Physical Therapy Question:
Recently I slipped and fell on ice, landing on my left side. Since then I have noticed left lower back pain that radiates into my left buttock and the back of my thigh. It is difficult for me to sit, walk and move due to the pain. I saw my family physician who ordered X-rays which where negative. He recommended naproxen and rest. This is not helping. Can physical therapy help me?
Physical Therapy Answer:
Approximately 40 percent of all low back pain is related to sacroiliac joint dysfunction. The sacroiliac joint (SI joint) is one of two joints in your pelvis that connect the tailbone (the sacrum) and the large pelvic bone (the ilium). The sacroiliac joints connect the spine to the pelvis there by forming the base by which spinal movements occur. Injury to the sacroiliac joint can occur from a direct fall on the buttocks, a motor vehicle accident, or even a lifting injury. In some cases it occurs through normal activities without a specific trauma. Regardless of the cause, the sacroiliac joints can become misaligned and the ligaments/muscles around the joint become strain/sprained causing inflammation, pain and difficulty with movement.
Sacroiliac joint dysfunction symptoms:Left or right side low back pain with stiffnessPain may radiate to the buttocks, back of thigh or groin.Pain is achy and becomes sharp with movementPain is often made worse with rolling in bed, putting on shoes/socks, getting up from a seated position.Tenderness to touch around the bony lumps on one side of your lower back.Sacroiliac joint dysfunction vs. SciaticaSacroiliac joint dysfunction can often be confused with Sciatica. The difference being that sciatia is caused by irritation of a nerve (low back nerve that makes up the sciatic nerve) in the low back. This is often associated with a herniated disc.
The most common symptoms of sciatica are; low back pain, pain/numbness/tingling radiating into the leg below the knee often into the foot. The pain is often hot/burning and lancinating with occasional weakness of the foot/ankle.Physical therapy treatment of sacroiliac joint dysfunctionPhysical therapy and chiropractic care is the treatment of choice for sacroiliac joint dysfunction. First of all, your physical therapist or chiropractor will take a complete history and perform an examination of the low back and pelvis to determine the structural cause of the pain.
The best treatment approach is to utilize a combination of hands-on soft tissue and sacroiliac joint techniques. There is an abundance of research demonstrating the efficacy of hands on techniques to decrease pain and improve function. Often soft tissue techniques (myofascial release, Graston technique, Active Release Technique) are used to help decrease muscle spasms, reduce inflammation, normalize healing tissue and desensitize painful nerve ending. This is followed by gentle joint techniques (mobilization, manipulation or muscle energy) to realign the sacroiliac joint. The patient is then given gentle stretches and exercises to promote healing and prevent recurrence. With treatment the patient most likely will notice a significant reduction in symptoms and a return to function.
pottstownmercury.com
Feb 22, 2009
Aching Back? Cholesterol Medication Might Help
Study finds that using statins may be useful in treatment for degenerative disc disease.
Back pain, a hallmark of degenerative disc disease, sends millions of people to their doctor. In fact, more than 80 percent of patients who undergo spine surgery do so because of disc degeneration. And part of the answer may be as close as a patient's medicine cabinet.
In their quest to discover ways to stop or reverse degenerative disc disease, orthopaedic researchers have been removing disc tissue from patients who are having spine surgery and extracting cells from that tissue for cultivation in vitro (a controlled environment outside of a living organism). They then transfer the cells back into the patient. Shu-Hua Yang, MD, PhD, is part of a Taiwanese research team that has discovered that Lovastatin, a cholesterol-lowering medication, helps the differentiation of disc cells in vitro.
Dr. Yang, who is chief of the department of orthopedics at National Taiwan University Hospital, Yun-Lin-Branch, is presenting the group's findings in the poster "Lovastatin Helps Re-Differentiation of Human Nucleus Pulposus Cells During Monolayer Expansion" during the 55th Annual Meeting of the Orthopaedic Research Society, Feb. 22-25, 2009, in Las Vegas. Dr. Yang is also presenting the results of a related study, "Influences of Age-Related Degeneration on Regenerative Potential of Human Nucleus Pulposus Cells," at the same meeting. The two studies reveal the findings of a team of researchers from National Taiwan University Hospital.
In one study, the researchers removed nucleus pulposus tissues from six human patients. (Nucleus pulposus is the jelly-like substance in the middle of the spinal disc.) The patients, ages 23 to 29, were undergoing surgery for herniated lumbar discs. Researchers then isolated the nucleus pulposus cells and eventually added Lovastatin, hoping to optimize the properties of the regenerative tissues. They hoped to maximize the expression of collagen II and minimize the expression of collagen I, two proteins involved in facilitating bone formation.
