|HEALTH & FITNESS|
Four steps to
treat chronic low back pain
way to live healthy life
with parents helps teens cope with stress
differ in effect on colon cancer risk
dose errors can cause bleeding
steps to treat chronic low back pain
A majority of low back pain cases pertain to lumbar spine as the vertebrae comprising this area are subjected to maximum stress and strain. This problem affects virtually everyone at some point of time. Unfortunately, some cases are not diagnosed correctly nor treated properly, resulting in long-term pain and agony.
Acute pain occurs due to sudden injury that gradually resolves on healing. If low back pain persists for more than two or three months it is termed as chronic low back pain. This occurs due to inadequate/ incorrect rehabilitation after injury, disc problem, sciatica, osteoporosis, etc. The usual complaints are morning stiffness, inability to sit or stand for long periods of time, tiredness and feeling of anxiety/ depression.
The cause for pain can be ascertained by going into medical history carefully and physical and neurological examinations along with appropriate investigations.
Such patients usually suffer from a constant low level of stimulation to the nervous system, which becomes the usual pattern. Hence even if the initial source of irritation is resolved, pain may persist as neural memory. This adaptation of the nervous system creates an environment in which events previously causing no pain become a source of pain.
The treatment entails a four step approach, which is very effective and is devoid of recurrence of symptoms.
Most cases respond immediately to spinal manipulation. This involves giving low velocity amplitude thrust at the appropriate vertebrae or joint. These manipulations are done daily or on alternate days for two to four weeks. Manipulation facilitates regaining the alignment of the vertebrae of the back and also relaxes the surrounding muscles and ligaments.
Exercises help stimulate the body’s natural pain controlling hormones and thereby reducing pain perception. The fact is that chronic low back pain prevents patients to do enough exercises, which adversely affects disc nutrition. Physical activities move vertebrae leading to the swelling of the disc with water and nutrients and then squeezing them out (like a sponge). On stopping physical activity/ exercise, the disc is deprived of nutrition and then begins the degeneration process.
Proper rehabilitation means aerobic conditioning, stretching and strengthening of the body with specific concentration to the back. Three types of muscles support the spine.
Extensor muscles help in straightening and extending the back.
Flexor muscles help in bending and supporting the spine.
Oblique muscles help at the time of bending sideways, rotation and maintenance of proper posture.
Most of these muscles do not get adequate exercise from day-to-day activities and tend to become weak with age. Hence the need for specific exercises. The muscles of the lower back and abdomen play an important role in providing support and stability to the spine. Lumbar stabilisation exercises not only decrease the pain but also improve the lumbar spine function and eliminate further injury.
The need to exercise varies from one individual to another. Clinical tests are undertaken to assess the requirement of an individual as regards flexibility and strength of the muscles controlling the back and postural evaluation so that proper advice can be rendered and effective exercise routine initiated.
There are a number of biomechanical forces that act on the lumbar spine. Proper treatment aims at reducing such biomechanical forces. People suffering from chronic low back pain due to poor posture need to correct it, otherwise even post-treatment the low back pain is not resolved. Hence the importance of postural support during sitting — back-rest to maintain neutral back to reduce strain during sitting.
Similarly, during walking or standing the lumbar spine and pelvis maintain the balance of lower extremities. If there is biomechanical defect in the leg or foot or alignment difficulty due to knee arthritis then abnormal forces are transmitted to lower back leading to discomfort and pain. Difference in the leg length also produces undue stress on lower back that can be effectively reduced with heel lift.
In cases of flat feet, the arch should be placed so as to improve the alignment of the leg. Individuals with disc affliction suffer from increased low back pain when the foot strikes the ground. Wearing a shock-absorbing shoe insert containing viscoelastic component can drastically reduce this. These days silicon soles are readily available.
It is not uncommon for those suffering from chronic low back pain to feel bouts of depression. An effective solution is to distract the nervous system by means of an appropriate exercise programme to allow healing of the injured area. Individuals who do not suffer from bouts of depression heal faster as compared to those suffering from depression.
Proper rehabilitation thus is the mainstay of effective and permanent cure of chronic low back pain. This will also improve the quality of life. One does not have to live with pain.
The writer is a former doctor/physiotherapist, Indian cricket team.
