The practice of yoga has increasingly been demonstrated to improve chronic pain and other symptoms of diseases, including cancer and arthritis, said researchers at Oregon Health & Science University.

“It’s not an alternative to medication,” said study researcher James Carson, a clinical health psychologist and assistant professor at OHSU, “but the techniques in the yoga tradition really address individual needs and can decrease the psychological distress associated with pain.”

The new study was published today (Oct. 14) in the journal Pain.

Yoga gets put to the test

Carson’s study included 53 women (up to 90 percent of fibromyalgia cases are in women) whose average age was 54. Participants typically had been living with the disorder for at least a decade, and were on a stable treatment regimen of medication.

The patients were divided into two groups, and 25 of the women immediately began a Yoga of Awareness program, developed by Carson. The other 28 women were added to a waiting list for the yoga program, and were used as a control group.

The participants attended one 2-hour class per week for eight weeks, and were encouraged to do at least 20 minutes of yoga daily, five days a week, using DVDs provided by the researchers.

Using a combination of self-reported symptoms and physical measurements of tender points (sensitive areas of the body), the researchers found 77.3 percent of the participants were “at least a little better” as a result of the yoga, compared with 19.2 percent of the control group on standard therapy. In particular, half of those who had done yoga reported a 30 percent reduction in pain.

None of the yoga participants reported a significant worsening of their symptoms at the end of the two-month program, but almost 8 percent of the control group did.

To date, there has been only one other randomized, controlled trial using yoga to treat fibromyalgia, Carson said. Although the results showed overall improvements in pain symptoms, the study was smaller in scope.

Current treatments for fibromyalgia include a combination of medication, exercise and training in coping skills. The researchers said yoga therapy could be a better adjunct to drugs.

“Yoga teaches patients a set of techniques, such as breathing and meditation, in addition to incorporating poses that improve strength and balance,” Carson said.

Prescribing yoga for pain

Many doctors have already begun to prescribe yoga to patients. Carol Krucoff, a certified yoga instructor with the American Council on Exercise and author of “Healing Yoga for Neck and Shoulder Pain” (Raincoat Books, 2010), regularly works with patients who’ve been referred to her by physicians at Duke Integrative Medicine in Durham, N.C.

“Yoga is particularly helpful in a multifaceted disorder like fibromyalgia,” Krucoff said. “It offers tools to handle symptoms on many levels – physical, psychological and spiritual.”

For example, in the study, the 2-hour yoga session was divided into 40 minutes of stretching and 80 minutes of learning breathing techniques. They studied how to apply yoga principles to coping with their condition, discussed yoga with other group members, and trained in mindfulness. Mindfulness – learning how to live in the moment – may be particularly helpful for patients dealing with chronic pain, the researchers said.

“Mindfulness teaches patients to see their pain from a different perspective,” Carson told MyHealthNewsDaily. “They learn to understand that a pain flare might be happening at a particular moment, but that moment will pass.”

These techniques may have a powerful effect inside the body. Relaxation is known to cause many changes in the body, including decreased heart rate and improved breathing. Because dysregulation of the nervous system is thought to be the source of fibromyalgia symptoms, Carson hopes to study biological changes brought about by yoga teachings such as mindfulness and “healthy acceptance.”

“Yoga may be changing the way pain is processed at the neural level,” Carson said.

Although the results of his study are promising, its small size and reliance on self-reported information make it difficult to generalize the results.

Carson plans to next look at a larger group of fibromyalgia patients that includes men, and to follow-up with participants for one year to see if the benefits of yoga are more lasting.

Technorati Tags: Fibromyalgia, Fibromyalgia pain relief, yoga

The shocking question came from a respected spine surgeon tracked down by Keith Swenson, who was still in severe pain after an earlier back operation.

He didn’t know what to believe. Two other surgeons had urged more operations, different ones.

And Swenson, who’s from Howard Lake, Minn., is far from alone. Even though only a fraction of people with back pain are good candidates for surgery, complicated spine operations are on the rise.

So is the hunt for any relief.

By one recent estimate, Americans are spending a staggering $86 billion a year in care for aching backs — from MRIs to pain pills to nerve blocks to acupuncture. That research found little evidence that the population got better as the bill soared over the past decade.

“The way medicine is so Star-Treky these days, they believe something can be done,” said Dr. Charles Rosen, a spine surgeon at the University of California, Irvine.

