Pain Archives

Nov

2022

Poetry Helps Anxiety and Depression

By Ray Schilling | Anxiety, depression, Pain

Recently CNN published an article that stated that poetry helps anxiety and depression. Notably, poetry helps to cope with loss, fear, a marital break-up and helps during loneliness like a quarantine for Covid-19. Certainly, it is because of this that two authors, David Haosen Xiang and Alisha Moon Yi wrote this 2020 review about poetry’s healing power throughout the pandemic. It is important to realize that they conducted poetry classes at Harvard Medical School and Harvard College. In doing this they observed various health benefits from writing, reading and listening to poetry. Indeed, they saw that poetry combatted stress and depression and reduced postsurgical pain. In addition, poetry improved mood, work performance and memory.

Poetry helped hospitalized children

Another key point, a 2021 study involving 44 hospitalized children measured the effects of poetry on fear, sadness, anger, worry and fatigue. By all means, all of these parameters were reduced when the children were reading, writing or listening to poetry. However, one exception was pain in this group of children, which was unaffected by poetry.

Details of the statistical results

To clarify, here are the results of this study in more detail. A statistically significant reduction of symptoms requires a p value of 5% or less. The 44 hospitalized children had a fear reduction with a p value of 2.1%. Exposure to poetry reduced sadness with a p value of 0.4%, anger with 3.9%, worry with 4.1%, and fatigue with 0.1%. As indicated already the only exception was pain reduction, which had a p value of 9.1% meaning that it was not statistically significant. Poetry has the ability to provide comfort and boost your mood when you are exposed to stress, trauma and grief.

Emotional responses elicited by hearing poetry

Poetry can also elicit peak emotional responses. In a study from 2017, researchers examined psychophysiological responses of 27 people. They measured how many people experienced chills or goosebumps when they listened to poetry read aloud. The researchers concluded that physical responses are connect to the rewards-sensing area of the brain.

Pleasure inducing activities can stimulate the reward areas of the brain

The pleasure center consists of the nucleus accumbens, the amygdala and the hippocampus. Together they contain dopamine neurons that communicate with the grey matter nerve cells in the prefrontal cortex. I have discussed this elsewhere in more detail. A pleasurable meal, sex, winning a video game, listening to music, earning money and reading a funny cartoon can all cause dopamine release that the person perceives as pleasure. But so can drugs, smoking cigarettes, drinking alcohol and taking street drugs.

Dr. Amen’s SPECT scans

Dr. Amen is a psychiatrist who specializes in SPECT scan technology. SPECT stands for Single Photon Emission Computerized Tomography. This is summarized in this review. Briefly, a SPECT scan shows where most of the blood flow occurs in the brain. People who abuse drugs or nicotine develop areas that have a lack of perfusion. It looks like holes in the brain as depicted under point 5 of the above link, which can create abnormal thinking patterns. Fortunately, with drug rehabilitation the brain pattern can normalize again.

Discussion of why poetry helps anxiety and depression

It is the excitement of the pleasure centers in the brain that relieves anxiety and depression. It seems to not matter whether we listen to poetry read aloud, read it or create it. But a pleasurable meal, sex, winning a video game, listening to music, earning money and reading a funny cartoon can also release dopamine in the pleasure centres of our brain. Repeated stimulation of the pleasure centers from exposure to poetry seems to be what gives us relief from anxiety and depression.

Xiang and Yi who observed students writing, reading and listening to poetry at Harvard Medical School and Harvard College said: “Whether it is coping with pain, dealing with stressful situations, or coming to terms with uncertainty, poetry can benefit a patient’s well-being, confidence, emotional stability, and quality of life.”

Poetry Helps Anxiety and Depression

Conclusion

Newer research showed that poetry helps anxiety and depression. This is true in university and college students as well as in hospitalized children. One study concluded that poetry seems to activate the rewards-sensing area of the brain. Other studies showed that it is the nucleus accumbens, the amygdala and the hippocampus, which form the pleasure centers in the brain. The psychiatrist Dr. Daniel Amen did detailed studies with SPECT scans where brain changes are made visible. Brain SPECT scans have a similar appearance in people exposed to writing, reading and listening to poetry as people who had a pleasurable meal, sex, were winning a video game, listening to music, earning money or reading a funny cartoon. The common denominator is the release of dopamine from the pleasure centres of the brain.

Jul

2022

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

By Ray Schilling | Arthritis, back pain, chronic pain, osteoarthritis, Pain, regenerative medicine, stem cells

Traditional treatment for osteoarthritis is not very successful, but stem cell therapy is a new way to treat osteoarthritis.

Traditional treatment of osteoarthritis

Osteoarthritis is a common degenerative type of arthritis. Wear and tear are diminishing the hyaline cartilage that coats joint bones. The lubrication of synovial fluid is diminishing as well. The end result is that the patient suffers pain from bone rubbing on bone in affected joints with swelling of the synovial membranes. The physician usually prescribes diclofenac topical solution for the affected joints and also gives anti-inflammatory drugs by mouth (diclofenac or ibuprofen). Unfortunately, the patient may develop side effects of the anti-inflammatory medication, such as kidney damage and gastritis. The end result after years of suffering is that the joints turn stiff and the joint pain becomes unbearable.

Joint replacement surgery

This is when the doctor refers the patient to an orthopedic surgeon, and an artificial hip or a knee joint replacement is the next suggestion. These surgical procedures are not without dangers. Postsurgically blood clots can develop and cause pulmonary emboli. Infection and sepsis can also develop. Often the surgery does not solve all of the problems and leaves the patient with a permanent limp.

Stem cell therapy to treat osteoarthritis

Regenerative medicine has developed an alternative to the conventional treatment of osteoarthritis. I described this new approach to osteoarthritis before here.

