Public Funding Spurs Couples to Seek Fertility Treatment

After Quebec mandated IVF coverage, study found change in patient demographics

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- Public funding of assisted reproductive technology, including in vitro fertilization (IVF) treatments, broadens the range of couples who seek treatment for infertility by attracting a more diverse population, according to new research from Canada.

When the province of Quebec began to fund up to three cycles of IVF in August 2010, researchers compared patients who sought that treatment before and after the mandate.

Afterward, "we found larger numbers of lower income, less well-educated, unemployed people seeking fertility treatment," said Phyllis Zelkowitz, director of research in the department of psychiatry and senior investigator at the Lady Davis Institute of the Jewish General Hospital, in Montreal.

The study is published in the May 16 New England Journal of Medicine.

For the study, Zelkowitz and her colleagues compared data on nearly 3,600 couples. Of those, 436 sought treatment before the policy change, 821 immediately after and 2,316 eight months after the policy change.

The investigators found the proportion of treated couples with college degrees declined from 68 percent to 63 percent eight months later. Unemployed couples seeking treatment rose from 3.6 percent to 11.6 percent. And the proportion of patients with household incomes of $65,000 a year or less increased from about 37 percent to more than 47 percent.

For white couples, the proportion dropped from about 67 percent to 63 percent in the eight-month period, after rising immediately after the policy change.

Zelkowitz also found the rate of couples seeking treatment for secondary infertility doubled from 14 percent to 29 percent. Secondary infertility means being unable to get pregnant or carry a pregnancy to term after having one or more biological children.

The mandated policy change came with stipulations, Zelkowitz said. It approved coverage for up to three treatment cycles of IVF. It mandated the transfer of only one embryo per treatment cycle, with a goal of reducing preterm births, she noted.

Preterm births are more common with multiple pregnancies and are riskier to the babies, experts agree.

"One of the goals of the funding was to reduce preterm births, and they have already done that," Zelkowitz said.

The study findings are in conflict with earlier U.S. studies, which have shown that even when patients have access to public funding for assisted reproductive technology, barriers continue to exist, including social, economic and ethnic obstacles. As a result, these earlier studies suggested, the typical patients remain older, wealthier, more-educated white couples.

In the United States, infertility affects about one of eight women of reproductive age and their partners, according to the American Society for Reproductive Medicine.

Currently, 15 states have passed laws that mandate insurers to cover or offer coverage for infertility diagnosis and treatment, but some states exclude coverage for IVF.

View the original article here

Acute Migraines More Apt to Turn Chronic With Poor Treatment

Study compared patients to see who made the jump to frequent headaches within year

By Robert Preidt

HealthDay Reporter

FRIDAY, June 28 (HealthDay News) -- People who receive inadequate treatment for acute migraine headaches are more likely to develop chronic migraines, according to a new study.

Researchers looked at data from more than 4,600 people with episodic migraines (14 or fewer migraine days per month) and found that 48 percent of them received poor or very poor treatment.

These patients were more likely to progress to having chronic migraines (15 or more migraine days a month) than those who received better treatment, according to the study, which was presented this week at the International Headache Congress meeting in Boston.

Within a year, about 8 percent of patients who received very poor treatment progressed to chronic migraine, compared with 4.4 percent of those who received poor treatment, 2.9 percent of those who received moderate treatment and 2.5 percent of those who received the best treatment.

Migraines are debilitating headaches involving intense pulsing or throbbing pain, and often nausea, vomiting and hypersensitivity to light and sound.

The study was conducted by a team from the Montefiore Medical Center and Albert Einstein College of Medicine, in New York City, and Vedanta Research, in Chapel Hill, N.C.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"These findings are exciting as they provide clinical targets for intervention. When we discover factors that increase the risk of progression, health care providers can focus their efforts in those areas to improve care and outcomes," study co-author Dawn Buse said in an International Headache Congress news release.

"In this case, we have found several factors in acute migraine treatment which may likely improve outcomes, including using medications that work quickly and maintain pain-free results, which allows and empowers people who live with migraines the freedom and confidence to make plans and fully engage in their lives," Buse said.

View the original article here

Public Funding Spurs Couples to Seek Fertility Treatment

By Kathleen Doheny
HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- Public funding of assisted reproductive technology, including in vitro fertilization (IVF) treatments, broadens the range of couples who seek treatment for infertility by attracting a more diverse population, according to new research from Canada.

When the province of Quebec began to fund up to three cycles of IVF in August 2010, researchers compared patients who sought that treatment before and after the mandate.

Afterward, "we found larger numbers of lower income, less well-educated, unemployed people seeking fertility treatment," said Phyllis Zelkowitz, director of research in the department of psychiatry and senior investigator at the Lady Davis Institute of the Jewish General Hospital, in Montreal.

The study is published in the May 16 New England Journal of Medicine.

For the study, Zelkowitz and her colleagues compared data on nearly 3,600 couples. Of those, 436 sought treatment before the policy change, 821 immediately after and 2,316 eight months after the policy change.

The investigators found the proportion of treated couples with college degrees declined from 68 percent to 63 percent eight months later. Unemployed couples seeking treatment rose from 3.6 percent to 11.6 percent. And the proportion of patients with household incomes of $65,000 a year or less increased from about 37 percent to more than 47 percent.

For white couples, the proportion dropped from about 67 percent to 63 percent in the eight-month period, after rising immediately after the policy change.

Zelkowitz also found the rate of couples seeking treatment for secondary infertility doubled from 14 percent to 29 percent. Secondary infertility means being unable to get pregnant or carry a pregnancy to term after having one or more biological children.

The mandated policy change came with stipulations, Zelkowitz said. It approved coverage for up to three treatment cycles of IVF. It mandated the transfer of only one embryo per treatment cycle, with a goal of reducing preterm births, she noted.

Preterm births are more common with multiple pregnancies and are riskier to the babies, experts agree.

"One of the goals of the funding was to reduce preterm births, and they have already done that," Zelkowitz said.

The study findings are in conflict with earlier U.S. studies, which have shown that even when patients have access to public funding for assisted reproductive technology, barriers continue to exist, including social, economic and ethnic obstacles. As a result, these earlier studies suggested, the typical patients remain older, wealthier, more-educated white couples.

In the United States, infertility affects about one of eight women of reproductive age and their partners, according to the American Society for Reproductive Medicine.

Currently, 15 states have passed laws that mandate insurers to cover or offer coverage for infertility diagnosis and treatment, but some states exclude coverage for IVF.

Assisted reproductive technology is typically defined as fertility treatments in which both eggs and sperm are handled, such as IVF, but not procedures such as taking medicine to stimulate egg production, according to the U.S. Centers for Disease Control and Prevention.