Weather is known to have an effect on rheumatoid arthritis. It is quite known that arthritis patients show an increase in their symptoms during cold weather. The winters can be very bad for some of them. Even a wet weather aggravates the condition for many patients. Some RA (rheumatoid arthritis) patients seem to be too sensitive about weather changes. So much so that they often come up saying that they know “it’s going to rain” as their joints start to ache.
Homoeopathy can be a great boon for all those suffering from rheumatoid arthritis. As a homoeopathic prescription is based on a careful analysis of the symptoms of the patients, it becomes a system of medicine that understands and treats the patients’ individualised disease characteristics, deeply enough to ensure complete elimination of the disease.
Rheumatoid arthritis is a chronic disorder that affects the joints. The lining of the joints (synovium) gets inflamed and slowly gets destroyed. This causes the patients to suffer from pain, aches and stiffness in joints, and eventually the joints get deformed. The exact cause is uncertain but it is believed that it is an autoimmune disorder. This means that the body’s own defense cells attack the joint lining and cause gross changes in them. Although it can affect anybody at nearly all ages, this disorder is more common in women and those between the ages of 20-50. Diagnoses of arthritis is made on the basis of a combination of factors; by assessing medical history, performing a physical examination, ordering specific laboratory tests, and x-rays.
The scope of homoeopathic treatment in rheumatoid arthritis is very favourable. But the patient needs to understand that the homoeopathic system is aiming to clear out the disease from the body and not trying merely to suppress or give temporary relief .Thus, it could take a while before one experiences relief. The time for its treatment is dependent on various factors — the chronicity of the disease (the duration since the disease has been in the body), genetic propensity and the extent of damage.
Although it is not very clear as how homoeopathy works in rheumatoid arthritis, it is hypothesized that homoeopathic medicines regulate the immune system and deactivate the misdirected immune cells. They also help in reducing the inflammation in the joints too. Reversal of deformity with homoeopathy is still under debate and nothing conclusive can be said about it.
Homoeopathy works on the principle of “like cure like”; this in homoeopathic terms means that substances which in their raw state produce symptoms similar to the disease have the potential to stimulate the body’s own restorative process for a similar illness when given in an activated dilution.
Homoeopathic medicines that are used in treating rheumatoid arthritis are mainly from all plant, mineral kingdom. They are then highly diluted and succused (shaken in a specific way). These activated dilutions then stimulate our body’s own restorative systems to eradicate the disease. When rightly prescribed, they are extremely safe.
Is it possible that one can use homoeopathic medicines on one’s own?
Firstly, one has to realise that rheumatoid arthritis is a complex chronic disorder and needs to be evaluated properly before any prescription is made. Secondly, homoeopathy is a very individualised system of medicine. For example, the prescription for the arthritis patient that gets an increase of symptoms in cold weather will be totally different from the one who shows an increase during a wet weather. That is why homoeopathy is called a symptom-based system of medicine. Selecting the right homoeopathic medicine also requires complete analysis of our body on various levels — mental, physical and the symptoms of rheumatoid arthritis. Thus, one should completely avoid self-medication.
The writer is a Chandigarh-based homoeopath.
way to live healthy life
There are a number of herbal and natural supplements that offer new hope for cardiovascular conditions. Clinical trials on these substances and studies comparing their effectiveness to pharmaceutical drugs have been conducted, and these provide supporting evidence for their use. Here are some:
Hawthorn (crataegus oxyacantha): Clinical research on standardised hawthorn extracts (1800 mg daily) has shown positive results in cardiac failure patients, including improvements in exercise capacity and clinical symptoms, with fewer adverse events such as dizziness and vertigo.
Garlic (alliums sativum): Garlic has numerous important effects on the cardiovascular system, including anti-oxidant, anti-platelet (blood thinning) and anti-thrombotic (prevents blood clots) activities, inhibition of cholesterol synthesis and an ability to reduce the atherosclerotic process (hardening of the arteries). A number of trials have also shown that garlic can produce significant reduction in blood pressure. The doses varied between 600 mg and 900 mg daily in divided doses (delivering around 5000-6000 mcg of the active ingredient, allicin). Garlic’s cholesterol lowering ability appears to be modest, according to clinical research. Garlic can also be added to the diet as a supplement on a daily basis.