Stem cells are harvested from fatty tissue of the patient and injected into the affected joint. Stem cell stimulators like platelet rich plasma and low-dose laser therapy activate the stem cells that were lying dormant in the fatty tissue. These type of stem cells are mesenchymal in origin, so they go by the name of mesenchymal stem cells. When injected into a joint with osteoarthritis they can transform into any tissue that is needed to repair the damage of the joint. A defect of the hyaline cartilage is covered by stem cells transforming into cartilage cells and fixing the hyaline cartilage defect.

What stem cells do

Stem cells fix any meniscal degeneration in the knee joint by mending what is degenerated. They can form new tissue that over-bridged mini tears in the meniscus. If the synovial membranes that produce joint lubrication are damaged, the stem cells rejuvenate the old tissue and joint lubrication normalizes. The end result following stem cell treatment is that the osteoarthritic joint becomes regenerated with normal function. Stem cell treatment normalizes the osteoarthritic process in the joint, and down the road no joint replacements are necessary. This is a huge advantage in comparison to the conventional treatment of osteoarthritis.

My own experience with stem cell therapy for osteoarthritis of my left knee

I have experienced mild left knee arthritis for 5 years. It was not severe enough to treat with anti-inflammatory pills. I used higher amounts of fish oil capsules, which helped somewhat. I heard that Dr. Michael Weber from Lauenförde, Germany treats osteoarthritis with stem cell therapy.

He had treated my back successfully on several occasions in the past. I had previous stem cell treatment 4 years earlier as summarized here. Part of this was stem cell therapy for my left knee. During the Covid time I could not go to the gym for a period of time. Instead, I went for long walks on a nature trail that was bumpy and had many roots. This flared up my previous problem with my left knee. But in early June 2022 I made my way back to Dr. Weber’s clinic for more stem cell therapy.

The following summarizes how he treated my left knee with stem cells.

Liposuction to harvest stem cells for treatment

The doctor used a local anesthetic to freeze the skin and subcutaneous tissue on the right flank. Subsequently a solution of normal saline that contained adrenaline and bicarbonate was injected. This allowed Dr. Weber to withdraw fatty tissue easier 20 minutes after the normal saline injection. The generous portion of fatty tissue harvested was brought to a cell separator, which separated stem cells, fat cells and connective tissue. The stem cells were counted by a technician. They were found to be 100% viable and there was a total of 980 million stem cells.

Intravenous stem cells

Dr. Weber administered one portion of the total stem cell harvest intravenously. I was told that this ensured that stem cells would be delivered to tissues that needed renewal through stem cell therapy. There are several methods to stimulate stem cells. One of these methods is to give oxygen intravenously with a device with the name Oxyven (from Swiss Medica) . This procedure took 20 minutes. A second method to stimulate stem cells is with low-dose laser therapy. Dr. Weber used intravenous red, green, blue and yellow lasers, for 20 minutes each.

The laboratory kept the rest of the stem cells overnight at room temperature. Dr. Weber told me that it would have been a mistake to keep the stem cells in the refrigerator overnight as the cold temperature kills all of the stem cells!

Targeted stem cell therapy

The following day I received treatments with my stem cells harvested the day before. The doctor drew blood up first, which underwent centrifugation. The interface between the red blood cell portion and the plasma contains PRP (platelet rich plasma). Dr. Weber mixed PRP in with the stem cells. PRP is a powerful stimulator of stem cells.

Dr. Weber inserted a needle into my left knee and injected stem cells (and PRP) into the left knee. Following this he inserted a thin sterile fiberglass applicator. This served to introduce four laser lights into the knee, namely red, green, blue and yellow low-dose laser beams. Dr. Weber connected each for 20 minutes. He explained that the laser light activates the stem cells, similar to PRP and to oxygen (Oxyven, Swiss Media).

Lower cervical spine, upper thoracic spine and lower lumbar spine also treated

I get monthly chiropractic manipulations to my spine to stabilize it. My chiropractor told me that it would help to have stem cell therapy in the C4 to T4 area of the upper spine and in the L4 to S1 region in the lower spine. Dr. Weber concentrated his treatments on exactly these levels of my spine. He placed interstitial needles over the facet joints bilaterally in the lower cervical spine, upper thoracic spine and lower lumbar spine. Subsequently he injected the stem cell/PRP mix and followed this up with the four laser lights for 20 minutes each.

Follow up after the stem cell treatments

There was a lot of swelling in my left knee during the first two days after the stem cell treatment. I also experienced pain with walking. But on the third day the swelling disappeared completely. After 1 week the previous mild left knee pain improved significantly. After 1 month the left knee no longer ached with stairs or uneven ground. Presently I am still completely pain-free. My back pain also disappeared within 2 to 3 weeks.

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

Conclusion

When it comes to the treatment for osteoarthritis, conventional medicine offers topical and oral anti-inflammatory medicine. Usually, the physician also recommends active exercises and heat applications by a physiotherapist. When anti-inflammatories no longer work and bone rubs on bone in a hip or knee joint, total hip or total knee replacement by an orthopedic surgeon is usually the next step. Unfortunately, these surgical procedures have a certain complication rate. They often do not lead to perfect end results with residual pain and possibly a limp

Stem cell therapy is usually not what a family practitioner recommends. But when the physician does stem cell therapy at an early stage, the success rate is good and as in my case you can always do another stem cell therapy to improve the knee or hip joint further. There are three procedures that help to stimulate stem cells: platelet rich plasma (PRP), intravenous oxygen (Oxyven, Swiss Media) and low-dose laser activation. In my case Dr. Weber applied all of these methods together with stem cell therapy. Improvement in my case was very rapid, and it was a delight to witness the result of stem cell therapy as a patient.

Nov

2021

How to Fall Asleep Quicker

By Ray Schilling | alcohol, Circadian rhythm, Diabetes, Insomnia, melatonin, Pain, sleep, Sleep apnea

Early October 2021 CNN had an article about how to fall asleep quicker. Most people take 15 to 20 minutes to fall asleep.

