FROM OUR EXPERTS
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 major risks of having spine surgery is the development of an infection. Discitis is an uncommon infection of the spinal disc that can occur after spinal surgery. Because of its rarity, discitis is often not on the minds of doctors. In this world of rushed, inattentive doctors, a person with an infection of the spine can be dismissed as a "common back pain" case when in fact discitis is the culprit.
A 58 year old woman who had years of lumbar pain came to me one and a half years following a complicated lumbar fusion; the surgery was complicated by the fact that the surgeon had to operate twice in order to get the hardware placed correctly. Unfortunately, the surgery did not cure her pain; and she came to me for pain management.
Two months into her treatment with me, she had a severe episode of low back pain after shoveling snow. She went to her primary doctor with not only complaints of worsening back pain, but she also had a fever and an upset stomach. That ...
In this study, researchers from the Gait and Posture Lab at the University of Montreal in Canada compare walking patterns between patients who had a total hip replacement versus a surface replacement arthroplasty . An earlier study by Mont et al comparing these two groups reported a slower walking speed and decreased muscle force in the hip abductor muscle of the hip. Results for the patients in the previous study were reported for six to 18 months after surgery. The effects of different implants on gait pattern were measured six to eight months after surgery in this study. The authors thought that a tighter time frame might give them a better way to compare these two patient groups. Hip joint resurfacing was introduced several years ago to help younger patients who are more active and who would likely dislocate or wear out a total hip replacement. Surgeons found a way to replace the surface of the joint without removing the bone and replacing the entire joint. Bone is saved because the...
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