Back Pain

Comments on “FDA clears Cymbalta to treat chronic musculoskeletal pain”

SJCRG:  Good news, more treatment options for chronic musculoskeletal pain! Here is the link to the FDA press release.   “..Cymbalta was first used to treat major depressive disorder in 2004..” 

SJCRG:  Very interesting is the FDA’s philosophy for drug approval for serious illnesses:

Quoting:  “..While these serious side effects have been associated with the use of Cymbalta, they have occurred in less than 1% of treated patients. There are a finite number of drugs available for the treatment of chronic musculoskeletal pain, all of which are associated with rare, serious side effects. There are patients in whom none of the available treatments are effective. ….

So let us do the math: According to the US Govn’t “..An estimated 1.5 million adults had rheumatoid arthritis in 2007….”
…so 15,000 patients are expected to come down with serious side effects.

 But  “..Since its initial approval, about 30 million patients in the United States have used Cymbalta..[for other conditions]..”  Let us do the math now for that larger population: 1% of 30 million= 300,000 patients with serious side effects!  half of the Multiple sclerosis popultation in the US!

Please do a careful risk/reward analysis with your doctor if you need Cymbalta, or any of these potent drugs….

Cymbalta is no free ride…

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Low Back Pain: Exercise and Alternative Treatments (sciencedirect)

Care resource Guide:Lower Back pain interventions  are often painful themselves, so the patient needs to be convinced of the prospective treatment efficacy. Complementary and alternative (CAM) treatments tend to be less aggressive, But do they work?

 Care resource Guide: Here is link to a background article on CAM treatments  

Quoting Conclusions:“…Based on the current literature, it appears that yoga is the most effective nonphysician-directed active treatment approach to nonspecific low back pain when comparing other CAM treatments. Acupuncture… has been shown to be a good adjunct treatment…”

  Care resource Guide Notes: Yoga when you having lower back pain sounds challenging, but it still worth investigating.

Talk to your health practitioner

Where it's at....

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The failed back surgery syndrome (sciencedirect)

Care Resource Guide: Contemplating back surgery ?

Here are your odds of success/failure according to this study from the European Journal of Pain Supplements:

“….Approximately 30% of patients experience persistent or recurrent low back and/or pain projecting into the legs following technically adequate lumbosacral surgery…”

Your back..

The articles proceeds with an anlysis of the causes and remedies. Note the accent on spinal cord stimulation (SCS). Here is the link to Wikipedia  for background on SCS.  Note current clinical trial on SCS at Boston Scientific (prnews)

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Back Surgery: Closing the Gap (Ivanhoe)

CareResourceGuide:   Doctors devellopping a technique to fill the gap of herniated discs.  Follow link to Ivanhoe

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