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Do Not Be Afraid of Pain

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Nicholas Bakalar
, New York Times
Do Not Be Afraid of Pain

Learning a bit of neuroscience may provide some relief from pain.

In a randomized clinical trial, researchers assigned 120 men and women with chronic back or neck pain to one of two treatments.

The first group received the commonly recommended program of physical therapy and general exercises.

The second received a program of “pain neuroscience education,” in which they learned about the function of neurons and synapses, the ways in which pain is transmitted along nerve fibers via the spinal cord to the brain, and how pain itself can modify central nervous system functions, producing pain with even the mildest stimulation. They also performed exercises, closely integrated with the education program, that gradually introduced increasingly difficult movements, concentrating on functionality rather than pain relief, and trying to continue exercising despite the pain.

Treatment in both groups lasted three months, and researchers re-examined the participants at six and 12 months afterward. Compared with the controls, the neuroscience education group had higher pain thresholds, a significant reduction in disability, and improved self-reported physical and mental health. The study is in JAMA Neurology.Multivitamins May Not Provide Heart Benefits

Taking multivitamins does not reduce the risk for heart disease, a review of studies has found.

The analysis, in Circulation: Cardiovascular Quality and Outcomes, pooled data from 18 studies with more than 2 million participants. All took supplements that included at least three vitamin and mineral ingredients and no herbs, hormones or drugs. Eleven of the studies were done in the United States, four in Europe and three in Japan. Follow-up varied from five to 19 years. Two were randomized controlled trials, and the rest prospective observational studies. The pooled data showed no association between multivitamins and the risk for cardiovascular disease, coronary heart disease or stroke incidence or mortality. In observational studies, there was a small association with coronary heart disease incidence, but none in randomized controlled trials.

“Multivitamins rarely cause harm, but they’re not completely safe either,” said the lead author, Dr. Joonseok Kim, an assistant professor of medicine at the University of Alabama at Birmingham. “Some ingredients can interact with other medicines and cause side effects. But a third of Americans take them, and the real problem is that they distract people from following measures that can really lower cardiovascular risk,” like exercising more and eating fruits and vegetables.

45-Hour Workweek Increases Diabetes Risk in Women

Women who work long hours may be at increased risk for diabetes, a new study has found.

Canadian researchers studied 7,065 workers, following their working hours and health over an average of 12 years. They recorded diabetes diagnoses beginning two years after the subjects enrolled in the study.

They found that compared to women who worked 35-40 hours a week, those who worked 45 hours or more had a 51 percent increased risk of diabetes. But there was no effect of working hours on diabetes in men.

The study, in BMJ Open Diabetes Research & Care, controlled for many other health and behavioral factors that could affect the development of diabetes, including age, ethnicity, body mass index, high blood pressure and extended sitting.

The lead author, Mahée Gilbert-Ouimet, a postdoctoral fellow at the Institute for Work & Health in Toronto, said that women probably worked more hours than men, if all household chores and family responsibilities were taken into account.

“It’s not easy to reduce working hours, and sometimes it’s impossible,” she said. “But women should know that this is a factor that may be important, especially if they have other risk factors for diabetes.”

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