Cure my back pain

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Posted on March 30, 2009 by editor

There are numerous causes of paraspinal pain. We will address many of them over time although primarily addressing mechanical pain. Some topics will be equally applicable across all spinal segments, cervical through lumbar. Others will be segment specific, often lumbar. We are about alternatives, complementary treatment and self-care. We link to traditional medicine sites and encourage you to familiarize yourself with standard medical and surgical views. However, western medicine and surgery are usually focused upon injury and disease management. We focus upon contemporary health, nutrition, fitness, injury prevention, self care and alternative perspectives.

This site does not intend to replace perspectives provided via your primary or specialty medical/surgical clinician, particularly for those of you who are satisfied with services delivered to date. Rather, we will supplement your knowledge, point you to complementary/self-care tools and offer alternative lifestyle and care perspectives including ideas that should steer you into directions that you may not have previously considered.

We are about alternative perspectives and strategies. Moreover, where possible, we hope that you cure your back pain.

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Cannabis as an Anti-inflammatory/Analgesic

Posted on January 16, 2012 by editor

Many cannabinoids act primarily to inhibit prostaglandins and COX-2, while providing powerful anti-oxidant properties to salvage free radicals, and inhibit macrophage and TNF (tissue necrosis factor) activity. All of this means that cannabis is an excellent anti-inflammatory-analgesic that lacks the side effects of steroids, the NSAIDs, and the COX-2 inhibitors like Celecoxib.This anti-inflammatory action may help quell some of the arterial inflammation common in numerous diseases and joint inflammation of arthritis that induces pain.

If medical marijuana is legal in your State, pursue a physician consultation regarding its use.

Cannabis is an Antispasmodic

Posted on January 16, 2012 by editor

Some elements of cannabis (possibly CBD) act as anti-spasmodic agents similar to anti-convulsants such as gabapentin. This action of cannabis helps relieve peripheral muscular pain and cramping as well as that which may occur in gastrointestinal diseases such as IBS.

Please note the significant numbers of side effects associated with use of traditional prescription muscle relaxants and anti-spasmodics and anti-convulsants. If medical marijuana is legal in your State, pursue a consultation regarding its use.

Spine Injuries and Football’s Cowboy Collar

Posted on December 29, 2011 by editor

Do any of you one time gridiron athletes remember the neck collar, the head rest, the cowboy collars and neck rolls? Much as the back braces in industrial environments fail to directly avert “heavy-lifting” related lumbar spine injuries, the neck rolls are just as ineffective.

The rolls and collars primarily remind players to not use their heads as battering rams and may provide very limited additional padding over the muscles and nerves at the lateral base of the neck. They primarily just look good. They make the players wearing them look bigger, meaner, giving the opposition the impression that this larger-than-life puffed up guy might need the extra protection given how hard he is going to hit others.

It turns out that there is actually no data available to support the hypothesis that the equipment protects the cervical spine, preventing injury. These equipment adorned too numerous to count numbers of players between 1970 and 2000. However, they have all but disappeared, having been relegated to the fashion heap along with the notion that black stripes or strips under the eyes decreases visual glare. Like peacocks, they were puffed up and painted for show.

The best way to cure (preventively) these cervical spine injuries is to avoid them by not using your head as a battering ram.

Indicators predictive of chronic low back pain

Posted on November 18, 2011 by editor

Prognostic indicators (predictive factors) are those which suggest an expectation of a particular outcome. Regarding low back pain (LBP), the issue in prediction is the persistence of pain LBP into a chronic state.

There are often significant differences between the acute and chronic LBP groups in characteristics and clinical course. Determination of associations between potential predictive indicators and pain/disability persistence has been studied. The final outcomes of data analyses tend to point to being unemployed (and otherwise meaningfully inactive), having widespread pain, a high level pain grade, and believing the pain to be a life-catastrophe as the strongest predictors of persistence of disability at 12 months after an acute injury. However, fear of pain is most significant indicator associated with disability in chronic low back pain.

In response, consider the following as a comprehensive approach to engage as best and early as is possible:

Stay employed in some function and/or fully engaged in life’s activities.
Address pain assertively so that if not alleviated, it is localized as much as is possible.
A multiple intervention approach is generally more effective than a single intervention at diminishing the pain grade (i.e., reducing in from a 7/10 to 4/10 level).
Do not accept pain (or its causal factors) to be a life-catastrophe, rather a hurdle to surmount.
Do not “fear” and “own” pain, rather acknowledge and address it as an unwelcome interloper.

Factors causal of indicators will either persist or not. However, while addressing these factors as you are able to yourself, to cure back pain, you must dissociate from the pain (it is not “your” pain), acknowledging but not embracing or fearing it.

Passive and active alternative treatment for low back pain.

