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Where to Turn for Low Back Pain Relief

Man suffering from back pain. Photo credit: Wavebreakmedia
Man suffering from back pain. Photo credit: Wavebreakmedia
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Where to Turn for Low Back Pain Relief

Man suffering from back pain. Photo credit: Wavebreakmedia
Man suffering from back pain. Photo credit: Wavebreakmedia

Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.

When pain strikes
There are many causes of low back pain. Some of the most common include an injury to a muscle or tendon (a strain), an injury to a back ligament (a sprain), and a herniated or "slipped" disc (when the soft material inside of a disc between spinal bones leaks and irritates nerves). Many of these issues will eventually resolve on their own.

But some causes of low back pain, such as a narrowing of the spinal canal (spinal stenosis), may require a specialist. "A referral makes sense when conservative measures have failed to address your back pain, symptoms aren't improving or are getting worse, or there's a suspicion that surgery might be needed," says Dr. Shmerling.

Where to turn
Since you shouldn't try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. "Both can serve as the entry point for back pain," says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women's Hospital. "And 35% to 42% of people with their first episode of back pain will consult a chiropractor."

Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. "A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor," Dr. Kowalski explains.

The next step
If you do need a specialist on your team, there are many experts who can help, depending on your needs. You may be referred to any of these:

- A neurologist, a doctor specializing in treatment of the nervous system. "Back pain is commonly associated with lower-extremity symptoms, such as numbness and tingling. These symptoms can also be caused by neurological conditions that are not spine-related, such as multiple sclerosis. Neurologists are great at sorting this out and offering solutions," says Dr. Kowalski.

- A physiatrist, a doctor with expertise in physical medicine and rehabilitation. "This may be helpful for back pain related to a sports injury, if surgery is not needed, and when medications are not working," says Dr. Shmerling.

- A rheumatologist, a doctor who treats diseases of the joints, muscles, and bones. "Referral is most appropriate when there is inflammation of the joints in the back, or if the back pain might be related to an inflammatory disease, such as psoriatic arthritis," explains Dr. Shmerling.

- A physical therapist, a licensed therapist who can help you strengthen back and core muscles to absorb pressure on the spine.

- A pain management physician, a doctor who can prescribe medications, provide injections, and consider other approaches. "People with symptoms that aren't responding to treatment are great candidates for pain management, such as injections or procedures to smaller joints in lower back," says Dr. Kowalski.

- An orthopedic spinal surgeon or a neurosurgeon who primarily does spine surgery, if surgery is likely needed for severe, unrelenting pain that may be due to a disc or spinal column problem.

Keep in mind
It may take several types of tests, such as x-rays, MRIs, and blood tests, to determine the exact cause of your back pain.

And you may need more than one expert managing your back pain. It just depends on the situation. "Most people who see more than one expert have more than one problem or have not improved with prior treatments," says Dr. Shmerling.

But for back sprains, strains, and herniated discs, a visit to your primary care physician or chiropractor may be all it takes to feel better. Make that initial call if back pain is interfering with your day.

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Saturn's Moon Titan May Not Have a Buried Ocean as Long Suspected, New Study Suggests

This image made by the Cassini spacecraft and provided by NASA on March 12, 2006, shows two of Saturn's moons, the small Epimetheus and smog-enshrouded Titan, with Saturn's A and F rings stretching across the frame. (NASA via AP)
This image made by the Cassini spacecraft and provided by NASA on March 12, 2006, shows two of Saturn's moons, the small Epimetheus and smog-enshrouded Titan, with Saturn's A and F rings stretching across the frame. (NASA via AP)
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Saturn's Moon Titan May Not Have a Buried Ocean as Long Suspected, New Study Suggests

This image made by the Cassini spacecraft and provided by NASA on March 12, 2006, shows two of Saturn's moons, the small Epimetheus and smog-enshrouded Titan, with Saturn's A and F rings stretching across the frame. (NASA via AP)
This image made by the Cassini spacecraft and provided by NASA on March 12, 2006, shows two of Saturn's moons, the small Epimetheus and smog-enshrouded Titan, with Saturn's A and F rings stretching across the frame. (NASA via AP)

Saturn's giant moon Titan may not have a vast underground ocean after all.

Titan instead may hold deep layers of ice and slush more akin to Earth’s polar seas, with pockets of melted water where life could possibly survive and even thrive, scientists reported Wednesday.

The team led by researchers at NASA's Jet Propulsion Laboratory challenged the decade-long assumption of a buried global ocean at Titan after taking a fresh look at observations made years ago by NASA’s Cassini spacecraft around Saturn.

They stress that no one has found any signs of life at Titan, the solar system’s second largest moon spanning 3,200 miles (5,150 kilometers) and brimming with lakes of liquid methane on its frosty surface, The AP news reported.

But with the latest findings suggesting a slushy, near-melting environment, “there is strong justification for continued optimism regarding the potential for extraterrestrial life,” said the University of Washington’s Baptiste Journaux, who took part in the study published in the journal Nature.

As to what form of life that might be, possibly strictly microscopic, “nature has repeatedly demonstrated far greater creativity than the most imaginative scientists," he said in an email.

JPL’s Flavio Petricca, the lead author, said Titan’s ocean may have frozen in the past and is currently melting, or its hydrosphere might be evolving toward complete freezing.

Computer models suggest these layers of ice, slush and water extend to a depth of more than 340 miles (550 kilometers). The outer ice shell is thought to be about 100 miles (170 kilometers) deep, covering layers of slush and pools of water that could go down another 250 miles (400 kilometers). This water could be as warm as 68 degrees Fahrenheit (20 degrees Celsius).

Because Titan is tidally locked, the same side of the moon faces Saturn all the time, just like our own moon and Earth. Saturn’s gravitational pull is so intense that it deforms the moon’s surface, creating bulges as high as 30 feet (10 meters) when the two bodies are closest.

Through improved data processing, Petricca and his team managed to measure the timing between the peak gravitational tug and the rising of Titan’s surface. If the moon held a wet ocean, the effect would be immediate, Petricca said, but a 15-hour gap was detected, indicating an interior of slushy ice with pockets of liquid water. Computer modeling of Titan’s orientation in space supported their theory.

Sapienza University of Rome’s Luciano Iess, whose previous studies using Cassini data indicated a hidden ocean at Titan, is not convinced by the latest findings.

While “certainly intriguing and will stimulate renewed discussion ... at present, the available evidence looks certainly not sufficient to exclude Titan from the family of ocean worlds," Iess said in an email.

NASA’s planned Dragonfly mission — featuring a helicopter-type craft due to launch to Titan later this decade — is expected to provide more clarity on the moon’s innards. Journaux is part of that team.

Saturn leads the solar system’s moon inventory with 274. Jupiter’s moon Ganymede is just a little larger than Titan, with a possible underground ocean. Other suspected water worlds include Saturn’s Enceladus and Jupiter’s Europa, both of which are believed to have geysers of water erupting from their frozen crusts.

Launched in 1997, Cassini reached Saturn in 2004, orbiting the ringed planet and flying past its moons until deliberately plunging through Saturn’s atmosphere in 2017.

Varieties

Catch the Ursid Meteor Shower as it Peaks just before Christmas

People look up to the sky from an observatory near the village of Avren, Bulgaria, Aug. 12, 2009. (AP Photo/Petar Petrov, File)
People look up to the sky from an observatory near the village of Avren, Bulgaria, Aug. 12, 2009. (AP Photo/Petar Petrov, File)
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Catch the Ursid Meteor Shower as it Peaks just before Christmas

People look up to the sky from an observatory near the village of Avren, Bulgaria, Aug. 12, 2009. (AP Photo/Petar Petrov, File)
People look up to the sky from an observatory near the village of Avren, Bulgaria, Aug. 12, 2009. (AP Photo/Petar Petrov, File)

The last major meteor shower of the year, known as the Ursids, peaks soon, bringing glowing streaks to nighttime and early morning skies. Compared to other meteor showers, it's more subdued, but experts say it's still worth a glimpse.

Meteor showers happen when space rocks hit Earth's atmosphere at extremely high speeds and burn up, gaining fiery tails — the end of a “shooting star.” Random meteors are visible from Earth on any given clear night, but more predictable meteor showers happen yearly when Earth passes through streams of cosmic leftovers from comets or asteroids, Reuters reported.

The Ursids peak Sunday night into Monday morning and will be visible until Dec. 26 from the Northern Hemisphere. Skygazers usually see five to 10 meteors per hour during the height and there's a possibility for outbursts of up to 25 meteors per hour, according to the American Meteor Society.

How active a shower will appear from Earth depends on the amount of debris and the moon's brightness, which can blot out glowing meteors. The Ursids feature less space debris than other showers like the Geminids, but the narrow crescent moon won't be much of an obstacle when they peak.

