Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It has several special features that make it different from other kinds of arthritis. For example, rheumatoid arthritis generally occurs in a symmetrical pattern, meaning that if one knee or hand is involved, the other one also is. The disease often affects the wrist joints and the finger joints closest to the hand. It can also affect other parts of the body besides the joints. In addition, people with rheumatoid arthritis may have fatigue, occasional fevers, and a general sense of not feeling well.

Rheumatoid arthritis affects people differently. For some people, it lasts only a few months or a year or two and goes away without causing any noticeable damage. Other people have mild or moderate forms of the disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions. Still others have a severe form of the disease that is active most of the time, lasts for many years or a lifetime, and leads to serious joint damage and disability.

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Features of Rheumatoid Arthritis

• Tender, warm, swollen joints
• Symmetrical pattern of affected joints
• Joint inflammation often affecting the wrist and finger joints closest to the hand
• Joint inflammation sometimes affecting other joints, including the neck, shoulders, elbows, hips, knees, ankles, and feet
• Fatigue, occasional fevers, a general sense of not feeling well
• Pain and stiffness lasting for more than 30 minutes in the morning or after a long rest
• Symptoms that last for many years
• Variability of symptoms among people with the disease

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Did you know your Blood Ph Levels could be keeping you in Pain?

Remember the litmus test from high school chemistry lab? You stuck a small strip of litmus paper into a solution, and if it turned red, it meant the solution was acidic. If it turned blue, the solution was basic (alkaline).

Well, the body has its own sort of litmus test: It’s called your pH level. And many health care professionals consider a balanced pH level to be the key to good health. The term pH stands for Potential Hydrogen, which is the concentration of hydrogen ions in a substance or solution. The pH range is 0 to 14. Human blood pH is ideally 7.35. Higher numbers indicate alkalinity; lower numbers indicate acidity.

Constricted muscles

The body simply cannot tolerate extended acid imbalances. In the early stages of an imbalance, symptoms may include such things as skin eruptions, headaches, allergies, colds and flu, and sinus problems. As things get further out of kilter, weakened systems start to give way. If tissue pH deviates too far to the acid side, oxygen levels decrease and cells die.

On the other side of the coin, it is virtually impossible for a health disorder or disease to sustain itself when your pH is in the neutral zone (7.0-7.4). At this level, the body has a strong immunity to diseases. Most Americans, however, have a pH level of 6.2 to 6.4. When your pH is out of the normal range, all sorts of bad things happen. For one thing, disease-producing organisms thrive. This explains why some people exposed to certain bacteria or viruses get sick while others don’t. Acidic conditions can cause muscles to constrict and inhibit the exchange of nutrients and waste products in muscle cells, causing fatigue, soreness, and pain. In fact, a pH imbalance affects all cellular activity in the body and can lead to a wide range of degenerative diseases and symptoms. Among other things, acidic blood blocks vitamin absorption, creates toxic buildup in clogged cells, slows organ function, prevents proper digestion, creates excess gas and bloating, causes unhealthy weight gain, and speeds the aging process. When pH is lower than 7.0, aging is accelerated because natural acid salts build up in the walls of your cells, causing them to stiffen and dry up. By the same token, aging is slowed when acid waste is removed from the body.

How it happens

Diet and stressful lifestyle can directly affect the pH levels of all body fluids, which determines how well your immune system functions. A weakened immune system, of course, means low resistance to infections. High acid also allows LDL-cholesterol (the bad cholesterol) to build up faster in your arteries, damaging artery walls and creating plaque buildup.

High acidity enters your body when you eat processed foods, pre-packaged foods, sugary foods, pastas, dairy products (milk, cheese, ice cream, etc.), alcoholic beverages, drugs, table salt. Meats also promote acidity. Stress plays a significant role in creating excess acid. This is why Type A personalities – who tend to live in a perpetual state of tension and rigidity – are prone to develop acidic conditions. If you don’t get enough sleep or exercise or face life-changing events – loss of a job, divorce, moving to a new city, etc. – your body probably has more acid than it can handle.

Restoring the balance

Moderate changes in your diet can help restore your pH balance. For starters, try eating more fresh fruits and vegetables, almonds, and yogurt. And go lighter on cheeses, soft drinks, alcohol, processed foods, and sweeteners (use raw honey instead). Roughly 75 percent of your diet should consist of alkaline-producing foods.

If these dietary changes seem too oppressive, you might consider taking alkaline supplements. One recent study looked at whether supplementation with alkaline minerals would influence symptoms in patients with chronic low back pain. Researchers gave 82 such patients 30 grams of a lactose-based alkaline mineral supplement (Basica) daily over a period of four weeks in addition to their medication. Pain symptoms were measured using the Arbus Low Back Pain Rating Scale. Average pain scores significantly dropped by 49 percent, total blood buffering capacity was significantly improved, and blood pH increased. The conclusion: an unbalanced pH level may contribute to the symptoms of low back pain. To lower your stress level, which will help put your pH reading in the normal range, you may want to try deep-breathing exercises and eating alkaline foods or what ever type of relaxation technique works for you. Moderate exercise – even walking 10 minutes a day – can also go a long way toward reducing stress and restoring balance, the key to good health.

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Green Tea May Help Protect Against Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects more than 2.1 million Americans. It is characterized by joint pain, stiffness, inflammation, swelling, and sometimes joint destruction. Nonsteroidal anti-inflammatory drugs are the standard treatment for RA, but their prolonged use is associated with adverse effects and discomfort. Natural plant alternatives like green tea are being investigated for the management of RA. Green tea is the most widely consumed beverage in the world, and its polyphenols (substances rich in antioxidants) possess anti-inflammatory properties.

NCCAM-funded investigators at the University of Maryland and Rutgers University examined the effects of green tea polyphenols on RA by using an animal model in rats. The animals consumed green tea in their drinking water (controls drank water only) for 1-to-3 weeks before being injected with a protein (Bhsp65) to induce arthritis. The researchers found that green tea significantly reduced the severity of arthritis.

