The article in the European Spine Journal highlights a major difficulty in assessing the effectiveness of various back pain treatments. No two studies used the same criteria to measure improvement. The lack of uniformity appears to be present in every aspect of the enigma of low back pain. Recent studies demonstrated that the tests a family physician uses to establish probability of a disc herniation may not be valid. There are inconsistent criteria for fusion vs. a simple laminectomy or foraminotomy for back pain.

June 24, 2010 - 9:49am — Posted by Dr. Norman Marcus

I just read an article on the under treatment of chronic pain with the most common associated disease states listed as osteoarthritis, rheumatoid arthritis, fibromyalgia, and sickle–cell anemia. Since physical deconditioning is fraught with many serious negative consequences, such as obesity, high blood pressure, stroke, heart disease and diabetes in addition to be being a cause of most common pain problems, it should probably rank as a form of disease.

May 25, 2010 - 5:53pm — Posted by Dr. Norman Marcus

I saw a 60 year old artist who had been complaining of neck pain for 2 months. The pain began without any accident and had been getting worse. He had problems moving his neck, especially extending it backwards, and found that wearing a soft collar prevented movement and diminished his pain.  The only way he could exercise on his stationary bike was to use the collar.  He was taking anti-inflammatory medication but it wasn’t helping.

May 21, 2010 - 6:02am — Posted by Dr. Norman Marcus