For Back Pain, Steroid Shots No More Effective Than Placebo

Posted on May 2, 2012 by PHB Communications

A randomized trial of steroid injections for back pain has shown that they are no more effective than a placebo.
Because the long-term benefits of surgery remain unproven and pain medicines often have serious side effects, doctors have increasingly turned to steroid injections to treat lumbosacral radiculopathy, a common cause of back pain. The condition stems from damage to the discs between the vertebrae that often leads to sciatica, numbness or pain in the legs. Read more

Epidural Steroids, Etanercept, or Saline in Subacute Sciatica, A Multicenter, Randomized Trial

Posted on May 1, 2012 by PHB Communications

Authors: Steven P. Cohen, MD; Ronald L. White, MD; Connie Kurihara, RN; Thomas M. Larkin, MD; Audrey Chang, PhD; Scott R. Griffith, MD; Christopher Gilligan, MD; Ralph Larkin, PhD; Benny Morlando, RN; Paul F. Pasquina, MD; Tony L. Yaksh, PhD; and Conner Nguyen, MD

The objective of this study, published in the March issue of Annals of Internal Medicine, was to evaluate whether epidural steroids, etanercept, or saline better improves pain and function in adults with lumbosacral radiculopathy.

Researchers concluded that epidural steroid injections may provide modest short-term pain relief for some adults with lumbosacral radiculopathy, but larger studies with longer follow-up are needed to confirm their benefits. Abstract and comments

The Effect of Lumbar Extension Training with and without Pelvic Stabilization on Lumbar Strength and Low Back Pain

Posted on February 25, 2012 by Jim Evanger

This article in The Journal of Back and Musculoskeletal Rehabilitation published by IOS Press discusses the effect of lumbar extension training with and without pelvic stabilization on lumbar strength and low back pain. For more information, or to order the article click here.

Authors

Dave Smith¹, Gary Bissell², Stewart Bruce-Low³, Caroline Wakefield⁴

¹Department of Exercise and Sport Science, Manchester Metropolitan University, UK
²ProPhysio Spinal and Sport Injury Clinic, UK
³Centre for Health, Exercise and Sport Science, Southampton Solent University, UK
⁴Department of Sport and Exercise Science, University of Chester, UK

Abstract

Introduction: A dynamometer employing a stabilization procedure (lumbar extension machine, MedX, Ocala, FL) is effective in improving strength and reducing symptoms of low back pain (LBP), and researchers have hypothesized that this effectiveness is due to the pelvic stabilization. However, effects of the dynamometer with and without pelvic stabilization on LBP have not been compared: This was the aim of the present study.

Methods: Forty-two chronic LBP patients were randomly assigned to a lumbar extension training with pelvic stabilization group (STAB; n=15), a lumbar extension without pelvic stabilization group (NO-STAB; n=15) and a control group (n=12). STAB and NO-STAB participants completed one weekly session of dynamic variable resistance exercise (one set of 8–12 repetitions to fatigue) on the lumbar extension machine (with or without pelvic stabilization) for 12 weeks. Pre- and post-test measures of self-reported LBP (101-point visual analog scale; pre-test mean of 25), related disability (Oswestry disability index; pre-test mean of 34) and lumbar strength were taken.

Results: After the exercise program, the STAB group increased significantly in lumbar strength at all joint angles, and decreased significantly in visual analogue and Oswestry scores. However, there were no significant changes in these variables in the NO-STAB and control groups.

Discussion: Isolated lumbar extension exercise is very effective in reducing LBP in chronic patients. However, when the pelvis is not stabilized, otherwise identical exercises appear ineffective in reducing LBP.