Health
Just 1 in 10 back pain treatments work, study says — what to do instead
Chronic back pain is the most common type of pain, affecting around 16 million American adults — and now a new study has revealed some discouraging findings about potential treatments.
Only around one in every 10 treatments was found to be effective in relieving lower back pain, according to a new study published in BMJ Evidence-Based Medicine.
Many of them are “barely better than a placebo” in terms of pain relief, as stated in a press release from the University of New South Wales (UNSW) in Sydney, Australia.
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“Our review did not find reliable evidence of large effects for any of the included treatments,” said lead study author Dr. Aidan Cashin, deputy director of the Centre for Pain IMPACT at Neuroscience Research Australia (NeuRA) and conjoint senior lecturer in the School of Health Sciences at UNSW Sydney.
Only around one in every 10 treatments was found to be effective in relieving lower back pain, according to a new study. (iStock)
The researchers reviewed 301 randomized, controlled trials that included data on 56 non-surgical treatments for adults experiencing acute low back pain, chronic low back pain or a combination of both types, comparing them to groups that received placebos.
“Treatments included in the research were pharmacological, such as non-steroidal anti-inflammatory drugs – or NSAIDs – and muscle relaxants, but also non-pharmacological, like exercise and massage,” Cashin said.
Effective and ineffective treatments
Ineffective treatments for acute low back pain included exercise, steroid injections and paracetamol (acetaminophen), the study found.
For chronic low back pain, antibiotics and anaesthetics were also “unlikely to be suitable treatment options,” the study found.
Around 16 million adults experience persistent or chronic back pain, data shows. (iStock)
For acute low back pain, non-steroidal anti-inflammatory drugs (NSAIDs) could be effective, the study found.
For chronic low back pain, therapies including exercise, taping, spinal manipulation, antidepressants and transient receptor potential vanilloid 1 (TRPV1) agonists may be effective — “however, those effects were small,” Cashin noted.
“Things like stress, sleep quality, fatigue, fear, social situations, nutrition, sickness and previous history of pain all play a role in how we experience pain.”
The findings were “inconclusive” for many other treatments due to the “limited number of randomized participants and poor study quality,” the researchers stated.
“We need further high-quality, placebo-controlled trials to understand the efficacy of treatments and remove the uncertainty for both patients and clinical teams,” Cashin said.
Dr. Stephen Clark, a physical therapist and chief clinical officer at Confluent Health in Georgia, noted that the study was looking at “isolated interventions.”
“They excluded studies where it was not possible to isolate the effectiveness of the target intervention,” Clark, who was not involved in the study, told Fox News Digital.
‘Complex condition’
Pain is a complex condition influenced by many different factors, according to Clark.
“Determining a specific cause of low back pain, particularly when the pain is persistent, is difficult, as the BMJ study points out,” he said.
For acute low back pain, non-steroidal anti-inflammatory drugs (NSAIDs) could be effective, the study found. (iStock)
“Things like stress, sleep quality, fatigue, fear, social situations, nutrition, sickness and previous history of pain all play a role in how we experience pain.”
Clark recommends “multimodal” treatments for pain, including multiple interventions tailored to each individual patient’s experience.
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“Physical therapy research shows that manual therapy (joint mobilization/manipulation, soft tissue techniques), active interventions like exercise, and education about why you hurt and what to do about it is the ticket,” he said.
“It’s also important to remember that what worked for someone else might not be the exact pathway that works for you,” one physical therapist said. (iStock)
“It’s also important to remember that what worked for someone else might not be the exact pathway that works for you.”
While surgical intervention can be effective for some patients, Clark noted that it can present its own challenges and should be a “last resort” for non-emergency situations.
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“While surgery is indicated in some cases, it’s almost never the answer in isolation,” he said. “Understanding pain and the complexity around a person’s situation must be in view.”
“In many cases, conservative care can prevent or delay the need for invasive procedures.”
Researchers are warning that men who regularly dodge prostate cancer screening appointments are 45% more likely to die from the disease.
Prostate cancer is the most common cancer among men and the second-leading cause of cancer deaths, according to UC San Francisco (UCSF).
But if screening programs are introduced on a national scale — particularly those that measure levels of prostate-specific antigen (PSA) in the blood — they could give men earlier access to treatment, experts say.
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They would thus have a better chance of being cured, according to reporting by news agency SWNS and others.
Screening can also prevent costly treatments associated with advanced prostate cancer.
A new study examined the link between the consistent decline of men’s screenings and the risk of dying from prostate cancer. It reveals a “stark contrast” that emphasizes the potential consequences of screening avoidance. (iStock)
That’s according to data from the European Randomised Study of Screening for Prostate Cancer (ERSPC).