The researchers suggest that green tea affects arthritis by causing changes in various arthritis-related immune responses—it suppresses both cytokine IL-17 (an inflammatory substance) and antibodies to Bhsp65, and increases cytokine IL-10 (an anti-inflammatory substance). Therefore, they recommend that green tea be furthered explored as a dietary therapy for use together with conventional treatment for managing RA.

Reference

• Kim HR, Rajaiah R, Wu QL, et al. Green tea protects rats against autoimmune arthritis by modulating disease-related immune events. The Journal of Nutrition. Nov. 2008:138(11):2111–2116.

Glucosamine

Description:
Glucosamine is an aminopolysaccharide (a combination of an amino acid – glutamine and a sugar – glucose). Glucosamine is concentrated in joint cartilage where it is incorporated in longer chains known as glycosaminoglycans and finally into very large structures known as proteoglycans. The proteoglycans function to attract water into the joint space for lubrication of the cartilage during movement.

Claims:

Reverses osteoarthritis

Protects joints and tendons from injury

Decreases inflammation

Theory:
The principle behind glucosamine supplementation is that the glucosamine is delivered to the joint space and incorporated into proteoglycans of joint cartilage to maintain structure and repair damage. Glucosamine may also stimulate chondrocytes (cartilage cells) to begin producing healthy new cartilage matrix (both collagen and proteoglycans).

Scientific Support:
There are numerous European studies showing a clear benefit of glucosamine supplements for relief of joint pain and stiffness associated with arthritis. Many of the studies have been criticized for lack of scientific control, short duration and small size, but recent meta-analyses of the smaller studies have supported the beneficial role of glucosamine supplements as a safe and effective approach to treating osteoarthritis. In general 1-3 months of glucosamine supplementation seems to be more effective than a placebo and at least as effective as analgesic and non-steroidal anti-inflammatory drugs (NSAID), like acetaminophen and ibuprofen, in reducing the joint pain of osteoarthritis. Until more rigorous studies are conducted in the United States, the Arthritis Foundation has stated that it cannot recommend glucosamine supplements as a treatment for osteoarthritis, but this stand has not stopped the Foundation from accepting financial support from the producer of the best selling brand of glucosamine supplements on the market – Rexall Sundown’s Osteo-Bi-Flex. Perhaps the supplements with the best clinical substantiation are Dona from Rotta Labs and Cosamin from NutraMax Labs.

Safety:
Occasional symptoms of gastrointestinal discomfort have been noted, but no significant adverse effects have been noted with glucosamine supplementation. Although there have been no long-term safety studies conducted in humans, animal studies on glucosamine have found it to be non-toxic. Diabetics may want to exercise a degree of caution when using glucosamine supplements, as there have been several animal studies and one small human pilot study that have suggested an increase in blood sugar levels during regular glucosamine consumption (though most of the animal studies have used injections of glucosamine).

Value:
Glucosamine supplements tend to be among the more expensive products on the shelf. A one-month supply of capsules can range from $15 to well over $100. Because they have to be consumed for 1-3 months before any noticeable benefit is apparent, you may need to invest a significant amount of money before you realize any benefits. However, because arthritis pain is one of the most debilitating conditions, most people dealing with such pain would gladly invest a dollar or so per day in a supplement that relieved their discomfort and helped repair their damaged cartilage tissue. For people with existing chronic joint pain, glucosamine supplements are probably worth the significant dollar investment for the benefits that they deliver. For those individuals with intermittent joint pain or those with more mild joint stiffness, the high cost associated with glucosamine supplements may not be justified – and the money might be better spent on other more relevant supplements.

Dosage:
No dose-response studies have been conducted with glucosamine supplements. Virtually all oral supplementation studies on glucosamine have used 1500mg per day – usually in 3 divided doses of 500mg each. While this level appears to be an effective dose, there is no information to suggest that a higher does would work better or faster – or that a lower dose would be less effective. A common supplementation strategy, which can decrease the daily cost of supplements, is to consume 1500mg of glucosamine per day for the first 60-90 days of your regimen, followed by a reduced intake of 250-750mg per day as a “maintenance level.” Following the initial 60-90 day period, dosage levels can be increased or decreased based on individual pain and stiffness levels.

Glucosamine Joint Pain Supplements

References:
1. Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother. 1998 May;32(5):574-9.
2. da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis. Ann Pharmacother. 1998 May;32(5):580-7.
3. Deal CL, Moskowitz RW. Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheum Dis Clin North Am. 1999 May;25(2):379-95.
4. Delafuente JC. Glucosamine in the treatment of osteoarthritis. Rheum Dis Clin North Am. 2000 Feb;26(1):1-11.
5. Denham AC, Newton WP. Are glucosamine and chondroitin effective in treating osteoarthritis? J Fam Pract. 2000 Jun;49(6):571-2. 6. Donohoe M. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241; discussion 1242.
7. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol. 1999 Nov;26(11):2423-30.
8. Leeb BF, Schweitzer H, Montag K, Smolen JS. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol. 2000 Jan;27(1):205-11.
9. Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med. 1999 Feb;164(2):85-91.
10. Mautone G. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241; discussion 1242.
11. McAlindon TE, LaValley MP, Felson DT. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241.
12. McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA. 2000 Mar 15;283(11):1469-75.
13. Rindone JP, Hiller D, Collacott E, Nordhaugen N, Arriola G. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med. 2000 Feb;172(2):91-4.
14. Towheed TE, Anastassiades TP. Glucosamine and chondroitin for treating symptoms of osteoarthritis: evidence is widely touted but incomplete. JAMA. 2000 Mar 15;283(11):1483-4.

Heal-n-Soothe and Systemic Proteolytic Enzymes

How Can You Benefit from Them?

