REPOST: FDA warns of risks to cortisone injections in the spine

The Food & Drug Administration warns about the danger of corticosteroids injections for back pain. This Los Angeles Time article has the details.  

Corticosteroid injections into the spine's epidural space that are often used to treat radiating back pain carry rare but serious risks, the FDA has warned, and physicians should discuss those risks with patients who are considering getting the shots. (Jay L. Clendenin / Los Angeles Times). Image Source: latimes.com

The Food & Drug Administration is warning that injections of corticosteroids into the spine's epidural space -- an extremely common treatment for radiating back or neck pain -- in rare cases may result in loss of vision, stroke, paralysis and death.

And that's even in the absence of fungal and other contamination introduced by compounding pharmacies that killed 48 people in 2012 and 2013.

Physicians offering these injections to patients with back or neck pain should discuss these rare but serious risks with patients considering a jab of steroidal medication into the cerebrospinal fluid, the FDA said Wednesday.

The warnings mark the opening volley of an FDA effort to improve the safety of a pain treatment that thrives in medical practice without ever having received the agency's formal blessing. While many patients and physicians swear by the treatment for back and neck pain, the use of corticosteroids injected into the spinal space has never been shown safe and effective in clinical trials assessed by the FDA.

Later this year, the drug-safety agency said it will convene an advisory panel to discuss the risks and benefits of such injections and explore whether further regulation would reduce injuries from this use of injected methylprednisolone, hydrocortisone, triamcinolone, betamethasone and dexamethasone. An expert panel of pain specialists convened by the FDA has drafted a slate of recommendations to minimize possible harms from this specific use of corticosteroids, and the FDA says it will release those guidelines when they're finalized.


North American Spine is at the forefront of minimally invasive spine care that helps patients
understand various options for neck and back pain treatments. Follow this Twitter page for more updates.

REPOST: New - Acupuncture Relief From Low Back Pain

A new study reveals that acupuncture eases low back pain. Read more in this HealthCMi.com article.

Image Source: healthcmi.com

Researchers conclude that acupuncture is effective for the treatment of chronic low back pain. A randomized, controlled trial was performed at the Dongzhimen Hospital in Beijing, China with a group of 60 participants. Acupuncture effectively decreased patient pain levels and reduced days missed from work due to low back pain.

Another study of 236 patients published in the Journal of Musculoskeletal Pain concludes that acupuncture is effective for the treatment of low back pain. A total of 14 acupuncture treatments were administered over 4 weeks in this randomized trial. The researchers concluded that acupuncture has “beneficial and persistent effectiveness against CLBP (chronic lower back pain).”

Image Source: healthcmi.com

Another study investigated the effects of distal acupuncture on low back pain. Distal acupuncture involves acupuncture point selections from areas that are not located in the affected region. For this study, a single acupuncture point, LI4 (Hegu), was chosen. A group of 187 patients with chronic low back pain received 18 treatments at LI4 over a 7 week period in this controlled clinical trial. The patients demonstrated significant relief from low back pain.

LI4 is located on the dorsum of the hand, between the 1st and 2nd metacarpal bones at the midpoint of the 2nd metacarpal bone, at the high point of the thenar eminence and distal to the transverse carpal ligament. In Traditional Chinese Medicine (TCM), acupuncture is applied to this point for the treatment of many pain related conditions including headaches, jaw pain, eye pain and toothaches. Nearby, another well known set of distal points on the hand, Yaotongxue, are often used by licensed acupuncturists for the relief of pain due to acute low back sprain. A large scale analysis of a multitude of studies finds acupuncture effective for the relief of low back pain. In a meta-analysis of 11 randomized-controlled trials, researchers note that “current evidence is encouraging in that acupuncture may be more effective than medication….” They note that, “Compared with nonsteroidal anti-inflammatory drugs, acupuncture may more effectively improve symptoms of acute LBP (lower back pain).” The study eliminated variables such as the placebo effect by using sham (simulated) acupuncture controls to ensure the validity of the data.

Another study finds acupuncture effective for the treatment of neck and lower back pain. The researchers concur with prior studies demonstrating that acupuncture is effective for pain relief and that acupuncture is sometimes more effective than NSAIDs (nonsteroidal anti-inflammatory drugs). Acupuncture was determined to be effective for both long and short-term pain relief of lumbar disc herniations and cervical disc related pain.


Cost-Effectiveness

A great deal of press has been given to the administration of healthcare within the USA. Concern over implementation of recent healthcare legislation such as the PPACA (The Patient Protection and Affordable Care Act, “Obamacare”) has received enormous news coverage. Other systems providing healthcare for all its citizens including those of Canada, the UK, Australia, Germany and France have also received attention as a result of the new USA basic standards in healthcare insurance established by the PPACA. Acupuncture research has focused on this aspect of the conversation and not only on clinical effectiveness.

