Breakthrough Treatments for Chronic Diseases
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By Janice Billingsley
HealthDay Reporter

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FRIDAY, Aug. 8 (HealthDayNews) -- Chronic disease. Even the name sounds painful.


But for suffers of several such unrelenting health problems, life has taken a turn for the better.


From sinusitis, to lower back pain, to migraine headaches, recent medical 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 34 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 has 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 at New York City's Lenox Hill Hospital. "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, the chief of allergy and immunology 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 leads to better, more targeted treatments, she adds.


So do new nasal sprays, including intranasal nebulized antibiotics, certain antihistamines that didn't exist 10 years ago, and antibiotics that target the specific fungi and bacteria that often plague sinusitis sufferers, Josephson says.


In addition, 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 going to their 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 the Mayo Clinic estimates hobbles 65 million Americans a year, 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 wear off after several months. But 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, sold under the trade name Lidoderm. Although the U.S. Food and Drug Administration (news - web sites) has only approved the drug for the treatment of shingles-related pain, 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 26 million migraine sufferers. But here, too, breakthrough therapies are providing dramatic results.

The introduction a decade ago of a class of drugs called triptans -- they mimic the neurotransmitter serotonin, which is in short supply during migraine attacks -- has 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.

And Botox injections appear to reduce migraine symptoms, too.

More information

Facts about sinusitis can be found at the National Institutes of Health. Visit the American Academy of Orthopaedic Surgeons for tips on how to prevent back pain and injury.