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SaveYourself
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- June 16, 2011
- 11:15 AM
- 282 views
SHIN SPLINTS: Running softly and the impact of impact
by Paul Ingraham in SaveYourself
This guy seems pretty sharp. I don’t know his identity, but he works for the University of Virginia Center for Endurance Sport, and his blog commenters all seem to know who he is — “Jay” — and he writes well and seems to know his stuff. This is a great paragraph:
I love reading running forums where people with way too much time on their hands armchair quarterback running styles. They look at a picture or video of a contact pattern of some guy running across the screen and say........ Read more »
Zadpoor AA, & Nikooyan AA. (2011) The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clinical biomechanics (Bristol, Avon), 26(1), 23-8. PMID: 20846765
- June 16, 2011
- 11:15 AM
- 262 views
SHIN SPLINTS: Running softly and the impact of impact
by Paul Ingraham in SaveYourself
This guy seems pretty sharp. I don’t know his identity, but he works for the University of Virginia Center for Endurance Sport, and his blog commenters all seem to know who he is — “Jay” — and he writes well and seems to know his stuff. This is a great paragraph:
I love reading running forums where people with way too much time on their hands armchair quarterback running styles. They look at a picture or video of a contact pattern of some guy running across the screen and say........ Read more »
Zadpoor AA, & Nikooyan AA. (2011) The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clinical biomechanics (Bristol, Avon), 26(1), 23-8. PMID: 20846765
- April 17, 2011
- 11:00 AM
- 781 views
CHRONIC PAIN: How often does injury lead to chronic pain?
by Paul Ingraham in SaveYourself
How often does injury lead to chronic pain? Why do some injured people develop chronic pain and others do not? I’ve wondered this a lot in my career, and I wondered it even more throughout 2010 as my wife recovered from serious fracture to her arm and spine inflicted by a car accident in Laos last February.
So I’m pleased that Australian researchers Clay et al went to some effort to keep tabs on 168 patients who suffered non-life-threatening orthopaedic injuries. What happened to the........ Read more »
Macea DD, Gajos K, Daglia Calil YA, & Fregni F. (2010) The efficacy of web-based cognitive behavioral interventions for chronic pain: a systematic review and meta-analysis. The journal of pain : official journal of the American Pain Society, 11(10), 917-29. PMID: 20650691
- March 29, 2011
- 02:45 PM
- 747 views
ACUPUNCTURE: The last word on acupuncture? If only!
by Paul Ingraham in SaveYourself
Acupuncture fail
Not so popular, ancient, safe, or effective after all.
The journal Pain, one of the top ten journals for pain and injury science, has published a thorough and harsh scientific smack down of acupuncture, concluding that there is “little truly convincing evidence that acupuncture is effective in reducing pain,” and that — alarmingly — “serious adverse effects continue to be reported,” such as infections and collapsed lungs.
Nothing like a little sepsis and colla........ Read more »
Ernst, E., Lee, M., & Choi, T. (2011) Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews. PAIN, 152(4), 755-764. DOI: 10.1016/j.pain.2010.11.004
- March 28, 2011
- 06:00 PM
- 832 views
LOW BACK PAIN: "Diagnosing low back pain is a nightmare"
by Paul Ingraham in SaveYourself
I won’t have time to get around to reporting on this particular bit of science for a while, and why bother? Neil O’Connell of BodyInMind.org has got it covered:
…beyond MRI simply not telling us much, a paper from last year suggests that MRI scans might achieve something worse.
So the nugget here is just that MRI may well be worse than useless. Called it. Not to boast (well, maybe a little ), but I have been predicting for years that the evidence would go this way. And now it has......... Read more »
van Ravesteijn H, van Dijk I, Darmon D, van de Laar F, Lucassen P, Hartman TO, van Weel C, & Speckens A. (2011) The reassuring value of diagnostic tests: A systematic review. Patient education and counseling. PMID: 21382687
Carragee EJ, Alamin TF, Miller JL, & Carragee JM. (2005) Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. The spine journal : official journal of the North American Spine Society, 5(1), 24-35. PMID: 15653082
Kalichman L, Kim DH, Li L, Guermazi A, & Hunter DJ. (2010) Computed tomography-evaluated features of spinal degeneration: prevalence, intercorrelation, and association with self-reported low back pain. The spine journal : official journal of the North American Spine Society, 10(3), 200-8. PMID: 20006557
Kalichman L, Li L, Kim DH, Guermazi A, Berkin V, O'Donnell CJ, Hoffmann U, Cole R, & Hunter DJ. (2008) Facet joint osteoarthritis and low back pain in the community-based population. Spine, 33(23), 2560-5. PMID: 18923337
Jarvik JJ, Hollingworth W, Heagerty P, Haynor DR, & Deyo RA. (2001) The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: baseline data. Spine, 26(10), 1158-66. PMID: 11413431
Kalichman L, Hodges P, Li L, Guermazi A, & Hunter DJ. (2010) Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 19(7), 1136-44. PMID: 20033739
Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, & Hunter DJ. (2009) Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine, 34(2), 199-205. PMID: 19139672
Webster BS, & Cifuentes M. (2010) Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine, 52(9), 900-7. PMID: 20798647
- March 16, 2011
- 11:00 AM
- 666 views
CHIROPRACTIC: Spinal manipulative therapy damned with faint praise (again)
by Paul Ingraham in SaveYourself
Spinal manipulation: underwhelming effects on back pain since 1895.
