L-Theanine: What’s The Tea?

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L-Theanine: What’s The Tea?

We’ve touched previously on l-theanine, when this newsletter was new, and we had only a few hundred subscribers and the carefully organized format wasn’t yet what it is today.

So now it’s time to give this potent dietary compound / nutritional supplement the “Monday Research Review” treatment…

What is it?

L-theanine is an amino acid found in tea. The human body can’t produce it, and/but it’s not essential for humans. It does have a lot of benefits, though. See for example:

L-Theanine as a Functional Food Additive: Its Role in Disease Prevention and Health Promotion

How does it work?

L-theanine works by moderating and modulating the brain’s neurotransmitters.

This sounds fancy, but basically it means: it doesn’t actually add anything in the manner of a drug, but it changes how we use what we have naturally.

What does it do? Read on…

It increases mental focus

It has been believed that l-theanine requires the presence of caffeine to achieve this (i.e., it’s a combination-only effect). For example:

The combination of L-theanine and caffeine improves cognitive performance and increases subjective alertness

But as it turns out, when a group of researchers actually checked… This isn’t true, as Foxe et al. write:

❝We asked whether either compound alone, or both in combination, would affect performance of the task in terms of reduced error rates over time, and whether changes in alpha-band activity would show a relationship to such changes in performance. When treated with placebo, participants showed a rise in error rates, a pattern that is commonly observed with increasing time-on-task, whereas after caffeine and theanine ingestion, error rates were significantly reduced. The combined treatment did not confer any additional benefits over either compound alone, suggesting that the individual compounds may confer maximal benefits at the dosages employed❞

See: Assessing the effects of caffeine and theanine on the maintenance of vigilance during a sustained attention task

It promotes a calmly wakeful feeling of serenity

Those are not words typically found in biopharmaceutical literature, but they’re useful here to convey:

  • L-theanine promotes relaxation without causing drowsiness
  • L-theanine promotes mental alertness without being a stimulant

Here is where l-theanine really stands out from caffeine. If both substances promote mental focus, but one of them does it by making us “wired” and the other does it while simultaneously promoting calm, it makes the choice between them clearer!

Read more: L-theanine, a natural constituent in tea, and its effect on mental state

It relieves stress and anxiety

Building on from the above, but there’s more: l-theanine relieves stress and anxiety in people experiencing stressful situations, without any known harmful side effects… This is something that sets it apart from a lot of anxiolytic (antianxiety) drugs!

Here’s what a big systematic review of clinical trials had to say:

Theanine consumption, stress and anxiety in human clinical trials: A systematic review

L-theanine has other benefits too

We’ve talked about some of the most popular benefits of l-theanine, and we can’t make this newsletter too long, but research also suggests that it…

If you’re interested in this topic, we recommend also reading our previous article on l-theanine—pardon that we hadn’t really nailed down our style yet—but there’s a bunch of useful information about how l-theanine makes caffeine “better” in terms of benefits. We also talk doseage, and reference some other studies we didn’t have room to include today!

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  • Vaccines and cancer: The myth that won’t die

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    Two recent studies reported rising cancer rates among younger adults in the U.S. and worldwide. This prompted some online anti-vaccine accounts to link the studies’ findings to COVID-19 vaccines. 

    But, as with other myths, the data tells a very different story. 

    What you need to know 

    • Baseless claims that COVID-19 vaccines cause cancer have persisted online for several years and gained traction in late 2023.
    • Two recent reports finding rising cancer rates among younger adults are based on pre-pandemic cancer incidence data. Cancer rates in the U.S. have been on the rise since the 1990s.
    • There is no evidence of a link between COVID-19 vaccination and increased cancer risk.

    False claims about COVID-19 vaccines began circulating months before the vaccines were available. Chief among these claims was misinformed speculation that vaccine mRNA could alter or integrate into vaccine recipients’ DNA. 

    It does not. But that didn’t prevent some on social media from spinning that claim into a persistent myth alleging that mRNA vaccines can cause or accelerate cancer growth. Anti-vaccine groups even coined the term “turbo cancer” to describe a fake phenomenon of abnormally aggressive cancers allegedly linked to COVID-19 vaccines. 

