Daily Health and Medicine News

Back Pain News

St Jude Medical reports positive results from chronic low back pain study

St. Jude Medical, Inc., a medical device company, has announced two-year results in a post-market clinical study evaluating neurostimulation for the management of chronic low back pain.

The study found that 70 percent of neurostimulation patients reported overall pain relief of 50 percent or better at their final two-year visit. Additionally, 88 percent of these patients reported that their quality of life was improved or greatly improved.

“This study is the largest neurostimulation study conducted to date and is specifically designed to gather more information about the effectiveness of spinal cord stimulation for low back pain,” said Dr Eugene Mironer, presenter of the results and managing partner of the Carolina Center for Advanced Management of Pain in Spartanburg, S.C. “Our findings at the two-year mark indicate that the therapy is sustainable long-term. In addition to reporting an improvement in their quality of life, 89 percent of patients were satisfied or very satisfied with their results.”

Neurostimulation therapy uses an implantable medical device to deliver mild electrical pulses to the epidural space to mask or interrupt pain signals as they travel to the brain. St. Jude Medical is sponsoring this research to continue to build on the published data supporting the long-term sustainability of the therapy.

“There is a growing body of evidence that confirms the effectiveness of neurostimulation for the management of chronic pain, especially for those patients who have tried multiple therapies only to continue to suffer with pain,” said Chris Chavez, president of the St. Jude Medical Neuromodulation Division. “Over the course of the past decade, physician training, technology improvement and patient selection criteria have advanced greatly. Our study validates the significant impact of these advances in further improving the effectiveness of neurostimulation therapy.”

Low back pain patients’experiences of work modifications; a qualitative study

Research indicates that work modifications can reduce sickness absence and work disability due to low back pain. However, there are few studies that have described modified work from the perspective of patients.

A greater understanding of their experiences may inform future workplace management of employees with this condition.

Methods: Individual semi-structured interviews were conducted with twenty-five employed patients who had been referred for back pain rehabilitation. All had expressed concern about their ability to work due to low back pain.

Data was analysed thematically.

Results: Many participants had made their own work modifications, which were guided by the extent of control they had over their hours and duties, colleague support, and their own beliefs and attitudes about working with back pain. A minority of the participants had received advice or support with work modifications through occupational health.

Access to these services was limited and usually followed lengthy sickness absence. Implementation largely rested with the manager and over-cautious approaches were common.

Conclusions: There was little evidence of compliance with occupational guidance on modified work.

There appears to be insufficient expertise among managers and occupational health in modifying work for employees with low back pain and little indication of joint planning. On the whole, workers make their own modifications, or arrange them informally with their manager and colleagues, but remain concerned about working with back pain.

More effective and appropriate application of modifications may increase employees’confidence in their ability to work.

Lower back pain is a very common problem

Lower back pain is a very common problem and the chances of having it reoccur are likely, but why is this? Low back pain can be caused from many different tissues and pathologies, but the lumbar multifidus muscles (LMM) are one cause that is often overlooked and neglected.

The lumbar multifidus muscles (LMM) stabilize the spine when in a neutral position. When the spine is injured, a reflex occurs that can inhibit the activation of the lumbar multifidus muscles (LMM). When this inhibition persists, atrophy and fatty invasion of the muscle will ensue and often persist after the pain is gone. When the lumbar multifidus muscles (LMM) atrophies, it causes instability within the lower back which can lead to prolonged pain. Assessment of the lumbar multifidus muscles (LMM) as a source of pain with reoccurring low back pain is often overlooked. If the LMMs are the cause of pain, rehabilitation is essential if longterm resolution is to be achieved.

Health Care News

U.S. Health Department Lays Out Its Health Goals For The Next Ten Years

As 2010 gets closer to its end, the U.S. Department of Health and Human Services (HHS) has posted its latest strategies for promoting public health in over forty categories by the year 2020. The Healthy People 2020 objectives deal with nearly six hundred aspects of health, from decreasing children’s exposure to allergens, to cutting down the use of suntanning beds which cause cancer, to getting more people insured and food poisoning.

One of the goals laid out in the initiative is to lower the number of deaths from stroke and heart disease by twenty percent, and reduce new cases of diabetes, cancer deaths, and obesity rates by ten percent. Specified objectives to fight obesity feature building more neighborhood sidewalks, pressuring schools to keep their tracks and gyms open for after-hours exercising, and offering healthier meals in day care centers and schools.

The Healthy People goals are to some degree a guide for public health organizations, identifying what problems are improvable and which ones to direct resources toward in the next ten years. Since the Healthy People 2010 goals were set, only 19% of the goals have been met, but progress has been made toward 52% of those goals.

Meeting the goals set forth in Healthy People 2020 will depend less on developing new methods, programs and tools than on our commitment to putting the tools and methods we already have to their best use. For example, the medical establishment is convinced that heart disease could be all but eradicated if we fully applied what we already know about the use of tobacco, and the importance of exercise and proper diet.

CMS to Hold Listening Session on Health Care Delivery System Reform

On Tuesday, December 14, the Centers for Medicare and Medicaid Services (CMS) will host an open door forum for Region 2 to discuss health care delivery system reforms established by the Affordable Care Act of 2010. Dr. Richard Gilfillan, Acting Director of the Center for Medicare and Medicaid Innovation (CMMI), and Cheryl Powell, Deputy Director for the Federal Coordinated Health Care Office, will provide a brief overview of the Accountable Care Organization Shared Savings Program, CMMI, and the Federal Coordinated Health Care Office, before opening the discussion for public comment.

Doctors fear health reform

SHREWSBURY — Massachusetts should tread slowly and carefully as it adopts new ways to pay for health care, representatives from medical groups told the state’s top health official yesterday.

Reforms aimed at bringing down costs could unintentionally block patients from their doctors or the care they need, according to some medical professionals and organizations.

“First of all, we need to protect our patients,” said Dr. Barbara Rockett, a general surgeon who practices at Newton-Wellesley Hospital in Newton. “This process should be a very slow process.”

The comments came during a public forum before a committee of the Massachusetts Health Care Quality and Cost Council, a group created as part of the state’s 2006 health care reform law.

About 100 people representing family physicians, registered nurses, anesthesiologists, physical therapists, home health workers and others crowded into a conference room at the University of Massachusetts Medical School’s center at 222 Maple Ave., Shrewsbury, to testify. The committee is preparing recommendations on legislation aimed at reforming health care payments.

Many of the speakers focused on a proposed method of paying for medical care called “global payments.” Insurers generally pay set fees to health professionals for specific procedures. Under global payments, insurers would give set amounts of money to groups of health professionals to manage all the care that patients need. Doctors, nurses, hospitals and others would form groups called “accountable care organizations” or “integrated provider organizations.”

There is no proof that approach will lower costs, said Dr. Bruce S. Auerbach, vice president of Sturdy Memorial Hospital in Attleboro.

“Too much consolidation can result in entities having so much market clout that prices are driven up,” Dr. Auerbach said.

Some patients seeking emergency care ran into barriers under a similar payment method, called capitation, used in the past, according to Dr. Joseph Bergen, past president of the Massachusetts College of Emergency Physicians. “Our fundamental principle is that patients must be protected by some consideration for emergency care,” Dr. Bergen said.

A payment reform commission established by the state has already recommended that any move to global payments take place over at least five years, said Dr. JudyAnn Bigby, state secretary of health and human services, who attended part of the forum. Although a number of speakers urged slow steps toward reform, Dr. Bigby said she has heard others say the state has not moved fast enough.

“I hear anxiety,” she said. “I also hear people say the system is untenable.”

Diabetes News and Treatment

Diabetes Mortality High Despite Better Management

Since management of type 1 diabetes improved markedly in the 1980s, survival rates in those with the disease have improved as well, but mortality is still much higher than that in the general population, according to research published in the December issue of Diabetes Care.

TUESDAY, Nov. 30 (HealthDay News) — Since management of type 1 diabetes improved markedly in the 1980s, survival rates in those with the disease have improved as well, but mortality is still much higher than that in the general population, according to research published in the December issue of Diabetes Care.

Aaron M. Secrest, Ph.D., of the University of Pittsburgh, and colleagues studied data from an Allegheny County registry of childhood-onset type 1 diabetes.

The researchers found the death rate in people with type 1 diabetes to be seven-fold higher than their expectations, though standardized mortality ratios (SMRs) based on local mortality data showed an improving trend by diagnosis cohort at 30 years of diabetes duration (SMRs, 9.3 for 1965 to 1969, 7.5 for 1970 to 1974, and 5.6 for 1975 to 1979). Women with type 1 diabetes had a risk of dying 13 times that of age-matched women in the general population, and African-Americans had a significantly lower 30-year survival rate than Caucasians.

“Although survival has clearly improved, those with diabetes diagnosed most recently (1975 to 1979) still had a mortality rate 5.6 times higher than that seen in the general population, revealing a continuing need for improvements in treatment and care, particularly for women and African-Americans with type 1 diabetes,” the authors write.

Skyrocketing Diabetes Costs Point to Need for More Preventive Care, Largest Insurer Says

With the costs of diabetes care expected to skyrocket in the next 10 years, providers need to develop improved preventive care and early intervention strategies for the condition, according to a release by UnitedHealth Group, the nation’s largest insurer.

If nothing more is done, the annual cost of treatment for diabetes and pre-diabetes would grow from an estimated $194 billion this year to $500 billion in 2020 and the 10-year cost would reach $3.35 trillion, UnitedHealth’s Center for Health Reform & Modernization predicted.

The center said more programs to prevent and control diabetes could save up to $250 billion over the next 10 years. “What is now needed is concerted, national, multi-stakeholder action,” said Simon Stevens, executive vice president at UnitedHealth and chairman of the center. He cited the need to “engage consumers in new ways, while working to scale nationally some of the most promising preventive care models.”

Arthritis News and Treatment

Early treatment ‘best way to get arthritis under control’

Early treatment is the best way to get rheumatoid arthritis under control, it has been claimed.

According to Arthritis Research UK, aggressive early treatment is the best way to get the condition under control before any serious damage to the joints is sustained, however, many people don’t get diagnosed in time for early treatment to start.

The charity’s Jane Tadman said: “Unfortunately, in the real world, the average length of time that people with rheumatoid arthritis wait before going to their GP after developing symptoms is 12 weeks – and then there is a further wait before they are referred to see a specialist and start treatment.”

She added that more needs to be done to inform people about the symptoms of arthritis so they can get quick access to the help they need.

Ms Tadman’s comments follow research from the Netherlands which shows that patients who are diagnosed early with rheumatoid arthritis are less likely to experience joint damage.

Arthritis: New Treatment Rebuilds Damaged Cartilage

Secret Process Sparks Hope For Joint Pain Sufferers.

Breakthrough joint supplement has demonstrated re-growth in damaged cartilage.

Osteoarthritis (OA) is the most common type of arthritis and it is not confined to the older generations, as many believe. Young people can also develop OA, often as a result of a sports injury or excessive exercise leading to wear and tear on joints.

OA is also surprisingly common among athletes, hardcore training regimes, pressure from peers and the drive to be the best can lead athletes to push themselves too hard and suffer the consequences of joint damage. In the UK alone there are 27,000 people under the age of 25 suffering from arthritis1. A subtle ache, a little pain after exercise or physical work – these could be the warning signs of things to come.

There is no known cure for osteoarthritis, however an innovative natural supplement has emerged as the only product with clinical evidence to indicate it can halt and even rebuild damaged cartilage, potentially improving the lives of millions of OA sufferers and getting injured athletes on the road to recovery much quicker.

Clinical trials have demonstrated that Flexeze Fortify, containing a secret formulation of Collagen Hydrolysate (Fortigel), actually appears to re-grow cartilage, relieving pain and greatly improving mobility.

Dr Andrew Carson, a GP who is Associate Dean, GP Education, Birmingham and Solihull and Medical Advisor to the NHS Executive in the West Midlands said;

“I am not aware of any other product that has been shown to regenerate articular cartilage. The best that other products have achieved in the past is a reduction in the speed of disease progression and a subjective improvement in pain sensation. I would recommend anyone taking glucosamine and Chondroitin to consider this option, which is a natural product with no known side effects.”

Many people don’t realise the importance of looking after your joints and just accept joint pain and stiffness as a part of the aging process. All types of exercise can put pressure on joints, from everyday walking to training for a triathlon. It is therefore essential to take care to protect them, and it’s never too early to start.

Whilst exercise is essential for strong healthy joints, sports injuries can leave you more prone to joint pain and osteoarthritis. There are a few tips to consider that can decease your likelihood of having an injury; never exercise when tired, keep yourself hydrated, always warm-up and down and never push yourself through joint pain, wear supportive shoes and exercise on forgiving surfaces.

Certain activities put your joints under more stress, for example running on concrete, varying these activates with other sports such as swimming, yoga or cycling will build the strength of your joints without putting them under unnecessary pressure.

Professor Alan Silman, medical director at Arthritis Research UK explains:

Despite the overriding benefits of participating in sport and exercise, there are hidden hazards related to sports injury. From the limited research carried out, we know some sport-related injuries will cause osteoarthritis, which is a painful and debilitating condition. 2

It is therefore essential to take preventative action to protect your joints from wear and tear, and keep them strong to prevent injuries. There are many supplements that can aid joint health, however up until now there have been none to actually support the regeneration of cartilage.

