Rheumatoid Arthritis Treatment – A link between drug treatments, new FAR infrared and targeting the IL-6 protein.

Last month a news article in The Daily Express, a UK newspaper, appeared referencing a new drug treatment for Rheumatoid Arthritis (RA).  The drug targets the IL-6 protein which is responsible for inflammation.

This stimulated my memory banks for a different study for knee pain which I vaguely remembered made reference to an IL protein … hang on, it’s the IL-6 protein!

Have I just discovered a link to a potential treatment for RA?

Here is the extract from the article and a link, but read on.

Sarilumab

http://www.express.co.uk/news/health/444653/New-breakthrough-jab-to-ease-arthritis-agony-and-slow-disease

Whilst preparing a summary of evidence for new FAR infrared (FIR) elements, I came across a study showing the effects of the FIR treatment on patients who had undergone knee surgery (total knee arthroplasty).  As well as significant pain reduction, reference is also made to IL-6 reduction:

FAR infrared and IL 6 protein

http://www.ncbi.nlm.nih.gov/pubmed/22339105

“This study demonstrated that the FIR can lower the NRS of pain and thus reduce the discomfort experienced by the patient. Findings indicated that effective application of FIR decreased the serum level of Interleukin-6 (IL-6) and Endothelin ET-1, which represent the subjective indicator of pain.”

FAR Infrared TherapyNow, anecdotally we hear countless testimonials from people with arthritis (not specifically RA) reporting significant pain relief from using TherMedic infrared ProWraps, as well as other conditions including low back pain, Frozen Shoulder and more.

Some of these effects may be down to the thermal effects of sustained vasodilation but other studies detail non-thermal effects which may explain other significant properties and benefits of TherMedic FIR for pain relief, see evidence summary.

For some people living with Rheumatoid Arthritis, medication does not always work and can include side-effects.

l220100-heat-pad_jpgThe above paper looking at the application of FIR for knee arthroplasty and reduction of IL-6 protein is not a large double-blind randomised controlled trial.

HOWEVER, in the context of this and other scientific evidence surrounding the re-emergence of FAR infrared, as well as the growing anecdotal evidence, there is surely a case for more detailed investigation into the potential applications of the new localised carbon-fabric infrared modality, TherMedic for the relief of pain caused by Rheumatoid Arthritis.

This question may well be being addressed in Asia where the new carbon fabric infrared element was developed, but to the scientific community in the UK, the new technology is still unknown.  That is changing.

NOTES:

Endothelins are proteins that constrict blood vessels and raise blood pressure. They are normally kept in balance by other mechanisms, but when they are over-expressed, they contribute to high blood pressure (hypertension) and heart disease

Interleukin-6 (IL-6) is an interleukin that acts as both a pro-inflammatory and anti-inflammatory cytokine. Expression of IL-6 is enhanced at the site of inflammation, and blockade of IL-6 and IL-6 signalling is effective at prevention and treatment in models of inflammatory diseases (including arthritis and colitis).  Overall IL-6 is important – indeed, critical under certain conditions – to the development of persistent inflammation.

(C. Gabay Interleukin-6 and chronic inflammation  Arthritis Research & Therapy 2006, 8(Suppl 2):S3 http://arthritis-research.com/content/8/S2/S3

Author: Stephen Small
Director www.steadfastclinics.co.uk

I first came across infrared whilst using it with IDD Therapy spinal decompression.  Initially I saw it as a simple heat modality but it quickly became apparent that there was a lot more to TherMedic than meets the eye.  Steadfast Clinics distribute Thermedic in the UK.

Sciatica or Back Pain? – Google statistics show us what people are actually looking for.

Working with clinics treating herniated discs with IDD Therapy spinal decompression, I am interested to see back pain statistics and trends around the subject of back pain.

Whilst “Back Pain” is the number one musculoskeletal condition people visit their doctor for, is it really back pain they need help with or does Google search traffic data reveal something not factored into the statistics?

Here below you can see the UK monthly search volume for certain keywords.

Google adwords Back Pain Searches

As can be seen, for every “back pain” search in Google, there are over three times as many searches for ‘sciatica’.

What about globally?

Google sciatica search results global

Again we see the same trend.

This throws up some questions which someone probably has the answers to (appreciating that sciatica and back pain are closely related): 

Is back pain more prevalent than sciatica?
Is the pain of ‘sciatica’ less bearable than ‘back’ pain?
Is it the latter which prompts proportionally more people to search for info/help with sciatica than back pain?

What do you think?

Author: Stephen Small, Director Steadfast Clinics Ltd
LinkedIn Profile
www.steadfastfastclinics.co.uk   www.iddtherapy.co.uk
Steadfast Clinics Ltd – Expanding IDD Therapy spinal decompression treatment for intervertebral discs and Thermedic Infrared Therapy Systems for joint pain and soft tissue healing.

Exercise compliance – Insights from using Yoga DVDs at home to instill discipline and motivation in patients.

I leave the clinicians to work out what the best exercises are, my interest is improving compliance.  

Knowing exercises is one thing, doing them is another! 

For a few years I have had a growing feeling that I need to preserve joint mobility, particularly in my lower back!   So I have toyed with the idea of doing yoga (also for a few years!).

or

At the end of the summer I bought a box set of yoga DVDs and over the last couple of months I have started to use the Yoga videos in the morning, at least twice a week.