Researchers in Calgary, Alberta investigated the cost-effectiveness of acupuncture for the treatment of low back pain. They discovered that acupuncture reduces the total of health services spending. A group of 201 acupuncture and 804 non-acupuncture low back pain patients were evaluated for the number of medical doctor visits required for the treatment of low back pain.

The mean age of the group was 48 years and 54% of those investigated were female. Results were tabulated as a comparison of the 1 year period prior to receiving acupuncture therapy versus the 1 year period after having had acupuncture therapy. The same period of time was evaluated for the 804 non-acupuncture patients in the control group. The acupuncture group saw doctors 49% less after having acupuncture. The non-acupuncture patients had a decrease of only 2%. The acupuncture patients total monetary cost of physician services decreased by 37%. The non-acupuncture patients had a 1% drop in cost. The researchers concluded that low back pain patients are less likely to visit medical practitioners for low back pain after having had acupuncture therapy thereby reducing overall health service expenses.

Multidisciplinary approaches have also been studied. A new study finds that acupuncture combined with massage is more effective for treating lumbar disc herniation (LDH) than coenzyme B12 injections combined with physiotherapy. Researchers randomly divided 60 patients into an acupuncture group and an injection group. The acupuncture group received acupuncture needling on myofascial pain related trigger points combined with massage. The injection group received coenzyme B12 injections combined with traction and heat therapy. The acupuncture group achieved an overall effective rate of 96.7% and the injection therapy group had an 80.0% effective rate.

Other very serious investigations found acupuncture effective for back pain related to cancer pain. Researchers conducted a randomized, placebo controlled study to investigate whether or not acupuncture reduces pain associated with pancreatic cancer. This type of cancer is often accompanied by severe abdominal or back pain. The researchers concluded that, “Electroacupuncture was an effective treatment for relieving pancreatic cancer pain.”

Image Source: healthcmi.com

The acupuncture points used in the study were the Jiaji points from T8 to T12, bilaterally, for a total of 30 minutes of acupuncture needle retention time per office visit. Treatment frequency was once per day for a total of 3 days of care. The placebo control group showed little to no change in pain levels. The electroacupuncture group showed a significant reduction in pain intensity levels.

This is not an exhaustive list of all of the acupuncture research to be published in recent years. Acupuncture now has an established track record for the relief of low back pain. This is supported by clinical trials, laboratory experiments and meta-analyses. In addition, mounting evidence now finds acupuncture cost-effective for the treatment of low back pain. The slow and steady integration of acupuncture into conventional medical settings combined with acupuncture continuing education and research now brings acupuncture into the mainstream for the treatment of acute and chronic pain.


North American Spine provides minimally invasive neck and back pain relief procedures. Follow this Twitter page for more updates.

REPOST: Disabled children 'murders' - what is spinal muscular atrophy?

 What is spinal muscular atrophy? This Telegraph.com article has the answer.

Image Source: telegraph.co.uk

Spinal muscular atrophy (SMA) is a genetic neuromuscular disease that limits a person’s physical abilities, such as moving, walking and breathing, but does not affect their mental development.

The condition is inherited from parents and affects the nerves that control muscle function.

According to the SMA Trust, a charity dedicated to finding a cure, the progressive wasting of muscles can lead to skeletal deformities, breathing problems and difficulties in eating and drinking.

There are three types of SMA that affect children, which range in severity. Sufferers of SMA Type 1 – the most common form – are unlikely to reach their second birthday, so it is thought Ben, Max and Olivia had SMA Type 2.

Children are usually diagnosed with SMA Type 2 under the age of two, and are able to sit up unaided at some point in their lives, but will not stand or walk unaided.

As they grow older, those with the condition develop an abnormal curvature of the spine as the surrounding muscles become weaker, and there is also a risk of fatal respiratory problems.

Most people with Type 2 SMA are expected to live into their teenage years.

Type 3 is the mildest of the three forms, and while sufferers experience breathing and swallowing difficulties, it does not usually affect life expectancy. One in 40 people is an SMA carrier, which is approximately 1.5 million people in the UK, and one in every 6,000 births is affected by the condition, according to the SMA Trust.

SMA is an autosomal recessive neuromuscular disease, meaning two genes, inherited through both parents, are needed in order to have the disease. When two SMA carriers have a child together, there is a 50 per cent chance that the child will be a SMA carrier. When two SMA carriers have a child together there is a 25 per cent chance that the child will have inherited both defective SMN1 genes and will develop SMA.

North American Spine uses a multi-disciplinary approach to spinal treatment depending on the needs of the individual patient. Follow this Twitter page for more updates.

Care for the back is care for the whole body

You may not notice this, but every day, your back does a lot of work the moment you sit up in the morning after waking up. It is probably one of the most used parts of the body, especially the lower part. This is why it is very important to take care of it as much as you can.

Image Source: njchirosport.com

A back injury can be the most painful ailment that you might experience in your entire life. To prevent this, here are a few things that you can do to take care of your back:

1. Exercise regularly. This may be difficult for some, but allotting 20 minutes a day for extra movement can help you keep a healthy back. It would even be better if you can add core exercises that concentrate mainly on the lower back.