The study collects information from seven European nations — Finland, the Netherlands, Italy, Sweden, Switzerland, Belgium and Spain. It is said to be the world’s largest prostate cancer screening study, said SWNS.
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Long-term data from this entity consistently shows that PSA screening programs can lead to a 20% reduced risk of dying from prostate cancer.
‘Stark contrast’
Now, an analysis of 20-year follow-up data from the ERSPC is the first to look at the link between the consistent decline of screening invitations and men’s risk of dying from this type of cancer.
It reveals a “stark contrast” that emphasizes the potential consequences of screening avoidance.
Of the 72,460 men invited to partake in screenings, around one in six were non-attenders and skipped every appointment.
Researchers from Erasmus MC Cancer Institute at the University Medical Centre in the Netherlands led the analysis, said SWNS.
Of the 72,460 men invited to partake in the screenings, around one in six were non-attenders and skipped every single appointment.
That group had a 45% higher risk of dying from prostate cancer compared with those who attended screening appointments, according to the findings.
Choosing not to participate in screening is a choice that may be driven by a complex collection of factors, said one expert. (iStock)
When comparing outcomes with the control group – men who were never invited to have screenings – those who attended the screening appointments had a 23% lower risk of dying from prostate cancer, while non-attenders faced a 39% higher risk, SWNS reported.
Lead study author Renée Leenen, M.D., Ph.D., said the choice not to participate in screening may be driven by a complex collection of factors.
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Said Leenen, who is with the Erasmus CM Cancer Institute in the Netherlands, “It may be that men who opted not to attend a screening appointment are care avoiders — meaning they’re less likely to engage in healthy behaviors and preventative care in general.”
Experts “need to better understand who these men are, why they choose not to attend appointments and how to motivate them.”
She added, “This is the opposite behavior of people who are perhaps more health-conscious and are more likely to attend a screening appointment … Our study identifies that men who were invited for screening, but do not attend screening appointments, are at a significantly higher risk of dying from prostate cancer compared to men who were not offered screening or accepted an invitation for screening.”
Long-term data from this entity consistently shows that PSA screening programs can lead to a 20% reduced risk of dying from prostate cancer. (iStock)
Dr. Leenen said that experts “need to better understand who these men are, why they choose not to attend appointments and how to motivate them.”
Doing so, she added, “will help us design population-based prostate cancer screening programs that encourage higher rates of informed participation … Tackling attendance rates in this way could be a big factor in the long-term success of a national prostate screening program,” SWNS reported.
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Urologist Tobias Nordström, M.D., Ph.D., of the Karolinska Institute in Sweden, said, “We need to better understand why these men might actively choose not to participate in screening, despite being invited to attend, and how this behavior is linked to worse outcomes when they get a diagnosis.”
The findings from the study are scheduled to be presented this weekend at the European Association of Urology (EAU) Congress in Madrid, Spain, said SWNS.
Fox News’ senior medical analyst Dr. Marc Siegel, who was not involved in the new study on prostate cancer risks, previously called out the need for regular medical screenings.
Siegel has emphasized the need to “diagnose it early for better outcomes.”
Angelica Stabile of Fox News Digital contributed reporting.
Late in February, as the Trump administration ramped up its quest to transform the federal government, a psychiatrist who treats veterans was directed to her new workstation — and was incredulous.
She was required, under a new return-to-office policy, to conduct virtual psychotherapy with her patients from one of 13 cubicles in a large open office space, the kind of setup used for call centers. Other staff might overhear the sessions, or appear on the patient’s screen as they passed on their way to the bathroom and break room.
The psychiatrist was stunned. Her patients suffered from disorders like schizophrenia and bipolar disorder. Treating them from her home office, it had taken many months to earn their trust. This new arrangement, she said, violated a core ethical tenet of mental health care: the guarantee of privacy.
When the doctor asked how she was expected to safeguard patient privacy, a supervisor suggested she purchase privacy screens and a white noise machine. “I’m ready to walk away if it comes to it,” she wrote to her manager, in a text message shared with The New York Times. “I get it,” the manager replied. “Many of us are ready to walk away.”
Scenes like this have been unfolding in Veterans Affairs facilities across the country in recent weeks, as therapy and other mental health services have been thrown into turmoil amid the dramatic changes ordered by President Trump and pushed by Elon Musk’s Department of Government Efficiency.
Among the most consequential orders is the requirement that thousands of mental health providers, including many who were hired for fully remote positions, now work full time from federal office space. This is a jarring policy reversal for the V.A., which pioneered the practice of virtual health care two decades ago as a way to reach isolated veterans, long before the pandemic made telehealth the preferred mode of treatment for many Americans.
