Epidural Injections Not Effective for Back Pain

Epidural Injections Not Effective for Back Pain


Epidural back painEpidural steroid injection, a common non-surgical treatment of low back pain, appears to  be on the rise in the US and UK.1-2  Yet the efficacy of epidural steroid injections remains controversial. Some patients do report pain relief in the short term, but the long term benefits of injections are contested. 

A new study examined the effects of epidural steroid and saline injections in 133 patients with low-back pain. The patients had suffered from low back pain for over 12 weeks.  Participants were given one of three treatments: steroid injections, saline injections or  placebo injections. After 6, 12, and 52 weeks, there were no significant differences among the groups in terms of patients' pain, quality of life, and disability. Epidural steroid and saline injections were therefore not effective for low-back pain relief in this study. This led researchers to conclude that epidural steroid and saline injections should not be recommended to patients who have had low-back pain longer than 12 weeks.

"This study is very important when we talk to our patients who have low back pain," noted Hans-Christoph Diener, a  neurologist at the University of Essen in Germany. He contended that although this procedure is non-surgical, it can still be invasive. "Our advice should be to stay with conservative treatments like regular exercise, physical therapy, and if necessary intake of non-steroidal anti-inflammatory drugs and behavioral therapy." Chiropractic is a much better, natural approach to relieving back pain without any of the dangerous complications of epidural injections.
  1. Price C, Arden N, Coglan L, Rogers P. Cost-effectiveness and safety of epidural steroids in the management of sciatica. Health Technol Assess 2005;9:1-58,iii.Quoted in Iverson, et al.
  2. Friedly J, Chan L, Deyo R. Increases in lumbosacral injections in the Medicare population:1994 to 2001. Spine (Phila Pa 1976) 2007;32:1754-60.Quoted in Iverson, et al.
  3. Iverson, Trond, Tore Solber, Bertil Romner, Tom Wilsgaard, Jos Twisk, Audny Anke, Øystein Nygaard, Toralf Hasvold, and Tor Ingebrigtsen. "Effect of caudal epidural steroid or saline injection inchronic lumbar radiculopathy: multicentre, blinded, randomised controlled trial." BMJ. 2011; 343. d5278 doi: 10.1136/bmj.d5278.
  4. Diener, Hans-Christoph. "Low Back Pain: Time to Put Down the Needle?" Medscape. October 21, 2011. Accessed January 3, 2012. http://www.medscape.com/viewarticle/751916
  5. Posted in back painBack Pain Newsback pain treatmentepidural steroid injectionlow back pain

Tagged as back pain, charlotte chiropractor southpark 28209, epidural steroid injection, low back pain.

Drugs Ineffective for Sciatica Pain

Drugs Ineffective for Sciatica Pain

Posted in sciatica treatment
 
Chiropractic and back painThe efficacy of drugs for sciatica treatment has been called into question in a recent  literature review. Although there are consistent guidelines for prescribing medication for low-back pain, "this is not the case for sciatica." To address this lack of clear guidelines, researchers analyzed the results of current literature on pharmaceutical treatment of sciatica.

After evaluating 23 studies, researchers concluded that there is no clear evidence demonstrating "favourable effects of NSAIDs, corticosteroids, antidepressants, or opioid analgesics in the immediate term [relief of pain] even compared with placebo." That means that in many studies, drugs were no more effective than a placebo in relieving pain. Several drugs also did not significantly impact leg pain, one of the primary symptoms of sciatica. Though some NSAIDs and an anti-convulsant called gabapentin did reduce overall pain in the short term, the long-term effective  were unclear.

For long-lasting relief of sciatica pain, chiropractic care combined exercise may ultimately prove more effective by addressing the root cause of sciatic pain instead of simply easing symptoms.

Rafael Zambelli Pinto, Chris G Maher, Manuela L Ferreira, Paulo H Ferreira, Mark Hancock, Vinicius C Oliveira, Andrew J McLachlan, Bart Koes."Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis." British Medical Journal. 2012, February; 344:e497 doi: 10.1136/bmj.e497.
Posted in sciatica treatment

Tagged as charlotte chiropractor southpark 28209, sciatica treatment.

Smoking Linked to Back Pain

Smoking Linked to Back Pain


 
Quitting Smoking Can Reduce Spinal PainResearch suggests that smoking could increase your risk of back pain.