Only about 5 percent of infertile couples need assisted reproductive technology, the society estimates.

For others, egg stimulation or lifestyle changes such as losing weight or stopping smoking can help them achieve a pregnancy.

However, for those who do need IVF, the cost can be prohibitive. A cycle of IVF costs about $12,400, the society estimates.

The study findings about patient demographics changing after public funding became available do not surprise Dr. Wendy Schillings, a fertility specialist in Allentown, Pa. When she meets patients who have only diagnosis covered, she said, they often delay treatment if they need IVF, hoping to save up the money needed.

Couples who don't have IVF coverage often ask for more embryos to be transferred, she said, and she then counsels them on the risks of multiple births.

"Absolutely lower-income couples can do it [seek treatment] and will do it," Schillings said. However, for those with higher incomes, the decision may involve fewer sacrifices, she added.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Phyllis Zelkowitz, Ed.D., director of research, department of psychiatry, and senior investigator, Lady Davis Institute, Jewish General Hospital, Montreal, Canada; Wendy Schillings, M.D., fertility specialist, Allentown, Pa.; May 16, 2013, New England Journal of Medicine

View the original article here

Treatment for Painful Curved Penis Shows Promise

Xiaflex up for FDA approval later this year, but some experts think injections required would be a tough sell

By Barbara Bronson Gray

HealthDay Reporter

WEDNESDAY, May 8 (HealthDay News) -- Some diseases are especially tough to discuss.

When Tony Lee realized that his penis was curving whenever he had an erection -- making it painful and difficult for him to have sex -- he had no idea what was wrong. He became depressed and very worried, and his relationship with his wife started to change.

"For a man to dread sex, it's just not natural," he said. "There were times when I would stay up late on purpose, just to make sure my wife was sleeping before I got into bed. I was just totally embarrassed."

His wife finally convinced him to see his primary care physician, who referred him to a urologist. The specialist told him he had Peyronie's disease, a connective tissue disorder involving the growth of fibrous collagen plaques in the soft tissue of the penis. The condition can cause pain, erectile dysfunction and shortening of the penis.

The diagnosis was difficult to face.

"You do freak out. It's such a personal area. It's like, 'Noooooo! Why couldn't I just lose a finger? Anything but this,'" said Lee, who is 46. Lee asked that his full name not be used.

Experts estimate Peyronie's disease, a connective tissue disorder, affects at least 5 percent of men. Although the cause of the disorder is not known, physicians think genetic predisposition and repetitive minor trauma to the penis during sexual activity may play a role. People with diabetes, and those who have had prostate cancer surgery or erectile dysfunction, are also susceptible to the disease, according to Dr. Larry Lipshultz, a professor of urology at Baylor College of Medicine.

The treatment options are very limited, and there is no cure. "There is no oral or topical medication," said Dr. Elizabeth Kavaler, a urologist at Lenox Hill Hospital, in New York City. "You can excise the plaque and tighten up the other side, but that reduces the length, or you can use a penile prosthesis."

Lipshultz said he's had some luck with about half of his patients when he gives them a drug called verapamil, a calcium channel blocker, which is injected into the shaft of the penis. The use of the drug is based on its ability to degrade collagen, slowing, preventing or even reversing plaque formation and the progression of Peyronie's disease, according to a 2002 study published in the International Journal of Impotence Research. A verapamil gel that is applied to the skin is also sometimes used, according to Kavaler.

Lee, who has been dealing with Peyronie's for about two years, has used a "straightening machine" that stretches the penis, and he participated in one of two clinical trials for a new drug that is up for review by the U.S. Food and Drug Administration: Xiaflex, produced by Auxilium Pharmaceuticals Inc. He said his penis is now 70 percent of its pre-disease length as a result of the interventions.

View the original article here

Treatment for Painful Curved Penis Shows Promise

By Barbara Bronson Gray
HealthDay Reporter

WEDNESDAY, May 8 (HealthDay News) -- Some diseases are especially tough to discuss.

When Tony Lee realized that his penis was curving whenever he had an erection -- making it painful and difficult for him to have sex -- he had no idea what was wrong. He became depressed and very worried, and his relationship with his wife started to change.

"For a man to dread sex, it's just not natural," he said. "There were times when I would stay up late on purpose, just to make sure my wife was sleeping before I got into bed. I was just totally embarrassed."

His wife finally convinced him to see his primary care physician, who referred him to an urologist. The specialist told him he had Peyronie's disease, a connective tissue disorder involving the growth of fibrous collagen plaques in the soft tissue of the penis. The condition can cause pain, erectile dysfunction and shortening of the penis.

The diagnosis was difficult to face.

"You do freak out. It's such a personal area. It's like, 'Noooooo! Why couldn't I just lose a finger? Anything but this,'" said Lee, who is 46. Lee asked that his full name not be used.

Experts estimate Peyronie's disease, a connective tissue disorder, affects at least 5 percent of men. Although the cause of the disorder is not known, physicians think genetic predisposition and repetitive minor trauma to the penis during sexual activity may play a role. People with diabetes, and those who have had prostate cancer surgery or erectile dysfunction, are also susceptible to the disease, according to Dr. Larry Lipshultz, a professor of urology at Baylor College of Medicine.

The treatment options are very limited, and there is no cure. "There is no oral or topical medication," said Dr. Elizabeth Kavaler, an urologist at Lenox Hill Hospital, in New York City. "You can excise the plaque and tighten up the other side, but that reduces the length, or you can use a penile prosthesis."

Lipshultz said he's had some luck with about half of his patients when he gives them a drug called verapamil, a calcium channel blocker, which is injected into the shaft of the penis. The use of the drug is based on its ability to degrade collagen, slowing, preventing or even reversing plaque formation and the progression of Peyronie's disease, according to a 2002 study published in the International Journal of Impotence Research. A verapamil gel that is applied to the skin is also sometimes used, according to Kavaler.

Lee, who has been dealing with Peyronie's for about two years, has used a "straightening machine" that stretches the penis, and he participated in one of two clinical trials for a new drug that is up for review by the U.S. Food and Drug Administration: Xiaflex, produced by Auxilium Pharmaceuticals Inc. He said his penis is now 70 percent of its pre-disease length as a result of the interventions.

Xiaflex, which breaks down the scar tissue that is a component of penile plaque, was approved by the FDA in 2010 to treat Dupuytren's contracture, an inherited connective tissue disorder that causes the fingers to bend toward the palm. The concept of using Xiaflex with Peyronie's is based on some common features of both diseases. The hand condition is caused by an abnormal buildup of a substance called collagen. Fingers begin to bend toward the palm and the patient cannot straighten them.

