Archives for category: Sleep Pain

We were reading through “Diagnostic Testing and Treatment of Low Back Pain in United States Emergency Departments: A National Perspective” on MedScape and were struck by a couple items.

“Diagnostic testing was performed in nearly 1 of every 2 patients with low back pain and opioids were administered to nearly two-thirds of the sample.” http://www.medscape.com/viewarticle/732744_4

Most low back pain can be evaluated clinically and manually without imaging studies. A clinician familiar with back problems is usually able to determine the etiology (root cause) of the back pain, and then decide on an appropriate course of action. For example, in physical therapy graduate programs, neurological testing — sensation, reflexes, strength, etc. — is recommended (required really) when there are symptoms past the gluteal fold into the thigh or leg. If no loss of strength and function is present, then treatment and education may proceed.

Then the question of opioids comes in. While a physical therapist cannot prescribe medication, all treatment interventions are considered in the context of desired results. Pain control is a laudable goal, but healing, resolution, self management education, and return to function might be considered more desirable in the long, and even near, term.

“Savings may be realized if visits can be shifted to primary care settings, where typical charges and propensity for diagnostic testing may be less.”

We’d like to see people offered a solution to their problem, not simply more tests and treatment to mask the symptoms. What do you think?

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Do you have difficulty falling asleep? Do you wake up during the night tossing and turning? Feel tired, achy or sore in the morning? Check out the tips below to get a better night’s rest.

1. Invest in a good mattress.

The lifespan of most quality mattresses is about 8-10 years. But keep in mind that your body changes over time. So what may have worked for you even 5 years ago may no longer be a good fit now.

If you are a side-sleeper you will probably prefer a plush-firm to plush mattress. This allows the bonier and wider hip and shoulder areas to sink in a bit, while giving support to the low back and legs. *Quick Fix: If your mattress is too soft, side-sleepers support your low back pain by putting a folded towel under your waist.

Back and stomach sleepers usually do better with a firm to plush-firm mattress that will support the spine in neutral better. *Quick Fix: If your mattress is too soft, back sleepers support your low back by placing a folded towel under the small of your low back or under your stomach for stomach sleepers. Read the rest of this entry »