Epidural injections of steroids for back pain under review by FDA !!!!

The U.S. Food and Drug Administration is reviewing epidural injections of steroids to treat neck and back pain following a warning by Bristol-Myers Squibb (NYSE:BMY) seven months ago that administering its Kenalog steroid around the spine could cause serious complications, according to a report by Bloomberg.

Bristol-Myers in New York revised its label for Kenalog to say it is not recommended for injection into the epidural space near the spine because of “reports of serious medical events, including death,” associated with administering steroids that way, the article said. But the drugmaker and the FDA have not yet publicized the label change, Bloomberg said.

The article cited physicians who said the steroid is still widely used in epidural injections to treat neck and back pain.

Bristol-Myers’ steroid Kenalog and the Pfizer (NYSE:PFE) drug Depo-Medrol are the most commonly used steroids for epidural injections, Bloomberg said. More than 8 million such shots were administered in the U.S. in 2010.

FDA spokesman Morgan Liscinsky told Bloomberg the regulator is in the midst of reviews for epidural injections of steroids — one focusing on injections in which the needle is used very close to critical arteries. In another, the FDA is working with outside experts looking at particulate steroids that could create blockages that could set off a stroke if injected into arteries, the article said.

Ipads can cause you say Ihurt!!!

Researchers looking to catch up to the exploding popularity of tablet computers have published recommendations for guidelines that ensure devices like Apple’s iPad and Motorola’s Xoom are comfortable and safe to use.

“Compared to typical desktop computing scenarios, the use of media tablet computers is associated with high head and neck flexion postures, and there may be more of a concern for the development of neck and shoulder discomfort,” said lead investigator Jack T. Dennerlein, PhD, of the Department of Environmental Health, Harvard School of Public Health, and Brigham and Women’s Hospital.

The study found that tablet users generally had more acute angles of head and neck flexion than with desktop or notebook computers.  To alleviate discomfort, the researchers say to place the tablet higher to avoid low gaze angles, use a case that provides optimal viewing angles.

The paper, published in the accident-prevention journal Work, did not assess the impact of tablet use over a long period, nor did it address the positions of the arms, wrists and hands, an issue it said needed further research.

Who is a Good Candidate for Nonsurgical Spinal Decompression?

We have been providing spinal decompression therapy in Vancouver for over 7  years now. The machine we use is the DRX9000. We treat mostly lumbar disc bulges and disc herniations, as well as degenerative disc disease, facet syndrome, and spinal stenosis.

We do not accept every case…because not everyone that presents with the conditions listed above is a candidate for spinal decompression. First of all…if you have had cervical or lumbar spinal fusion you are automatically disqualified from treatment with the DRX9000. If you have any hardware such as screws, plates, metal mesh, or cement work, you are also disqualified.

Some of the other contraindications to spinal decompression are moderate to severe scoliosis, aortic aneurysm, unstable spondylolithesis, advanced osteoporosis, and cancer of the spine. There are more…but the point is not everyone qualifies for decompression.

When a patient does qualify for treatment, we consider the age of the patient, level of spinal degeneration, whether or not there is a single disc herniation or multiple levels of involvement, overall health, and likelihood of treatment compliance. We only want to initiate treatment with those we feel will benefit and are willing to do their part. Because of this, we are able to help the overwhelming majority of the cases we accept.

There are many variables involved that are adjustable that can improve the odds of a favorable outcome. Things such as water intake, diet, exercise, stress, ergonomics, sleeping postures, and attitude. We try to address all of them.

There is also an art to the actual set-up and harnessing process on the spinal decompression machine itself. Mess this up and you can delay healing or even set it back. We like to think we have it mastered…though we continue to learn more every single day. For sure you want a spinal decompression doctor with lots of experience…not just a machine.

if you would like to schedule an appointment with Dr. Akhavan for a complimentary consultation, simply call 604-984-4601.

Shin Splints

What is it?

Medial shin splints are a condition wherein the periosteum of the tibia is damaged when it is pulled away by an overstressed tibialis posterior muscle. Anterior shin splints are a condition in which the blood flow is obstructed from the anterior compartment due to the hypertrophy of the overstressed tibialis anterior cmpartment.

What are the common symptoms/complaints?