2. Quit smoking and avoid stress. Oxygen in the body decreases when you smoke. The less oxygen you have, the more prone to spasms your muscles get. Mix it with stress, and you have a dangerous combination as it increases the risk of injury.

Image Source: secretsparks.wordpress.com

3. Stretch out. Even if you don’t work out regularly, stretching improves the flexibility of your muscles and prevents any sudden injuries.

4. Practice good posture. Standing or sitting straight will not only help you prevent back pains but also make you look and feel more confident.

5. Stay hydrated. Similar to oxygen, water helps the bones and muscles to stay flexible. It also prevents spine disc shrinking.

Image Source: icmm2012.us

There are lots of ways to take care of your back. Just keep in mind that the most basic thing you can do is to always pay attention to any warning signs and avoid putting a lot of pressure on your back.

North American Spine is a renowned clinic in Dallas, Texas, that provides minimally invasive spine treatment. Visit its website for more information on its services.

Sleep position: Possible culprit for constant back pain

Chronic back pain is one of the problems that many American adults have to deal with. It is one of the most common reasons for missed work and it is expected that most adults will experience some age-related back pains by the time they turn 30.

Image Source: istockphoto.com

When people experience pain, many are likely to think about their physical activities. The normal response to pain is to try and cease activity until the ache goes away. With back pain, however, regular movement may not be the cause of the discomfort. There are times when the pain stems from extended periods of inactivity.

Ideally, people spend six to eight hours a day asleep and in most cases, many stay in a position that they prefer. However, there are actually some sleeping positions that are not ideal for the spine and the lower back.

Image Source: selfmadefitness.com

People who sleep on their stomach and those that like to sleep in a fetal position are likely to experience some discomfort later in the day. In these positions, it is impossible to maintain a neutral spine position and it puts a lot of pressure on the nerves and joints. An uncomfortable position is painful enough to maintain for just a few minutes, so it is not hard to imagine what the effects would be if one held those position for hours.

Image Source: cbsnews.com

North American Spine is an authority on minimally invasive spine care. Find information on the treatments currently available for chronic back pain on its official website.

Improving pain tolerance through regular exercise

Image Source: womansday.com

According to estimates, about 80 percent of Americans are expected to suffer from back pain at some point in their life. The condition is one of the major reasons why adults miss work. It also accounts for about 10 percent of primary care visits to doctors every year.


Suffering from back pain is an unappealing prospect. It is difficult to concentrate on one’s tasks or to enjoy the moment when one is experiencing major discomfort. Pain relievers could sometimes help but long-term reliance on medications is not advisable. It can be expensive, too. Given these issues, what is the average adult supposed to do?

Image Source: about.com

The usual response to pain is to cease all forms of strenuous activity. This is the recommended course of action but only for a short period of time. Inactivity, in the long run, can actually undermine healing and it does little to deal with the causes of pain.

Image Source: about.com

Regular physical activity, on the other hand, could help alleviate discomforts in the long term. Most age-related back problems can be eased by strengthening the muscles that support the back and encouraging the flow of nutrients to the spine through exercise, enough hydration, and a proper diet. Regular activity could also help people tolerate some types of pain that could prevent them from going on with their daily activities.

North American Spine is comprised of spine specialists from several fields including orthopedic spine, neurosurgery, and pain Management who are dedicated to the relief of chronic back pain. For information on chronic back pain treatments, visit its official website.

What is AccuraScope?

Image Source: dndprocedure.wordpress.com

With many Americans suffering from back pains, there are a whole slew of procedures to relieve the ailment. With the advancement of medical technology, more and more people are now opting for minimally invasive procedures over traditional methods.

At North American Spine, medical professionals take pride in the clinic’s ability to treat patients with minimally invasive spine surgery. In fact, the clinic assures the term “minimally invasive” in its truest sense through AccuraScope.

AccuraScope is an advanced back pain procedure that enables North American Spine surgeons to not only get a diagnosis of the problem in real time, but to also treat the causes of chronic back pain.

Through a small incision on the skin, a surgeon inserts an endoscopic fiber-optic scope through to the natural opening at the base of the spine. Upon accurately assessing the problem area, a laser is then used to perform the necessary procedure. The entire procedure normally takes 30 to 40 minutes.

Image Source: northamericanspine.com

“The difference in the AccuraScope procedure as compared to other minimally invasive spine surgery techniques is that the AccuraScope approaches the spine horizontally rather than vertically,” said Sam Bailey, Ph.D., chairman of North American Spine. This makes it possible for surgeons to engage the problem areas on the different levels of the spine.

With such precision and real-time diagnosis, patients can undergo treatments for more than one level at a single time; thus eliminating the need for multiple sessions. The AccuraScope procedure is only available at North American Spine.

Image Source: prweb.com

North American Spine provides back pain patients with complete and immediate relief. Visit the clinic’s website for more information on treatments and services.