Acupuncture Decreases High Blood Pressure

A recent study published in Medical Acupuncture has shown that electroacupuncture can significantly reduce systolic and diastolic blood pressure in hypertensive subjects. After the treatment, plasma levels of norepinephrine, renin and aldosterone were all significantly decreased and this is thought to be related to the beneficial effects of the electroacupuncture.

Tips For Weight Loss

Last month a group of researchers from Tufts University published a fascinating article in The American Journal of Clinical Nutrition. Their objective was to determine how changes in intake of protein foods, glycemic load (GL) of carbohydrates, and the interrelationship between the two influence long-term weight gains.  The GL of food is a number that estimates how much the food will raise a person’s blood glucose level after eating it. Glycemic load accounts for how much carbohydrate is in the food and how much each gram of carbohydrate in the food raises blood glucose levels.

They followed a group of over 120,000 men and women for 16 to 24 years whilst adjusting for body mass index and lifestyle changes such as smoking, physical activity, television watching and sleep duration.

Protein

• Meat, chicken (with skin) and regular cheese were positively associated with long-term weight gain
• No association for milk, legumes, peanuts, eggs
• Yogurt, peanut butter, nuts, chicken (without skin), low-fat cheese and seafood were associated with weight loss

Glycemic Load

• Increases in GL were associated with weight gain

Protein & Glycemic Load Synergy

• Changes in GL of carbohydrates affect the usual weight changing effects of protein foods; for example, increased cheese intake was associated with weight gain when GL increased, with weight stability when GL did not change, and with weight loss when GL decreased.

“Our study adds to growing new research that counting calories is not the most effective strategy for long-term weight management and prevention,” said senior author Dariush Mozaffarian. “Some foods help prevent weight gain, others make it worse.  Most interestingly, the combination of foods seems to make a big difference.  Our findings suggest we should not only emphasize specific protein-rich foods like fish, nuts, and yogurt to prevent weight gain, but also focus on avoiding refined grains, starches, and sugars in order to maximize the benefits of these healthful protein-rich foods, create new benefits for other foods like eggs and cheese, and reduce the weight gain associated with meats.”

Paracetamol Ineffective For Back Pain And Osteoarthritis

Most of us have us have used paracetamol at some point in our lives, whether to bring down a fever, for a headache, joint pain or some other painful condition. In fact, if we have a look in our medicine cabinets we’ll probably find a box…or two! Machado et al. from George Institute for Global Health at the University of Sydney recently reviewed the scientific literature with the aim of investigating the efficacy and safety of paracetamol (acetaminophen) in the management of spinal pain and osteoarthritis of the hip or knee. They included 13 randomised controlled trials in their review and the results were published in the BMJ.

They found that for low back pain, paracetamol was ineffective at reducing pain or disability and at improving quality of life. It’s important to point out that by “ineffective”, they mean that paracetamol did not provide more benefit than a placebo. For hip and knee osteoarthritis they found that there was a significant, although not clinically important, effect on pain and disability in the short term. Adverse events were not more likely with paracetamol than placebo but patients taking paracetamol are 4 times more likely to have abnormal results on liver function tests.

Although the clinical importance of the last finding is uncertain, paracetamol has been linked to increasing incidence of mortality, increased risk of cardiovascular, gastrointestinal and renal disease. This study has prompted the BMJ to release an editorial discussing the use of paracetamol for back pain and osteoarthritis. One of the problems for GPs is that the National Institute for Clinical Excellence (NICE) recommends paracetamol as the first port of call for low back pain and arthritis. Taking this option away leaves NSAIDS and opioids which both present even more health risks… Non-pharmalogical options should be pursued and developed i.e. physical activity and exercise, weight loss, nutritional supplements and physiotherapy of course!

New Pain Mechanisms Revealed

Neuropathic pain is a chronic pain condition caused by a damaged or dysfunctional nervous system. It is characterised by shooting and burning pain that lasts long after the initial onset. Common causes of neuropathic pain include:

• alcoholism
• amputation
• back, leg and hip problems
• chemotherapy
• diabetes
• facial nerve problems
• HIV or AIDS
• multiple sclerosis
• shingles
• spine surgery

Unfortunately neuropathic pain doesn’t respond much to conventional analgesics but instead, antidepressants (amitriptyline and duloxetine) and anticonvulsants (gabapentin and pregabalin) have been found to help relieve pain.

A new study published in this month’s edition of Neuron by Thomas Nevian et al from the Department of Physiology at the University of Bern has revealed some of the mechanisms involved in neuropathic pain. In a mouse model, they found that neurons in the gyrus cinguli, a part of the brain found in the limbic system (usually associated with emotion) are modified by pain forming a “pain memory”. Neurons in the gyrus cinguli become more excitable due to a down-regulated ion channel. This leads to an increased number of nerve impulses which the brain perceives as pain.