    They used the American Cancer Society’s 2024 cancer projection—based on incidence data through 2020—and a study of global cancer trends between 1999 and 2019 to bolster the false claims. This exposed the dishonesty at the heart of the anti-vaccine messaging, as data that predated the pandemic by decades was carelessly linked to COVID-19 vaccines in viral social media posts.

    Some on social media cherry-pick data and use unfounded evidence because the claims that COVID-19 vaccines cause cancer are not true. According to the National Cancer Institute and American Cancer Society, there is no evidence of any link between COVID-19 vaccines and an increase in cancer diagnosis, progression, or remission. 

    Why does the vaccine cancer myth endure?

    At the root of false cancer claims about COVID-19 vaccines is a long history of anti-vaccine figures falsely linking vaccines to cancer. Polio and HPV vaccines have both been the target of disproven cancer myths. 

    Not only do HPV vaccines not cause cancer, they are one of only two vaccines that prevent cancer.

    In the case of polio vaccines, some early batches were contaminated with simian virus 40 (SV40), a virus that is known to cause cancer in some mammals but not humans. The contaminated batches were discovered, and no other vaccine has had SV40 contamination in over 60 years

    Follow-up studies found no increase in cancer rates in people who received the SV40-contaminated polio vaccine. Yet, vaccine opponents have for decades claimed that polio vaccines cause cancer.

    Recycling of the SV40 myth

    The SV40 myth resurfaced in 2023 when vaccine opponents claimed that COVID-19 vaccines contain the virus. In reality, a small, nonfunctional piece of the SV40 virus is used in the production of some COVID-19 vaccines. This DNA fragment, called the promoter, is commonly used in biomedical research and vaccine development and doesn’t remain in the finished product. 

    Crucially, the SV40 promoter used to produce COVID-19 vaccines doesn’t contain the part of the virus that enters the cell nucleus and is associated with cancer-causing properties in some animals. The promoter also lacks the ability to survive on its own inside the cell or interact with DNA. In other words, it poses no risk to humans.

    Over 5.6 billion people worldwide have received COVID-19 vaccines since December 2020. At that scale, even the tiniest increase in cancer rates in vaccinated populations would equal hundreds of thousands of excess cancer diagnoses and deaths. The evidence for alleged vaccine-linked cancer would be observed in real incidence, treatment, and mortality data, not social media anecdotes or unverifiable reports. 

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Try This At Home: ABI Test For Clogged Arteries

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    Arterial plaque is a big deal, and statistically it’s more of a risk as we get older, often coming to a head around age 72 for women and 65 for men—these are the median ages at which people who are going to get heart attacks, get them. Or get it, because sometimes one is all it takes.

    The Ankle-Brachial Index Test

    Dr. Brewer recommends a home test for detecting arterial plaque called the Ankle-Brachial Index (ABI), which uses a blood pressure monitor. The test involves measuring blood pressure in both the arms and ankles, then calculating the ratio of these measurements:

    • A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
    • Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
    • High ABI scores (above 1.4) may indicate artery hardening

    Peripheral Artery Disease (PAD), associated with poor ABI results (be they high or low), can cause a whole lot of problems that are definitely better tackled sooner rather than later—remember that atherosclerosis is a self-worsening thing once it gets going, because narrower walls means it’s even easier for more stuff to get stuck in there (and thus, the new stuff that got stuck also becomes part of the walls, and the problem gets worse).

    If you need a blood pressure monitor, by the way, here’s an example product on Amazon.

    Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy. For this reason, this test can be used to raise the alarm, but not to give the “all clear”.

    For more on all of the above, plus a demonstration and more in-depth explanation of the test, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

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    Take care!

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  • A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?

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    A much-awaited treatment for postpartum depression, zuranolone, hit the market in December, promising an accessible and fast-acting medication for a debilitating illness. But most private health insurers have yet to publish criteria for when they will cover it, according to a new analysis of insurance policies.

    The lack of guidance could limit use of the drug, which is both novel — it targets hormone function to relieve symptoms instead of the brain’s serotonin system, as typical antidepressants do — and expensive, at $15,900 for the 14-day pill regimen.

    Lawyers, advocates, and regulators are watching closely to see how insurance companies will shape policies for zuranolone because of how some handled its predecessor, an intravenous form of the same drug called brexanolone, which came on the market in 2019. Many insurers required patients to try other, cheaper medications first — known as the fail-first approach — before they could be approved for brexanolone, which was shown in early trials reviewed by the FDA to provide relief within days. Typical antidepressants take four to six weeks to take effect.

