Options for Pain? Dr. Oz Misses the Obvious

While giving an excellent description of the neurological mechanism of pain, Time overlooks the obvious in their most recent edition highlighting pain. The march 7th issue titled, Understanding Pain, addresses traditional, emerging, and alternative options for those suffering from chronic pain of various causes.  Dr. Mehmet Oz (cardiac surgeon, author, and Emmy award-winning TV Host) gives an overview of options for pain sufferers: exercise, stretching, anti-inflammatories, opiods, antidepressants (all suggested there for short-term use).  If that doesn’t work, then: steroid shots, nerve blocks, surgery, and local anesthetics.  The article endorses acupuncture and meditation as potentially helpful “alternatives.”

So what’s missing from this discussion?

According to the Annals of Internal Medicine, “clinicians should consider the addition of non-pharmacological therapy with proven benefits– for acute low back pain, spinal manipulation; for chronic low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, cognitive behavioral therapy, and progressive relaxation.” (go to article)

According to the Institute for Clinical Systems Improvement, difficult acute and chronic low back pain without nerve damage should be referred to a non-surgical spine specialists for education, exercise, and manual therapies. (go to article)

According to the 2010 Task Force on Neck Pain and Its Associated Disorders, exercise, manual therapy, and acupuncture are more effective for neck pain in the short term than usual medical care. Manipulation and exercise get the highest recommendation for cervicogenic headache (headache caused by neck dysfunction). Manual therapy and exercise are likely helpful for both non-traumatic and whiplash associated neck pain. (go to article)

These clinical recommendations are conservatively and carefully made by groups of researchers and clinicians after thoroughly reviewing large studies published in the Annals of Internal Medicine, Spine, Spine Journal, Cochrane Database of Systemic Reviews, and others.

The best option for any individual in pain is specifically dependent on the cause of the pain, an individual’s complete health status, and an individual’s goals/values. Yet in presenting options for pain in general, Time blatantly omitted the obvious. Since the significant effectiveness of manual therapy (manipulation, mobilization, massage) and rehabilitative exercise have been so well demonstrated throughout the medical literature, any health care professional that fails to appropriately recommend these treatments is failing their patient.

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