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Don’t let back pain cripple you Back pain? There
is a lot you can do to help yourself. Scientific evidence shows
the best treatment is to stay active, try simple pain relief and
if you need it, get advice. Evidence also shows: * The shorter
you are off work, the less risk there is of developing chronic pain * You do not
have to be completely pain free to return to work * Employees,
employers and health professionals working together can support
you at work. If you have
severe pain, which gets worse over several weeks instead of better
you should see your doctor. You should
see a doctor straightway if you have: * Difficulty
in passing or controlling urine * Numbness
around your back passage or genitals * Numbness,
pins and needles or weakness in both legs * Unsteadiness
when on your feet Back facts * Back pain
affects nearly everyone at some point in his or her life but is
rarely serious. * Back pain
or ache is usually not due to any serious disease. * Often back pain settles quickly, at least enough to get on with your normal routine. * About half
the people who develop backache will have it again within a couple
of years. This does not mean that it is serious. Between attacks
most people return to normal activities with few if any symptoms. * It can be
very painful and you may need to reduce some activities for a time,
but rest for more than a day or two usually does not help and may
do more harm than good. So keep moving. * Your back
is designed for movement. The sooner you get back to normal activity
the sooner your back will feel better. * The people
who cope best are those who stay active and get on with their life
despite the pain. Causes of
back pain Your spine
is one of the strongest parts of your body. It is made of solid
bony blocks joined by discs to give it strength and flexibility.
It is reinforced by strong ligaments. It is surrounded by large
and powerful muscles, which protect it. It is surprisingly difficult
to damage your spine. Most x-ray
findings in your back are normal changes with age - as normal as
gray hair. In most people
it is not possible to pinpoint the exact source of the trouble.
It can be frustrating not to know exactly what is wrong. But it
is also good news - you do not have any serious disease or any serious
damage in your back. Most back pain
comes from the muscles, ligaments and joints in your back. They
may be simply not moving and working as they should. You can think
of your back as "out of condition". So what you
need to do is get your back working properly again. Stress can
increase the amount of pain you feel. Tension can cause muscle spasm
and the muscles themselves can become painful. People who
are physically fit generally get less back pain, and recover faster
if they do get it. So the cure
for backache is to get your back moving and working properly again.
It's your back
- get going! Treatment The old fashioned
treatment for back pain was prolonged rest. But bed rest for more
than a day or two is not good because: * Bones get
weaker * Muscles get
weaker * You get stiff * You lose
physical fitness * Depression
sets in * The pain
feels worse * It is harder
and harder to get going again No wonder it
didn't work! No longer is bed rest used to treat any other common
condition. It is time to stop bed rest for backache. The message
is clear: bed rest is bad for backs. Of course,
you might need to do a bit less when the pain is bad. You might be
forced to have a day or two in bed at the start. But the most important
thing is to get moving again as soon as you can. Exercise is
good for you Your body must
stay active to stay healthy. It thrives on use. Use it or lose it! Regular exercise: * Gives you
stronger bones * Develops
fit, active muscles * Keeps you
supple * Makes you
fit * Makes you
feel good * Releases
natural chemicals, which reduce pain, so that even when your back
is sore, you can make a start without putting too much stress on
your back. Dealing with
an acute attack What you do
depends on how bad your back feels. Remember, your
back isn't badly damaged. You can usually: * Use something
to control the pain * Modify your
actualities * Stay active
and at work You may have
good days and bad days - that's normal. Control
of pain There are many
treatments which help back pain. They may not remove the pain completely,
but they should control it enough for you to be active. These treatments
help to control the pain, but they do not cure your back pain. Painkillers Your GP will
provide you with adequate analgesics, anti-inflammatory tablets,
and muscle relaxants. Heat or
cold In the first
48 hours you can try a cold pack on your back for 5 -10 minutes
at a time - a bag of frozen peas wrapped in a towel. Other people
prefer heat; a hot water bottle, a bath or a shower. Spinal manipulations Most doctors
now agree that manipulation can help pain and activity levels and
higher patient satisfaction. It is best within the first six weeks.