They reported the following results:
After 72 hours, researchers found that the number of nucleus pulposus cells had increased.
Lovastatin increased the synthesis of collagen II, a protein that makes up moveable joints, and decreased the synthesis of collagen I, a protein that is related to fibrosis (the formation or development of excess fibrous connective tissue).
Lovastatin had no cytotoxicity (the quality of being toxic) on nucleus pulposus cells.
"Regeneration of the nucleus pulposus tissue in the early stage of intervertebral disc degeneration can theoretically retard or even reverse the degenerative process and possibly regain a healthy intervertebral disc," says Dr. Yang. "Further studies are needed to determine the potentials of statins for regeneration and repair of degenerative disc disorders."
In a related study, Dr. Yang and his fellow researchers looked at how the patient's age affected the suitability of nucleus pulposus tissue for regeneration.
Researchers removed tissue from two groups -- adolescent patients (who were undergoing surgery for scoliosis) and adult patients (who were undergoing surgery for herniated discs) -- to find out how to manipulate the cells in the healthiest way. The researchers found that the tissue of younger patients was generally more suitable for regeneration than tissue from older patients.
These two studies represent just two of the latest advances in tissue engineering. Spine surgeons at one German institute are already using cells from the discs of human patients for autologous cell transplantation (reimplanting cells back into the same individual the cells came from). Other published studies about disc degeneration have looked at animal cells, instead of human cells.
Degenerative disc disease is one of the leading sources of back and neck pain. Disc degeneration is part of the normal aging of the spine. In this condition, the spinal discs (the pillow-like pads between the bones) lose their cushioning. When this happens, it can cause persistent pain in the lower back, legs, neck or arms. Treatments for pain can include medications and physical therapy. Sometimes surgery is needed if the pain is severe and keeps a person from participating in everyday activities.
sev.prnewswire.com
Back pain, a hallmark of degenerative disc disease, sends millions of people to their doctor. In fact, more than 80 percent of patients who undergo spine surgery do so because of disc degeneration. And part of the answer may be as close as a patient's medicine cabinet.
In their quest to discover ways to stop or reverse degenerative disc disease, orthopaedic researchers have been removing disc tissue from patients who are having spine surgery and extracting cells from that tissue for cultivation in vitro (a controlled environment outside of a living organism). They then transfer the cells back into the patient. Shu-Hua Yang, MD, PhD, is part of a Taiwanese research team that has discovered that Lovastatin, a cholesterol-lowering medication, helps the differentiation of disc cells in vitro.
Dr. Yang, who is chief of the department of orthopedics at National Taiwan University Hospital, Yun-Lin-Branch, is presenting the group's findings in the poster "Lovastatin Helps Re-Differentiation of Human Nucleus Pulposus Cells During Monolayer Expansion" during the 55th Annual Meeting of the Orthopaedic Research Society, Feb. 22-25, 2009, in Las Vegas. Dr. Yang is also presenting the results of a related study, "Influences of Age-Related Degeneration on Regenerative Potential of Human Nucleus Pulposus Cells," at the same meeting. The two studies reveal the findings of a team of researchers from National Taiwan University Hospital.
In one study, the researchers removed nucleus pulposus tissues from six human patients. (Nucleus pulposus is the jelly-like substance in the middle of the spinal disc.) The patients, ages 23 to 29, were undergoing surgery for herniated lumbar discs. Researchers then isolated the nucleus pulposus cells and eventually added Lovastatin, hoping to optimize the properties of the regenerative tissues. They hoped to maximize the expression of collagen II and minimize the expression of collagen I, two proteins involved in facilitating bone formation.
They reported the following results:
After 72 hours, researchers found that the number of nucleus pulposus cells had increased.
Lovastatin increased the synthesis of collagen II, a protein that makes up moveable joints, and decreased the synthesis of collagen I, a protein that is related to fibrosis (the formation or development of excess fibrous connective tissue).
Lovastatin had no cytotoxicity (the quality of being toxic) on nucleus pulposus cells.
"Regeneration of the nucleus pulposus tissue in the early stage of intervertebral disc degeneration can theoretically retard or even reverse the degenerative process and possibly regain a healthy intervertebral disc," says Dr. Yang. "Further studies are needed to determine the potentials of statins for regeneration and repair of degenerative disc disorders."
In a related study, Dr. Yang and his fellow researchers looked at how the patient's age affected the suitability of nucleus pulposus tissue for regeneration.
Researchers removed tissue from two groups -- adolescent patients (who were undergoing surgery for scoliosis) and adult patients (who were undergoing surgery for herniated discs) -- to find out how to manipulate the cells in the healthiest way. The researchers found that the tissue of younger patients was generally more suitable for regeneration than tissue from older patients.
