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...
“Sciatica” is an old world term that refers to leg pain felt down the back of the thigh into the calf and foot. What about thigh pain? What about buttock pain? Unfortunately, “sciatica” has been wrongly applied to all types and locations of leg pain. In 1948, the use of the word “sciatica” was declared “unhelpful” by a leading orthopedic specialist because it is limited to a certain location and really does not address the origin of the pain. Over the years, many older medical terms like sciatica have become archaic as the newer research technologies give doctors clearer definitions and a better understanding of the human body. Leg pain that comes from the low back is most accurately categorized as referred pain or neurogenic pain. These terms apply to all locations and address the origin of the pain. With these newer terms, the antiquated word, “sciatica”, has no place in the modern world. Sally has been waking up with right ...
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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