Sleep environment

It is important to arrange a sleep environment where you can sleep well. This includes bedroom darkening and keeping the room temperature of 60 to 67 degrees Fahrenheit (15 to 20 degrees Celsius). Make sure your bed is comfortable and use your bedroom only for sleeping and sex. Do not read in the bedroom, keep your cell phone in another room and do not have a TV or computer in the bedroom. These produce blue light, which stimulates your brain. This is exactly what you do not want to have in your bedroom.

Normal sleep duration for different ages

There are always exceptions to rules. In this case there is a rare gene that allows the carrier to sleep only 5 hours at night and still have normal energy during the day. It is called short sleep gene.

Here are the hours of sleep that everybody else needs every night in different age groups:

Adults: 7-8 hours
School-age children: 12 hours
Teenagers: 8-10 hours

If you get the proper hours of sleep, but you are still tired during the day, you may have a lack of quality of sleep. Older people often have to go to the bathroom several times during the night. As it takes some time to reach the deepest level of sleep at night (REM sleep) older people often miss significant amounts of REM sleep during which they dream. The end result is a lack of energy during the day.

Conditions that interrupt your sleep

There are some medical conditions that can interfere with a good night’s sleep. Obstructive sleep apnea is one such condition that 25 million Americans have. A person with this kind of condition snores, gasps, chokes or stops breathing periodically during the course of the night. Restless leg syndrome is another condition, which interferes with a restful, deep sleep. Other conditions are chronic pain, heart disease, diabetes, asthma and gastroesophageal reflux. Medication can affect sleep depth as well.

Falling asleep naturally

Despite many studies it is not clear why some people have no problem falling asleep while others find it difficult. Taking 10 to 20 minutes of falling asleep is normal. If you cannot fall asleep after 20 minutes of trying, go to a dim room and do something calming until you feel drowsy again. Then return to your bed. Follow the same procedure, if you wake up in the middle of the night and you have difficulties falling asleep again. Deep breathing, yoga and meditation are proven remedies to pipe down and help you to fall asleep.

Monitoring sleep at a sleep clinic

A sleep study can be very helpful in diagnosing sleep disturbances. The sleep expert measures several body functions simultaneously. These are heart rate, air flow, blood oxygen level, breathing rate, brain wave activity, muscle movements and eye movements. During a night sleep study, a polysomnogram records all these body functions automatically. The finding helps the sleep expert to diagnose and treat the sleep disturbance.

Self-help supplements for insomnia

My regular sleep supplement every night is 3 mg of melatonin.

Sometimes this is not enough, because I watched an exciting movie or I wrote too much for Quora online. When I can’t fall asleep within 30 minutes, I take a capsule of 500 mg of valerian root. I would say that this helps in 95% of the nights to fall asleep.

If for some reason I still can’t fall asleep, I use 25 drops of Passion Flower Extract: I find that this is very reliable and puts me to sleep within 15 to 20 minutes of taking it. This way I am avoiding prescription narcotics and I am not getting addicted to benzodiazepines. The last step (Passion Flower Extract) I require only once or twice a month. The chemical in the Passion Flower Extract is very similar to benzodiazepines, which means you don’t want to take this every night or your system could get addicted to it.

How to Fall Asleep Quicker

Conclusion

Falling asleep is something we all can learn. It starts with a quiet and relaxing bedroom ambience. We need to allow for enough sleep duration. Adults need 7 to 8 hours of sleep, children and youth more. Deep breathing, yoga and meditation are proven remedies to prepare you to fall asleep easier. When all fails there are a number of self-help supplements you can take to help you ease into sleep. If you still have problems falling asleep a sleep study can be very helpful in diagnosing sleep disturbances. In a sleep clinic your heart rate, air flow, blood oxygen level, breathing rate, brain wave activity, muscle movements and eye movements are recorded with a polysomnogram. The doctor from the sleep clinic can formulate the diagnosis of the sleep disorder and help you overcome any identified problems.

The subchapter “Self-help supplements for insomnia” was published by me earlier here.

Sep

2021

World Suicide Prevention Day is on September 10

By Ray Schilling | alcohol, Anxiety, depression, Pain, Prevention, stress, Substance abuse, suicide

A CNN article points out that world suicide prevention day is on September 10.

Some statistics regarding suicides

According to the WHO more than 700,000 People die from suicide every year.

In the US suicide rates have risen between 1999 and 2018. President Joe Biden stated: “In 2019, suicide was the 10th leading cause of death in the United States, and the second leading cause of death for young people between the ages of 10 and 34.”

This was further underlined by a study from the CDC. It pointed out the emergency room visits started to climb in May 2020 for attempted suicide in youth. The CDC stated: “The mean weekly number of these visits was 26.2% higher during summer 2020 and 50.6% higher during winter 2021 compared with the corresponding periods in 2019”.

Triggering factors that make people commit suicide

Suicidal thoughts start when a vulnerable person encounters stressful events. The life situation can become so painful that in their way of thinking suicide is the only way to stop the pain. There are huge differences of opinions: what may be meaningless to one person, may feel devastating to another.

Common triggering factors are as follows.

Illness and physical discomfort
Conflicts with family or friends
Illness of family members
Death of family member or friend
Loneliness

In a study 50% expressed two of these 5 triggers, 37.5% expressed one of the 5 triggers. 12.5% expressed three of the 5 triggers.

With the Covid-19 epidemic there are new pressures on people. They cannot freely move around or travel. He/she may have lost a friend or relative to Covid. And people may be anxious about their own survival. I described this here before.