In one study of 95,000 nurses, women who smoked were three times more likely to developpsoriatic arthritis. This inflammatory arthritis causes pain in  the low back and sacrum. Past smokers were 1.5 times more likely to develop psoriatic arthritis, and women who smoked for over 25 years had the highest risk of all. Researchers suggested that smokers may be more susceptible to psoriatic arthritis because smoking could induce oxidative stress that causes inflammation and harms the immune system.

In another study, smokers were more likely to have an early onset of inflammatory back pain. Compared to non-smokers, patients who smoked had greater disease activity, worse function, and a poorer quality of life. MRI scans revealed that smokers were also more likely to have structural lesions on their spines and sacroiliac joints. More severe symptoms forced smokers to miss work more often than nonsmokers. Researchers recommended that patients with inflammatory back pain be "strongly advised" to quite smoking.

Previous  research has shown that smoking can increase your risk of developing sciatica and otherchronic pain conditions.  If  you suffer from back pain, a doctor of chiropractic can ease your pain while supporting you in making healthy lifestyle choices to reduce pain and improve your overall health.

Chung HY, Machado P, Heijde D, et al. Smokers in early axial spondyloarthritis have earlier disease onset, more disease activity, inflammation and damage, and poorer function and health-related quality of life: results from the DESIR cohort. Annals of the Rheumatic Diseases 2012;71:809-816.doi:10.1136/annrheumdis-2011-200180.
Li W, Han J, Qureshi A. Smoking and risk of incident psoriatic arthritis in US women. Annals of the Rheumatic Diseases 2012;71:804-808. doi 10.1136/annrheumdis-2011-200416.
Walsh, Nancy. Smoking Tied to Back Pain, Arthritis. Medpage Today. May 18,2012. Accessed May 24, 2012. http://www.medpagetoday.com/Rheumatology/Arthritis/32763.
Posted in Back Pain Newsback pain researchback pain treatmentFeatured

Tagged as back pain, back pain research, charlotte chiropractor southpark 28209.

Inheriting the Risk of Sciatica Pain

Inheriting the Risk of Sciatica Pain

Woman Back PainScientists have discovered a new risk factor for developing sciatic pain: your genes. Though scientists have suspected that genes play a role in sciatica, this study examines the impact of familial history on the risk of lumbar disc disease. The term lumbar disc disease refers to a set of spinal degenerative disorders that leads to sciatica characterized by low-back pain and  radiating leg pain.

In the study, researchers analyzed records  from the Utah Population Database, which includes data dating back to early settlers. Using familial genealogy of 1264 patients, researchers were able to track the presence of lumbar disc disease over several generations. They found that having a close relative quadrupled your risk for lumbar disc disease. But if you're parents didn't have lumbar disc disease, you're not off the hook: even having a distant cousin can elevate your risk.

Genetics isn't the only cause of sciatica; mechanical stress on the spine, occupational loading, aging, and even smoking has been linked to sciatica. Learning whether you have a genetic risk of lumbar disc disease can help you take additional steps to prevent or minimize sciatic nerve pain.
Patel AA, Spiker WR, Daubs M, et al. Evidence for an Inherited Predisposition to Lumb
ar Disc Disease. The Journal of Bone and Joint Surgery 2011;93(3):225-229.


Posted in genetic sciaticaUnderstanding Sciatica

Tagged as charlotte chiropractor southpark 28209, genetic sciatica, understanding sciatica.

Lowering Diabetes Risk with Yogurt

Lowering Diabetes Risk with Yogurt

Yogurt and diabetesWhen most people think about lowering their risk of type 2 diabetes, they consider losing weight, eliminating high sugar sources, and engaging in regular exercise. However, one study recently published in BMC Medicinesuggests that reducing the likelihood that you would ever receive this diagnosis may be as simple as increasing your yogurt consumption.

A group of researchers looked at almost 200,000 people who took part in three different cohort studies which occurred between 1980 and 2010: the Health Professionals Follow-Up Study, the Nurses' Health Study, and the Nurses' Health Study II. All of the participants involved were evaluated in regard to their food consumption habits as well as whether or not they developed type 2 diabetes during this particular timeframe.