By Steven Hefferon, CMT, PTA, CPRS

Proteolytic enzymes, also referred to as “proteases,” are enzymes that break down proteins into their smallest elements. If this breakdown of proteins happens in your gut, we call the enzymes “digestive,” because they help us digest our food. Systemic proteolytic enzymes, however, have a completely

different purpose, so please don’t confuse the two.When taken on an empty stomach, proteolytic enzymes will pass through the stomach or intestine lining and enter the circulatory system. This is why they are called “systemic” – once they enter the circulatory system, they circulate throughout the body.

Why are systemic proteolytic enzymes important?

The most important thing that systemic proteolytic enzymes do is to break down excess fibrin in your circulatory system and in other connective tissue, such as your muscles. These enzymes bring nutrients and oxygen-rich blood that remove the metabolic waste produced by inflammation and excess fibrin.

For example, If you have an injury or are recovering from a painful condition of any kind and your blood flow is restricted, you will have a longer recovery process. In addition, the exchange of nutrients and oxygen in your body will be limited, and there will be not only a longer recovery but an increase in pain and inflammation.

One more important thing to understand: Whenever you’re recovering from a muscle irritation, injury, or surgery, the body uses fibrin to help heal itself. This is normal and healthy. The only problem is that with poor blood flow and a lack of enzyme activity, that fibrin will start to accumulate. If the area in question is slow to heal, an excess of fibrin will appear as clumps of scar tissue in the muscle or at the surgical site. Once this happens, you acute condition becomes chronic.

Now that you know that excess fibrin throughout your circulatory system will severely limit the amount of blood flow to areas that need it the most, you may be wondering how the body tries to compensate for this restriction. The answer is simple: by forcing the heart to work harder and increasing your blood pressure.

How do you know if you have too much fibrin?

As I have noted, the body will do what it needs to do to keep us alive – sometimes at great cost to your overall health. Some possible indicators of excess fibrin in your system include:
chronic fatigue, slow healing, inflammation and pain, and elevated blood pressure. There is also a medical test to measure something called “blood monomers.”

The dangers of too much fibrin…

The medical community has long known that excess fibrin presents a cardiac and stroke risk. Finally, they have acknowledged a link between excess fibrin and chronic systemic inflammation, the true root cause of virtually every disease and painful condition know to man.

Which conditions do proteolytic enzymes help and how?

The list below is only a sample of the types of conditions that can be addressed with systemic proteolytic enzymes. If you are still wondering how one little substance can support all of these conditions, remember that they all have one thing in common – excess fibrin, which causes a reduction in blood flow.

Arthritis
Atherosclerosis
Back Pain
Chronic Fatigue
Chronic Pain
Fibrocystic Breast
Fibromyalgia
High Blood Pressure

Herniated Disc
Hyper-coagulation
Sciatica
Spinal Stenosis
Strains and Sprains
Post-operative Scar Tissue
Traumatic Inflammation
Uterine Fibroids

Which would you rather take – a pain killer or a healing enzyme?

Truth is, very few pain killers help heal the body, and in most cases the side effects are rather unpleasant. On the other hand, systemic proteolytic enzymes support the body’s ability to heal itself, and they reduce the signs and symptoms of a chronic condition.

Can proteolytic enzymes be used with other pain meds?

I knew you were going to ask. Yes, enzymes can used if you are taking low-dose non-steroidal anti-inflammatory drugs (NSAIDs), as long as they are taken 60 minutes apart.

How about clinical research?

Where is the proof? There are untold numbers of clinical studies that have been done on proteolytic enzymes, and we have 76 of the most relevant studies listed on our site. Let’s not forget that these enzymes have been in use in Europe for more than 50 years. And in Japan, some proteolytic enzymes are classified as
prescription drugs.

Where do proteolytic enzymes come form?

Some are animal-bases, some are plant-based – such as Bromelain and Papain – and some are fungus-based, such as Serrazimes®.

Which types are best and why?

I recommend plant- and fungus-based enzymes because they tolerate the gastric environment better, so more of the enzymes make their way into the circulatory system.

How long does it take to start to work?

Enzymes go to work immediately. The big difference between enzymes and vitamins is the way they are measured. Enzymes are not measured by weight; they are measured in Units of Fibrolytic Activity, which
means how much fibrin they break down in a set amount of time.

The questions you really want answered are: “How long will it take to get pain relief and reduce my inflammation?” and “How fast will my healing happen?” Truth is, there is no simple answer because the
healing process and outcome will be different for everyone.

There are a number of factors that bear on how fast the enzymes will work for you, including dosage, quality of sleep, diet, and physical activity. Even the very treatments you are undergoing to try to get better could be holding you back.

Are proteolytic enzymes safe for continued use?

Yes, proteolytic enzymes should be considered safe for continued use. There are three suggested usage protocols: one is a rotation of 12 weeks on and 4 weeks off; two is to take them continuously; and three
is to take them on as-needed basis.

Who should not take proteolytic enzymes?

1. Individuals taking prescription blood thinners (Coumadin, Heparin,
Plavix)
2. Anyone who will be having surgery in less than two weeks
3. Individuals with known ulcers of the stomach
4. Individuals with Gastroesophageal Reflux Disease.(GERD)
5. Pregnant or lactating women
6. Individuals currently taking antibiotics
7. Individuals with an allergic reaction to pineapples or papayas

Are there any side effects?

Proteolytic enzymes have an excellent safety record, with no significant side effects reported. With any supplement, however, there is always the risk of developing an allergy to one or more ingredients. If this
happens, you should discontinue use.

Choosing to try systemic proteolytic enzymes.

Remember, the enzymes are supporting the healing process, so recovery from any condition is going to take time. You don’t just take the enzymes and expect to get better immediately. By using these enzymes as
part of a well-planned recovery process, you’re making a commitment to doing what it takes to make improvements in your life.

Everything I’ve told you so far I learned from people who are far more knowledgeable than I am about the role enzymes play in helping us achieve optimal health.

