Doctor Of Osteopathy Or Doctor Of Medicine? Learn The Difference

January 25th, 2012 AmeeL

If you have a chronic back pain condition, you’re likely looking for the right specialist to provide effective diagnosis and treatment. Yet few people know that they can make an important choice starting with the type of physician they initially see. The conventional M.D. (doctor of medicine) is not the only option for those seeking a doctor. Doctors of osteopathy (D.O.s) are physicians who have the same responsibilities and qualifications as M.D.s, but take a much different approach.

Both D.O.s and M.D.s receive an undergraduate degree after 4 years of study in a field of science related to medicine. They then must participate in 4 years of training before taking their licensing exams. Both types of doctor then have the option to study a specialized area of health care for 2 to 6 years. Osteopathic doctors can perform surgery and prescribe medicine just as M.D.s can.

If you’ve never heard of a D.O., you’re not alone. According to KidsHealth.org, only 5% of physicians in the U.S. are osteopathic doctors. The method of the osteopathic doctor is often referred to as holistic (treating the whole system), whereas the conventional method of doctors of medicine is considered allopathic (treating the symptoms). These different approaches can determine how effective your treatment is, and it is important to understand your options.

Holistic Vs. Allopathic

Unfortunately, many cases of chronic back pain are categorized as non-specific or idiopathic, which means that the cause is unknown. Undiagnosed back pain is, of course, more difficult to treat than pain whose source is understood. Doctors of osteopathy have a distinct advantage over conventional doctors when it comes to treating musculoskeletal pain, as their training emphasizes the importance of this system to overall health and the interconnectedness of bones, muscles and nerves. Whereas an M.D. may seek to eliminate muscular pain by prescribing a muscle relaxer, a D.O. may notice that the muscular pain is being cause by dysfunction somewhere else, such as nerve entrapment in the spine or postural issues. In this way, D.O.s can treat the actual causes of back pain.

D.O.s have another advantage over doctors when it comes to musculoskeletal pain: They are trained in manipulation techniques called osteopathic manipulation treatment (OMT) similar to what chiropractors use, as well as tissue work similar to what massage therapists perform. This means a D.O. is better equipped to both diagnose and treat the cause of your pain. Although they do prescribe medications, D.O.s are likely to rely less on medication than M.D.s given their hands-on, holistic approach to treatment.

Cost

It is important to know that most, but not all, insurance companies cover osteopathy, and not all D.O.s accept insurance. Look around for one who does. A study comparing the cost effectiveness of osteopathic versus allopathic treatment for migraine patients showed that people receiving osteopathic care spent half as much, in medication and visit costs, as those seeking conventional treatment. Pain scores were the same for both groups. The osteopathic doctors in this study prescribed much less medication than doctors of medicine. See more at www.jaoa.org.

If you wish to avoid prescription drugs and receive thorough back pain treatment, consider seeking out a doctor of osteopathy. They are better equipped to detect musculoskeletal pain and dysfunction than medical doctors and may even cost less. Refer to www.osteopathic.org for information on osteopaths in your area.

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Women More Susceptible To Three Back Pain Conditions

January 24th, 2012 AmeeL

There is some debate over whether or not back pain is more prevalent among women. While it is obvious that certain kinds of back pain, such as those related to pregnancy and PMS, are exclusive to women, there are a number of other chronic pain conditions that women experience more commonly than men. Learning what links women and back pain can help you prevent it.

Osteoporosis

Osteoporosis, a condition characterized by loss of bone density, affects 4 times more women than men. People with osteoporosis are highly susceptible to compression fractures which often occur in the hips and spine. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, half of women over 50 will experience a bone fracture related to osteoporosis at some time, which is double the rate of men.

Estrogen is a major player in keeping bones strong. After menopause, estrogen levels plummet and bone loss occurs at a much faster rate in women than in men. Preventing osteoporosis means setting your body up to counter bone density loss. Women should consume 1000mg of calcium per day before menopause and 1200 mg a day after menopause. Postmenopausal women are also instructed to take 800 IU (international units) of vitamin D a day, as this facilitates the absorption of calcium through the intestinal walls.

Exercise is also important to maintaining strong bones. As with muscles, bones become stronger and recover faster when subjected to the stress of exercise.

