Tuesday 30 June 2009

Back Pain can be a real pain

Hello and welcome.

We are experiancing hot weather in the UK right now. I get home, get changed, cook a meal just in time to watch the sun go down.

Acouple of friends and I went for a walk yesterday in the noon day sun, it was a nice day, the sun was shinning and the company pleasant. I managed to get dehdrated and arrived home, cooked a meal and started to feel unwell. A short time later I began to feel unwell and spent the evening in bed. I I became because I allowed myself to become overheatede and did not take the simple precautions that, in hindsight were obvious and simple.

The same applies to back pain. I have a pain in my shoulder, on the right side, caused by excessive data entry, a repetiitive strain injury, aggrivated by bad postueg and stresss. The event happened months ago, but the pain returns if I sit in a certain position, hold the mouse and look at the screen, I dont have to grip the mouse or type. I have "learned" this pain.

My cure away from home is to mobilise the shoulder and "walk" along the csapula with my fingers, finding the the little lumps of lymph that I can only find if I rub against bone. At home we use Aloe Vera heat rub. It works for everything from sore and tired muscles, to headaches ro blocked sinuses.

There is a lot more information at www.backpainloss.com

Regards

Paul

Sunday 28 June 2009

Back Pain can ruin your day

From the Gaston Gazette

Lower back pain can ruin anyone's day. If I suffered with lower back pain I would see a health care professional to pin point the cause before I embarked on the exercises recommended to strengthen my back.

Our backs are probably the most abused part of our body. We pick up heavy things incorrectly or things only a crane should lift.

We pick up children from a bent over position and plunk them on our hip, stretching the spine completely out of alignment in an unnatural position, walking around half the day is this position.

Another cause of back pain is that we carry too much extra weight in the front of our bodies and we compensate by walking with our back arched, allowing the abdominal muscles to get a free ride out of their normal workload.

And mattresses can cause backaches. Too soft, too hard or too old and we start each day with a hurting back. Not a good thing for a positive attitude to start your day.

There is a catch 22 about this - you are darned if you do and darned if you don't.

When we start the day with a backache the last thing we want to think about is exercise - that is the catch. But after defining the issues that caused the back pain, exercise is the option that most health care providers recommend.

The American College of Sports Medicine found that exercising four days a week gave people greater relief from back pain than working out fewer times a week or not at all. In the study, 120 people were randomly assigned to one of four groups for 12 weeks, with the groups doing strength training two, three, four days per week. The fourth group did no exercise. Those in the four-day-a-week program had 28 percent reduction in pain compared with 14 percent for those who exercised two days a week. The four-day group reported better quality of life and less disability.

That is good news.

If you have had an injury or other condition that has affected your back and you suffer lower back pain, your orthopaedic surgeon and physical therapist may recommend that you exercise during your early recovery.

A dear friend has been depressed with back pain, until she learned from her doctor that no surgery was needed, and back specific exercise therapy was prescribed. We rejoiced together. It was good to hear her laugh again, and this column is dedicated to her. You go girl!

An interesting article. More on back pain at thr usual www.backpainloss.com

Saturday 27 June 2009

Yoga as a medicene

From the National Examiner this time, Yoga is a great aid to dealing with back pain


Yoga increasingly viewed as a progressive medical treatment

Yoga as medicine is an ancient concept given modern day credence by "credible, clinical trials that increasingly support what people have known forever," said Little Rock's John Kepner, executive director of the International Association of Yoga Therapists, "that yoga can provide real medical benefits such as relief for chronic lower back pain, depression, anxiety, heart disease and a host of other issues."

People have long accepted that yoga can soothe the stresses of daily demands. Little Rock internet entrepreneur, Aristotle CEO, Marla Johnson Norris, relies on yoga to stay focused and connected to the better part of herself, "It's hard to explain how important yoga is to me," said Norris, "the combination of movement and breath and mental focus is such a powerfully healing force."

Recent clinical trials suggest yoga offers benefits for a host of issues from asthma to aging, hypertension to happier pregnancies.

Heart disease reversed through yogic principles

What we are finding is that "a lifestyle that involves yogic principles can actually reverse heart disease," said Kepner, "moderate exercise and stress reduction, which yoga offers, along with a low fat diet, for many people is better than having their chest cracked open in surgery." A string of published studies found on the National Institutes of Health and PubMed websites point to the whole body benefits of yoga including:

- Reduction of hypertension (blood pressure) through slow, deliberate yogic breathing (Journal of Alternative and Complementary Medicine, June17, 2009)

- Greater insulin sensitivity and reduced autonomic response in young males practicing yoga over a year; in short, that’s good news for the heart muscle

- Improved breathing with short-term yoga training for patients with chronic obstructive pulmonary disease (COPD), a precursor to cardiac failure

Chronic lower back pain relief through yoga

The bane of so many people's existence is back pain. According to Kepner, "A clinical trial about four years ago showed that a carefully crafted sequence of yoga exercises for back care provided better back related function and less pain than conventional treatments, with conventional being either education about back care or a conventional exercise class for back care."

Depression and anxiety reduced or alleviated through yoga

This summer, the Harvard Mental Health Letter published an article showing yoga for anxiety and depression modulates the stress response. See https://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/April/Yoga-for-anxiety-and-depression for more details.

Yoga: the original behavior medicine

When asked about anxiety and depression, Kepner compared yoga to the field of behavior medicine, also known as health psychology. "We have whole buildings dedicated to behavioral medicine," said Kepner, "yoga is the 'original' behavioral medicine. It's all about reducing suffering.

Of course, that's not unique to Yoga. Many traditions have the idea of saying 'let's just slow down, take a deep breath, think about what you are and want you want to do, and then act accordingly,' but it's just that yoga has lots of techniques for doing that, physical techniques, breathing techniques. If you say take a deep breath in yoga, well there are a lot breathing techniques, but what yoga does is put a whole lot of things together into a system that works.”

Yoga offers hope for a better night's sleep

Yet another study found significant mental and physical differences, including better sleep quality and a reduction in cortisol (stress hormone) levels in long-term yoga subjects.

Seniors discovering yoga to improve quality of life

Seniors given six months of gentle 'silver age' yoga exercises experienced better sleep quality, alertness and blood pressure with decreased depression. The overall health status of the older adults improved with ongoing participation. Perhaps, it's not surprising that studies hoping to aid Alzheimer's patients with yoga are happening even as this article is being written.

