Monday, November 29, 2010

A Cure For Back Pain?



This title was used by Dr. Nicoli Bogduk in recent review of a very promising new treatment for chronic discogenic back pain (Bogduk, 2010). Dr. Bogduk ia  a prominent scientist from the University of Newcastle in Australia, well-known throughout the world for his pain research.


Dr. Bogduk described results from a new study by Dr. Baogan Peng (2010), documenting the success of a new treatment procedure for chronic discogenic back pain.


Here are some comments from Dr. Bogduk (2010):


"Peng et al. announced astounding results, unprecedented and unrivalled in the history of research into the treatment of chronic discogenic back pain."


"If the results of Peng et al. are true, this intervention will revolutionize the treatment of low back pain. Spinal surgery for back pain will be rendered obsolete."


Dr. Peng's treatment procedure involved a spinal injection of 1% methylene blue and 2% lignocaine. Results were evaluated in a scientifically rigorous, randomized placebo-controlled study, reported in the prestigious peer reviewed journal Pain. Their results showed that at 24 months, 19% of patients achieved complete relief, with 72% experiencing only slight pain and requiring no medication.


This study will need to be tested and repeated in other centres throughout the world. According to Dr.Bogduk, this will be relatively easy to do. In fact, his lab is already underway with another study of this promising new treatment.


Caution is in order, of course, along with much hope.  For the millions of people around the world who live every day in pain, sometimes hope is hard to find. Realistic hope even harder.


Congratulations to Dr. Peng and his colleagues. The scientists are very excited and that in itself is a huge accomplishment.


References


1. Bogduk N. A cure for back pain? Pain 2010: 149: 7-8.


2. Peng B, Panf X, Wu Y, Zhao C, Song X. A randomized placebo-controlled trial of interdiscal methylene blue injection for the treatment of chronic discogenic low back pain. Pain 2010: 149: 124-129.


Yours with care
Michael

Monday, November 1, 2010

Even Olympic Gold Medalists Struggle With Long-Term Pain

Tessa Virtue is " A beauty, and a (competitive) beast". This apt description comes from the headline of Rosie Dimanno's recent column in the Toronto Star (October 31, 2010, p. S3).


Yet, even a tough highly competitive superstar like Tessa Virtue can struggle with persistent pain. Even an Olympic Gold Medal winner.


What struck me from Dimano's article was how Ms. Virtue's struggle seemed very similar to what many of my patients go through in their fight with long-term pain. Here are some quotes from this article, in Ms. Virtue's own words.


"I wasn't admitting I was in pain because I thought, if i think I'm healthy, then maybe I will be.  That wasn't the case. Just to walk for 10 minutes was a struggle."


"I was told there was no reason for me to be in pain."


"At some point, you're thinking: suck it up, just do it. If there is no answer, then maybe I am just a baby."


According to Dimanno, Ms. Virtue was feeling a little embarrassed to complain since all of the experts were telling her she shouldn't have been feeing pain. She wondered if they were hinting that all of her pain was in her head.


How many of the millions of people who live every day in pain have felt like this? I'm betting almost everyone.


Ms. Virtue has now undergone a new surgery, in early October, to help solve this physical, not psychological, problem. We wish you well and thank you for your candor and bravery.


Yours with care
Michael