The course of back pain over time

Back pain is among the most frequently reported health problems in the world. New research published in Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals, examines patterns in back pain over time and identifies the patient characteristics and the extent of healthcare and medication use (including opioids) associated with different patterns.

The study included a representative sample of the Canadian population that was followed from 1994 to 2011. A total of 12,782 participants were interviewed every two years and provided data on factors including comorbidities, pain, disability, opioid and other medication use, and healthcare visits.

During the 16 years of follow-up, almost half (45.6 percent) of participants reported back pain at least once. There were four trajectories of pain among these participants: persistent (18 percent), developing (28.1 percent), recovery (20.5 percent), and occasional (33.4 percent).

Full story at Science Daily

Turned down for federal disability payments, thousands die waiting for appeals to be heard

MILWAUKEE – It isn’t easy to be patient when you can’t work and you’re in pain, as Christine Morgan knows all too well.

Her chronic pain comes from fibromyalgia. Morgan, 60, also has spinal stenosis, a narrowing of the spaces within the spine that pinches the nerves, most often in the lower back and neck. To top it off, she is diabetic, has kidney disease, high blood pressure and depression.

Yet Morgan has been turned down for Social Security Disability Insurance –  twice. “They sent me a letter that said I wasn’t disabled,” she said.

Full story at Science Daily

Back pain shows significant association with mortality among older women

Researchers at Boston Medical Center found that frequent, persistent back pain is associated with earlier death in a study of more than 8,000 older women who were followed for an average of 14 years. After controlling for important sociodemographic and health factors, women who reported frequent, persistent back pain had a 24 percent increased risk of death compared to women with no back pain. Published in the Journal of General Internal Medicine, the study is the first to measure the impact of back pain persisting over time on mortality. The researchers also found that disability measured after back pain helped explain the association.

Back pain is the leading cause of disability worldwide, and women aged 40-80 years have the highest prevalence of back pain. Also, women report more frequent and debilitating back pain compared to men. The proportion of adults over the age of 65 is increasing rapidly in the United States, and optimizing physical health in order to extend life for older adults is a well-documented public health goal.

“To our knowledge, our study is the first to measure disability after measurement of back pain. This allowed for a prospective analysis of back pain that persisted over time and later rates of disability, which may help explain the association between back pain and mortality,” said Eric Roseen, DC, MSc, a research fellow at Boston Medical Center and leading author of the study. “Our findings raise the question of whether better management of back pain across the lifespan could prevent disability, improve quality of life, and ultimately extend life.”

Full story at Science Daily

Aging and Disability Institute Webinar: Sustainability for All: A Multi-Partner Approach to Growing Evidence-Based Program

Decreased resources and changing priorities among funders are challenging community-based organizations to become more creative in how they sustain their evidence-based healthy aging programs. While significant attention has focused on integration with healthcare systems to provide this source of sustainability, what is needed is a more global and diverse approach—one that includes advocacy at multiple levels and involves program developers, community organizations, and newly empowered participants who have benefited from programs. In this webinar, the Evidence-Based Leadership Council, a national collaborative of program developers and community implementers, shares its experiences and successes with scaling and sustaining programs through partnerships, community outreach and strategic steps towards policy change.

Participants will:

  • Be able to identify three benefits to partnering with program developers in long-term sustainability efforts;
  • List three ways to engage newly empowered participants in future program efforts; and,
  • Identify three solutions to the challenges of partnering with community organizations.

Full story at acl.gov

Direct Support Workers In Short Supply As Demand Surges

COLUMBUS, Ohio — The commercial lasts less than a minute. Time enough, Ben Young hopes, for viewers to see what he needs and to imagine what he can give.

“Come change my life,” Young says in a computer-generated voice. “I promise it will change yours forever. Help me help myself.”

The pitch, from a bright and determined young man who can neither feed nor dress himself, or even speak clearly without aid of technology, is part of a statewide campaign to recruit the workers known as “direct support professionals.” The well-being of Young and tens of thousands of other Ohioans with developmental disabilities turns on the availability of competent and reliable support providers.