Glucosamine and Chondroitin, both popular supplements for sufferers of joint pain and Osteoarthritis, have recently received a lot of criticism. Sales of the two supplements have reached an estimated one billion dollars in just the USA3, despite little scientific evidence to prove they do any more than a placebo.

A study by world expert Professor Juni, from Berne University, Switzerland and published in the British Medical Journal into the effects of Glucosamine and Chondroitin came to the following conclusions;

“Compared with placebo, Glucosamine, Chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.” 4

In comparison Flexeze Fortify, a natural supplement taken once a day, has clinical evidence to suggest that it reduces the deterioration of cartilage, and actually helps to rebuild damaged cartilage. It contains the award-winning ingredient Fortigel, made up of the patented Collagen Hydrolysate – a specially processed form of collagen claimed to be more bioavailable – that is absorbed by our body more easily, than unprocessed collagen.

Clinical trials undertaken in America by Harvard Medical School and Tufts Medical Centre in Boston have shown that where other supplements may simply slow down the deterioration of cartilage, Flexeze Fortify appears to not only stop the deterioration but also reverses the process. When tested on 30 patients, all suffering with arthritis, 15 were given Flexeze Fortify and 15 were given a placebo. The results of the year-long trial demonstrated that patients taking Flexeze Fortify had experienced cartilage re-growth, decreased joint pain and improved mobility. In comparison the patients taking the placebo saw continued deterioration in their cartilage.

Osteoarthritis Treatment

According to a new study announced recently at the yearly meeting of the Radiological Society of North America, people who are susceptible to developing osteoarthritis may postpone its development or possibly arrest the development by becoming more physically active.

“According to the results of our study, participating in a high-impact activity, such as running, more than one hour per day at least three times a week appears associated with more degenerated cartilage and potentially a higher risk for development of osteoarthritis,” said the study’s senior author Thomas M. Link, M.D., professor of radiology and chief of musculoskeletal imaging at the University of California, San Francisco (UCSF). “On the other hand, engaging in light exercise and refraining from frequent knee-bending activities may protect against the onset of the disease.”

Osteoarthritis is a worsening disease of the joints causing severe pain and deficient mobility. The National Institute of Arthritis and Musculoskeletal and Skin Diseases state that it is the most prevalent type of arthritis affecting in excess of 27 million people in the U.S. over 25 years of age.

Researchers examined 132 subjects showing no sign of the disease but at risk for developing osteoarthritis, as well as 33 control subjects. There were 99 female and 66 male study participants between 45 and 55 years of age. The group consisted of 3 sub-groups divided up according to their answers to the Physical Activity Scale for the Elderly or PASE test. Degrees of exercise for each group were labelled sedentary, light, and moderate to strenuous exercise.

MRI tests showed that the light exercise group participants enjoyed the healthiest knee cartilage and those with little strength exercise had healthier cartilage overall than those with no strength exercise and those with frequent strength exercise.

“The results for this group indicate that moderate to strenuous exercise may accelerate cartilage degeneration, putting these women at even greater risk of developing osteoarthritis,” said study coauthor Keegan K. Hovis, B.S., R.N., research associate in the Department of Radiology at UCSF.

“People can reduce their risk for osteoarthritis by maintaining a healthy weight and avoiding risky activities and strenuous exercise,” he said. “Lower-impact sports, such as walking, swimming or using an elliptical trainer are likely more beneficial than high-impact sports, such as running or tennis.”

“Our findings indicate that light exercise, particularly frequent walking, is a safer choice in maintaining healthy cartilage,” Hovis added.

Wellness Today

BioVeda Health and Wellness Center of Cerritos Introduces Smoking Cessation Program

BioVeda Health and Wellness Centers, LLC is pleased to announce the introduction of a new smoking cessation program now available at BioVeda Health and Wellness Center of Cerritos. The center, headed by Dr. James Augustine, is successfully managing patient health through a holistic program which combines acupuncture, applied kinesiology and homeopathy to boost the immune system, promote natural detoxification and increase core level energy, often resulting in the alleviation of symptoms associated with such conditions as allergies, IBS, chronic fatigue, migraines, skin conditions, and general pain and inflammation.

This clinic utilizes meridian and energy stress assessment to measure the patient’s neurological reactions to specific environmental substances and to determine which substances are negatively impacting the patient. The substances that trigger a physiological stress spike, which is measured by the body’s impedance to each substance, are recorded and then presented back to the patient during low level light therapy. Light therapy conditions the autonomic nervous system to react normally to the otherwise harmless substances.

The system is designed to reduce physiological stress, not to be confused with anxiety, which not only weakens the immune system, but is also the trigger for food allergies, seasonal allergies, pet allergies, asthma, eczema, migraines, shingles, celiac and numerous other auto-immune related conditions. How these specific substances affect the stress levels placed on our immune system has a direct impact on the quality of our daily lives.

The smoking cessation program uses light therapy and homeopathic remedies to help a person quit, while reducing cravings, side effects, stress and irritability. It helps to remove harmful toxins known to build in the blood, tissue and cells through habitual use of tobacco products. It is faster than traditional methodologies, requiring 3 visits over a one week period, along with the use of a herbal remedy and homeopathic supplement.

“I have a holistic healthcare practice and believe in the future of energy medicine. It fits into my practice to help me discover the causes of healthcare problems. Since the core of healing in the body is the central nervous system, interference to it causes ill health. This therapy assists in removing interferences to allow the body to heal. I’m especially excited to now have a smoking cessation program for those struggling with this addiction,” states Dr. Augustine.
BioVeda Health and Wellness Centers are being established across the country through BioVeda Health and Wellness Centers, LLC., based in Boca Raton, FL. Each clinic is independently owned and operated by a licensed physician. BioVeda, which means “knowledge and wisdom of the body,” reflects the vision and commitment of the BioVeda Health and Wellness Center of Cerritos to alternative health care methods that can help thousands of patients reduce their level of suffering from common and debilitating symptoms and increase their overall health and wellness. Patients receive a customized treatment plan which best fit their individual symptoms and conditions; however, many patients notice significant results after just a single therapeutic session. The cost for therapy is very affordable and results are long-lasting.

CDC Wants You for Wellness Study

The thirst for wellness information and advice never seems to be quenched. There is a new national opportunity to help provide data and learn more.

Heart disease and stroke are the first and third leading causes of death for both men and women in the United States. To avoid the high costs of treating these conditions, employers must consider providing worksite prevention services and interventions to promote employee health.

The Centers for Disease Control and Prevention (CDC), in collaboration with Emory University, state health departments and worksite experts have developed the CDC Worksite HealthScoreCard (HSC) to support efforts in these areas. The HSC examines worksite health promotion interventions (programs, policies and environmental supports) that employers can put in place to promote a healthy workforce, reduce health care costs and increase productivity.

In the first phase of this project, the CDC/Emory study team held meetings and focus groups with subject matter experts and potential end-users to develop the survey tool, establish a weighting and scoring methodology and improve the tool’s scientific evidence base, usability and relevance. The second phase of this project will focus on field-testing the tool in order to evaluate its reliability and validity in preparation for public dissemination. They have invited Indiana businesses to participate in this study.

Health on Monday: The push-up – A symbol of health and wellness

They can be done anywhere as they do not require any equipment of any kind and the many variations of the push-up allow you to target different muscle groups of your body. If you are a beginner, performing traditional push-ups can be a challenging endeavour since they require considerable upper body strength to perform correctly. Luckily there are many levels of progression that make this exercise effective for both beginners as well as advanced athletes.

Movement analysis and muscle involvement

The push-up brings about two primary movements in the body:

1 Horizontal adduction of the shoulder: This movement is brought about through contraction of the pectoralis major (chest muscle) and the anterior deltoid (frontal head of the shoulder muscle). The degree to which either of these 2 muscles are loaded depends on the angle of the arms to the torso and the width of the hand placement

2 Elbow extension: Elbow extension refers to the straightening of the elbow joint during exertion and happens during the lifting phase of the body. The primary muscle responsible for this muscle is the tricep, located in the posterior side of the upper arm.

Besides these primary muscles, a whole lot of other muscles are involved in the push-up movement. The shoulder girdle is locked in position through contraction of the serratus anterior, located on the upper part of your rib cage, just under your arm pits. Your body is kept in a straight position through contraction of the rectus abdominus, the “six-pack” muscle on the anterior part of your torso and the contraction of the hip flexors which prevent your hips from crashing to the ground during the movement. Your quadriceps or anterior thigh muscles contract in order to keep your knees from bending during the movement.

Variations

In a typical push-up position, body weight is distributed between hands and feet. By tilting the body’s position the loading between hands and feet can be altered, which affects the amount of weight the arms have to lift during the exercise. During the typical push-up about 60% of the body’s weight is transferred to the arms, with the remaining 40% being borne by the feet. Once the body is inclined, the load applied to the arms is reduced, therefore facilitating execution of the movement. On the contrary, the loading of the arms can be increased by tilting the body in a way to elevate the foot position in comparison to the hand position.

Beginner’s variation on your feet

Stand against a table or other similar elevated object. Place your hands on the table and tilt your body forward on the balls of your feet so that you form a right angle between your torso and your arms. Keep your body in a perfectly straight line, taking care not to stick out your bum. Now bend your elbows, lowering your chest towards your hands and keep your abdominals braced. Once your elbows are bent around 90 degrees, push back up into the original position.

Beginner’s variation on your knees

Kneel on the floor and position a box or other sturdy, elevated object, about 30-40cm in height in from of you. You can also use your stairs for this exercise by kneeling in front of them and placing your hands on the first step, shoulder-width apart. Bend your elbows and lower your chest towards the step, whilst slightly sticking out your butt. You can pivot the movement from your hips, which further reduces the load on your arms.

Advanced variation: Spiderman push-up

This variation is great for challenging the core muscles besides working all the other muscles used in the conventional push-up. Assume a push-up position on the floor supporting yourself on your hands and toes. Whilst lowering your body towards the floor, lift off one foot and bring your knee forward towards the elbow of the arm on the same side. Your whole body should tilt slightly forward on your hands to maximize engagement of the core muscles. Return your foot to the floor and repeat with the other side.

Various other modifications to the push up exist. These can include props like stability balls, TRX suspension trainers, dumbbells, kettlebells and more. They can add variety and fun to your workout and help to challenge your body from various angles to keep improvements coming long term.

The push-up not only replaces but surpasses most fitness equipment in terms of effectiveness, functional application and workout options and should be a staple exercise of any fitness programme. It is equally relevant for both men and women and effective for building whole body strength and burning calories.

Sinusitis Treatment News

Your Opinions: Compelling link to sinusitis

Reflux of digestive contents occurs when the one-way safety valve at the bottom of the esophagus fails to close correctly. Heartburn is the usual response to the reversed flow of harsh, acidic, digestive juices. However, many GERD sufferers do not signal this problem with heartburn. Called atypical/silent GERD, patients have little or no heartburn. They have numerous manifestations, i.e., hoarseness, lump feeling in the throat, runny nose, post nasal drip, ear pain, fatigue, chest pain, short of breath, cough, etc. (atypical GERD has been called “The Great Masquerader”).

This compelling information, as novel as it may seem, clearly reinforces the minority position maintained for well over 15 years that GERD can cause a variety of recurring, often hard to treat, non-digestive problems. The vagus nerve links internal organs allowing for mutual communication. The “excited” response from the lower esophagus is mimicked by the sinuses via vagus communication; both organ tissues leak fluid, swell, make mucus and become inflamed. This is good for the esophagus but the unintended response causes sinus problems and more. Treat the cause (GERD) and these noxious, unhealthy symptoms vanish.

Atypical/silent GERD is exceptionally common and can be ongoing for years. Great relief results from the expanded understanding, acknowledgement and successful treatment for atypical/silent GERD. I encourage questions about this condition.

Sinusitis difficult to self-diagnose

It’s getting to be the time of year when everyone seems to have a runny nose. Sometimes it’s a cold or allergies. And sometimes it’s sinusitis, or inflamed linings in the sinus cavities. The cavities become blocked and infected. Dr. Alan Oshinsky, an otolaryngologist at Mercy Medical Center, says it’s not always easy to self-diagnose sinusitis, but there are treatments that can help.

Question: What is sinusitis, and who is likely to develop it?

Answer: Sinusitis means inflammation and infection in the paranasal sinuses. We are born with eight sinuses around our head and face. These are air-filled bony cavities. When the lining of the sinus gets inflamed (swollen) or infected, you have sinusitis. Sinusitis will likely affect everyone multiple times in their lifetime, from infancy through adulthood. The most common cause of sinusitis is the common cold. Other causes of sinusitis are bacterial infection, inhalant allergies, nasal polyps, exposure to smoke, various systemic diseases and use of illicit substances in the nose.

Q: Everyone’s nose runs in the colder months, so how do you tell if you have a sinus problem versus an allergy or cold?

A: The distinction between the symptoms of a cold, allergy and a bacterial sinusitis can be difficult. All of these conditions can cause the nose to run. Most colds have multiple symptoms, including sore throat, nasal congestion, runny nose and cough. These symptoms rarely last more than 10 to 14 days. If they persist, then the cold may have developed into an acute bacterial sinusitis. Allergy symptoms can present with similar symptoms to a cold but people rarely feel as sick and the symptoms usually recur in the same seasons each year. Facial pressure, facial pain and dental pain are among the most specific symptoms of bacterial sinusitis.

