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Jensen et al (2018) conducted a latent class analysis of six subgroups of longitudinal data of 412 low back imaging findings in pain free subjects describing two pathways of increasing degeneration on upper (L1-L3) and lower (L4-L5) lumbar levels. An association with LBP was found for the subgroups describing severe and multiple degenerative MRI findings at the lower lumbar levels but none of the other subgroups were associated with LBP.
As with Lam's work showing strong correlations between discography and Pfirmann grading on imaging as we understand more MRIs will become increasingly valuable.
bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-018-1978-x#Sec2
bmcmusculoskeletdisord.biomedcentral.com
Research into the clinical importance of spinal MRI findings in patients with low back pain (LBP) has primarily focused on single imaging findings, such as Modic changes or disc degeneration, and found only weak associations with the presence of pain. However, numerous MRI findings almost always co-...Olive Oil
Olive oil has potent anti-nociceptive, anti-inflammatory and anti-oxidant properties. Olives contain Decarboxymethyl-aglycone ligstroside or oleocanthal, a phenolic compound that mimics the inhibitory action of cyclooxygenase (COX) by the NSAID ibuprofen, as a natural NSAID (Beauchamp et al 2005). Takeda et al (2013) showed olive oil to be effective in reducing VAS scores in patients with early stage knee osteoarthritis. Extracts from the leaves have been investigated with the n-hexane extract displayed 12.7–27·8 % inhibition on the carrageenan-induced hind paw oedema model at the 400 mg/kg dose (Süntar et al 2010).
References
Beauchamp, G.K., Keast, R.S., Morel, D., Lin, J., Pika, J., Han, Q., Lee, C.H., Smith, A.B. and Breslin, P.A., 2005. Phytochemistry: ibuprofen-like activity in extra-virgin olive oil. Nature, 437(7055), p.45.
Süntar, İ.P., Akkol, E.K. and Baykal, T., 2010. Assessment of anti-inflammatory and antinociceptive activities of Olea europaea L. Journal of medicinal food, 13(2), pp.352-356.
Takeda, R., Koike, T., Taniguchi, I. and Tanaka, K., 2013. Double-blind placebo-controlled trial of hydroxytyrosol of Olea europaea on pain in gonarthrosis. Phytomedicine, 20(10), pp.861-864.
Plant Based Diet
Towery et al (2018) reduced pain and increased function in 14 subjects with chronic musculoskeletal pain with an 8-week plant based diet intervention. 20 subjects started and only 14 finished the trial. Numeric Pain Rating Scale (NPRS) and the Short Form Health Survey (SF-36) were measured. A registered dietitian nutritionist provided a sample menu cycle and education on a plant-based diet. Subjects utilized a phone app to log food intake and to receive support from the dietitian. Diet adherence by ten of fourteen subjects was 89% based on completion of food intake records and adherence to allowed foods. Thus even with these results, adherence was poor and thus quite likely there is potential for even greater improvement if adherence can be improved.
References
Towery, P., Guffey, J.S., Doerflein, C., Stroup, K., Saucedo, S. and Taylor, J., 2018. Chronic musculoskeletal pain and function improve with a plant-based diet. Complementary therapies in medicine, 40, pp.64-69.
Last weekend I attended @greglehman's excellent course on reconciling pain science with biomechanics. I really feel he presented the importance of biomechanics about right. There are obviously many factors that come in to play but where we know biomechanics are important we should address them, where we are unsure we can focus more on other factors we know can help within a bio-psycho-social framework. www.greglehman.ca/
greglehman.ca
This 2-day course is geared toward the health care provider and fitness professional. With emerging research there is often the feeling that a traditional approach needs to be wholly discarded. Instead, this course helps the therapist to integrate thepain science and biopsychosocial model of pai...Axoplasmic Transport
Dilley and Bove (2008b) showed that axonal transport disruption without inflammation or degeneration also leads to axonal mechanical sensitivity but does not cause ongoing activity at the time point when axonal mechanical sensitivity occurs, despite causing cutaneous hypersensitivity.
Local nerve inflammation, known as neuritis leads to ongoing activity and axonal mechanical sensitivity along intact nociceptor axons and disrupts axonal transport. Satkeviciute et al (2018) suggest this phenomenon forms the most feasible cause of radiating pain, such as sciatica.
Satkeviciute et al (2018) present the time course of ongoing activity from primary sensory neurons following neuritis and vinblastine-induced axonal transport disruption. Whereas 24% of C/slow Aδ-fiber neurons had ongoing activity during neuritis, few (<10%) A- and C-fiber neurons showed ongoing activity 1–15 days following vinblastine treatment. In contrast, axonal mechanical sensitivty increased transiently at the vinblastine treatment site, peaking on days 4–5 (28% of C/slow Aδ-fiber neurons) and resolved by day 15. Conduction velocities were slowed in all groups.