Fibromyalgia

WomensHealth.gov’s fact sheet on fibromyalgia estimates that 80-90% of cases occur in women. Fibromyalgia is characterized by the brain’s abnormal processing of sensory signals, sensing pain when it normally wouldn’t.

While not fully understood, there are hypotheses that seek to explain the higher incidence of fybromyalgia among women. Testosterone is a hormone that, among other things, delays muscle fatigue. Since women have less testosterone, their muscles generally tire faster than men and signals sent from these muscles may be interpreted as pain.

Other predisposing factors for women likely exist but are not known at this time. There is no definite way to prevent fibromyalgia because of the number of questions that still remain in the medical field about the condition. See http://ezinearticles.com for a summary of the latest theories and potential avenues of prevention.

Stress

There is some evidence that women experience more stress than men. Stress often manifests as physical pain, likely due in part to the fact that physical and emotional stress signals are processed by the same parts of the brain. When stressed, we tend to unconsciously tense up the muscles in our backs and necks. Some theorize that this is due to the “fight or flight” instinct; when stressed, our brain instructs the body to send a rush of blood to our muscles in order to prepare us for action. When we don’t need to flee or fight, however, this influx of blood in the muscles can manifest as inflammation and cause soreness.

There are some biological factors specific to women that may cause them to experience more stress. Serotonin, a neurotransmitter essential to a balanced mood, relies on estrogen for release. When women’s estrogen level drops, such as before menstruation, after birth and during menopause, serotonin levels decrease. Results of a study conducted at the Children’s Hospital of Philadelphia suggest that women may be more sensitive to a stress hormone called corticotropin-releasing factor (CRF). More on this can be found at http://helpingpsychology.com. Exercise and meditation are two effective ways to combat biological stress factors.

Also worth noting is the existence of societal stressors unique to women. Whether striving to fit in the box society has drawn for her or striving to live outside it, today’s woman encounters her share of stressful situations.

There are biological and societal causes of back pain in women that can be countered with diet, exercise and healthy emotional practices like meditation. Women are not doomed to suffer chronic pain; educating yourself about risks and prevention is the first step to living pain-free.

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Spinal Fusion Risks and Alternatives

January 22nd, 2012 AmeeL

You’ve tried everything for your back pain: chiropractic, physical therapy, decompression treatments, massage, acupuncture – yet the pain hasn’t gone away. If your back pain is caused by disc degeneration, you’re likely considering surgery as a last resort.

Spinal fusion surgery is by far the most common surgical procedure administered for degenerative discs. With high costs and the risk of long-term complications, the prevalence of the procedure is now being called into question, especially considering the existence of a cheaper and potentially more effective option.

Risks

Spinal fusion entails the removal of degenerated disc material and fusion of adjacent vertebrae. The fusion is accomplished by placing bone grafts between vertebrae, and the fusion site is often reinforced by hardware such as screws and plates. Hardware provides additional structural support to the fusion site, but carries the risk of misplacement and nerve impingement. Fusion can be performed at one segmental level or several, depending on the number of degenerated discs.

Spinal fusion carries with it other risks associated with nearly any surgical procedure: infection, bleeding and scar tissue formation. An additional risk specific to the operation is adjacent segment degeneration, also called transitional syndrome. The fused segment limits mobility and increases the amount of pressure experienced by nearby spinal discs, as the disc removed is no longer available for shock absorption. The risk of adjacent segment degeneration greatly increased with the number of levels fused.

There is no exact percentage available for the rate of adjacent segment degeneration associated with spinal fusion. One study, found at http://www.journals.elsevierhealth.com, shows that 5.6% of participant required re-operation at adjacent levels within four years of initial fusion surgery.

Artificial Disc Replacement: An Alternative

The above study compares the effectiveness of spinal fusion surgery compared to artificial disc replacement, a procedure that has been performed in the U.S. since 2000. The operation entails the removal of a degenerated disc and its replacement by a synthetic one designed to perform the same tasks as a natural disc, including mobility facilitation and shock absorption.

The study showed that the number of patients requiring re-operation at 4 years was 4 times higher among the spinal fusion group (11.3% versus 2.9%). The pain reduction scores of patients who underwent disc replacement were on par with those who received fusion surgery.