They really help and now, I would probably be happy to join a class because I understand that “Cobra” is not a beer brand we have with a curry!

The point is, I did know what a sun salutation was but I never bothered doing them on my own.

With the DVD there is a framework and time structure.  From 30 minutes to 45 minutes.  ie it’s doable and someone is there with you.

Many patients leave a clinic with a set of written or verbal exercises to do. That is not going to work for most.  It DOESN’T work for most people!

I have written about exercise diaries, wall planners etc, my strong recommendation is to find a DVD that you like and sell it to patients for them to do at home (and record when they do it in their exercise diary!)

Then tell them to do the exercises at least 3 times a week or daily or whatever is appropriate.

The APPI do a video for back pain which I believe you can buy at trade prices
http://www.ausphysio.com/product.aspx?productid=344

but there are many others.

IDEA – Why not put on a “back class” at your clinic or elsewhere, get a local videographer to record it and then give that to patients as your own-branded DVD, give complimentary copies to GPs etc etc, then who’s the local daddy?!

If you do hear yourself saying to patients “do try to do your exercices” you know that most won’t bother. Try the DVD route, it can can only help and you will stand out from the masses.

Now time for some Cobras … I’ll do my yoga in the morning 😉

Author: Stephen Small, Director Steadfast Clinics

Steadfast Clinics is the international distributor of IDD Therapy spinal decompresion, SDS SPINA, Accu SPINA and Thermedic Infrared Therapy Systems. We’re on a pain relief mission !

Leominster Osteopaths, Four Years of IDD Therapy Spinal Decompression for Back Pain, Neck Pain and Sciatica

Leominster Osteopaths was the second clinic in the UK to provide IDD Therapy for their patients.

With some great results and an expanding practice, the clinic is attracting patients from far and wide to get relief from chronic disc-related problems.

[youtube=http://www.youtube.com/watch?v=MlnlgEI0jfQ]

Stephen Small and Mark Roughley

Stephen Small of Steadfast Clinics is pictured here with Leominster Osteopaths Clinic  Director Mark Roughley.

For more information about IDD Therapy treatment at Leominster Osteopaths, visit www.leominsterosteopaths.co.uk

‘Sarcopenia’, my holiday and insights for back pain patient exercise compliance

Sarcopenia is my favourite word.  I heard it a few years ago when I discovered that, like everyone else, I was suffering with it.  The gradual reduction in skeletal muscle mass as we get older (0.5%-1% per year after age 25), the stuff middle aged-crises are made of!

I have always played sports and been active.  As a 42 year old (I count that as young!), I still run, swim and go to the gym once or twice a week.  No major injuries and, touch wood, no back pain issues which is the subject I deal with the most at Steadfast.

I got back from a 2 week holiday in Spain last weekend.

Aside from a little swimming, my activity levels dropped enormously as I tucked into tapas and the odd glass of Rioja!  Now 3 weeks on, I feel a noticeable, alarming reduction in what muscle mass I had before I went away.  Use it or lose it I think is the saying.

However the other thing I notice, which is what got me thinking about back pain patients, is that my will power to return to doing exercise is at rock bottom!

I now have no desire or motivation to go to the gym or do anything.

My principal personal reason for exercising is that my body stagnates when I don’t do anything, so I have to crank things up. Yesterday I did manage to win a herculean mental battle and take myself off for a run but it was painful (run = jog/ run any slower and you’ll be stationary).

It was also depressing because I realised how much pace, strength and stamina I had lost in such a short space of time!

All clinicians prescribe exercises to their patients and patients expect (are resigned) to walk out of a clinic with a list of exercises.

For people who perhaps haven’t had a habit of exercising for a long time, who have pain and particularly those who are overweight, is it any wonder that they find it so difficult to comply with an exercise programme?

And when someone fails to comply with an exercise programme and they remain in pain, doesn’t it reinforce a negative mindset?  Those ‘depressed’ feelings about themselves and what they are (not) capable of are extremely demotivating.

I have written a couple of articles about taking lessons from other industries to improve exercise compliance.

E.g clinicians can use exercise diaries for personal exercise accountability, wall planners as visual reminders and clinicians can link up with personal trainers to create short programmes to help patients with exercise compliance.  There must be other ways too … group classes etc etc.

Given that chronic back pain is the #1 musculoskeletal cost to society, there has to be a case for putting in place more robust systems to help patients and back pain sufferers in particular overcome inertia and progressively develop a habit of activity and exercise.

Otherwise, people will never get off the chronic back pain merry-go-round and, for the reasons outlined here, certain financial inefficiencies will persist as money is spent on treatments when there is limited long term benefit.

PS It’s 8.30 Saturday morning as I write this.  The gym is open for business, there is bacon in the fridge and I feel the battle already in my brain.  Battle won …. I’m getting back on the virtuous circle … though I might I have some bacon when I get back!

Stephen Small linkedinBy Stephen Small
Director Steadfast Clinics Ltd
www.SteadfastClinics.co.uk

Steadfast Clinics is expanding the availability of IDD Therapy spinal decompression for disc-related back pain and Thermedic Infrared Therapy systems for joint pain relief and soft tissue injury rehabilitation.