The reality is that time often is the best antidote. Most people will experience back pain at some point, but up to 90 percent will heal on their own within weeks. In fact, for run-of-the-mill cases, doctors aren’t even supposed to do an X-ray or MRI unless the pain lingers for a month to six weeks.

Yet a study last year found nearly one in three aching Medicare patients get some kind of back scan within that first month.

Why is that a problem? Those scans can be misleading. By middle age, most people who don’t even have pain nonetheless have degeneration of their disks, those doughnut-looking shock absorbers between vertebrae. So in someone who does have pain, pinpointing that a particular black spot or bulge on a scan is the true cause is tricky.

The bigger problem: When the misery lingers, there’s no one-size-fits-most treatment.

“There are a lot of procedures going on for patients in whom we don’t have good scientific evidence that it’s going to help,” said Dr. Richard Deyo of Oregon Health and Science University in Portland, who long has studied how people fare with different options for this tough ailment.

For example, there’s a wide variety of spinal injections that aim to numb back pain, using different drugs and targeting different spots. Which one works depends on what study you read.

When the Institute of Medicine recently listed the 100 how-to-treat questions that doctors most need answered, back pain neared the top of the list.

Lots of things can cause chronic back pain, from arthritis to bone-thinning osteoporosis, which has its own controversy over whether cementing cracks in the spine really helps.

But those cushiony disks are a big reason. They naturally thin and shrink with age. Sometimes they herniate, or rupture, so the gel-like center leaks and pressures a nerve. Sometimes a vertebra slips out of alignment. Sometimes the spinal canal painfully narrows, a condition called stenosis.

The right operation can help, but specialists say only about 10 percent of people with lasting pain are candidates. More than 333,000 of the simpler decompression operations — laminectomies and diskectomies that cut away part of a bone or disk to relieve nerve pressure — were performed in 2007, the latest data compiled by the American Academy of Orthopaedic Surgeons. There were nearly 381,000 spinal fusions — more complex, riskier surgeries that bind vertebrae together with a bone graft and sometimes metal hardware.

There is some hopeful news — increasing evidence that more people should try pushing past the pain in aggressive exercise programs. Deyo calls them boot camps for back pain.

That’s what ended Swenson’s five-year pain odyssey. After a volleyball injury, scans showed he had degeneration in seven disks but one bulged in a way that doctors thought explained the pain radiating down both legs. They cut away part of that spot; it didn’t help. Neither did multiple pain-blocking options.

“Exercise is medicine, but it has to be the right exercise,” said Dave Carpenter, president of Physicians Neck & Back Clinics in Minneapolis, where Swenson finally turned.

The clinic’s rehabilitation program focuses on strengthening muscles that support the spine, and published a study showing that only three of 38 patients prescribed surgery still needed it in the 13 months after completing tailored rehab.

Swenson, now 51, said he was so debilitated that it took several months to improve, plus two years of “maintenance” conditioning. Today, he’s running a thriving gardening business near Minneapolis that ships peonies nationwide. It’s a job that requires tremendous manual labor.

“Do I have flare-ups? Yes. But now that my back is strengthened, instead of flare-ups lasting one to two months … the flare-ups last one to two days,” he said. “This form of treatment is a lifetime change.”

In New York City, Nicia Cortez wishes someone had told her of other options before her 2003 operation on a herniated disk.

“I was naive, and in severe pain. I didn’t think properly at the time,” said Cortez, who felt worse after surgery. It took her six years to work up the nerve to try again, this time a fusion that mostly relieved the pain: “I have my life back.”

Her new doctor cautions that scar tissue and altered anatomy mean each subsequent back surgery has less chance of success than the one before.

“It’s like trying to pave your driveway, layer upon layer, but at some point you replace the whole driveway. We don’t have that ability with the spine,” said Dr. Alok Sharan, spinal chief at New York’s Montefiore Medical Center.

He makes patients exhaust nonsurgical options first, knowing that about one in five who has one back operation will have another in a decade.

“Sometimes people jump to this and think it will be a cure-all, and then five years later you need another procedure. If you’re only 40, that’s a big deal,” Sharan said.

What’s the best advice? First, some types of back pain are accompanied by red flags that need immediate attention — such as numb or weak legs or urinary problems. But for most people:

_Don’t expect an X-ray, MRI or CT until a month to six weeks has passed, unless the doctor suspects a more serious problem. Following that guideline is becoming a quality-of-care measure in many organizations.

