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Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
Q. I definitely want to avoid lymphedema. Is there anything I can do to ward it off, or is lymphedema totally random? A. The very best thing you can do to help prevent lymphedema is to make sure you get full range of motion back in your arm, whether after surgery or radiation. Favoring the arm on your affected side, hunching your shoulder protectively, being too stiff to stretch your arm up over your head and around towards your back–these are all things that will make it easier for lymphedema to gain a foothold. I have a friend who’s a physical therapist specializing in lymphedema treatment. In fact, we became close as she gave me daily massages to relieve my own swollen arm. (Just as getting a tummy tuck is the silver lining of a tram flap reconstruction, a daily massage is the big plus of having lymphedema!) This friend says that women who’ve had surgery, particularly a mastectomy with lymph node removal (even if just a single node) need physical thera...
Damage to the spinal cord, an information superhighway that originates in the brain, is a very devastating injury that can lead to paralysis. Most people have heard of traumatic spinal cord injuries because the sudden tragedies grab headlines from time to time. But, few people have heard of spinal stenosis, a narrowing of the tube which shelters the spinal cord called the spinal canal (See Spine Anatomy 101 ). As the space tightens like a noose, this slow strangulation of the nerves in the spine can disrupt anyone’s life. Sara turned 68 years old last month. She has enjoyed good health and has been an avid golfer. But, lately she has noticed an aching pain in her legs that occurs when she is walking or standing. This new problem has really slowed her golf game down and has made it difficult for her to even do her own grocery shopping. The only way she can make it up and down the aisles is by leaning on the shopping cart because that eases her pain. Frustrated, she calls to ...
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