Is yoga a miracle?

It can feel like a miracle, "if a practical one," said Kepner, "for the person who is trying to cope with dying from cancer and needs to find a physical or spiritual outlet to cope with treatment; or for the woman who six years ago couldn't get up off the floor without a chair or stair to climb up on; who now rises up from the floor from a seated position without touching anything at all; to that person, now in her 70's, it is a kind of miracle."

Kepner cautioned, “Let’s be careful and not oversell the benefits of yoga. Much more research still needs to be done in accordance with modern research methods in order to better document health benefits. Also, there is a shortage of well-trained Yoga therapists. Yoga teachers need to be specially trained to work with students toward therapeutic goals.”

Yoga for a clear, focused mind and greater understanding of self

"Classical yoga, to paraphrase," said Kepner, "is about cultivating a clear, focused mind to help you understand yourself better. From that base you can act wiser and prevent or minimize future suffering. In addition, yoga provides breathing, stretching and strengthening exercises that could extend life but more certainly will improve the overall quality of life. Yoga allows you to begin getting better however and wherever you are at the moment you choose to begin."

"If I am tired, yoga can energize me,” said Norris, “If I am anxious, yoga can calm me. If I am sick, yoga can activate all my self-healing power and make me well. It keeps me young, relieving stress and connecting me to all that is good in the world."



J Altern Complement Med. 2009 Jun 17. [Epub ahead of print]

I do mention Yoga at www.backpainloss.com I am trying to get into Ashtanga Yoga, hard work, but fun.

Yours

Paul

Tips to relieve back pain

From the Irish Independent this time, tips to relieve back pain

Tips to relieve Back Pain?
It could be a condition called Fibromyalgia. Read on to find out..

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speak with top back pain therapist on this informative forum for free.

www.backpain.com.au/forum/index.php
By Eilish O'Regan


Monday June 22 2009

BACK pain leaves people in misery, so here are some tips on how to reduce risks and improve your quality of life.


Exercise your back regularly. Walking, swimming (especially back stroke) and using exercise bikes are all great ways to strengthen your back muscles.
Bend at your knees and your hips, not your back.
Never twist and bend at the same time.
Always lift and carry objects close to your body.
Try to carry loads in a rucksack and avoid sling bags.
Maintain good posture. Avoid slumping in your chair.
Use a chair with a backrest. Sit with your feet flat on the floor or on a footrest. Change how you sit every few minutes.
Quit smoking. It is thought that smoking reduces the blood supply to the discs between the vertebrae and this may lead to degeneration of these discs.
Lose any excess weight. Ask your doctor or pharmacist to measure your body-mass index to find out if you are a healthy weight for your height.
Choose a mattress suited to your height, weight, age and sleeping position.

- Eilish O'Regan

Dont forget, for more on back pain go and look at www.backpainloss.com

Best

Paul

How to beat Back Pain

How to beat Back Pain from the Independent. I love it when British newspapers talk about back pain, and how to treat it, non surgically for a change. Please dive in and read.
How to beat back pain

Don't go rushing to your doctor, don't take to your bed for days – and do get to know your sacro-iliac joints. Dr David Delvin exposes the myths about lumbar pain and explains what really works
Beating back pain: You should take care of your sacro-iliacs


Every day of the year, the number of Britons who are off work with back pain would fill London's new Olympic stadium. Yes, Britain's got backache – and in a very big way. Yet rather surprisingly, a lot of people have no idea about what causes back pain, or of how to avoid it, or how to treat it. Many of them think, "Oh, it won't happen to me". But it probably will. So here are 10 things not a lot of people know about back pain. Reading it might just save you from a lot of discomfort in the future.



Back pain is often preventable

Back pain doesn't just happen out of the blue. Very frequently, it's caused by doing something that is distinctly unwise. Common examples include: leaning forward to pick something up, without bending your knees – this puts a big strain on your lumbar region; lifting something that's far too heavy for you; carrying something weighty, but holding it away from your body – a load that is held tight against the body will put much less stress on the back; twisting round suddenly – for instance, to get something off the back seat of the car; continuing with what you were doing when the back pain started – if you suddenly feel pain while gardening, golfing, working out in the gym, carrying a toddler or sitting in an uncomfortable chair, then stop. Alas, the British have an endearing tendency to carry on, in the hope that it will all be OK. It probably won't.


You should take care of your sacro-iliacs

Most British people have never heard of the sacro-iliac joints. This is in sharp contrast to Americans, who are forever staggering into their doctors' offices muttering, "I guess it's my S-I joints again, Doc." The sacro-iliacs are a fairly common source of low back pain. There are two of them, and they are located just under the pair of dimples many people have at the top of their buttocks.

They are easily thrown out of kilter by sudden or awkward bending forward. Thus, the last time I had trouble with mine was on the day I tried to trim the lawn using a cheap, nasty, unwieldy strimmer that was much too short for my height.

Bending forward to vacuum the floor is another common cause of S-I joint pain. Typically, this is a dull ache that gets worse whenever you try to stand up from a chair. Happily, it gets better with rest. Manipulation often helps.


In most cases, your doctor can't diagnose exactly what's wrong with your back

At least 80 per cent of the time, it's impossible to make a really precise diagnosis of the cause of back pain. This is mainly because the back is such a complex structure, with so many different joints, muscles and ligaments in it. However, all experts agree that most attacks of backache are due to minor "mechanical" causes, which will generally get better within 10 days or so.

Just a minority of cases are due to a protruding disc (a "slipped disc"). Only a tiny percentage are due to very serious causes, like cancer.


When you get a sudden back ache, there's not much point in rushing straight off to your doctor

Since most backaches get better quite rapidly, why bother to join the hurly-burly of patients who are trying to get an appointment with their GP? Even if you do manage to see your doctor, what is she going to do for you? Most probably, she won't be able to make an exact diagnosis. And it's very unlikely that she will know how to manipulate your back. Yes, she can prescribe you some pills – but you might just as well take the kind that you can buy over the counter from a chemist.


Pills cannot cure back pain

A lot of people have a rather touching faith in the idea that tablets can, by some mysterious process, make back disorders better. But how could they? Years ago there was a wildly successful tablet called "Lobak". Because of its cleverly chosen name, thousands of people – including some doctors – believed that it was a specific treatment for low back pain. In fact, it was just a simple analgesic.