_Get back to normal activity as quickly as possible; the days of prescribed bed rest are over.

_Patients with sciatica, pain radiating down the leg, have the best outcomes from those nerve-easing decompression surgeries, Deyo stressed. California’s Rosen said three criteria determine chances of success: a scan that correlates with the pain site; the patient has some weakness; and specific pain occurs when the doctor raises and straightens the legs.

Herniated disks heal on their own over about two years, but surgery for a faster fix is reasonable in good candidates, he said.

Fusions are appropriate for far fewer patients, those with fractures, unstable or slipping spines, curvature of the spine and rare other reasons, Rosen said.

Deyo recently studied surgeries for stenosis, that painful narrowing, and found decompression surgery as effective and less risky than fusions, which are more complicated and costly.

A formal exercise program is especially effective if coupled with cognitive behavioral therapy that teaches patients to manage and function with pain, Deyo said.

What if surgery fails? Usually, it was the wrong operation or the wrong candidate, said Rosen, who sees one or two patients a week classified as having “failed back syndrome” because of multiple failed surgeries.

Always get a second opinion. Rosen, who founded the Association for Medical Ethics, also recommends asking about a doctor’s ties to companies that make spine-surgery products. That way you’ll feel assured that a recommendation to cut doesn’t come from a too-cozy relationship.

Not a good candidate? A primary care physician can be a neutral adviser in helping navigate next steps. Patients with more challenging back problems may fare better at a multidisciplinary spine center with numerous specialists — in rehab and pain management — under one roof.

“You don’t want to leave them hanging,” said Rosen.

Technorati Tags: back pain, back surgery, exercise programs, pain management, Pain pills, severe pain

What’s more alarming is that the findings suggest these more challenging operations are riskier, leading to more complications and even deaths.

“This is exactly what the health care debate has been dancing around,” said Dr. Eugene Carragee of Stanford University Medical Center.

“You have one kind of operation that could cost $20,000 and another that could cost $80,000 and there’s not good evidence the expensive one is being used appropriately in the majority of cases,” Carragee said.

Add to that the expense for patients whose problems after surgery send them back to the hospital or to a nursing home and “that’s not a trivial amount of money” for Medicare, said Carragee. He wrote an accompanying editorial in the Journal of the American Medical Association where the federally funded study appears Wednesday.

The cost to Medicare, just for the hospital charges for the three types of back surgery reviewed is about $1.65 billion a year, according to the researchers.

All the patients in the study had stenosis in their lower backs, a painful squeezing in the spine that’s most common in people over 50. The researchers compared the risks for three different types of surgery for the condition: decompression, simple fusion and complex fusion.

“All operations aren’t the same and some seem to be associated with higher complication rates than others,” said lead author Dr. Richard Deyo of Oregon Health and Science University in Portland. “It’s not necessarily true that the more aggressive surgery is better, at least in terms of safety.”

There’s little agreement about the best way to treat chronic lower back pain, and much depends on what’s causing the pain.

Patients should ask their doctors about alternatives to complicated operations, Deyo said. Could steroid injections and physical therapy be tried? Would a simple decompression procedure be as helpful as a spinal fusion and with less risk?

In a decompression procedure, the simplest method in the Medicare study, a surgeon cuts away part of the bone that’s painfully pressing on nerves. It can cost about $30,000 in hospital and surgeon fees.

For a fusion, a surgeon binds two or more vertebrae together using a bone graft, with or without plates and screws. The researchers defined a complex fusion as one involving three or more vertebrae or more than one side of the spine. Fusions cost $60,000 to $90,000.

The researchers analyzed data on more than 32,000 Medicare patients who had one of the three types of surgeries in 2007.

About 5 in 100 patients who had simple or complex fusions suffered major complications such as stroke compared to 2 in 100 with decompressions. The risk of death within 30 days after surgery was different too: 6 in 1,000 for complex fusions compared with 5 in 1,000 for simple fusions and 3 in 1,000 for decompressions.

The study didn’t address how successful the various types of surgeries were at relieving pain.

More than half the patients who had complex fusions had a simple stenosis, which usually calls for decompression alone. They did not have the curvature of the spine or a slipped vertebra — additional conditions that might suggest a fusion is needed. There’s not much evidence for doing a complex fusion for a person with simple stenosis, Carragee and other experts said.

