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BackPage Online, March 2017

doi: 10.1097/01.BACK.0000513487.76260.15
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Performing Scientific Investigations of the Supplement Industry Increasingly Hazardous

Dietary supplements are widely used in the management of low back pain, though few have proven to be safe and effective. And because of lax manufacturing practices, some are outright hazardous because of contaminants and other dangerous ingredients.

Scientific investigators have been slow to perform rigorous research on many supplements—and many regulatory agencies around the world don't require evidence of safety and effectiveness. However, there is a growing movement to perform more rigorous studies in this area.

Unfortunately, there are some chilling developments in this area—with scientific researchers being threatened with lawsuits for harming the prospects of some supplements and the reputations of their developers.

An excellent article at STAT recently detailed the case of a Harvard professor who was sued for libel and slander for statements in a peer-reviewed study and subsequent media interviews.

Though he was innocent, the article points out that investigators may be in a perilous situation because of promises by US President Donald Trump to ease libel laws, making it easier for plaintiffs to win judgments and cash awards. https://www.statnews.com/2017/01/10/supplement-harvard-pieter-cohen/

Social Isolation A Risk Factor for Pain and Ill-Health?

Back pain often has an intimate relationship with social isolation. People grappling with back pain often retreat from normal social activity and social interactions. And the treatment of low back pain can have an isolating effect—taking people out of their usual lives, jobs, and physical activities. Here is a link to a New York Times article about growth of social isolation in modern societies and its negative impact on health: https://www.nytimes.com/2016/12/22/upshot/how-social-isolation-is-killing-us.html

Yoga for Low Back Pain: No Panacea

Yoga offers modest benefits in the management of chronic low back pain, with a greater impact on function than on pain, according to a recent systematic review from the Cochrane Collaboration. “There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance,” according to Susan Wieland, PhD, and colleagues. And it is not clear whether yoga offers any greater benefit than other forms of physical activity. But the latter finding shouldn't come as a surprise. No single form of physical activity or exercise stands out above all others in rigorous systematic reviews.

Here is a link to the abstract of the Cochrane Review: https://www.ncbi.nlm.nih.gov/pubmed/28076926

And here is a link to a brief review of it at Medpage Today: http://www.medpagetoday.com/PrimaryCare/BackPain/62478

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