As the first wave of providers reports to offices where there is simply not enough room to accommodate them, many found no way to ensure patient privacy, health workers said. Some have filed complaints, warning that the arrangement violates ethics regulations and medical privacy laws. At the same time, layoffs of at least 1,900 probationary employees are thinning out already stressed services that assist veterans who are homeless or suicidal.
In more than three dozen interviews, current and recently terminated mental health workers at the V.A. described a period of rapid, chaotic behind-the-scenes change. Many agreed to speak on the condition of anonymity because they want to continue to serve veterans, and feared retribution from the Trump administration.
Clinicians warn that the changes will degrade mental health treatment at the V.A., which already has severe staffing shortages. Some expect to see a mass exodus of sought-after specialists, like psychiatrists and psychologists. They expect wait times to increase, and veterans to eventually seek treatment outside the agency.
“Psychotherapy is a very private endeavor,” said Ira Kedson, a psychologist at the Coatesville V.A. Medical Center in Pennsylvania and president of AFGE local 310. “It’s supposed to be a safe place, where people can talk about their deepest, darkest fears and issues.” Veterans, he said, trust that what they tell therapists is confidential.
“If they can’t trust us to do that, I think that a sizable number of them will withdraw from treatment,” he said.
A Veterans Affairs spokesman, Peter Kasperowicz, dismissed the contention that a crowded working environment would compromise patient privacy as “nonsensical,” saying that the V.A. “will make accommodations as needed so employees have enough space to work and comply with industry standards for privacy.”
“Veterans are now at the center of everything V.A. does,” Mr. Kasperowicz added. “Under President Trump, V.A. is no longer a place where the status quo for employees is to simply phone it in from home.” Anna Kelly, a White House spokeswoman, said the president’s return-to-office order was “ensuring that all Americans benefit from more efficient services, especially our veterans.”
The DOGE cuts have already sparked chaos and confusion within the sprawling agency, which provides care to more than nine million veterans. The Trump administration has said it plans to eliminate 80,000 V.A. jobs, and a first round of terminations has halted some research studies and slashed support staff.
The cuts drive at a sensitive constituency for Mr. Trump, who has campaigned on improving services at the V.A. In Mr. Trump’s first term, the agency expanded remote work as a way to reach veterans who are socially isolated and living in rural areas, who are at an elevated risk for suicide. Now those services are likely to be sharply reduced.
“The end of remote work is essentially the same as cutting mental health services,” said a clinician at a mental health center hub in Kansas, who spoke on the condition of anonymity. “These remote docs aren’t moving and they have other options if they are forced to drive to some office however many miles away every day to see their patient virtually from there.”
Veterans, too, are expressing anxiety. Sandra Fenelon, 33, said she had a rocky transition back to civilian life after leaving the Navy in 2022. “I just constantly felt like I am at war,” said Ms. Fenelon, who lives in New York and is training to become a pharmacist.
It took a year, working with a V.A. psychologist, until she felt safe enough to begin sharing the troubling things she had seen on deployment, things that, she said, “people on the outside would never understand.”
Now, Ms. Fenelon is worried that the tumult at the V.A. will prompt her therapist to leave before she is better. In her session this past week, she burst into tears. “I feel like I’m now forced to be put in a position where I have to start over with someone else,” she said in an interview. “How can I relate to a therapist who never worked with veterans?”
‘You Deserve Better’
For a suicide prevention coordinator in California, mornings start with referrals from a crisis hotline. On a typical day, she said, she is given a list of 10 callers, but sometimes as many as 20 or 30. The work is so intense that, most days, there is no time for a lunch break or bathroom breaks.
“My job is to build rapport, to figure out what I need to do to keep them alive. I let them know: ‘I’m worried about you, I’m going to send someone out to check on you,’” the coordinator said. “I tell them, ‘You served this country. You deserve better.’”
The team, which is responsible for covering some 800,000 veterans, was supposed to get three more social workers, but the new positions were canceled as a result of the administration’s hiring freeze, the coordinator said.
She said the stress around the staff reductions is intense, and fears it will cause her to miss something critical. “I’m so scared I’ll make a mistake,” she said. “I’m not sleeping well, and it’s hard to stay focused.”
Veterans are at sharply higher risk for suicide than the general population; in 2022, the suicide rate was 34.7 per 100,000, compared to 14.2 per 100,000 for the general population. A major factor in this is the availability of firearms, which were used in 73.5 percent of suicide deaths, according to the V.A.
In Denver, Bilal Torrens was just finishing a shift when he was notified by email that he was being terminated.