So, when I say that I had a hand in creating Lifezyme – albeit a small hand – I nevertheless did my part, which was to find the world’s best enzyme formulators. Once I had done that, I told them to make me the
best product in the world – and that’s exactly what they did.

Without question, the Lifezyme Plus formula has the highest fibrolytic activity of any product in the world per dose. Our formulators blended 11 ingredients that would have a cascading effect, which means that
they help support the work of the enzymes and deliver even more beneficial results.

I’m not a big fan of taking a lot of supplements. I drink my multivitamin and pop my enzymes – that’s it. I know that trying to figure out which supplements to take can be overwhelming and that taking supplements can get expensive. Still, I look at supplements as a long-term investment toward achieving optimal health.

So, if working toward optimal health is your goal and you think that your life and your body would benefit form having less fibrin and better blood flow, then you should seriously consider enzymes.

If you do decide to try enzymes, do me one favor: Never – ever – buy an enzyme that lists the dose in milligrams (mg) or has “Proprietary Enzyme Blend” on the label.

Enzymes are not measured in mg and should not be sold in mg. “Proprietary Enzyme Blend” is a shady way of not telling you the consumer how much enzyme is in the product, so don’t support a company that cannot be honest with you. Demand full disclosure on the label.

Reduce Inflammation and Pain Fast… And Without Harmful and Addictive Drugs!

You don’t have to rely on dangerous medications… there is a safer alternative and it’s called Lifezyme Plus and it’s THE world’s strongest, all-natural pain and inflammation reducing formula. And unlike medications which mask the pain, this powerful formula reduces inflammation in part by replacing enzymes that the body loses as we age.

Click here for more about  Heal-n-Soothe to learn more about how Lifezyme Plus can help you get your life back!

***These statements have not been evaluated by the Food and Drug
Administration. This product is not intended to diagnose, treat, cure, or
prevent any disease.***

What is Inflammation and How Does It Cause Pain?

I’ve got a great article for you today about the “hidden cause” of so many diseases and conditions like chronic pain, heart disease, stroke, alzhiemers and others.

If you suffer from any type of ache or pain, whether it’s big or small, acute or chronic, or if you want to learn about how you can reverse and prevent damage caused by these diseases and conditions, then you I’m sure you are going to find this quick read very eye opening.

What is Inflammation and How Does It Cause Pain?

Inflammation is a response from your immune system in response to an irritant.

For example, if you sprain your ankle, your immune system creates a protein called a Circulating Immune Complex (CIC for short).

The CIC travels down to the injured ankle and causes pain and swelling.

The pain you feel is to inform you of the injury or damage. And the swelling is protective as it prevents you from moving it and causing more irritation.

This is also your body’s way of running to the problem with fresh blood, antibodies and vital cells in order to begin healing and repairing the damage.

Then what normally happens is our bodies produce proteolytic enzymes which counteract the inflammation, and things return to normal. That’s why a sprained ankle as a young child heals within a few weeks at most, but can take six weeks or more for an adult of say 45.

The problem is, after around age 25, our production of these enzymes drops off almost completely so there is nothing to tell the body to stop the inflammation. These enzymes are also responsible for cleaning the blood, fighting off viral and bacterial infections and breaking down excess fibrin (scar tissue).

You can learn more about proteolytic enzymes and how they work here

In addition to the decrease in production of proteolytic enzymes, there are also numerous other things that contribute to the build up of inflammation in our bodies.

Here is just a short list of factors that contribute to inflammation:

• Un-addressed pain and injuries
• Toxins and chemicals in our air, water and food
• Poor nutritional habits
• Bacterial or viral infections
• Allergies
• Prescription medications
• Auto-immune diseases
• Negative mental and emotional stress
  

Over time, inflammation continues to increase in our bodies causing damage to all of the tissues and organs, often without us even knowing it’s happening.

If inflammation is not controlled and the body continually fights this battle, symptoms of chronic inflammation can show itself as arthritis, colitis, chronic fatigue, sinusitis, cataracts, chronic pain, hair loss heart disease, stroke, Alzheimer’s and dozens of other ailments and conditions.

Inflammation is what slowly kills us.

More and more research is coming out now that proves this. For example, here’s a quote from a study published in The New England Journal of Medicine: “there is convincing evidence that inflammation is strongly linked to heart attacks and stroke.”

And in another study published in The Annals of Neurology, the researchers concluded, “inflammation is linked to Alzheimer’s and other dementing diseases.” And a recent Harvard study found that “half of all heart attacks are caused by inflammation”.

We know that reducing inflammation is critical to eliminating pain and preventing disease and illness, but how do you do it safely and naturally?

Here are just some of the things you can do:

• Make dietary changes – be sure to read Dr Chilton’s book “Win the War Within”
  
• Learn how to eliminate negative emotional stress
• Minimize the amount of junk that enters your body – and not just food but toxins and other chemicals
• Replace lost proteolytic enzymes with supplementation

Remember, the key is to keep in inflammation under control because it does far more than just cause swelling and pain.

Inflammation and joint health

Eating Right to Treat Hurting Joints

What Is the Difference Between Acute and Chronic Pain?

Pain that hits you suddenly – after falling from a ladder, being tackled on the football field, or lifting a load that is just too heavy, for example – is acute pain. Acute pain comes on quickly and often leaves just as quickly. To be classified as acute, pain should last no longer than 6 weeks. Acute pain is the most common type of back pain.

Chronic pain, on the other hand, may come on either quickly or slowly, and it lingers a long time. In general, pain that lasts more than 3 months is considered chronic. Chronic pain is much less common than acute pain.

How Is Back Pain Treated?

Treatment for back pain generally depends on what kind of pain you experience: acute or chronic.

Acute Back Pain: Acute back pain usually gets better on its own and without treatment, although you may want to try acetaminophen, aspirin, or ibuprofen to help ease the pain. Perhaps the best advice is to go about your usual activities as much as you can with the assurance that the problem will clear up. Getting up and moving around can help ease stiffness, relieve pain, and have you back doing your regular activities sooner. Exercises or surgery are not usually advisable for acute back pain.

