Spine-Pain

from The National Osteonecrosis Foundation and
The Center for Osteonecrosis Research and Education website

Osteonecrosis means death of bone which can occur from the loss of the blood supply or by some other means. It has been known by a number of other names including ischemic necrosis of bone, aseptic necrosis or avascular necrosis (AVN). AVN has been quite popular in its use because it is shorter to say and write. More recently the term ON (osteonecrosis) has been adopted.

Unfortunately many patients with ON have had the disease for quite some time before symptoms are present. The initial symptoms are usually felt during activity and include pain or aching in the affected joint. Symptoms usually begin slowly and may initially be sporadic. Sometimes, the pain may begin quite suddenly. As the disease progresses, the pain increases and is associated with stiffness and loss of motion of the involved joint. Limping becomes common. The hip is the most common joint affected, and the pain is usually felt in the groin.

There are no established pharmaceuticals (drugs) for the prevention or treatment of osteonecrosis. In order to treat the disease, we must first understand how the disease develops. In spite of considerable effort by researchers, we still do not know for sure what causes some forms of osteonecrosis (that is, the forms that are not a result of a fracture or radiation).

Bisphosphonates

Bisphosphonates are a class of drugs that have been used to treat osteoporosis – a disease that is characterized by a low bone mass. Recently, in an effort to reduce bone loss, one bisphosphonate - alendronate has been evaluated in 60 patients diagnosed with osteonecrosis of the hip10. All patients had symptomatic improvement at one year. Although the follow-up time ranged from three months to five years, only six patients (ten hips) progressed to the point of needing surgery. It is important to note that these patients were also instructed to avoid bearing weight on their affected hip. Recently, concern has been raised relating to a possible association between bisphosphonate therapy and an increased incidence of osteonecrosis of the jaw11,12. Further study is needed to clarify this possible complication.

http://www.nonf.org/nofbrochure/nonf-brochure.htm

Small fiber neuropathy is a relatively common disorder often associated with systemic conditions, such as diabetes, HIV, and vasculitis. Painful burning feet with diminished pain and temperature perception, and in some cases autonomic dysfunction, characterize this syndrome. Despite the magnitude of the symptoms there are few objective measures to identify and quantify these neuropathies. Skin biopsy and new immunohistochemical staining techniques have facilitated the evaluation of this syndrome.

Introduction. Peripheral neuropathies involve different populations of nerve fibers. Most patients present with large fiber neuropathies characterized by numbness, tingling, weakness, loss of deep tendon reflexes, and abnormal electrophysiologic studies. A more enigmatic group of patients present with severe pain and a paucity of findings on clinical examination and electrophysiologic studies. Many of these patients have small fiber neuropathies. The disparity of subjective sensory complaints to objective signs sometimes leads to an erroneous diagnosis of psychogenic pain. Patients with these syndromes are often difficult to treat. Thus, prompt evaluation and accurate identification of these syndromes is important.

http://www.thecni.org/reviews/13-2-p07-treihaft.htm

Sick Around the World Documentary

A Frontline documentary compares America’s health care system to others around the world.

T.R. Reid is a veteran foreign correspondent for The Washington Post, a commentator for National Public Radio and the author of nine books, including three in Japanese. He is currently working on his 10th book, titled We’re Number 37!, in which he compares America’s health care system to others around the world. It is scheduled to be published by Penguin Press in early 2009.

How did you choose the five countries featured in this report?

Two of our choices, Britain and Japan, were pretty obvious. I had lived in both countries, I had doctors there and knew the systems. I could speak the language, sort of, in both places.

Beyond that, we were looking for examples of each of the established models of health care systems. The U.K. uses the Beveridge model; Taiwan has chosen the Canadian-style National Health Insurance [NHI] model; Germany, Japan and Switzerland use the Bismarck model. We went to three Bismarck countries on the theory that these private-sector systems are more relevant to America than a British-style National Health Service.

I got interested in Taiwan because Taiwan’s Health Ministry did what our film does; it traveled the world studying health care systems. In the end, Taiwan chose the Canadian model. We went to Switzerland because it is a ferociously free-market economy with politically powerful insurance and drug companies. But still, the Swiss managed to revamp their system, making it cheaper and fairer. We thought that might inspire Americans to believe that change is possible here, too.

The following is a link to view the online Sick Around the World Documentary video

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

view/main.html

The video runs approximately an hour.

I found this documentary well done informative and insightful.

I feel the video is well worth watching.

Last year, on the television program ‘Mystery Diagnosis’ was a case of a woman who went for years without a diagnosis for her debilitating chronic pain. Finally, a neurologist in L.A. diagnosed her with Complex Regional Pain Syndrome (CRPS).

I found the episode very informative.

The following is a link to view this television episode on the blinkx.tv web site.

Discovery Health’s “Mystery Diagnosis”: RSD (Part 1 of 2)
  
Discovery Health’s “Mystery Diagnosis”: RSD (Part 1 of 2)

Cynthia Toussaint of For Grace discusses her life with RSD. Originally aired on Discovery Health in October 2005 (currently still running)

http://www.blinkx.com/burl?blinkxreferrer=getJSOpenLink&v=JD-cHvPpoAlRBPCPHSMaeA

If you suffer from chronic pain and are taking narcotic pain medication and/or anti-depressants,  then you most likely struggle with chronic constipation.

The following is an excerpt from the book titled ‘The Natural Laxative Cookbook’ by Karin Cadwell, Ph.D., R.N. & Edith White, M. Ed.

Certain medications and dietary supplements, such as narcotic pain-killers, anti-depressants, or aluminum-containing antacids can lead to constipation. People who are immobolized after surgery often become constipated.

There are two different types of fiber - soluble and insoluble. Oat bran which lowers the levels of cholesterol is water-soluble fiber. Wheat and rice bran are insoluble; they are not water soluble. They soften the stool and add bulk to it which helps prevent constipation.

Human beings do not have the enzymes needed to break down fiber. As fiber passes through the intestinal system, it attracts and holds water. The result is that the end product of digestion-feces, or stool-is bulkier and softer and more easily passed when it is higher in fiber.

People who eat high-fiber foods have increased peristalsis. Peristalsis refers to the wavelike motions that move food onwards from the time it is swallowed and as it makes its way down the throat, through the stomach, and all along in the digestive tract. Increased peristalsis means tat waste is moved out of the body faster.

The sensation of needing to have a bowel movement comes from the pressure of the weight of waste building up in the colon. This is a direct result of the amount (especially fiber) in the food that was eaten.

The waste of the person on a low-fiber diet remains in the body for a longer time than that of a person on a high-fiber diet and some of the water is reabsorbed.