The two clinical trials designed to test how Xiaflex worked in people with Peyronie's disease -- done in 2011 and 2012 -- together involved a total of 551 patients who received Xiaflex and 281 who were given a placebo. Each participant received four to six injections with a small needle into the penis every 25 to 72 hours over a period of several weeks. "The results showed people got a 30 percent improvement in curvature, which is clinically significant in terms of function," Lipshultz said

Recent data on the treatment appeared online in February and will be published in the July print issue of the Journal of Urology.

Lipshultz, who was involved in the clinical trials and is paid by Auxilium to speak to physicians about the treatment, said the company thinks Xiaflex will be approved by the FDA by mid-September.

Yet, Kavaler expressed concerns about whether Xiaflex will be helpful.

"The data show it looks like the drug made people feel better about their condition, maybe because they were getting treatment in the clinical trial, but I'm not sure if functionally it made a big difference," she said. "I don't think I could convince somebody to let me inject their penis four to six times with the hope of getting some small improvement."

Side effects from the injection of the drug included: bruising, swelling and pain. There were also three serious adverse events involving penile fracture and three hematomas, according to Auxilium Pharmaceuticals.

But Lee is hopeful.

"I was so far gone with this, the curvature was so bad, and so I feel a whole lot better about myself now," he said. "It's kind of like if a person was paralyzed, and then all of a sudden you can walk, even though you might need assistance, it's a wonderful thing. That's how I'm looking at it."

Lee encouraged people to involve their partners to help them deal with the disease. "If there is a significant other in your life, you guys need to come together with this. For me, that made all the difference."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Larry Lipshultz, M.D., professor, urology, and chief, division of male reproductive medicine and surgery, Baylor College of Medicine, Waco, Texas; Elizabeth Kavaler, M.D., urologist, Lenox Hill Hospital, New York City; Tony Lee, Georgia; April 23, 2013, press release, Auxilium Pharamacuticals

View the original article here

Most Docs Don't Follow ADHD Treatment Guidelines for Preschoolers: Study

Some specialists turn to medications too soon while others avoid them completely

By Robert Preidt

HealthDay Reporter

SATURDAY, May 4 (HealthDay News) -- About 90 percent of pediatric specialists who diagnose and manage attention-deficit/hyperactivity disorder (ADHD) in preschool children do not follow treatment guidelines published recently by the American Academy of Pediatrics, according to a new study.

Some prescribe medications too soon, while others do not give the young patients drugs even as a second-line treatment, according to study author Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y., and colleagues.

The American Academy of Pediatrics (AAP) guidelines recommend that behavior therapy be the first treatment approach for preschoolers with ADHD, and that treatment with medication should be used only when behavior-management counseling is unsuccessful.

The researchers also found that more than one in five specialists who diagnose and manage ADHD in preschoolers recommend medications as a first-line treatment alone or in conjunction with behavior therapy.

The study is scheduled for Saturday presentation at the Pediatric Academic Societies' annual meeting in Washington, D.C. Data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"It is unclear why so many physicians who specialize in the management of ADHD -- child neurologists, psychiatrists and developmental pediatricians -- fail to comply with recently published treatment guidelines," Adesman said in a medical center news release.

Some physicians also deviate from guidelines with their choice of medication. Although methylphenidate (Ritalin) is recommended as the first drug to try when medications are warranted, many doctors prescribed other types of drugs.

"With the AAP now extending its diagnosis and treatment guidelines down to preschoolers, it is likely that more young children will be diagnosed with ADHD even before entering kindergarten," Adesman said. "Primary care physicians and pediatric specialists should recommend behavior therapy as the first-line treatment."

Awareness is lacking across specialties, another study author said.

"Although the AAP's new ADHD guidelines were developed for primary care pediatricians, it is clear that many medical subspecialists who care for young children with ADHD fail to follow recently published guidelines," study principal investigator Dr. Jaeah Chung said in the news release.

"At a time when there are public and professional concerns about overmedication of young children with ADHD, it seems that many medical specialists are recommending medication as part of their initial treatment plan for these children," Chung added.

View the original article here

Pediatricians Endorse New Acne Treatment Guidelines

Experts note many medications now available for range of cases

By Amy Norton

HealthDay Reporter

MONDAY, May 6 (HealthDay News) -- Pimples have long been the bane of teenage existence, but pediatricians say there is now enough evidence on effective treatments to put out the first guidelines on battling acne in children.

There is a range of medications that can clear up even severe cases of acne, according to the American Academy of Pediatrics (AAP). Writing in the May issue of its journal Pediatrics, the group throws its support behind new guidelines from the American Acne and Rosacea Society that detail how to treat acne in children and teens of all ages.

That "all ages" part is important because acne is becoming more and more common in pre-teens, too, said Dr. Lawrence Eichenfield, the lead author of the AAP report. One study of 9- and 10-year-old girls found that more than three-quarters had pimples.

It's thought that it may be because boys and girls are, on average, starting puberty earlier compared with past generations, said Eichenfield, a pediatric dermatologist at Rady Children's Hospital in San Diego.

According to the AAP, mild acne often can be tackled with over-the-counter fixes. Washes, lotions and other products containing benzoyl peroxide are the best studied, and the best place to start, the group said.

"It's a pretty effective agent, especially for mild acne," Eichenfield said. Benzoyl peroxide is also the most common ingredient in over-the-counter acne fighters. Another common one is salicylic acid, but there has not been much research on it. When it has been tested head-to-head against benzoyl peroxide, Eichenfield said, the latter has won out.

If over-the-counter products do not do the job, the next step could be topical retinoids -- prescription medications like Retin-A, Avita and Differin. They are vitamin A derivatives and work by speeding up skin cell turnover, which helps unclog pores.

The main side effects of all the topical treatments are skin irritation and dryness, the AAP said.

If the acne is moderate to severe, oral antibiotics could be added to the mix because bacteria that live on the skin play a role in acne. When pores become clogged with oil and skin cells, bacteria can grow in the pore and cause inflammation. Antibiotics help by killing bacteria and soothing inflammation.

But, Eichenfield said, "it's important to use antibiotics appropriately." One reason is because acne-causing bacteria have become less sensitive to common antibiotics in the past couple decades, due to widespread use of the drugs.

Another is that antibiotics can have side effects, such as stomach upset, dizziness and, in girls, yeast infections.

When acne is severe and other treatments have failed, the AAP said, doctors and parents might consider the prescription drug isotretinoin -- brand-names including Roaccutane (formerly known as Accutane) and Claravis.

