In The News: March 2012
Back Pain? Move, Donít Rest
If you suffer from acute low back pain, your best remedy may be to stay active. Researchers at the University of Gothenburg, Sweden, examined 109 patients with acute severe low back pain and advised them to 1) stay active even though it hurts, or 2) adjust their activity to the pain. They also were asked to keep a diary for seven days to note to what extent they could carry out daily activities and how they felt physically. In spite of experiencing more pain, the group that was asked to be as active as possible recovered more quickly. The other subjects, who had been advised to adjust their activity to their pain, were less mobile and felt slightly depressed. Authors of the study said that if you donít keep moving when youíre in pain, it is easy to get locked into a downward spiral, as inactivity combined with pain can, in a worst-case scenario, turn into long-term disability.
Lower Corticosteroid Dose Just as Effective as Higher for Shoulder Pain
Researchers at Koreaís Ajou University School of Medicine have discovered that lower doses of corticosteroid are just as effective in relieving shoulder pain as higher doses. Investigators followed 79 patients with at least one monthís duration of pain. Subjects were assigned to three groups, with 27 participants receiving a 40 mg dose of triamcinolone acetonide, 25 receiving a 20 mg dose (20 mg and 40 mg are the two most commonly doses administered for shoulder pain), and 27 receiving a placebo injection. All were followed up at two, four, and eight weeks and asked to rate their degree of shoulder pain. The high-dose (40 mg) and low-dose (20 mg) groups both showed improvement in pain, disability, and range of motion, while the placebo group showed no difference. Importantly, the study showed no significant differences between the high- and low-dose groups. Because a higher dose may increase the incidence of local and general complications, researchers recommended that a lower dose be administered at the initial treatment stage.
Poor Footwear Linked to Disability in Gout Patients†
Gout patients who make poor footwear choices experience higher foot-related pain, impairment, and disability, according to a study published in Arthritis Care & Research. Recent statistics show that gout has risen over the past 20 years and now affects 8.3 million individuals in the U.S. alone. With these and other findings in mind, researchers in Auckland, New Zealand, recruited 50 patients with a history of gout to assess disease characteristics, overall function, foot impairment, and disability. Roughly 56 percent of the patients had made good footwear choices by wearing walking shoes, athletic sneakers, or oxfords. Of the remaining patients, 42 percent wore footwear that was considered poor (lacking ample cushioning, adequate motion control, and sufficient forefoot width), including sandals, flip-flops, slippers, and moccasins. Those who wore inadequate footwear reported significantly higher foot-related impairment and disability. More than half of all participants also wore shoes that were 12 months or older and showed excessive wear patterns.
Single Injection Limits Pain After Spinal Cord Injury
A collaborative research group, led by researchers at Cleveland Clinic, has found that a one-time injection of fibronectin immediately after a spinal cord injury can limit pain for an extended period of time. Fibronectin, a protein that exists naturally in humans, supports the survival, growth, and communication of neurons in the brain and spinal cord. The researchers discovered, through testing in mice, that an injection of fibronectin into the spinal cord activates specific signaling pathways and results in pain-curbing effects. While the exact mechanisms underlying the fibronectin connection to pain relief are not yet clear, results show that the protein not only maintained the integrity of the blood-spinal cord barrier but also suppressed inflammation significantly over an eight-month period. Researchers found that fibronectin also reversed spinal cord injury-induced decreases in serotonin, which plays an important role in pain perception.