Biochemical changes in the brain with depression

In the past low serotonin levels in the brain were thought to be the main cause of depression. But researchers realized later those medications that increased serotonin levels did not always help depression. They found that dopamine and norepinephrine are also important brain transmitters that play a role in depression. When dopamine levels are low, depression occurs. Similarly, when norepinephrine is low, the patient can develop depression. On the other hand, in bipolar disorder the brain produces too much norepinephrine, which causes manic episodes. https://www.verywellmind.com/the-chemistry-of-depression-1065137 The physician needs to take a thorough history and note from that which brain transmitter system would be mainly affected. This helps the physician later to decide which antidepressant to choose from to rebalance the brain transmitters.

How to detect stress signals

There are a number of risk factors, which the CDC has outlined, for which the health professional or a family member wants to look in order to assess the suicide risk.

Does the patient have a history?

People with a mood or anxiety disorder, or with an alcohol or substance abuse disorder are at a higher risk of developing depression and suicide.

Did the person experience a loss?

A loss can be a death in the family, a loss of a job or the loss of an important person in a relationship. This is particularly bad when there is social isolation and a lack of support. With Covid-19 millions of people have suffered the loss of a job, social isolation and having to quarantine.

Is it easy for the distressed person to get a gun?

Firearms are a common means for people to kill themselves. When there is easy access to a gun, there is a high probability that the person uses it in times of distress.

History of previous suicide attempt

When a person attempted to commit suicide, but failed, there is a higher risk for them to repeat a suicide attempt and succeed. Also, there is a copycat phenomenon when the news comes out that a famous personality committed suicide. For instance, when the comedian Robin Williams committed suicide in 2014 there was a 10% rise in suicides in the following months all over the US.

Belief system that honours personal sacrifice

Some religious or cultural groups consider suicide a noble solution to a personal dilemma.

A person from this background is at a much higher risk to commit suicide.

Warning signs of pending suicide attempt

There are a number warning signs that point to a higher risk of possibly planning suicide.

A person may talk about wanting to die or kill themselves.
Searching online for ways to kill oneself or buying a gun.
Feeling trapped or feeling unbearable pain.
Talking about feeling hopeless and having no reason to live.
Stating that they feel they are a burden to others.
Drinking more alcohol and using more drugs.
Acting agitated or anxious. Reckless behavior.
A person withdrawing or isolating themselves.
A person sleeping too much or too little.
Extreme mood swings.
Talking about seeking revenge or showing rage.

These are all red flags that should alarm you to ask for help. Not all of these alarm signs are present all the time with people who are considering to attempt suicide. When you have suicidal thoughts in the US, call the National Suicide Prevention Lifeline at 800-273-8255. For Spanish crisis support call: 888-628-9454.

World Suicide Prevention Day is on September 10

Conclusion

World suicide prevention day is on September 10. This reminds us every year that suicide is a colossal problem of society. Stress, loss of health, losing a loved one, a broken marriage and financial loss can all contribute to depression. If patients with mental distress do not receive timely intervention and treatment, the life situation can become so painful that in the patient’s way of thinking suicide is the only way to stop the pain. The key is for the loved ones in the circle of friends to pay attention to the warning signs and bring the suicidal person to the attention of the psychiatric health professionals. Sometimes an in-patient admission to a psychiatric facility may be required to interrupt the negative thinking pattern. Ignoring the warning signs can have devastating consequences. Prevention is the only way to avoid suicide.

May

2021

The Power of a Placebo

By Ray Schilling | chronic pain, fractures, Pain, wound healing

A publication in Nature Communications investigated the power of a placebo. Specifically, they wanted to know whether there is a difference between a hidden and a known placebo. With a hidden placebo the patient is unaware whether a pill is a placebo pill or a real medication. With a non-deceptive or known placebo, the patient knows it is a placebo. In this study the investigators wanted to know whether a non-deceptive placebo still can have an effect. As we shall see below the answer is: yes, non-deceptive placebos still have an effect. This was also summarized in this review.

Literature review

The authors reviewed the literature about placebo effects. They found 26 studies that reported positive effects with placebos, but they were mostly self-reporting. However, 8 studies measured objective markers. Only one study found improvement with a placebo therapy, namely by performing a task. The researchers also learnt that physical conditions do not respond to a placebo therapy. Examples of such physical conditions are wound healing, healing of fractures or appendicitis requiring surgery. In contrast, the conditions responding to either hidden placebo or non-deceptive placebo involved emotional distress. This was what the subsequent experiments concentrated on.

The experiments

62 men and women participated in experiment 1. Experiment 2 had a nonclinical sample from another large university in the Midwest. Only females were accepted for experiment 2. The investigators wanted no sex differences in brain structure, brain formation and emotion processing.

The first experiment

For the first experiment the researchers recruited 62 healthy male and female students between the ages of 18 and 30. They were from two universities, namely the Michigan State University and the University of Michigan. Before the experiment started the hidden placebo group read an article about pain treatment. They were also given nasal placebo drops with the remark that this would help making the measurements more accurate. The known placebo group read another article that explained how placebos work. The text included a passage that explained that placebos work even in the case where the person knew they were a placebo. The same nasal drops were given with the remark that there was no active ingredient in it, but it “would help reduce their negative emotional reactions to viewing distressing images if they believed it would. “

Results of first experiment

The researchers asked participants to view a series of 20 images with negative and cruel content. The subjects also viewed 10 images that were neutral in content. The participants viewed each image for a few seconds, then the investigators asked how they felt on a scale of 1-9. The group who knew that the nasal spray was a placebo felt less negative after viewing the distressing images compared to the other group.

The second experiment

In the second experiment the researchers showed a mixed sequence of neutral and distressing images to female subjects. The purpose was to measure the brain activity as a result of invoking various feelings. The investigators employed a modified continuous electroencephalography (EEG) recording of the brain activity to measure the processing of feelings. They showed a neutral screen between the negative and neutral images and asked the participants to clear their mind. The researchers scanned the brain activity at two time points. The first point measured the patient’s immediate reaction. The second point measured the brain activity at the end of emotional processing and understanding of the image. As discussed below this experiment showed the power of the placebo.