The researchers managed to restore the function of the ion channel by activating a receptor sensitive to serotonin. This explains the success of some antidepressants in treating neuropathic pain. Nevian et al were able to identify the specific subtype of serotonin receptor that was more efficient at reducing the perception of pain. Excitingly, this could lead to the development of more effective drugs to treat neuropathic pain.

Meditation Decreases Chronic Neck Pain

A group of German researchers recently published the results of a study looking into the benefits of meditation on people with chronic neck pain. The article was published in The Journal of Pain. They studied about 90 people who had neck pain for an average of 11 years. The average age of the participants was 50 years. Their results found significant improvements in pain reduction and pain coping but no effect on functional disability.

The findings suggest that meditation could be used as an adjunct alongside physical treatments that provide functional benefits.

The Miracle Cure

Scarlett McNally, a Consultant Orthopaedic surgeon, and her colleagues have spent 2 years analysing more than 200 separate pieces of research. The effect that regular exercise could have on our health is amazing. Exercise could:

• prevent type 2 diabetes
• reduce the risk of getting breast cancer by 25%
• decrease the risk of bowel cancer by 45%
• reduce the risk of having a stroke by 30%
• reduce the risk of developing dementia by 30%
• cut the risk of developing heart disease by over 40%
• as well as improvements to mental health

Exercise doesn’t have to be vigorous but it should be regular. Simply start by increasing your physical activity in whatever way you can: walk more, take the stairs, do some gardening, ride a bike…the possibilities are endless!

What Triggers Low Back Pain?

A study published this month in Arthritis Care and Research by Daniel Steffens et al. from the University of Sydney has looked at the risk factors that could lead to acute low back pain. Acute low back pain is back pain that comes on suddenly and resolves after a few days or weeks as opposed to chronic low back pain which is long-standing.

They surveyed close to 1000 people and asked them about the presence of 12 physical and psychosocial factors up to 4 days before the onset of back pain. The results revealed that a number of triggers were linked to acute low back pain:

• moderate to vigorous physical activity increased the risk by 3
• manual tasks involving awkward postures increased the risk by 8
• being distracted during an activity increased the risk by 25
• age decreased the effect of exposure to heavy loads
• risk was highest between 7 am and mid-day

Over the years, I’ve noticed that the parents of young children have an increased incidence of low back pain. Having seen some of the risk factors high-lighted in this study, it becomes evident how sleep-deprived, fatigued and distracted parents that often lift their children in awkward positions can dramatically increase the risk of low back pain. It’s also interesting to note that distraction seems to massively increase the risk of low back pain and therefore underlines the importance of mindfulness.

Sleep Quality Linked to Rumination

Jacob Nota and Meredith Coles from the Department of Psychology at Binghamton University in the US have made some interesting discoveries regarding sleep duration and timing. Their research confirmed what others had already noticed, that rumination (repetitive negative thinking) was associated with reduced sleep duration. In addition to this, they found that the timing of sleep was also important. Individuals that reported later sleep and activity times also reported more repetitive negative thinking.

People that ruminate tend to suffer more from anxiety, depression, post-traumatic stress disorder and obsessive-compulsive disorders. For those that sleep too few hours, increasing sleep has already been found to decrease symptoms of psychopathology. Further efforts to get to bed earlier may provide even more benefit.

These recent findings highlight the importance of sleep on health.

Diabetes Linked To Shoulder & Hand Pain and Disability

A recent study by Shah et al. found that about two-thirds of patients attending a diabetes outpatient clinic reported shoulder pain and/or disability. They had significant restrictions in shoulder movement, decreased shoulder strength and hand grip strength. In addition to this, they had a greater likelihood of decreased sensation and limited mobility of the hand. Further research is needed to understand the underlying mechanisms and to find preventative measures.

Side Planking Reduces Scoliosis

Dr Loren Fishman et al. studied a group of 25 patients with scoliosis. They taught the patients how to perform the side plank, which is a static exercise performed in Yoga and Pilates. The patients were then asked to perform the exercise once a day for as long as possible. They were instructed to only perform it on one side, with the scoliotic convexity downwards. The theory being that it would strengthen the weaker side of the spine and help address the muscle imbalance.

Measurements and x-rays were taken pre and post treatment. On average, patients reported practising the pose for 90 seconds a day, 6 days a week, for just under 7 months. A significant improvement of 32% was found in the Cobb angle of the primary scoliotic curve. The improvement rose to above 40% among the 19 most compliant patients.

This is an amazing result given the minor time investment!