Treat Osteoporosis, Save Your Hips
November 12th, 2008
A new study shows that aggressive screening and treatment of osteoporosis can help to prevent hip fractures. The researchers claim that their three step approach could help cut hip fractures by up to 25%.
The first step was performing a bone scan. Researchers performed bone scans on all female patients over the age of 65, all male patients over the age of 70, all patients over 50 with a history of fragility fractures, and various other patients on high doses of certain drugs.
The second step involved osteoporosis education and treatment. Patients received prescription drugs for their bones, along with home visits to check safety and help prevent future falls.
The third step focused on fall prevention. Patients were treated through fall-prevention programs that involved physical therapy, among other things.
More than 620,000 patients were observed over a four year period (2002-2006). The results revealed that hip fractures dropped by 37% overall, disproving the need for experimental drugs and radical treatments.
However, according to the study team, what was required was an integrated, aggressive approach by the patient’s healthcare team. As noted in the November 2008 issue of The Journal of Bone & Joint Surgery, “The first step must be a more active role by orthopaedic surgeons in osteoporosis disease management.”
If you suspect you are at risk for or might have a bone fracture or osteoporosis, here are some resources and additional reading you can print out and take to your doctor to discuss:
Osteoporosis Diagnosis: http://www.spine-health.com/conditions/osteoporosis/osteoporosis-diagnosis
Osteoporosis: Fracture Symptoms: http://www.spine-health.com/conditions/osteoporosis/osteoporosis-fracture-symptoms
By Sylvia Marten
Sources:
Orthopaedic Management Improves the Rate of Early Osteoporosis Treatment After Hip Fracture – Journal of Bone & Joint Surgery - http://www.ejbjs.org/cgi/content/abstract/90/11/2346
Additional Reading:
Osteoporosis: 4 Proven Steps to Prevent Osteoporosis Fractures
The Truth about Medical Tourism: Overhyped or Rapidly Growing?
There has been a great deal of focus on medical tourism in the media recently. Stories and accounts of medical tourism claim that it gives patients significant savings and suggest that the number of patients seeking overseas treatment is growing rapidly. According to these accounts, the most popular destinations for spine surgery include Delhi, Chennai, Mumbai and Bangalore (all in India), where patients can enjoy a beautiful, relaxing post-surgery vacation. But as it turns out, the hype surrounding this phenomenon may be overstating the popularity of medical tourism.
Patients from the U.S. and other developed countries only make up a small portion of medical tourists; most of these people come to industrialized nations from developing countries seeking better quality treatment. A survey was conducted within a 50,000 patient sample and results showed that:
- 40% of patients traveled for access and treatment using the most advanced technology available
- 32% traveled to obtain better quality care
- 15% traveled for quicker access to a procedure. This is especially significant for countries such as Canada and the U.K., where a patient can be on a waiting list for as long as two years
- Only 13% of all patients surveyed traveled abroad for cost-saving reasons
Collecting comprehensive data on the subject is difficult because there is no consistent definition of medical tourism. The representation of the survey results is likely flawed because only a handful of facilities were observed, and the only procedures considered were those that required hospital admission. In reality, much of the medical tourism industry lies in cosmetic procedures and dental care, which are typically not performed in hospitals.
Most Americans seeking overseas care are uninsured. Although there is potential for cost-saving through medical tourism, about 80% of procedures are more cost-effective in the U.S. once the patient’s insurance coverage is factored in.
by Ben Parr
Sources:
Health Point Capital - Despite the Hype, Few Go Abroad for Medical Care
Wall Street Journal - Medical Tourism is Still Small
Additional Reading:
2) 29 Best Travel Tips for Your Aching Back
3) Traveling Doesn't Have to Be a Pain in the Neck! - Patients' Advice
Doctors are Using Placebos More: About Half Prescribe Placebos, 60% Believe It's Ethically Acceptable
By: Ben Parr
October 24th, 2008
A new survey published in the British Medical Journal has uncovered some very interesting data on how physicians view and use placebos.