There is certainly a place for analgesics when you have a bad backache, because it's a relief to have the pain eased. However, NICE (the Government's official therapeutics advisory body) has just issued guidelines that say that the initial treatment should be regularly taken paracetamol.


If you get back pain, there's a lot you can do to help yourself

When back pain strikes, that's a sign for you to take action. Stop whatever you're doing and get yourself into a comfortable position. Keep warm. Try putting a wrapped-up hot water bottle on the area. If that doesn't work, try a "cold pack" from the pharmacy. An alternative is to wrap a packet of frozen peas (or whatever) in a towel and apply it to your skin.

Take those paracetamol. If they haven't worked after 24 hours, then consider moving on to a mild anti-inflammatory analgesic, like ibuprofen. But read the contra-indications on the leaflet first. And don't take anti-inflammatories if you have a history of ulcers. At all costs, do not become immobile. That's likely to make your back worse.


If things haven't improved after a few days, consider manipulation

In the UK, the experts in dealing with back pain are the osteopaths and chiropractors – not the doctors. After all, they deal with little else but backache, all day long. They are skilled at spinal manipulation or, as chiropractors prefer to call it, "adjustment". They certainly aren't miracle-workers, as some people imagine. But they usually do help.After long experience of being treated by both osteopaths and chiropractors, I'd say that I have rarely come out of a manipulator's consulting room without feeling quite a lot better.

Most importantly, make sure you choose a qualified practitioner. Trained osteopaths have the letters "DO" after their names. Trained chiropractors have the letters "DC".


If you have a local 'Dial-a-Physio' service, use it

The other group of people who know a lot about backache are the physiotherapists (or "physical therapists"). Until recently, getting to see an NHS physio about back pain took forever. But a far better scheme has been introduced in Scotland, and is slowly spreading into the rest of the UK. It works like this: most general practices have a physical therapist linked to them. If you get a bad back, you can ring the physio and ask her advice. She is trained to ask you certain "Red Flag" questions, in order to make sure that your backache isn't caused by anything really serious, such as malignancy or ankylosing spondylitis.

If she thinks that physical therapy will help you, she will give you an appointment to visit her department as soon as possible.

Exercise is good for your back

In the last 15 years, all authorities, including physiotherapists, osteopaths, chiropractors and doctors, have come to the conclusion that the worst possible thing for a bad back is to lie around or sit around, doing nothing. This is in sharp contrast to the medical attitudes which prevailed in much of the 20th century, when patients were often urged to lie flat on a board, or on the floor, for week after week.

Research has now shown that people get better more quickly if they take gentle exercise. Your GP can advise you about exactly what form of activity to undertake, but good ones include walking, gentle jogging, supervised gym work-outs and swimming – but avoid the breast-stroke, which puts a strain on the neck.


Acupuncture is well worth trying

For generations, western doctors have resisted the exotic allure of acupuncture. But there is no doubt that it does relieve pain, probably by encouraging the release of endorphins (the body's natural painkillers) into the bloodstream.

Whether it can actually do anything to heal a back problem is quite another matter. But in spring 2009, the NICE committee announced that in cases of "non-specific" low back pain (in other words, the usual common-or-garden backache in which no specific diagnosis can be made), then doctors should "consider offering a course of up to 10 sessions of acupuncture needling over a period of up to 12 weeks".

The reality is that in most parts of the country, you would have to get your acupuncture done privately. But if it relieves your pain, the outlay of cash could certainly be worthwhile.


Dr David Delvin is the author of 'Backache – What You Need To Know' (Sheldon Press, £7.99)

There is more on back pain, nutriton, complementary health, loads of stuff at www.backpainloss.com take a look, I think its great.

Stay well

Paul

Wednesday 24 June 2009

Something completly differant.

Hello everyone.
A bit of a change today. I have received some feedback, yes someone writes to me, and more variety was asked for.

So as the theme of this blog is back pain, and the intent is to help, today I will do something unusual.

So whats your most embarrassing back pain situation, and why. I, having asked, have to kick off the discussion.

What is my most embarrassing back pain incident, and why? This is difficult for me, I have injured my back in those long off Martial Arts days, I have caused injury, working on a computer, excess exercise and work, but never in an embarrassing way.

That is, unless you count the time I had an epileptic fit. I came home,Friday afternoon, and the lady who cared for our children gave a cup of tea, I was drowsy and vague. I just let the tea pour into my lap and soak into my clothes. I then fitted, several times. Eventually a doctor was called, I was sent to Hospital. My wife found me sitting in a wheelchair several hours later, and nobody knew why. So i got home, spent a weekend with the family. Monday came and with a strange aroma, off to the doctors, there was mild panic, I had severe burns all around my pelvis and back, the wound had formed a boil, it had burst. The doctor, who had seen me the previous Friday, was shocked to find I had not been told of the injury and returned daily for treatment.
A month followed, 4 weeks, of daily visit to the doctor, followed by a mile long walk home, money was scarce. I arrived at the surgery feeling great, the scabs got picked and cleaned, I felt ill and walked home.
Eventually I got to go back to work, still burnt, and sat on a childs inflatable ring to ease the pain. Great fun for my collegues. I still have the scars, and the memories.
Any comments?
Best

Tuesday 23 June 2009

Amatsu and Back Pain.

Hello everyone.
Its time for another look at therapies and back pain.

Today a little known, yet highly effective therapy I studied and found highly effective, Amatsu.
The origins of Amatsu, if I remember correctly, lie in Nin Jitsu, or the Art of the Ninja. All to few Martial Arts today teach how to heal, alongside how to hurt, the Ninjas art does. Its not very widely known, although thanks to a few hardy souls at the ATA it is growing in England.
The Philosophy behind Amatsu is that your body has the inbuilt ability to heal itself, to regain the healthy natural pattern which is the aim of Amatsu, to re pattern the body, to help the whole body heal. This system does not work on symptoms. Using a number of techniques including massage, mobilisation, re-patterning and cranial balancing, in various combinations, the Amatsu practitioner works to help the clients body find its own natural shape.
This may be a vigorous, or gentle time. You the client, through your body should set your limits. Amatsu is safe and effective whatever the vigour used.
Amatsu works on many levels at once, the physical-bones, muscles, nerves, electrical- nerve impulses and energy systems, chemical- hormones and blood, Mental-thoughts and the envoironment- the place you exist. All this has an influence on you ant the treatment.
Amatsu is particularly effective for back pain as it helps the skull, neck, shuoder and arm, spine, pelvis, the whole body.
Indeed it was whilst studying Amatsu that I realised that everything pyhsical is connected, and that everything in existance is energy. So by working on a finger, i will affect a toe, a disck, anything.
Amn amatsu balance may include a massage or a less tradditional, equally effective treatment, if you can get a tratment, it will be a treat. Two websites to look at:www.amatsu.info and www.amatsu.co.uk

Hope you enjoyed this, I will be back soon with more energy relatede therapies. Untill then if Back Pain is your thing,thats bad, goto www.backpainloss.com
Paul

Saturday 20 June 2009

Is your workout hurting your back?