Q: How common is sinusitis, and are the number of sufferers increasing?

A: Bacterial sinusitis is relatively uncommon compared with the common cold. Every year approximately 30 million Americans will suffer from a viral cold. Only about 1 percent to 2 percent of these cases will fail to clear and result in an acute bacterial sinusitis. There are also people who suffer with recurrent episodes of bacterial sinusitis and they are diagnosed with chronic sinusitis. It is most important that the patient have an X-ray study to confirm the diagnosis of chronic sinusitis. The standard is to get a CT scan. Many people believe that they have “chronic sinus” only to find out that they just have some type of nasal problem.

Q: Will the problem go away on its own?

A: The common cold will resolve without the use of antibiotics over 98 percent of the time. Bacterial sinusitis may resolve on its own but will usually require antibiotics and other medications such as decongestants. When the natural openings that lead from the sinuses into the nose get blocked, mucus and bacteria may back up in the sinus and cause sinusitis.

Q: What are the best treatments?

A: The best treatment for bacterial sinusitis is an appropriate antibiotic. Decongestant tablets can be of some value but patients with high blood pressure usually need to avoid these medications. Patients will also do well with using saline sprays multiple times per day in both nostrils. No antibiotics should be used for the common cold.

Q: When might the new technique, sinuplasty, be necessary?

A: When patients have persistent symptoms and the X-rays show evidence of chronic sinusitis, additional treatment is usually necessary. Conservative therapy may include a more prolonged course of antibiotics. An allergy evaluation may be helpful if the history indicates the possibility of allergy. Topical nasal sprays containing steroids can also be very helpful and are very safe. If conservative medical therapy fails to resolve the symptoms, then surgery may be an appropriate alternative. We now have a much less-invasive procedure to handle chronic sinusitis called Balloon Sinuplasty. With this technique we use a specially designed balloon to open the natural openings that are blocked because of chronic infection. The operation is quick, practically painless and done as an outpatient. Most patients can return to work in one or two days.

Put a Stop To Sinusitis With Food Intolerance Testing

Do you suffer from chronic congestion of the sinuses, ears and / or the nose? Frustrating sinusitis problems that do not ever truly seem to go away? The primary age group for chronic sinus problems are working adults 20 to 65 years of age, their sinus problems are often co-workers problems since the pain and discomfort of sinus problems means 25 million missed workdays annually!

In terms of treatment your doctor may prescribe a nasal steroid spray to reduce congestion and swelling. If there is a bacterial infection, antibiotics may be given. Other drugs may be used to reduce the risk of attacks, and stop the pain and discomfort. Giving medicines to control symptoms is easy to do, however, along with their therapeutic effects, medicines can cause side effects, and often do not tackle the route cause. It is clear now that it isn’t only factors such as pollen or house dust that are the triggers, and it appears likely that a delayed form of food allergy or food intolerance may explain some of these cases.

However which foods are causing the problem? Unfortunately there is no one clear answer as people react differently to certain food groups than others. Therefore to find out if food is causing sinusitis, tests have to be run to determine whether you have intolerance to food. For years the way to do this is through an elimination diet whereby certain foods are restricted from your diet for a certain period of time and the effects were analysed. However elimination diets are a long process and it goes without saying that it’s rather impractical for the vast majority of the population. Also due to the combination of different foods it is virtually impossible to ever the effects of all foods on a given person making the elimination diet pretty ineffective.

Luckily over time there is a new method of testing for food intolerance and allergies and that is via a simple finger prick blood test. These tests measure food-specific IgG antibodies which can help to determine a reaction you may have to a particular food or food group. Compared to elimination diets the process is extremely quick and hassle free and means that you can easily make dietary changes to help yourself to feel better if food intolerance is detected.

Pain Management News

NewsWatch: Pain management firm settles for $16.3 million

A Baltimore pain management company that provides urine-testing services will pay $16.3 million to settle federal complaints that it paid kickbacks to physicians so they would steer Medicare business to it.

Ameritox, a portfolio company of Sterling Capital Partners of Baltimore and Chicago, agreed to the payment in a civil case prompted by a former employee and whistleblower, Debra Maul, who filed suit in 2007 in U.S. District Court in Tampa, Fla., according to federal prosecutors, who later joined as plaintiffs.

Maul, who was a senior sales representative at Ameritox and worked there from March 2005 until she was fired in May 2006, will receive $3.4 million of the settlement, according to a statement from prosecutors and the suit. Several states also sued Ameritox and will split $814,000 from the settlement.

Ameritox, which provides testing services to measure levels of prescribed narcotics in patients’ urine, also entered into a five-year agreement with federal authorities to engage an independent organization to monitor its contracts.

Company spokesman Symkai Scott was not immediately available for comment.

PharmAthene wins

longstanding suit

A breach-of-contract lawsuit filed four years ago by Annapolis biodefense company PharmAthene against Siga Technologies of New York will go to trial in January, PharmAthene announced Wednesday.

A Delaware Court of Chancery rejected Siga’s motion for partial summary judgment, clearing the way for a trial.

PharmAthene claims that it has development and marketing rights to Siga’s drug candidate, SIGA-246, which it is developing as a preventive and therapeutic product for smallpox, as per a merger agreement between the companies that was terminated in October 2006. PharmAthene also claims that Siga failed to negotiate those licensing terms in good faith.

Survey: Business activity

up sharply in Maryland

Business activity has risen significantly in Maryland this month, according to the Federal Reserve’s monthly survey.

The general business activity index increased to 24 from four in October, its highest reading since April. Sales and customer traffic grew, with labor conditions still weak. Expectations for future activity also increased, with two-thirds of the respondents anticipating more business activity six months from now.

“Somewhat unexpectedly, investment in new equipment and software rose for the month with the index reaching its highest level since the beginning of the survey in September 2007,” the Fed reported Wednesday.

WeatherBug is selected

for services in Spain

WeatherBug of Germantown was selected by Servicio de Salud de Castilla-La Mancha in Spain to provide its lightning detection technology to help the agency deploy its emergency medical helicopters more safely.

The WeatherBug system will help the agency “rapidly respond to calls made to our 112 emergency call centers in the safest and most effective manner possible,” said its general manager, Antonio Alvarez Rello, in a statement.

SunEdison completes

solar project in Italy

SunEdison, a solar energy services provider in Beltsville and subsidiary of MEMC Electronic Materials of St. Peters, Mo., reported that it has interconnected the largest single-operating solar power plant in Europe.

