Low Back Pain: Early Physical Therapy Associated with Reduced Imaging, Invasive Procedures and ER Visits

PainRelief.com Interview with:
Richard L. Skolasky, Jr., Sc.D.
Professor, Orthopaedic Surgery and Physical Medicine & Rehabilitation
Vice Chair of Research, Orthopaedic Surgery
Director, Surgical Outcomes Research Center
Johns Hopkins University
601 North Caroline Street, Room 5244
Baltimore, MD 21287

Dr. Skolasky

PainRelief.com: What is the background for this study?

Response: Low back pain (LBP) affects a sizeable proportion of the US population (from 1.4 to 20%), and accounts for substantial healthcare expenditures (between $12 billion and $91 billion, not accounting for indirect costs associated with loss of productivity and unemployment). Current recommendations for initial treatment of acute low back pain include physical therapy. Earlier initiation of physical therapy has been associated with less healthcare utilization and spending; however, these studies have been limited to single institutions or health systems. Research is needed to evaluate the effects of early physical therapy on healthcare use, particularly within the first 30 days after initial presentation for acute low back pain, when they are most likely to experience pain and seek care.

Study Finds Majority of Hemp Products Mislabeled for CBD and/or THC Content

PainRelief.com Interview with:
Tory R. Spindle, Ph.D. 
Assistant Professor
Behavioral Pharmacology Research Unit
Department of Psychiatry and Behavioral Sciences 
Johns Hopkins University School of Medicine

PainRelief.com:  What is the background for this study?  What are the main findings?

Due to recent policy changes, hemp products and anything derived from hemp, including non-THC cannabis constituents such as CBD are now federally legal. As a result, CBD products are now available nation-wide, including in states where cannabis remains illegal. Some prior work had shown oral or vaporized cannabinoid products have poor labeling accuracy, but no one had examined the labeling accuracy of topical cannabinoid products, which are a product category growing in popularity. We purchased 105 topical cannabinoid products (e.g., lotions, creams, gels, patches) from national retailers and online. 

We found that the vast majority of the products were inaccurately labeled for CBD and/or THC and that many of the products had health claims on the label that are not recognized by the FDA, the most common of which was pain/inflammation.

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Astronauts Risk Herniated Discs and Back Pain From Space Flight

PainRelief.com Interview with:
Dr. Radostin Penchev
Johns Hopkins Medicine

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Although fewer than 600 people have travelled to space, human space travel is expected to exponentially surge with several companies now offering space excursions as well as with the establishment of the U.S. Space Force in 2019. In parallel with this effort, NASA plans to have a sustained presence on the Moon by 2028.

It turns out that more than 50% of astronauts experience back pain (termed space adaptation back pain) during their mission and are over 4 times more likely to suffer from herniated discs than the normal population. As such, physicians should anticipate a surge in space-related back pathology. More importantly, understanding the cause of back pain in astronauts may also improve the care for other austere environment populations including deep sea divers, fighter pilots and high-altitude explorers.

In this comprehensive review of the literature, we examined the epidemiology, potential causes, and treatments for spinal pain in astronauts.

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