The cost of artificial disc replacement, according to Spine-Health.com, ranges from $35,000 to $45,000. Spinal fusion, considering hospital stay required, can max out over $100,000. However, many insurance companies do not offer full reimbursement for disc replacement due to its newness, meaning this must be factored into your cost comparison. One study, found at http://www.journals.elsevierhealth.com, showed hospital expenses to be 49% lower for those receiving artificial disc replacement surgery. Growing suspicious has mounted within recent years as the rate of fusion procedures skyrockets and surgeons using hardware receive massive kickbacks from manufacturers.

The criteria for receiving disc replacement are more limiting than those for receiving fusion. Artificial disc replacement is not recommended for those with spinal misalignment, joint problems like arthritis, multilevel degeneration or bone weakness associated with osteoporosis.

If you are considering surgery, talk with your doctor and surgeon about spinal fusion risks and alternatives. It is always beneficial to do your own research and make sure your health care professionals are looking out for your best interests instead of just their own. Surgery is a serious decision, and you deserve to be well-informed.

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Weak Piriformis Muscle Can Cause Back Pain, Sciatica

January 18th, 2012 AmeeL

The piriformis muscle deep in the buttocks has gotten a lot of attention as a possible back pain and sciatica cause. The muscle stretches from the top of the femur to the sacrum on each side of the body and helps secure the upper thigh in the hip joint.

The pelvis has a network of muscles that work together to facilitate many types of motion. The piriformis is mainly responsible for rotating the thigh laterally and abducting the thigh when the hip is flexed. For a more thorough understanding of the position of this muscle and the movements it facilitates, see the interactive tutorial at http://www.getbodysmart.com.

The piriformis muscle can cause significant back pain, sciatica and sacroiliac (SI) joint dysfunction by being too tight or too weak. By far, piriformis tightness is the more popularly discussed problem this muscle experiences. It is important to understand that weakness in this muscle may also be to blame for a number of pain conditions.

Piriformis Syndrome

When the muscle is tight, it can compress the sciatic nerve which runs near it in the buttocks. Women and people who participate in activities that involve a lot of thigh rotation and hip flexing such as cycling and running are at the most risk of piriformis syndrome.

Tightness of the piriformis can be caused in a number of ways. Overuse of the muscle without flexibility training can leave it chronically tight. Injury to the gluteus muscles can weaken them, causing the piriformis to compensate for them. People who sit for prolonged periods of time usually have weak gluteal muscles, and this can also cause the piriformis to be called to action at inappropriate times.

Piriformis syndrome can cause sciatica, back pain from the pull the muscle exerts on the sacrum and SI joint hypomobility. It can be diagnosed by a doctor or physical therapist trained to detect tightness by observing your movements and receiving feedback about how they feel. Treating piriformis syndrome should involve myofascial release to restore flexibility and normal length to the muscle. Learn more about this treatment here: http://ezinearticles.com.

Weak Piriformis

In his book Applied Kinesiology, Robert Frost brings to light the fact that a weak piriformis muscle can cause as much trouble as a tight one. The piriformis muscles are responsible for stabilizing the SI joints. If the muscles are weak, the joints may be hypermobile. This causes significant pelvic instability, spinal instability and joint pain. SI dysfunction can also lead to sciatica. People with two weakened piriformis muscles may also experience sexual problems, manifesting as impotence in men and pain during intercourse in women.

More commonly, only one piriformis muscle is weak. This can cause one-sided SI dysfunction. If one piriformis is overstretched and weak because the other is tight and shortened, then the joint on the side of the weak muscle may be hypermobile while the other joint is stuck due to the rigidity of its neighboring piriformis.

Piriformis muscle weakness can be diagnosed by a trained therapist who moves your legs in a variety of ways to observe how much your muscle activates. One prime indicator of potential piriformis weakness is over-pronation (when the ankle rolls inward and the inside edge of the foot takes the body’s weight) and valgus knee pattern (when the knee turns inward). The muscle can be strengthened by step-ups, lunges and partial squats.

While everyone’s talking about piriformis syndrome, remember that muscles are susceptible both to tightness and weakness. If you have SI joint dysfunction, sciatica and lower back pain, make sure your piriformis muscle is being assessed as a possible cause, both for flexibility and strength.

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