Alternative Treatments For Musculoskeletal Pain

Physical therapists.  Citations for pictures at end of post.

Here is a refreshing article suggesting that instead of just prescribing medication, doctors should suggest exercise therapy and "psychosocial interventions" - a change from the 'quick fix" attitude of just popping a pill to solve very problem.  The conclusion of the abstract:

This review presents a comprehensive summary and critical assessment of current evidence for the treatment of pain presentations in primary care. The evidence synthesis of interventions for common musculoskeletal pain presentations shows moderate-strong evidence for exercise therapy and psychosocial interventions, with short-term benefits only from pharmacological treatments. Future research into optimal dose and application of the most promising treatments is needed.

Citations for pictures:

By _US_Navy_100723-N-7214P-020_Machinist's_Mate_Fireman_George_F._Avinger_practices_cone_drills_during_physical_therapy_in_the_Comprehensive_Combat_and_Complex_Casualty_Care_facility_at_Naval_Medical_Center_San_Diego.jpg: U.S. Navy photo by Mass Communication Specialist 1st Class Anastasia Puscian_US_Navy_090508-F-7885G-021_Staff_Sgt._Hugo_Reiner,_a_physical_therapy_craftsman_aboard_the_Military_Sealift_Command_hospital_ship_USNS_Comfort_(T-AH_20),_makes_a_wrist_brace_for_Teresa_De_la_Pena_during_a_Continuing_Promise_200.jpg: U.S. Air Force photo by Airman 1st Class Danielle GrannanUS_Navy_070917-N-8704K-072_Lt._Gwen_Smith,_attached_to_Military_Sealift_Command_hospital_ship_USNS_Comfort_(T-AH_20),_performs_physical_therapy_for_Marcus_Pryce_at_the_Arima_Health_Facility.jpg: U.S. Navy photo by Mass Communication Specialist 2nd Class Joshua Karsten_US_Navy_070706-N-8704K-101_Lt._Gwen_Smith,_attached_to_Military_Sealift_Command_hospital_ship_USNS_Comfort_(T-AH_20),_performs_physical_therapy_with_the_help_of_translator_Zoela_Armstrong_at_the_Paul_Brown_Arena.jpg: U.S. Navy photo by Mass Communication Specialist 2nd Class Joshua Karsten_US_Navy_081610-A-6522B-002_Physical_therapist_Lt._Cmdr._Mitchel_Ideue,_Officer_in_Charge_of_Inpatient_Services_at_Landstuhl_Regional_Medical_Center,_in_Landstuhl,_Germany,_gives_Army_Sgt._Charlie_McCall_a_physical_therapy_trea.jpg: U.S. Navy photo_US_Navy_091003-N-8960W-011_Gunner's_Mate_2nd_Class_Patrick_Cornwell_undergoes_an_exam_by_Lt._Cristi_Zohlen_to_document_his_shoulder_pain_in_the_physical_therapy_clinic_aboard_the_aircraft_carrier_USS_Nimitz_(CVN_68).jpg: U.S. Navy photo by Mass Communication Specialist Seaman Apprentice Robert Winn_US_Navy_020128-N-6077T-008_CVN_74_crew_member_receives_medical_treatment_aboard_ship.jpg: U.S. Navy photo by Photographer’s Mate 1st Class Kevin H. Tierneyderivative work: Jnyles (talk) - _US_Navy_100723-N-7214P-020_Machinist's_Mate_Fireman_George_F._Avinger_practices_cone_drills_during_physical_therapy_in_the_Comprehensive_Combat_and_Complex_Casualty_Care_facility_at_Naval_Medical_Center_San_Diego.jpg_US_Navy_090508-F-7885G-021_Staff_Sgt._Hugo_Reiner,_a_physical_therapy_craftsman_aboard_the_Military_Sealift_Command_hospital_ship_USNS_Comfort_(T-AH_20),_makes_a_wrist_brace_for_Teresa_De_la_Pena_during_a_Continuing_Promise_200.jpgUS_Navy_070917-N-8704K-072_Lt._Gwen_Smith,_attached_to_Military_Sealift_Command_hospital_ship_USNS_Comfort_(T-AH_20),_performs_physical_therapy_for_Marcus_Pryce_at_the_Arima_Health_Facility.jpg_US_Navy_070706-N-8704K-101_Lt._Gwen_Smith,_attached_to_Military_Sealift_Command_hospital_ship_USNS_Comfort_(T-AH_20),_performs_physical_therapy_with_the_help_of_translator_Zoela_Armstrong_at_the_Paul_Brown_Arena.jpg_US_Navy_081610-A-6522B-002_Physical_therapist_Lt._Cmdr._Mitchel_Ideue,_Officer_in_Charge_of_Inpatient_Services_at_Landstuhl_Regional_Medical_Center,_in_Landstuhl,_Germany,_gives_Army_Sgt._Charlie_McCall_a_physical_therapy_trea.jpg_US_Navy_091003-N-8960W-011_Gunner's_Mate_2nd_Class_Patrick_Cornwell_undergoes_an_exam_by_Lt._Cristi_Zohlen_to_document_his_shoulder_pain_in_the_physical_therapy_clinic_aboard_the_aircraft_carrier_USS_Nimitz_(CVN_68).jpg_US_Navy_020128-N-6077T-008_CVN_74_crew_member_receives_medical_treatment_aboard_ship.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=14511419

