Booster Shots

Oddities, musings and news from the health world

Category: pain

Study finds that glucosamine is as good as placebo for chronic lower back pain

July 6, 2010 |  1:55 pm

Many people who suffer with lower back pain rely on glucosamine supplements for some relief. But does the stuff really work? A new study shows that glucosamine was no different from a placebo in treating lower back pain.

Hmeledkf The study, released Tuesday in the Journal of the American Medical Assn., was a large, double-blind, randomized placebo-controlled trial that included 250 adults with chronic lower back pain. It was conducted at the Oslo University Outpatient Clinic in Norway.

Chronic lower back pain plagues millions of people in the U.S., and treatments include physical therapy, medication and the use of glucosamine supplements. Glucosamine is naturally produced by the body and is found in healthy cartilage. Glucosamine supplements (usually combined with chondroitin) are typically taken for the pain and discomfort that accompanies osteoarthritis, because they are thought to restore cartilage and reduce inflammation.

Some studies have shown the supplement to be effective in treating some joint pain, but others show no benefit.

Among the participants in this study, half were randomly assigned to take 1,500 milligrams of glucosamine for six months, while the other half took a placebo for the same amount of time.

The participants were assessed at the beginning of the study and again at six weeks, three months, six months and one year. They were allowed to continue with their usual pain medication and therapies.

After six months, the test subjects were asked to rate their pain on a 24-point scale. At the beginning of the study, the glucosamine group's pain score was 9.2 on average, and the placebo group's was 9.7. After six months, pain decreased -- but by the same amount in both groups. The glucosamine and placebo groups’ pain scores were both 5.0. At one year, the glucosamine group's score was 4.8, while the placebo group's was 5.5. In both groups, about the same number of people continued to use analgesics and therapies during the trial.

Based on these results, the study authors concluded that recommending glucosamine to people with lower back pain wouldn't be a good idea. However, they added that more research is needed to see if glucosamine might work for some people with chronic lower back pain.

-- Jeannine Stein

Photo credit: Ken Hively / Los Angeles Times


Endometriosis and loss of work productivity are, hold on, connected

June 28, 2010 |  6:29 pm

Aleve In endometriosis, tissue that's supposed to grow inside the uterus instead begins to grow outside the uterus -- on the fallopian tubes, ovaries or elsewhere in the body, usually in the pelvic region but not always. And that tissue reacts as it ordinarily would to the body's hormonal changes -- thickening, then breaking down and bleeding, often worsening and causing scarring over time. You don't have to be familiar with the condition to see how this might cause pain.

Now researchers have found that, yes, such pain can lead to a loss of productivity at work.
 
"Duh," you might well, and justifiably, think if you're one of the estimated 5 million women in the U.S. who have the condition. (That number and other endometriosis facts can be found at womenshealth.gov.) But bear with us -- because the researchers also quantified that dent in productivity.

In what's touted as the first worldwide study of the condition's impact on society, researchers at the University of Oxford in the United Kingdom found that, among employed women, those with pelvic pain related to endometriosis reported 10 hours of lost work productivity per week, compared to seven hours for those with pelvic pain not traceable to endometriosis.

The endometriosis-and-productivity findings were announced Monday at the annual meeting of the European Society of Human Reproduction and Embryology. Here are other details on the endometriosis study, funded by the World Endometriosis Foundation.

Considering that the condition is still something of a mystery, that it's a leading cause of infertility and that women in the study, after reporting their first symptoms, went an average of seven years before being diagnosed ... well, beginning to quantify the effects -- obvious though they may seem at first glance -- can only be for the good.

Here's more basic endometriosis information, in the form of a pamphlet, from the American Congress of Obstetricians and Gynecologists.

And in other recent news from the meeting:

-- If you could put your biological clock on hold, would you?

-- A blood test may be an accurate way to predict menopause

Plus, more fertility research reported there.

-- Tami Dennis

Photo: Aleve and other over-the-counter pain medications are on often recommended to relieve the pain of endometriosis.  For many women, they don't help.