Results of the second experiment

There was no difference of the known placebo group and the control group (the deceptive placebo group) with regard to the initial reaction to the images. However, the placebo group showed less activity in the second period. The researchers monitored the brain activity with a modified EEG and in comparison to the control group. According to the authors the known placebo group was able to process their emotional response to the distress better than the control group.

The authors attempted to correct for confounding variables. In the process they found out that those who did not believe in the power of a placebo still reacted the same way as the placebo group did. The researchers performed the second experiment only on women as the brains and processing modes are sex-specific. They did not want to introduce confounding variables unwittingly. At this point we do not know how males as a group react in similar experiments.

Conclusion

With a hidden placebo the patient is unaware whether a pill is a placebo pill or a real medication. With a non-deceptive or known placebo, the patient knows it is a placebo. In a study with two experiments the investigators wanted to know whether a non-deceptive placebo still can have an effect. The result of the experiments showed that non-deceptive placebos still have an effect. The proof for his was with placebo nasal drops. The subjects viewed 20 upsetting images and subsequently 10 neutral images. They scored on a scale of 1-9 how upset they felt about the distressing images. The group who knew that the nasal spray was a placebo felt less negative after viewing the distressing images in comparison to the other group.

Placebo helps to process emotional response better than control group

In the second experiment investigators employed a modified continuous electroencephalography (EEG) recording of the brain activity to measure the processing of feelings. The investigators showed alternating upsetting images and neutral images to a female group of students. According to the authors the non-deceptive placebo group was able to process their emotional response to the distress better than the control group. This showed the power of the placebo. The authors concluded that these results may help develop new treatment plans for depression, emotional disorders and emotional distress.

Oct

2020

Medical Myths about Aging

By Ray Schilling | andropause, cholesterol, Circadian rhythm, Dementia, diet, exercise, fractures, heart attack, High Blood Pressure, Hormones, lung cancer, Menopause, Mortality, Obesity, Pain, Smoking, Stroke

Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier. Here I discuss 7 common myths about aging.

Myth 1: Everyone will experience physical deterioration

It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

But you can maintain good cardiovascular function and good muscle strength with a regular exercise program. This study showed that men and women can reduce mortality by exercising regularly, even in older age.

Myth 2: Older adults cannot exercise

There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

Myth 3: As we age, we need less sleep

For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

This will also slow down our aging clock.

Myth 4: Your brain slows as you age

Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

Physical activity reduces risk for dementia

Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

Myth 5: Osteoporosis occurs only in women

There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

Myth 6: People stop sex as they age

With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

Myth 7: It is too late to stop smoking now

One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

Medical Myths about Aging

Conclusion

There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

The truth behind the medical myths about aging

I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

Jun

2020

Chronic Inflammation Can Cause Many Diseases

By Ray Schilling | Alzheimer’s disease, Asthma, Cardiovascular disease, Diabetes, fish oil, heart attack, Inflammation, kidney disease, Obesity, omega-3 fatty acids, osteoarthritis, Pain, polyunsaturated oil, Vitamins and supplements

We knew since the mid 1990’s that chronic inflammation can cause many diseases. Among these are cancer, hardening of the arteries (atherosclerosis), arthritis, dementia (Alzheimer’s disease), frailty and other degenerative disorders. LifeExtension reviewed this topic in 2019.

Older people often accumulate chronic inflammation, which associates with the aging process. Persistent pain is one of the symptoms that chronic inflammation can cause.

Doctors use tests like the C-reactive protein, hemoglobin A1C, homocysteine and the erythrocyte sedimentation rate to measure chronic inflammation.

When the doctor diagnoses chronic inflammation, it is important to find ways to inhibit it and finally resolve it. Curcumin, ginger and non-steroidal anti-inflammatories are examples of measures that help inhibit inflammation. But it is only lately that scientists have found specialized pro-resolving mediators (SPM) that help to resolve chronic inflammation. They are polyunsaturated fatty acids, which health food stores offer as supplements.

Specialized pro-resolving mediators (SPM)

Researchers isolated several pro-resolving mediators that are metabolites of omega-3 fatty acids. This link discusses an experiment where researchers obtained synovial fluid from arthritis patients who took omega-3 fatty acids. They compared this to synovial fluid from volunteers who also took omega-3 fatty acid supplements. Within 4 weeks there was a big difference for the arthritis patients with higher levels of E- and D-series SPMs in synovial fluid and plasma. Dr. Silverman reviewed the action of SPMs here. He points out that they can be taken as supplements and that they are safe, because they do not have any side effects. Conditions such as asthma, irritable bowel syndrome and various musculoskeletal conditions with chronic inflammation respond very well to SPM supplements. Omega-3 fatty acid supplements (EPA) metabolize into the E-series resolvins. On the other hand, Krill oil with Docosahexaenoic acid (DHA) metabolizes into protectins, maresins and the D-series resolvins.

Three vital tasks of pro-resolving mediators

SPMs fulfill three vital tasks, called remove, restore and renew. First, they activate macrophages, which remove dead cells and cellular debris as a result of chronic inflammation. Second, they restore the healthy balance of inflammatory compounds and anti-inflammatory substances. Third, SPMs help renew tissues that were damaged by chronic inflammation.

Some examples where SPM’s were helpful resolving inflammation in health conditions

Alzheimer’s disease patients had reduced SPMs in cerebrospinal fluid of living patients and in the hippocampus of corpses who had Alzheimer’s disease.
A research group showed that defective SPM resolution can be responsible for missing resolution of atheromatous plaques in arteries. This leads to more and more hardening of arteries until a heart attack or stroke occurs.
With obesity or metabolic syndrome insulin resistance develops. Researchers found that certain SPM’s are missing in obesity, which causes chronic inflammation. However, they also found that precursors of SPMs such as 17-hydroxydocosahexaenoic acid (17-HDHA) can serve as a novel treatment agent to treat obesity-related complications.

