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By admin, August 29, 2007 6:20 pm

August 23, 2007 — Daily back pain is associated with decreased quality of life, mobility, longevity, and increased risk for coronary heart disease (CHD) in elderly women, according to the results of a study reported in Spine.

“The consequences of back pain in elderly people have not been well studied, perhaps because its high frequency has resulted in the symptom being regarded as ‘normal’,” write Kun Zhu, PhD, from the Sir Charles Gairdner Hospital in Nedlands, WA, Australia, and colleagues. “Because there has been no study that investigated the association between the frequency of back pain, a good index of the severity of back pain, and the risk of incident heart disease and mortality, the aim of this study was to assess the prevalence of self reported back pain frequency at baseline and 5 years later in a community based cohort of 1484 elderly Australian women and evaluate its long-term impact on the health of the individuals with this complaint.”

The investigators analyzed data from 1484 community-dwelling Australian women 70 to 85 years old who were enrolled in a 5-year randomized controlled trial of calcium intervention with observational cohort design.

“Daily back pain is associated with reduced quality of life, mobility and longevity and increased risk of coronary heart events,” the investigators write. “The adverse health effects of chronic back pain deserve greater recognition.”

“Management of back pain and health conditions related to back pain is likely to be important in the maintenance of functional independence and well-being of elderly women,” the study authors conclude.

The Healthway Health Promotion Foundation of Western Australia, the Australasian Menopause Society, and the National Health and Medical Research Council of Australia supported this study.

Spine. 2007;32:2012-2018.

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By admin, August 17, 2007 9:41 am

In this day and age many people use their laptop as their primary computer, so it’s important to have it setup correctly in order to avoid back pain, neck pain, and other musculoskeletal injuries or strains. The problem is that laptop computers are designed with portability in mind rather than sound ergonomic principles. Basically, if the screen is at the right height then keyboard is too high, and if the keyboard is in the right position, then the screen is too close and too low.And laptop touchpads and trackballs are never very user friendly. Given these challenges, here are 10 simple tips for the best laptop setups:

1. Use a large screen. Get a laptop with the largest screen possible for your needs to avoid the stressful posture that results from straining to see the text on a small screen. Many laptops offer large screens (15″ plus), but these can be difficult to use while on the go. There are a number of smaller notebook and ultra-portable laptops on the market, and while a smaller screen (12.1″) can be useful in mobile settings, make sure that you’re able to read the screen characters and easily use the keyboard (the smaller the laptop, the smaller the keyboard). If you find yourself straining to see your screen, increase the font size.

2. Place the screen at eye level. Ideally, set your laptop height and screen angle so you can easily view the screen without bending or rotating your neck, and put it about an arm’s length in front of you. To do this, you will usually need to elevate the laptop a few inches above your desk, which you can do by placing it on a stable support surface such as a laptop stand or on a thick book.

3. Don’t slouch. Despite the name “laptop”, you want to avoid propping your laptop on top of your lap as this requires you to slouch down to see the screen.If you have to work on your lap, such as while you’re on the train, at least put the laptop on top of your computer bag or briefcase so you can raise it up slightly.

4. Use a separate keyboard. When using the laptop for extended periods, use an external, full-sized keyboard with your laptop and position it at a height that allows your shoulders and arms to be in a relaxed position, with your elbows at a 90° angle when typing. Ideally, place the separate keyboard on a keyboard tray beneath your desk surface to help ensure that your wrists stay in a neutral (flat) position.

5. Use a separate mouse. Be kind to your wrists by using an independent mouse rather than the mouse that’s incorporated into your laptop keyboard. Ideally, place the mouse on an adjustable-position mouse platform so you can keep it near your body and keep your wrist flat while using it.

6. Recline slightly. If you can’t use a separate keyboard and mouse, an alternative is to find a chair that allows you to recline slightly. This will allow you to position the laptop keyboard and mouse with the least strain on your neck. Angle the screen slightly upward so that you can view the screen without having to bend your neck too far down.

7. Prop up your feet. If you have to raise your chair so that your arms and wrists are positioned comfortably, check to see how your legs are angled. Your knees should be at about the level of your hips. If your hips are too high, you need to put a footrest or small box under your feet to prop them up and keep excess strain off your lower back.

8. Make your chair work for you. The type of office chair you use is critical.Basically, any office chair that is fully adjustable and has lumbar support will work, but you need to be sure to set it up correctly.Follow this diagram on how to set up your office chair.

