Archive for February, 2008
Chronic Pain| Fibromyalgia| Physical Function
February 29, 2008 1:55 pmFebruary 29, 2008
An online survey to investigate predictors of high physical function in 2,580 people with fibromyalgia (FM) showed that significant explanatory variables of high physical function were: men, greater education, younger age, lower intensity fatigue, spasticity, and balance problems, not using prescription pain medications, using aerobic or strength training exercise, and not using relaxation methods.
Conclusions were that people with FM suffer from multiple symptoms and use many modalities to control symptoms to remain functional. The authors had questions pertaining to developing strategies to promote better functioning, prospective trials to track the natural course of study variables, measuring their effect on function, and to test effects of interventions to maximize function. (Rutledge, Dana N.; Jones, Kim; Jones, C. Jessie Predicting High Physical Function in People With Fibromyalgia. Journal of Nursing Scholarship. 39(4):319-324, December 2007).
Important to note is that the study variables can be seen in earlier and milder cases of fibromyalgia which relates to better function levels in these types of individuals.
Self-care education is very important in patients with fibromyalgia to maintain physical function. Repetitive motion activities (even if aerobic) are to be avoided as much as possible with frequent rest periods if exposed to such tasks.
Strength training activities are not encouraged. Weightlifting should be curtailed and anything lifted should be less than 2 pounds (maximum less than 5 pounds) at a time and lifting must be with using both arms. There should be no reaching forward or lifting with arms outstretched or performing overhead activities. Any lifting should be done with the elbow at the side of the body. This pertains also to any activities that involve pushing or pulling. Unsuspecting injuries occur with opening or closing heavy-duty doors and drawers.
Any activities done should have equal duration of rest for the duration of activity performed. There is tendency for patients to continue exercises either by number of repetitions or by a set time session for the exercise. The best way is to titrate the activities by the level of feelings of discomfort, soreness, pain, achiness, tightness, stiffness, and fatigue. The activities must be stopped immediately and the patient must rest as soon as the symptoms increase so that the pain symptoms do not escalate.
Pain and discomfort symptoms in nerve related muscle pain is from ischemia and anoxia to nerve and muscle tissue when the muscles shorten and tighten. Pushing through pain will just make to ischemia and anoxia worse leading to escalating pain through ireversible nerve damage.
Chronic pain and fibromyalgia are lifelong diseases and patients must learn how to preserve their physical functions for as long as possible by knowing about self-care techniques.
Treatments to decrease the level of pain is essential for maintaining or increasing function with improvement in quality of life. eToims reverses the ischemia and anoxia that causes nerve damage allowing nerves and muscles to heal. Please visit the main site of www.stopmusclepain.com to learn about the role of eToims in relieving acute and chronic nerve related muscle pain such as that experienced by patients with fibromyalgia.
© 2008 copyright all rights reserved www.stopmusclepain.com Chronic Pain| Fibromyalgia| Physical Function
Neck Pain| Strength Training
February 23, 2008 1:45 amFebruary 23, 2008
Neck pain has been steadily increasing over the past two decades and is now second to back pain, the most common musculoskeletal disorder.
One of the newest randomized controlled studies on 94 Danish women suffering from trapezius muscle pain due to work-related repetitive injuries, such as typing and assembly line work, had shown that specific strength training exercises can lead to significant prolonged neck pain relief whereas general fitness training resulted in only mild neck pain reduction.
Both exercise groups worked out for 20 minutes three times a week for 10 weeks. Those who did supervised specific strength training (SST) exercises for the neck and shoulder muscles showed a marked decrease in pain over a prolonged training period and with a lasting effect after the training ended (1).
What is unclear with this study is the amount of resistance used for the supervised specific strength training (SST) group and which muscles were exercised. Usually strength training in those with pain can cause increase in pain. This is because muscle pain due to tightness and spasm is from intramuscular lack of blood to nerves and blood vessels entrapped within the spasm as well as the traction effect on periosteum of bones and synovial tissue within joints.
On the other hand, if strength training occurred to the powerful lifting muscles of the shoulder such as lattisimus dorsi, deltoid and triceps, this could reduce the load on the trapezius muscle. Trapezius is not a muscle suitable in weight lifting activities and in the weakness of the above mentioned 3 muscles, trapezius is called into play for lifting activities by performing the shoulder shrug. This is the main reason for trapezius myalgia for those with repetitive motion activities.
