One of the most common problems seen in a primary care medical practice is low back pain. It accounts for more discomfort, lost work and productivity, and frustration for many patients than any other malady. Some think it is the price we, as humans, pay for walking upright. The lower back is a complex structure made of bone, muscles, connective tissue and nerves that, along with our legs, hold us erect, allow us to bend, run, twist, catch a football, or just lay down and rest. However, once a problem arises, the complexity of its structure makes pain in the lower back difficult to diagnose and treat. The lower back consists of a spinal column from the lumbar region of the mid-back down to the tail bone or coccyx. The spinal column consists of 5 lumbar vertebrae which are cylindrical bony structures with a ring like component behind the cylinder also made of bone. In between the vertebrae are disc shaped cushions filled with a gelatinous central core known as the nucleus pulposis
If I have right knee osteoarthritis, do I have to work out my left side as well?
I was recently asked by a patient why he had to work out both sides of his body in physical therapy if only his right knee hurt. I can understand some of the confusion. After all, if your right shoulder were painful and inflamed and required an injection, the medication would only be put at the site of inflammation -- in your right shoulder. You would not be a candidate for a right and a left shoulder injection! However, physical therapy, for the most part, is much different. I'll explain.
There are two basic components to physical therapy -- passive and active. In the passive component, the therapist may apply ice, heat, ultrasound, electrical stimulation, and other modalities to the painful area. For the most part, these modalities are only placed at the site of injury (there are a few exceptions that are beyond the scope of this blog). So, in this sense, physical therapy is functioning si...
Raise your right hand if you are taking a cholesterol-lower medication like Crestor or Lipitor. Now, raise your left hand if you have chronic pain. Those of you with both hands in the air should listen up. Cholesterol-lowering medications can cause pain and Lipitor is the most prescribed drug in America . Yikes! Now ask yourself these questions: did the pain start within a year or two of starting the offending drug? Did the pain get worse within a year or two of starting the offending drug? If you answered yes to either of these questions, you may need to reconsider your use of a medication that causes pain.
Crestor, Lipitor, Zocor, Pravachol, Mevacor; this group of drugs are generally called the "statins" because the generic name of these drugs that lower cholesterol ends in "statin". These medications have the potential to cause serious muscle problems including muscle pain. The most serious problem is called rhabdomyolysis which means that the muscles literally start to disin...
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