No special equipment is needed to view a meteor shower. To see the Ursids, which hail from a comet called 8P/Tuttle, bundle up and get away from city lights.

“The darker your sky, the better the shower is going to be,” said astronomer Peter Brown with Western University in Canada.

The meteors can be seen over the whole sky, but all the streaks will seem to come from a central point near a constellation for which the shower is named. In this case, that's the constellation Ursa Minor, also known as the Little Dipper.

Once it gets dark, avoid bright lights from cellphones, which will make it harder for your eyes to adjust.

Varieties

Private Astronaut Jared Isaacman Becomes NASA Chief

NASA's next-generation moon rocket, the Space Launch System (SLS) rocket with its Orion crew capsule perched on top, is seen in the Vehicle Assembly Building (VAB) before it is scheduled to make a slow-motion journey to its launch pad at Cape Canaveral, Florida, US March 16, 2022. REUTERS/Thom Baur
NASA's next-generation moon rocket, the Space Launch System (SLS) rocket with its Orion crew capsule perched on top, is seen in the Vehicle Assembly Building (VAB) before it is scheduled to make a slow-motion journey to its launch pad at Cape Canaveral, Florida, US March 16, 2022. REUTERS/Thom Baur
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Private Astronaut Jared Isaacman Becomes NASA Chief

NASA's next-generation moon rocket, the Space Launch System (SLS) rocket with its Orion crew capsule perched on top, is seen in the Vehicle Assembly Building (VAB) before it is scheduled to make a slow-motion journey to its launch pad at Cape Canaveral, Florida, US March 16, 2022. REUTERS/Thom Baur
NASA's next-generation moon rocket, the Space Launch System (SLS) rocket with its Orion crew capsule perched on top, is seen in the Vehicle Assembly Building (VAB) before it is scheduled to make a slow-motion journey to its launch pad at Cape Canaveral, Florida, US March 16, 2022. REUTERS/Thom Baur

The US Senate confirmed billionaire private astronaut Jared Isaacman to become President Donald Trump's NASA administrator, making an advocate of Mars missions and a former associate of SpaceX CEO Elon Musk the space agency's 15th leader. The vote on Isaacman, who Trump removed and then renamed as NASA administrator nominee this year, passed 67-30, two weeks after he told senators in his second hearing that NASA must pick up the pace in beating China back to the moon this decade, Reuters reported.

Isaacman will lead an agency of 14,000 employees as it invests billions of dollars into its most ambitious space exploration endeavor yet: returning humans to the moon to seed a long-term presence on the surface before eventually sending astronauts to Mars.

NASA WORKFORCE CUT IN EFFICIENCY PUSH

The White House, in its government efficiency push led by Musk, slashed NASA's workforce by 20% and has sought to cut the agency's 2026 budget by roughly 25% from its usual $25 billion, imperiling dozens of space-science programs that scientists and some officials regard as priorities.

Isaacman envisions a revamped focus on sending missions to Mars on top of the Artemis moon effort, as well as a greater dependence on private companies such as SpaceX to save taxpayer money and stimulate private-sector competition.

Of the 67 votes in Isaacman's favor, 16 were from Democrats, joining 51 from Republicans. All 30 votes against his confirmation were from Democrats.

Maria Cantwell, the ranking member of the Senate Commerce Committee that oversees NASA, has criticized the Trump administration's efforts to cut NASA's science unit. She supported Isaacman's confirmation on Wednesday.

"During his nomination process, Mr. Isaacman emphasized the importance of developing a pipeline of future scientists, engineers, researchers, (and) astronauts to support the science and technology development and align with NASA's objectives. I strongly agree," Cantwell said.

Some Democratic senators said during Isaacman's hearing on December 3 they are concerned about Isaacman's closeness to Musk, whose company holds about $15 billion in NASA contracts and could benefit from certain policies Isaacman has advocated.

Musk advocated for Isaacman's nomination when Trump was elected in 2024. Musk had sought to realign the US space program with a greater focus on Mars during his stint as a close adviser to Trump.

Senate Republicans and some Democrats, including Cantwell, have also stressed urgency in NASA's moon race with China, which is aiming to send its astronauts to the lunar surface by 2030. NASA faces a shaky target of 2028 using its Space Launch System rocket and SpaceX's giant Starship rocket, under development, as the lander.

Acting NASA chief Sean Duffy, who also leads the US Transportation Department, congratulated Isaacman on X, wishing Isaacman "success as he begins his tenure and leads NASA as we go back to the Moon in 2028 and beat China."