Low back pain

Type 2 diabetes may impact vertebral discs, cause low back pain

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The way type 2 diabetes affects the spine may explain why people experience lower back pain.

  • People with type 2 diabetes are at high risk for several diseases and health complications, including back pain.
  • Researchers from the University of California San Diego and the University of Utah report that type 2 diabetes negatively impacts the vertebral discs that form the spine, via an animal model.
  • This finding could explain why people with type 2 diabetes often experience chronic body pain, including back pain.

Researchers estimate about 508 million peopleTrusted Source around the world have type 2 diabetes — a condition where the body stops using insulin properly.

A person who has type 2 diabetes is at a higher risk for heart diseaseTrusted Source, strokeTrusted Source, high blood pressureTrusted Source, kidney diseaseTrusted Source, and dementiaTrusted Source.

Type 2 diabetes can cause several health complications, including nerve damageTrusted Source, eye diseasesTrusted Source, skin problemsTrusted Source, sleeping issuesTrusted Source, and chronic body painTrusted Source, including back painTrusted Source.

Now, researchers from the University of California San Diego and the University of Utah report that type 2 diabetes negatively impacts the vertebral discsTrusted Source that form the spine.

Via an animal model, scientists found that type 2 diabetes causes the collagen fibrilsTrusted Source within discs to become inflexible, comprising their ability to withstand pressure.

The new study was recently published in the journal PNAS Nexus.

How diabetes affects the spine

Past studies show that type 2 diabetes can adversely affect the body’s spine and back.

For example, people with type 2 diabetes are at an increased risk of developing diffuse idiopathic skeletal hyperostosis (DISH)Trusted Source. DISH is a type of arthritis that hardens the tendons and ligaments around the spine, causing stiffness, decreased motion, and pain.

A study published in March 2022 found that people with type 2 diabetes are at a higher riskTrusted Source for lumbar disc degeneration disease.

Other studies have linked type 2 diabetes with an increased risk for other spinal diseases, including spinal stenosisTrusted Source and vertebral osteomyelitisTrusted Source.

Previous research has also associated type 2 diabetes disease progression with chronic back painTrusted Source.

Prior studies have shown that people with diabetes have a 35% increased riskTrusted Source of experiencing low back pain and a 24% heightened risk of having neck pain compared to those who do not have the disease.

Diabetes may damage collagen fibrils in spine

“We wanted to see if the effects of diabetes we were seeing in the bones were also present in the vertebral discs, which could explain disc degeneration and low back pain in these populations,” Dr. Claire Acevedo, assistant professor in the Department of Mechanical and Aerospace Engineering at the University of California San Diego, adjunct assistant professor of biomedical engineering and mechanical engineering at the University of Utah, and co-lead author of this study explained to Medical News Today when asked why they decided to focus on the vertebral column for their study.

For this study, researchers used a rat model of type 2 diabetes. Vertebral discs from rats with type 2 diabetes were compared to healthy rats to look for any collagen fibril deformation in the discs. The outer portion of vertebral discs is made from layers of collagen and proteins.

The researchers discovered in rats with type 2 diabetes, the compression ability of the disc collagen fibrils became compromised, causing the collagen to become stiff and brittle and making it difficult for the collagen to handle being compressed like it would when healthy.

“Type 2 diabetes and the associated hyperglycemia (cross-links) the collagen fibrils more than usual, like a fast aging process.”
— Dr. Claire Acevedo

“This increase in cross-linking limits the usual compression mechanisms — energy dissipation mechanisms — in the discs via one, limitation of the collagen fibrils deformation making the collagen more stiff and brittle, (and) two, limitation of the lamellar rotation,” Dr. Acevedo explained.

“Future treatment can target the cross-link removal to restore the disc’s ability to deform normally,” she added.

Looking at a nanoscale

Scientists used an experimental technique called synchrotron small-angle x-ray scattering (SAXS)Trusted Source to look for any change in disc collagen behavior on a nanoscaleTrusted Source.

“Small angle X-ray scattering is an X-ray diffraction technique that enables (us) to measure the collagen fibril periodicity (67 nm). When we perform a tensile test in front of the X-ray beam, the collagen periodicity increases,” Dr. Acevedo said.

“We can capture this change in collagen periodicity, which allows us to calculate the collagen deformation or strain and measure the whole-disc deformation or strain at the same time,” she continued. “Therefore, we can see how much disc strain is transferred to the collagen level at the nanoscale.”

For the next steps in this research, Dr. Acevedo said they will be looking at ways to find a proxy for advanced glycation end-products (AGEs)Trusted Source crosslink assessment. AGEs are a biomarker associated with aging and both the development and worseningTrusted Source of degenerative conditions like diabetes.

“Assessing AGEs content in discs or bones is complicated and intrusive while assessing AGEs crosslink increase in (the) skin might be a good way to assess the same increase in discs and bones, even though the absolute content value will differ between tissues,” she said.

Type 2 diabetes affects collagen all over body

MNT also spoke about this study with Dr. Neel Anand, an orthopedic surgeon and co-director of spine trauma at Cedars-Sinai Spine Center in Los Angeles.

Dr. Anand said he was not surprised by this study’s findings.

“Type 2 diabetes affects collagen — it’s a collagen disease and discs (are) collagen,” he explained. “The ring of the disc on the outside is made of collagen fibers. So it’s not surprising that it will affect the disc in some form, shape, or fashion.”

“Type 2 diabetes affects collagen all over the body. The collagen will get affected just like it affects the blood vessels in the body. That’s what type 2 diabetes does — that’s why you get vascular problems, you get heart problems, you get kidney problems. You get a million problems with type 2 diabetes, including eye problems, so it affects a lot of things.”
— Dr. Neel Anand

However, Dr. Anand did point out this research was conducted through a rat model.

“Humans are not rats,” he continued. “Is (this) true in humans? (It) probably is — there’s probably some element to it. Someone’s got to prove that’s true in humans at some point. Ultimately, it has to translate to humans.”

Is Vitamin D Supplementation Effective for Low Back Pain?

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BACKGROUND: Low back pain (LBP) is the leading cause of years lived with disability worldwide. Current intervention strategies are failing to reduce the enormous global burden of LBP and are prompting researchers to investigate alternative management strategies, such as vitamin D supplementation. Vitamin D supplementation appears to down regulate pro-inflammatory cytokines which lead to pain and up regulate anti-inflammatory cytokines that reduce inflammation. These mechanisms might explain the increasing interest in the use of vitamin D supplementation for LBP.

OBJECTIVES: To determine whether vitamin D supplementation improves pain more than a control intervention for individuals with LBP.

STUDY DESIGN: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

METHODS: We performed searches in numerous electronic databases combining key words relating to “vitamin D” and “LBP” until March 2017. Studies were included if they investigated vitamin D supplementation in participants with LBP, provided there was a comparison intervention. There was no restriction on the type of LBP, the intervention parameters investigated, or the type of clinical trial (e.g., randomized, non-randomized). Two reviewers independently performed the selection of studies, extracted data, rated the methodological quality of the included studies, and evaluated the overall quality of the evidence using the Grading of Recommendations Assessment, Delevopment, and Evaulation (GRADE) approach.

RESULTS: After screening 3,534 articles, 8 clinical trials were included in this systematic review. There is very low quality evidence (based on the GRADE approach) that vitamin D supplementation is not more effective than any intervention (including placebo, no intervention, and other conservative/pharmacological interventions) (continuous pain measures [0-100]: mean difference [MD] = -2.65, 95% confidence interval [CI]: -10.42 to 5.12, P = 0.504, n = 5; self-reported reduction in pain: pooled odds ratio [OR] = 1.07, 95% CI: 0.35 to 3.26, P = 0.906, n = 5) or placebo/no intervention for individuals with LBP (continuous pain measures: MD = 1.29, 95% CI: -3.81 to 6.39, P = 0.620, n = 4; self-reported reduction in pain: pooled OR = 1.53, 95% CI: 0.38 to 6.20, P = 0.550, n = 4), where ‘n’ is the number of studies included in the meta-analysis. These results did not change when we stratified the meta-analyses by the type of vitamin supplementation (vitamin D3 vs. alfacalcidol) or the type of LBP (non-specific vs. LBP resulting from osteoporosis or vertebral fractures).

LIMITATIONS: The overall quality of evidence was “very low” due to the poor methodological quality and small sample sizes of the included studies.

CONCLUSIONS: Vitamin D supplementation is not more effective than placebo, no intervention, or other conservative/pharmacological interventions for LBP (based on very low quality evidence). These results are consistent, regardless of the type of LBP or vitamin D supplementation. Until well-designed and adequately powered clinical trials suggest otherwise, the prescription of vitamin D for LBP cannot be recommended.

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For Bad Backs, It May Be Time to Rethink Biases About Chiropractors

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Spinal manipulation or physical therapy such as heat and stretches (above) seem as effective as traditional approaches to help lower back pain. 

About two of every three people will probably experience significant low back pain at some point. A physician like me might suggest any number of potential treatments and therapies. But one I never considered was a referral for spinal manipulation.

It appears I may have been mistaken. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink our biases.

Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer.

Most back pain resolves over time, so interventions that focus on relief of symptoms and allow the body to heal are ideal. Many of these can be nonpharmacological in nature, like the work done by chiropractors or physical therapists.

Physicians are traditionally wary of spinal manipulation (applying pressure on bones and joints), in part because the practitioners are often not doctors and also because a few chiropractors have claimed they can address conditions that have little to do with the spine. Patients with back pain haven’t seemed as skeptical. A large survey of them from 2002 through 2008 found that more than 30 percent sought chiropractic care, significantly more than those who sought massage, acupuncture or homeopathy.

Researchers have been looking at the evidence supporting spinal manipulation for some time. Almost 35 years ago, a systematic review evaluated the available research, most of which was judged to be low in quality, and found that there might be some short-term benefits from the procedure. Two reviews from 2003 agreed for the most part, finding that spinal manipulation worked better than a “sham procedure”, or placebo, but no better or worse than other options.

Almost a decade later, a Cochrane review assessed the literature once more, and found 12 new trials had been conducted. This review was more damning. It found that spinal manipulation was no better than sham interventions.

But since then, data have accumulated, as more higher-quality studies have been performed. Recently, in The Journal of the American Medical Association, researchers looked for new studies since 2011, as well as those that had been performed before.

The evidence from 15 randomized controlled trials, which included more than 1,700 patients, showed that spinal manipulation caused an improvement in pain of about 10 points on a 100-point scale. The evidence from 12 randomized controlled trials — which overlapped, but not completely with the other trials — of almost 1,400 patients showed that spinal manipulation also resulted in improvements in function.

In February, in Annals of Internal Medicine, another systematic review of nonpharmacologic therapies generally agreed with the other recent trials. Based upon this review, and other evidence, the American College of Physicians released new clinical practice guidelines for the noninvasive treatment of subacute back pain. They recommended that patients should try heat, massage, acupuncture or spinal manipulation as first-line therapies.

The only things that might detract from the use of spinal manipulation in this situation would be its cost and potential harms.

Because they fear those potential harms, some physicians are hesitant to refer patients to chiropractors or physical therapists for care. But in all the studies summarized above, there were really no serious adverse events reported. It’s possible to find anecdotes of harm to the spinal cord from improper manipulations, but these are rare, and almost never involve the lower spine.

Some physicians are concerned about the cost of spinal manipulation, especially since most insurance carriers don’t cover it. Visiting a chiropractor costs more than taking many non-narcotic pain medications. But more invasive interventions can cost a lot of money. In addition, studies have shown that, in general, users of complementary and alternative medicine spend less over all for back pain than users of only traditional medicine.

Medication and surgery can also lead to harms. We shouldn’t forget that prescription pain medications, like opioids, can lead to huge costs, especially when they’re misused.

Some physicians are uncomfortable that we don’t have a clear picture of how spinal manipulation actually works to reduce pain. It’s also possible that some chiropractors do it “better” than others, and we can’t tell. This concern should be tempered by the fact that we don’t have a great understanding of why many other therapies work either. Some of the more traditional things we recommend don’t even work consistently.

206COMMENTS

Still, there is no merit to many other claims about spinal manipulation — that it has been proved to work for things like infantile colic, painful periods, asthma, gastrointestinal problems, and more. For most conditions, the therapy lacks a good evidence base.

But given the natural course of back pain — that most of it goes away no matter what you do — the ideal approach is to treat the symptoms and let the body heal. Noninvasive therapies seem to do that well enough.

Source:www.nytimes.com

Antibiotics May Relieve Back Pain Symptoms.

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antibiotic

Story at-a-glance

  • Taking antibiotics may relieve symptoms in up to 40 percent of people with low back pain, according to a new study that found a link between back pain and bacterial infection
  • With antibiotic-resistant diseases already on the rise, and serious side effects linked to unnecessary antibiotic use, using antibiotics for back pain could have serious repercussions
  • Poor posture and/or improper movement is to blame for most cases of back pain
  • One of the best steps you can take to prevent and manage back pain is to address improper posture and sitting, exercise regularly and keep your back and abdominal muscles strong

In a new study from Denmark, researchers found a link between back pain and bacterial infection, which they say may be treated effectively with a 100-day course of antibiotics.1

It’s estimated that up to 85 percent of Americans experience back pain at some point in their lives, while more than 26 million suffer from back pain frequently.2

Back pain is actually the leading cause of disability in Americans under the age of 45,3 but while many seek treatment, spending at least $50 billion annually toward this end,4 relief is often only fleeting.

If you’re among those struggling with back pain, and are growing frustrated when common treatments don’t work, this connection with antibiotics may sound like a welcome new option, but it’s one that comes with a hefty downside.

Are Antibiotics a Good Choice for Back Pain Relief?

Previous research suggests that between 7 percent and 53 percent of patients with herniated discs have a type of bacteria that entered the disc when it was herniated. The Danish researchers similarly found bacteria in 46 percent of slipped discs among patients who’d received spinal surgery for back pain.

The researchers then gave a 100-day course of antibiotics to half of a group of patients struggling with low back pain from a slipped disc. One year later, those who’d taken antibiotics reported less low back pain, leg pain and physical disability than the placebo group.

They were also less likely to have missed days of work due to back pain. Researchers estimated that antibiotics could potentially relieve the symptoms of up to 40 percent of people suffering from chronic low back pain.

The results sound promising, particularly for those who feel they’ve triedeverything and still have gotten no pain relief. But the use of antibiotics, especially long-term for three-plus months at a time, should not be taken lightly…

WARNING: Antibiotics May Promote Fungal Growth, Weight Gain and Chronic Disease

Conventional antibiotics can save your life if they’re necessary, such as if you develop a serious bacterial infection, but it’s important to understand that they come with serious risks. These antibiotics, by design, disrupt the balance of good and bad bacteria in your gastrointestinal tract, often killing off both beneficial and harmful microorganisms without distinction.

We now know, however, that your health is intricately tied to, and in many ways dependent upon, a healthy balance of bacteria in your gut.

When this balance is disrupted, it paves the way for a number of chronic diseases. According to data analyzed by journalist Maryn McKenna for Wired,5 the US states with the highest levels of antibiotic overuse are one in the same as those that have the worst health status, including the highest rates of obesity, asthma, heart disease, heart attack, diabetes and stroke.

As Doug Kaufmann wrote in his book The Fungus Link, Volume 2:

“ … every time you swallow antibiotics, you kill the beneficial bacteria within your intestines. When you do so, you upset the delicate balance of your intestinal terrain. Yeasts grow unchecked into large colonies and take over, in a condition called dysbiosis.

Yeasts are opportunistic organisms. This means that, as the intestinal bacteria die, yeasts thrive, especially when their dietary needs are met. They can use their tendrils, or hyphae, to literally poke holes through the lining of your intestinal wall. This results in a syndrome called leaky gut.

… In addition to possibly causing leaky gut syndrome, I believe that parasitic yeasts can also cause you to change what you eat in that they encourage you to binge on carbohydrates including pasta, bread, sugar, potatoes, etc. So, it should come as no surprise that weight gain counts as one of the telltale signs of antibiotic damage and subsequent yeast overgrowth. 

By altering the normal terrain of the intestines, antibiotics can also make food allergies more likely. An array of intestinal disorders can ensue, as well. Sadly, most doctors claim ignorance concerning their patients’ intestinal disorders rather than admit that the drugs they themselves prescribed actually caused the disorders to begin with.”

Antibiotic-Resistant Disease Is Already a Major Public Health Threat

Antibiotic overuse has already spurred a vicious cycle. Whenever you use an antibiotic, you’re increasing your susceptibility to developing infections with bacteria that are now not only resistant to that antibiotic, but much harder to treat because of it — and as a result, you can become a carrier of this resistant bug, and can spread it to others.

The rise of antibiotic-resistant disease is actually one of the world’s most pressing public health threats. There are already numerous bacteria resistant to many commonly prescribed antibiotics, and this is a direct result of the vast overuse of antibiotics in both the medical system and conventional livestock farming. If increasing numbers of people begin taking even moreantibiotics, now to treat back pain, the problem could get even worse.

One of the most beneficial steps you can take to combat infection is to maintain a healthy intestinal system by eating a diet rich in natural probiotics, especially naturally fermented foods, such as those described in Dr. Campbell-McBride’s GAPS Nutritional Program. If bacteria are in fact involved in your back pain, this may be a good place to start, which will help to heal your gut rather than further harm it.

The other benefit of using fermented vegetables and increasing the volume of beneficial bacteria is that it will help your body produce secretory IgA, which is a powerful stimulus for your immune response. So rather than taking antibiotics, which can disrupt your beneficial flora, optimizing your gut flora will help your own body fight the infection that might be contributing to back pain and also help you avoid the antibiotic side effects.

Drug Companies Are Salivating at the Thought of Coming Up With the Next Back Pain Treatment

When drug companies see a condition that impacts many people and has only limited (or ineffective) treatment options available, they see dollar signs. Not surprisingly, back pain has become a major target for Big Pharma disease mongering.6 The latest example of this is the emergence of ads for ankylosing spondylitis, a chronic inflammatory disease of the axial skeleton, which includes the spine.

“Do you have back pain? Are you dismissing it as resulting from ‘lifting too much’ at the gym or ‘bad posture’?” one radio ad asks. “You might have ankylosing spondylitis.”

The drug advertised is Humira, which has a price tag of about $20,000 a year. It is reprehensible for drug companies to promote this expensive and dangerous drug for an exceedingly rare cause of low back pain, which likely is responsible for less than a tenth of a tenth of 1 percent of low back pain. In the case of antibiotics for treating a herniated disc, drug companies will undoubtedly be thrilled at the prospect. But considering the fact that most cases of low back pain are probably not caused by infection, or certainly not a lack of any drug, you probably do not need drugs to treat it.

Poor posture and/or improper movement is to blame for most cases of back pain, including herniated discs, which means one of the best steps you can take to prevent and manage back pain is to exercise regularly and keep your back and abdominal muscles strong. Many are also finding success using the posture-improvement methods taught by Esther Gokhale, the so-called “posture guru” of Silicon Valley. The NY Times reports:7

“She believes that people suffer from pain and dysfunction because they have forgotten how to use their bodies. It’s not the act of sitting for long periods that causes us pain, she says, it’s the way we position ourselves.

