(Reuters Health)—Spinal manipulation may work as well for easing lower back pain as anti-inflammatory medications, a research review concludes. Based on data from 15 previously conducted trials involving a total of 1,711 adults, the study team found that spinal manipulation achieved meaningful reductions in pain and improvements in function after six weeks of treatment. The…
New NICE Guidance for Low Back Pain
If left untreated, low back pain can cause long-term disability. To aid its diagnosis and management, the National Institute for Health and Care Excellence has released revised guidance. Recommendations include the use of risk stratification tools for diagnosis, as well as physical activity or a comprehensive program that addresses biomechanical, aerobic and/or psychological needs…
Don’t Reach for Pills for Most Chronic Low Back Pain
(Reuters Health)—People should try non-drug treatment options like massage or stretching for most cases of chronic low back pain before choosing treatment with over-the-counter or prescription drugs, according to new guidelines from the American College of Physicians (ACP). If the pain began recently, the guidelines recommend superficial heat, massage, acupuncture or spinal manipulation. If patients…
When Chronic Pain Is Personal
Opening up to patients about a medical condition is a personal choice for physicians. But for Richard Brasington, MD, who has chronic back pain and arthritis, it helps him communicate with and connect to some of his patients. In an interview, he provides insights into his experiences managing pain on the job…
Lateral Hip Pain: Could It Be Gluteal Tendinopathy?
Researchers recently found that physical tests that involve an active muscle contraction were most useful in identifying gluteal tendinopathy in patients with lateral hip pain. However, patients who were not palpably tender over the greater trochanter were unlikely to have GT detected during an MRI…
Docs Still Order Imaging for Low Back Pain, Against Recommendations
(Reuters Health)—Many doctors who order computed tomography (CT) or magnetic resonance imaging (MRI) scans for patients with low back pain do so fearing that patients will be upset if they do not get imaging and because there is too little time to explain the risks and benefits of the tests, a new study found. The…
The Role of Benign Joint Hypermobility in Functional Pain Disorders
Physicians have been puzzled by the role of benign joint hypermobility syndrome in the development of gastrointestinal disorders and other autonomic symptoms and co-morbidities. However, new research found that benign joint hypermobility syndrome only minimally affects autonomic abnormalities…
Massage May Be an Option for Pain Relief
(Reuters Health)—Massage is better than nothing for pain relief, according to a new review. The therapy may also be an acceptable choice for people considering other options, such as acupuncture and physical therapy. “It should be considered at least for musculoskeletal pain as a viable option in the mix of pain management techniques in these areas,”…
Diagnostic Imaging in Patient with Chronic Left Ankle Pain: History
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 49-year-old woman presents with one year of chronic left ankle…
Diagnostic Imaging in Patient with Chronic Left Ankle Pain: Findings
Radiographic imaging showed circumferential soft tissue swelling of the ankle with a soft-tissue density seen in the tibiotalar and posterior subtalar joints, as well as a large, lobulated effusion. MRI of the left ankle shows cystic changes within the talus and first cuneiform bones, as well as a lobulated abnormal soft tissue density with low…
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