“It certainly looks like there’s more complex surgery being done than we have very good evidence to support,” Carragee said.

Rates of complex fusions in Medicare patients rose 15-fold from 2002 to 2007, while decompressions and simple fusions declined, the study found. Although the overall procedure rate fell, hospital charges grew 40 percent.

Aggressive marketing of devices used in complex fusions is likely playing a role in the increase, Deyo said. The marketing includes ads in medical journals and lectures by surgeons on the payroll of device manufacturers.

Allegations of kickbacks to spine surgeons for using products and questionable financial arrangements to doctors as consultants have plagued the multibillion-dollar industry. One company, Medtronic Inc., reached a $40 million settlement with the U.S. Justice Department in a whistleblower case that included allegations the company paid doctors to use its spine surgery products. The company denied any wrongdoing.

Dr. Charles Rosen, a spine surgeon at the University of California, Irvine, founded the Association for Medical Ethics to nudge doctors toward scientific evidence over vested interests. Forty-nine spine surgeons have joined, pledging to refuse any type of compensation or earnings from companies for using a product.

Rosen applauded a provision in the new health care law that requires device makers and others to file annual reports to the government on their financial ties to doctors. Patients will be able to look up possible conflicts in a government database.

“Too much fusion surgery is done in this country and often for inappropriate reasons,” Rosen said. While complex fusions are needed for some conditions, he said, patients “should not hesitate to get a second opinion.”

Technorati Tags: back pain, spinal fusion surgeries, treat lower back pain

A Food and Drug Administration panel on Tuesday voted 20-17 that prescription drugs that combine acetaminophen with other painkilling ingredients should be pulled off the market.

The FDA has assembled a group of experts to vote on ways to reduce liver damage associated with acetaminophen, one of the most widely used drugs in the U.S.

Despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., according to the FDA.

Panelists cited FDA data indicating 60 percent of acetaminophen-related deaths are related to prescription products. Acetaminophen is also found in popular over-the-counter medications like Tylenol and Excedrin.

“We’re here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact,” said Dr. Judith Kramer of Duke University Medical Center.

But many panelists opposed a sweeping withdraw of products that are so widely used to control severe, chronic pain.

“To make this shift without very clear understanding of the implications on the management of pain would be a huge mistake,” said Dr. Robert Kerns of Yale University.

In a separate vote, the panel voted overwhelmingly, 36-1, that if the drugs stay on the market they should carry a black box warning, the most serious safety label available.

The FDA is not required to follow the advice of its panels, though it usually does.

Prescription acetaminophen combination drugs were prescribed 200 million times last year, according to FDA data. Vicodin is marketed by Abbott Laboratories, while Percocet is marketed by Endo Pharmaceuticals. Both painkillers also are available in cheaper generic versions.

The FDA convened the two-day meeting to ask experts to discuss and vote on a slew of proposals to reduce overdoses with acetaminophen. The drug has been on the market for about 50 years and many patients find it easier on the stomach than ibuprofen and aspirin, which can cause ulcers.

Earlier in the day, panelists took aim at safety problems with Tylenol and dozens of other over-the-counter painkillers. In a series of votes, the panel endorsed lowering the maximum dose of those products.

FDA’s experts voted 21-16 to lower the current maximum daily dose of nonprescription acetaminophen, which is 4 grams, or eight pills of a medication like Extra Strength Tylenol.

The group was not asked to recommend an alternative maximum daily dose.

The panel also voted 24-13 to limit the maximum single dose of the drug to 650 milligrams. The current single dose of Johnson & Johnson’s Extra Strength Tylenol is 1,000 milligrams, or two tablets.

In a third vote, a majority of panelists said the 1,000-milligram dose should only be available by prescription.

However, panelists rejected a proposal to pull certain cold and cough medicines off the market because of their role in overdosing.

The drugs in question, such as Procter & Gamble’s NyQuil or Novartis’ Theraflu, combine acetaminophen with other ingredients that treat cough and runny nose.

The FDA says patients often pair the cold medications with pure acetaminophen drugs, like Tylenol, exposing themselves to unsafe levels of the drug.

But panelists cited FDA data that said the medications play a minor role in acetaminophen overdoses, with only 10 percent of acetaminophen-related deaths involving a cold and cough product.