Osteopaths, chiropractors and some physiotherapists with special
training carry out manipulation. It is safe if a qualified professional
does it. Other treatments Many other
treatments are used, e.g.. Acupuncture which some feel helps. It
is up to you to find out what helps you. Stress and
muscle tension If stress is
a problem, you need to recognize it at an early stage and try to
do something about it. It is not always possible to remove the cause
of stress, but it is quite easy to learn to reduce its effects by
breathing control, muscle relaxation and mental calming techniques. Prevention
and pain alleviationLifting Lift what you
can handle. Always lift and carry close to your body. Bend your
knees and make your legs do the work. Don't twist your back - turn
with your feet. Deep car boots can be dangerous in this respect. Sitting Use an upright
chair. Try a rolled towel or cushion in the small of your back.
Get up and stretch every 20-30 minutes. Standing Try putting
one foot on a low box or stool to vary your weight allocation. Have
your working surface at a comfortable height Activity 20-30 minutes
walking, cycling or swimming every day. Sleeping Some people
prefer a firm mattress - or try boards beneath the mattress. Choose
a position which provides the most comfort, e.g. on your back with
a pillow under your knees or on your side with your knees bent and
a pillow between them. Bed Take care getting
in and out of the bed without twisting your back. When getting in
- sit on the side of the bed, lower the body onto the elbow and
shoulder, draw knees up until the feet are on the bed. Then roll
the body over to face the ceiling and straighten the knees. When
getting out - reverse the procedure. Bend both knees, and then turn
over to the side. Push the trunk up with the top hand lowering the
knees at the same time to the sitting position. Wearing
socks and shoes Use a straight
back chair. Try to bend one knee and place the ankle above the opposite
knee. Put your sock and shoe on. Repeat the procedure on the opposite
foot. To remove them adopt a similar posture. Getting
in and out of a car Getting in
- open the door, first sit and gently lift both feet in with the
help of your hands, placed underneath the knees close the door. Getting out
- open the door, lift both feet out, stand with the help of the
door and walk away closing the door without twisting your back. Driving Adjust your
seat from time to time. Try a rolled towel or cushion in the small
of your back. Take a break on long drives. Relax Learn to relax.
Use relaxation techniques. Remember, you have to run your own life and do the things you want to do. Don't let your back take over - you really can help yourself.
By Katharine
Arney The researchers,
led by Dr Frank Hu, an expert in nutrition, found that watching
television for an extra two hours a day increased the rate of obesity
by 25%, and diabetes by 14%. This was even
after factors such as smoking and diet had been taken into consideration. There was also bad news for office workers. The risks of obesity and diabetes also increased with every additional two hours spent sitting down at work - though these were much smaller than the risks from watching the box for the same length of time. Dr Hu said he was not surprised that watching television seemed to have such a powerful effect. "Compared with other sedentary behaviours, TV watching is associated with a lower resting metabolic rate. "Also, people tend to eat junk foods while watching TV, due to constant exposure to food commercials." Exercise Every additional
two hours per day spent walking or standing at home cuts the risk
of obesity by 9%, and the risk of diabetes by 12%. Brisk walking
for an hour per day was enough to drop the risk of obesity 24%,
and diabetes by 34%. The researchers
have calculated that adopting a relatively active lifestyle can
prevent nearly a third of new cases of obesity and over 40% of new
cases of diabetes. They define this healthy lifestyle as no more
than 10 hours television per week, and at least 30 minutes of brisk
walking per day. Dr Hu said:
"We should not only promote increasing physical activity levels
but also target a decrease in sedentary behaviours, especially prolonged
TV watching. "Personally, I have a treadmill in front of a
TV so that I can do some exercise while watching the news." The research is published in the Journal of the American Medical Association. Vertigo is described
as the illusion of movement. It's the feeling that our surroundings
are spinning around us whilst we remain still, or that we are spinning
within our surroundings, rather like the gyroscope ride at the fun
fair. The spinning is usually felt as rotation, moving round and
round. It's different
to dizziness, which is usually a feeling of unpleasant fuzziness
in the head. Vertigo, however, is horrible, and often confines people
to their home, even their bed. Trying to move is difficult because
of the loss of balance that occurs, and the nausea and vomiting
that often accompanies episodes of vertigo. Possible
causes Middle ear
infection Middle ear
inflammation Benign Positional
Vertigo Meniere's disease Circulation
problems Head injury After ear surgery Side effects
of medication Recreational
drugs Alcohol Neurological
disease What's behind
vertigo? Vertigo occurs
most often when there is a problem with the middle ear balance mechanisms.