9. Take a break. Take brief breaks every half hour, at the very least taking your eyes off the screen and letting them rest on something in the distance, and doing some simple stretches while at your desk, such as stretching your neck, shoulders, arms and legs. Every one or two hours, leave your desk to walk around to get your blood flowing and move your muscles. Downloadable Stretch Break™ software reminds you to stretch and gives you stretching ideas.

10. Travel light. Be careful when carrying your laptop around. The power supply cord, spare battery and other accessories in your laptop bag may add a lot of weight. If you carry your laptop to work and home again, get duplicate power cords and other peripheral components to leave in each place so that you don’t have to carry everything back and forth. Carry your bag across your lower back in a messenger bag style, or use a backpack with dual padded shoulder straps (and avoid draping the bag over just one shoulder). If your laptop and components weigh more than 10 lbs, a roll-along carrier is the best choice.

I realize that not all of the above tips will always be practical, but if you use your laptop daily, paying attention to how you set it up will go a long way to easing back pain and strain on your joints and muscles.

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By admin, August 10, 2007 8:42 am

Many who live with chronic back pain would really love to be less dependent on painkillers to manage their pain. But how? Natural pain relievers may be the answer. Here’s a list that might help – each of these won’t be for everyone, but any number of these natural pain relievers might help you be able to rely less on pain medications and feel more in control of your life.
Release your inner endorphins. These natural chemicals block pain signals from reaching your brain. Endorphins are the body’s natural pain relievers, and they can be as strong as many of the strongest pain relievers. Endorphins also help alleviate anxiety, stress and depression — conditions that often accompany and exacerbate chronic pain. The body produces endorphins during aerobic exercise. A “runner’s high” is not just for those running long distances — any activity that gets your blood pumping for a sustained period will release pain relieving endorphins into your system.
Find good company. Those who have regular contact with others dealing with similar forms of chronic pain find that their pain becomes more manageable. An online group that is both active and supportive is best. Members of the Spine-health.com Back Pain and Chronic Pain discussion forums say that it is quite simply “free therapy”.

Eat cookies. Research shows that eating sweet foods like cookies, chocolate or ice cream, helps reduce the sensation of pain.

Or just bake the cookies. Enjoying a smell that is both sweet and pleasant has been shown to reduce the perception of pain.

Feel the heat. Applying some form of heat — a hot water bottle, gel-filled pad heated in the microwave, electric heating pad, or hot bath — can go a long way in easing your pain. Benefits of heat are twofold: it increases the flow of healing oxygen and nutrients to the damaged area, and it suppresses pain signals being sent to your brain. Some find that wearing a heat wrap, such as Thermacare heat wrap, is best because it releases a low level heat for several hours and can be worn under clothes so you remain mobile.

Cool it with ice. Ahh, how this cools down inflamed and sore tissues. Back pain almost always comes with some level of inflammation, and ice is the best natural way to reduce it. Ice also helps by acting as a local anesthetic, and by slowing the nerve impulses, which in turn interrupts the pain-spasm reactions between the nerves in the affected area.

Loosen up. Almost everyone can benefit from stretching the soft tissues – the muscles, ligaments and tendons – in and around the spine. Your back is designed for movement, and if your motion is limited it can make your back pain worse. If you suffer from chronic back pain, you may find it takes weeks or months of stretching to loosen up your spine and soft tissues, but you will find that meaningful and sustained pain relief will follow the increase in motion.

Enjoy the outdoors. People who got the recommended daily 400 to 800 IU of vitamin D experienced less pain than those who didn’t, according to a Boston University study of 221 men and women with knee osteoarthritis. Researchers surmised that Vitamin D helps relieve pain by aiding in the absorption of calcium, which is needed for bone growth and repair. Other research shows vitamin D may directly help soothe pain. 93% of 150 people with unexplained sources of pain were recently found to be deficient in Vitamin D levels, according to recent research at the University of Minnesota. About 15 minutes of sun exposure on your face and hands a day is enough to get your daily dose of D, or a 200-IU supplement of Vitamin D and as much calcium as is found in two glasses of milk.

Imagine yourself to a better place. Guided imagery allows you to hear and internalize therapeutic suggestions that help you feel better. In one study of 28 women with osteoarthritis pain, half of the women listened to a 10- to 15-minute recorded script twice daily that guided them through muscle relaxation techniques. On average, women in the guided imagery group reported that their pain eased by 18% and that their mobility improved by 13%; vs. those in the control group who experienced a 16% worsening of pain and a 2% decrease in mobility. Guided imagery can be learned with a practitioner or on your own using audiotapes or CDs.