Chronic Back Pain: Treatment for chronic back pain falls into two basic categories: the kind that requires an operation and the kind that does not. In the vast majority of cases, back pain does not require surgery. Doctors will nearly always try nonsurgical treatments before recommending surgery. In a very small percentage of cases – when back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome, for example – prompt surgery is necessary to ease the pain and prevent further problems.

Following are some of the more commonly used treatments for chronic back pain.

Nonsurgical treatments

Hot or cold: Hot or cold packs – or sometimes a combination of the two – can be soothing to chronically sore, stiff backs. Heat dilates the blood vessels, both improving the supply of oxygen that the blood takes to the back and reducing muscle spasms. Heat also alters the sensation of pain. Cold may reduce inflammation by decreasing the size of blood vessels and the flow of blood to the area. Although cold may feel painful against the skin, it numbs deep pain. Applying heat or cold may relieve pain, but it does not cure the cause of chronic back pain.

Exercise: Although exercise is usually not advisable for acute back pain, proper exercise can help ease chronic pain and perhaps reduce the risk of it returning. The following four types of exercise are important to general physical fitness and may be helpful for certain specific causes of back pain:

Flexion: The purposes of flexion exercises, which are exercises in which you bend forward, are to (1) widen the spaces between the vertebrae, thereby reducing pressure on the nerves; (2) stretch muscles of the back and hips; and (3) strengthen abdominal and buttock muscles. Many doctors think that strengthening the muscles of the abdomen will reduce the load on the spine. One word of caution: If your back pain is caused by a herniated disc, check with your doctor before performing flexion exercises because they may increase pressure within the discs, making the problem worse.

Extension: With extension exercises, you bend backward. They may minimize radiating pain, which is pain you can feel in other parts of the body besides where it originates. Examples of extension exercises are leg lifting and raising the trunk, each exercise performed while lying prone. The theory behind these exercises is that they open up the spinal canal in places and develop muscles that support the spine.

Stretching: The goal of stretching exercises, as their name suggests, is to stretch and improve the extension of muscles and other soft tissues of the back. This can reduce back stiffness and improve range of motion.

Aerobic: Aerobic exercise is the type that gets your heart pumping faster and keeps your heart rate elevated for a while. For fitness, it is important to get at least 30 minutes of aerobic (also called cardiovascular) exercise three times a week. Aerobic exercises work the large muscles of the body and include brisk walking, jogging, and swimming. For back problems, you should avoid exercise that requires twisting or vigorous forward flexion, such as aerobic dancing and rowing, because these actions may raise pressure in the discs and actually do more harm than good. In addition, avoid high-impact activities if you have disc disease. If back pain or your fitness level make it impossible to exercise 30 minutes at a time, try three 10-minute sessions to start with and work up to your goal. But first, speak with your doctor or physical therapist about the safest aerobic exercise for you.

Medications: A wide range of medications are used to treat chronic back pain. Some are available over the counter. Others require a doctor’s prescription. The following are the main types of medications used for back pain.

Analgesics: Analgesic medications are those designed specifically to relieve pain. They include over-the-counter acetaminophen (Tylenol)¹ and aspirin, as well as prescription narcotics, such as oxycodone with acetaminophen (Percocet) or hydrocodone with acetaminophen (Vicodin). Aspirin and acetaminophen are the most commonly used analgesics; narcotics should only be used for a short time for severe pain or pain after surgery. People with muscular back pain or arthritis pain that is not relieved by medications may find topical analgesics helpful. These creams, ointments, and salves are rubbed directly onto the skin over the site of pain. They use one or more of a variety of ingredients to ease pain. Topical analgesics include such products as Zostrix, Icy Hot, and BenGay.

¹ Brand names included in this booklet are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that relieve pain and inflammation, both of which may play a role in some cases of back pain. NSAIDs include the nonprescription products ibuprofen (Motrin, Advil), ketoprofen (Actron, Orudis KT), and naproxen sodium (Aleve). More than a dozen others, including a subclass of NSAIDs called COX-2 inhibitors, are available only with a prescription.

All NSAIDs work similarly – by blocking substances called prostaglandins that contribute to inflammation and pain. However, each NSAID is a different chemical, and each has a slightly different effect on the body.²

²Warning: NSAIDs can cause stomach irritation or, less often, they can affect kidney function. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a patient is being treated with NSAIDs because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. Also, NSAIDs sometimes are associated with serious gastrointestinal problems, including ulcers, bleeding, and perforation of the stomach or intestine. People age 65 and older and those with any history of ulcers or gastrointestinal bleeding should use NSAIDs with caution.

Side effects of all NSAIDs can include stomach upset and stomach ulcers, heartburn, diarrhea, and fluid retention; however, COX-2 inhibitors are designed to cause fewer stomach ulcers. For unknown reasons, some people seem to respond better to one NSAID than another. It’s important to work with your doctor to choose the one that’s safest and most effective for you.

Other medications: Muscle relaxants and certain antidepressants have also been prescribed for chronic back pain, but their usefulness is questionable.

Traction: Traction involves using pulleys and weights to stretch the back. The rationale behind traction is to pull the vertebrae apart to allow a bulging disc to slip back into place. Some people experience pain relief while in traction, but that relief is usually temporary. Once traction is released, the stretch is not sustained and back pain is likely to return. There is no scientific evidence that traction provides any long-term benefits for people with back pain.

Corsets and braces: Corsets and braces include a number of devices, such as elastic bands and stiff supports with metal stays, that are designed to limit the motion of the lumbar spine, provide abdominal support, and correct posture. Although these may be appropriate after certain kinds of surgery, there is little, if any, evidence that corsets and braces help treat chronic low back pain. In fact, by keeping you from using your back muscles, they may actually cause more problems than they solve by causing lower back muscles to weaken from lack of use.

