Better Backs by Better Beds?

Kim Bergholdt, DC; Rasmus N. Fabricius, DC; Tom Bendix, MD, DrMedSci - Medscape Today

A study was done to objectively evaluate 3 structurally different mattresses relative influence on patients with chronic low back pain (CLBP).

In several advertisements, it is proclaimed that certain mattresses have a positive effect on low back pain, and especially a hard mattress is commonly believed to have a positive effect.

One hundred sixty chronic low back pain patients were randomized to 1 of 3 groups, having a mattress/bed mounted in their sleeping room for 1 month. The beds were: (1) waterbed (Akva), (2) body-conforming foam mattress (Tempur), and (3) a hard mattress (Innovation Futon). At baseline and after 4 weeks, a blinded observer interviewed the patients on low back pain levels (0-10), daily function (activities of daily living, 0-30), and on the amount of sleeping hours/night.

Results: Both the waterbed and the foam mattress seemed superior to the hard mattress, especially when using the probably most relevant worst case data. There were no relevant difference between the effects of the water bed and the foam bed.

Conclusion: The Waterbed and foam mattress' did influence back symptoms, function and sleep more positively as apposed to the hard mattress, but the differences were small.

When looking for a mattress for your home, consider the following:

1. Better sleep at night leading to a greater sense of well being, which may affect the perception of pain during the day.

2. The back should probably be kept more or less in a neutral position, so that long lasting end-range positions of 1 or more tender spinal joints are avoided. To obtain this demand, the mattress should be appropriately soft, conforming body curvatures by having a reasonable capacity to equalize the pressure. How close the spinal posture should mimic that of the standing posture is unclear.

3. The capability of easy turning from side to side to avoid a painful loaded twist in the back.

4. A specific mattress may influence intervertebral disc nutritional flow positively or negatively as a function of spinal movement, because movement affects the discal metabolism. It is likely that the significance of this factor varies between those being sedentary or physically active during the daytime.

5. A waterbed and a body-contour foam mattress generally influenced back symptoms, function, and sleep more positively than a hard mattress, but the differences were small.

Rheumatoid Arthritis

There have been some interest surrounding Rheumatoid Arthritis this past month. Rheumatoid Arthritis (RA) affects over 2 million poeple in the United States. RA roughly begins between the ages of 25 and 45, while it cannot be passed along to your family, there is a specific gene that has been identified that can make your more likely to get RA. One fact that has been identified is that women are more suspeptable than men.

RA is an inflammatory process because your own immune system attacks your own cells, which is considered an autoimmune disorder. This can weaken your joints and in time deteriote bones and cartilage within your joints. Some common symptoms of RA include: fatigue, morning stiffness, muscle aches, loss of appitite and weakness, and joint pain. Othere symptoms, which are not as common, include: redness, swelling, round nodules on joints and skin, deformities, and a low grade fever.

Treatment include: Disease modifying antirheumatic drugs (DMARDs): These drugs are the current standard of care for RA, in addition to rest, strengthening exercises, and anti-inflammatory drugs. Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis.Leflunomide (Arava) may be substituted for methotrexate. Anti-inflammatory medications such as aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen and others. Although NSAIDs work well, long-term use can cause stomach problems, such as ulcers and bleeding, and possible heart problems.

Physical Therapy can aid in pain relief and prevention by using range-of-motion exercises and individualized exercise programs prescribed by a physical therapist can delay the loss of joint function. Joint protection techniques, heat and cold treatments, and splints or orthotic devices to support and align joints may be very helpful.Sometimes therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint mobility. Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night, are recommended.

If you suspect you have RA, take the Rheumatoid Arthritis Screening Quiz found in the following link: http://arthritis.about.com/od/rheumatoidarthritis/l/blrheumarthquiz.htm
It is a good idea to seek your personal physician for blood specific tests (Rheumatoid Factor) to be specifically diagnosed as well as seeking the aid of a rheumatologist.

Sources:
Cecil's Essentials of Medicine, Carpenter, Griggs, Loscalzo
http://www.enbrel.com/ra/understanding-ra.jsp?channel=GOSEA&subchannel=SRAC
http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020/DSECTION=4
http://www.nlm.nih.gov/medlineplus/ency/article/000431.htm