Newer studies about SPMs

62 patients with knee osteoarthritis had the precursor of resolvins, 17-HDHA tested in the blood. Compared to controls with no arthritis the 17-HDHA level in the arthritis patients was low. When levels of 17-HDHA were high, there was no pain in osteoarthritis patients.
Chronic periodontitis is a chronic inflammatory condition in the mouth. In a rabbit model this condition was cured with resolvin E1 derived from omega-3 fatty acids.
Delayed wound healing is typical for type 2 diabetes. In a mouse model with diabetic mice researchers inflicted skin wounds on mice. Subsequently they showed that with resolvins mice wounds healed much faster than in control mice.
Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system in humans. Potentially they will be healed with the help of resolvins or their precursors, which includes the omega-3 fatty acids EPA and DHA.

Chronic Inflammation Can Cause Many Diseases

Conclusion

New compounds have been detected that derive from the omega-3 fatty acids EPA and DHA. They have the name specialized pro-resolving mediators (SPM). Included are the resolvins D1 and D2, the resolvins E1, E2 and E3 as well as the precursors 18-hydroxyeicosapentaenoic acid (18-HEPE) and 17-hydroxydocosahexaenoic acid (17-HDHA). The function of these compounds is to stimulate macrophages to clean up areas of chronic inflammation and remove cell debris and injured cells that cannot survive. While anti-inflammatories like ginger and curcumin only tone down the inflammation, SPMs help to resolve chronic inflammation. Various chronic clinical conditions were identified as being due to chronic inflammation. Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system. We may soon see alternative approaches treating these conditions with specialized pro-resolving mediators.

Oct

2019

Steroid Injections Are Doing Harm, But Stem Cells Help

By Ray Schilling | Arthritis, osteoarthritis, Pain

When a person has osteoarthritis, steroid injections are doing harm, but stem cells help. A new study published in the journal “Radiology” came to the conclusion that steroid injections are doing harm.

The article was published on October 15, 2019. 459 patients with osteoarthritis of knees or hips received injections with intraarticular corticosteroids or placebo to conduct this study. As a matter of fact steroid injections are a standard treatment for moderate to severe osteoarthritis. The injections consisted of triamcinolone 40 mg mixed with a local anesthetic. 36 of these patients (8%) had adverse events in their joints.

Here is the break down of these negative events following intraarticular corticosteroid injections.

Accelerated osteoarthritis progression (6%)
Subchondral insufficiency fracture (0.9%)
Osteonecrosis (0.7%)
Rapid joint destruction with bone loss (0.7%)

Critical analysis of effects of intraarticular corticosteroid injections

The authors reviewed the literature and came across an evidence-based review by the Cochrane Musculoskeletal Group involving 1767 participants. The review showed an overall low evidence for all outcomes. Intraarticular corticosteroid injections were inconsistent and variations between trials were high. Certainly, there was a moderate improvement of joint pain, and physical joint function improved as well.

But then again more severe osteoarthritis in knee or hip joints showed a lack of improvement and in many cases even joint deterioration. With this in mind, these cases often ended up with total hip or total knee replacements. Overall the Cochrane review showed a lack of objective evidence of symptom improvement after intraarticular corticosteroid injections in people with osteoarthritis.

Mesenchymal stem cell injections for osteoarthritis

A fairly recent alternative approach to treating osteoarthritis is by mesenchymal stem cell injection with platelet-rich plasma activation. Researchers conducted a meta-analysis of 35 studies regarding knee osteoarthritis and mesenchymal stem cell injections in 2018. There were minor adverse events like knee pain and swelling. No serious side effects of the stem cell treatments were noted. The outcome of the treatment was classified as “very low” to “low”. The reason for this were poor study designs, large heterogeneity among the studies and wide variation among the 95% confidence intervals regarding study outcomes.

Australian study of mesenchymal stem cell injections into symptomatic knees

A short-term study from Australia examined 30 patients with mesenchymal stem cell therapy for knee osteoarthritis. There were two treatment groups. One group received 100 million adipose tissue derived mesenchymal stem cells into symptomatic osteoarthritis knee joints. Another treatment group received 100 million mesenchymal stem cells twice, namely at baseline and at 6 months after the first injection. The third group served as a control with continued conservative management. All of the groups had baseline MRI scans (magnetic resonance imaging) to assess the knee conditions. Both treatment groups had pain and inflammation at baseline. After 1 year following the initial treatment the patients had repeat MRI scans. They showed modification of the disease process in the treatment arm, while the controls had deteriorating osteoarthritis. The researchers concluded that adipose derived mesenchymal stem cell treatment of knee osteoarthritis has the potential of preventing disease progression.

Why stem cells help with osteoarthritis of the knees and the hips

Here is a research project between researchers from Palm Harbor, Florida and researchers from Serbia. The Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences University of Kragujevac, Serbia reviewed the literature on treatment of osteoarthritis.

The researchers explain that the physician can easily harvest mesenchymal stem cells by doing a liposuction of fat cells. These stem cells maintain their differentiation potential and there is only minor immunological rejection because of low histocompatibility antigen expression. As a result mesenchymal stem cells stay in the joint where they are injected.

Two processes that occur with injected stem cells

Two main advantages of mesenchymal stem cells stand out. Mesenchymal stem cells are capable of building up hyaline cartilage and in addition they have immunosuppressive characteristics. In comparison with controls patients who receive intraarticular injections of mesenteric stem cells have less pain and less swelling.

