Pro Health Therapies Massage

12/03/2024

L-S: Incidence of and risk factors for lumbar disc herniation with radiculopathy in adults: A Systematic Review

Analysis by Physio Meets Science

👉 “Radiculopathy due to lumbar disc herniation (LDH) is one of the most recognizable disorders of the low back. The diagnosis is typically based on a combination of symptoms and signs suggesting lumbar spinal nerve root compression or irritation, such as radicular pain with nerve root tension signs, neurologic deficits, and imaging findings that correlate with the clinical syndrome (https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007431.pub2/full, https://pubmed.ncbi.nlm.nih.gov/24239490/).

👉 LDH, defined as the localised displacement of disc material beyond the margins of the intervertebral disc space (s. figure below, https://pubmed.ncbi.nlm.nih.gov/24768732/), is the most common cause of lumbosacral radiculopathy (https://www.ncbi.nlm.nih.gov/books/NBK430837/). Compared with nonspecific low back pain without radiculopathy, LDH with radiculopathy is typically associated with greater pain, disability, healthcare use, and intervention (https://pubmed.ncbi.nlm.nih.gov/9516703/, https://pubmed.ncbi.nlm.nih.gov/15125627/, https://pubmed.ncbi.nlm.nih.gov/21358478/, https://pubmed.ncbi.nlm.nih.gov/31296665/).

📘 However, little is known about the incidence of LDH with radiculopathy, and consequently, risk factors are not well understood. The aim of a brand-new Systematic Review by Hincapié and colleagues was to synthesise the evidence on the incidence of and risk factors for LDH with radiculopathy in adults. (https://pubmed.ncbi.nlm.nih.gov/39453541/)

🔍 Methods

A systematic search of five electronic databases was conducted, covering research published from 1970 to September 2023. The databases included Medline, Embase, Cochrane Central Trials Registry, among others. The researchers focused on cohort and case-control studies while excluding cross-sectional, cadaveric, and animal studies. A total of 87 studies were critically reviewed, with 59 studies (68%) assessed as having low to moderate risk of bias, and thus included in the best evidence synthesis.

📊 Results

👉 Incidence of LDH with Radiculopathy

The incidence rates varied significantly depending on the population and case definitions used:

▶︎ For surgical cases, the annual incidence ranged from 0.3 to 2.7 per 1,000 persons.

▶︎ For hospital-based cases, the incidence was between 0.04 to 1.5 per 1,000 persons.

▶︎ For clinical cases (based on symptoms without surgery), estimates varied widely, from 0.1 to 298.3 per 1,000 persons. The variability in incidence rates was due to differences in diagnostic criteria, population characteristics, and settings (e.g., general, occupational, or healthcare-specific populations).

👉 Risk Factors for LDH with Radiculopathy:

👩‍🦳 Age: Middle-aged adults (30-50 years) showed a higher incidence compared to younger adults: Risk ratio 1.3 (1.2–1.5) to 1.8 (1.5–2.0).

👉 Behavioral and Lifestyle Factors:

🚬 Smoking increased the risk, especially in women, with a risk ratio of 1.4.

⚖️ Higher Body Mass Index (BMI) and other 🫀 cardiovascular risk factors were linked to a higher likelihood of developing LDH in women with associations ranging from 1.1 (1.0–1.3) to 1.5 (1.2–2.0)

👉 Occupational Factors:

🛠️ Jobs involving heavy lifting, repetitive forward bending, or prolonged sitting significantly contributed to the risk with associations ranging from 1.6 (1.1–2.7) to 3.7 (2.3–6.0).

🪚 Manual material handling and physically demanding work environments were particularly high-risk.

👉 Other Factors:

🤯 Mental stress and number of psychological distress symptoms were associated with LDH with radiculopathy in exploratory phase II studies (compared with none), with associations ranging from 1.6 to 3.0 (0.9–5.9).

💡 Conclusion:

The annual incidence of LDH with radiculopathy varies widely, reflecting the variability in evidence due to differences in case definitions and study populations. From phase III and low risk of bias studies, key risk factors have been identified. These include occupational physical factors, particularly cumulative lumbar load from activities like forward bending and manual materials handling, which show a strong association with LDH. Lifestyle factors such as smoking and high BMI are also contributors. Additionally, mental stress has been highlighted as a potential risk factor.

📷 Figure: CT and MRI Terminology for Herniated Disks. Panel A shows a normal lumbar intervertebral disk. Panel B shows a bulging disk. The dashed line indicates the normal disk space. Annular tissue extends beyond the normal disk space. Panel C shows protrusion of a disk. The greatest measure of the displaced material is less than the measure of the base of the displaced material. Panel D shows extrusion of a herni-ated disk. The greatest measure of the displaced disk material is greater than the measure of the base of the displaced disk material. Panel E shows sequestration of a herniated disk. The displaced disk material has lost all connection with the disk of origin.” (https://pubmed.ncbi.nlm.nih.gov/27144851/)

- Physio Meets Science

06/11/2024

I read this and I cried. Let me continue to be this person:

“Forever in awe of people who pay attention.

People who wait for you while you tie your shoes while the others have walked away.

When they continue listening intently while the rest of the group stopped listening.

Noticing your moments of silence when everyone else hasn’t.

“This made me think of you” noticing things you never even noticed about yourself.

People who say “text me when you get home safe.

”People who make you laugh until you cry.

