LOW BACK PAIN? DON’T BLAME THE WEATHERLOW BACK PAIN? DON’T BLAME THE WEATHER
From the FMS Global News Desk of Jeanne Hambleton Wiley Science Newsroom Arthritis Care and Research
Australian researchers reveal that sudden, acute episodes of low back pain are not linked to weather conditions such as temperature, humidity, air pressure, wind direction and precipitation. Findings published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), indicate that the risk of low back pain slightly increases with higher wind speed or wind gusts, but was not clinically significant.
According to the World Health Organization (WHO) nearly everyone experiences low back pain at some point in their life, making it the most prevalent musculoskeletal condition and affecting up to 33% of the world population at any given time. Those with musculoskeletal (bone, muscle, ligament, tendon, and nerve) pain report that their symptoms are influenced by the weather. Previous studies have shown that cold or humid weather, and changes in the weather increase symptoms in patients with chronic pain conditions.
“Many patients believe that weather impacts their pain symptoms,” explains Dr. Daniel Steffens with the George Institute for Global Health at the University of Sydney, Australia. “However, there are few robust studies investigating weather and pain, specifically research that does not rely on patient recall of the weather.”
For the present case-crossover study 993 patients seen at primary care clinics in Sydney were recruited between October 2011 and November 2012. Weather data from the Australian Bureau of Meteorology were sourced for the duration of the study period. Researchers compared the weather at the time patients first noticed back pain (case window) with weather conditions one week and one month before the onset of pain (control windows).
Results showed no association between back pain and temperature, humidity, air pressure, wind direction or precipitation. However, higher wind speed and wind gusts did slightly increase the chances of lower back pain, but the amount of increase was not clinically important.
“Our findings refute previously held beliefs that certain common weather conditions increase risk of lower back pain,” concludes Dr. Steffens. “Further investigation of the influence of weather parameters on symptoms associated with specific diseases such as fibromyalgia, rheumatoid arthritis, and osteoarthritis are needed.”
5 THINGS TO KNOW ABOUT CHRONIC LOW-BACK PAIN AND COMPLEMENTARY HEALTH PRACTICES
From the FMS Global News Desk of Jeanne Hambleton National Center for Complementary & Alternative Medicine (NCCAM)
Time to Talk Tips
Low-back pain is a very common condition, but often the cause is unknown. Most people have significant acute back pain at least once in their lives. Usually it resolves on its own without specific treatment.
But for some people, the pain can become chronic or even debilitating, and difficult to treat. Spinal manipulation, acupuncture, massage and yoga are complementary health approaches often used by people with low-back pain. They are all included in a longer list of treatment options recommended by the American Pain Society and the American College of Physicians for patients whose low-back pain does not improve with more conservative care. Other options include exercise, physical/occupational rehabilitation, cognitive-behavioral therapy, and progressive relaxation.
Here’s what you need to know about what the science says for chronic low-back pain and some of these practices.
- Overall, studies have provided good evidence that spinal manipulation is moderately effective for chronic low-back pain. Spinal manipulation includes various interventions administered by osteopathic physicians, chiropractors, and physical therapists.
- There is fair evidence that acupuncture is helpful in relieving chronic back pain. Current evidence suggests that factors such as expectations and beliefs of the patient and the provider, rather than acupuncture-specific effects of needling, are primarily responsible for beneficial effects of acupuncture on pain.
- There is also fair evidence that massage is helpful in relieving chronic low back pain. In general, however, these effects appear to be short term.
- Current research, while limited in scope, suggests that a carefully adapted set of yoga poses may reduce low-back pain and improve function. NCCAM is also supporting research specifically associated with safety of this widely-used self-care practice. People with back pain should work with an experienced teacher who can help modify or avoid some yoga poses to prevent adverse effects.
- Be sure to tell your health care provider about any complementary health practice you are considering. This will help ensure coordinated, safe care.
FEAR, SAFETY AND THE ROLE OF SLEEP IN HUMAN PTSD
From the FMS Global News Desk of Jeanne Hambleton 26-Aug-2014 Citations Journal of Neuroscience
Source: University of California, San Diego Health Sciences
Newswise — The effectiveness of post-traumatic stress disorder (PTSD) treatment may hinge significantly upon sleep quality, report researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System in a paper published today in the Journal of Neuroscience.
“I think these findings help us understand why sleep disturbances and nightmares are such important symptoms in PTSD,” said Sean P.A. Drummond, PhD, professor of psychiatry and director of the Behavioral Sleep Medicine Program at the VA San Diego Healthcare System.