This review paper cites all the major animal and human studies regarding mesenchymal stem cell therapy for osteoarthritis. It concludes that stem cell therapy is most effective in mild to moderate osteoarthritis cases. It stresses the point that stem cells can regenerate joint tissues and that the inflammatory process of osteoarthritis is interrupted by the stem cells. This stabilized the osteoarthritic condition.

Steroid Injections Are Doing Harm, But Stem Cells Help

Conclusion

Mesenchymal stem cells derived from fatty tissue will repair tissue defects in joints afflicted by osteoarthritis. The stem cells also take care of the inflammation, which takes care of pain and swelling. Range of motion of the joint increases following stem cell treatment. Other studies have shown that intraarticular steroid injections do not interrupt the degenerative process. MRI scan studies have shown deterioration of the joint tissues following steroid injections. All in all, stem cell treatments of joints with osteoarthritis are superior to a treatment with steroid injections.

Aug

2019

Fasting Mimicking Diet For 5 Days Every Month

By Ray Schilling | Anti-aging medicine, autoimmune disease, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, fasting mimicking diet, food, heart attack, High Blood Pressure, Multiple sclerosis, Nutrition, Obesity, Pain, Prevention, stem cells, Stroke, telomeres

In December 2017 I heard Dr. Longo speak at a medical conference in Las Vegas. He suggested the use of the fasting mimicking diet for 5 days every month. I am getting into the age group where a little help from nature would not harm (I am 74 years old). I started immediately in December 2017 to do a fasting mimicking diet (FMD) for 5 days.

Effects of fasting mimicking diet

In the beginning you just notice that you are not as hungry as you thought you would be, because you do take in three mini meals of about 200 calories each, which curbs your appetite. It is also important to consume enough liquids. Please note: liquids! Not liquor! Wine, beer or any alcoholic drinks are not part of the diet. You can drink water, but, this may get boring, and you can take water with lemon, herbal teas, black tea and coffee, as long as you stay away from sugar-laced drinks.

How the FMD works

Your total calorie intake will amount to no more than 600 calories per day for the 5 days where you do the fasting mimicking diet. Your body mass index (BMI) decreases between 0.1 and 0.4 per day to a total of 0.5 to 0.9 for the 5 days. This does not seem much, but if it is accumulating every month, a person who is obese now could have a normal weight within one year. The first day of this fast may present some challenges. I found that in the afternoon I felt hungry. What helped was a hot drink( tea, coffee, clear broth). Day two was better, and from day three it has become a routine. There are no ferocious hunger pangs, no headaches or feelings of weakness or tiredness. I am always surprised that my energy level is improving when I do the fasting mimicking diet for 5 days every month.Dr. Longo suggests not to exercise during the fast. It is obvious that this time is not suitable for half- marathons or taxing hikes, but I found that thirty minutes of aerobics and thirty minutes of weight training felt good. Listen to your body! If you feel lightheaded at any time, stop! The emphasis is on “moderate”.

Dr. Longo noticed the following findings in a mouse model as well as on humans. I summarized this before in a previous blog:

Specific results when on the fasting mimicking diet for 5 days every month

Obesity diminishes, because of the weight loss effect due to missing calories.
Diabetes: insulin resistance becomes lower and blood sugar levels drop.
High blood pressure reduced: many patients were able to reduce their medications or discontinue them
Pain conditions improve as all kinds of pain disappears, an effect for which there is no explanation at this point
Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
Prevention of heart attacks and strokes because of reduction of LDL, triglycerides and CRP
Cancer cure rates improve by protecting normal cells, the bone marrow and stimulating the immune cells
Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect leads to less disease in older age.

Meal samples of fasting mimicking diet

Dr. Longo developed a kit containing all pre-packaged foods for 5 days under the name “ProLon Fasting Mimicking Diet”. The package is not larger than a shoebox, and the diet is plant-based, has some nutrition bars, drinks as well as freeze-dried soups. You can argue about the nutritional value, as it has an average rating of 3.5 out of 5. It also comes in at a hefty price of 300.00 USD. In reality it is a matter of calorie-math to consume very little food. There are plenty of tables available on the Internet that tell you the nutritional value of foods, and it does not take much effort to compose your own menu.

Here is a fairly typical list of foods

Breakfast: A typical breakfast consists of 2 slices of rye crisp bread (Wasa or Ryvita) with a bit of almond butter on it, a cup of coffee and either black or with stevia and milk.

Lunch: 8 oz. of tomato soup and coffee or tea.

Dinner: A tossed salad with organic bell peppers, ½ tomato, and two thin slices of avocado, vinegar and 1 tablespoon of olive oil.

Here is an alternative meal sample:

Breakfast: Eat a nutrition bar that is based on nuts. It should not be more than 250 calories. Alternatively make your own! Have tea or coffee.

Lunch: 8 oz. of homemade vegetable soup without the addition of pasta or beans.

Dinner: Miso soup and 4 rice crackers, alternatively a small tossed salad with olive oil and vinegar.

Results of fasting mimicking diet for 5 days every month

Here are typical results that I found over several months. I am using body composition scales every day to measure my weight, body fat percentage, visceral fat percentage, muscle percentage, calories burnt and the BMI.

One month the BMI went from 21.9 to 21.1 during a 5-day FMD. Another month the BMI experienced a reduction from 21.7 to 21. 2. Here is a list of the some of the 5-day losses of my BMI on a couple of occasions: 0.8, 0.4, 0.9, 0.7, 0.6, 0.5, 0.7 and so on.

It is important that you are not going on an eating binge after those five days. The FMD conditioned your body to be content with very small amounts of food. Enjoy your food, but stick to moderate portions.

Discussion of fasting mimicking diet for 5 days every month

An intermittent fasting mimicking diet was shown to have a diversified positive health effect in both animal models and humans. For instance, inflammatory bowel disease improves on FMD by improving the bowel microbiota and by promoting the intestinal regeneration.