(1) Lars L. Andersen, Michael Kjær, Karen Søgaard, Lone Hansen, Ann I. Kryger, Gisela Sjøgaard: "Effect of Two Contrasting Types of Physical Exercise on Chronic Neck Muscle Pain,", Arthritis Care & Research, January 2008; 59:1; pp. 84-91.
© 2008 copyright all rights reserved www.stopmusclepain.com Neck pain|Strength Training
Back Pain| Neck Pain| Expenses
February 15, 2008 12:15 pmFebruary 15, 2008
According to a study in the February 13 issue of JAMA, expenses related to back and neck problems have increased substantially in the last decade. However, outcomes such as functional disability and work limitations are not improving,
In a 2002 survey of U.S. adults, 26 percent reported low back pain and 14 percent reported neck pain in the previous three months. Rates of imaging and therapy for back and neck problems have increased substantially in the last decade, but it is not clear how this has effected expenditures or health outcomes for individuals with these problems.
The study sampled a total of 23,045 adult respondents in 1997 (3,139 who reported spine problems) and again in 2005, sampled 22,258 respondents (3,187 who reported spine problems). It was found that expenditures were higher in each year for those with spine problems than for those without. In 1997,the average age- and sex-adjusted medical costs for respondents with spine problems was $4,695, compared with $2,731 among those without spine problems (inflation adjusted to 2005 dollars). In 2005, the average age- and sex-adjusted medical expenditures among respondents with spine problems was $6,096, compared with $3,516 among those without spine problems.
From 1997 to 2005, these trends resulted in an estimated 65 percent inflation-adjusted increase in the total national expenditure of adults with spine problems, a more rapid increase than overall health expenditures to an estimated $85.9 billion nationally One of the biggest drivers of spending was increased use of expensive painkillers. Spending on narcotic drugs for back pain soared an astonishing 423% during the period.
The estimated proportion of persons with back or neck problems who self-reported physical functioning limitations increased from 20.7 percent to 24.7 percent from 1997 to 2005. Adjusted self-reported measures of mental health, physical functioning, work or school limitations, and social limitations among adults with spine problems were worse in 2005 than in 1997. "These data suggest that spine problems are expensive, due both to large numbers of affected persons and to high costs per person. We did not observe improvements in health outcomes commensurate with the increasing costs over time. Spine problems may offer opportunities to reduce expenditures without associated worsening of clinical outcomes," the authors conclude. (JAMA. 2008;299[6]:656-664).
Pharmacotherapy plays an important role in LBP treatment, although drug cost data in LBP is limited. Newer, more costly agents such cyclooxengenase-2 selective nonsterioidal anti-inflammatory agents will increase drug costs as a portion of total costs, particularly if not used in accordance with treatment guidelines. (Asche CV. Kirkness CS. McAdam-Marx C. Fritz JM. The societal costs of low back pain: data published between 2001 and 2007. Journal of Pain & Palliative Care Pharmacotherapy. 21(4):25-33, 2007).
eToims® Twitch Relief Method provides nerve related muscle pain relief with state-of-the-art noninvasive, surface electrical stimulation to excite deep neuromuscular junctions. The twitches elicited provide internal stretch to the deep muscle layers so that there will be removal/reduction of traction/compression/distortion of pain sensitive structures such as nerves and blood vessels within tight shortened muscles, annulus fibrosus of intervertebral discs, periosteum and synovial tissue within joints. The twitch induced intramuscular exercise also help in bringing fresh circulation and help heal irritated nerves and muscles and also help in the out flow of pain causing chemicals within blood stagnated at the injured site due to inability of tight and short muscles to contract.
Depending on the duration of pain and extent of nerve damage, there is potential for cure with eToims® Twitch Relief Method. With more long-standing severe pain continuation of treatments on a regular basis provide ongoing pain relief and pain reduction with improvement in quality-of-life. We have a long-term retention of 85% of the self pay patients who return for more than three treatments.
The press release of the launch of our much-anticipated web site as the only web site dedicated to reversing back pain was featured in Forbes, Business Journals including Philadelphia Business Journal, AOL Money News, Fox Business News, etc. Please do visit the main site www.stopmusclepain.com by clicking on the left homepage button above.