View the original article here

Most Men With Erectile Dysfunction Don't Seem to Get Treatment

In study of 6 million ED patients, 75 percent either didn't receive or fill prescriptions

By Kathleen Doheny

HealthDay Reporter

MONDAY, May 6 (HealthDay News) -- Never mind the commercials with men talking freely to their doctor about their erectile dysfunction, taking a prescription for treatment to the pharmacy and settling in for a romantic evening.

Despite a wide range of treatment options, most men with erectile dysfunction (ED) don't get treated, according to a new study.

"ED treatments, overall, are underutilized," said Dr. Brian Helfand, an assistant clinical professor of urology at Northshore University Health System and the University of Chicago. "Only 25 percent of men are actually treated."

Helfand led the study, which looked at the medical records of more than 6 million men with an ED diagnosis. He is due to present his findings Monday at the American Urological Association annual meeting, in San Diego.

The study was funded by the Havana Day Dreamers Foundation (which promotes men's health), the Goldstein Fund in Male Pelvic Health and the SIU Urology Endowment Fund.

Helfand used an insurance claims database and looked for the medical code for erectile dysfunction from June 2010 through July 2011. He found 6.2 million men aged 30 and older who received a diagnosis of erectile dysfunction. ED is defined as an inability to maintain an erection satisfactory for sexual performance.

He then looked to see how many filled a prescription. Patients were considered treated if they filled a prescription for an erectile dysfunction drug such as Viagra (sildenafil) or Cialis (tadalafil), drugs called prostaglandins that are given by injection or urethral suppositories, or androgen (hormone) replacement.

He considered them untreated if they received a diagnosis of erectile dysfunction but did not fill a prescription.

He took into account, too, the men's ages and other health problems.

Even though erectile dysfunction is likely to become more common with age, he actually found older men the least likely to be treated. Only about 18 percent of men aged 65 and above were treated.

When Helfand looked to see what bearing other health conditions might have had on treatment, he found those with prostate cancer were least likely to be treated. Only 15 percent were.

The study didn't have information on why the men went untreated, he said. But he speculates there are probably several reasons.

The undertreatment, Helfand said, is probably a result of doctors often not offering the prescription or patients getting a prescription but not filling it at the pharmacy.

"Men may not be bothered by it," he said. Or a doctor may not write a prescription because he may not think the man is a candidate, or perhaps they didn't respond to erectile dysfunction treatment in the past.

Other reasons, he said, could include costs and embarrassment.

For men, Helfand said, the message is: "There are available therapies out there. These can be useful if you have ED."

View the original article here

Faith May Complement Treatment for Mental Illness

Patients with stronger belief in God did better in small study

By Robert Preidt

HealthDay Reporter

THURSDAY, April 25 (HealthDay News) -- A belief in God may boost the effectiveness of short-term treatment for mental illness, according to a small new study.

The study included 159 psychiatric patients whose levels of depression, well-being and self-harm were assessed at the start and end of the study. The patients also were asked about their belief in God.

Patients with higher levels of belief in God were twice as likely to respond to treatment as those with no or little belief in God. Even among the more than 30 percent of patients who said they had no specific religious affiliation, those who had a moderate or high belief in God had a better response to treatment than those with little or no belief.

The study appears in the latest issue of the Journal of Affective Disorders.

"Our work suggests that people with a moderate to high level of belief in a higher power do significantly better in short-term psychiatric treatment than those without, regardless of their religious affiliation," study author David Rosmarin, a clinician at McLean Hospital in Belmont, Mass., and an instructor in the psychiatry department at Harvard Medical School, said in a hospital news release. "Belief was associated with not only improved psychological well-being, but decreases in depression and intention to self-harm."

A strong belief in God may boost patients' conviction that treatment will help them and their expectations of success, the researchers suggested.

Although the study found an association between belief in God and increased response to psychiatric treatment, it did not prove a cause-and-effect relationship.

"Given the prevalence of religious belief in the United States -- more than 90 percent of the population -- these findings are important in that they highlight the clinical implications of spiritual life," Rosmarin said. "I hope that this work will lead to larger studies and increased funding in order to help as many people as possible."

View the original article here

Treatment for New, Deadly Coronavirus Shows Promise

THURSDAY, April 18 (HealthDay News) -- A treatment for a new coronavirus that has caused 11 deaths, mostly in the Middle East, shows promise in early tests, U.S. government researchers report.

The investigators discovered that a combination of two antiviral drugs -- ribavirin and interferon-alpha 2b -- can stop the so-called nCoV coronavirus from multiplying in laboratory-grown cells. While the results suggest that this drug combination could be used to treat patients infected with nCoV, more research is needed to confirm these early findings.

Both drugs are approved in the United States for treating people with hepatitis C.

The nCoV coronavirus was first identified in Saudi Arabia in September 2012. As of April 16, 2013, there had been 17 reported cases, including 11 deaths. Most cases have occurred in the Middle East.

While the number of cases is small, there has been person-to-person transmission of the nCoV coronavirus in situations where people -- mainly family members -- have had close contact with infected people, the researchers noted in a news release from the U.S. National Institute of Allergy and Infectious Diseases (NIAID).

That, along with the high death rate, led the NIAID researchers to look for treatments. In laboratory tests using cells from two monkey species, the research team found that either ribavirin or interferon-alpha 2b alone could stop nCoV from replicating in the cells.

However, the drug concentrations needed to do this were higher than what is recommended for people. The researchers then combined the two drugs, and found that they were effective at a dose that can be used in people, according to the study in the April 18 issue of the journal Scientific Reports.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. National Institute of Allergy and Infectious Diseases, news release, April 18, 2013

View the original article here

Deep Brain Stimulation Studied as Last-Ditch Obesity Treatment

No major side effects seen in 3 patients over nearly 3 years

By Amy Norton

HealthDay Reporter

THURSDAY, June 13 (HealthDay News) -- For the first time, researchers have shown that implanting electrodes in the brain's "feeding center" can be safely done -- in a bid to develop a new treatment option for severely obese people who fail to shed pounds even after weight-loss surgery.

In a preliminary study with three patients, researchers found that they could safely use the therapy, known as deep brain stimulation (DBS). Over almost three years, none of the patients had any serious side effects, and two even lost some weight -- but it was temporary.

"The first thing we needed to do was to see if this is safe," said lead researcher Dr. Donald Whiting, vice chairman of neurosurgery at Allegheny General Hospital in Pittsburgh. "We're at the point now where it looks like it is."

The study, reported in the Journal of Neurosurgery and at a meeting this week of the International Neuromodulation Society in Berlin, Germany, was not meant to test effectiveness.