From the New York Times. Does a workout cause back pain> Interesting article, take a look.


June 17, 2009, 11:00 am
Is Your Ab Workout Hurting Your Back?
By Gretchen Reynolds


The genesis of much of the ab work we do these days probably lies in the work done in an Australian physiotherapy lab during the mid-1990s. Researchers there, hoping to elucidate the underlying cause of back pain, attached electrodes to people’s midsections and directed them to rapidly raise and lower their arms, like the alarmist robot in “Lost in Space.”

In those with healthy backs, the scientists found, a deep abdominal muscle tensed several milliseconds before the arms rose. The brain apparently alerted the muscle, the transversus abdominis, to brace the spine in advance of movement. In those with back pain, however, the transversus abdominis didn’t fire early. The spine wasn’t ready for the flailing. It wobbled and ached. Perhaps, the researchers theorized, increasing abdominal strength could ease back pain. The lab worked with patients in pain to isolate and strengthen that particular deep muscle, in part by sucking in their guts during exercises. The results, though mixed, showed some promise against sore backs.



From that highly technical foray into rehabilitative medicine, a booming industry of fitness classes was born. “The idea leaked” into gyms and Pilates classes that core health was “all about the transversus abdominis,” Thomas Nesser, an associate professor of physical education at Indiana State University who has studied core fitness, told me recently. Personal trainers began directing clients to pull in their belly buttons during crunches on Swiss balls or to press their backs against the floor during sit-ups, deeply hollowing their stomachs, then curl up one spinal segment at a time. “People are now spending hours trying to strengthen” their deep ab muscles, Nesser said.

But there’s growing dissent among sports scientists about whether all of this attention to the deep abdominal muscles actually gives you a more powerful core and a stronger back and whether it’s even safe. A provocative article published in the The British Journal of Sports Medicine last year asserted that some of the key findings from the first Australian study of back pain might be wrong. Moreover, even if they were true for some people in pain, the results might not apply to the generally healthy and fit, whose trunk muscles weren’t misfiring in the first place.

“There’s so much mythology out there about the core,” maintains Stuart McGill, a highly regarded professor of spine biomechanics at the University of Waterloo in Canada and a back-pain clinician who has been crusading against ab exercises that require hollowing your belly. “The idea has reached trainers and through them the public that the core means only the abs. There’s no science behind that idea.” (McGill’s website is backfitpro.com.)

Related
More from Gretchen Reynolds
Faster, Higher, Stronger
Fitness and Nutrition News

The “core” remains a somewhat nebulous concept; but most researchers consider it the corset of muscles and connective tissue that encircle and hold the spine in place. If your core is stable, your spine remains upright while your body swivels around it. But, McGill says, the muscles forming the core must be balanced to allow the spine to bear large loads. If you concentrate on strengthening only one set of muscles within the core, you can destabilize your spine by pulling it out of alignment. Think of the spine as a fishing rod supported by muscular guy wires. If all of the wires are tensed equally, the rod stays straight. “If you pull the wires closer to the spine,” McGill says, as you do when you pull in your stomach while trying to isolate the transversus abdominis, “what happens?” The rod buckles. So, too, he said, can your spine if you overly focus on the deep abdominal muscles. “In research at our lab,” he went on to say, “the amount of load that the spine can bear without injury was greatly reduced when subjects pulled in their belly buttons” during crunches and other exercises.

Instead, he suggests, a core exercise program should emphasize all of the major muscles that girdle the spine, including but not concentrating on the abs. Side plank (lie on your side and raise your upper body) and the “bird dog” (in which, from all fours, you raise an alternate arm and leg) exercise the important muscles embedded along the back and sides of the core. As for the abdominals, no sit-ups, McGill said; they place devastating loads on the disks. An approved crunch begins with you lying down, one knee bent, and hands positioned beneath your lower back for support. “Do not hollow your stomach or press your back against the floor,” McGill says. Gently lift your head and shoulders, hold briefly and relax back down. These three exercises, done regularly, McGill said, can provide well-rounded, thorough core stability. And they avoid the pitfalls of the all-abs core routine. “I see too many people,” McGill told me with a sigh, “who have six-pack abs and a ruined back.”

The Phys Ed column will appear here in Well every Wednesday and also in print once a month, in the Sunday magazine. In it, Gretchen Reynolds, who is working on a book about the frontiers of fitness, will write about what the latest science can tell us about how to make ourselves stronger, more flexible, less prone to pain and generally fitter and healthier. We want to hear what you think, so stay tuned and offer your comments and questions.


As always, exercise with care, more advice om www.backpainloss.com

Regards
Paul

Shoes and back pain

From the examiner.com
Let’s face it ladies, every single one of us is likely guilty of owning AT LEAST one pair of heels that give us the firm shapely calves, juicy butt and lofty height we crave while screaming “come and get me boys”. And each and every one of us rues the day a man decided to put a woman in heels as we hobble torn, blistered, swollen and tender for the next day (or three). Common sense should kick in at some point here and cause us to forego the whole lot. We never do, likely never will and really, what harm could there be?

A lot.

The most common issues include blisters, corns, calluses, and bunions and nearly every woman who wears heels for any length of time has at least one.

For those who wear them more regularly problems progress to include ankle sprains, stretched ligaments, chronic pain in the ball of the foot (metatarsalgia), achilles tendonitis and lower back pain due to incorrect posture.

Progress further to women who are never caught dead in flats and ailments include neuromas (benign nerve tumors), loss of arch integrity and “pump bump”. Women who wear heels even on a semi regular basis also run a greatly increased risk of developing osteoarthritis of the knee, contributing a huge number of the 300,000 patients submitted for knee replacement every year. Some of these conditions take as little as one wear to occur. The more sever may take months, years or decades to appear.

How high is too high?

