vertebrectomy is a safe and effective treatment for single-level metastatic spinal disease: a case series of 15 patients

Sat, 19 Mar 2016 01:34:47 +0100

BACKGROUND CONTEXT: Vertebrectomy is an established means of improving pain control and mobility for single-level metastatic spinal disease, but is associated with significant post-operative morbidity when performed via a traditional thoracotomy approach. (Source: The Spine Journal)

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Coccygodynia—transsacrococcygeal ganglion impar block

Sat, 19 Mar 2016 01:34:47 +0100

BACKGROUND CONTEXT: Coccydynia (Coccygodynia) is a relatively uncommon, debilitating pain condition affecting predominantly females with significant impairment of quality of life with unpredictable surgical results. (Source: The Spine Journal)



Outcome of surgical management of spinal metastases secondary to renal cell carcinoma in a district general hospital

Sat, 19 Mar 2016 01:34:47 +0100

BACKGROUND CONTEXT: Metastatic spread of renal cell carcinoma (RCC) to the spine is common; symptoms include pain and/or neurological deficit. Surgical intervention offers symptomatic relief using a combination of tumour de-bulking, vertebral stabilisation and spinal cord decompression. A Tokuhashi scoring system predicts prognosis and guides management decisions. In isolated RCC spinal metastasis, surgical cure can be attempted. (Source: The Spine Journal)



Epidemiological analysis of psoriatic arthritis patients in Japan

Sat, 19 Mar 2016 00:00:00 +0100

In conclusion, the ratio of psoriatic arthritis in Japan is increasing, and nearly 10% of new psoriasis patients had psoriatic arthritis. This study shows the current status of psoriatic arthritis in Japan, including several unexpected findings such as male predominance, longer duration between the onset of cutaneous psoriasis and arthritis, and dominance of polyarthritis. (Source: The Journal of Dermatology)



18F-FDG –PET avid paraspinal soft tissue mass mimicking a malign neoplasm: non-traumatic myositis ossificans

Sat, 19 Mar 2016 00:00:00 +0100

A 31-year-old man presented with 2 weeks history of back pain. He had no trauma history. A lumbar magnetic resonance imaging (MRI) showed a lesion in the left paraspinal muscle at the level of L4. The lesion was globally isointense on T1-weighted images and slightly hyperintense on T2-weighted imaging. The mass strongly enhanced on contrast-enhanced T1-weighted images (Fig. 1). The lesion showed intense fluoro-deoxyglucose (FDG) uptake on PET-CT, suggesting a malignant process (Fig. 2). Biopsy of the lesion was performed and histopathological examination was consistent with myositis ossificans. (Source: The Spine Journal)



Inferior accessory ossicle of the anterior arch of the atlas in a trauma patient

Sat, 19 Mar 2016 00:00:00 +0100

A 28-year-old man was admitted to our emergency service with symptoms of scalp laceration and neck pain, after being involved in a car accident. The physical examination revealed tenderness in the upper cervical spine, but the patient showed no neurological abnormalities and he was in a hemodynamically stable condition. Computed tomography (CT) imaging of the cervical spine was performed. CT showed a triangular shape, well corticated bone fragment that articulates with the inferior aspect of the anterior arch of the atlas (Figure 1). (Source: The Spine Journal)

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Neural arch tuberculosis of cervical spine causing compression of spinal cord

Sat, 19 Mar 2016 00:00:00 +0100

A 24-year-old man presented with a 4-month history of neck pain and stiffness in the legs. Physical examination revealed tenderness over the lower cervical spine, hyperreflexia of the lower extremity and positive babinski sign on both sides. Lateral radiograph and CT showed severe osteolysis at the posterior element of C6 and partial C7 (Fig. 1). Magnetic resonance imaging (MRI) of the neck showed a large swelling posterior to C6-C7 with communication to the spinal canal and compression of the spinal cord (Fig. (Source: The Spine Journal)



Mom's Powerful Project Helps Parents Cope With Loss

Fri, 18 Mar 2016 20:17:29 +0100

On Oct. 27, 2014, Lexi Behrndt's son Charlie passed away at the age of 6 months. Now, over a year later, the Florida mom is joining with others who have experienced loss to share stories of grief and "rising from the ashes" through a project she calls "On Coming Alive." Behrndt invites others to write their stories of loss for the On Coming Alive website and social media accounts or share them with the hashtags #OCAStories and #oncomingalive. So far, hundreds have participated. While many of the participants are parents who, like Behrndt, have experienced child loss, there are also stories of domestic violence, depression, death of loved ones, sexual abuse, rape, and homelessness. "I named it On Coming Alive because to me, this was the process I was undergoing after a year from the pi...