    “We’ll have to see if insurers cover this drug and what fail-first requirements they put in” for zuranolone, said Meiram Bendat, a licensed psychotherapist and an attorney who represents patients.

    Most health plans have yet to issue any guidelines for zuranolone, and maternal health advocates worry that the few that have are taking a restrictive approach. Some policies require that patients first try and fail a standard antidepressant before the insurer will pay for zuranolone.

    In other cases, guidelines require psychiatrists to prescribe it, rather than obstetricians, potentially delaying treatment since OB-GYN practitioners are usually the first medical providers to see signs of postpartum depression.

    Advocates are most worried about the lack of coverage guidance.

    “If you don’t have a published policy, there is going to be more variation in decision-making that isn’t fair and is less efficient. Transparency is really important,” said Joy Burkhard, executive director of the nonprofit Policy Center for Maternal Mental Health, which commissioned the study.

    With brexanolone, which was priced at $34,000 for the three-day infusion, California’s largest insurer, Kaiser Permanente, had such rigorous criteria for prescribing it that experts said the policy amounted to a blanket denial for all patients, according to an NPR investigation in 2021.

    KP’s written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. Because the drug was approved only for up to six months postpartum, and trials of typical antidepressants take four to six weeks each, the clock would run out before a patient had time to try brexanolone.

    An analysis by NPR of a dozen other health plans at the time showed Kaiser Permanente’s policy on brexanolone to be an outlier. Some did require that patients fail one or two other drugs first, but KP was the only one that recommended four.

    Miriam McDonald, who developed severe postpartum depression and suicidal ideation after giving birth in late 2019, battled Kaiser Permanente for more than a year to find effective treatment. Her doctors put her on a merry-go-round of medications that didn’t work and often carried unbearable side effects, she said. Her doctors refused to prescribe brexanolone, the only FDA-approved medication specifically for postpartum depression at the time.

    “No woman should suffer like I did after having a child,” McDonald said. “The policy was completely unfair. I was in purgatory.”

    One month after NPR published its investigation, KP overhauled its criteria to recommend that women try just one medication before becoming eligible for brexanolone.

    Then, in March 2023, after the federal Department of Labor launched an investigation into the insurer — citing NPR’s reporting — the insurer revised its brexanolone guidelines again, removing all fail-first recommendations, according to internal documents recently obtained by NPR. Patients need only decline a trial of another medication.

    “Since brexanolone was first approved for use, more experience and research have added to information about its efficacy and safety,” the insurer said in a statement. “Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.”

    “Kaiser basically went from having the most restrictive policy to the most robust,” said Burkhard of the Policy Center for Maternal Mental Health. “It’s now a gold standard for the rest of the industry.”

    McDonald is hopeful that her willingness to speak out and the subsequent regulatory actions and policy changes for brexanolone will lead Kaiser Permanente and other health plans to set patient-friendly policies for zuranolone.

    “This will prevent other women from having to go through a year of depression to find something that works,” she said.

    Clinicians were excited when the FDA approved zuranolone last August, believing the pill form, taken once a day at home over two weeks, will be more accessible to women compared with the three-day hospital stay for the IV infusion. Many perinatal psychiatrists told NPR it is imperative to treat postpartum depression as quickly as possible to avoid negative effects, including cognitive and social problems in the baby, anxiety or depression in the father or partner, or the death of the mother to suicide, which accounts for up to 20% of maternal deaths.

    So far, only one of the country’s six largest private insurers, Centene, has set a policy for zuranolone. It is unclear what criteria KP will set for the new pill. California’s Medicaid program, known as Medi-Cal, has not yet established coverage criteria.

    Insurers’ policies for zuranolone will be written at a time when the regulatory environment around mental health treatment is shifting. The U.S. Department of Labor is cracking down on violations of the Mental Health Parity and Addiction Equity Act of 2008, which requires insurers to cover psychiatric treatments the same as physical treatments.

    Insurers must now comply with stricter reporting and auditing requirements intended to increase patient access to mental health care, which advocates hope will compel health plans to be more careful about the policies they write in the first place.

    In California, insurers must also comply with an even broader state mental health parity law from 2021, which requires them to use clinically based, expert-recognized criteria and guidelines in making medical decisions. The law was designed to limit arbitrary or cost-driven denials for mental health treatments and has been hailed as a model for the rest of the country. Much-anticipated regulations for the law are expected to be released this spring and could offer further guidance for insurers in California setting policies for zuranolone.