TV Viewing Increases Physical Frailty In The Elderly

By Wags05 at English Wikipedia - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=43906515

A study was performed to determine whether the time spent watching television was associated with increased physical frailty in older individuals.

The background/objective from the abstract:

Sedentariness is an important risk factor for poor health. The main objective of this work was to examine the prospective association between television viewing time and indicators of physical function, mobility, agility, and frailty.

And the conclusions from the abstract:

Among older adults, longer television viewing time is prospectively associated with limitations in physical function independently of physical activity.

So, it would seem sitting watching television is a particularly pernicious form of inactivity that causes decreased physical function, at least in the older individuals studied.  Perhaps because watching television is such a passive experience (for example, reading a book may be physically passive but at least the mind is being used) it has such a negative impact. Get off the couch and start doing something.

Four guidelines to keep children’s weight under control

Below are the slightly modified recommendations by Dr. Robert Lustig, MD, UCSF School of Medicine:

1. Get rid of every sugared liquid in the house. Children should drink only water and milk.
 

2. Provide at least five servings of vegetables and/or fruit a day (this equals about five handfuls).

3. Serve individual portions. Serve a second portion only if the child still claims to be hungry after waiting for 20 minutes.

4. Children should have at least 60 minutes of physical activity every day.

If you would like to know more about some of these recommendations, watch “Sugar, the bitter truth”, a great presentation by Dr. Lustig available on YouTube.

Oxygen masks for all, including our doctors

At a recent meeting dedicated to a community health initiative, all attendees were marveling at the slide above, which is from the webinar “CDC's CommunityGuide:Improving the Science of Built Environment and Public Health for Physical Activity”, presented by David Hopkins (Centers for Disease Control and Prevention, 05/06/2015). 

The graph illustrates the dramatic ability of physical activity to decrease all major diseases in the Westernized world. As we were discussing the slide, a physician exclaimed, ”There is not a single medication that can achieve these results”. The inevitable thought was, “If our medications are so ineffective, why are not physicians prescribing physical activity before considering any medication?”
 
There are probably many reasons; however, two may be crucial. The first is that most patients prefer an “easy fix”, something that helps their health without testing their willpower. The second is that most doctors do not practice healthy lifestyle themselves. In fact, physicians frequently function at the brink of physiological and psychological breakdown.
 
Remember the recommendations on the use of oxygen masks on a plane? In case of decompression, oxygen masks are available; however, the rule is that “if you are traveling with a child or someone who requires assistance, secure your mask on first, and then assist the other person”. The same rule of “take care of your own condition first” should apply to our physicians, because if they do not adopt a healthy lifestyle themselves, they are not fit to fulfill their duties of healers. In fact, the same responsibility is relevant to everyone who is in charge of someone. Parents should be an example for their children, teachers should be an example for their students, and bosses should be an example for their employees. 

The American Institute for Cancer Research recommends 30 minutes of physical activity a day for adults. This activity does not have to be strenuous or associated with expenses (e.g., a gym membership), but could be walking, gardening, or cleaning the house. The exercise does not have to be continuous for 30 minutes, one could do “bursts of activities” of five minutes several times a day anywhere, even in front of the TV, in the waiting room, or in the office. In this manner, we can enhance our own health and be role models, representing a healthy lifestyle, to others.


Here is more on taking care of yourself: