Sunday, August 13, 2017

A comprehensive guide to the new science of treating lower back pain - Vox

Cathryn Jakobson Ramin's back pain started when she was 16, on the day she flew off her horse and landed on her right hip.

For the next four decades, Ramin says her back pain was like a small rodent nibbling at the base of her spine. The aching left her bedridden on some days and made it difficult to work, run a household, and raise her two boys.

By 2008, after Ramin had exhausted what seemed like all her options, she elected to have a "minimally invasive" nerve decompression procedure. But the $8,000 operation didn't fix her back, either. The same pain remained, along with new neck aches.

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https://www.vox.com/science-and-health/2017/8/4/15929484/chronic-back-pain-treatment-mainstream-vs-alternative

Surgery Is One Hell Of A Placebo | FiveThirtyEight

The guy's desperate. The pain in his knee has made it impossible to play basketball or walk down stairs. In search of a cure, he makes a journey to a healing place, where he'll undergo a fasting rite, don ceremonial garb, ingest mind-altering substances and be anointed with liquids before a masked healer takes him through a physical ritual intended to vanquish his pain.

Seen through different eyes, the process of modern surgery may look more more spiritual than scientific, said orthopedic surgeon Stuart Green, a professor at the University of California, Irvine. Our hypothetical patient is undergoing arthroscopic knee surgery, and the rituals he'll participate in — fasting, wearing a hospital gown, undergoing anesthesia, having his surgical site prepared with an iodine solution, and giving himself over to a masked surgeon — foster an expectation that the procedure will provide relief, Green said.

These expectations matter, and we know they matter because of a bizarre research technique called sham surgery. In these fake operations, patients are led to believe that they are having a real surgical procedure — they're taken through all the regular pre- and post- surgical rituals, from fasting to anesthesia to incisions made in their skin to look like the genuine operation occurred — but the doctor does not actually perform the surgery. If the patient is awake during the "procedure," the doctor mimics the sounds and sensations of the true surgery, and the patient may be shown a video of someone else's procedure as if it were his own.

Sham surgeries may sound unethical, but they're done with participants' consent and in pursuit of an important question: Does the surgical procedure under consideration really work? In a surprising number of cases, the answer is no.

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https://fivethirtyeight.com/features/surgery-is-one-hell-of-a-placebo/?

Wednesday, August 02, 2017

Almost half of all opioid misuse starts with a friend or family member's prescription | PBS NewsHour

More than half of adults who misused opioids did not have a prescription, and many obtained drugs for free from friends or relatives, according to a national survey of more than 50,000 adults.

Although many people need medical narcotics for legitimate reasons, the National Survey on Drug Use and Health reported Monday that regular access to prescription opioids can facilitate misuse. The results, outlined in the Annals of Internal Medicine, indicate when the medical community overprescribes opioids, unused drugs are then available for abuse.

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http://www.pbs.org/newshour/rundown/opioid-misuse-starts-friend-family-members-prescription/?