    In the meantime, Burkhard said, patients suffering from postpartum depression should not hold back from asking their doctors about zuranolone. Insurers can still grant access to the drug on a case-by-case basis before they formalize their coverage criteria.

    “Providers shouldn’t be deterred from prescribing zuranolone,” Burkhard said. 

    This article is from a partnership that includes KQEDNPR and KFF Health News.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Brown Rice vs Wild Rice – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing brown rice to wild rice, we picked the wild.

    Why?

    It’s close! But there are important distinctions.

    First let’s clarify: despite the name and appearance, wild rice is botanically quite different from rice per se; it’s not the same species, it’s not even the same genus, though it is the same umbrella family. In other words, they’re about as closely related as humans and gorillas are to each other.

    In terms of macros, wild rice has considerably more protein and a little more fiber, for slightly lower carbs.

    Notably, however, wild rice’s carbs are a close-to-even mix of sucrose, fructose, and glucose, while brown rice’s carbs are 99% starch. Given the carb to fiber ratio, it’s worth noting that wild rice also has lower net carbs, and the lower glycemic index.

    In the category of vitamins, wild rice leads with more of vitamins A, B2, B9, E, K, and choline. In contrast, brown rice has more of vitamins B1, B3, and B5. So, a moderate win for wild rice.

    When it comes to minerals, brown rice finally gets a tally in its favor, even if only slightly: brown rice has more magnesium, manganese, phosphorus, and selenium, while wild rice has more copper, potassium, and zinc. They’re equal in calcium and iron, by the way. Still, this category stands as a 4:3 win for brown rice.

    Adding up the categories makes a modest win for wild rice, and additionally, if we had to consider one of these things more important than the others, it’d be wild rice being higher in fiber and protein and lower in total carbs and net carbs.

    Still, enjoy either or both, per your preference!

    Want to learn more?

    You might like to read:

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  • What’s the difference between ‘strep throat’ and a sore throat? We’re developing a vaccine for one of them

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    What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.


    It’s the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”.

    But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried?

    Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter.

    Prostock-studio/Shutterstock

    How are they similar?

    It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar.

    People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days.

    Thankfully, both types of sore throat usually get better by themselves.

    How are they different?

    Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus).

    These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted antibiotic side-effects.

    But strep throat is caused by Streptococcus pyogenes bacteria, also known as strep A. Strep throat is most common in school-aged children, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications.

    In fact, the potential for complications is one key difference between a viral sore throat and strep throat.

    Generally, a viral sore throat is very unlikely to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as chronic fatigue syndrome, multiple sclerosis and certain cancers).

    But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick.

    Invasive strep A infections and deaths have been rising in recent years around the world, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear.

    Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells.

    The most common example is rheumatic heart disease. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection.

    Around the world more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries.

    However, parts of Australia have some of the highest rates of rheumatic heart disease in the world. More than 5,300 Indigenous Australians live with it.

    Streptococcus pyogenes
    Strep throat is caused by Streptococcus bacteria and can be treated with antibiotics if needed. Kateryna Kon/Shutterstock

    Why do some people get sicker than others?

    We know strep A infections and rheumatic heart disease are more common in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease.

    However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease.

    We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out.

    How about a vaccine for strep A?

    There is no strep A vaccine but many groups in Australia, New Zealand and worldwide are working towards one.

    For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the Australian Strep A Vaccine Initiative to develop strep A vaccines. There’s also a global consortium working towards the same goal.

    Companies such as Vaxcyte and GlaxoSmithKline have also been developing strep A vaccines.

    What if I have a sore throat?

    Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP.

    Your GP can examine you, consider running some tests and help you decide if you need antibiotics.

    Kim Davis, General paediatrician and paediatric infectious diseases specialist, Murdoch Children’s Research Institute; Alma Fulurija, Immunologist and the Australian Strep A Vaccine Initiative project lead, Telethon Kids Institute, and Myra Hardy, Postdoctoral Researcher, Infection, Immunity and Global Health, Murdoch Children’s Research Institute

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Elon Musk says ‘disc replacement’ worked for him. But evidence this surgery helps chronic pain is lacking

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    Last week in a post on X, owner of the platform Elon Musk recommended people look into disc replacement if they’re experiencing severe neck or back pain.