Most experts agree that heels greater than 2 inches in height as well as heels with a width of less than ¾ inch are to be avoided to the greatest extent possible, especially in situations where they will be worn for more than a couple of hours. Podiatrists also recommend the following:

- Wearing flat shoes for walking distances and changing into heels once arriving at your destination.

- Take smaller steps and try to place your heel first, in a gliding step.

- Buy short, chunky heels for all day wear.

- Avoid open backed shoes.

- Avoid pointed toe shoes to allow toes to maintain a natural shape and placement.

- Practice stretching, joint mobility exercises and soak or massage feet to ease the discomfort.

- Lastly, if suffering from pain more than twice a week, seek medical advices, as foot problems get progressively harder to treat as then become chronic.

Also of great concern is the growing number of girls and young women who are being treated for high heel related foot conditions. Girls are young as 10 years old are being treated for compression injuries, ligament and tendon conditions, back and knee pain and can suffer for years to come as a result of these injuries. Sustaining injuries to growing bones and joints can cause developmental restrictions and permanent damage. Growth plates of the knees, feet and hips are typically fused around age 16, so wearing heels, especially very high or narrow heels, can cause serious problems in the future.

Heels are not the only culprits

Flat shoes can be just as harmful as heels. Flat shoes with no support structure, such as slippers, ballet shoes and flip flops, cause different but equally harmful changes in gait and posture. Unstructured flats cause the foot to roll forward and stretch ligaments in the foot which causes incorrect toe alignment and can lead to bunions as well. Flip flops and slings create shuffling rather than walking gaits and (aside from being incredibly obnoxious to listen to) cause poor posture and weakening of core muscles. Shoes with arch support, natural foot shape, heel containment and one half to one inch of sole are recommended for flat footwear.

Options to ease the suffering

Buy shoes that fit. Most women suffer unnecessary pain as a result of wearing shoes up to a size too small. Get fitted at a reputable shoe store and be conscious of the width of your foot, arch height and the swelling that occurs naturally as the day wears on.

Shop in the afternoon or evening after a typical day of activity so that your foot is in the condition in which the most comfort is desired.

Purchase inserts. Dr. Scholl’s makes clear gel inserts and heel guards to prevent every day soreness and rubbing.

Custom orthotics can be costly, but will also greatly improve posture, correct gait and support the arch.

Do not wear shoes you can’t walk in. It doesn’t matter how cute it is, if you wobble for more than a step or two, the heel is too high and/or narrow and begs for injury. And trying to walk but looking like a toddler all over again this way takes away from the feminine grace that is the point of the exercise.

Compromise on heels around two inches in height and ensure a chunky rather than slender heel.

If you simply have to have more height, try a platform or wedge. While this will not alleviate the stress injuries, it will reduce much of the wobbling which can cause traumatic injury. Just get used to the difference in walking in rigid shoes before venturing out into the world.

Author: Angela Bowen
Angela Bowen is an Examiner from Phoenix. You can see Angela's articles on Angela's Home Page
This is a vital subject, to me. So many people are causing harm to themselves through the use of poor footwear. There is more on shoes and back pain at www.ackpainloss.com
Paul

Back Pain and hot water

From the Morning Sentinal
Back Pain and hot water? sounds interesting

For people in pain, comfort is often a matter of degrees: The warmer the better.

Cheryl Carr of Winslow understands this every time she dips her body into the therapy pool at Alfond Youth Center. The water is warm and welcoming, a soothing 91 degrees.

Carr relies on that water to help her with her ongoing rehabilitation from a terrible car accident in 2002.

Pain pills became a way of life for Carr after that accident. She suffered damage to her neck and spine, injuries that ultimately led to a broken back in 2005. She rolled over in bed and felt a terrible pop.

A surgeon reconstructed Carr's back with titanium plates and screws. But it's the therapy pool that has given her the ability to exercise again to help her battered body regain its strength.

"All the pressure was off my back," Carr said during a recent session in the pool. "All the pain just disappeared."

And the water's warmth means Carr's body doesn't stiffen but stays loose and fluid, physical therapist Susanne M. Bouchard said. Bouchard is the founder of Bouchard Physical Therapy Services, a practice with offices in Waterville and Augusta.

In her native Germany, the therapeutic value of warm water has long been understood, and spending time in pools and bath houses is part of the culture.

Not so in this country.

Bouchard said when she moved to the United States in 1977, the Yellow Pages in Maine didn't even have an entry for physical therapy -- never mind water therapy.

When she decided to settle in the area in 1984, Bouchard said she worked with a Waterville orthopedic surgeon -- the now retired Robert Hottentot -- on offering pool therapy as part of her rehabilitation services.

The first sessions started in 1985.

Exercise hot spot

Bouchard said one of the challenges with water therapy is finding a pool with the right temperature. One set at 89 degrees does not qualify, she said.

"When the water gets colder than 90 degrees," she said, "people right away know it."

They know it, she said, because their bodies start to chill unless they are moving constantly and fairly rigorously. That is not the case with many of the patients receiving water therapy through Bouchard's practice.

"Most of the patients we see are either post-surgical or have such a debilitating issue that they not able to exercise on land," physical therapist Marnie Allen said.

Allen and physical therapy assistant Beth Froman lead the water therapy group at Alfond Youth Center.

For many patients, Allen said, the warm water of the therapy pool is the only place they can exercise.

"For some of them," she said, "this is the longest time they are upright."

Bouchard said finding a pool with a water temperature of at least 90 degrees is a challenge. The YMCA recently established standard temperatures nationally for their large and small pools, the warmest being 88 degrees.

In Waterville, Bouchard said, Alfond Youth Center is the only facility with a pool warm enough for water therapy.

Augusta has none.

That's why Bouchard has raised and spent $500,000 to build her own pool in a building attached to her Augusta office. The pool is part of a nonprofit offshoot of her physical therapy practice.

The pool has been completed, as well as a hot tub and a cold tub, but Bouchard said she still has to install a dehumidification system before the pool can be filled and used.

"We are waiting for the money," she said. "We have applied for grants. We did as much as we could. Now we are waiting or help."

Bouchard is determined to complete the project. Her clients in Augusta, she said, need the pool close to home. Bouchard said many of them can't tolerate a 20-minute drive to the Alfond pool in Waterville.

"This will provide the (Augusta-area) community access to a better lifestyle," she said.

"The body does not have to fight for its balance (in the pool)," Bouchard said, "so your needs are met in that regard in so far as your body is able to balance itself."

