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An important collection of papers published in research journal The Lancet highlight the global impact of low back pain, the ineffectiveness of current medical treatments, and the value of spinal manipulation and other nondrug options before turning to medication is receiving substantial media attention.
One of the brightest spotlights: a "Health Alert" segment on a recent episode of "Good Morning America" titled "New Research on Lower Back Pain: Are Millions of People Getting Ineffective Treatment?"
"GMA" anchor Robin Roberts opened the segment with this statement to the show's estimated 4.5 million viewers regarding lower back pain: "As many as 540 million people suffer from it. According to new research, many treatments, [including surgery and pain medication] ... could be all wrong."
She then introduced Dr. Jennifer Ashton, chief health and medical editor for the show. Dr. Ashton, who described the papers as the "magnum opus on low back pain" and The Lancet as "very reputable," said the material "[draws] attention to the massive gap between evidence-based medicine and what's really going on" when it comes to the treatment of back pain.
According to Dr. Ashton, reporting on the papers, back pain is a "massive global public health burden." First-line treatments include staying active ("the worst thing you can do is get in bed") and education: learning "what works and doesn't from reputable sources." Second-line treatment options (Dr. Ashton urged viewers, "This is really what I want people to pay attention to") include superficial heat, spinal manipulation, massage and acupuncture. [Italics ours]
Dr. Ashton added that NSAID medication (nonsteroidal anti-inflammatory drugs, commonly available as over-the-counter pain meds such as Advil, Aleve, etc.) is also considered a second-line treatment according to The Lancet papers, but should be utilized "only if the other things are not working."
The Lancet content on lower back pain, published online on March 21, features two "series" papers, a "viewpoint" and a "comment," all of which are available in full-text format free of charge on the journal's website:
- "What Low Back Pain Is and Why We Need to Pay Attention" (Series 1) (Hartvigsen J., et al.)
- "Prevention and Treatment of Low Back Pain: Evidence, Challenges and Promising Directions" (Series 2) (Foster N.E., et al.)
- "Low Back Pain: A Call for Action" (Viewpoint) (Buchbinder R., et al.)
- "Low Back Pain: A Major Global Challenge" (Comment) (Clark S., et al.)
The "GMA Health Alert" on LBP is also available online in its entirety, and can be accessed by clicking here. To access the Lancet content, click the links above. To learn more about the value of chiropractic spinal manipulation for low back pain and why pain medication isn't your first option, talk to your doctor.
If you haven't already tuned out any conversation about giving your children cough and cold medication when they're under the weather, this should do it. The Food and Drug Administration has strengthened its warning on prescription cold medicine, stating that no product containing opioid ingredients such as hydrocodone or codeine should be given to children – of any age. That's ages 0-17, in case you're wondering.
New language being added to warning labels on all prescription cold medicines will indicate that the risks of using the products outweigh the benefits in children and should only be used by adults ages 18 and older.
What about over-the-counter cold medication? Well, in the past decade, the FDA has already issued several warnings and required language to be added to labels limiting their use in kids. In fact, a consumer update on the FDA website titled "Most Young Children With a Cough or Cold Don't Need Medicine" makes its position abundantly clear, especially for the youngest (ages 2 and under); while a 2016 update, "Use Caution When Giving Cough and Cold Products to Kids," offers additional safety information and includes alternative treatments that may work better.
What alternative treatments? The FDA mentions cool mist humidifiers, saline nose drops / spray, and drinking plenty of liquids among the nondrug options. We would be remiss if we didn't add honey; such a simple remedy often overlooked by parents rushing to the drugstore for a quick fix to their child's discomfort. For example, a Pennsylvania State University College of Medicine study found that children given buckwheat honey before bed coughed less and slept better than children who didn't receive honey. And other research suggest zinc lozenges may be effective for resolving cold symptoms in children and adults, particularly if taken within close proximity to the arrival of symptoms.
Your doctor can tell you more about the dangers of over-the-counter and prescription cold medicine and why natural alternatives are safer, effective options for you and your child.
We all have our "story" when we don't show up at work on any given day; some more valid than others. After all, "My car broke down" or "I had to take my daughter to urgent care" generally come off much better than "I slept in and missed the bus" or "I lost my car keys." Now here's a truly valid reason for work absenteeism, and unfortunately, it's becoming more prevalent throughout the U.S.: chronic pain.
According to a recent study published in the peer-reviewed research journal Spine, workers suffering from chronic pain are more likely be absent from work – and more likely to stay absent – compared to workers not suffering from chronic pain. In fact, among a study population of more than 8,000 workers, chronic pain sufferers were significantly more likely to be absent from work one or more days: 20 percent more likely if suffering from neck pain, and 22 percent more likely if suffering from low back pain or headache pain (migraines), respectively.