    According to a biography of the billionaire, he’s had chronic back and neck pain since he tried to “judo throw” a 350-pound sumo wrestler in 2013 at a Japanese-themed party for his 42nd birthday, and blew out a disc at the base of his neck.

    In comments following the post, Musk said the surgery was a “gamechanger” and reduced his pain significantly.

    Musk’s original post has so far had more than 50 million views and generated controversy. So what is disc replacement surgery and what does the evidence tells us about its benefits and harms?

    What’s involved in a disc replacement?

    Disc replacement is a type of surgery in which one or more spinal discs (a cushion between the spine bones, also known as vertebrae) are removed and replaced with an artificial disc to retain movement between the vertebrae. Artificial discs are made of metal or a combination of metal and plastic.

    Disc replacement may be performed for a number of reasons, including slipped discs in the neck, as appears to be the case for Musk.

    Disc replacement is major surgery. It requires general anaesthesia and the operation usually takes 2–4 hours. Most people stay in hospital for 2–7 days. After surgery patients can walk but need to avoid things like strenuous exercise and driving for 3–6 weeks. People may be required to wear a neck collar (following neck surgery) or a back brace (following back surgery) for about 6 weeks.

    Costs vary depending on whether you have surgery in the public or private health system, if you have private health insurance, and your level of coverage if you do. In Australia, even if you have health insurance, a disc replacement surgery may leave you more than A$12,000 out of pocket.

    Disc replacement surgery is not performed as much as other spinal surgeries (for example, spinal fusion) but its use is increasing.

    In New South Wales for example, rates of privately-funded disc replacement increased six-fold from 6.2 per million people in 2010–11 to 38.4 per million in 2019–20.

    What are the benefits and harms?

    People considering surgery will typically weigh that option against not having surgery. But there has been very little research comparing disc replacement surgery with non-surgical treatments.

    Clinical trials are the best way to determine if a treatment is effective. You first want to show that a new treatment is better than doing nothing before you start comparisons with other treatments. For surgical procedures, the next step might be to compare the procedure to non-surgical alternatives.

    Unfortunately, these crucial first research steps have largely been skipped for disc replacement surgery for both neck and back pain. As a result, there’s a great deal of uncertainty about the treatment.

    There are no clinical trials we know of investigating whether disc replacement is effective for neck pain compared to nothing or compared to non-surgical treatments.

    For low back pain, the only clinical trial that has been conducted to our knowledge comparing disc replacement to a non-surgical alternative found disc replacement surgery was slightly more effective than an intensive rehabilitation program after two years and eight years.

    A medical practitioner examines a patient's lower back.
    Many people experience chronic pain. Yan Krukau/Pexels

    Complications are not uncommon, and can include disclocation of the artificial disc, fracture (break) of the artificial disc, and infection.

    In the clinical trial mentioned above, 26 of the 77 surgical patients had a complication within two years of follow up, including one person who underwent revision surgery that damaged an artery leading to a leg needing to be amputated. Revision surgery means a re-do to the primary surgery if something needs fixing.

    Are there effective alternatives?

    The first thing to consider is whether you need surgery. Seeking a second opinion may help you feel more informed about your options.

    Many surgeons see disc replacement as an alternative to spinal fusion, and this choice is often presented to patients. Indeed, the research evidence used to support disc replacement mainly comes from studies that compare disc replacement to spinal fusion. These studies show people with neck pain may recover and return to work faster after disc replacement compared to spinal fusion and that people with back pain may get slightly better pain relief with disc replacement than with spinal fusion.

    However, spinal fusion is similarly not well supported by evidence comparing it to non-surgical alternatives and, like disc replacement, it’s also expensive and associated with considerable risks of harm.

    Fortunately for patients, there are new, non-surgical treatments for neck and back pain that evidence is showing are effective – and are far cheaper than surgery. These include treatments that address both physical and psychological factors that contribute to a person’s pain, such as cognitive functional therapy.

    While Musk reported a good immediate outcome with disc replacement surgery, given the evidence – or lack thereof – we advise caution when considering this surgery. And if you’re presented with the choice between disc replacement and spinal fusion, you might want to consider a third alternative: not having surgery at all.

    Giovanni E Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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