Behavioral modification: Developing a healthy attitude and learning to move your body properly while you do daily activities – particularly those involving heavy lifting, pushing, or pulling – are sometimes part of the treatment plan for people with back pain. Other behavior changes that might help pain include adopting healthy habits, such as exercise, relaxation, and regular sleep, and dropping bad habits, such as smoking and eating poorly.

Injections: When medications and other nonsurgical treatments fail to relieve chronic back pain, doctors may recommend injections for pain relief. Following are some of the most commonly used injections, although some are of questionable value:

Nerve root blocks: If a nerve is inflamed or compressed as it passes from the spinal column between the vertebrae, an injection called a nerve root block may be used to help ease the resulting back and leg pain. The injection contains a steroid medication or anesthetic and is administered to the affected part of the nerve. Whether the procedure helps or not depends on finding and injecting precisely the right nerve.

Facet joint injections: The facet joints are those where the vertebrae connect to one another, keeping the spine aligned. Although arthritis in the facet joints themselves is rarely the source of back pain, the injection of anesthetics or steroid medications into facet joints is sometimes tried as a way to relieve pain. The effectiveness of these injections is questionable. One study suggests that this treatment is overused and ineffective.

Trigger point injections: In this procedure, an anesthetic is injected into specific areas in the back that are painful when the doctor applies pressure to them. Some doctors add a steroid medication to the injection. Although the injections are commonly used, researchers have found that injecting anesthetics or steroids into trigger points provides no more relief than “dry needling” (inserting a needle and not injecting a medication).

Prolotherapy: One of the most talked about procedures for back pain, prolotherapy is a treatment in which a practitioner injects a sugar solution or other irritating substance into trigger points along the periosteum (the tough, fibrous tissue covering the bones) to trigger an inflammatory response that promotes the growth of dense, fibrous tissue. The theory behind prolotherapy is that such tissue growth strengthens the attachment of tendons and ligaments whose loosening has contributed to back pain. As yet, studies have not verified the effectiveness of prolotherapy. The procedure is used primarily by chiropractors and osteopathic doctors.

Complementary and alternative treatments: When back pain becomes chronic or when medications and other conventional therapies do not relieve it, many people try complementary and alternative treatments. Although such therapies won’t cure diseases or repair the injuries that cause pain, some people find them useful for managing or relieving pain. Following are some of the most commonly used complementary therapies.

Manipulation: Spinal manipulation refers to procedures in which professionals use their hands to mobilize, adjust, massage, or stimulate the spine or surrounding tissues. This type of therapy is often performed by osteopathic doctors and chiropractors. It tends to be most effective in people with uncomplicated pain and when used with other therapies. Spinal manipulation is not appropriate if you have a medical problem such as osteoporosis, spinal cord compression, or inflammatory arthritis (such as rheumatoid arthritis) or if you are taking blood-thinning medications such as warfarin (Coumadin) or heparin (Calciparine, Liquaemin).

Transcutaneous electrical nerve stimulation (TENS): TENS involves wearing a small box over the painful area that directs mild electrical impulses to nerves there. The theory is that stimulating the nervous system can modify the perception of pain. Early studies of TENS suggested it could elevate the levels of endorphins, the body’s natural pain-numbing chemicals, in the spinal fluid. But subsequent studies of its effectiveness against pain have produced mixed results.

Acupuncture: This ancient Chinese practice has been gaining increasing acceptance and popularity in the United States. Acupuncture is based on the theory that a life force called Qi (pronounced chee) flows through the body along certain channels, which if blocked can cause illness. According to the theory, the insertion of thin needles at precise locations along these channels by practitioners can unblock the flow of Qi, relieving pain and restoring health.

Although few Western-trained doctors would agree with the concept of blocked Qi, some believe that inserting and then stimulating needles (by twisting or passing a low-voltage electrical current through them) may foster the production of the body’s natural pain-numbing chemicals, such as endorphins, serotonin, and acetylcholine.

A consensus panel convened by the National Institutes of Health (NIH) in 1997 concluded that there is clear evidence this treatment is effective for some pain conditions, including postoperative dental pain. Although there is less convincing evidence to support using acupuncture for back pain and some other pain conditions, the panel concluded that acupuncture may be effective when used as part of a comprehensive treatment plan for low back pain, fibromyalgia, and several other conditions.

Acupressure: As with acupuncture, the theory behind acupressure is that it unblocks the flow of Qi. The difference between acupuncture and acupressure is that no needles are used in acupressure. Instead, a therapist applies pressure to points along the channels with his or her hands, elbows, or even feet. (In some cases, patients are taught to do their own acupressure.) Acupressure has not been well studied for back pain.

Rolfing: A type of massage, rolfing involves using strong pressure on deep tissues in the back to relieve tightness of the fascia, a sheath of tissue that covers the muscles, that can cause or contribute to back pain. The theory behind rolfing is that releasing muscles and tissues from the fascia enables the back to align itself properly. So far, the usefulness of rolfing for back pain has not been scientifically proven.

Surgical treatments

Depending on the diagnosis, surgery may either be the first treatment of choice – although this is rare – or it is reserved for chronic back pain for which other treatments have failed. If you are in constant pain or if pain reoccurs frequently and interferes with your ability to sleep, to function at your job, or to perform daily activities, you may be a candidate for surgery.

In general, two groups of people may require surgery to treat their spinal problems. People in the first group have chronic low back pain and sciatica, and they are often diagnosed with a herniated disc, spinal stenosis, spondylolisthesis, or vertebral fractures with nerve involvement. People in the second group are those with only predominant low back pain (without leg pain). These are people with discogenic low back pain (degenerative disc disease), in which discs wear with age. Usually, the outcome of spine surgery is much more predictable in people with sciatica than in those with predominant low back pain.