Ms. Gokhale … is not helping aching office workers with high-tech gadgets and medical therapies. Rather, she says she is reintroducing her clients to what she calls “primal posture” — a way of holding themselves that is shared by older babies and toddlers, and that she says was common among our ancestors before slouching became a way of life. It is also a posture that Ms. Gokhale observed during research she conducted in a dozen other countries, as well as in India, where she was raised.

For a method based not on technology but primarily on observations of people, it has been embraced by an unlikely crowd: executives, board members and staff members at some of Silicon Valley’s biggest companies, including Google and Oracle …”

Gokhale’s approach to treating back pain is in line with others that seek to treat the foundational, mechanical body issues that often lead to pain. Most back, neck, and other muscle pains are related to imbalanced absorption of force throughout your body, created by working and sitting in unnatural positions for extended periods. When you teach your body to establish and repeat correct positioning, the pain often goes away.

Foundation Training Was Developed Specifically to Relieve Its Founder’s Low Back Pain

Foundation Training—an innovative method developed by Dr. Eric Goodman to treat his own chronic low back pain—is an excellent alternative to the Band Aid solutions so many are given. Foundation Training exercises work to gradually pull your body out of the movement patterns that are hurting you. The focus is on strengthening your complete core, which includes anything that directly connects to your pelvis, whether above or below it. Foundation Training teaches all those muscles to work together through integrated chains of movement, which is how your body is structurally designed to move.

Every muscle that directly connects to your pelvis should be considered a piece of your core and this includes your glutes, adductors (inner thigh muscles), deep lower back muscles, hip flexors, hamstrings and all of your abdominal muscles.

Having strong, balanced core muscles is like having a built-in corset that not only holds your gut in, but also stabilizes your spine, vertebrae, discs, and most importantly your pelvis. The program is inexpensive and can be surprisingly helpful, as these exercises are designed to help you strengthen your entire core and move the way nature intended.

In the video below you can see a demonstration of one of the key exercises, called “The Founder,” which helps reinforce proper movement while strengthening the entire back of your body. The Founder is an excellent exercise that can help reverse the effects of frequent and prolonged sitting (i.e. back pain).

Two More Non-Drug Options for Relieving Back Pain

Addressing your posture (or other factors that may be contributing to the strain, such as sleeping in an awkward position) and treating the condition with exercises and movement changes as described above are often effective at relieving the pain and addressing the underlying cause. Two other natural, non-drug options that provide relief to many include:

  1. Osteopathic manipulation: This may involve moving joints back into place, massaging soft tissue and helping relax stressed muscles. In one study, 63 percent of those who’d had osteopathic manipulation reported a moderate improvement in their pain while half said they had a substantial improvement.8
  2. Chiropractic care: Seeing a qualified chiropractor is certainly a wise consideration if you suffer from back pain. I am an avid believer in the chiropractic philosophy, which places a strong emphasis on your body’s innate healing ability and far less reliance on drugs and surgery. One study published in the Annals of Internal Medicine even revealed that chiropractic care is often better than medication for treating musculoskeletal pain.9

12 Tips Virtually Everyone With Back Pain Should Know

Back pain is often unique in how it is caused and experienced by each individual, which is why the best treatment for you will likely be unique too. It may take some trial and error and experimentation with different methods before you find what works best, but keep trying before you resort to drugs or other invasive methods like surgery; there are many natural options available, including these tips below.