Froman, the physical therapist at the Alfond pool, said water is an ideal element to work in, whatever your physical state.

Those with more profound injuries or conditions can go slowly and benefit from an environment that allows virtually non-impact exercise.

At the same time, water can greatly aid in strengthening the body. The faster a person moves in a pool, the greater the resistance that person encounters, and that resistance is what builds muscles, Froman explained.

Bouchard has seen great progress in her own health, she said, since beginning pool therapy last December.

"I have days when I can actually put my shoes on," she said. "I'm having more good days since I started this."

Colin Hickey -- 861-9205

chickey@centralmaine.com

Hope you found this interesting.
Paul Truscott www.backpainloss.com

Exercise balls and abck pain

From Fitness and weight loss, exercise balls ans back pain
Exercise Balls

Exercise balls are one of the most innovative ways to exercise. These little balls will catch every one’s fancy due to their shape and very attractive colors. The real benefit of these balls, which were introduced by a group of Swiss medical therapists, is a substitute of support during exercise.

Working out with the exercise balls will strengthen and tone all of the major muscles of the body. The soft texture of the balls make it an ideal choice for Yoga positions, using dumbbells for muscle toning, or working on heavy duty weight training equipment.

The advantage of exercise balls is that they are durable and maintain shape well under pressure. The documentation with the balls will provide test load figures for how much weight the exercise balls will hold. The advantage here is the fact that the balls provide soft yet firm support that doesn’t harm your body.

You can find exercise balls in several different colors and finishes. You can even get a ball that matches the texture of your room. They are simple to store and you can even roll them under your bed or a table if you prefer. When you aren’t using them, you can let kids play with them. These balls are very fun for kids, as they are very soft and won’t cause them any harm.

Medical equipment
Originally developed for use in medical therapy, the exercise ball is used to support the body during exercise. These balls will provide support to the body when you do a specific exercise in a specific position and still need to maintain the balance. Most exercise balls are made of burst proof latex or other material that is very safe to use.

There are many postures with yoga and muscle toning exercise that can only be done with the help of support. For these postures, exercise balls are quite useful. The exercise balls will introduce an element of stability to the exercise that you wouldn’t normally get with the floor exercise.

Your body responds automatically to the instability to keep balanced on the exercise ball. This will help in strengthening the muscles that aren’t actively participating in exercise.

An exercise is also very useful for physiotherapy treatment. Exercise balls will help to get rid of backache and spinal disorders. The small range of movement and adjustment of balance of the spine that is induced by exercising with the exercise ball will help reduce back pain.

The Swiss ball exercise is for people with back pain to provide them with a simple way to restore movements after an episode of back pain. It also results in improved muscle strength, greater flexibility, and a wide range of motion of the spine during treatment.
Remeber, if you have any back pain, always start an exercise program gently. If you rush a back pain may be aggravated, build up slowly and exercise will help your back pain, works for me.
For more on ecercise and back pain, www.backpainloss.com.
All the best
Paul

More exercise and back pain

From The Los Angeles Times. Some interesting comments on Back Pain and exercise

Lower back pain? Don't just sit there -- exercise
2:45 PM, June 3, 2009
More is better when it comes to alleviating lower back pain -- more exercise, that is.

Although many who suffer back pain don't exercise, fearing it will exacerbate the problem, a recent study found that exercising four days a week gave people greater relief from back pain than those who worked out fewer times per week, or not at all.

In the study, 120 people were randomly assigned to one of four groups for 12 weeks: one did a strength training program two days a week, one did it three days a week, and one four days a week. A control group did no exercise, but participated in a two-week exercise familiarization program. Exercises in the workout program included bench presses, lat pull downs and leg presses.

Those in the four-day-a-week program had the most reduction in pain -- 28% -- compared with 14% for those who exercised two days a week. The four-day group also reported having a better quality of life and less disability than those who exercised less. In addition, it showed the greatest strength gains. The control group showed insignificant change in all areas.

Robert Kell, an assistant professor in the department of social sciences at the University of Alberta, Augustana Campus, was the lead author of the study presented recently at the annual meeting of the American College of Sports Medicine in Seattle.

-- Jeannine Stein

I do hope this is of interest. For more on back pain and exercise, please goto www.backpainloss.com

Regards

Paul

Tuesday 16 June 2009

Massage and Back Pain.

Hello again.
One of my favourite way of dealing with lower back pain, be it muscular pain or strains and sprains is through massage. A client may choose a localised and limited massage, or a full body massage. The last is my treatment of choice.
As I have been attuned to the Reki energy, I always like to think a client is getting a "double whammy" the massage itself, and a reki treatment at the same time.
It is my personal belief that a full massage is ideal when dealing with back pain. Over a long period of treating and talking to back pain sufferers I have come to the conclusion that a back pain may have many causes.
The obvious strains and excesses of daily life are a primary cause. Bad posture and lack of respect for your body also may lead to back pain. Also a bang on the elbow or the knee even a stubbed toe may lead to back pain.
So a full body massage, a relaxing and invigorating treatment will ease pains and tension throughout the body. As the song goes "The foot bone is connected the ankle bone, and so on" the whole body is linked through bones, muscles, sinews and tendons. By relaxing one part of the body, another part is affected. If the whole body is relaxed, then many and different causes of back pain are relieved.
As well as this relaxation, the Lymph glands are encouraged to work and poisons are drained from your body.
On top of this a massage is fun and enjoyable, although there are rules to any massage technique carried out by professionals. What you do at home is, however, another thing.
As a means of dealing with back pain, massage is great. If however you have a treatment, and the problem comes back, then go for another treatment. If your problems returns again, then what are you doing? There is a phrase in Marketing that applies to life generally and it goes, roughly "If you keep doing what you have always done, then you will keep getting, what you always got"
So if you have bad posture, sit at your workstation incorrectly, keep wearing high heels, this may lead to back pain. Start to help your body out.
For more information on massage and back pain, goto www.backpainloss.com
All the best
Paul

Friday 5 June 2009

Rejuvanessence and Back Pain.