Full story at Disability Scoop

Imaging may allow safe tPA treatment of patients with unwitnessed strokes

A study led by Massachusetts General Hospital (MGH) investigators may lead to a significant expansion in the number of stroke patients who can safely be treated with intravenous tPA (tissue plasminogen activator), the “clot busting” drug that has greatly reduced stroke-related disability and deaths in eligible patients. The report, published online in Annals of Neurology, describes the results of a trial using MR-based imaging technologies to identify patients likely to be within 4.5 hours of stroke onset, even though their initial symptoms had not been witnessed.

“In up to 25 percent of stroke patients, the start of their symptoms is unwitnessed, preventing them from receiving tPA,” says Lee Schwamm, MD, executive vice chair of the MGH Department of Neurology and director of the MGH Comprehensive Stroke Center, co-lead and corresponding author of the paper. “For many of these patients, the first time anything is noticed is when they get up from sleeping. Our study showed — for the first time — that tPA could be given safely to patients with stroke of unwitnessed onset if their imaging suggested the stroke was very early in its progression and they met other treatment criteria. These results pave the way for a large randomized trial of tPA in patients with unwitnessed strokes.”

Full story at Science Daily

What Are the Secrets to Aging Well?

Numbers are important to Jan Sirota, a retired investment banker who lives in Sarasota, Florida. Sirota just celebrated 11 years of marriage, he cycles 40 miles per day, mentors four high school students and races cars 150 miles per hour in High Performance Driver Education events. The number that doesn’t seem to matter? His age.

“I’m 75, and it’s irrelevant to me,” Sirota says. “There’s no reason to say that I’ll slow down because I’m getting older.”

Many older adults do slow down, however, when faced with chronic disease, disability or isolation. So why is it that some people, like Sirota, can escape that fate and live vibrantly later in life? “Certainly genetics play a big part in this, and then of course luck. However, I don’t want anyone to think we can’t fight destiny a little bit,” says Dr. Patricia Harris, a geriatrician and professor at the David Geffen School of Medicine at UCLA.

Full story at US News

Battling Pervasive Ageism

Older people who have negative views about their aging live on average 7.5 years less than people with positive attitudes. In fact, they walk more slowly, experience memory problems and recover less fully from a fall or fracture, among other things. Their attitude literally pulls them down.

And yet, how can older people help feeling negative, especially given how pervasive ageism is in the worldwide culture? In the World Values Survey” analyzed by the World Health Organization, 60 percent of respondents reported that older people are not respected. The lowest levels of respect came from the highest income countries.

New York Times reporter Frank Bruni saw ageism in action when he met Nancy Root on a cruise. Despite her high intellect, curiosity and determination, she was alienated by others. It’s a compelling story and shows ageism (and disability) in action.

Full story at US News Health

Migraine surgery produces ‘dramatic improvements’ in functioning, study finds

In addition to reducing headache frequency and severity, surgical treatment for migraine leads to significant improvements in everyday functioning and coping ability, according to a study in the January issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Our study demonstrates the high functional disability experienced by migraine patients, compared to those with other pain conditions, ” comments ASPS Member Surgeon William Gerald Austen, Jr, of Massachusetts General Hospital. “The results also show that migraine surgery can lead to dramatic improvements in functioning and coping ability, even in patients who are very disabled before surgery.”

Full story at Science Daily

Research Insights About Disability Employment

Last week, HHS presented its National Disability Employment Awareness Month Observance. I was enthusiastic about the opportunity to participate in a panel discussion with Commissioner for the Administration on Disabilities Melissa Ortiz and Michael Murray from the Office of Personnel Management. My aim in the discussion was to share high level information, and highlight some of the NIDILRR-sponsored research, training, and knowledge translation activities in employment for people with disabilities conducted by ACL.

I discussed the NIDILRR domain framework for the research portfolio – Community Living, Health and Function, and Employment, and the value and impact of our employment research on improving employment outcomes, broadly defined, for people across the working-age spectrum and across disability types. During the discussion, I presented major themes of NIDILRR’s employment research portfolio which include employment statistics, employer practices, return on investment, employment disincentives, school to work transition, and employment for individuals with psychiatric disabilities. More specific detail was provided on several of our Rehabilitation Research and Training Centers (RRTC) focused on employment.

Full story at acl.gov