Posted on October 18, 2011 by editor

Knowledge about all forms of treatment, including passive and active complementary and alternative medicine (CAM) treatments, is essential in the treatment of low back pain. Mechanical/manual treatments may be divided into categories of :

Medical practitioner delivered passive treatment would be anything that a health professional delivers without your assistance.
Medical practitioner delivered active treatment would be anything that a health professional delivers with your active participation.
Non-clinician delivered passive treatment would be anything that a non-professional delivers without your active participation.
Non-clinician delivered active treatment would be anything that a non-professional delivers with your active participation.

The decision regarding whether a patient should pursue an active or passive treatment program is often made by medical practitioners. However, well informed patients should be involved in the decision process. Some e xamples of alternative treatment for low back pain from the above described intervention categories are:

A medical practitioner directed active treatment – Physical therapy-based exercise programs, such as core stabilization, may be performed independently. However, they often require therapist direction.
Acupuncture is a medical practitioner delivered passive treatment that has been shown to be a good adjunct treatment for many. Often you can determine if it will work for you within three sessions.
Current literature suggests that yoga is the most effective non-physician delivered active treatment approach to non-specific low back pain compared to other CAM treatments.
Current literature suggests that massage is a very effective non-physician delivered passive treatment approach to non-specific low back pain compared to prescription medication.

There are various forms of passive and active, complementary and alternative treatment for low back pain; consider them.

Laugh to cure my low back pain.

Posted on September 25, 2011 by editor

The September 2011 Proceedings of the Royal Society of Biological Sciences published a compilation of the findings from six studies that jointly noted the following regarding laughter:

laughter appears to increase pain tolerance and the level of painful stimulus needed to cause pain.
laughter appears to effectively increase microcirculation thereby decreasing painful events of all types that are related to local diminished circulation.
laughter tends to increase your overall sense of well-being
laughter tends to parallel periods of lower blood pressure and relaxation.

Laughter and the well-being associated with it are often found in circumstances of diminished pain. So, I will laugh to cure my low back pain.

Cannabis for your Pain

Posted on August 2, 2011 by editor

Most naturally occurring cannabis plant hybrids contain over 300 compounds, approximately twenty percent cannabinoids. While many of these have recognized biological functions, some have unknown activity. The most commonly recognized is delta⁹-tetrahydrocannabinol (THC). Endocannabinoid products include the drugs Sativex® (THC/cannabidiol) and nabilone.

The endocannabinoid receptor system was only recently discovered. These receptors function in a number of ways. To date, two cannabinoid receptors have been identified, and labeled CB1 and CB2. Compounds that act at the endocannabinoid receptors include both substances created by our bodies (endogenous) and foreign substances (exogenous). Two endogenous cannabinoids were identified in the 1990s. Naturally occurring compounds are found solely in the Cannabis plant.

The endocannabinoid system interacts with a number of pain control systems in the body. The receptors, labeled CB1 and CB2 are found in the brain and on immune cells respectively, in their highest densities, with a low density of CB2 found in the brain. However, compared to opiate (e.g., oxycodone) receptors, CB1 receptors are of very low density in the brain, thereby the low toxicity and lethality of cannabinoids compared to opiates. CB1 and CB2 receptors in the brain help to modulate pain, whereas CB2 in the periphery addresses pain and inflammation control.

Endocannabinoid blocking agents have been demonstrated to increase pain sensation in mice. Additionally, endocannabinoid deficiency has been demonstrated in some persons with migraine, irritable bowel syndrome, and fibromyalgia. Naturally occurring THC has 20 times the anti-inflammatory potential of aspirin and no steroidal anti-inflammatory drugs.

The percentages of many of the chemicals in cannabis can be dramatically influenced by where the plant is grown, how much water that it receives, and other factors. Of interest, GW Pharmaceuticals plc (Salisbury, United Kingdom) has genetically developed specific strains of cannabis that produce single specific compounds. However, just as most of the great advances in many areas of science, engineering, and computer software and technology were not produced by large educational and corporate entities, much of the functional organic chemistry and clinical effectiveness of cannabis is going to be performed by backyard chemists, and via the combined efforts of patients and dispensaries.

In humans, both smoked and oral cannabinoids have been evaluated. Unfortunately, well-designed randomized, placebo-controlled trials are lacking for smoked cannabis. Legal use varies by State.

Not Predominantly Leg Pain: No Spinal Surgery

Posted on August 1, 2011 by editor

Patients present to their physicians with a variety of descriptions relating to their low back pain. Physicians tend to grossly divide the patients into three groups:

Patients with low back pain only.
Patients with pain in the low back and legs, pain in the back being greater or equal to that in the legs.
Patients with pain in the low back and legs, pain in the legs being greater than that in the back.