While no correlation was found between dairy consumption as a whole and type 2 diabetes, researchers did find a relationship between yogurt consumption specifically and this diagnosis. This led the researchers to conclude that consuming at least one serving of yogurt per day as part of a "healthy dietary pattern" could actually lower your risk of type 2 diabetes by as much as 18%. Why? Probiotics.

Yogurt contains probiotic bacteria which is a healthy bacteria that your digestive system uses when processing the foods you eat. Unlike "bad" bacteria that you don't want in your body, probiotics have been linked to many beneficial health qualities such as lower cholesterol levels, better lipid amounts, healthier levels of antioxidants, and even lower body weights.

Researchers point out that more studies are necessary to truly understand the impact that yogurt--and probiotics--have on a person's body weight and blood sugar levels, and they are quick to remind their readers that it is often difficult to establish cause and effect. In other words, people who tend to eat yogurt are often healthier, thus it is hard to determine if it is the yogurt that is providing the benefits, or simply a healthy lifestyle.

In the meantime, engaging in healthy activities, such as eating nutritious food, getting regular exercise, and receiving regular chiropractic adjustments can help you obtain the highest level of health possible.

Chen M, Sun Q, Giovannucci E, et al. Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Medicine 2014;12(215).
Posted in Chiropractic Newsdiabetes and yogurt

Tagged as charlotte chiropractor southpark 28209, chiropractic news, Diabetes, yogurt.

Is weight lifting harming your spine?

Is weight lifting harming your spine?

Injury from weightliftingA popular training technique, the squat lift, may be putting undue stress on your spine, according to research presented to the North American Spine Society.

Trainers and coaches have long blamed spinal fractures on incorrect lifting form. But even athletes with "textbook form" could be harming their spines.

Researchers recruited twenty male athletes in their 20s and took several x-rays of them in various positions. They noticed that the sacrum- the part of your spine connecting your hip bones- sloped to an unhealthy degree when an athlete performed a back or front squat. This unnatural slope makes athletes highly susceptible to spinal fractures or damage. The risk is especially high for teenagers or young people whose spines are still maturing.

Although they haven't yet gone so far as to recommend that athletes stop doing the squat lift, doctors did recommend that athletes be extremely cautious when performing the activity. Despite the fact that the squat lift is effective in building muscle, it can lead to a lifetime of low-back pain and degenerative disc problems. Many chiropractors and physical therapists specialize in sports medicine and can help advise you on safe-lifting techniques.

Fauber, John. "Training Technique Stresses Athletes' Spines." Medpage Today. November 2, 2011. Accessed November 16, 2011
McClellan John, et al. "The effects of two different types of squat exercises on radiography of the lumbar spine". North American Spine Society. November 2011.

Posted in athleteChiropractic Newsheavy liftingspinal healthspinesquat lift

Tagged as athlete, charlotte chiropractor southpark 28209, chiropractic news, heavy lifting, spinal health, spine, squat lift.

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Why Chiropractic is the Best Solution for Sciatica Pain


Sciatica and chiropracticSciatica and chiropractic
Sciatica pain is often so debilitating that it forces people to miss work and other normal activities.  Of all patients with low-back pain, sciatica patients have the highest level of disability (1).  In fact, patients with sciatica are disabled for an average of 72 days according to Norwegian public-health records.
Fortunately, a recent study offers hope to sciatica patients: chiropractic care can speed the recovery from sciatica flare ups and allow patients to return to work sooner (2).

The study evaluated 44 Norwegian workers after they came to the hospital with severe sciatica pain. Most of those patients had been experiencing pain for three or more weeks prior to their hospital visit.
The hospital chiropractor examined each patient to evaluate his/her posture and gait, range of motion, and palpation of the lumbar spine.

The chiropractic then performed various joint adjustments to the spine and other limbs that had been injured through patients compensating for pain. Ice treatment was also used to relieve soft tissue soreness.Patients were treated daily in the hospital and later three times a week for the first two weeks. Some patients needed additional follow-up treatment but typically did not exceed 14 treatments.

In matter of 21 days, 91% of patients returned to work full-time. Two patients returned to work part time. Researchers concluded this study demonstrates the potent benefits of collaboration between chiropractors and orthopedic surgeons. Chiropractic care can put an end to your sciatica pain so you can begin living your life fully again.

Posted in chiropracticChiropractic NewsSciaticasciatica treatmentUnderstanding Sciatica
  1. Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.
  2. Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.