Ginger (zingiber officinal): Ginger has anti-atherosclerotic and anti-platelet activity. Very high doses of at least 10 g are required; whereas lower doses of 2 g have no effect on bleeding time or platelet function. In addition to ginger supplements, drinking ginger tea and using the herb in cooking can contribute to your ginger intake.
Turmeric (curcuma longa): Preliminary research shows that turmeric extract or an extract of its main active ingredient, curcumin, lowers blood fats. One study found that a dose of 500 mg daily of turmeric for seven days resulted in a significant decrease in the level of blood lipid peroxides, an increase in HDL (so-called “good” cholesterol) and a decrease in total cholesterol.
Milk thistle (silybum marianum): Cholesterol lowering activity has also been reported for the herb milk thistle. Doses of 420 mg daily of the active ingredient silymarin appear to reduce total cholesterol and LDL cholesterol levels.
Fish oils: Fish oil has long been recognised for its role in reducing the risk of heart disease. In one study, 11,324 patients who had recently survived a heart attack were treated with either a placebo or a fish-oil supplements (about 1 g daily of EPA and DHA) were found to reduce the death rate by 20 per cent cardio-vascular deaths by 30 per cent and sudden deaths by 45 per cent.
Vitamin E: Vitamin E supplementation (400 IU and 800 IU daily) reduces the risk of cardiovascular death, and non-fatal heart attack by over 75 per cent.The writer is a retired Lieut-Colonel of the Indian Medical Corps.
Bond with parents helps teens cope with stress
New York: Teens who have a secure relationship with their parents show faster development of coping skills than their peers with insecure parental ties, a new study shows.
presents the first evidence that secure individuals seek support and
reflect upon possible solutions more frequently and become
increasingly competent in dealing with a variety of stressors from
early adolescence to young adulthood,”
Less securely attached teens, they found, were more likely to withdraw from their problems and less likely to seek support from others, increasing their risk of depression and other mental and physical health problems.
The researchers looked at three basic coping styles: active coping, in which a person seeks support from others and takes action to solve the problem; internal coping, in which a person thinks about possible solutions; and withdrawal, in which a person basically avoids the problem.A balance between active and internal approaches is considered healthy while heavy reliance on withdrawal is not. — Reuters
Meats differ in effect on colon cancer risk
NEW YORK: People who eat a lot of processed meats may have a higher risk of developing pre-cancerous growths — polyps — in the colon, while the opposite may be true for fans of chicken, a new study suggests.
Researchers found that among 1,520 adults with a history of colon polyps, those who ate a diet heavy in processed meats had a higher risk of polyp recurrence than those with the lowest intake. On the other hand, patients who favoured chicken had a lesser risk of new polyps than those who ate the least.
Colon polyps are growths that, while usually benign, can become cancerous. Patients in the current study had all had polyps removed and were then followed for four years to detect any recurrences.
Overall, the one-quarter of patients with the highest intake of processed meat were 75 per cent more likely to develop an advanced polyp compared with the one-quarter of patients who ate the least processed meat, the researchers found.
In contrast, those with the highest chicken intake were 39 per cent less likely than those who ate the least to develop an advanced polyp.
“Our data indicate that intake of specific meats may have different effects on risk,” the study authors state in the American Journal of Gastroenterology.A number of studies have linked heavy consumption of red or processed meats to a higher risk of colon cancer, while diets high in fibre from fruits, vegetables and whole grains have been tied to a lower risk of the disease. — Reuters
Blood-thinner dose errors can cause bleeding
CHICAGO: Some heart patients are given too large a dose of blood thinner at the hospital, which can lead to excessive bleeding, researchers said.
The dosing errors found in 42 per cent of more than 30,000 cases stemmed from factors including physicians using a “one size fits all” dosing criteria, underestimation of the importance of using the right dosage or a lack of information about a patient’s weight or other indicators.The dosing errors with three classes of blood thinners — unfractionated heparin, low-molecular-weight heparin and glycoprotein IIb/IIIa inhibitors — most often affected patients more vulnerable to bleeding such as the elderly, women, low-weight patients, diabetics, or patients with diminished renal function, the study said. — Reuters