Shoulder Pain Treatment

Shoulder and back pain can be closely related - sometimes one leads to another and sometimes the two share a common source related to nerve entrapment.

The shoulder joint and all of its muscles and soft tissues are derived from the same part of the embryo as the fifth vertebra and nerve of the neck. This means that lower neck pain and shoulder area pain can be directly related.

Sometimes shoulder pain and back pain between the shoulder blades can also occur. Irritation of the lower segments of the neck will typically send pain down into the area between the shoulder blades - this pain is called referred pain. It is often dull and aching in quality and made worse by movements of the neck. This type of shoulder related back pain often causes trigger points to form in the muscles and these can be felt as acutely tender spots.

Labels: back pain, frozen shoulder, pain control, shoulder and back pain, shoulder blade, shoulder nerve, shoulder pain

Back pain due to cancer is very rare - that's the good news - but it does happen and it's very important for both doctors and their patients to be aware of the warning signs.

A recent article published in the European Spine Journal highlights the most important issues.

The researchers looked at all published studies covering issues related to back pain and cancer.

Six studies evaluating 22 different clinical features and tests were identified.

Malignant cancer as a cause of back pain is rare - the scientists in this study foun rates between one in a thousand cases and, at most in some groups of patients, three in a hundred.

Features that acted as major warning signs or red flags for cancer were

• A previous history of cancer
• A high ESR blood test
• A reduced hematocrit blood test
• And overall clinician judgement

A combination of age more than 50 years, a previous history of cancer, unexplained weight loss, and failure to improve after 1 month were highly worrying features.

The authors emphasised that malignancy is rare as a cause of low back pain. The most useful features and tests are a previous history of cancer, elevated ESR, reduced hematocrit, and clinician judgement.

I'll say again here what I've said many, many times before .... if you are concerned about a persistent back ache then go see your doctor. Now please !

Labels: back pain, cancer, joint pain, red flag signs

Surgery for Back Pain

Should you have an operation for chronic back pain?

The majority of those with chronic back pain will get better or find pain relief without surgery but new research shows that an operation may speed recovery for some

The New England Journal of Medicine have published new research to compare surgery with the simple passing of time for people with severe back pain. Those in the study mainly were known to have a slipped or herniated disc or sciatica

A spine specialist in Holland looked at 283 patients who had suffered from sciatica for at least six weeks before the study began. He found that 95 per cent of patients reported recovery after one year, whether or not they had surgery.

But about 40 per cent of the participants assigned to conservative wait-and-see care also opted for surgery, which seemed to relieve symptoms more quickly than would otherwise have been expected.World recognised spine expert: Richard Deyo of the University of Washington in Seattle - said in a journal editorial

"For patients with persistent sciatica, there seems to be a reasonable choice between surgical and nonsurgical treatment, which may be influenced by aversion to surgical risks, the severity of symptoms, and willingness to wait for spontaneous healing,".

Most experts agree that surgery should only be considered an option if the pain has persisted for at least six weeks .

Labels: arthritis, back pain, joint pain, pain control