© 2008 copyright all rights reserved www.stopmusclepain.com Back Pain| Neck Pain| Expenses
lower body topics, upper body topics
Back pain| Lifting |Handling
February 8, 2008 6:08 pmFebruary 8, 2008
A study just published showed that advice and training on working techniques and lifting equipment does not prevent back pain in jobs that involve heavy lifting. The study included analysis of randomised trials (17,720 participants) with follow-up time from six months to 5.5 years. Cohort studies (772 participants) were followed for eight weeks to two years. The outcome measurements included back pain, consequent disability, or sick leave. These findings challenge current widespread practice of advising workers on correct lifting technique. Many health professionals are involved in training and advising workers on lifting and handling. Even though there may be other reasons to continue this practice, this review does not provide evidence that it prevents back pain.The article stated that there needs to be new and innovative ways to prevent back pain1.
As we age, nerves and muscles subjected to trauma do not recover well depending on the duration, intensity and time since trauma. In fact, just the activities of daily living alone can cause trauma to spinal nerve roots with subsequent partial reversible and irreversible denervation leading to muscle shortening and tightness. If reversible denervation can be immediately treated, preferably within 24 hours, there is a potential chance for a cure for the nerve.
However, if the nerve is not allowed to heal, this will be a setup for new injuries especially when the person is exposed to repetitive lifting and handling. Every new injury reduces the chance for injured nerves to fully recover. When the window of opportunity for nerve recovery is exceeded, the nerve progresses into irreversible denervation and this cascade of events can develop into chronic pain. Chronic pain is defined as pain that last longer than three months.
Patients undergoing eToims® Twitch Relief Method, a new and innovative way of treating and preventing back pain, return for treatments on a weekly basis so that new nerve injuries are immediately stimulated electrically. This stimulation releases the tourniquet effect of the tight muscles on intramuscular nerves, blood vessels allowing them to heal.Please visit the main section of www.stopmusclepain.com for further details on eToims® Twitch Relief Method and the mechanisms by which the method works to relieve nerve related muscle pain.
Kari-Pekka Martimo, Jos Verbeek, Jaro Karppinen, Andrea D Furlan, Esa-Pekka Takala, P Paul F M Kuijer, Merja Jauhiainen, Eira Viikari-Juntura: The effect of training and lifting equipment for preventing back pain in lifting and handling. NEJM, February, 2008.
Neck Pain| Low Back Pain| Spinal Degeneration
February 2, 2008 1:22 amSaturday, February 02, 2008
In a study on cervical spine specimens (59-92 years) including C2-C7 levels, it was found that the prevalence of cervical facet joint degeneration was very high in individuals aged 50 years and more, with a tendency to increase in severity with age. All levels of the middle and lower cervical spine were affected to almost the same degree, whereas in the lumbar spine an increase in degeneration towards the lower levels was reported. Also, in the cervical spine in most cases the facet joint cartilage was evenly degenerated all over the joint surface while in the lumbar spine certain regions were reported to be affected predominantly. Least osteophytes were found on the medial border of the facet joints (1).
A study on 1,064 unselected women (181 monozygotic and 351 dizygotic twin pairs) was performed to assess genetic and environmental influences on low back and neck pain to examine the extent to which these are explained by structural changes seen on magnetic resonance imaging (MRI) and psychological and lifestyle variables.
For all definitions of pain, there was a consistent excess concordance in monozygotic twins when compared with dizygotic twins, equating to a heritability for low back pain in the range of 52-68% and for neck pain in the range of 35-58%. The strongest associations were between low back pain and MRI change and between neck pain and psychological distress and these associations were mediated genetically.
It was concluded that genetic factors have an important influence on back and neck pain reporting in women. These factors include the genetic determinants of structural disc degeneration and an individual's inherited tendency toward psychological distress. MRI changes are the strongest predictor of low back pain (2).
(1) Kettler A. Werner K. Wilke HJ. Morphological changes of cervical facet joints in elderly individuals. European Spine Journal. 16(7):987-92, 2007 Jul.
(2) MacGregor AJ. Andrew T. Sambrook PN. Spector TD. Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis & Rheumatism. 51(2):160-7, 2004 Apr 15.
www.stopmusclepain.com Neck Pain| Low Back Pain| Spinal Degeneration