Change your inner thinking. Hypnosis involves influencing the subconscious mind in order to change your inner thinking, thereby enabling you to change the way you view pain and assisting in the your body’s healing process. The human body has an infinite capacity for healing, and this is just one technique that many find helpful.

Meditate twice daily. Easy to learn and immediate results make this one of my favorite paths to natural pain relief. Meditation comes in a huge variety of forms –some complex, some simple. My personal favorite is just to find a sound that is pleasing to you but has no particular meaning (my sound is “som”), close your eyes, sit (or lie) still and comfortably, and repeat the sound in your mind. When your thoughts wander, notice that they have wandered and return to your sound. If you feel your pain, notice the pain and return to your sound. Start with a few minutes, and gradually lengthen to thirty minutes. You will find yourself refreshed and reinvigorated, with less pain overall. Meditation can also help reduce the depression, anxiety, stress and sleeping problems that often accompany chronic pain.

Realign your energy flow. The mechanism of action for the ancient Chinese healing technique of acupucture is still not completely understood, but it has been proven in medical trials to reduce certain types of chronic pain, including back pain. The American Association of Oriental Medicine has a list of trained acupuncturists. P.S. the needles are super-thin and not painful.

Get enough restorative sleep. Getting enough sleep is critical to managing the pain and healing, so it’s important to employ a variety of sleep aids to help you get a healthy amount of sleep. Regular exercise that physically exhausts the body is the best way to promote deep sleep. Visualization, meditation, and other psychological techniques can also help you get to sleep and stay asleep. And don’t forget the power of naps.

Enjoy a massage. In my book, nothing beats a good therapeutic massage. It gets the blood flowing, which helps nourish and heal the body, and releases endorphins, which release powerful pain relieving substances in the body (see first point on the list).

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By admin, August 9, 2007 3:47 pm

Chiropractors have always sought to provide the safest and most effective healing methods for their patients. In order to achieve this, the chiropractic profession has been dedicated to conducting scientific studies to improve their diagnostic methods and treatment techniques. In the last 20 years chiropractic health care has established an impressive array of scientific research that demonstrates the efficacy, safety and cost effectiveness of chiropractic care. There are many further studies currently underway, and several have been performed by medical doctors and government researchers in both the U.S. and a number of other countries.

In fact, the chiropractic profession has accumulated a greater number of scientific trials on chiropractic than the medical profession has accumulated for many of the treatments rendered by medical doctors. According to David M. Edy, M.D., Ph.D., professor of health policy and management with Duke University, North Carolina, only 15 percent of all medical interventions are supported by solid scientific evidence. Paul G. Shekelle, M.D., M.P.H., of the RAND Corporation made the following statement on ABC’s 20/20:

“There are considerably more randomized controlled trials which show benefit of this (chiropractic care) than there are for many, many other things which physicians and neurosurgeons do all the time.”

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By admin, August 8, 2007 2:07 pm

http://www.memag.com/memag/article/articleDetail.jsp?id=144764&sk=&date=&&pageID=1

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By admin, August 8, 2007 2:01 pm

1: Clin Orthop Relat Res. 2005 Aug;(437):251-9. Links
More evidence of educational inadequacies in musculoskeletal medicine.

Schmale GA.
Children’s Hospital and Regional Medical Center, University of Washington, Seattle, 98105, USA. gschmale@u.washington.edu
In their study, Freedman and Bernstein suggested that 80% of a group of graduates from many of the best medical schools in the United States were deficient in their knowledge of basic facts and concepts in musculoskeletal medicine. How do these results compare with results from students attending a medical school with a long-standing dedicated program to musculoskeletal education? Does additional clinical experience in musculoskeletal medicine improve understanding of the basic facts and concepts introduced in a second-year course? A modified version of an exam used to assess the competency of incoming interns at the University of Pennsylvania was used to assess the competency of medical students during various stages of their training at the University of Washington. Despite generally improved levels of competency with each year at medical school, less than 50% of fourth-year students showed competency. Students who completed a musculoskeletal clinical elective scored higher and were more competent (78%) than students who did not take an elective. These results suggested that the curricular approach toward teaching musculoskeletal medicine at this medical school was insufficient and that competency increased when learning was reinforced during the clinical years.

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