Credit: Getty Images


New Benadryl recall adds to consumers' headaches

June 17, 2010 | 11:09 am

The Food and Drug Administration and the maker of a wide range of over-the-counter medicines have announced a new addition to a wide-ranging recall of popular medicines that started in December. The latest recall urges consumers who may have purchased certain 100-count packages of Benadryl Allergy UltraTab tablets and 50-count packages of Extra-Strength Tylenol Rapid Release Gels to stop using these products and contact the manufacturer (either by logging on here or by calling 1-888-222-6036), about refund or replacement.

McNeil Consumer Products says these medications should have been included in the recalls issued in January, which were prompted by reports of a musty, moldy odor emanating from several of the company's products. 

Since the first and second rounds of recalls were announced in December and January -- affecting such products as Tylenol, Motrin, Benadryl and Rolaids -- McNeil Consumer Products says it has discovered the source of the unsettling odor: the breakdown of a product used on the wooden crates and pallets on which the products are transported and stored. "The risk of serious adverse medical events is remote," the company said in its notice of the latest addition to its recall list.

Do you want to be the first on your block to know when the FDA issues a product warning or recall? You can sign up for regular alerts, you know. (But better be ready to get a lot of e-mail!)

--Melissa Healy


More time with the computer and TV could mean more back pain and headaches for teens

June 9, 2010 | 12:42 pm

Teens and screens are often inseparable, but there could be a price to pay for all that time spent in front of the television and computer. A new study finds that, for adolescents, there may be an association between screen time and back pain and headaches.

L08mh1nc The study included 31,022 teens from Denmark, Finland, Iceland, Greenland and Norway who were part of the Health Behavior in School-Aged Children study. Teens reported how much time they spent playing computer-based or television-based games, how much time they spent on the computer and how much time they spent watching TV. They were also asked about the frequency of headaches, backaches and bouts of feeling low.

Researchers found a consistent but weak link between boys who reported having backaches weekly and those who said they spent more time using computers, watching television and playing computer games. For girls, a link was found between those who had headaches and who also said they spent more time on the computer and watching TV. The results held even when the researchers adjusted for levels of physical activity.

The study's authors think that the link between back and head pain and screen time might not be related to the kind of screen activity the teens were engaged in, but to the amount of time they spent doing it and how they sat or stood while screen-engaged.

"A rising prevalence of physical complaints such as back pain, neck and shoulder pain and headache has been reported for adolescent populations," Torbjorn Torsheim, the lead author of the study, said in a news release. "Parallel to this, adolescents are spending an increasing amount of time on screen-based activities, such as TV, computer games or other types of computer-based entertainment."

Copious amounts of screen time have also been associated with obesity in young people, as well as lower amounts of muscular fitness. Despite the findings in this study, the authors noted that longer studies are needed to better examine the relationship between time spent on computers and watching TV and physical ailments.

The study was released Tuesday in the journal BMC Public Health.

-- Jeannine Stein

Photo: Speding more time on the computer or watching TV could result in back pain and headaches for teens. Credit: Sam Yeh / AFP/Getty Images.


Stronger hips may mean less knee pain for runners

June 5, 2010 |  9:00 am

Knee pain is the bane of many runners, sometimes causing them to give up running altogether. But knee pain might be lessened by strengthening the hips, a new study finds.

L2jclznc The pilot study, presented yesterday at the annual meeting of the American College of Sports Medicine in Baltimore, tested nine female runners who had patellofemoral pain, which some refer to as runner's knee, although other athletes are not immune. The pain often feels like a dull ache around or under the kneecap.

All the runners entered the study with knee pain that was graded on a scale of 1 to 10 while the participants ran on a treadmill. At the beginning of the study all runners were at a pain level of 7. All took part in a six-week hip strengthening program that was guided by Indiana University researchers and included single-leg squats and exercises using resistance tubes. The control group, composed of four of the runners, took part in a six-week control period before starting the program.

After completing the exercises, both groups were at a pain level of 2 or lower. All runners also saw a significant increase in hip strength. According to the study, increased hip strength may have improved dynamic alignment while running, which in turn alleviated the pain. However, since there can be many contributors to knee pain, there could be other causes for the pain as well.