Current literature continues to support the common hypothesis that patients with leg pain more than back pain do better after surgery than their alternative symptom peers. A recent study referred to as the Sine Patient Outcomes Research Trial included patients with degenerative instabilities (listhesis) and narrowing about the spinal cord (spinal stenosis) by pre-operatively categorizing them as above (groups 1 – 3) according to the predominant areas of pain. After following the patients for two years, the study produced corroborative findings: for patients with leg-predominant pain, surgery resulted in greater improvement than in those with back-predominant or back-only pain.

This study (Pearson A, Blood E, Lurie J, et al., Spine 2011;36:219-229) provides quantitative support for a decision tree for both clinicians and patients who are assessing the treatment options for a “back pain predominant” case. The data continues to suggest that in the absence of other significant findings, such patients should consider alternatives to surgery.

Self-Help to Cure my Low Back (or other) Pain

Posted on July 31, 2011 by editor

An adaptation of cognitive behavior therapy (CBT) may be a useful addition to treating patients with unexplained pain, weakness, and fatigue. According to a study published online July 27 in Neurology (2011;77:564-572), patients who received guided self-help plus usual care were twice as likely to report improvements in overall health as those who received only usual medical care.

Clinicians frequently see patients with vague symptoms unexplained by defined disease labels. Intensive CBT can reduce these symptoms, along with the associated distress and disability. However, therapists trained in CBT are not always available; patients may not be accepting of CBT, and not willing to acknowledge the psychological component of symptoms.

Dr. Sharpe and colleagues tested the guided self-help approach in 127 outpatients from two neurology services in the United Kingdom. The most common symptoms were tingling, pain, numbness, and headache; generalized anxiety and panic disorder were the most common psychiatric issues. Seventy-five percent of all patients reported having their symptoms for more than a year.

Results

At 3 months, subjects who received guided self-help plus usual care reported a significantly greater improvement in self-rated health on the clinical global improvement scale (CGI). Subjects in the guided self-help group also had a greater easing of their presenting symptoms. There were no differences in physical function.

At 6 months, the effect of guided self-help on improvement on the CGI was smaller and was no longer statistically significant according to the investigators. A future version of the self-help guide would have to address additional, explainable symptoms that patients experience during the normal symptom management. Otherwise, a formal clinical follow-up every 3 to 4 months may be reasonable if symptoms are held significantly at bay with this type of intervention given timely clinical reassessment and CBT self-care training reinforcement.

The study still needs to be reproduced with and without professional psychologists delivering the intervention. In this case, patients received a significant amount of professional psychological interface via directed CBT. As such, a placebo effect, as represented by the high volume of work with the health professionals, could have been the primary factor producing the desired outcomes.

Medical Urgency: Training to address Opiate Consumer Behaviors

Posted on April 24, 2011 by editor

Motor vehicle accidents are the leading cause of accidental death in the US. As such, our current federal administration reported on 4/19/11 that it would seek legislation requiring all automotive vehicle dealerships, their sales personnel, independent mechanics and individual citizens electing to sell vehicles direct to the public to undergo training regarding “motor vehicle accident (MVA) prevention” before being allowed to sell vehicles. Moreover, those who are high volume sellers will be required to obtain biannual certification demonstrating participation in training and passing associated tests. The government believes that benefits of such training will be the sharing of the information with customers resulting in markedly enhanced driver awareness of the risks associated with use of motor vehicles and improvement of driver/passenger fatality statistics. The federal government has long been believed that it is not so much the adverse driving habits and poor decision making by drivers that causes fatal accidents, rather public unawareness of the powerful nature of motor vehicles is culprit in MVA-related deaths. As such, it is anticipated that either a plethora of MVA-avoidance training/certification services will mushroom around the country to meet the demand of people lining up for the new training, or fewer businesses and persons will sell cars and trucks if they will by implication become increasingly responsible for the poor driving choices, habits and incidents related to their customers’ behavior.

Purveyors of tobacco products, liquor, fast food and physicians could face similar legislation that would affect their practices, businesses and livelihoods, given the adverse health outcomes associated with smoking, alcohol consumption, high calorie and fat content foods and use of opiate medications. However, note that the general public is always considered sufficiently intelligent and well enough informed about all other possible life choices, even financial. This allows for decisions precipitating MVAs, lung, liver and other diseases, reproductive pro-choice options, and financial ruin to be acceptable results of their personal choices. As such, federal and state governments should not act as though the physicians force opiates upon anyone.

This article does not advocate for opiates as the best and safest of many, many products on the overstuffed US consumer shelves. The FDA and commercial media support a “buyer beware” attitude about everything else, so why get overtly consumer protective with the medical industry? Just as the Automotive Industry lets you purchase and drive motor vehicles at your discretion, the pharmaceutical industry put the opiates out there for your use, as you prefer or not.

Cure My Low Back Pain

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