Health problems among nursing workers in a haemodialysis service.

Fri, 18 Mar 2016 12:50:01 +0100

Conclusion In spite of the positive results of the work-related health assessment among the studied population, the results confirm the need to promote the health of nursing workers. PMID: 26982679 [PubMed - as supplied by publisher] (Source: Revista gaucha de enfermagem EENFUFRGS)



A case report of a 13-year-old girl diagnosed with superior mesenteric artery syndrome after undergoing spine correction with posterior fusion for rapidly progressed juvenile idiopathic scoliosis

Fri, 18 Mar 2016 00:00:00 +0100

Conclusions (1) SMAS can occur frequently in patients after surgical correction of the spine deformities. (2) At the curvatures of the order of 100°–120° or more, there is a significant change in the topography of the anatomical structures and their adaptation to a new position after surgery. (3) Special attention must be paid to young, lean patients, with BMI below 19, and the postoperative effect of an elongated axis of the spine. (4) Even if SMAS occurs, in most cases it can and should be treated conservatively. (Source: Polish Annals of Medicine)



Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral lumbar disc herniations in children

Fri, 18 Mar 2016 00:00:00 +0100

Conclusions Transforaminal percutaneous endoscopic discectomy achieved satisfactory results for children with far-lateral lumbar disc herniations. (Source: International Orthopaedics)

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Epidemiology of chronic low back pain in US adults: National Health and Nutrition Examination Survey 2009‐2010

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion: US adults with cLBP are socio‐economically disadvantaged, make frequent healthcare visits and are often covered by government‐sponsored health insurance. The clustering of behavioral, psychosocial, and medical issues should be considered in the care of Americans with cLBP. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)



Patients aged 16‐45 years with chronic back pain of a short duration and maximally 1 SpA‐feature: Are additional tests needed to rule out axial spondyloarthritis? (results from the SPACE cohort)

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion: In these patients in a secondary care setting with 1 SpA‐feature at most, axSpA could not be ruled out without sacroiliac joint imaging and/or HLA‐B27 testing. This article is protected by copyright. All rights reserved. (Source: Arthritis Care and Research)



No role for paracetamol in treating pain in osteoarthritis

Fri, 18 Mar 2016 00:00:00 +0100

Large meta-analysis finds that no dose of paracetamol is effective for managing osteoarthritic pain Related items from OnMedicaSome common painkillers can raise heart risksGP prescribing intervention cuts emergency admissions Long-term risk of paracetamol is underestimatedParacetamol 'does not help back pain or arthritis'Opioid or muscle relaxant no extra benefit for back pain (Source: OnMedica Latest News)



Evaluating the effects of recombinant human bone morphogenetic protein-2 on pain-associated behaviors in a rat model following implantation near the sciatic nerve.

Fri, 18 Mar 2016 00:00:00 +0100

CONCLUSIONS In this study, rhBMP-2/ACS did not appear to induce pain independent of grossly visible ectopic bone formation. At the earliest time points, rhBMP-2 appeared to have a neuroprotective effect as evidenced by decreased pain exhibited by the rhBMP-2-treated animals in the CCI cohort, but this effect diminished over time, and by Day 28, the pain behavioral responses in the rhBMP-2-treated group were comparable to those in the group in which saline was applied to the nerve. In the Sham cohort, there was a dose-independent induction of pain at later time points, presumably due to new bone formation mechanically irritating the nerve. Histological examination revealed nerve lesions that appeared to be caused by mechanical trauma associated with surgical manipulation of the nerve during...