Medial shin splints: Patients complain of a dull, aching pain felt along the medial side of the tibia. Once it starts, any activity will aggrevate it.

Anterior shin splints: Patients complain of dull, aching pain felt along the anterior side of the tibia.

How is it caused?

Medial shin splints: The tibialis poeterior muscle plamtarflexes and inverts the foot (anti-pronator) due to its distal attachment (insertion) on the medial aspect of the foot. During over-pronation the tendon of the tibialis posterior is stretched and pulled upon excessively, thereby attacking the weakest area, namely its origin (proximal attachment) on the periosteum of the tibia. The small pain fibers of the periosteum are torn away causing pain and chronic inflammation.

Anterior shin splints: The tibialis anterior muscle dorsiflexes and inverts the foot, acting as an anti-pronator due to its distal attachment (insertion) on the medial aspect and base of the first metatarsal. During over-pronation the tibialis anterior muscle fibers must fire constantly to oppose (re-supinate) the over-pronation, thus causing hypertrophy (swelling) of the tibialis anterior compartment.

  How is it treated?

Medial and anterior shin splints: Depending on the severity of the injury, treatment may include standard acute care, restricted activity and an orthotic device that corrects the over-pronation and stops the foot from falling too far medially (reducing the strain on the tibialis posterior) and facilitates proper foot function and timing, reducing the stress on the tibialis anterior.

Tips on Avoiding Winter Weight Gain

The New Year is upon us and for some, new resolutions are made to lose those holiday pounds and to get in shape. During the winter months, however, many people have a pretty hard time keeping their weight under control. As the days get short and dark, many of us crave carbohydrate-rich foods. Breads, potatoes and pasta become irresistible, not to mention cookies, cake and donuts. And carbohydrates beget more carbohydrates. One potato chip invites another. And who has ever been able to keep a resolution to eat just one oreo? All that delicious food combined with a low level of activity tends to make a person go into hibernation. Hibernation leads to lots of excess weight, which of course needs to be dropped once again in time for warmer weather and bathing suit season.

This winter, you can take charge of your waist line and your health by applying some of these common sense tips on how to never gain those extra pounds in the first place!

First of all, don’t deny yourself all of the things you love. People who diet by refusing themselves treats (a candy bar here and there, a latte) tend to gain more weight than people who occasionally indulge themselves. It’s human nature not to be happy about removing something from your life that you want-so when you fail, you fail big. It’s OK to have a candy bar once in a while, or a latte. But do it in moderation. Don’t eat the second candy bar, or have the latte every day. If you give yourself a reward or two when you deserve it, weight loss won’t have to control your life, and you won’t annoy your friends and family by counting calories all the time!

Take a walk and enjoy the winter wonders. Or take up that yoga class you’ve always wanted to take! Small choices like these are key to keeping the weight off. The more active you are every day, the less likely you are to pick up extra winter weight. Don’t give in to the temptation to just sit around and be a “couch potato” all weekend, you can find chores to do…even in the winter months! Clean out your closet, or your basement. Shovel the snow, do whatever is necessary to stay active. You’ll end up burning the winter calories, and end up feeling energized and happy that you’ve gotten so much accomplished! If you’re experiencing aches and pains that are preventing you from getting up and getting moving, visit your Doctor of Chiropractic. Gentle spinal manipulation can help you feel better and minimize the chance for injury when you’re working out.

If you slipped up and gained some weight over the holidays, don’t go on crash diets. Lose weight fast diets don’t give you the nutrients you need or the discipline needed to keep the weight off when the diet is through. Stick to eating three healthy meals a day and avoid fast food. If you have a sweet tooth, don’t sit down and eat the entire chocolate cake, have an apple, or a banana instead. Get in some moderate exercise 3 to 4 times a week for at least a half hour. Do this and you’ll be much happier, and lose more winter weight faster than with the quick fix diets. You can also remove some of the “extras” from your routine. Drink your coffee black, cream and sugar add a ton of calories. Cut back on chocolate and other sweets unless it’s an occasional thing, skip the cheese and mayo on your sandwich at lunch, skip the soda in favor of some tea (but no sugar!), and look at your daily food choices and try to cut out the extra calories. In no time at all, you’ll shed those extra pounds and you’ll have more energy to do the things you love to do!