These two studies represent just two of the latest advances in tissue engineering. Spine surgeons at one German institute are already using cells from the discs of human patients for autologous cell transplantation (reimplanting cells back into the same individual the cells came from). Other published studies about disc degeneration have looked at animal cells, instead of human cells.
Degenerative disc disease is one of the leading sources of back and neck pain. Disc degeneration is part of the normal aging of the spine. In this condition, the spinal discs (the pillow-like pads between the bones) lose their cushioning. When this happens, it can cause persistent pain in the lower back, legs, neck or arms. Treatments for pain can include medications and physical therapy. Sometimes surgery is needed if the pain is severe and keeps a person from participating in everyday activities.
sev.prnewswire.com
Feb 17, 2009
HealthWatch: Electrode Treatment For Migraines
Migraine headaches are a real, biological disease characterized by throbbing head pain – usually on one side of the head – sometimes paired with nausea or sensitivity to light or sound.
While new medications help, some are still debilitated by their headaches – but now there's a possible alternative. "It's a really sharp, intense pain [and] a lot of nausea," migraine sufferer Rebecca Scott says. "Sometimes it's above my eyes, sometimes it radiates all the way through the top and the back of my head."
Rebecca, a 32-year-old mother of two, gets debilitating headaches three or four times a week, each lasting anywhere from eight hours to three days long.
The migraines have made it difficult for her to hold down a job, and even to be a mom.
"It's hard when your kids want to go out and play," Rebecca says. "They want me to jump on a trampoline with them, they want me to play sports with them, and I can't do that."
When drugs failed, Rebecca came to New York from her home in North Carolina to see Dr. Alon Mogilner, who's running an experimental trial using electrodes and a nerve stimulator to treat migraines.
The electrodes are placed below the base of the skull, and then connected to a battery-powered pulse generator. "
One of the theories is that stimulation of particular nerves in the upper neck and the back of the head can actually send signals back to parts of the brain that control the pain signals," Dr. Mogilner, of North Shore Long Island Jewish Health System, says. "The signals that are sent to the blood vessels in the brain and head, may be, in fact, causing the migraines."
The actual implant procedure is fairly simple – the electrodes are placed under the skin at the back of the neck, under X-ray guidance.
Rebecca is even awake for part of the surgery to check electrode placement.
The hope is that the nerve stimulation will make migraines less frequent milder. "
If it's affecting the quality of my life, then why not take a chance at it," Rebecca says.
Even though the stimulator implant is relatively minor as far as surgical procedures go, the clinical trial is meant for people who suffer migraines at least three to four days a week.
The technology itself has been around for years, being used as a stimulator in treatment for Parkinson's, Dystonia, and for chronic back pain.
(CBS)
While new medications help, some are still debilitated by their headaches – but now there's a possible alternative. "It's a really sharp, intense pain [and] a lot of nausea," migraine sufferer Rebecca Scott says. "Sometimes it's above my eyes, sometimes it radiates all the way through the top and the back of my head."
Rebecca, a 32-year-old mother of two, gets debilitating headaches three or four times a week, each lasting anywhere from eight hours to three days long.
The migraines have made it difficult for her to hold down a job, and even to be a mom.
"It's hard when your kids want to go out and play," Rebecca says. "They want me to jump on a trampoline with them, they want me to play sports with them, and I can't do that."
When drugs failed, Rebecca came to New York from her home in North Carolina to see Dr. Alon Mogilner, who's running an experimental trial using electrodes and a nerve stimulator to treat migraines.
The electrodes are placed below the base of the skull, and then connected to a battery-powered pulse generator. "
One of the theories is that stimulation of particular nerves in the upper neck and the back of the head can actually send signals back to parts of the brain that control the pain signals," Dr. Mogilner, of North Shore Long Island Jewish Health System, says. "The signals that are sent to the blood vessels in the brain and head, may be, in fact, causing the migraines."
The actual implant procedure is fairly simple – the electrodes are placed under the skin at the back of the neck, under X-ray guidance.
Rebecca is even awake for part of the surgery to check electrode placement.
The hope is that the nerve stimulation will make migraines less frequent milder. "
If it's affecting the quality of my life, then why not take a chance at it," Rebecca says.
Even though the stimulator implant is relatively minor as far as surgical procedures go, the clinical trial is meant for people who suffer migraines at least three to four days a week.
The technology itself has been around for years, being used as a stimulator in treatment for Parkinson's, Dystonia, and for chronic back pain.
(CBS)
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