Hello and welcome to my third blog dealing with how complementary therapies may assist in the management of back pain and its associated issues.
First of all, what is Rejuvanessence? Not the best known therapy, perhaps because it is considered a luxury treatment most often found in high end Beauty Salons, though some of "us" offer it from home, or visit. I learnt this beauty system, the tag line for the whole process being "a face lift without surgery" and it certainly works.
This whole system was not designed as a pain relief system, but I found clients gaining a two fold benefit from my visits. The first was the undoubted improvement in their general facial appearance, both men and women. Secondly a great relaxation, spreading from the head to the toes. This relaxation allowed a healing process to take place in tight, twisted and strained muscles and ligaments, encouraged the flow of blood and the release of toxins. There was always a flow of energy going on.
What does Rejuvanessence consist of, and how often need a treatment occur?
There are 6 basic treatments and top up visits are recommended on a monthly basis.
The first session consists of a gentle skull massage that works on the subcutaneous fat and results in an amazing release with the whole face becoming more mobile.
The following 5 sessions work from the scalp down to the chest in separate treatments e.g. the third would work around the areas of the eyes, but going much deeper, covering a smaller area but acheiving very pleasant result, bringing blood to the face and starting to reverse the effects of lines and wrinkles.
With each treatment comes relaxation and a feeling of calm. I would come out of the hotel in central London after the course, and feel the dirt in the air and hate to get into a tube, it all felt dirty and chipped away at my peace.
So this system which helps ladies hold the effects of age at bay naturally without the knife or chemical, also relaxes and invigourates. So Rejuvanessence helps you look and feel great.
More on complementary therapies and how they are a natural answer to back pain management at www.backpainloss.com
Best wishes
Paul

Pilates and Back Pain

An interesting article on Pilates and back pain

Laura Coale

Pilates helped Laura Coale recover from back surgery over 10 years ago. She believes in the benefits of pilates so much that she became a pilates instructor and owner of Colorado Pilates. Contact her at info@coloradopilates.com.




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Next ArticleDenver Pilates Examiner Pilates shouldn't be a pain in the neck
June 2, 6:57 PM · Add a Comment
Add a CommentShareThisFeed What should you do if you feel neck tension or pain in your neck during some of the abdominal exercises? Modify the exercise or choose different types of exercises.

Neck tension and pain can be caused by a number of different things, but working through the pain is certainly NOT going to help alleviate it.

In many of the exercises where you are lying flat on your back, you can keep your head on the floor and not curl up (i.e. during the hundreds) until the deep muscles in your neck gain strength to support the weight of the head. Also, as your abdominal muscles increase in strength, you’ll be able to curl up higher off the mat so that your head will be more supported on top of the shoulders.

Weak abdominals may be the cause of the neck tension so working on strengthening the abdominal muscles is always good. Choosing exercises that start seated on the sits bones and roll back from there are more “neck-friendly” than others. In addition, exercises in the all-fours position can really help you connect with your deepest abdominal muscle, the transversus abdominis, and this will help your abdominal muscle endurance as well.

There are many modifications to Pilates exercises so please ask your instructor what you can do to avoid neck tension or pain. After all, Pilates is supposed to make you feel better not worse!

While performing the Pilates "hundreds" exercise you can simply place one hand behind your head or place your head on the mat to relieve any neck tension you may feel.
--------------------------------------------------------------------------------
Morenformation on complementary therapies and back pain at www.backpainloss.com
Besr wishes
Paul

Shoes and Back Pain

From the Daily Mail, less the photos, sorry
The shoes that heal: They claim to ease back pain, burn calories and tone your bottom. But do they live up to their promise? By Peta Bee
Last updated at 2:50 PM on 02nd June 2009
Comments (14) Add to My Stories
They're the latest thing in health and fitness - shoes that are 'functional'. These promise a whole range of benefits from improving your posture and soothing arthritic feet to toning your bottom muscles. But does such footwear live up to the hype? We asked Emma Supple and Lorraine Jones of the Society of Chiropodists and Podiatrists to review some of the newest products on the market.

VIVO BAREFOOT CANDY, £55
Vivo Barefoot Candy
Terraplana.com; 01458 449081

BENEFIT: Improved posture.
CLAIM: 'Naturally flexes and strengthens the muscles in the feet and realigns your posture.' The soles are thin enough so you can feel stones and changes in the surface underfoot - this is to mimic the benefits of walking barefoot, which promotes good posture and muscle strength in the feet and ankles. The shoes' cushioning means you land more gently on your heels.
EXPERT VERDICT: 'They're great for that barefoot-walking feeling - allowing your feet to move freely and in a natural fashion - without the risk of something splintering the sole,' says Lorraine Jones.
'It could be that they also help strengthen the foot as walking barefoot has been shown to do. But although described as shoes that can be worn anywhere, restrict them to soft surfaces such as grass, sand and carpet - avoid using on harder or stonier surfaces because you might hurt the skin and soles of the feet.'


RATING: 7/10

REEBOK EASYTONE, £65
Reebok Easytone
reebok.com; 0800 305 0500


BENEFIT: Toned bottom muscles.
CLAIM: Independent tests have proved that, wearing EasyTone, a woman can generate up to 28per cent more muscle activation in her bottom. Launched in the UK on July 1, they promise to tone more effectively than any other shoe on the market. A balance pod in the sole creates instability with each stride, making the abdominal, bottom and leg muscles work harder to stay balanced.
EXPERT VERDICT: 'These seem to have had some rigorous testing, so they might help some people get in shape, especially those who don't exercise much,' says Lorraine Jones. 'With the balance pod in the sole and the shoe designed for exercise, there is a chance you will do more of a workout in these, which will further any toning effect.
'A good lace-up trainer like this supports the foot well. It is breathable and provides arch support. The cushioning reduces the impact on the foot when you run.'
RATING: 9/10

More...Ask the doctor: What can I do to ease my stiff shoulders?
Patients plagued by crippling migraine are being cured by operations on the HEART

EARTH EXERFIT, £36
Earth Exerfit

lovethoseshoes.com; 0161 975 5380

BENEFIT: Calorie burning.
CLAIM: Will help you use up to four times more calories with every step than with normal shoes. The lightweight sandals are made with 'negative heel technology'; the back of your foot sits 3.7 degrees lower than your toes, so it is like walking on a treadmill. The slope of the shoe means your hips shift forward and you walk with better posture, which may possibly relieve back pain.
EXPERT VERDICT: 'Negative-heeled shoes are not recommended for most people,' says Lorraine Jones. 'They're suitable only if you have very well developed Achilles tendons and leg muscles - something you'd get only from going to the gym regularly.
'If you're used to wearing any sort of heel - even half an inch in a man's shoe - these are likely to cause problems. High heels shorten the Achilles tendon and these types of shoe lengthen it. Switching between the two will probably cause pain.'
RATING: 1/10