Intermittent fasting, as this article shows, can prevent age-associated diseases.

This article suggests that T-killer cells that attack cancers are promoted by the intermittent fasting mimicking diet.

A FMD in type 1 diabetic patients has been shown to restore insulin generation in islets of the pancreas of these patients. The result was an improvement of their type 1 diabetes.

More research data on fasting mimicking diet

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet. The FMD makes chemotherapy more tolerable.

Fasting Mimicking Diet For 5 Days Every Month

Conclusion

I have shown that with the fasting mimicking diet (FMD) done for 5 days in every month you can lower your body mass index (BMI) by 0.4 to 0.9 units. On the long-term this helps you to keep your BMI stable and in the 21.0 to 22.0 range. Dr. Longo has researched the effect of the FMD in both mice and humans. He found that you age better with less age-related diseases. In addition, inflammatory bowel disease, autoimmune diseases like MS, rheumatoid arthritis and type-1 diabetes improve. Cancer patients who need chemotherapy tolerate it better. Their immune system also produces more killer T cells that destroy cancer cells. The FMD prevents heart attacks, strokes and cancer. Dr. Longo also has shown that there is stimulation of stem cell production and telomeres are increasing in length. Telomeres are important for longevity, which allows you to age healthier with less disease.

Feb

2018

Causes Of Back Pain And Their Treatment

By Ray Schilling | Arthritis, back pain, laser therapy, low back pain, osteoarthritis, Pain, strain

There are many possible causes of back pain and their treatment is described in this blog. I have listed the 10 most common causes of back pain below. I also added brief therapeutic suggestions.

Facet joint disease (lower back strain)

When there is a misalignment of the facet joints, the joint capsules of these small joints are pulled, which can cause severe back pain. Chiropractic or physiotherapy treatments initially followed by active exercises will help (facet joint pain).

Degenerative disc and facet joint disease

Degenerative changes of the disc material between vertebral bodies and osteoarthritis of the facet joints can cause back pain. This is due to irritation of the nerve roots. Anti-inflammatory medication and physiotherapy treatments often help; swimming will be beneficial as well. End stage intractable disease, if confined to one or two levels, may respond to fusion surgery by a spinal surgeon. While you research the surgical option, I suggest you investigate about the possibility of stem cell therapy with PRP (platelet rich plasma). This is less invasive and will likely heal better than conventional surgery.

Spondyloarthropathies

This is a family of chronic inflammatory joint diseases of the spine . The physician treats the underlying disease and uses anti-inflammatories to control inflammation. Most of all, a person with this condition needs a referral to a rheumatologist for more specific therapy.

Osteoporosis

Osteoporosis is a bone condition that can lead to compression fractures of the spine. These in turn can irritate one of the nerve roots to lea to radiating pain into one or both legs. The physician will treat the underlying hormone disbalance, if present. Regular walking and swimming are used to remobilize. Avoid alcohol, caffeine and stop smoking. Supplements like calcium, bisphosphonates, vitamin D in higher doses and vitamin K2 can help re-calcify the bone.

Scoliosis

Scoliosis is often congenital. This spinal curvature leads to back pain and hurts more the more the spine is curved. Treatment: bracing during growth spurts; good posture; strengthening exercises; in severe cases corrective surgery by a spinal surgeon through the use of Harrington rods.

Spinal stenosis

Spinal stenosis is often the end condition of severe degenerative arthritis of the spine. It is more common in the older generation. As this link explains, there is a narrowing of the channel through which the spinal cord travels. In the past decompression surgery for severe cases was the only means to free spinal cord and nerve roots. In the last few years stem cell therapy is a new addition as an alternative to orthopedic surgery. The advantage of stem cell therapy is that there is no scarring following the procedure and the stem cells function like a biological knife from inside.

Posttraumatic fibromyalgia

Some people develop lower back pain following traumatic injuries. Instead of resolving their muscle sprain, they end up with chronic pain. Often low dose antidepressants and cognitive therapy will help. Mild physical exercises may help to rehabilitate the patient and return to normal muscle mobility. Unconventional therapy like prolotherapy, dry-needling and low-dose laser therapy (Dr. Weber) may be useful.

Disc herniation with or without sciatica

With disc herniation the back pain is intense, which often prompts the orthopedic surgeon to do an early discectomy (back surgery). But long term studies have shown that only in 3% of all acute back pain cases surgery is necessary; many cases heal on their own. In this case the new regenerative medicine approach of stem cell therapy with PRP will give superb clinical results. Stem cells will rebuild the disc and also take care of any arthritis in the small joint along the spine.

Spondylolisthesis and other congenital malformations

There are 4 grades of slipped vertebral body diseases (spondylolisthesis), where grade IV is the most severe case. Grade I to IIIA do not need surgery, stage IIIB and IV need fusion with instrumentation by a spinal surgeon.

Bone metastases

In stage 4 of many cancers metastases travel through the whole body including the skeleton. The underlying cancer needs treatment, often chemotherapy is required. Unfortunately cancers with bone metastases have a very poor prognosis. Here is a link how to manage symptoms of bone metastases.

Causes Of Back Pain And Their Treatment

Conclusion

I have listed the ten most common ones of back pain. For muscle spasms, simple physiotherapy or chiropractic treatment are often very helpful. Early degenerative changes in joints and discs will often respond to anti-inflammatory medication. But anti inflammatory drugs can be hard on your liver and your kidneys. If your back pain is getting more chronic, your doctor may want to arrange for an MRI scan of the area that causes pain. If this shows degenerative change in the discs and facet joints it is time to contact a regenerative medicine clinic. They specialize in stem cell and platelet rich plasma (PRP) treatments. This may be what you need to restore your back to normal. Conventional surgical methods are often the choice, but they are not always successful. Surgery can leave scarring behind, which by itself can give you chronic back pain.