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...
Are you 55 years old or older and still pain free? Chances are you have osteoarthritis and don't know it. X-rays show arthritic changes in eight out of every 10 adults age 55 and older. Knees, hips, and spines are affected most, in that order. Older adults with leg pain may have arthritic changes in both the hip and spine. They sometimes have a total hip replacement (THR) only to develop groin and buttock pain next. Or suddenly they have muscle weakness that isn't related to the THR. In these cases, lumbar spinal stenosis (LSS) may be the problem. LSS occurs when age-related changes narrow the canal where the spinal cord and nerves travel. Bone spurs, thickened ligaments, and worn-down joints are just some of the changes leading to LSS. These doctors from Baylor College of Medicine offer other orthopedic surgeons some guidance. They say that when a patient with a recent THR has severe pain after the operation, look for infection, an unstable implant, or LSS. Location of the pain is a key...
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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