In The News: May 2010
Surgeons Less Likely than Family Doctors to Recommend Back Surgery
Surgeons are less likely than family physicians to view surgery as the preferred treatment for low back pain. According to a study in a recent issue of Spine, researchers presented hypothetical back pain situations to surgeons (orthopaedic surgeons and neurosurgeons), family physicians, and patients with back or leg pain. The scenarios reflected key factors related to back pain: walking ability, pain duration, pain severity, neurological symptoms, and pain location. Each group rated their preference for surgery in each situation. Unexpectedly, surgeons had the lowest preferences for surgery, while family physicians and patients had the highest preferences for surgery. The factors affecting preferences for surgery varied. For surgeons, the most important factor was the location of pain, preferring surgery for patients with pain predominantly in the leg, rather than the back (surgery provides better results in patients with problems affecting the spinal nerve roots, which tend to cause leg pain). In contrast, family physicians considered neurological symptoms, followed closely by walking ability and pain severity, the most important factors in recommending surgery.
High-Impact Sports May Boost Older Adults’ Bone Health
Participating in high-impact sports may help increase bone density in older adults. In a study appearing in a recent issue of Sports Health, ultrasound scans of 560 participants, age 50 to 93, revealed that those who took part in high-impact sports, such as running, had better bone density than people who participated in low-impact sports, such as cycling. Though arthritis and other maladies keep some older adults from participating in high-impact sports, the study suggests that if you can do it, it can play a significant part in healthy bone aging and preventing or delaying the onset of osteoporosis.
Most Patients Gain Weight After Knee Replacement
Conventional wisdom would suggest that following a total knee replacement—enabling you to walk and exercise without pain—one would lose weight, not put on pounds. Surprisingly, according to a recent University of Delaware study, that’s not the case. Physical therapists in the university’s College of Health Services found that patients typically lose weight in the first few weeks after a knee replacement, but then the scale starts creeping upward. The study, which appeared in a recent issue of Osteoarthritis and Cartilage, involved 106 individuals with end-stage osteoarthritis who had knee replacement surgery, and an age-matched, healthy control group of 31 subjects who did not have surgery. Although the control group showed no significant weight gain over two years, 66 percent of those in the surgical group gained, on average, 14 pounds. Authors of the study said that "practices and habits that surgical patients develop to get around in the years prior to surgery may be hard to break, and often they don’t take advantage of the functional gains once they get a new knee." They concluded by recommending that more emphasis be put on retraining patients with new knees to walk normally and more systematically.
Pain Increases Fall Risk in Older Adults
Older adults who suffer from musculoskeletal pain are more likely to experience a fall, according to a study published in the Journal of the American Medical Association.During the 18-month study, which included 749 adults age 70 or older, 40 percent reported chronic pain in more than one joint area, and 24 percent reported chronic pain in only one joint area. Compared with those who reported no pain or had the lowest pain scores, those who reported two or more sites of pain had an increased risk of falls, as did those with the highest pain severity. Researchers concluded that if pain forces an individual to alter his or her gait, this may cause balance impairments. Additionally, chronic pain may distract an individual from the physical maneuvers that may be required to avoid falling.