“Our study suggests the physiological mechanism whereby sleep difficulties can help maintain PTSD. It also strongly implies a mechanism by which poor sleep may impair the ability of an individual to fully benefit from exposure-based PTSD treatments, which are the gold standard of interventions.
“The implication is that we should try treating sleep before treating the daytime symptoms of PTSD and see if those who are sleeping better when they start exposure therapy derive more benefit.”
PTSD is an often difficult-to-treat mental health condition triggered by a terrifying event. It is frequently associated with persons who have served in war zones and is characterized by severe anxiety, flashbacks, nightmares and uncontrollable thoughts, often fearful. Research has shown that fear conditioning, considered an animal model of PTSD, results in disruption of animals’ rapid eye movement (REM) sleep – periods of deeper, dream-filled slumber. Fear conditioning is a form of learning in which the animal model is trained to associate an aversive stimulus, such as an electrical shock, with a neutral stimulus, such as a tone or beep.
Drummond and colleagues investigated the impact of fear conditioning – and another form of behavioral training called safety signal learning – upon human REM sleep, using 42 healthy volunteers tested over three consecutive days and nights. Safety signals are learned cues that predict the non-occurrence of an aversive event.
“We examined the relationship between REM sleep and the ability to learn – and consolidate memory for – stimuli that represent threats and that represent safety,” said Drummond.
“In PTSD, humans learn to associate threat with a stimulus that used to be neutral or even pleasant. Often, this fear generalizes so that they have a hard time learning that other stimuli are safe. For example, a U.S. Marine in Iraq might suffer trauma when her personnel carrier is blown up by road side bomb hidden in trash alongside the road. When she comes home, she should learn that trash on the side of I-5 does not pose a threat – it’s a safe stimulus – but that may be difficult for her.”
The researchers found that increased safety signaling was associated with increased REM sleep consolidation at night and that the quality of overnight REM sleep was related to how well volunteers managed fear conditioning.
Drummond said stimuli representing safety increased human REM sleep and that “helps humans distinguish threatening stimuli from safe stimuli the next day. So while animal studies focused on learning and unlearning a threat, our study showed REM sleep in humans is more related to learning and remembering safety.”
He noted, however, that the findings are not conclusive. No comparable animal studies, for example, have examined the relationship between safety and REM sleep. Nonetheless, the findings do encourage further investigation, eventually into human PTSD populations where fear, safety and sleep are on-going and paramount concerns among military veterans and others.
“A very large percentage of missions in both Iraq and Afghanistan were at night,” said Drummond, who is also associate director of the Mood Disorders Psychotherapy Program at VA San Diego Healthcare System. “So soldiers learned the night was a time of danger. When they come home, they have a hard time learning night here is a time to relax and go to sleep.”
Co-authors include Anisa J. Marshall, VA San Diego Healthcare System; Dean T. Acheson and Victoria B. Risbrough, VA San Diego Healthcare System and Department of Psychiatry, UCSD; and Laura D. Straus, VA San Diego Healthcare System and SDSU-UCSD Joint Doctoral Program in Clinical Psychology.
Funding support came, in part, from the Defense Medical Research and Development Program (DM102425). Infrastructure support provided by VA San Diego Center for Excellence in Stress and Mental Health.
POOR SLEEP SCHEDULE CAN AFFECT HORMONE HEALTH
From the FMS Global News Desk of Jeanne Hambleton 27-Aug-2014 Source Newsroom: Endocrine Society
Washington, DC—As summer draws to a close, students need to rise earlier to make it to classes on time. This seasonal adjustment can leave students and parents alike short of sleep. If it persists, long-term sleep loss can even contribute to increased risk of obesity and diabetes.
Endocrine Society member Orfeu M. Buxton, an expert on sleep, health and metabolism, is available to offer comment on many aspects of this issue, including:
• When college students pull an all-nighter, what impact does that have on sleep health and metabolism?
• How does late-night exposure to laptops, tablets and other electronic devices students may use to study affect their ability to get a good night’s sleep?
• What impact can sleep deficiency have on weight and metabolism over time?
• Is there an optimum amount of sleep to aim for to improve performance in the workplace or school?
• What kinds of interventions can help people get the sleep they need?
WHO: Orfeu M. Buxton, PhD
• Associate Professor, Department of Biobehavioral Health, Penn State University
• Assistant Professor, Division of Sleep Medicine, Harvard Medical School Associate Neuroscientist, Department of Medicine, Brigham and Women’s Hospital
• Adjunct Associate Professor, Department of Social and Behavioral Sciences, Harvard School of Public Health
Founded in 1916, the Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, the Endocrine Society’s membership consists of over 17,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Washington, DC.
Back tomorrow all being well. Jeanne