1200 practicing internists and rheumatologists in the United States were surveyed. Of those 1200, 679 doctors responded, and the results have created some talk amongst the news. Here are some of the most interesting information the survey uncovered:
- 62% of physicians believe that the practice of prescribing a placebo (giving a patient a treatment that has no theraputic benefit while allowing the patient to believe there is one) is ethically permissible.
- When prescribing placebos, doctors usually give a patient over the counter analgesics (41%), vitamins (38%), and sometimes antibiotics or sedatives (13% each)
- Doctors usually describe the placebo as potentially beneficial medicine or a treatment not usually associated with their condition (68%)
- Only 5% of physicians explicitly describe them as placebos
The numbers are surprising for a lot of people. Some doctors believe that this is not a cause for alarm - patients may feel better "taken care of" or may receive other benefits from vitamins or analgesics. Others physicians have voiced concern that prescribing sedatives or antibiotics can have unintended consequences to patients.
Regardless, this survey may be highlighting a new trend in health.
Posted by: Ben Parr
Source: Prescribing "placebo treatments": results of national survey of US internists and rheumatologists, British Medical Journal, 23 October 2008.
Additional Reading:
1) NSAIDs: Non-Steroidal Anti-Inflammatory Drugs
2) Analgesics
Osteoporosis Needs to Be Treated after a Spine Fracture
By: Stephanie Burke
October 23rd, 2008
More than 10 million Americans aged 50 and older suffer from osteoporosis, a degenerative bone disease caused by decreased bone density. Originally thought to be a women’s disease, it is now known that 30% of sufferers are men.
Osteoporosis is one of the leading causes of vertebral compression fractures (VCF), which will affect more than 50% of women and 30% of men during their lifetime. Oftentimes, doctors will treat the fracture without identifying or treating this underlying cause. A previous fracture is the greatest risk factor for a new fracture; studies show that the rate of refracture after osteoporosis-related vertebral fractures is 20% within the first year. This underscores the need for timely diagnosis and treatment.
A retrospective study was conducted in which the 2002 medical records of 156 patients (average age: 77.3) were obtained from a large military health-care system. All patients sampled were 50 years or older and had previously sustained a vertebral compression fracture. The purpose of the study was to determine the proportion of patients followed up with osteoporosis interventions within one year of being treated for their spine fracture.
Overall, The Percentage of Patients Receiving Osteoporosis Treatment is Low
The study found that one year after sustaining a vertebral compression fracture, a relatively low percentage of patients were being treated for osteoporosis - the underlying cause of the fracture.
- 28% (vs. 6-7 previously) of patients not previously being treated for osteoporosis were started on a new active osteoporosis medication
- 35% (vs. 15% previously) were started on any new medication for the treatment of osteoporosis
While this study demonstrates a general trend toward increased diagnosis and treatment, these numbers are still less than ideal.
Osteoporosis Undertreated in Men
Another finding was that significantly lower rates of interventions were prescribed to males who had sustained an osteoporosis-related spine fracture. The risk of subsequent fractures, especially in the spine, is almost double in males than females, suggesting that osteoporosis treatment after a vertebral compression fracture is even more critical in males.
Posted by: Stephanie Burke
Source: The Spine Journal, September/October 2008. Official Journal of the North American Spine Journal
Additional reading:
2) When is Back Pain a Fracture?
3) Osteoporosis: 4 Proven Steps to Prevent Osteoporosis Fractures
5) Kyphoplasty: Osteoporosis Fracture Treatment
6) Definitive Guide to Osteoporosis
Announcing New and Up-To-Date Video and Spine Surgery Directories
By: Ben Parr, Spine-Health.com Interactive Content Manager
September 25th, 2008
Hello everyone!
The Spine-Health.com team has been hard at work creating a better and simpler experience for all of our users. Since last year we've switched to newer and smarter technology that allows us to expand our content, speed up the site, and improve our navigation. To that end we're launching a series of new directories for our doctor-written, doctor-reviewed content, including our articles and videos.