His job, he said, was helping homeless veterans settle into life indoors after years of living on the street. During those early months, Mr. Torrens said, the men are often overwhelmed by the task of collecting benefits, managing medications, even shopping for groceries; he would sit with his clients while they filled out forms and paid bills.
The layoffs reduced the support staff at the homeless service center by a third. The burden will now shift onto social workers, who are already staggering under caseloads of dozens of veterans, he said.
“They’re not going to have enough time to serve any of the veterans properly, the way that they should be served and cared for,” Mr. Torrens said.
Alarms Over Privacy
In Coatesville, Penn., mental health providers have been told they will conduct therapy with veterans from several large office spaces, sitting with their laptops at tables, said Dr. Kedson. The spaces are familiar, he said — but they have never before been used for patient care.
“That would sound like you’re seeing them from a call center, because you’d be in a room with a bunch of people who are all talking at the same time,” Dr. Kedson said. “The veterans who are going to be in that position, I suspect they will feel very much like their privacy is being violated.”
So far, only supervisory clinicians have been affected by the return-to-office policy; unionized workers will be expected to report to the office in the coming weeks.
Dr. Kedson said clinicians have warned that the orders compromise patient privacy, but he has seen little response from the agency’s leadership. “They’re doing it because these are the marching orders coming out of the current administration,” he said. “People are trying to make something that is really untenable work.”
Dr. Lynn F. Bufka, head of practice at the American Psychological Association, said the “longstanding presumed practice for the delivery of psychotherapy” requires a private location, like a room with a door and soundproofing outside the room.
She said HIPAA, the health privacy law, allows for “incidental disclosures” of patient information if they cannot be reasonably prevented — a threshold that she said the V.A. risks not meeting. In this case, she said, the privacy risk could be prevented “by simply not requiring psychologists to return to the office until private spaces are available.”
Several V.A. mental health clinicians told The Times they were interviewing for new jobs or had submitted their resignations. Their departures risk exacerbating already severe staffing shortages at the V.A., outlined in a report last year from its inspector general’s office.
“Everybody is afraid, from the top down,” said Matthew Hunnicutt, 62, a social worker who retired in late February after nearly 15 years, much of it in supervisory positions, at the Jesse Brown V.A. Medical Center in Chicago.
When staff were ordered to shut down diversity initiatives, Mr. Hunnicutt decided to speed up his retirement, feeling that “everything I had done was just wiped away.” He said care at the V.A. had been improved during his time there, with better community outreach, shorter wait times and same-day mental health appointments.
“Just to have it be destroyed like this is extreme,” he said.
Alain Delaquérière and Kirsten Noyes contributed research.
An experimental drug has shown promise in preventing Alzheimer’s for people at higher risk of developing the disease.
That’s according to a new study from Washington University School of Medicine in St. Louis, where researchers ran a clinical trial of people with rare genetic mutations that almost “guarantee” future Alzheimer’s development, according to a press release.
The study included 73 people in their 30s, 40s and 50s who have the mutation, which causes an overproduction of amyloid in the brain.
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Amyloid, a protein that builds up in the brain and can interfere with cognitive function, is one of the hallmarks of Alzheimer’s.
An experimental drug has shown promise in preventing Alzheimer’s for people at higher risk of developing the disease. (iStock)
All participants had no (or very mild) cognitive decline, had a family history of Alzheimer’s, and were within 15 years before to 10 years after their expected age of developing symptoms, the release stated.
For 22 of the participants who received a drug called gantenerumab for eight years, their risk of developing symptoms was cut in half — from 100% to 50% — the researchers reported.
“What we do know is that it’s possible to at least delay the onset of the symptoms of Alzheimer’s disease and give people more years of healthy life.”
“There was no effect seen in those only treated for two to three years of treatment,” senior author Randall J. Bateman, MD, the Charles F. and Joanne Knight Distinguished Professor of Neurology at WashU Medicine, told Fox News Digital.
The findings were published in the journal The Lancet Neurology on March 19.
For 22 of the participants who received a drug called gantenerumab for eight years, their risk of developing symptoms was cut in half — from 100% to 50% — the researchers reported. (iStock)
Gantenerumab, a monoclonal antibody designed to target and remove amyloid plaques in the brain, was in development by Roche in Switzerland and its U.S. affiliate, Genentech.
Development was stopped in 2023, however, after Roche/Genentech’s own clinical trials found that the drug did not meet their “primary endpoint” for slowing cognitive decline in people with early symptomatic Alzheimer’s disease, according to the release.
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“Everyone in this study was destined to develop Alzheimer’s disease and some of them haven’t yet,” said Bateman in the release.