Recently I posted a quick link to this new review of spinal manipulative therapy, and promised to say a little more about it later. It’s time …
A new Cochrane review of all the science so far reported that spinal manipulative therapy (SMT) for low back pain is “no better or worse” than other therapies … which damns it with very faint praise, of course, because no therapy has ever been shown to be all that effect........ Read more »
Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, & van Tulder MW. (2011) Spinal manipulative therapy for chronic low-back pain. Cochrane database of systematic reviews (Online). PMID: 21328304
- March 10, 2011
- 08:00 AM
- 761 views
CHIROPRACTIC: The devil is in the details
by Paul Ingraham in SaveYourself
There’s a new study about spinal adjustment, with some fanfare. Neil O’Connell:
The email from the industry was effusive. In a cock-a-hoop, caps lock-happy frenzy it bellowed “ALL MANUAL MEDICINE PROVIDERS SHOULD BE AWARE OF THIS STUDY.”
Or not. Neil readily identified numerous serious problems with it.
It is of course possible that the results of this study are accurate and maintenance manipulations are effective, but these problems make it difficult to judge. The message f........ Read more »
Senna MK, & Machaly SA. (2011) Does maintained Spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?. Spine. PMID: 21245790
Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, & van Tulder MW. (2011) Spinal manipulative therapy for chronic low-back pain. Cochrane database of systematic reviews (Online). PMID: 21328304
Martel J, Dugas C, Dubois JD, & Descarreaux M. (2011) A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC musculoskeletal disorders, 41. PMID: 21303529
- January 19, 2011
- 11:30 AM
- 651 views
PAIN: Pain changes how pain works: what we know about central sensitization so far
by Paul Ingraham in SaveYourself
This is a direct jargon-to-English translation of an important scientific paper by Clifford Woolf, a distinguished pain researcher, published in Pain in Oct 2010. Everyone — and I do mean everyone — needs to know this. It’s owners manual stuff.
Pain itself often modifies the way the central nervous system works, so that a patient actually becomes more sensitive and gets more pain with less provocation. That sensitization is called “central sensitization” because it involves change........ Read more »
Woolf CJ. (2010) Central sensitization: Implications for the diagnosis and treatment of pain. Pain. PMID: 20961685
- January 19, 2011
- 11:30 AM
- 490 views
LOW BACK PAIN: Does low back increase as you age? Has it increased for humanity over the decades?
by Paul Ingraham in SaveYourself
Nearly everyone assumes that back pain increases with age because backs hurt as they start to “degenerate.” In fact, studies of low back pain have contradicted this over and over again. Although certain types of back pain are relatively absent in the young and become increasingly common with age, it doesn’t affect the overall trend: most back pain occurs in middle age, and then either declines or levels off in the last third of life — exactly the opposite of what you’d expect if b........ Read more »
Harkness EF, Macfarlane GJ, Silman AJ, & McBeth J. (2005) Is musculoskeletal pain more common now than 40 years ago?: Two population-based cross-sectional studies. Rheumatology (Oxford, England), 44(7), 890-5. PMID: 15784630
- January 12, 2011
- 10:00 AM
- 677 views
RUNNING: Great free tool to calculate how fast you can run a marathon without hitting the wall
by Paul Ingraham in SaveYourself
This item is for the runners: a formula that tells you exactly how fast to run to avoid hitting “the wall.” Just plug in some information about yourself … and get back the Holy Grail of marathoning.
“The” wall is the point in a race when your carbohydrate reserves are exhausted, and about 40% of racers hit it — despite the fact that it’s what every marathoner most wants to avoid. It doesn’t have to be that way, says Ben Rapoport, an MD student at Harvard Medical School, a Ph........ Read more »
Rapoport BI. (2010) Metabolic factors limiting performance in marathon runners. PLoS computational biology, 6(10). PMID: 20975938
- July 27, 2010
- 11:00 AM
- 517 views
LOW BACK PAIN: Can low back pain be treated with hope?
by Paul Ingraham in SaveYourself
My short answer is: yes, and I call it “the confidence cure” (see The Mind Game In Low Back Pain). But it’s a deliciously complex subject. Steve Kamper writing for Body in Mind raises a number of good questions:
… just pump up the expectation volume and you get extra bang for your treatment buck. But what if the expectation effect is all you are getting?
A nice little read for therapists.
Steve Kamper for Body In Mind: What did you expect? Hands-up who thinks a patient’s........ Read more »
[1] Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, & Miller FG. (2008) Prescribing "placebo treatments": results of national survey of US internists and rheumatologists. BMJ (Clinical research ed.). PMID: 18948346
[2] Amanzio M, Pollo A, Maggi G, & Benedetti F. (2001) Response variability to analgesics: a role for non-specific activation of endogenous opioids. Pain, 90(3), 205-15. PMID: 11207392
[3] Machado LA, Kamper SJ, Herbert RD, Maher CG, & McAuley JH. (2009) Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials. Rheumatology (Oxford, England), 48(5), 520-7. PMID: 19109315
[6] Nunn, R. (2009) It's time to put the placebo out of our misery. BMJ, 338(apr20 2). DOI: 10.1136/bmj.b1568
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