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Physical therapy as good as surgery for common spine-related back pain

New study findings provide better guidance to men about treatment options for spinal stenosis.

Spinal stenosis, a progressive narrowing of the space around the lower (lumbar) spinal nerves, is a common cause of back pain and disability in men over age 65. When anti-inflammatory medications and injections fail, stenosis sufferers start looking for other solutions. A surgical procedure called decompression can improve things temporarily, but like any back surgery, it comes with risks.

Exercise prevents serious injuries in women who fall

A randomized controlled trial of Finnish women over 70 has demonstrated that regular exercise can significantly reduce the risk of serious injury from a fall. Researchers from Tampere University studied 370 women who had fallen during the previous year. They were randomly divided into two groups. One group of 187 participated in classes in which they learned exercises to increase strength, balance, and agility. They attended exercise class twice a week for a year and once a week the next year. They exercised at home on the days they weren't in class. The women in the control group continued their normal routines. All the women kept daily diaries in which they noted whether they had fallen, and if so, the type of injury they sustained and whether they required medical attention. They mailed their diaries to the researchers every month.

At the end of the period, the number of falls was about the same in both groups: 140 in the exercise group and 141 in the control group. The consequences of those falls, though, differed noticeably between the groups: women in the exercise group had 20 falls requiring medical attention, including eight fractures and six head injuries. That compared with 39 such falls in the control group, involving 14 fractures and 12 head injuries.

The benefits and risks of rediscovering your favorite sport

Playing a sport in our older years is great exercise. But before stepping onto a playing eld, make sure to address physical limitations.
Image: iStock

Competition is great for older adults, but don't skip training camp before your season starts.

Try Tai Chi for better balance and thinking skills

Tai chi appears to have positive effects on a wide range of thinking skills in healthy adults, such as attention, learning, memory, and perception.

Tai chi: A gentle exercise that may help heal your heart

Described as "meditation in motion," tai chi may foster a sense of relaxation that helps lower stress levels.

Research suggests benefits for a range of cardiovascular conditions.

Ask the doctor: Understanding ejection fraction

Q . Can you explain exactly what "ejection fraction" means? And is there any way to increase it?

A. Ejection fraction refers to the volume of blood that's pumped out of the heart's left ventricle each time it contracts. Contrary to what many people believe, a normal ejection fraction is not 100%. Even a healthy heart pumps out only about half to two-thirds of the volume of blood in the chamber in one heartbeat. So a normal ejection fraction lies somewhere in the range of 55% to 65%.

Don't worry about sudden cardiac arrest during exercise

Getting regular exercise is the best way to prevent most types of heart disease—including sudden cardiac arrest.

Images: Thinkstock

New findings may help allay fears about sports-related heart death.

Tests for hidden heart disease

Electrocardiograms, which monitor the heart's electrical patterns, don't reliably reveal the risk of having a heart attack.

Unless you have symptoms of a heart problem, taking a cautionary look under the hood is unlikely to help—and could even be harmful.

Ask the doctor: Stretching before exercise

Q. Should I stretch before or after my workout to help prevent muscle injuries and soreness? I've gotten conflicting advice on this.

A. We all remember the importance placed on stretching in our high school physical education classes. However, recent expert opinion has moved away from static stretching before activity and toward a gradual and active warm-up period before exercise. Stretching a healthy muscle before exercise does not prevent injury or soreness.

Injections don't improve physical therapy for knees

Physical therapy is helpful for wear-and-tear knee osteoarthritis, especially if you start doing it early. But injecting a painful knee with an anti-inflammatory steroid medication before starting physical therapy offers no additional benefit, according to a clinical trial in JAMA Internal Medicine.

Studies have shown that physical therapy modestly reduces pain and improves daily functioning in people with knee osteoarthritis. That could mean being able to walk farther with less pain or to continue leisure activities such as gardening. Before you start physical therapy, your doctor may offer to inject the knee with a cocktail of anti-inflammatory steroid medication and an anesthetic. Hypothetically, this could make it easier for you to stick with exercise and therefore lead to better results.

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