Bed Rest: Still Unadvisable for LBP
 Considerable
evidence in the past decade shows that bed rest has not been beneficial to
patients suffering from low back pain (LBP). A recent review by the Cochrane
Collaboration Back Review Group analyzed all randomized studies up to March
2003, yielding two new trials comparing advice to rest in bed with advice to
stay active for patients with LBP. In total, six trials compared bed rest
with staying active for the management of LBP.
Results found that advice to rest in bed was
clearly less effective than advice to stay active for patients with acute
simple LBP. High-quality evidence shows small but consistent differences in
favor of staying active for pain and functional status at 3-4 weeks and 12
weeks follow-up, respectively. Additionally, in patients with acute simple
LBP, evidence shows that bed rest will increase length of sick leave in the
first 12 weeks, compared to advice to stay active. For patients with
sciatica, evidence shows that bed rest has little or no effect on pain and
functional status, compared to staying active at 3-4 weeks and 12 weeks.
All in all, it appears that LBP sufferers
should not count on bedrest to help decrease their recovery time or stave
off pain. If you suffer from LBP, talk to your Doctor of Chiropractic about
an appropriate treatment plan to include staying active.
Reference: Hagen KB, Jamtvedt G, Hilde
G, Winnem MF. The updated Cochrane Review of bed rest for low back pain and
sciatica. Spine, March 1, 2005;30(5):542-46.
Caffeine Increases Risk for Chronic
Daily Headache
Before your reach for your next "cup-o'-jo,"
consider the consequences of excessive caffeine consumption. Caffeine has
been shown to cause withdrawal headache, which may contribute to the
development of chronic daily headache (CDH), or headache occurring at least
15 days per month.
 To
confirm such a hypothesis, researchers recruited population-cases and
control subjects from three U.S. metropolitan areas as part of a study
designed to address caffeine’s potential involvement in CDH. Control
subjects reported two to 104 headache days annually (average: 30 days),
while population-cases reported 180 or more headache days per year (average:
260 days). Current and past caffeine consumption was assessed by way of
self-report.
Results:
High caffeine exposure, defined as being in the upper quartile of dietary
consumption or using a caffeine-containing over-the-counter medication as a
headache treatment, was associated with onset of CDH. Approximately
one-fourth of case subjects reported taking pain medication of any type
daily for headache in the previous three months.
According to the authors, “High medicinal or
dietary caffeine consumption at the time of CDH onset (e.g., pre-CDH
consumption) was a modest risk factor for CDH onset. Secondary analyses
revealed that pre-CDH caffeine consumption might be an initiating factor in
a subset of CDH sufferers, with the high-risk groups being women and those
younger than age 40."
Still need a "pick-me-up" in the morning, but
want to wean off caffeine? Try drinking green tea instead, which contains
substantially less caffeine than coffee and has been shown to have a host of
health benefits, including antioxidant and anti-cancer properties.
Reference: Scher AI, Stewart WF,
Lipton RB. Caffeine as a risk factor for chronic daily headache. A
population-based study. Neurology, Dec. 14, 2004;63(11):2022-27.
Study Shows Exercise May Help Reduce
Depression
In 1997, a study found that mild to moderate
major depressive disorder (MDD) ranked second behind heart disease in terms
of years of life lost due to premature death or disability. National
estimates indicate that fewer than one-fourth of individuals with MDD seek
treatment, and only one in 10 receive adequate treatment. A recent study was
designed to test whether exercise is beneficial in treating mild to moderate
MDD, and to determine the dose-response relation of exercise and reduction
in depressive symptoms.
Eighty adults diagnosed with mild to moderate
MDD were randomized to one of four aerobic exercise treatment groups that
varied total energy expenditure (7.0 kcal/kg/week or 17.5 kcal/kg/week) and
frequency (three days/week or five days/week), or to a placebo control group
that participated in flexibility exercises three days a week. Outcome was
determined by the score on the 17-item Hamilton Rating Scale for Depression
(HRSD).
Results:
After 12 weeks, the group expending 17.5 kcal/kg/week (consistent with
public health recommendations) had the lowest scores, while the placebo
control group had the highest scores. The authors concluded that “Aerobic
exercise in the amount recommended by consensus public health
recommendations was effective in treating mild to moderate MDD. The amount
of exercise that is less than half of these recommendations was not
effective."
If you suffer from mild to moderate
depression, try engaging in some type of physical activity. You'll
experience a wide range of benefits in a short amount of time, including
elevated mood, increased stamina and improved health, overall.
Reference: Dunn AL, Trivedi MH,
Kampert JB, et al. Exercise treatment for depression. Efficacy and dose
response. American Journal of Preventive Medicine 2005;28(1):1-8. |