Intense pulsed light versus photodynamic therapy using liposomal methylene blue gel for the treatment of truncal acne vulgaris: a comparative randomized split body study

Fri, 18 Mar 2016 00:00:00 +0100

The objective was to study the effect of PDT in truncal acne vulgaris using liposomal methylene blue (LMB) versus IPL alone. Thirty-five patients with varying degrees of acne were treated with topical 0.1 % LMB hydrogel applied on the randomly selected one side of the back, and after 60 min the entire back was exposed to IPL. The procedure was done once weekly for three sessions and patients were re-evaluated 1 month after the third session by two independent dermatologists. Acne severity was graded using the Burton scale. Patient satisfaction using Cardiff Acne Disability Index (CADI) was recorded before and after treatment. On LMB-pretreated side, inflammatory acne lesion counts were significantly decreased by 56.40 % compared with 34.06 % on IPL alone. Marked improvement was seen o...

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Proximal Junctional Kyphosis.

Thu, 17 Mar 2016 22:34:02 +0100

Authors: Kim HJ, Iyer S Abstract Proximal junctional kyphosis (PJK) is a common complication following adult spinal deformity surgery. It is defined by two criteria: a proximal junctional sagittal Cobb angle (1) ≥10° and (2) at least 10° greater than the preoperative measurement. PJK is multifactorial in origin and likely stems from surgical, radiographic, and patient-related risk factors. The diagnosis of PJK represents a broad spectrum of disease ranging from asymptomatic patients with recurrence of deformity to those presenting with increased pain, functional deficit, and, in the most severe cases, neurologic deficits. Recent studies have demonstrated increased pain levels in select patients with PJK. In keeping with the broad spectrum of the disease, classification schemes ...



Prescription painkiller addiction epidemic can be traced back to two key changes

Thu, 17 Mar 2016 21:50:12 +0100

Two experts from Washington University in St Louis reveal how early recognition and proactive treatment of pain, and the introduction of the painkiller OxyContin marked a turning point, leading to the epidemic. (Source: the Mail online | Health)



Well: Ask Well: Pregnancy and Back Pain

Thu, 17 Mar 2016 15:25:13 +0100

Simple exercises can ease back pain in pregnancy, including arching the back like a cat. (Source: NYT)



A cure for my back pain? They’ll invent the head transplant first | Emma Brockes

Thu, 17 Mar 2016 14:35:31 +0100

On Sunday night, while tidying the living room floor, I suddenly joined a suffering subcultureAfter I had my kids and turned 40, last year, I thought I was done for rites of passage for a while. Then this week, out of the blue, came another. Those who’ve been through it will understand, and those who haven’t will think I’m exaggerating, but either way, when I got up from tidying the living room floor on Sunday night, my back went into spasm and the world divided into before and after. Related: Everything you ever wanted to know about back pain (but were afraid to ask) Continue reading... (Source: Guardian Unlimited Science)



Well: Ask Well: Pregnancy and Back Pain

Thu, 17 Mar 2016 11:02:16 +0100

Simple exercises can ease back pain in pregnancy, including arching the back like a cat. (Source: NYT)

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Study shows spinal cord stimulation reduces emotional aspect of chronic pain

Thu, 17 Mar 2016 04:00:00 +0100

(MediaSource) Researchers at The Ohio State University Wexner Medical Center have shown that patients with chronic pain can reduce their emotional response to the pain through spinal cord stimulation. (Source: EurekAlert! - Medicine and Health)



Low back pain and femoral neuralgia revealing myeloid sarcoma with megakaryocytic differentiation

Thu, 17 Mar 2016 00:00:00 +0100

Publication date: Available online 16 March 2016 Source:Joint Bone Spine Author(s): Gonçalo Boleto, Matthias Michel, Nadia Salam, Jean-Paul Eschard, Jean-Hugues Salmon (Source: Joint Bone Spine)



Atypical femoral fracture in a 51-year-old woman: Revealing a hypophosphatasia

Thu, 17 Mar 2016 00:00:00 +0100

We report a 51-year old woman who suffered 2 atypical subtrochanteric femoral fractures (AFFs). She had a history of several metatarsal fractures. She had a normal bone densitometry. An adult form of hypophosphatasia (HPP) was diagnosed from low serum alkaline phosphatase (ALP), and tissue nonspecific isoenzyme of ALP (TNSALP) mutation analysis revealing 2 heterozygous mutations: c.299C>T (p. T100M) and c.571G>A (p. E191K). Low ALP is the hallmark of the diagnosis of HPP; which is associated in adults with premature loss of deciduous teeth, recurrent metatarsal stress fractures, and joints and tendons disorders. The incidence of AFFs in the population is 5.9 per 100,000 person-years. Physicians and patients with bone fragility must pay attention to prodromal pain, which requ...



Melittin, the Major Pain-Producing Substance of Bee Venom

Thu, 17 Mar 2016 00:00:00 +0100

Abstract Melittin is a basic 26-amino-acid polypeptide that constitutes 40–60% of dry honeybee (Apis mellifera) venom. Although much is known about its strong surface activity on lipid membranes, less is known about its pain-producing effects in the nervous system. In this review, we provide lines of accumulating evidence to support the hypothesis that melittin is the major pain-producing substance of bee venom. At the psychophysical and behavioral levels, subcutaneous injection of melittin causes tonic pain sensation and pain-related behaviors in both humans and animals. At the cellular level, melittin activates primary nociceptor cells through direct and indirect effects. On one hand, melittin can selectively open thermal nociceptor transient receptor potential vanilloid recep...

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Physical and social factors determining quality of life for veterans with lower-limb amputation(s): a systematic review.

Thu, 17 Mar 2016 00:00:00 +0100

Conclusions The identified physical and social determinants were similar to those found in civilian traumatic amputees. More high quality research designs, interventions and complex statistical analyses are warranted to identify the physical and social factors that influence the HRQoL of veteran amputees. Implications for Rehabilitation Rehabilitation staff should promote physical activity and participation in sport among veterans with lower-limb amputation(s). Level of amputation, back pain severity, years of education, duration of phantom pain and severity of phantom pain have been found to be determining factors for HRQoL and should be taken into consideration when planning rehabilitation programs for veterans with lower-limb amputations. PMID: 26985705 [PubMed - as supplied by publ...



Ventral cervicothoracic epidural hematoma during anticoagulant therapy and rapid spontaneous resolution

Thu, 17 Mar 2016 00:00:00 +0100

A 71-year-old woman who was undergoing anticoagulant treatment because of atrial fibrillation for a long time was admitted with neck pain and paraparesis of 2 days duration. Magnetic resonance imaging of the cervical and thoracic spine revealed a cervicothoracic ventral epidural hematoma, causing anterior cord compression. The lesion demonstrated mixed signal intensity on T2-weighted images and marked low signal intensity “blooming” on T2-weighted gradient-echo images (Fig. 1). It was iso/hyperintense to cord on T1-weighted images and did not show enhancement on postcontrast images (Fig. (Source: The Spine Journal)



Extensive bone remodeling from a solitary fibrous tumor of the cervical spine

Thu, 17 Mar 2016 00:00:00 +0100

A 33-year-old healthy male presented with progressive right hand weakness and mild non-mechanical upper cervical pain over 3 months. Neurological examination revealed gait imbalance, limb spasticity and impaired rapid alternating movements of the upper right extremity. Magnetic resonance imaging (MRI) showed a homogeneously enhancing right-sided extradural extra-medullary mass extending from C1 to C4 with marked spinal cord compression (Fig.1). CT-scan showed extensive bone erosion and canal expansion, with bone loss of the right-sided C2 lamina, C2/3 facet joint and pedicles (Fig.2). (Source: The Spine Journal)



Autograft versus Allograft for Cervical Spinal Fusion: A Systematic Review

Thu, 17 Mar 2016 00:00:00 +0100

Conclusion Although the available literature suggests ICBG and allograft may have similar effectiveness in terms of fusion rates, pain scores, and functional outcomes following anterior cervical fusion, there are too many limitations in the available literature to draw any significant conclusions. No individual study provided greater than class III evidence, and when evaluating the overall body of literature, no conclusion had better than low evidence support. A prospective randomized trial with adequate sample size to compare fusion rates, efficacy measures, costs, and safety is warranted.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  open access Full text (Source: Global Spine Journal)



Guidelines for diagnosing and managing paediatric concussion: Ontario Neurotrauma Foundation guideline

Thu, 17 Mar 2016 00:00:00 +0100

Information about current guideline Concussion, relating to professional sport, has appeared in the headlines with increasing frequency over the last few years. The lessons learnt have trickled down to amateur and youth sport, and in June 2014, the Ontario Neurotrauma Foundation (ONF) published the "Guideline for diagnosing and managing paediatric concussion"1 with the aim to guide healthcare professionals in diagnosing concussion in children. The guideline is not limited to the initial assessment and management but includes a structure for ongoing reassessment, return to school and sport and an approach for managing common complications. The ONF, funded by the Government of Ontario, is a "health organisation that focuses on the practical application of research to improve the lives of peo...

