Spinal manipulative therapy (SMT) has significant but very small benefits for patients with chronic low back pain, according to a special review article in the June 1 issue of Spine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. "High-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with low back pain, " concludes the report. The lead author was Sidney M. Rubinstein of VU University Medical Center, Amsterdam. Updated Review Assembles Data from 26 Clinical Trials The researchers performed a comprehensive review of the medical research literature to identify randomized controlled trials-the most reliable type of scientific study-of SMT for adult patients with chronic low back pain.
A study introduced at SNM's 58th Annual Meeting shows potential relief for patients who suffer chronic pain after back surgery. A molecular imaging procedure that combines functional and anatomical information about the body is able to zero in on the site of abnormal bone reaction and provide more accurate diagnoses and appropriate pain management for patients who have received hardware implants or bone grafts. "With PET/CT we can pinpoint the exact screw or rod that was loose or failing. We can help doctors and patients accurately decide whether surgical and nonsurgical treatment is the best option, " says Andrew Quon, MD, assistant professor of radiology and chief of clinical PET/CT for the molecular imaging program at Stanford University, Stanford, Calif. "This eliminates unnecessary or erroneous hardware replacement surgeries and provides a surgical map for patients who need further operations to treat their chronic pain.
Duke University and University of North Carolina (UNC) researchers report in the November issue of Arthritis Care & Research that narcotics and diagnostic testing are overused in treating chronic neck pain. Their findings indicate clinicians may overlook more effective treatments for neck pain, such as therapeutic exercise. According to reviews cited in the study, evidence to support the effectiveness of therapeutic exercise in treating chronic neck pain is good, yet only 53% of subjects were prescribed such exercise. This information was based upon reported data from a representative sample of North Carolina residents. Prior studies point out that neck pain affects 30%-50% of adults in the general population in any given year, and roughly 50%-85% of those patients do not find their symptoms completely resolve, with some experiencing chronic, impairing pain.
Eli Lilly and Company (NYSE: LLY) announced that the U.S. Food and Drug Administration (FDA) has approved Cymbalta ® (duloxetine HCl) for the management of chronic musculoskeletal pain. This has been established in studies in patients with chronic low back pain and chronic pain due to osteoarthritis. This is the fifth indication the FDA has approved for Cymbalta. Cymbalta, which has been shown to significantly reduce chronic low back pain and chronic pain due to osteoarthritis, is a non-narcotic pain reliever that is meant to be taken once a day, every day by people with these pain conditions. "People with chronic musculoskeletal pain often struggle to find a medication that works for them. The approval of Cymbalta for chronic musculoskeletal pain by the FDA gives doctors another option to help an underserved and suffering group of patients, " said Michael Clark, M.
The U.S. Food and Drug Administration approved Cymbalta (duloxetine hydrochloride) to treat chronic musculoskeletal pain, including discomfort from osteoarthritis and chronic lower back pain. Cymbalta was first used to treat major depressive disorder in 2004. "Up to three quarters of the population experience chronic pain at some time in their lives, " said Janet Woodcock, M.D., director of FDA's Center for Drug Evaluation and Research. "This approval means that many of those people now have another treatment option." Since its initial approval, about 30 million patients in the United States have used Cymbalta. It was approved for the treatment of diabetic peripheral neuropathy in 2004; generalized anxiety disorder and maintenance treatment of major depression in 2007; and fibromyalgia in 2008.