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Newswise — Total Hip Replacement Relieves Low Back Pain
Source: Newswise & NASS
Total hip
replacement is one of the most successful operations in medicine, and
it may have an unanticipated benefit. According to a small study from
American and Israeli spine centers, the procedure can also relieve low
back pain and improve spinal functional limitations. Peleg Ben-Galim,
MD, and colleagues prospectively studied changes in hip and spine
symptoms and disability in 25 men and women (mean age 67 years). In
addition to expected improvements in hip pain and function, they noted
significant decreases in low back pain and Oswestry disability scores.
The study is among the first to demonstrate “the clinical benefits
total hip replacement has upon back pain,” suggested Ben-Galim, of
Baylor College of Medicine in Houston. For patients with problems in
both anatomic areas, the findings may help answer the common question,
“What should I treat first—the hip or the spine?”
Cervical Spine Degeneration No Impediment to Healthy Elders
Some
very elderly (over age 80) men and women who have degenerative cervical
spines suffer in pain while others report no symptoms or functional
impairment, according to Shunji Matsunaga, MD, PhD, and colleagues from
Kagoshima University in Japan. Scientists hope eventually to determine
what causes some degeneration to be painful and some to be painless.
The authors compared radiographic findings in 52 elderly patients who
reported neurological symptoms to findings in 50 “super healthy elders”
who had no neck pain and who led independent, healthy lives. There were
no differences between groups in disc degeneration and spur formation,
though the spinal canal diameter was significantly greater among
healthy elders. Healthy elders also had performed significantly more
exercise during their lifetimes. Radiographic evidence of degeneration
is common in healthy elderly with no symptoms and is not an indication
for intervention, conclude Matsunaga et al.
Spine MRI Abnormalities Rarely Cause Serious Low Back Pain
Patients
with a new episode of vexing back pain should not expect MR imaging to
provide a diagnostic explanation. Development of serious low back pain
is rarely marked by corresponding new and relevant structural changes,
according to a prospective study by NASS member Eugene Carragee, MD,
and colleagues at Stanford University and the University of Hawaii. The
authors took MR images of 200 patients who had a lifetime history of no
significant back problems but risk factors for future low back pain,
and followed them for five years. Only two of 51 patients (4%) who
developed serious low back pain had clinically significant MRI changes,
suggesting that the cause of the pain is rarely structural. “Common
degenerative findings are often interpreted as recent developments and
the probable anatomic cause of new symptoms,” according to Carragee et
al. Instead, suggests the new data, “Findings on MR imaging within 12
weeks of serious low back pain inception are highly unlikely to
represent new structural changes.”
About NASS
The
North American Spine Society (NASS) is a multidisciplinary organization
that advances quality spine care through education, research and
advocacy. NASS members are MDs, DOs and PhDs in 22 spine-related
specialties including orthopedics, neurosurgery, physiatry, pain
management and other disciplines. Nurse practitioners, physician’s
assistants, chiropractors, physical therapists, practice administrators
and other allied health care professionals involved in spine care are
also represented in NASS as affiliate members. For more information on
spine care or to find a spine specialist in your area, please contact
1-877-SPINE-DR or visit http://www.spine.org.
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