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Answers to Illuminations questions

Thu, 17 Mar 2016 00:00:00 +0100

Answers (1) True, (2) False, (3) True, (4) False, (5) True, (6) False, (7) True, (8) False. The image shows herniation of the cerebellar tonsils below the foramen magnum, with effacement of CSF spaces at the craniocervical junction. On the complete MR scan, the right cerebellar tonsil extended 17 mm below the foramen magnum, and the left 10 mm. Subjectively, the posterior fossa looks normal in size and there was no other intracranial abnormality. The answer to Question 3 may therefore be true or false, depending on how you interpret the question. In Chiari I (sometimes called Arnold-Chiari I) malformation, the cerebellar tonsils protrude or herniate below the foramen magnum (the craniocervical junction) into the upper cervical spinal canal. This may be referred to as cerebellar t...



IL-17 mediates inflammatory reactions via p38/c-Fos and JNK/c-Jun activation in an AP-1-dependent manner in human nucleus pulposus cells

Thu, 17 Mar 2016 00:00:00 +0100

Low back pain and sciatica caused by intervertebral disc (IVD) disease are associated with inflammatory responses. The cytokine interleukin 17 (IL-17) is elevated in herniated and degenerated IVD tissues and a... (Source: Journal of Translational Medicine)



Chronic prostatitis induces urinary bladder hypersensitivity and sensitizes bladder afferents in the mouse

Thu, 17 Mar 2016 00:00:00 +0100

The objective of this study was to determine the extent of: 1] changes in immunomodulatory mediators in both the prostate and bladder after inflammation of the prostate and 2] bladder function and bladder afferent sensitization. (Source: The Journal of Urology)



Reirradiation of spinal metastases with intensity-modulated radiation therapy: an analysis of 23 patients

Thu, 17 Mar 2016 00:00:00 +0100

In conclusion, spinal metastasis reirradiation using IMRT appears safe; pain relief and paresis improvement and/or prevention can be expected, along with a reduced risk of radiation-induced toxicity, especially in the spinal cord. (Source: Journal of Radiation Research)



Effect of Preemptive Flurbiprofen Axetil and Tramadol on Transurethral Resection of the Prostate under Spinal Anesthesia.

Wed, 16 Mar 2016 23:45:01 +0100

Conclusions. Preoperative flurbiprofen axetil and tramadol can reduce and delay postoperative pain and then decrease analgesic consumption for TURP under spinal anesthesia without an increase of side effects. PMID: 26977315 [PubMed] (Source: Pain Research and Treatment)

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CDC Aims to Curb Painkiller Prescriptions

Wed, 16 Mar 2016 14:09:00 +0100

WASHINGTON (AP) — Prescription painkillers should not be a first choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the Centers for Disease Control and Prevention is urging primary care doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. Opioid drugs include medications like morphine and oxycodone as well as illegal narcotics like heroin. The new recommendations — which doctors do not have to follow — represent an effort to reverse nearly two decades of rising painkiller use, which public health officials ...



Is It Normal to Wake Up at Night?

Wed, 16 Mar 2016 12:27:58 +0100

Waking up at night is common. Is it a normal part of sleep? It's common to wake up during sleep. In fact, most people wake two or three times during the night. We can all remember a time, when as teenagers or young children, sleep was a continuous period of unawareness or oblivion that lasted between eight or nine hours, or even longer. However, that is not normal adult sleep. Indeed, once we pass our teens, sleep tends to be lighter and awakenings during sleep more frequent. In women by the age of 50, it's normal to wake 3-4 times per night. Humans don't sleep for eight hours continuously Historically if you read about how human sleep has been described over thousands of years, it has been described as three to four hours of deeper sleep after the sun goes down followed by a period of be...