The good news is there are natural solutions to all three of these common conditions, starting with chiropractic care, and research supports it. Talk to your chiropractor if you're suffering from pain, whether acute or chronic, before it gets so bad that you have to miss work. After all, you deserve to save your personal leave time for a well-deserved vacation, not to endure chronic pain.
10 potential causes of upper and middle back pain.
Written by Stewart G. Eidelson, MD
In order to get the best, most effective treatment for your upper back pain (also known as mid-back pain), you should understand what may be causing it. Your doctor can help you figure that out, but here are some common causes:
1. Poor posture: Sitting with a rounded back, shoulders hunched forward, can put too much stress on the back muscles. Poor posture is one of the leading causes of upper back pain because so many office workers spend their work days at the computer. It's easy to fall into bad habits of not sitting properly, especially when you're at your desk for so many hours a day.
2. Improper lifting: When picking something up, you should also use good body mechanics so that you protect your spine. Not using the proper form can cause injury and pain.
4. Carrying a heavy backpack: Kids are obviously more in danger of getting an upper back injury because of a backpack. An overly loaded backpack is dangerous to the spine, but so is not wearing the backpack correctly (eg, just using one strap).
5. Trauma/injury: Traumatic events, such as car accidents, can cause upper back pain for various reasons. It's possible to fracture a vertebra (spinal bone). Or part of your vertebra(e) can press on a spinal nerve, which can cause pain.
6. Infection: A spinal epidural abscess or a paraspinal abscess can compress the spinal cord or spinal nerves in the thoracic spine, causing pain and other symptoms.
7. Osteoporosis: This is a condition affecting the bones. It weakens them, making them more likely to fracture and less likely to carry your weight well. If you have osteoporosis in your thoracic spine, you may develop upper back pain. Weakened vertebrae don't support your body's weight as well, so your muscles, ligaments, and tendons have to work harder to make up for the vertebrae. That can lead to sprain, strain, or muscle fatigue.
If you have a vertebral fracture or fractures because of osteoporosis, you will probably develop a rounded back—that's poor posture, which can lead to upper back pain.
8. Problematic kyphosis: When looked at from the side, your spine is supposed to curve outwards in your upper back (thoracic spine) region; that curve is called kyphosis or a kyphotic curve. However, it can start to curve outward too much, and that's problematic kyphosis. Various conditions, such as osteoporosis, can cause problematic kyphosis in the thoracic spine, leading to upper back pain.
9. Scoliosis: Scoliosis causes an unusual curve or curves in the spine. It can make your spine look like an "S"or a "C" when viewed from the back. If your spine is curving to the left or to the right in the upper back (thoracic spine), you may have pain because of how the curve affects spinal nerves, muscles, and other soft tissues.z
10. Other conditions: Upper back pain can develop in conjunction with other medical conditions not related to the spine. For example:
- Acid reflux (GERD)
- Cardiac conditions, such as angina
Anatomical Structure and Upper Back Pain
The upper back (thoracic spine) is much more stable than the neck (cervical spine) and low back (lumbar spine). It doesn't move as much as they do because one of its main jobs is to protect the internal organs in the chest. It does this in conjunction with the ribs, which are attached to the thoracic vertebrae.
Because the thoracic spine doesn't move as much, it's less prone to the joint and disc problems that more commonly affect the neck and low back. That doesn't mean that you can't have a herniated disc causing your upper back pain, but it is much less common.
It's also less common to have degenerative problems in the thoracic spine. The neck and low back move more, so the joints and discs may wear out sooner from use, overuse, and misuse.
Whether you're a current chiropractic patient or just considering becoming one, low back pain may be the reason why. Nearly 80 percent of adults experience at least one episode of low back pain during their lifetime, and for many, the pain can recur and/or become chronic.
Fortunately, the research continues to suggest spinal manipulation (chiropractic adjustments) is a primary treatment option to get rid of the pain.
Case in point: a study published in the Journal of the American Medical Association, no less, that reviewed 15 studies and found spinal manipulation reduced pain and improved function after six weeks of treatment. The benefits were similar to those achieved with nonsteroidal anti-inflammatory drugs (NSAIDs), common over-the-counter pain relievers that come with a long list of potential side effects, particularly if used for more than a short time.
These findings are particularly important because as we've discussed several times in recent issues, managing pain with drugs – particularly opioids – has become a dangerous epidemic, and health care providers of all types are increasingly appreciating the value of nondrug care for back pain. In fact, the American College of Physicians' new guidelines on low back pain recommend spinal manipulation among the nonpharmaceutical options that should be tried first, before resorting to medication. Talk to your doctor for more information.