So the big remaining question is, can deep brain stimulation actually promote lasting weight loss?

"Nobody should get the idea that this has been shown to be effective," Whiting said. "This is not something you can go ask your doctor about."

Right now, deep brain stimulation is sometimes used for tough-to-treat cases of Parkinson's disease, a movement disorder that causes tremors, stiff muscles, and balance and coordination problems. A surgeon implants electrodes into specific movement-related areas of the brain, then attaches those electrodes to a neurostimulator placed under the skin near the collarbone.

The neurostimulator continually sends tiny electrical pulses to the brain, which in turn interferes with the abnormal activity that causes tremors and other symptoms.

What does that have to do with obesity? In theory, Whiting explained, deep brain stimulation might be able to "override" brain signaling involved in eating, metabolism or feelings of fullness. Research in animals has shown that electrical stimulation of a particular area of the brain -- the lateral hypothalamic area -- can spur weight loss even if calorie intake stays the same.

The new study marks the first time that deep brain stimulation has been tried in that brain region. And it's an important first step to show that not only could these three severely obese people get through the surgery, but they also seemed to have no serious effects from the brain stimulation, said Dr. Casey Halpern, a neurosurgeon at the University of Pennsylvania who was not involved in the research.

"That shows us this is a therapy that should be studied further in a larger trial," said Halpern, who has done animal research exploring the idea of using deep brain stimulation for obesity.

"Obesity is a major problem," Halpern said, "and current therapies, even gastric bypass surgery, don't always work. There is a medical need for new therapies."

View the original article here

Menopause-Like Woes Hinder Breast Cancer Treatment: Study

FRIDAY, April 12 (HealthDay News) -- Hot flashes and other unpleasant side effects are a major reason one-quarter of breast cancer patients do not start or do not complete their recommended hormone-blocking therapy, a new study finds.

Five years of daily pills -- either tamoxifen or aromatase inhibitors -- is recommended for many women whose breast cancer expresses the hormones estrogen or progesterone. The drugs have been shown to reduce the risk of cancer returning and to extend survival.

Despite such benefits, this study of more than 700 breast cancer patients in Detroit and Los Angeles who were eligible for hormone therapy found that about 11 percent never started treatment and 15 percent stopped it early.

Unpleasant, menopause-type side effects, such as vaginal dryness, hot flashes or joint pain, were the most common reasons women either stopped or never started the therapy.

"We need to develop better ways of supporting women through this therapy," lead study author Christopher Friese, an assistant professor at the University of Michigan School of Nursing, said in a university news release.

Those most likely to complete their hormone therapy were patients who were most worried about their cancer returning and those who already took medication regularly, according to the study, which was published online March 31 in the journal Breast Cancer Research and Treatment.

Patients least likely to begin hormone therapy included those who received less information about hormone therapy, which suggests that doctors need to properly educate patients before treatment begins, the researchers said.

Women who saw a breast cancer surgeon instead of a medical oncologist as their primary follow-up also were less likely to begin hormone therapy.

"It was particularly interesting that greater fear of recurrence was associated in our patient sample with greater adherence to endocrine therapy," study senior study author Dr. Jennifer Griggs, a professor of internal medicine at the University of Michigan Medical School.

"We don't want our patients living under a cloud of fear, so we need to develop creative ways to both reassure and motivate them," said Griggs, a medical oncologist. "This means providing better education about the importance of staying on these medications and partnering with primary care and cancer doctors to help patients manage symptoms."

More than 234,000 Americans will be diagnosed with breast cancer this year and more than 40,000 will die from the disease, the American Cancer Society estimates.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: University of Michigan Comprehensive Cancer Center, news release, April 9, 2013

View the original article here

New Strategy Helps Young Lymphoma Patients Avoid Radiation Treatment

Approach resulted in high remission rates without the risks tied to radiotherapy, researchers say

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, April 10 (HealthDay News) -- A new treatment approach may mean that young people with a form of lymphoma can go without radiation therapy, sparing them side effects or raised cancer risks down the road.

In a trial conducted by the U.S. National Cancer Institute, nearly all patients with a form of cancer known as primary mediastinal B-cell lymphoma who received chemotherapy, but did not undergo chest radiation, achieved a full remission.

Standard treatment for this cancer typically includes radiation to the chest, the study authors pointed out, but this has been linked to significant harmful effects in the future, particularly for women.

"These results are exciting and demonstrate that, using this approach, almost all patients appear to be cured and very few patients require radiation," study co-author Dr. Kieron Dunleavy, of the U.S. National Cancer Institute, said in an agency news release.

One expert not connected to the study agreed.

"This study is a significant achievement in improving the care of a group of lymphoma patients that urgently need it: young patients with an aggressive and -- if left untreated -- rapidly lethal disease," said Dr. Joshua Brody, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.

The study "yielded very exciting success rates with almost all patients going into complete remission even without the use of radiation therapy, which is frequently used for this disease," Brody added. All of the patients in the study maintained remission "for a long time," he noted, and "most of the patients are certainly cured of their disease."

The study is published in the April 11 issue of the New England Journal of Medicine.

Primary mediastinal B-cell lymphoma usually affects people in their teens to early 30s. Although many people with the disease who are treated with both chemotherapy and radiation do achieve a cure, roughly 20 percent do not, according to an NCI news release.

The research team noted that radiation to the chest area could also boost a patient's risk for other types of cancer down the road, including breast cancer, as well as cause damage to the heart. Complicating matters, as young people age, their risk for heart disease and new forms of cancer also rises.

The NIH trial involved 51 patients with untreated primary mediastinal B-cell lymphoma who were followed over the course of 14 years. The largest tumor diameter of any patient in the study was 11 centimeters.

Each patient received a regimen of drugs known as dose-adjusted EPOCH-R. The regimen included the following drugs: etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab. The dosages of these drugs were adjusted to make them as effective as possible.

View the original article here

Oral Allergy Treatment May Ease Asthma, Hay Fever, Study Finds

This under-the-tongue alternative to shots is used in Europe, but not approved in U.S.

By Amy Norton

HealthDay Reporter

TUESDAY, March 26 (HealthDay News) -- Spring is here, and so are seasonal allergies. For the millions who suffer from hay fever or asthma in the United States, a new under-the-tongue treatment may hold promise.

Pills and drops designed to desensitize the immune system to allergens could bring some of these allergy patients relief, a new research review finds.

The review, published March 27 in the Journal of the American Medical Association, pulled together 63 studies on so-called sublingual immunotherapy.

