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...
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
Sometimes cancer cells spread to other parts of the body. When this happens, the breast cancer may be described in a few different ways: metastatic, advanced, or stage IV. The term "metastases" refers to specific areas of spread, such as bone metastases.
If you have signs or symptoms of metastases, your doctor will likely use local treatment (treatment directly to the cancer area) to relieve the symptoms and to control the disease at that spot. Radiation can shrink and help control specific spots where the cancer has spread. Radiation can help:
lower the risk of broken bones in areas that may be weakened from cancer
improve breathing by opening up a blocked airway
take pressure off a pinched nerve that might be causing pain, numbness, or weakness
The radiation dose and schedule for metastases depends on a number of factors, including:
the urgency of the situation (pain, loss of function, size and location of the metastasis, for example)
any previous ...
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