-Jeannine Stein

Photo: Many runners experience the pain of runner’s knee. Credit: Steve Bloom / Associated Press


Rodent of the Week: How acupuncture eases pain

June 4, 2010 |  1:00 pm

Rodent Acupuncture seems so mysterious. How can sticking needles into the body cause physical changes, such as pain or nausea relief or an enhanced immune system?

Researchers working on mice say they have a clue. They have identified a molecule, called adenosine, that seems to be involved in generating the physical effects seen in acupuncture. Adenosine is a natural substance known for helping to regulate sleep and for its anti-inflammatory properties. It also acts as a natural painkiller, developing in the body after an injury to stop nerve signals that are screaming "pain!" But scientists at the University of Rochester Medical Center found that the substance is also active in deeper tissues in the body that are affected by acupuncture.

In the experiment, researchers performed acupuncture on mice that had discomfort in one paw. The mice received a 30-minute acupuncture treatment at a point near the knee. The study showed that in mice with normal functioning levels of adenosine, acupuncture reduced pain by about two-thirds. During and after the treatment, the level of adenosine in the tissues near the needles was 24 times greater than before the treatment. But  the treatment had no effect on mice that lacked the adenosine receptor.

The researchers also tested the effects of a cancer drug called deoxycoformycin that makes it harder for the tissue to remove adenosine. Adding this drug significantly boosted the effects of the acupuncture.

"Acupuncture has been a mainstay of medical treatment in certain parts of the world for 4,000 years, but because it has not been understood completely, many people have remained skeptical," the lead author of the study, Maiken Nedergaard, a neuroscientist, said in a news release. "In this work, we provide information about one physical mechanism through which acupuncture reduces pain in the body."

The study was published online this week in the journal Nature Neuroscience.

-- Shari Roan

Photo credit: Advanced Cell Technology Inc.


Rodent of the Week: Is this mouse in pain?

May 14, 2010 |  1:00 pm

Rodent Animal research is critical to advancing medical knowledge. But no one wants our furry friends to suffer. A new study published earlier this week shows that mice, like humans, express pain with facial expressions and that a "mouse grimace scale" can help ensure that animals used in laboratory testing do not suffer.

In the study, published online in the journal Nature Methods, McGill University psychology professor Jeffry S. Mogil used five physical features, such as eye closing, nose and cheek bulges and ear and whisker positions, to track the severity of pain. The rodent coding system can be used by scientists to improve the lives of their research subjects. Moreover, a specific pain scale that researchers can follow could lead to better treatments for pain conditions in humans, said Mogil, an expert in using facial features in humans to assess pain.

Rodent models are vital to research on pain, but there have been few methods for measuring spontaneous pain in the animals, the researchers noted. "The ability to reliably and accurately detect pain, in real time, using facial expression might offer a unique and powerful scientific tool in addition to having obvious benefits for veterinary medicine," they wrote.

-- Shari Roan

Photo credit: Advanced Cell Technology Inc.


A little sugar IS good medicine for babies, study says

May 13, 2010 |  6:00 am

Mary Poppins was on to something: A spoonful of sugar really does help the medicine go down.

PoppinsActually, it takes only between a few drops and half a teaspoon to help take the sting out of immunizations, according to an analysis published online Thursday in Archives of Disease in Childhood.

Researchers from Canada, Australia and Brazil looked at 14 studies that compared the analgesic effects of sucrose (aka table sugar), glucose (the less-sweet component of sucrose) and water in infants who received shots. In 13 of the studies, a little something sweet seemed to help the babies, who were all between 1 and 12 months old.

Pooling the results of those studies, the researchers calculated that administration of either sucrose or glucose reduced crying time by 12 seconds. Sweeteners also made babies cry less often.

The researchers weren’t able to determine an optimal dose of sugar because the studies used different volumes, concentrations and types of sweeteners.None of the studies reported any adverse effects from the sugars.

Scientists had previously shown that sweet solutions relieve pain in newborns. Now pediatricians should extend the practice to babies up to 1 year of age, the researchers said.