First, we have launched an updated video directory. This directory divides our video content into categories. Our primary categories include:
- A complete listing of our videos
- Interactive Anatomy Videos
- Videos On Pain Conditions
- Videos on Back and Neck Surgery
- Videos on Pain Treatment Options
We have also created a new directory for the main types of back, neck, and spine surgery we cover. It includes (but is not limited to) the following:
- A full listing of our back surgery articles
- Decompression Surgery
- Spinal Fusion
- Instrumentation
- Kyphoplasty
- Laminectomy
- Lumbar Spine Surgery
- Minimally Invasive Surgery
- Neck Surgery
- Spine Surgeons
- Surgery Recovery/Postoperative Care
- Vertebroplasty
In the coming days and weeks, we will be adding many more directories to Spine-Health.com to make it easier to find the content you are searching for, or to make browsing the vast, 2000+ pieces of doctor-written content that we have on our site an easier process.
So watch out for new content, new features, and new updates every week on the Spine-Health.com Blog (we've also updated our blog interface) and the Spine-Health.com Pain Forums and Message Boards.
If you have questions, issues, or suggestions about the site's content, interface, layout, or message boards, you are welcome to email me at bparr@spine-health.com- Ben Parr, Spine-Health.com Interactive Content Manager
5 Easy Tips For Keeping the Entire Family Healthy for Back-to-School
By: Jay Triano, DC, PhD
September 10th, 2008
It's back-to-school time, and that means trips to school, scraped knees, books, back packs, and school sports. The activity can be great for you and the kids, but heavy back packs and bad posture can hurt your kids and their backs.
So here are 5 Easy Tips that will help keep the entire family healthy for back-to-school:
Find a good back pack! A good pack is light, snug and comfortable to wear. It should be made of vinyl or canvas, with two wide padded shoulder straps and a waist strap. All straps should be used and adjusted so that the pack is snug against the wearer’s back and not “falling away” from the body.
A quality back pack is only as good as the way it is packed! Make sure the heaviest objects are close to the body and any bumpy, odd-shaped objects are placed on the outside, away from the back.
Moving your kids into their college dorm room or new apartment? Lifting heavy boxes can give you back pain. Be sure to label your boxes so that helpers know what can be found inside and how heavy they will be. Tape the boxes so that they are sturdy and the contents do not shift while being handled.
Before lifting, make sure that you have balanced footing and good grip (boxes with handles are ideal).
Face your work. Stand so that your nose, hips and toes are facing forward. Keep the object as close to your body as possible and bend from the hips and knees.
Hit the books but help your back! When you are studying or reading, use a book stand so that your book is at eye level. This will reduce the amount of strain on your neck and shoulders from having your book lay flat. It also has the added bonus of giving you extra desk space!
Returning back to school sports after some time off during the summer? Remember that your body may not have done that sport in awhile and will need extra time to warm up.
Be sure to warm up for a minimum of 10-15 minutes before playing. The warm up should involve simple movements that “simulate” your sport and get the heart rate up. Always stretch after your sport.
Sitting in class with good posture will reduce the strain on your neck, shoulders and low back. It will also help keep you attentive during class! Sit with your shoulders back, chin tucked in and a gentle "C curve" in your low back. Don't arch your lower back or slump forward. Your ears, shoulders and hips should be in a straight line. Make use of your breaks! Between classes stand up, walk around and stretch.
Watch Your Back!
Do you sit in front of a computer nearly every day? Then you need to watch this important video to learn helpful ergonomic tips to protect your back!
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Also share and favorite this video on YouTube
Additional Reading
Office Chair: Choosing the Right Ergonomic Office Chair
Office Chair: How to Reduce Back Pain?
Ten Tips for Improving Posture and Ergonomics
Move More, Sleep Better and Longer
(Spine-Health.com) -- New research presented at the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS) shows that “an acute session of moderate aerobic exercise, but not heavy aerobic or moderate strength exercises” can improve the amount and quality of sleep for people with insomnia (without resorting to pharmaceutical sleep-aids).