Childhood friends who keep in touch.

People with genuine intentions.

People who are soft when the world has given them every opportunity to turn hard.

The “let’s get ice cream” at 3am friend.

The turn up the music in the car and sing friend.

People whose actions match their words.

People who make the world feel less chaotic.

Kindred spirits.

The trustworthy and honest.

Hard workers.

Good listeners.

Clear communicators.

People who love you for who you are.

People who don’t ask you to be anything other than yourself.

People who choose you.

People who stay."

06/05/2024

Did you know:
If you have a pacemaker, you can put it in your Will to have your pacemaker donated to a dog in need after you pass. Pacemakers cannot be donated to another human, but they can be donated to dogs with cardiac issues who would depend on it to stay alive.
You can have the pacemaker brought to a vet of your choice. So many of those get thrown away and dogs die because people don't know they can do this. It even saves the dog's owner the cost of the actual pacemaker which sometimes means the difference in being able to afford lifesaving treatment or not.

04/04/2024

Intro Info on Qigong for Beginners...

Feel your QI! This complete YOQI qigong flow routine designed for beginners to purge, tonify, regulate and circulate your qi.View over 50 more YOQI video rou...

04/04/2024

Excellent Info on Fascia...

There’s a connective tissue running all throughout your body that not only holds all your muscles and organs together, but also has sensory and mechanical pr...

03/23/2024

02/13/2024

🔈SHOULDER PAIN EXPLAINED

Shoulder pain, often associated with impingement, results from compression or irritation of structures within the shoulder joint. Three main types of shoulder impingement are:

1. Primary External Impingement:
- Compression of rotator cuff tendons and the subacromial bursa between the humeral head and acromion.
- Common in activities involving repetitive overhead motions.

2. Secondary External Impingement:
- Related to shoulder joint instability or abnormal motion.
- Caused by factors like muscle imbalances, weakness, or poor scapular control.

3. Internal Impingement:
- Compression within the shoulder joint, affecting rotator cuff tendons and the articular side.
- Often observed in athletes performing repetitive overhead motions, such as throwing athletes.

Referred pain to the shoulder can stem from the cervical and thoracic spine:

1. Referred Pain from Cervical Spine:
- Due to conditions like cervical radiculopathy, herniated discs, or foraminal stenosis.
- Involves muscles in the neck (trapezius, levator scapulae, and rhomboids) and nerves (brachial plexus and cervical nerves).

2. Referred Pain from Thoracic Spine:
- Less common than cervical spine-related pain.
- Associated with conditions like thoracic disc herniation or nerve compression.
- Involves muscles in the upper back (trapezius and rhomboids) and thoracic spinal nerves.

Neural Involvement:
- Neural issues may arise when nerves from the spinal cord are affected, particularly the brachial plexus.
- Nerve compression or irritation along the brachial plexus can lead to pain, tingling, or numbness radiating into the shoulder and upper extremities.

02/13/2024

WHY DO KNUCKLES CRACK... and is it Safe?

“What’s known with certainty is that the cracking happens when the space between joints is increased, by bending or pulling. This creates a pressure vacuum within the synovial fluid, as it’s called, and dissolved gases form an air bubble. What scientists don’t know is whether the sound is caused by the bubbles forming or collapsing.

Problem is, it’s hard to get inside a knuckle and watch what’s happening, but researchers did the best they could in a 2015 study, using an MRI machine. They concluded that the pop is made by air rushing into a cavity, forming a bubble.

Another group of scientists, using a mathematical model in 2017, argued that the collapse of a bubble would produce a sound consistent with what we actually hear.

Either way, the air bubbles help explain why most people can’t usually crack the same joint twice without a delay: The air must build back up (or dissolve back out, depending on which explanation is correct). There’s also room in all this for a partial crack, scientists say, which sometimes allows for a second cracking right away.

THE BRAIN SEEMS TO GET A KICK OUT OF IT

The force produced by these bubbles may activate sensory receptors in the joint, which some experts believe causes the satisfaction people derive from cracking their knuckles,” says Branden Daubel, physical therapist in UT Health Austin’s Musculoskeletal Institute. “These receptors send information about where your joint is in space to your brain, and your brain gives you a little hit of dopamine because it loves information.”

BUSTING THE ARTHRITIS MYTH

Importantly, and contrary to what Mom said, knuckle cracking does not seem to cause arthritis. A large study way back in 1975 found no greater risk for arthritis in older people who were lifelong, habitual knuckle-crackers. The finding was confirmed by a smaller 2011 study.

One study is hands-down the most interesting, however. Donald Unger, MD, conducted his own 50-year-long experiment. At least twice a day, he cracked the knuckles of his left hand only—more than 36,000 times in all, as described by Steve Mirsky in Scientific American. Then Unger published a study on the results in 1998, indicating that he’d suffered no arthritis, and there were no noticeable visible differences in his two hands.

As long as knuckle cracking doesn’t cause you pain, there's no reason to worry, says Alexander Soneru, MD, an orthopedic surgeon with Loyola Medicine.

“Parents frequently tell me that their child cracks their knuckles,” Soneru notes. “I tell them that they may not like the sound, but they shouldn’t worry about negative effects, such as arthritis, down the road.” Robert Britt

HOW DO YOU THINK THIS RESEARCH APPLIES TO OTHER SYNOVIAL JOINTS?

02/13/2024

🔈 Muscle Vocabulary Explained