Manuela L. Ferreira PhD Institute of Bone and Joint Research The Kolling Institute, Sydney Medical School
Paulo H. Ferreira PhD Musculoskeletal Health Research Group Faculty of Health Sciences University of Sydney, Sydney, NSW, Australia
PainRelief.com: What is the
background for this study? What are the
Response: One in four Australians experience back pain or neck pain. Diabetes
is also a worldwide prevalent condition, and currently affects over 382 million
people. These two diseases often co-exist and have very similar underlying
mechanisms, such as obesity and physical inactivity. We were unsure whether
having one condition would lead to developing the other, however.
We have found 11 studies published to date, and assessing the relation between back or neck pain and diabetes. The studies included over 165,000 participants published in the USA, Canada, Finland, Denmark, Iran and Spain.
When we pooled the results of these studies together, we observed that people with type 2 diabetes are 35% more likely to also have low back pain (compared to people without diabetes). The risk of having severe back pain symptoms in people with type 2 diabetes is 63% higher and the risk of having severe neck pain is almost 30% higher, than in people with no diabetes. We could not identify, however, whether type 2 diabetes can lead to back or neck pain, and it is possible that the two conditions are associated via other underlying mechanisms such as obesity and physical inactivity.
Steven Z. George, PT, PhD
Director of Musculoskeletal Research
Duke Clinical Research Institute
Vice Chair of Clinical Research
PainRelief.com: What is the background for this study? What are the main findings?Response: This study adds to existing health services research investigating the sequence of services/providers for musculoskeletal pain and its impact on opioid use.
The study suggest that early physical therapy (PT) for the 4 most common musculoskeletal conditions (back, neck, shoulder, and knee) can be protective of chronic/long term opioid use for individuals that were opioid naïve when presenting for their care. What is different about this study is that the 4 conditions were studied in the same cohort and the same definition of early PT was used (many of the previous studies just looked at 1 conditions, and used different definitions of early physical therapy). The other thing that was different is that we used a larger dataset of private insurance providers, so this study cuts across different regions of the study (many of the previous studies included one health system).
There was notable consistency in the findings for the 4 conditions and protection of any opioid use, but there were some contingencies.
First was that there was no benefit on decreased dosage for individuals with neck pain – as that was not expected.
Second was that in a follow up sensitivity analysis it looked like the largest benefit of early physical therapy may be for those with back and knee pain.Continue reading →
MedicalResearch.com Interview with:
Michael Perloff, MD PhD
Assistant Professor of Neurology
Interventional Pain Management
Boston University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Low back pain is very common. Patients with chronic low back pain that does not benefit from physical therapy, medications, or injections, often get spine surgery. If surgery fails to help (Failed back surgery syndrome-i.e. continued low back and leg pain after surgery), options for pain relief become more complex.
Typically, patients with failed low back surgery syndrome have tried complex procedures, repeat surgery or technology implants as their main options.
The SEAL procedure is a shortened, simple procedure (done in about 20 minutes) that can help as treatment for failed back surgery symptoms. In the published case series of 30 patients, some patients achieved very good, sustained, pain relief. Continue reading →