News in brief - Feb. 13, 2006

Effective treatment of back pain - More benefits of fruits and vegetables - NSAIDS better for moderate, severe osteoarthritis pain - High levels of particular protein associated with pre-eclampsia

Effective treatment of back pain

Two small studies point the way to more effective treatment for lower back pain.

A study in the December 2005 Journal of Occupational and Environmental Medicine found that a wrap that delivers a low level of topical heat for at least eight hours resulted in a significant reduction in pain for the 25 patients monitored. A control group of 18 received education on back therapy and pain management alone.

A second study, published in the February Radiology, found that the imaging procedure single-photon emission-computed tomography was able to identify patients with lower back pain who might benefit from spinal injections with steroids and anesthetics.

These facet joint injections can be a good short-term treatment in some patients, said lead author Spiros G. Pneumaticos, MD, assistant professor of orthopedic surgery at Baylor College of Medicine in Houston, but they are relatively expensive and can cause complications.

More benefits of fruits and vegetables

Eating more than five portions of fruit and vegetables a day could lower significantly the risk of stroke, according to a report in the Jan. 26 The Lancet.

The analysis pooled data from eight studies of fruit and vegetable consumption and stroke risk, involving more than 257,500 people from Europe, Japan and the United States. It found that when compared with individuals who ate fewer than three servings of fruits and vegetables a day, those who had three to five servings had an 11% reduction in the incidence of stroke, while those consuming more than five had a 26% reduction.

"Low intake of fruit and vegetables is a major modifiable risk factor contributing to the burden of ill health," said Lyn Steffen, PhD, MPH, assistant professor of public health at the University of Minnesota School of Public Health, in an accompanying article.

NSAIDS better for moderate, severe osteoarthritis pain

Acetaminophen reduces pain associated with osteoarthritis of the hip and knee, but nonsteroidal anti-inflammatory drugs appear to be better for those with more severe cases, at least in the short term, according to a Cochrane Collaboration review published last month.

Researchers with Queens University in Ontario analyzed 15 studies involving nearly 6,000 subjects, comparing these drugs with each other and placebo. Acetaminophen was found superior to no treatment. Traditional NSAIDS as well as the newer COX-2 inhibitors were found to have a greater effect on pain while also reducing stiffness and improving function. Aspirin was not included in this review.

There was no significant difference in the overall safety. Researchers expressed caution, though, because the average trial length was short, so not all adverse events might have been apparent in that timeline.

"The benefits between the drugs are modest, and the studies were only about six weeks long," wrote the authors. "Therefore, it is important to consider preferences, risks, costs, availability of the drugs and doctors' judgment when making a decision."

High levels of particular protein associated with pre-eclampsia

A protein implicated in the progression of several cancers also might play a role in the development of pre-eclampsia, according to a paper presented this month at the Society for Maternal-Fetal Medicine annual meeting in Miami.

Researchers analyzed archived placental tissue for the expression of HtrA1. The protein tends to increase during the course of a normal pregnancy, but this study found that in those who develop severe pre-eclampsia, it is markedly upregulated.

Scientists have been looking for a test to predict which women will develop this condition, and the authors hoped their data eventually will lead to just such an advance.

"The initial results are really encouraging, because the cause of this serious complication of pregnancy has not been well-understood," said Brian Brost, MD, senior author and a high-risk pregnancy specialist at the Mayo Clinic in Rochester, Minn.