Health Tip: Use Proper Lifting Technique

Wed, 16 Mar 2016 07:03:48 +0100

-- Lifting heavy things without the proper technique is an easy way to hurt your back. To help prevent back injury and pain, the American Academy of Orthopaedic Surgeons advises: Plan before you lift, and don't rush. Standing near the object,... (Source: Drugs.com - Daily MedNews)



Midcingulate Cortex: Structure, Connections, Homologies, Functions and Diseases

Wed, 16 Mar 2016 00:00:00 +0100

Publication date: Available online 15 March 2016 Source:Journal of Chemical Neuroanatomy Author(s): A. Brent Midcingulate cortex (MCC) has risen in prominence as human imaging identifies unique structural and functional activity therein and this is the first review of its structure, connections, functions and disease vulnerabilities. The MCC has two divisions (anterior, aMCC and posterior, pMCC) that represent functional units and the cytoarchitecture, connections and neurocytology of each is shown with immunohistochemistry and receptor binding. The MCC is not a division of anterior cingulate cortex (ACC) and the “dorsal ACC” designation is a misnomer as it incorrectly implies that MCC is a division of ACC. Interpretation of findings among species and developing models of human dise...

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Melatonin in Chronic Pain Syndromes

Wed, 16 Mar 2016 00:00:00 +0100

Abstract Melatonin is a neurohormone secreted by epiphysis and extrapineal structures. It performs several functions including chronobiotic, antioxidant, oncostatic, immune modulating, normothermal, and anxiolytic functions. Melatonin affects the cardiovascular system and gastrointestinal tract, participates in reproduction and metabolism, and body mass regulation. Moreover, recent studies have demonstrated melatonin efficacy in relation to pain syndromes. The present paper reviews the studies on melatonin use in fibromyalgia, headaches, irritable bowel syndrome, chronic back pain, and rheumatoid arthritis. The paper discusses the possible mechanisms of melatonin analgesic properties. On one hand, circadian rhythms normalization results in sleep improvement, which is inevitably di...



A retrospective observational study on the treatment outcomes of 26 patients with spinal cord astrocytoma including two cases of malignant transformation

Wed, 16 Mar 2016 00:00:00 +0100

Conclusions Two of 12 low-grade cases showed malignant transformations at 4 and 11 months, respectively, based on pathological confirmation. With spinal cord astrocytomas, enhanced MRI results appeared similar to those of a malignant lesion. We suggest close observation and image correlation of low-grade astrocytomas, even when pathologically confirmed as low-grade. In this review, we found that histologic grade is the most important prognostic factor, although it is not always concordant with biologic behaviors. (Source: European Spine Journal)



Effect of surgical correction of adolescent idiopathic scoliosis on the quality of life: a prospective study with a minimum 5-year follow-up

Wed, 16 Mar 2016 00:00:00 +0100

Conclusions Patients who underwent surgery for AIS a minimum of 5 years earlier had impaired self-reported physical QoL compared to control subjects, but they nevertheless performed better than before their surgery. Greater size of the residual hump and greater distal extension of the fusion area are negatively correlated with final self reported outcome. (Source: European Spine Journal)



Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Wed, 16 Mar 2016 00:00:00 +0100

Abstract Purpose To develop an evidence-based guideline for the management of grades I–III neck pain and associated disorders (NAD). Methods This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I–III NAD <6 months duration. Recommendation 1 Clinicians should rule out major structural or other pathologies as the cause of NAD. Once major pathology has b...



Cervical myelomeningocele associated with multiple spinal anomalies

Wed, 16 Mar 2016 00:00:00 +0100

A 28-year-old female patient presented with chronic pain and sensory loss in the cervical and dorsal region. Cervical spinal Magnetic Resonance Imaging (MRI) showed retraction and herniation of the cervical spinal cord and the adjacent dural structures to the paraspinal region through the fusion defect in the posterior aspect of the C6 vertebra which was compatible with myelomeningocele or spina bifida cystica. In addition to this rare developmental anomaly which accounts for only 1–5% of all neural tube defects, multi-level posterior fusion defects, large syringohydromyelia at the level of myelomeningocele, cerebellar tonsillar displacement into the craniocervical junction (Chiari malformation) and vertebral fusion between 2nd-3rd and 5th-6th cervical vertebrae were observed on the cerv...

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The discriminative value of inflammatory back pain in patients with persistent low back pain.

Wed, 16 Mar 2016 00:00:00 +0100

CONCLUSIONS: In this study population, IBP characteristics were in general common and the discriminative value was low, as IBP could not differentiate patients with SpA according to ASAS criteria from patients with other causes of back pain. PMID: 26982485 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Rheumatology)