The therapy, commonly used in Europe and Asia, essentially allows people to get traditional allergy shots in the form of pills or drops that dissolve under the tongue. The principle is the same: Expose the immune system to extracts of the substance causing a person's allergy -- grass pollen, for example -- until it builds up a tolerance.

Right now, no under-the-tongue allergy products are approved in the United States. But some doctors offer the therapy anyway; they take the extracts approved for allergy shots and give them to patients to use orally.

In the new review, researchers found "strong" evidence that under-the-tongue immunotherapy eased symptoms of allergy-induced asthma: In eight of 13 studies, patients saw more than a 40 percent improvement in symptoms, versus patients who either got a drug-free placebo or standard medication.

The evidence was weaker when it came to nasal allergies. Only nine of 36 studies showed a more than 40 percent drop in symptoms such as congestion, runny nose and itchy eyes.

Still, the majority of studies did show some benefit, said lead researcher Dr. Sandra Lin, an associate professor of otolaryngology at Johns Hopkins University School of Medicine in Baltimore.

Under-the-tongue products are being evaluated for approval by the U.S. Food and Drug Administration (FDA), and those results will be helpful, said Lin.

She said the results from European trials cannot be simply translated to the United States because of differences in the potency of the allergen extracts used.

"We need studies to see what are the most effective doses for U.S. patients," Lin said.

The idea of taking pills instead of getting shots definitely appeals to patients, said Dr. Harold Nelson, an allergy specialist at National Jewish Health in Denver, who wrote an editorial published with the study.

But his advice to U.S. patients was to wait for products to be approved by the FDA.

Even if your doctor offers under-the-tongue immunotherapy, "there's no guarantee" it would be the same as the products studied in clinical trials, Nelson said. He noted that U.S. doctors commonly give a patient a mix of different allergen extracts, because that's how it is done with allergy shots.

But the under-the-tongue products used in clinical trials have contained only a single allergen extract, Nelson said.

View the original article here

I have high systolic, but normal diastolic blood pressure. Do I need treatment?

Posted May 30, 2013, 2:00 am

I’m 71 years old. My systolic blood pressure is usually in the 150s to 160s, which is high. But my diastolic blood pressure is usually in the 70s, which is normal. Do I need treatment?

A blood pressure measurement includes two numbers: systolic pressure (the upper number) and diastolic pressure (the lower number). These numbers are measured in millimeters of mercury, or mmHg.

Your systolic pressure is high: 140 mmHg or over is high. And your lower number is normal: normal diastolic pressure is below 80 mmHg. When your systolic blood pressure is high and your diastolic blood pressure is low, it’s called isolated systolic hypertension (ISH). People with ISH do benefit from treatment, as it lowers the risk of heart disease and stroke.

Are you currently being treated for high blood pressure (hypertension)? If not, your doctor might start with lifestyle changes. Regular exercise, weight loss and cutting down on salt in your diet might fix the problem without medication.

If lifestyle changes aren’t enough, you’ll likely need medication. Because of your age, your doctor will probably aim to first gently lower your systolic pressure to below 150 mmHg. If you don’t have any bothersome symptoms, such as lightheadedness, your doctor will push to get your systolic pressure below 140 mmHg. Such treatment is also likely to lower your diastolic pressure, but the focus should be on your systolic pressure.

I was taught three things in medical school: (1) all that really mattered was the diastolic pressure; (2) older people had naturally higher pressures, so they didn’t need treatment; and (3) when you treated older patients, it caused symptoms such as lightheadedness.

Research since I was a medical student has shown conclusively that (1) and (2) are wrong. In fact, they were backward. Systolic pressure matters more than diastolic pressure, and older people clearly benefit from treatment. People like you with just a high systolic pressure are at higher risk for having a heart attack, heart failure or a stroke if you don’t get treatment. That’s as true for a 71-year-old person like you as for a 50-year-old person — even more true, since you’re at higher risk for heart disease and stroke at age 71 than at age 50.

It is true that a minority of older patients develop symptoms if blood pressure is lowered too suddenly. But that’s why your doctor is likely to go slow. I learned that lesson many years ago when I started taking care of a woman in her late 70s who had ISH.

She was not very receptive when I recommended treatment. She finally agreed, and I prescribed a standard dose of a blood pressure medicine. It made her quite dizzy, so she stopped taking it. It was six months before I could convince her to start again — on a lower dose. It worked like a charm.

window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

View the original article here

Is a CPAP machine the only treatment option for my sleep apnea?

Posted May 29, 2013, 2:00 am

I have sleep apnea. My doctor has urged me to use a CPAP machine, but it’s too uncomfortable. Are there other options?

Sleep apnea is a condition in which breathing stops or becomes shallower many times each night. Obstructive sleep apnea (OSA) occurs when your upper airway collapses or gets blocked during sleep. These airway obstructions starve your brain of oxygen and stress your cardiovascular system. Untreated sleep apnea increases your risk of high blood pressure, stroke and premature death.

OSA can be treated with a continuous positive airway pressure (CPAP) machine. A CPAP machine keeps your airways open as you sleep by delivering continuous air pressure through a mask worn over your nose and mouth. But many people find it uncomfortable, and as a result, they use CPAP inconsistently — or not at all.

Some new treatments may provide more comfortable alternatives. Discuss the pros and cons of these options with your doctor:

APAP is an “autotitrating” version of positive airway pressure (PAP). It continuously adjusts the pressure in your airway as your needs fluctuate during the night.Custom-made mouthpieces slide your jaw forward to keep your airway open. They are called “mandibular advancement systems,” or “MAS” for short. In recent years, studies have shown that MAS devices really work — and nearly as well as CPAP and APAP. For people who cannot tolerate CPAP, these devices can be valuable.Another device called Oral Pressure Therapy creates a negative pressure that “sucks” the tissues in the back of your throat forward, preventing the collapse of the upper airway. This device is approved for use in the United States by the Food and Drug Administration, and received recognition in the 2012 Wall Street Journal Technology Awards, for which I have served as a judge.Expiratory pressure resistance valves are disposable devices that stick to your nostrils. The valves force your own breathing to pressurize your airway and hold it open. These devices have not yet been as carefully studied as the MAS devices.

You should also talk to your doctor about medications you’re taking. Medications can help or hinder sleep apnea. For example, narcotic painkillers, sedatives and muscle relaxants can worsen sleep apnea. On the other hand, a sleep drug might help when you’re first getting used to a treatment device.

Lifestyle changes can also help. If your sleep apnea occurs only when you sleep on your back, switch to sleeping on your side. Try losing weight, which almost always reduces the severity of apnea. In some people, it eliminates the problem altogether. Finally, limit your alcohol intake. Alcohol may make you sleepy, but it can worsen your sleep apnea symptoms.