The 70-megawatt plant in northeast Italy, near Rovigo, was completed and interconnected in nine months, according to a company statement.

“With construction completion in less than one year, we believe this deployment signifies a new milestone for the industry and will become the standard for future mega projects,” said Carlos Domenech, SunEdison president.”

Prometric contracted for

radiology test conversion

Prometric of Baltimore has signed a long-term contract with the American College of Radiology in Reston, Va., to convert its paper-and-pencil diagnostic radiology training exam to a computerized format, according to a Prometric statement.

Starting in February, Prometric will manage the exam for the college and at the beginning of 2012 physicians in residency training programs at the college will be able to take their exam on a computer at any of Prometric’s secure test centers in North America and select non-U.S. locations.

“Computerizing the test allows us to better leverage technology to enhance security, widen the window of time during which it is available, and facilitate easy access for our residents and get the residency programs their scores more quickly,” Bill Murtagh senior vice president, sales and client services at Prometric, said in a statement.

According to company information, in addition to the accessibility of the exam, the computerized system will allow candidates to use online registration and their residency programs will receive their scores faster than from the paper-based version.

Edmonston nonprofit

to launch holiday event

Community Forklift, an Edmonston nonprofit that offers refurbished building materials from renovation leftovers, will host Green Friday this weekend.

Besides asking the public to bring in spare holiday decorations to help trim the warehouse for the season, the nonprofit is giving 25 percent off on selected renovation materials and hardware on Friday and 10 percent off selected antiques and architectural items in the salvage department.

The event also will include the Great Green Gift Extravaganza, which provides free space for local craftsmen, artisans and woodworkers to sell work made from recycled materials through Dec. 24.

Standard Solar

activates Rockville system

Standard Solar of Rockville, which installs and finances solar electric systems for commercial, government and residential customers, recently activated a 701-kilowatt solar energy system on the Rockville Ice Arena.

Tony Clifford, Standard Solar CEO, said in a statement that “having solar energy at the arena is literally a win-win for everyone.” He said the system, one of Rockville’s largest rooftop solar energy systems, will help control electricity costs, reduce carbon emissions and help guarantee the rink’s future as a training area for potential hockey stars.

The system is estimated to meet about 30 percent of the arena’s electricity needs and will help reduce carbon dioxide by about 757 tons each year, according to a news release. The installation also includes a large monitor where people can observe how much electricity the solar panel is generating.

Radio One regains

listing compliance

Radio One of Lanham reported that its class D shares have regained compliance for listing on the Nasdaq Stock Market.

The stock price had fallen below the exchange’s minimum bid listing requirement.

MedAssurant expands relationship

with Blue Cross and Blue Shield

Blue Cross and Blue Shield of Florida has expanded its relationship with MedAssurant of Bowie by implementing MedAssurant’s program to help improve care coordination for its Medicare Advantage customers.

Eris to work on security center

at Virginia Tech campus

Eris Technologies of Annapolis has entered into a public-private partnership with Virginia Tech and L-3 Stratis, the information technology center for L-3 Communications in Reston, Va., to develop a security and incident management center at the school’s campus in Blacksburg, Va.

This center will allow Virginia Tech to display the partnership’s platform that incorporates applications for campus security, incident management and response, facility management, energy monitoring, and cybersecurity, according to a news release.

MdBio Foundation donates

$10,000 to Montgomery College

MdBio Foundation, an affiliate of the Tech Council of Maryland, has donated $10,000 to Montgomery College. The gift will support the MdBio Scholarship for students working toward their certificate or associate degree in biotechnology at the college’s Germantown campus.

The MdBio Foundation is a private charitable organization that provides and supports bioscience awareness, education and work-force development in the state. The foundation made an initial $20,000 commitment to establish the scholarship in 2007, and 21 Montgomery College students have received financial support over the past three years, according to college information. The college and the foundation also have partnered on educational projects to inspire interest in science among K-12 students.

The college program provides educational opportunities in applied biotechnology and bioscience, integrating laboratory and classroom instruction.

Freeman foundation awards

$43K to Montgomery nonprofits

The Carl M. Freeman Foundation of Selbyville, Del., announced the winners of its 2010 Faces grant cycle for Montgomery County nonprofits. A total of $42,500 was awarded to Montgomery nonprofits that were recommended by community leaders, residents and activists based on community needs and priorities.

Since the foundation started in 2000, it has awarded more than $500,000 to dozens of Montgomery nonprofits, according to a news release. Organizations receiving funds this year are Circle of Hope Therapeutic Riding, Shepherd’s Table, Dwelling Place and the Red Wiggler Community Farm.

FDA Approved Pain Management Techniques at HealthQuest

HealthQuest, a multi-specialty healthcare center based in the Brooklyn area of New York City offers several FDA approved techniques for pain management. This includes the recently FDA approved BOTOX treatment for chronic migraine. Dr. Sady Ribeiro, an experienced interventional pain and headache specialist holding multiple qualifications renders these treatments aided by sophisticated technology.

The HealthQuest pain management methodology is unique, combining three kinds of care namely relief, correction, and maintenance. The center has pain management modalities to treat different kinds of pain ranging from pain in the lower back to pain arising from fibromyalgia or spinal stenosis. In order to get the best results from BOTOX for chronic migraine, Dr. Ribeiro utilizes a modern ultrasound machine that enables the most favorable needle guided injections, paving the way for superior outcomes.

Yet another FDA-approved technique that the doctor adopts is sodium hyaluronate for multiple peripheral joints. According to the doctor, a number of patients presenting with pain have experienced a better quality of life with HealthQuest’s treatment protocols for pain management.

Dr. Sady Ribeiro is fellowship trained in both headache medicine and pain management. The doctor has also finished an additional interventional pain fellowship through the World Institute of Pain. He is fluent in English, Spanish and Portuguese. Further information about pain management at HealthQuest or about Dr.Sady Ribeiro is available at 718-769-2521. Queries may be mailed to info@hqbk.com .

Aromatherapy News

Aromatherapy helps decrease stress for overwhelmed students

College life can be a very exciting time ; however, the stresses of exams, homework and studying can take a toll on students, but with the help of aromatherapy, there is relief.

Aromatherapy, a type of therapy, deals with essential oils from plants that improve psychological and physical well-being. The use of essential oils dates back to Ancient Egyptian times.

The name aromatherapy went unused until 1928 when Dr. René-Maurice Gattefossé, a cosmetic firm owner, coined the term. After burning his hand, he doused it with lavender oil and realized it healed very quickly. This le d him to experiment with essential oils and other curative properties these oils possessed.

Carol Schiller, who has been teaching aromatherapy since 1986, leads an aromatherapy class at Paradise Valley Community College.