Some of the diagnoses that may need surgery include:

Herniated discs: In this potentially painful problem, the hard outer coating of the discs, which are the circular pieces of connective tissue that cushion the bones of the spine, are damaged, allowing the discs’ jelly-like center to leak, irritating nearby nerves. This causes severe sciatica and nerve pain down the leg. A herniated disc is sometimes called a ruptured disc.

Spinal stenosis: Spinal stenosis is the narrowing of the spinal canal, through which the spinal cord and spinal nerves run.

It is often caused by the overgrowth of bone caused by osteoarthritis of the spine. Compression of the nerves caused by spinal stenosis can lead not only to pain, but also to numbness in the legs and the loss of bladder or bowel control. Patients may have difficulty walking any distances and may have severe pain in their legs along with numbness and tingling.

Spondylolisthesis: In this condition, a vertebra of the lumbar spine slips out of place. As the spine tries to stabilize itself, the joints between the slipped vertebra and adjacent vertebrae can become enlarged, pinching nerves as they exit the spinal column. Spondylolisthesis may cause not only low back pain but also severe sciatica leg pain.

Vertebral fractures: These fractures are caused by trauma to the vertebrae of the spine or by crumbling of the vertebrae resulting from osteoporosis. This causes mostly mechanical back pain, but it may also put pressure on the nerves, creating leg pain.

Discogenic low back pain (degenerative disc disease): Most people’s discs degenerate over a lifetime, but in some, this aging process can become chronically painful, severely interfering with their quality of life.

Following are some of the most commonly performed back surgeries:

For Herniated Discs:

Laminectomy/discectomy: In this operation, part of the lamina, a portion of the bone on the back of the vertebrae, is removed, as well as a portion of a ligament. The herniated disc is then removed through the incision, which may extend two or more inches.

Microdiscectomy: As with traditional discectomy, this procedure involves removing a herniated disc or damaged portion of a disc through an incision in the back. The difference is that the incision is much smaller and the doctor uses a magnifying microscope or lenses to locate the disc through the incision. The smaller incision may reduce pain and the disruption of tissues, and it reduces the size of the surgical scar. It appears to take about the same amount of time to recuperate from a microdiscectomy as from a traditional discectomy.

Laser surgery: Technological advances in recent decades have led to the use of lasers for operating on patients with herniated discs accompanied by lower back and leg pain. During this procedure, the surgeon inserts a needle in the disc that delivers a few bursts of laser energy to vaporize the tissue in the disc. This reduces its size and relieves pressure on the nerves. Although many patients return to daily activities within 3 to 5 days after laser surgery, pain relief may not be apparent until several weeks or even months after the surgery. The usefulness of laser discectomy is still being debated.

For Spinal Stenosis:

Laminectomy: When narrowing of the spine compresses the nerve roots, causing pain or affecting sensation, doctors sometimes open up the spinal column with a procedure called a laminectomy. In a laminectomy, the doctor makes a large incision down the affected area of the spine and removes the lamina and any bone spurs, which are overgrowths of bone, that may have formed in the spinal canal as the result of osteoarthritis. The procedure is major surgery that requires a short hospital stay and physical therapy afterwards to help regain strength and mobility.

For Spondylolisthesis

Spinal fusion: When a slipped vertebra leads to the enlargement of adjacent facet joints, surgical treatment generally involves both laminectomy (as described above) and spinal fusion. In spinal fusion, two or more vertebrae are joined together using bone grafts, screws, and rods to stop slippage of the affected vertebrae. Bone used for grafting comes from another area of the body, usually the hip or pelvis. In some cases, donor bone is used.

Although the surgery is generally successful, either type of graft has its drawbacks. Using your own bone means surgery at a second site on your body. With donor bone, there is a slight risk of disease transmission or rejection. In recent years, a new development has eliminated those risks for some people undergoing spinal fusion: proteins called bone morphogenic proteins are being used to stimulate bone generation, eliminating the need for grafts. The proteins are placed in the affected area of the spine, often in collagen putty or sponges.

Regardless of how spinal fusion is performed, the fused area of the spine becomes immobilized.

For Vertebral Osteoporotic Fractures³

Vertebroplasty: When back pain is caused by a compression fracture of a vertebra due to osteoporosis or trauma, doctors may make a small incision in the skin over the affected area and inject a cement-like mixture called polymethylacrylate into the fractured vertebra to relieve pain and stabilize the spine. The procedure is generally performed on an outpatient basis under a mild anesthetic.

³ Used only if standard care, rest, corsets and braces, and analgesics fail.

Kyphoplasty: Much like vertebroplasty, kyphoplasty is used to relieve pain and stabilize the spine following fractures due to osteoporosis. Kyphoplasty is a two-step process. In the first step, the doctor inserts a balloon device to help restore the height and shape of the spine. In the second step, he or she injects polymethylacrylate to repair the fractured vertebra. The procedure is done under anesthesia, and in some cases it is performed on an outpatient basis.

For Discogenic Low Back Pain (Degenerative Disc Disease)

Intradiscal electrothermal therapy (IDT): One of the newest and least invasive therapies for low back pain involves inserting a heating wire through a small incision in the back and into a disc. An electrical current is then passed through the wire to strengthen the collagen fibers that hold the disc together. The procedure is done on an outpatient basis, often under local anesthesia. The usefulness of IDT is debatable.

Spinal fusion: When the degenerated disc is painful, the surgeon may recommend removing it and fusing the disc to help with the pain. This fusion can be done through the abdomen, a procedure known as anterior lumbar interbody fusion, or through the back, called posterior fusion. Theoretically, fusion surgery should eliminate the source of pain; the procedure is successful in about 60 to 70 percent of cases. Fusion for low back pain or any spinal surgeries should only be done as a last resort, and the patient should be fully informed of risks.