When a person’s obstructive sleep apnea is caused by very enlarged tonsils, surgery (tonsillectomy) can cure the condition. However, it is unusual for there to be such a correctable cause of sleep apnea.

If you do decide to try a treatment device, remember that it works only if you use it.

window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

View the original article here

Public Funding Spurs Couples to Seek Fertility Treatment

After Quebec mandated IVF coverage, study found change in patient demographics

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- Public funding of assisted reproductive technology, including in vitro fertilization (IVF) treatments, broadens the range of couples who seek treatment for infertility by attracting a more diverse population, according to new research from Canada.

When the province of Quebec began to fund up to three cycles of IVF in August 2010, researchers compared patients who sought that treatment before and after the mandate.

Afterward, "we found larger numbers of lower income, less well-educated, unemployed people seeking fertility treatment," said Phyllis Zelkowitz, director of research in the department of psychiatry and senior investigator at the Lady Davis Institute of the Jewish General Hospital, in Montreal.

The study is published in the May 16 New England Journal of Medicine.

For the study, Zelkowitz and her colleagues compared data on nearly 3,600 couples. Of those, 436 sought treatment before the policy change, 821 immediately after and 2,316 eight months after the policy change.

The investigators found the proportion of treated couples with college degrees declined from 68 percent to 63 percent eight months later. Unemployed couples seeking treatment rose from 3.6 percent to 11.6 percent. And the proportion of patients with household incomes of $65,000 a year or less increased from about 37 percent to more than 47 percent.

For white couples, the proportion dropped from about 67 percent to 63 percent in the eight-month period, after rising immediately after the policy change.

Zelkowitz also found the rate of couples seeking treatment for secondary infertility doubled from 14 percent to 29 percent. Secondary infertility means being unable to get pregnant or carry a pregnancy to term after having one or more biological children.

The mandated policy change came with stipulations, Zelkowitz said. It approved coverage for up to three treatment cycles of IVF. It mandated the transfer of only one embryo per treatment cycle, with a goal of reducing preterm births, she noted.

Preterm births are more common with multiple pregnancies and are riskier to the babies, experts agree.

"One of the goals of the funding was to reduce preterm births, and they have already done that," Zelkowitz said.

The study findings are in conflict with earlier U.S. studies, which have shown that even when patients have access to public funding for assisted reproductive technology, barriers continue to exist, including social, economic and ethnic obstacles. As a result, these earlier studies suggested, the typical patients remain older, wealthier, more-educated white couples.

In the United States, infertility affects about one of eight women of reproductive age and their partners, according to the American Society for Reproductive Medicine.

Currently, 15 states have passed laws that mandate insurers to cover or offer coverage for infertility diagnosis and treatment, but some states exclude coverage for IVF.

View the original article here

Find the Right Treatment for Your Back Pain

Find the Right Treatment for Your Back Pain Skip to content Enter Search Keywords. Use the arrow keys to navigate suggestions. Health A-Z

Common Conditions

View All ADD/ADHD Allergies Arthritis Cancer Cold, Flu & Cough Depression Diabetes Eye Health Heart Disease Heartburn/GERD Pain Management Sexual Conditions Skin Problems Sleep Disorders

Featured Topics

Identifying Bugs and Their Bites Bothered by Yeast Infections? The Worst Shoes for Your Feet WebMD Symptom Checker Health concern on your mind?

See what your medical symptoms could mean, and learn about possible conditions.

Learn More

Resources

WebMD Expert Blogs: Read expert views and commentary on popular health topics. WebMD Communities: Connect with people like you, and get expert guidance on living a healthy life. WebMD Physician Directory: Find a doctor in your area.

WebMD Pain Coach

Track your pain levels, triggers, and treatments. Set goals and get tips with our app for iPhone. Drugs & Supplements

Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Find or Review a Drug Find or Review a Vitamin or Supplement Find Drug Coupons Drug Basics & Safety

Commonly Abused Drugs What's Your Medication IQ? Food, Medical Product & Cosmetic Safety WebMD Pill Identifier Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Learn More

Drug News

Get the Latest Drug Approvals & Alerts Find FDA Consumer Updates Sign up to receive WebMD's award-winning content delivered to your inbox. FDA Approves Diet Pill Belviq FDA Delays Decision on Blood Thinner Eliquis

WebMD Mobile Drug Information App

Drug, supplement, and vitamin information on the go. Living Healthy

Featured Content

Want luxurious locks?

WebMD cuts through the hype to reveal the best kept secrets for healthy hair.

Living Healthy at a Glance

Living Healthy Centers

View All Diet, Food & Fitness

Weight Loss & Diet Plans Food & Recipes Fitness & Exercise Beauty, Balance & Love

Healthy Beauty Health & Balance Sex & Relationships Oral Care Living Well

Women's Health Men's Health Aging Well Teens

Featured Topics

BMI Calculator: Get Personalized Results Portion Size Plate: Easy Serving Size Guide Your Birth Control Options 19 Secrets Men Wish Women Knew Quiz: Weird, Crazy Dreams Food & Fitness Planner: Personalize Your Weight Loss Plan

WebMD the Magazine App

Get every issue of WebMD the Magazine with a free subscription for your iPad. Family & Pregnancy

Featured Content

Traveling abroad?

Protect yourself and your family by learning which health precautions and vaccines are advised for your destination.

Family & Pregnancy at a Glance

Family and Pregnancy Centers

Pregnancy Trying to Conceive First Trimester Second Trimester Third Trimester Parenting Newborn & Baby Children's Health Children's Vaccines Raising Fit Kids Pets Healthy Cats Healthy Dogs

Featured Topics

Know the Signs of Early Pregnancy? Test Your Smarts: What's Safe to Eat When You're Pregnant? Peek Inside the Womb to See How Baby Grows Healthy School Lunches Quiz: Know How to Avoid The Next Toddler Meltdown? WebMD Vaccine Tracker: Manage Vaccinations for Your Entire Family

WebMD Baby App

Get parenting tips, track schedules, and create a mobile baby book. News & Experts

News

View All Today's Top Health Headlines Get the Latest Drug Approvals & Alerts Find FDA Consumer Updates On The Road Again: FDA Mobile Laboratories Sign up to receive WebMD's award-winning content delivered to your inbox.