“The course covers a wide range of information from the historical use of aromatic plants beginning in ancient times to methods of use, safety and handling ; how to effectively use the oils ; the difference between synthetic and natural ; common practices of adulteration; and more,” says Schiller.

The Mayo Clinic says the negative effects of stress can lead to depression, high blood pressure, weight gain and even a weakening of the immune system.

According to the University of Maryland Medical Center, the benefits from aromatherapy range from relaxation, deepened breathing, decreased stress and an overall positive impact on a person’s life.

Essential oils can be used several ways, ranging from steam inhalation in massages and baths to the most common use, absorbing through the skin or nose. Juniper and Sage, an aromatherapy business run by Herbalist Diane Abernathy, says that oils bergamot, cardamon, cinnamon and frankincense are typically used in relation to stress reduction and relieving mental tension.

Schiller says, “Many students experience a reduced level of stress, deeper breathing, better focus, as well as other benefits, upon coming in contact with the essential oils, and they begin to realize that these aromatic oils aren’t just used for their scent, but for their positive effects to improve well-being….”

When it comes to using these essential oils, it is imperative that the person is trained in how to use them properly and safely, Schiller says.

“The knowledge about the safety and handling guidelines is covered in the class,” says Schilling, and students can learn a great amount of important information in this experimental course.

From Thai steamboat buffets to aromatherapy

WHO among us can resist a great bargain? No matter what it is, going for a steal is something every Malaysian is guilty of.

So imagine a luxurious spa treatment at an 80% discount, or tucking in at a fine dining Japanese restaurant for only half the price. These deals can be yours with three easy-to-follow steps, and you do not even have to collect cut-outs, participate in competitions, or fight a crowd to get it.

If you can imagine it, theSun DailyDeals can provide it, and better yet, every daily deal is now available for purchase for 24 hours.

From Thai-style steamboat buffets to aromatherapy treatments, the DailyDeals are designed to give you unbeatable discounts that are not available anywhere else – nothing less than a 50% discount is not a tagline, it is a promise.

And the promise is simple: Everyday, a deal is offered at dailydeal.sun2surf.com. It could be anything from food to shopping vouchers, but the guarantee is that it will be at least 50% off the original price. All you have to do is register with your credit card or PayPal account, follow the instructions for purchase, and a voucher will be emailed to you. Just print it out and it can be used any time within 30 days (or more, depending on the terms and conditions).

You can also receive updates on the deals on the Facebook fan page at facebook.com/theSun DailyDeal.

Some previous deals already snapped up are discounts on food at five-star hotels, fine-dining restaurants and even an Aryan buffet.

While those deals pleased the palates of many a food lover, the spa and beauty treatments are guaranteed to pamper – aromatherapy, pedicures, manicures and massages were some of what was offered at more than half-off. If you think that it all sounds too good to be true, all we can say is: Be prepared to be pleasantly surprised.

Fit Calabasas: Aromatherapy Meets Yoga

Every Saturday at 9 a.m., Inner Power Yoga studio fuses both art forms in one fitness class called Aroma-Yoga Flow. The class is designed to heat up the body through yoga exercise, which allows body pores to open and the healing effects of the oils to take over.

Starting in the reverent Namaste pose, “yogis,” or yoga students, extend their bodies into traditional yoga stretches and as they breathe, instructor and creator of the class, Robin Barnette, comes around and places different oils on the yoga mat. While in the downward dog pose, Barnette brings around an oil called Breathe, known to boost the immune system.

And as yogis are in different positions, more oils are introduced like the scent of lavender, to work as an antibacterial against insomnia and headaches.

Perhaps more soothing than the mixture of the oils and stretches is the supportive environment.

“Do what is best for you” is the type of encouragement students hear during the class, and are constantly reminded that performance in the class is individually measured.

But there is one thing that is not tolerated—not smiling. “It’s very important in my class that you smile a lot,” says Barnette.

The healing and rejuvenating connection this class inspires is something Barnette found out firsthand decades ago. When she was diagnosed with Graves disease and told she would never have children, her yoga instructor told her to continue practicing yoga and let her body speak for itself. Now, Barnette’s 17-year-old-son attends classes as well.

“Everything is so pleasing,” said one of the yogis.

And she couldn’t be more correct. For $17 a class, Aroma-Yoga is a relaxing way to start each weekend.

Anxiety News and Treatment

Pumpkin Pie Can Get You in the Mood, Study Shows

This Thanksgiving, if you want to get your lover in the mood, serve him some pumpkin pie.

A study published in Medical Aspects of Human Sexuality, showed the smell of pumpkin pie aroused men by enhancing penile blood flow, WPBF-TV reported.

Also topping the charts as a fragrance turn-on for men was the smell of lavender.

“Maybe the odors acted to reduce anxiety,” said Dr. Alan Hirsch, director of Chicago’s Smell and Taste Treatment Center. “By reducing anxiety, it acted to reduce inhibitions.”

However, men with erectile dysfunction could also benefit from eating pumpkin seeds, health experts say.

Pumpkin seeds are rich in zinc, which can increase testosterone and sexual desire, said Dr. Ralph Monserrat, who specializes in alternative medicine in Palm Beach, Fla.

Coalition helps moms with anxiety and mood disorders

Elizabeth “Liz” Beachy was diagnosed with perinatal mood disorder about one month before giving birth to her second child, who was born Sept. 30.

“I just began to feel very anxious and my mind couldn’t think clearly,” the 26-year-old said. “I began to withdraw and I began crying at the drop of a hat.”

She eventually sought help but before the medicine could take effect, Beachy felt completely overwhelmed and was not able to function normally or take care of her 3-year-old daughter, Lena Beachy. She had to move in with her mother for about a week.

“I would stand in front of the fridge and just cry and not be able to put something together for lunch,” said Beachy, a former Lafayette resident who just moved to Kokomo. “There would be times I could not get up from the chair.”

To help women such as Beachy, local health care providers have formed the Lafayette Coalition for Community Awareness of Perinatal Anxiety and Mood Disorders. The coalition consists of representatives from Clarian Arnett Health, Riggs Community Health Center, St. Elizabeth Regional Health and local independent therapists.

The group started meeting about one year ago and held its first support group this summer at the Kathryn Weil Center for Education in Lafayette.

Marcia Daehler, a psychiatric clinical nurse specialist with St. Elizabeth Regional Health, said the coalition aims to increase physician awareness by providing education, creating a support group for women and men and identifying physicians and therapists who are skilled in treating postpartum depression and perinatal mood disorders.

Pam Smith, a registered nurse with St. Elizabeth Regional Health, said these disorders include postpartum anxiety disorder, where women experience extreme worry or fear about the health of their baby.