-- Karen Kaplan

Photo: It actually takes less than a spoonful of sugar to help the medicine go down. Credit: Joan Marcus/Disney/CML


Acupuncture in the delivery room remains a prickly research topic

April 28, 2010 |  5:12 pm

Acupuncture has been practiced in labor and delivery rooms since the 1970s, but its efficacy has been hard to judge. Two studies released Wednesday provide more mixed results.

Baby The first report pooled data from 10 clinical trials in which some patients received acupuncture (sometimes in conjunction with traditional pain relievers) and others were treated with drugs. The trials were conducted in Europe, China and Iran, with varying results.

Some of the trials found that women who used acupuncture were able to get through labor with lower doses of Demerol or other pain-relieving drugs. But the researchers said they weren’t persuaded that the acupuncture needles deserved the credit.

“Our analyses show that the effects of acupuncture perceived by women are largely due to placebo,” study co-author Dr. Edzard Ernst of Peninsula Medical School in England said in a statement.

The study was published in BJOG: An International Journal of Obstetrics and Gynecology.

Meanwhile, an Iraqi anesthesiologist dealing with extreme shortages of medicine reported that acupuncture reduced the need for oxytocin during Caesarean-section deliveries at Baghdad's Red Crescent Hospital for Gynecology & Obstetrics.

Dr. Lazgeen Zcherky said shortages forced anesthesiologists to use a drug called halothane during C-sections, even though it is known to relax the uterus and can cause increased bleeding. To counteract the effects of halothane, Zcherky inserted acupuncture needles into women as soon as possible after their babies were delivered. Six needles were placed in the feet and ankles at points related to uterine bleeding (SP1 and SP6) and another related to uterine contraction (BL67).

Of 200 women who received acupuncture, 45% did not need any oxytocin to counteract uterine bleeding. Another 35% required two units of the drug, 18% needed two to five units, and only 2% needed more than that.

“Without acupuncture, it had been standard for the surgeon to ask for a minimum of 10 units of oxytocin,” Zcherky wrote. “He would have preferred 20, but this was simply not available except in problem cases.”

The report appears in Thursday’s edition of the journal Acupuncture in Medicine.

-- Karen Kaplan

Photo: Could acupuncture needles take some of the pain out of childbirth? Credit: Victor Drachev/AFP/Getty Images


OxyContin gets a safety makeover

April 7, 2010 |  9:42 am

Oxycontin The painkiller OxyContin can be plenty dangerous if you knowingly abuse it; but it has long posed real dangers of overdose, as well, to those who had little thought of getting high. Cutting a pill in half may sound like a swell way to get just a little relief on a day when that chronic pain problem isn't so bad. But oxycodone, the chemical name of this often-prescribed opioid painkiller, has traditionally been packaged in high doses meant to release slowly over time so they can be taken once or twice daily. Cutting such pills can release of a high dose of opioid medication into the system very fast, risking overdose.

With both sets of risk -- accidental overdose and abuse -- in mind, the Food and Drug Administration this week approved a new formulation for OxyContin. In its new form, OxyContin will be much harder to crush, cut, ground, chew or dissolve in liquid. It's hardly the answer to opioid addiction and abuse. But, said the physician in charge of the FDA's division of anesthesia and analgesic drugs, Dr. Bob Rappaport, "it is still a step in the right direction." 

OxyContin, introduced to the U.S. market in 1996, quickly became a drug of choice for abusers, and, along with related drugs such as Percocet, Vicodin and methadone, has dramatically driven up overdose rates in the United States. (Between 2004 and 2005 alone, there was a 17% increase in emergency department visits attributable to oxycodone abuse.) A recent report by the Substance Abuse and Mental Health Service Administration found that more than a half-million Americans began abusing OxyContin each year for the last several years. 

In approving the new formulation, the FDA has ordered the maker of OxyContin, Purdue Pharma, to conduct a post-marketing study  aimed at determining whether and by how much the new formulation reduces abuse and overdoses.

-- Melissa Healy

Photo: Painkiller OxyContin, shown at a drugstore in 2001; in its new form, it will be much harder to crush, cut or dissolve in liquid. Credit: Darren McCollester / Getty Images



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