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

WebMD Experts & Blogs

Read expert views and commentary on popular health topics. WebMD Communities

Connect with people like you, and get expert guidance on living a healthy life. WebMD Answers

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

WebMD Newsletters

Sign up to receive WebMD's award-winning content delivered to your inbox. My WebMD Sign In, Sign Up

My WebMD Sign In

Please enter email address

Enter your password

Keep me signed in on this computer Show more Information If you select "Keep me signed in on this computer", every time you visit WebMD.com you won't have to type your email address and password. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you're using a publicly accessible computer, or if you're sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.

Forget your password? Having trouble signing in?

Why should I
sign up for WebMD?

With a WebMD Account you can:

Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Back Pain Health Center Back Pain Features Email a FriendPrint Article Back Pain Health Center Tools & ResourcesLow Back Pain Causes Is Your Back Pain Sciatica? Herniated Disk: What Happens Lower Back Pain QuizEveryday Aches and Pains QuizGet Chronic Pain Coping Tips webmd.m.share.init(); Font Size A A A webmd.m.fontSizer.init(); Find the Right Treatment for Your Back Pain ByR. Morgan Griffin
WebMD Feature Reviewed byLaura J. Martin, MD

What will help your back pain? There are a lot of choices.

Your best plan depends on your specific case. For instance, has your back been hurting for a couple of days, or a long time? Did it start with an obvious injury, or are you not really sure what happened? Are you basically healthy, or do you have other conditions, like diabetes or arthritis, to consider, too?

Recommended Related to Back Pain Managing Your Back Pain at Home

If you got up this morning and thought, “Ugh, my back hurts,” you’re not alone. About one in five Americans reports having experienced back pain at least once during the previous month. So, should you go to the doctor? Not necessarily. Most low back pain resolves on its own within about four to six weeks, with or without medical treatment. In many cases, you can manage your back pain at home.   First, you should know when it’s a bad idea to handle your back pain yourself. If you have significant...

Read the Managing Your Back Pain at Home article > >

The good news is that there are a lot of effective options for you and your doctor to consider, including some you can do at home for little cost.

Home Back Pain Treatments

Most back pain goes away on its own within a few days to weeks. For many, home back pain treatments are enough to ease discomfort while the body heals.

Exercise. Resting your back for a day or so after hurting yourself is fine. After that, you need to get active. Stretching, walking, swimming, and other gentle exercises can help you recover. You might want to check with a qualified trainer or physical therapist to make sure you aren't overdoing it, and that you are using good form, which can make a difference in how your back feels. Heat and Ice. If you're injured, apply cold packs to numb the pain and reduce swelling. Use them for up to 20 minutes, several times a day, for the first two to three days. After that, use a heating pad or warm baths to ease pain. Over-the-Counter Medications. Common painkillers like Advil, Motrin IB (ibuprofen), Aleve (naproxen), aspirin, and Tylenol or Paracetamol (acetaminophen) can help with mild pain. However, if you find yourself using these on an ongoing basis, you should tell your doctor. You may also get relief from painkilling creams or ointments that you rub on the skin. Treatments a Doctor Can Provide

See a doctor if at-home back pain treatments aren't working or your pain has lasted longer than a few weeks. You may need a new approach.

Injections. Your doctor may inject medicine into tissue, joints, or nerves in your back. Steroids can reduce swelling and pain. Painkillers can numb pain. Depending on the person and the type of medication injected, relief may last from several days to several months. Physical Therapy. A physical therapist can give you exercises to build strength, help your posture, and improve how you move, so your back can recover and you can keep it strong. Prescription Medication. For serious or long-lasting pain, your doctor may suggest prescription medication. This may include anti-inflammatory medications,  muscle relaxants, opioid painkillers, or antidepressants. Surgery. Most people with back pain don't need surgery. But for certain people it can be the right treatment. A surgeon can repair damaged discs or fractures. However, surgery may not be a permanent solution. The pain sometimes returns. 1 | 2 Next Page > #url_reference {display: none};#url_reference { display: block; line-height: 150%; margin-bottom: 10px; }#logo_rdr img { visibility: visible; }.titleBar_rdr .titleBarMiddle_fmt { padding-top: 1.5em !important;} Top Picks Exercises for Chronic Pain Injections for Back Pain: What You Need to Know Back Pain: What You Need to Know What Fibromyalgia Looks Like 12 Tips to Ease Back Pain Water Knife Surgery for Back Pain Back Pain Home News Reference Videos Community Questions and Answers Glossary Medications Back Pain Guide 1 Overview & Facts 2 Symptoms & Types 3 Diagnosis & Tests 4 Treatment & Care 5 Living & Managing 6 Support & Tools See what others are asking about

Visit WebMD Answers

Related to Back Pain Ankylosing Spondylitis Back Injuries Degenerative Disc Disease Living Healthy Osteoporosis Pain Management Pill Identifier Scoliosis More Related Topics Today in Back Pain Slideshow Get the Facts About Back Pain Quiz Low Back Pain: What Do You Know?   Slideshow Surprising Reasons You're in Pain Slideshow Acupuncture for Pain Relief   Article Yoga for Lower Back Pain Slideshow Chronic Pain: Get Relief   Health Check Coping With Chronic Pain? Article Back Pain Dos and Don'ts   Slideshow Sciatica: Symptoms and Treatments Slideshow Should You Consider Weight Loss Surgery?   Slideshow What's Causing Your Low Back Pain? Article Breast Reduction Surgery: What to Know   Subscribe to WebMD Newsletters

WebMD Daily Women's Health Men's Health Weight Loss Wisdom I have read and agree to WebMD's Privacy Policy. Sign up for more topics! WebMD Special Sections Living With Low Back Pain Low Back Pain: What Can You Do? Health Solutions From Our Sponsors Vaccine Questions? Support for Depression Hearing Aid Alternative Birth Control for Moms Living with Crohn’s? Chronic Widespread Pain Diagnosed With Low T? Fibromyalgia & Exercise Depression Treatment Blood Sugar Control Vaccines for All Ages Bent Fingers? Are You Depressed? Treating Fibromyalgia Crohn’s Disease Help In-depth coverage: Recognizing & Treating Depression|Healthy Mouth Help|RA Assessment|Living Healthy Guide|Family & Pregnancy Toolbox|Low Testosterone Find us on:URAC: Accredited Health Web SiteHonCode: Health on the Net FoundationAdChoicesAbout WebMD Advertise With Us Terms of Use Privacy Policy Sponsor Policy Site Map Careers Contact UsMedscape Reference eMedicineHealth RxList Medscape MedicineNet BootsWebMD WebMD CorporateFirst Aid WebMD Magazine WebMD Health Record WebMD Mobile Newsletters Dictionary Physician Directory

©2005-2013 WebMD, LLC. All rights reserved.

WebMD does not provide medical advice, diagnosis or treatment. See additional information.

View the original article here