It can also be caused by a problem in the brain itself, or with
the nerve connections between the brain and the middle ear. Infections,
circulatory problems, migraine, injury, or inflammation, can all
be responsible. In particular, the side effects of some medicines,
recreational drugs, and of course alcohol may also be the guilty
party. One of the
most common causes of vertigo is motion sickness, which many of
us have experienced and know just how unpleasant it can be. Benign positional
Although it
tends to last less than a minute it can be very unpleasant and disabling.
As with other causes of vertigo this type usually follows a viral
infection or is a result of inflammation or damage to the middle
ear. Fortunately it tends to settle after a few months without treatment.
Specialist physiotherapy can be of benefit for some sufferers if
the symptoms persist. Meniere's
disease The bouts of
vertigo can last anywhere from only a few minutes to as long as
twelve hours usually leaving an affected person vomiting and prostrate.
As if this isn't enough for someone to cope with, Meniere's disease
brings with it other problems. Tinnitus (ringing in the ears), and
difficulty with hearing complete the triad of symptoms that are
diagnostic of this unpleasant condition. When the attacks
are sporadic then treatment to calm symptoms down are used when
they're needed. If, however, attacks are occurring regularly and
preventing someone from living an enjoyable life then medication
is taken daily to prevent the attacks. On occasion, surgery to remove
the additional fluid in the middle ear may be performed. Establishing
the diagnosis SARS: Warnings of mutant strains The virus thought to cause SARS (Severe Acute Respiratory Syndrome) is constantly changing form, say scientists - which will make developing a vaccine difficult. The Beijing
Genomics Institute reported last week that the virus is "expected
to mutate very fast and very easily". Other experts
have warned that, once established, it could be particularly hard
to stop the SARS virus causing problems. SARS appears to be caused
by a new strain of the corona virus, which may have "jumped"
from animals to humans in the southern Chinese province of Guangdong. So far the
strain has killed more than 200 people, mainly in China, Hong Kong,
Canada and Singapore. The number of new cases in China continues
to rise, with the authorities admitting over the weekend that the
virus is more widespread than previously acknowledged. Teams of inspectors
are now being sent into remote regions to aid prevention efforts.
Chinese authorities are installing thermal imaging equipment to
check the temperatures of travellers moving across the southern
border between Shenzhen and Hong Kong. There have
now been almost 4,000 probable cases of SARS worldwide, according
to the World Health Organization (WHO). Scientific teams are racing
to produce a vaccine against the new strain, but have warned that
this may take years. Experts say that a vaccine may only offer limited
- and temporary protection. Other strains of the corona virus can
cause "common cold"-like infections in humans. They are also
a significant cause of illness in various types of animals, particularly
poultry. Dangerous
changes Natural selection
means that "mistakes" that end up benefiting the virus
will lead to the creation of strains that are more virulent, or
more easily transmitted from human to human. Dr. Adrian Mockett,
who has helped develop the corona virus vaccines for use in veterinary
medicine, said the virus had particular characteristics that could
prove a problem in humans. "The ability of the virus to mutate
has been a real problem in poultry vaccines. "The virus has
the ability to change quite quickly - a vaccine might be suitable
for a while, but not forever." He said that
because it was likely the new strain of the corona virus had only
just "jumped" to humans, newer versions better suited
to living in humans were possible. He said that other corona viruses
in animals had mutated so that the infection could be spread not
only through coughs and sneezes, but also through faeces - raising
the possibility that a future outbreak could be transmitted through
tainted water supplies or contaminated food. Scientists
believe that the current strain is transmitted through droplets
coughed out of the lungs, but are still not certain about other
possible routes of transmission. Even if a vaccine works at first,
said Dr Mockett, he said that the "duration of immunity"
had yet to be determined. He added: "You only get one chance
to eradicate something like this - once it's established, you've
got a real problem." The characteristics
of the corona virus and the way it infected humans meant that future
vaccines were likely to work in the same way as flu vaccines - with
different components needed to tackle a variety of common strains. However, he
said that if different strains evolved in North America and the
Far East, a jab that worked in one place would offer no protection
in the other. WHO defence
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