“We don’t yet know how long they will remain symptom-free – maybe a few years or maybe decades. In order to give them the best opportunity to stay cognitively normal, we have continued treatment with another anti-amyloid antibody in hopes they will never develop symptoms at all,” he went on.
The hope is that if late-onset Alzheimer’s trials have similar results, prevention methods could ultimately be available to the general population, according to the researchers. (iStock)
“What we do know is that it’s possible to at least delay the onset of the symptoms of Alzheimer’s disease and give people more years of healthy life.”
The hope is that if late-onset Alzheimer’s trials have similar results, prevention methods could ultimately be available to the general population, according to Bateman.
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“I am highly optimistic now, as this could be the first clinical evidence of what will become preventions for people at risk of Alzheimer’s disease,” he said. “One day soon, we may be delaying the onset of Alzheimer’s disease for millions.”
Howard Fillit, MD, co-founder and chief science officer at the Alzheimer’s Drug Discovery Foundation in New York, noted that the study shows for the first time that early treatment to clear the plaques before symptoms arise can delay the onset of Alzheimer’s — “similar to how we treat and prevent other chronic diseases.”
Although gantenerumab is no longer being developed, researchers are evaluating other anti-amyloid drugs — such as remternetug, which is made by Eli Lilly — to determine whether they may prevent Alzheimer’s disease. (iStock)
“We’ve entered into a new era of Alzheimer’s research where we can not only modify the course of the disease, but where prevention is possible with therapeutic intervention,” Fillit, who was not involved in the study, told Fox News Digital.
Potential limitations and risks
There were several main limitations to the research, Bateman told Fox News Digital.
The number of people was limited due to the rarity of Alzheimer’s disease caused by mutations, the use of external controls, and the fact that the study started with lower doses, he said.
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“Many of the participants are still cognitively normal and near or past their expected age of onset even after more than eight years of treatment, so the effects could be larger or smaller with continued treatment and follow-up,” Bateman noted.
The researchers noted that anti-amyloid medications like gantenerumab have been shown to cause amyloid-related imaging abnormalities (ARIA).
Amyloid, a protein that builds up in the brain and can interfere with cognitive function, is one of the hallmarks of Alzheimer’s. (iStock)
These appear on brain scans as “tiny spots of blood in the brain or localized swelling of the brain,” the release stated.
The majority of these side effects do not cause symptoms and resolve without treatment, but in rare cases ARIA can cause serious medical issues or can even be fatal.
This most recent study showed that 30% of participants experienced ARIA, likely due to the higher doses of the drug.
Although two participants had to stop using gantenerumab due to severe ARIA, there were no “life-threatening adverse events and no deaths,” the researchers noted.
“Overall, the safety profile of gantenerumab in the extension was similar to that in the original trial and in other clinical trials of gantenerumab,” they stated.
More research needed, experts agree
Dr. Chris Vercammen, a board-certified internal medicine physician who specializes in geriatrics and palliative care, said that while these initial findings are “encouraging,” more research is needed on the effects of these medications.
“Large, randomized trials, including diverse populations and individuals with late-onset Alzheimer’s, are needed to validate these early results and determine the full potential of these treatments,” Vercammen, who is also medical director at Remo Health in California, told Fox News Digital. (He was not involved in the new study.)
“It’s important to note that this study’s design focused on high-risk individuals in the pre-clinical stage, and therefore does not provide sufficient data on the impact of these medications on later-stage Alzheimer’s.”
Fillit added that this new research opens the door for further exploration of treating preclinical Alzheimer’s.
Anti-amyloid medications like gantenerumab have been shown to cause amyloid-related imaging abnormalities (ARIA), which appear on brain scans as “tiny spots of blood in the brain or localized swelling of the brain.” (iStock)
“We look forward to seeing the longitudinal data as well as further studies around this approach,” he told Fox News Digital.
“These efforts bring us one step closer to our ultimate goal of preventing the disease before it begins.”
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Although gantenerumab is no longer being developed, researchers are evaluating other anti-amyloid drugs — such as remternetug, which is made by Eli Lilly — to determine whether they may prevent Alzheimer’s disease.
“These efforts bring us one step closer to our ultimate goal of preventing the disease before it begins.”
“These rare families with mutations may wish to participate in ongoing trials,” Bateman told Fox News Digital.
“The older general population might be interested to know that there are ongoing trials in people with amyloid plaques to test this approach to determine if Alzheimer’s symptoms could be prevented.”
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The study was funded primarily by the Alzheimer’s Association, GHR Foundation and the National Institutes of Health (NIH).
Fox News Digital reached out to Roche/Genentech for comment.
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