MBT HABARI SANDAL, £150



swissmasai.co.uk; 020 7684 4633; John Lewis, Sweaty Betty nationwide

BENEFIT: Better posture, arthritic pain relief.
CLAIM: Masai Barefoot Technology (MBT) was inspired by the Masai tribe 'whose natural upright gait and posture, and minimal back or joint problems, reflect the advantages of walking barefoot on natural uneven surfaces'. The curved sole mimics natural instability when you walk.
Regular wear will activate neglected muscles, improve posture and gait, tone and shape the body and help with joint, muscle and tendon injuries. Until now MBT shoes have looked clumpy; this new version has a slimmed-down sole for a sleeker look.
EXPERT VERDICT: 'These are better than totally flat shoes or very high heels because they offer some cushioning and support,' says Lorraine Jones. 'But I doubt they'll strengthen or tone your body; there's nothing about the way they're made that's been proven to do this. You'd be better off getting some trainers and going for a walk.
'Yet they are wonderful if you have arthritic feet, helping you walk without putting pressure on your toes and causing pain.'
RATING: 7/10

NGR Trainer, £93
NGR Trainer
nogymrequired.com (available only online)
BENEFIT: Muscle strengthening.
RATING: 5/10
CLAIM: Walk in these and burn 30 to 50per cent more calories. NGR stands for No Gym Required: these shoes replicate the benefits of going to the gym. You can add weights to the sole to make exercise harder.
EXPERT VERDICT: Many women, especially those used to wearing ballet pumps or lightweight trainers, would find these very heavy and clumpy, says Lorraine Jones.
'Although the weights you can add would help tone the lower and upper legs, they could also change your walking style by forcing you to adopt a different gait and apply pressure on the joints, leading to injury if you wore them for too long.
'Yet they are a substantial shoe with good support; if you started wearing them for just five to ten minutes a day, you might get used to them.'


RATING: 5/10
FITFLOP FREEWAY, £49.99


Fitflop Freeway
fitflop.com; 08456 039802
BENEFIT: Toned leg muscles.
CLAIM: Creates a slightly unstable platform for the foot - the instability forces the muscles in the legs to switch on for longer to deliver a workout while you walk. The shoes have a highly cushioned heel area designed to absorb shock during activity and help those with vulnerable knee and hip joints.
EXPERT VERDICT: 'Because they have a slight heel, they're kinder to your feet than regular flat sandals,' says Emma Supple. 'They prevent straining of the Achilles tendon - many people don't realise that regular flip-flops can be damaging for this reason. Independent trials have shown they help tone, so they're worth a try.'
RATING: 7/10

TONEWALKER, £49.99



Tonewalker
lovethoseshoes.com; 0161 975 5380
BENEFIT: Improved muscle flexibility and balance.
CLAIM: Provide up to five times more of a workout for your muscles when walking or even standing compared with normal shoes. Calories are burned faster and the appearance of cellulite is reduced because of increased activity. Has a bizarre-looking V-shaped platform sole that forces your back, stomach and leg muscles to work hard just to stay balanced.
EXPERT VERDICT: 'These shoes might create a little too much imbalance to be of any benefit,' says Lorraine Jones. 'They could make the foot wobble too much, putting strain on the legs. I also doubt they are very comfortable for most people because of the bizarre shaped sole.'
RATING: 2/10

BEECH SANDALS, £29


Beech Sandals
beechsandals.co.uk;0161 975 5380


BENEFIT: Improved posture.
CLAIM: These sandals will improve balance and encourage correct body alignment. They have four toe-separators that stretch and properly align feet that have been stuffed into ill-fitting shoes. It's thought equal toe separation helps to balance the body so that posture is improved. A favourite among yoga enthusiasts.
EXPERT VERDICT: 'It's been shown that separating the toes relieves pressure on the foot, whereas many normal shoes increase pressure by constricting the toes,' says Emma Supple.
'I like them as they hold your foot in the most natural way, and they are excellent for undoing the damage caused by high heels. Worn regularly, they could help you walk more efficiently and with better style, which will improve your posture.'
RATING: 10/10

Miracle cures? Functional shoes claim to help a multitude of health woes

For more on shoes and Back Pain, go to www.backpainloss,com

Paul

Tuesday 2 June 2009

How will Reiki help back pain loss.

Hello again.
Welcome to no.2 in my series of complementary therapies and their effect, always good, on back pain.
There are many people with their own view, their "take" on Reiki. So heres one more.
I have felt for a long time that everything is energy, be it electricity going down wires, or a road train heading down the freeway. We are all composed of energy and at the sub atomic level science agrees. When you get below the smallest particle imaginable, when you break that particle up, what do you get? Lots of energy, not all of it good depending on the way it is released and the intention behind the release.
So, we are all energy and extreme back pain might be considered an energy blockage. Reflexologistd talk about energy pathways, Reiki practioners consider themselves channels, conduits for the flow of Universal energy. This energy, known as Chi ti the Chinese and Ki to the Japanese may be directed to help or hurt. In Reiki or Acupuncture the energy paths are utilised to heal the human body. The same energy is used in a Martial Art to hurt that same body.
But how it is used is irrelavant to a degree. A Reki practioner allows the energy to flow to where it is needed, a true "laying on of hands" to help someone in distress. It is a very spiritual system of healing, which some people, some men particularly are not comfortable with. If it helps your back pain, at least try it.
This is a non-intrusive system, the hands do not have to touch your skin and the process may be used as a distant healing technique.
Best of all I know it will help back pain. There are 2 types of client who dont lie and "tell" it how it is, children and animals. I have treated children and received a variety of positive comments, most along the lines of "thats nice" I did, however treat the dog of a family member. On a visit once I held the dogs paw and felt the heat going from me to her. I dont see lights, hear music, I ony feel the Ki going out, a reminder to me of my Martial Art days. The report I got back a few days later was that this elderly dog was running about as if she had lost a lot of years and was now young. The effect wore off after a week or so and she was the same old dog with artritis, till my next visit. Then the same behaviour was seen again. This lasted a few months till she succombed to the cancer I had not been told about.
So if you want to feel good, or trat a specific issue, like back pain, the visit your local Reiki practioner, you will feel relaxed and invigourated.
For more information go to www.backpainloss.com
Be well, Paul