This disorder can cause panic attacks, shortness of breath and chest pain. Another perinatal (the period immediately before and after birth) mood and anxiety disorder is pregnancy postpartum obsessive compulsive disorder, where women have repetitive, upsetting and unwanted thoughts or mental images.

Smith said the thoughts can be scary and unusual, but the women are unlikely to act upon them. However, they should seek clinical help if they are experiencing these symptoms. Other disorders include postpartum traumatic stress disorder, which is caused by a traumatic or frightening birth and postpartum psychosis, where the women see images or hear voices that others cannot.

Given the nature of these disorders, many women do not seek help because they fear removal of their baby.

However, these women can get better if they seek treatment, Smith said.

Now life is looking better for Beachy. Through medication and seeing a therapist, she is more equipped to manage her symptoms.

Also, making lifestyle changes such as moving from Lafayette to Kokomo to be closer to family, has helped remove stress.

“As long as I can keep things even keel, it’s fine,” she said. “Through lots of prayer, the support of my husband, family and friends, I am able to get back on track.”

Back Pain News and Treatment

Painful Knees Often Tied to Pain in Other Joints

MONDAY, Nov. 22 (HealthDay News) — The pain of knee osteoarthritis is more severe in people who also have foot, elbow and lower back pain, a new study has found.

In the study, researchers asked almost 1,400 knee osteoarthritis (OA) patients, aged 45 to 79, about pain in the lower back, neck, shoulder, elbow, wrist, hand, hip, knee, ankle or foot.

Low back pain was significantly associated with higher knee pain scores. Foot and elbow pain were also significantly associated with a higher knee pain score, the investigators found.

In addition, pain in multiple joints, regardless of location, was associated with greater knee pain, the study authors reported.

The findings were released online in advance of publication in an upcoming print issue of the journal Arthritis Care & Research.

“Our findings show that pain in the low back, foot and elbow may be associated with greater knee pain, confirming that symptomatic knee OA rarely occurs in isolation. Future studies are needed to determine whether treatment of pain occurring elsewhere in the body will improve therapy outcomes for knee OA,” Dr. Pradeep Suri, of Harvard Medical School, New England Baptist Hospital and Spaulding Rehabilitation Hospital in Boston, stated in a news release from the journal’s publisher.

Physician prescribes work as relief for low back pain

Low back pain is the most common cause of job-related injuries and accounts for the majority of workers’ comp claims and costs. But the vast majority of cases are benign and will get better regardless of the treatment provided.

By approaching low back pain as a condition rather than an injury, the workers’ comp system could save unnecessary aggravation for workers and employers, as well as untold thousands of dollars. An approach using evidence-based medicine, proactive measures from employers and an active recovery role by employees may be the answer.

“We follow a biopsychosocial model,” said Dr. John Anderson, senior vice president of medical operations for Concentra Health Services. “The approach is a combination of sports medicine as well as taking into consideration the psychosocial influences that might affect the outcome.”

Sports medicine approach. Traditional medicine typically suggests aggressive, invasive and costly treatment with only marginal outcomes. “The patient will be evaluated and told to go home, rest and follow up with his doctor,” Anderson said “They go home, lie down on the couch, take meds, and watch TV — further deconditioning themselves and detaching themselves from their social support structures.”

Sports medicine takes a completely different approach. “The intervention is timely, the advice is encouraging and supportive — to return to normal activities as soon as possible,” Anderson said. “We try to get them to stay at work in some capacity that will be manageable for them.”

Influencing factors. Part of that process involves identifying and addressing the psychosocial factors. “As a physician we need to be aware of those issues influencing a patient’s willingness and ability to return to work,” Anderson said. “The doctor must be astute enough to pick up on cues, sometimes from the patient or his supervisor. It’s a team of people that have to get these patients back on the road to recovery.”

Work site assessments should be included with questions about the employee’s satisfaction with his job, supervisor, type of work, shift, and potential downsizing. There may also be personal issues.

“It doesn’t have to be negative,” he said. “It can be good things causing them to reevaluate their ability to go to work. A multitude of factors — some that have nothing to do with the workplace and many that do — could influence their mind-set.”

Armed with the psychosocial information and using the sports medicine approach, Anderson said the next step is setting up the injured worker with appropriate treatment that often includes physical therapy.

“We make every effort to get patients into programs designed specifically for them to retain their level of conditioning and retain and improve their mobility and range of motion with appropriate exercises to reduce the spasms or irritability they have,” he said. “Therapists spend a great deal of time educating these patients and reinforcing that the condition is benign; they may have some discomfort, but they’re not worsening their progress.”

It’s important for patients with low back pain to understand that while their pain is real, it is not life threatening or a harbinger of long-term disability or chronic pain. The therapists progressively increase the physical capacity of the injured worker with the goal of getting them back to preinjury status.

The concept is based on a team approach. In addition to the injured worker, the therapists work with physicians and employers.

“They ask, ‘What are their functional demands? How far do they have to walk? How many pounds must they lift?'” he said. “When we know that it’s easier to get them back to that level and they can get back to the job without the risk of reinjuring themselves.”

NP Back Pain Assessment Shortens Wait Time

Nurse practitioners may help reduce wait times without impairing quality of care. Ninety-six percent of patients with back problems were satisfied with the assessment carried out by a specially trained nurse practitioner, according to a study in the December issue of the Journal of Advanced Nursing.

Moreover, the NP came up with exactly the same clinical diagnosis as two orthopedic spine surgeons in all 177 patients she assessed. She also suggested the same management plan as the two surgeons in 95% of cases.

“Nurse practitioners can play an effective and efficient role in delivering care to patients requiring specific disease management in a specialty setting. Although the required skill set in assessing these patients may vary from NP to NP, collaboration and support from the physician can help to develop expertise in a specialty area,” the paper concludes.

The aim of the year-long pilot study, conducted Toronto Western Hospital in Ontario, was to determine whether a clinic led by a nurse practitioner could speed up the diagnosis and management of patients with certain spinal conditions. (Most patients seen by spine surgeons are not surgical candidates, the researchers note; their treatment plan usually consists of education, and non-invasive therapies to help manage their conditions.)

The 96 male and 81 female patients with suspected disc herniation, spinal stenosis, or degenerative disc disease had been referred by their family doctors.

Just under 10% were correctly identified as surgical candidates by the nurse practitioner. In addition, 66 were referred for specific nerve root block, 14 for facet block, and 26 for further radiological imaging.

Overallsatisfaction was very high (96%), and 91% of patients reported that they understood their condition better after seeing the nurse practitioner.

Patients waited10 to 21 weeks to see the NP, with an average wait of 12 weeks. This compared with 10 to 52 weeks to be seen by the surgeons in a conventional clinic, with average waiting times ranging from three to four months for disc herniations to eight to 12 months for spinal stenosis.