New Treatments Found to Ease Pain of Chronic Ailments
(HealthDay News) – By its own definition, chronic disease doesn't have a cure.
The best one who suffers from such chronic conditions as sinusitis, lower back pain and migraine headaches can hope for is to cope successfully with these conditions without having them become overwhelming.
But medical research doesn't stand still. Advances have greatly improved patients' quality of life, although cures often remain elusive.
Chronic sinusitis, for instance, is one of the most common chronic diseases in the United States , affecting approximately 37 million people a year, according to the National Institute of Allergies and Infectious Diseases. For too long, too many struggled with the stuffiness, breathing problems, headaches and fatigue that can plague sufferers for weeks, months -- even years.
But breakthroughs in diagnosis, treatment options and, equally important, patient awareness of the condition have made it a far more manageable problem, doctors say.
"Over the past 10 years there has been a steady improvement in treatment," says Dr. Jordan Josephson, an eye, ear and nose surgeon and director of the New York Nasal and Sinus Center in New York City . "Even though you may have had surgery and medication for sinusitis in the past, there are newer techniques and medicines that can offer hope for significant improvement or cure."
Adds Dr. Mary Ann Michelis, medical director of the Center for Allergy, Asthma and Immune Disorders at Hackensack (N.J.) University Medical Center : "A decade ago we diagnosed sinusitis using a series of X-rays. But now we get much more information from CT scans of paranasal sinuses. And MRIs can help identify fungal infections."
All of which lead to better, more targeted treatments, she adds.
So do new nasal sprays, as well as intranasal nebulized antibiotics, certain antihistamines that didn't exist 10 years ago, and topical antifungals and antibiotics that target the specific fungi and bacteria that often plague sinusitis sufferers, Josephson says.
For those who need surgery, newer, less-invasive treatments mean safer operations with faster recovery times.
"Surgery used to be much more aggressive, entering through the mouth," Michelis says. "Now endoscopic surgery has allowed very small surgeries to open sinus passages or remove polyps or scar tissue."
Another important development, according to Josephson: Patients are becoming more involved in their own care. That means they're coming to the doctor sooner and adopting a more proactive role.
"They now realize they have to take part in their care," he says. So, in addition to taking medication, they're better at following their doctor's other suggestions, such as keeping their homes allergen-free, stopping smoking, and exercising.
But the breakthroughs extend beyond sinusitis.
Chronic lower back pain, which hobbles an estimated 70 million Americans a year, according to the Mayo Clinic, also has some new remedies.
One is Botox, the same toxin responsible for erasing the furrowed brows of appearance-conscious women and men across the country. At least four small studies in the last several years in the United States and England found that injections of the botulism toxin A at the site of back pain reduced pain by as much as 50 percent in people for whom traditional treatments had been ineffective.
The beneficial effects sometimes wore off after several months. Doctors say the drug may at least temporarily reduce muscle spasms or the pain sensory input to the spinal cord.
Another promising treatment: A lidocaine patch. Although the U.S. Food and Drug Administration has only approved the drug for the treatment of shingles-related pain and as a short-term anesthetic for injections, doctors report success in using it for back pain.
The patch, which contains 5 percent lidocaine, is placed directly at the site of the back pain, releasing the medicine to the nerves under the skin. In clinical trials, the treatment was shown to significantly relieve pain without causing serious side effects.
Pain is also the bane of the nation's estimated 30 million migraine sufferers. But here, too, breakthrough therapies are providing dramatic results.
The introduction a decade ago of a class of drugs called triptans -- which mimic the neurotransmitter serotonin, in short supply during migraine attacks -- have revolutionized treatment of the debilitating headaches.
And medicines that have been used successfully for other health problems are offering results for migraine sufferers. Beta blockers and calcium-channel blockers, both used to treat high blood pressure and cardiovascular disease, have been effective in preventing migraines, as have anti-seizure medications used for epilepsy and bi-polar disorders.
On the Web
Facts about sinusitis can be found at the National Institutes of Health and the American Academy of Orthopaedic Surgeons has suggestions on how to prevent back pain and injury.
SOURCES: Jordan S. Josephson, M.D., director, the New York Nasal and Sinus Center, New York City; Mary Ann Michelis, M.D., medical director, the Center for Allergy, Asthma and Immune Disorders, Hackensack University Medical Center, N.J., and associate clinical professor, University of Medicine and Dentistry of New Jersey, Newark
Author:
Janice Billingsley, HealthDay Reporter
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