“I don’t think we should be advocating a solution to a problem that really is not there,” said Dr. Osemwota Omoigui, of the Los Angeles pain clinic.

The panel voted 24-13 to keep the products on the market.

Technorati Tags: acetaminophen drugs, FDA, medications, painkillers, prescription drugs, tylenol

  Millions of people suffer from back pain unnecessarily when there is actually a very simple solution, according to Jesse Cannone , certified personal trainer and back pain specialist.  "Unfortunately, many people are led to believe that back pain is normal and were all supposed to experience it… well, thankfully, that’s not the case. Eliminating back pain is not nearly as difficult as most people think or are led to believe… it can actually be easy!" says Cannone. 

Here’s the simple system that MUST be followed if you are looking for real, long-term, lasting relief:

1. Identify the cause – nearly all of the treatments people receive for back pain only focus on the symptoms and the health care professionals zoom in on only the problem area. The real key in eliminating back pain is to find out exactly what’s causing the problem… and most of the time it’s not even the back!

2. Be aware – many people suffering from back pain are not in tune with their bodies and during their treatment they do not realize what is working and what is not. In order to achieve long-term relief you have to understand how your body works, what’s causing the problem, and what changes have to be made to correct it.

3. Address both the cause and the symptom – the best approach is a combination of treating the symptoms for pain relief while also addressing the underlying cause.

4. Consistent Focused Action – achieving success in anything requires consistency and focused action. Most people with back pain won’t make the time to work on their problem each day… instead they take pain killers which mask the pain and allow them to cause more damage while they continue with their life.

5. Don’t do what doesn’t work – we already know that most traditional treatments for back pain don’t work…. why waste your time, energy, and money? The real key to eliminating back pain is to identify the true cause of the pain and then address it with a combination of treatments to treat both the cause and symptoms. Over 80% of all back pain is caused by muscle imbalances… NOT a lack of pain killers or surgery! Find out what’s going on in your body and take action.

Because the rest of the article contains graphics and other images, we can’t post it all here.  To see the rest of this great article, please visit Healthy back institute site.  There, you will find the conclusion of this article as well as many others that may help you get rid of your back pain forever.

Technorati Tags: back pain cure, back pain treatments, relief from back pain, relieve back pain, treatment for back pain

Back pain is one of the main symptoms of preterm labor and is the second most common reason for a visit to the physician. By far the most common causes of back pain are "mechanical" caused by disc degeneration, muscle or ligament strain. But can sometimes be caused by a problem with the kidneys.

It is usually more severe than leg pain (sciatica). Sciatica is usually the result of a pinched nerve and occurs when a protruding disc is putting pressure on a spinal nerve. It is pain anywhere in the back form the neck to the low back. Most is related to activity and overuse of the muscles that are in the back.

Pain can also occur acutely during sporting events if a person has an injury during practice or game. But not all low back pain is actually due to a problem in the back, there are occasions when back pain is caused by a problem with the hip joint or musculature. But it can also be caused by fracture, arthritis, disc problems, or bony malalignment.

Back pain is also among the most difficult conditions to diagnose. Because only about 5 percent of cases can be detected with conventional imaging procedures, clinicians attempting to diagnose and treat usually must rely on what patients tell them about the condition. In the U.S., acute low back pain (also called lumbago) is the fifth most common reason for all physician visits.

Lower Back Pain Relief

Lower back pain affects the portion of the back known as the lumbar spine, and causes Americans to spend $50 billion annually on treatments. It’s also the top reason for disability on the job, and causes a high percentage of absences from work. It is often more common for people who are carrying extra weight and being overweight can make back pain a whole lot worse, as there is a lot more stress on the back. When there is more weight found in the stomach area, this can cause even more stress on the lower back.

The Common Conditions with Back Pain

Common conditions include herniated discs, sciatica, degenerative disc disease, slipped discs, back sprains, strains and fractures. Commonly, the pain extends from the lower back into the buttock and down the leg past the knee on the affected side, indicating sciatica. Coughing, sneezing, straining, or bending over while keeping the legs straight can trigger the sharp, radiating pain.

When you feel any kind of pain, you would try and consult your doctor as soon as possible because back pain is a major cause of disability in the United States. The lifetime prevalence of low back pain is estimated at 60-90%. So make sure you get a checkup as soon as possible.

Technorati Tags: chronic back pain relief, low back pain relief, lower back pain relief, relief for lower back pain, relief from back pain