  1. Exercise and physical activity will help strengthen the muscles of your spine. Make your exercise time count by includinghigh-intensity sessions. You probably only need this once or twice a week at the most. You’ll also want to include exercises that promote muscle strength, balance and flexibility. Remember to build up your entire core to avoid back pain. Always make sure you focus on strong, balanced posture.
  2. Optimize your production of vitamin D and K2, which will work through a variety of different mechanisms to reduce your pain, as well as prevent the softening of the bones that can often lead to lower back pain.
  3. If you spend many hours every day in a chair like I do, pay careful attention to consciously sucking in your belly and rotating your pelvis slightly up. At the same time make sure your head is back with your ears over your shoulders and your shoulder blades pinched. This will help keep your spine in proper alignment. You can hold these muscles tight for several minutes and do this every hour you are sitting.
  4. Address psychological factors, which often play a role in back pain. Underlying emotional issues and unresolved trauma can have a massive influence on your health, particularly as it relates to physical pain. Dr. John Sarno,10 for example, used mind-body techniques to treat patients with severe low back pain and has authored a number of books on this topic. His specialty was those who have already had surgery for low back pain and did not get any relief. This is one tough group of patients, yet he had a greater than 80 percent success rate using techniques like the Emotional Freedom Technique (EFT) (he has now retired from practice).
  5. Get regular massage therapy. Massage releases endorphins, which help induce relaxation and relieve pain.
  6. Keep your weight spread evenly on your feet when standing. Don’t slouch when standing or sitting to avoid putting stress on your back muscles.
  7. Always support your back, and avoid bending over awkwardly. Protect your back while lifting – this activity, along with carrying, puts the most stress on your back.
  8. Sleep in a firm bed. Sleeping on your side to reduce curving of your spine and stretching before getting out of bed is also helpful.
  9. Use chairs or car seats that offer good lumbar support. Switch positions often while sitting, walk around a bit and do some light stretching to relieve tension.
  10. Wear comfortable shoes. For ladies, minimize the time you spend in high-heel shoes, particularly those with higher heights.
  11. Drink plenty of water to enhance the height of your intervertebral disks. And because your body is composed mostly of water, keeping yourself hydrated will keep you fluid and reduce stiffness.
  12. Quit smoking as it reduces blood flow to your lower spine and causes your spinal disks to degenerate.

Source: mercola.com

 

Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial.

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PURPOSE We studied the efficacy of osteopathic manual treatment (OMT) and ultrasound therapy (UST) for chronic low back pain. METHODS A randomized, double-blind, sham-controlled, 2 x 2 factorial design was used to study OMT and UST for short-term relief of nonspecific chronic low back pain. The 455 patients were randomized to OMT (n = 230) or sham OMT (n = 225) main effects groups, and to UST (n = 233) or sham UST (n = 222) main effects groups. Six treatment sessions were provided over 8 weeks. Intention-to-treat analysis was performed to measure moderate and substantial improvements in low back pain at week 12 (30% or greater and 50% or greater pain reductions from baseline, respectively). Five secondary outcomes, safety, and treatment adherence were also assessed. RESULTS There was no statistical interaction between OMT and UST. Patients receiving OMT were more likely than patients receiving sham OMT to achieve moderate (response ratio [RR] = 1.38; 95% CI, 1.16-1.64; P <.001) and substantial (RR = 1.41, 95% CI, 1.13-1.76; P = .002) improvements in low back pain at week 12. These improvements met the Cochrane Back Review Group criterion for a medium effect size. Back-specific functioning, general health, work disability specific to low back pain, safety outcomes, and treatment adherence did not differ between patients receiving OMT and sham OMT. Nevertheless, patients in the OMT group were more likely to be very satisfied with their back care throughout the study (P <.001). Patients receiving OMT used prescription drugs for low back pain less frequently during the 12 weeks than did patients in the sham OMT group (use ratio = 0.66, 95% CI, 0.43-1.00; P = .048). Ultrasound therapy was not efficacious. CONCLUSIONS The OMT regimen met or exceeded the Cochrane Back Review Group criterion for a medium effect size in relieving chronic low back pain. It was safe, parsimonious, and well accepted by patients.

Source: Annals of Family Medicine