What's New In Science?
Very Little Movement in Sacroiliac Joint (SIJ), Thus, It Cannot Be “Out”
More recent evidence find that the SIJ have limited rotational movement based on six fresh cadavers. By setting up the pelvis and the lumbar spine to simulate load-bearing upon the SIJ, the researchers measured how much movement occurred at the joint at 60% to 100% of the corpses’ original bodyweight. In all the measurements, there were less than one millimeter and less than one degree rotational differences, which challenges the common idea that low back pain from the SIJ is caused by its instability. This study also supports in vivo studies that also found similar results.
Limitations of this study include the age of the pelvis, which were 80-plus, and lack of sufficient muscles (e.g. transversus abdominis, erector spinae) that may affect the amount of movement.
Illustration: Dr. Johannes Sobotta
Psychological Stress Can Break Down Skin Barrier From Certain Enzyme Activation
Researchers from South Korea cited that a hormone called 11β-hydroxysteroid deydrogenase 1 (11β-HSD1) can activate dormant cortisone into active cortisol, a stress hormone, which is also found in the endoplasmic reticulum of skin cells, leading to hyperhidrosis (likely to make your armpit sweat more visible through a shirt).
They took samples of oral mucosa from 25 male medical students and measured the amount of cortisol in their saliva prior to and after taking an exam. In addition to taking other skin samples and cultures, they found higher levels of 11β-HSD1 expressed in the subprabasal layer of the epidermis during stress.
suprabasal layer of the epidermis during stress. However, there were some variability among the subjects which indicates not everyone have high levels of activation during stress. While this study also examined the effects of an anti-depressant drug that can reduce the enzyme activation, it is possible that massage therapy, exercise, and activities that can reduce stress may likely yield similar benefits for certain populations.
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IASP recently submitted to WHO a re-categorization of chronic pain into two types: chronic primary pain syndrome and chronic secondary pain syndrome. The primary version refers to “pain in one or more anatomical regions that persists or recurs for longer than 3 months” and is associated with high emotional stress or disability that cannot be explained with another chronic condition. CRPS, IBS, non-specific low back pain, and chronic migraines would fit in this category.
Secondary pain syndrome are linked to other diseases, which includes cancer-related pain, PTSD, neuropathic pain, Parkinson’s disease, and various types of infections.
While this is the first systematic classification of chronic pain as part of the International Classification of Disease (ICD), this is a first step in further promoting the biopsychosocial model of pain to future research and applied science to the clinical setting.