What exactly does "acute" mean in this context? Merriam-Webster defines acute as “having a sudden onset, sharp rise, and short course”, so “moderate, but not heavy, aerobic exercise” is like a brisk 20-30 minute walk.
In this new research, 36 patients, all with primary chronic insomnia, were divided into four groups:
- Moderate aerobic exercise (e.g. walking)
- Intense aerobic exercise (e.g. running)
- Moderate strength exercise (e.g. pilates)
- A control group (no exercise)
Of the above 4 groups, the moderate aerobic exercise group (exercise walking) showed the most sleep improvements:
- 54% reduction in time it takes to fall asleep
- 36% less awake time during the night
- 37% increase in total sleep time
These findings highlight the importance of moderate physical exercise to help treat insomnia.
In general, about 30 percent of adults are thought to have symptoms of insomnia. It is more common among elderly people, women, and those suffering from a pain condition.
Source: American Academy of Sleep Medicine, http://www.aasmnet.org/Articles.aspx?id=926Scoliosis Awareness Month
An estimated 6 million people in the United States have some form of scoliosis, and it affects people of all races, ages and socio-economic classes. Scoliosis is not a disease. It is the term used to describe an abnormal, lateral (side-to-side) curvature of the spine. The onset of scoliosis is usually between 10 and 15 years of age (around the time of an adolescent's big growth spurt). While some cases of scoliosis have an identifiable cause (like congenital spine deformities, cerebral palsy or spina bifida), more than 80% of the cases diagnosed are idiopathic, which means there is no known cause.
Why it's important to be aware of scoliosis.
Catching the beginning of scoliosis in children and teenagers ensures the most options for treating the curvature and slowing or stopping the progression. Children's bones are not yet fully hardened, so non-surgical treatments like bracing are frequently employed -- to not only attempt to correct existing abnormalities, but in severe cases to delay the need for surgery until the child is older.
How do you check for scoliosis and what are the signs?
Most students are given the Adam’s forward bend test routinely in school when they are in fifth and/or sixth grade to determine whether or not they may have scoliosis. The test involves the student bending forward with arms stretched downward toward the floor and knees straight, while being observed by a health care professional. This angle most clearly shows any asymmetry in the spine and/or trunk of the adolescent’s body. The health care professional is looking for abnormal appearance in the spine, hips and shoulders, specifically:
- A hump or uneven appearance in the rib cage.
- Any lateral deviation in the spine (asymmetry).
- Shoulders at different heights.
- One hip more prominent than the other.
What should you do if you suspect you or your child has scoliosis?
Make an appointment to be evaluated by a physician. If a visual/external exam indicates an abnormal spinal curve, the doctor will probably order an x-ray or, if the patient is a child under the age of 11, an MRI to determine the degree of the curvature. A lateral spinal curve greater than 25-30 degrees is considered significant. A curve greater than 45 degrees is severe and requires aggressive treatment.
Want to learn more?
Read more about scoliosis, its causes and treatment options in the Spine-Health.com Scoliosis.
Spine-health launches new Web site design
Spine-health is very pleased to announce the release of our newly designed Web site. In February, we launched part one of our new site focusing heavily on the behind-the-scenes technology platform to enable dynamic content serving, increase site speed, and other enhancements. Today’s release marks the first wave of usability enhancements – new design, new functionality and enhanced navigation. Go ahead and take it for a test drive. The Spine-health library of more than 2,000 doctor written and reviewed articles is now even easier to search and navigate, and we have made important upgrades to our popular Pain Blog, Chats, and Message Boards to improve the user experience for our 10,000+ registered members and regular contributors.
On Spine-health, you won’t find a few articles on a wide range of topics. Our focus and our passion is providing the most in-depth and trusted content on the Web specifically about pain topics like: back pain, chronic pain, arthritis, osteoporosis, spinal stenosis and their co-morbidities such as depression, stress and sleep problems.
Please email us at admin@spine-health.com with your comments on what you like and your suggestions on how to better improve the site. Keep looking, as there will be a lot more to follow in the coming months.
Have a great day!
Stephanie Burke
CEO, Spine-health