Disc replacement: When a disc is herniated, one alternative to a discectomy – in which the disc is simply removed – is removing the disc and replacing it with a synthetic disc. Replacing the damaged one with an artificial one restores disc height and movement between the vertebrae. Artificial discs come in several designs. Although doctors in Europe had performed disc replacement for more than a decade, the procedure had been experimental in the United States until the Food and Drug Administration approved the Charité artificial disc (http://www.fda.gov/cdrh/pdf4/p040006.html).

What Kind of Research Is Being Done?

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is currently supporting a number of studies to better understand and treat back pain. Goals of current research include the following:

To compare the effectiveness of surgery versus nonsurgical treatment for low back pain. Although the percentage of people having spinal surgery in the United States has increased sharply over time, there is not much information on whether back surgery is better than nonsurgical treatments. One study is comparing the most commonly used surgical treatments to the most commonly used nonsurgical treatments for three common back problems: herniated discs of the lumbar spine, spinal stenosis, and spinal stenosis from spondylolisthesis. The study, being conducted at 12 medical centers, will follow patients for at least 24 months after treatment to determine the medical and cost-effectiveness of treatments.

To identify the best treatments for certain patients with low back pain. Just as certain treatments are effective for some back problems and not others, the same treatment may be effective for some people and not others – even if those people have the same medical problem. Researchers at several centers will study more than 3,000 patients who have one of three common causes of back pain – herniated discs, spinal stenosis, and spondylolisthesis – and who respond well to specific treatments. Extensive testing and surveys will allow doctors to identify the best treatments for these patients.

To test the effectiveness of lumbar fusion and other treatments for disc-derived pain. Discogenic pain is low back pain due to the wearing away of a disc between the vertebrae. Although treatment for this condition is often lumbar spinal fusion, its effectiveness, as well as that of other treatments, has not been established. A new study will compare the results of spinal fusion with those of nonsurgical care for patients with similar disc degeneration. Researchers will also try to find out (1) what distinguishes people who choose surgery from those who do not; (2) the consequences of common complications of spinal fusion surgery and how often they occur; (3) what predicts a good response to surgical therapy but not to other treatments; and (4) what are the characteristics and outcomes of patients who have repeat back surgery for this condition.

To measure the frequency of complications in lumbar fusion surgery. Lumbar spinal fusion is a commonly performed procedure for several back problems, including disc degeneration, spondylolisthesis, spinal stenosis, and scoliosis, but the procedure can have complications. A new study will follow 1,000 people who have spinal fusion for one of these diagnoses to find out (1) how often complications occur after surgery, (2) how the rates of specific serious complications vary with different types of lumbar fusion, (3) the consequences of specific types of complications, and (4) the characteristics of treatments or patients that predict particularly severe complications. The information will help doctors better assess the benefits versus the risks of the procedure.

To better understand the relationship between the loss of motor control and low back pain. Compared to people without back problems, those with low back pain show losses in motor control, including problems with trunk muscle response and posture. Some researchers believe that losses in motor control may predispose people to falls that result in back pain. Other researchers think losses in motor control may result from damage sustained by tissue during a fall. To explore the relationship between motor control loss and back pain, scientists will study varsity athletes to determine whether poor motor control of the lumbar spine increases the risk of low back injury. They will also study changes in the lumbar spine motor control of people with low back pain after they complete rehabilitation programs that emphasize motor control training.

To develop and evaluate a psychosocial program for people with acute low back pain. Acute low back pain is a common problem that affects people’s abilities to work and function, and it contributes to high health care costs. There are few studies, however, that prove whether or not a treatment truly reduces limitation and prevents the recurrence of pain. One new project will develop a program to enhance the social support and self-efficacy of people with acute low back pain. After developing and testing the program, researchers will evaluate its effectiveness by comparing the results of 160 participants with those of 160 people receiving usual care.

To evaluate the nervous system mechanisms of low back pain. Scientists think that when a disc ruptures, material leaking from its jelly-like filling leads to inflammation and the release of chemicals that irritate cells within the spinal canal. Scientists believe that the effects of these chemicals on the nerve endings in discs and adjacent tissue lead to low back pain, while the effects on dorsal nerve roots lead to sciatica. One study will test these ideas using a variety of techniques. A better understanding of pain mechanisms related to herniated discs will allow researchers to develop better treatments.

Super Foods to Fight Arthritis

The good old saying stands valid, you are what you eat. With some thought and effective planning it’s possible to get nutrient rich food into your system, believe me your body will thank you for it. The battle against arthritis should from start from inside your body, with so choices sometimes we take things for granted. Here are some of conscious choice you could make when it comes to battle against arthritis and full pain relief.

Salmon as you might know is full of omega 3 fatty acid, the good fat which your body requires on a day to basis. Eating salmon gives you a double edge advantage , it is good for your cardiovascular health , it has been known to raise the levels of good cholesterol, bringing your blood pressure down.

Bananas – one of the richest sources of potassium and sudden energy booster, its great drink any time of the day , best of all you it doesn’t need any preparation, its easy as peel and go. The specific arthritis fighting nutrients like folate and vitamin B6 is in the right proportion in a banana. Again banana has dual benefits; it contains a high fibre content which will give you the full feeling faster than other food groups there by helping you lose weight as well. Wouldn’t you eat a banana if you can achieve full pain relief ?

If you are a seafood lover like me, don’t ignore the importance of shrimps. They contain the hard to get vitamin D, in fact it contains more Vitamin D than a cup of milk. Just like salmon it contains Omega 3 fatty acids the vitamins B12 which keeps you in good all round health. In general for full pain relief include a wide range of deep sea food.

Green tea has recently come into the lime light as super food; it’s a known fact that green tea is an effective anti oxidant and has various other properties which will help you not only in curing arthritis but also help a whole raft of other health related problems. If you were to pick one among the discussed super foods, it would be green tea.

Little planning goes a long way when it comes to your intake of food and controlling arthritis. Don’t make the common mistake which people make, they stick to good food for a week or so and then revert back to old ways, the trick is to be always conscious of what you put into your system.

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