Chondroitin - Skin Cancer Promoter? PM&R News   •   April 2018 Itruly believe we all do the best we can to help our patients, particularly control pain and improve function in the field of PM&R. But I must say that it can be frustrating at times when new reports suggest that a treatment that we commonly recommend may be doing more harm than good. Another frustration is the limited amount of good research regarding supplements. In a recent article in Molecular Cell, there is a suggestion that chondroitin sulfate, the popular supplement of osteoarthritis may promote the growth of tumor cells in melanoma. Specifically, [...]

Blood Pressure Management Update PM&R News   •   December 2017 To start the new year off right, we thought we would kick start your learning by brushing up on your hypertension management.  The 2017 clinical practice guidelines for hypertension were just published and have a few different recommendations from previous years. These guidelines are recommendations that all physiatrists should be aware of so let’s go over some of those differences. The new guidelines now define SBP of 130-139 mmHg or DBP of 80-89 mmHg as stage I hypertension. Individuals with blood pressure in the above range have a 2 fold increase of cardiovascular disease. [...]

Efficacy of Particulate vs Non-Particulate Steroids in Patients with Radicular Pain   PM&R News   •   July 6, 2017 It has been well documented in the literature that particulate steroids carry a significant risk in their use during epidural injections.  In fact, there have been 13 reported cases of spinal cord ischemia or posterior circulation infarction after cervical epidural steroid injections and 19 cases of spinal cord ischemia in lumbar epidural steroid injections when using particulate steroids. Even though this risk exists, particulate steroids (triamcinolone, methylprednisolone, betamethasone) are still used by some providers due to theories of better efficacy. This systemic review argues that no [...]

Chondroitin vs. Celebrex: Keep NSAIDs on the Shelf?   PM&R News   •   June 29, 2017 For many years there has been serious debate whether or not glucosamine, glucosamine and chondroitin or chondroitin alone should be recommended for pain reduction secondary to osteoarthritis. For physiatrists, good benefit with these supplements can lead a pull back on the prescription of potentially detrimental NSAID and/or acetaminophen use. A recent study in the Annals of Rheumatic Diseases sheds further light on the topic. In this study, Reginster et al. recruited 604 patients with symptomatic knee osteoarthritis according to the American College of Rheumatology criteria. Participants were then [...]