Chronic Back and Knee Pain Relief: How Do Sham Procedures Compare to Surgery? Interview with:

Wayne B Jonas MD

Wayne B Jonas MD

H&S Ventures
Samueli Integrative Health Programs  What is the background for this study?

Response: The findings of this study are based on a systematic review of 25 randomized clinical trials evaluating surgical type interventions (open surgeries, arthroscopic, endoscopic, laparoscopic, heart catheterization, radiofrequency, laser, and other interventions) for chronic back and knee pain. In each study, researchers had also performed sham procedures on a control group where they replicated the invasive procedure by omitting the step believed to be therapeutically necessary. The purpose of this it to determine how much of the effects are due to the placebo response.

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Self-Administered Acupressure Studied for Chronic Low Back Pain Relief Interview with:

Susan Murphy, Sc.D., O.T.R.
Associate Professor
Physical Medicine and Rehabilitation Department
Research Health Science Specialist
VA Ann Arbor Health Care System, GRECC  What is the background for this study?

Response: Chronic low back pain is very common and affects quality of life by reducing the ability to carry out needed and valued activities. In addition, people with chronic low back pain tend to have other symptoms like fatigue, sleep disturbances, and depression. Medications are typically prescribed but have side effects, and in some cases, may increase the risk of abuse and addiction. Non-pharmacological treatments are an important part of chronic pain management and may reduce pain as well as other symptoms.

In this study, we examined the use of self-administered acupressure as a pain management strategy in people with chronic low back pain. Acupressure is a Traditional Chinese Medicine technique in which physical pressure is applied to specific points on the body. It is similar to acupuncture, but instead of needles, pressure is applied with a finger, thumb, or device. In previous studies, people with cancer-related or osteoarthritis pain who self-applied acupressure had reduced symptoms such as pain and fatigue. What are the main findings?

Response: Our pilot randomized controlled trial involved 67 participants with chronic low back pain. They were randomized into one of three groups – relaxing acupressure, stimulating acupressure, or usual care. Participants in the acupressure groups were trained to apply pressure to specific anatomical points on their body, and asked to complete daily treatment sessions for 6 weeks. We found that people who performed stimulating acupressure had improved pain and fatigue, and people who performed relaxing acupressure had improved pain after 6 weeks compared to those in the usual care group. No differences among the groups were found for sleep quality or disability after 6 weeks. Participants performed an average of 85% of the daily acupressure sessions and there were minimal adverse events. Adverse events, such as skin breakdown, muscle spasm, and headache were attributed to applying too much pressure and adjustments in application technique was done to avoid future issues. What should readers take away from your report?

Response: Self-administered acupressure shows some promising effects on pain and fatigue in people with chronic low back pain. It is a low cost and low risk symptom management strategy that people can adhere to. What recommendations do you have for future research as a result of this work?

Response: Because this was only a pilot study, larger studies are needed to support the effectiveness of this treatment for people with chronic low back pain.


Susan Lynn Murphy, Richard Edmund Harris, Nahid Roonizi Keshavarzi, Suzanna Maria Zick, Self-Administered Acupressure for Chronic Low Back Pain: A Randomized Controlled Pilot Trial, Pain Medicine, , pnz138,

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SEAL Procedure Gives Pain Relief To Some After Failed Back Surgery Interview with:
"Personal Injury Back Pain" by SanDiego PersonalInjuryAttorney is licensed under CC BY-SA 2.0
Michael Perloff, MD PhD

Assistant Professor of Neurology
Interventional Pain Management
Boston University School of Medicine 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

Three Genes Linked To Chronic Back Pain Interview with:
"Back Pain" by betterhealthosteopathy is licensed under CC PDM 3.0cDr. Frances MK Williams PhD

Department of Twin Research and Genetic Epidemiology
Division of Genetics & Molecular Medicine
Reader, King’s College London
Honorary Consultant in Rheumatology
Guy’s and St Thomas’ NHS Foundation Trust What is the background for this study?

Response: This study was led by scientists at King’s College London and the University of Washington. It has identified three new genes associated with the development of chronic back pain.

The findings, which are published in PLOS Genetics, could pave the way for the creation of more effective treatments for the condition, the leading cause of disability worldwide.

Part funded by the European Union, the research project focussed on understanding why in most people an episode of back pain gets better, while in around 20% of people it can persist for many months – chronic back pain is defined as pain that persists for more than three months.

To better understand the origins of the chronic condition, researchers conducted a genome-wide association meta-analysis (GWAS) of chronic back pain studies comprising a total of 440,000 individuals. The average age of the study’s participants ranged from 50 to 76 years, and the genders were approximately balanced.  Continue reading