Friday, 29 May 2009

Waiting for back pain loss

From the Daily Mail in the UK

Back pain? Prepare to wait six weeks or longer for treatment
By Jenny Hope
Last updated at 12:52 AM on 27th May 2009

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New guidelines state back-pain sufferers can expect to wait six weeks before receiving treatment

Back-pain sufferers will have to wait six weeks before treatment, according to the latest guidelines.

And they may have to wait longer in many areas due to limited services, it is claimed.

The guidance, from the National Institute for Health and Clinical Excellence (Nice), has backed widespread use of 'alternative' therapies for the first time.

Once they are referred, back sufferers in England and Wales will be able to opt for a three-month course of acupuncture, spinal manipulation or exercise - and try an alternative treatment if the first fails to work.

Treatment can be provided by physiotherapists, chiropractors, osteopaths or other qualified specialists.

Experts say they will not add to the £1.6billion NHS care bill because ineffective therapies will be dropped.

Prof Martin Underwood, a GP who was chairman of the committee overseeing the guidance, said it was a 'sea change' in the way back pain was treated on the NHS.

But he warned it was 'not going to happen tomorrow' because the availability of treatments was patchy.

He added: 'In some areas, people will get quite good access to these facilities but in other areas they won't be available.'

Prof Underwood said many patients were already advised to wait six weeks before specialist help because most get better in that time.

Prof Peter Littlejohns, of Nice, backed the use of acupuncture, saying: 'How it works is not completely clear but I think the evidence still shows that on balance patients do better'.

But Prof Edzard Ernst, a specialist in complementary medicine, was cautious about other treatments.

He said: 'The panel included three pro-manipulation experts.

'As a result, they over-estimated the benefits and under-estimated the risks of chiropractic spinal manipulation, in my view.'

For more help now goto www.backpainloss.com

Reflexology and Back Pain

Hello everyone

For a change I thought I would write a few words about back pain and how it may be relieved through the use of various complementary therapies I have studied and found to be of use with such problems as back pain and how they fit into the general idea of Back Pain Loss.

Reflexology was one of the first therapies I studied and as a student proved its use when dealing with back pain. particularly sciatic nerve pain. As many of you probably know reflexology is a system of applied pressure to various points on the foot and hand. These points or reflex points, correspond to organs, bones, muscles even the eyes, ears and teeth. So by applying pressure across the whole foot and ankle you may give a vitalising treatment to the whole body, or just choose a specific area. We were warned about the sexual reflex areas and the consequences of working to hard there, for instance.

The reflex points for the spine was the inside of the foot, on each foot and by working from the base of the big toe to the heel of the foot I was able to help people with back pain, as explained at www.backpainloss.com. As a general treatment Reflexology is relaxing and invigorating and I have made some discoveries that were later born out by medical diagnosis.

As an aid in back pain relief I have found Reflexology to be effective with the added advantage of being non instrusive and a client only has to take off their shoes and socks.

So if you have a Reflexologist near you, give them a try.

For more on therapies and back pain go to www.backpainloss.com

Be well

Paul

Thursday, 28 May 2009

Friday, 22 May 2009

Back Pain and Incontinence

Incontinence, back pain can be alleviated
By Carrie A. Moore

From The Deseret News

When people with urinary incontinence or low-back pain avoid seeking treatment, either because of a busy schedule or embarrassment, they are choosing to live with conditions that can often be alleviated or cured without surgery or pills.

That's the message physical therapists plan to share with callers on Saturday during the monthly Deseret News/Intermountain Healthcare Hotline, which runs from 10 a.m. to noon. For questions about either condition, call toll free at 1-800-925-8177.

Questions also may be e-mailed to hotline@desnews.com from 10 a.m. to 5 p.m. on Saturday. Answers to e-mails will be posted on the newspaper's Web site next Friday.

Jake Magel, director of the Intermountain Orthopedic and Spine Therapy Clinic at Intermountain Medical Center, and fellow physical therapist Susan McLaughlin will be available to answer questions about both topics.

McLaughlin said from 10 percent to 40 percent of people will deal with incontinence — an involuntary leakage of urine — at some point, with those in midlife more at risk. Stress incontinence is due to lack of muscle support and usually occurs when patients cough, sneeze, laugh or jump. Urge incontinence occurs when patients have a strong, constant urge to urinate and the leakage is triggered as they get close to a bathroom or hear water running. She said it's common for many people to have both types.



Though physical therapy is often effective in dealing with the condition, most people head straight to the urologist when they finally decide to deal with the problem. Many postpone addressing the issue out of embarrassment or the hope that it will subside on its own, she said.

And relatively few people understand that it can be treated without pills or surgery.

"All the studies around physical therapy and getting individualized treatment show muscle strengthening should be first line of defense. We would like to see more urologists referring people to us first," she said.

While both medication and surgery are effective in treating the condition, at least for a time, physical therapy is often less invasive and just as effective, though it takes dedication to daily exercises, she said.

In treating patients, McLaughlin helps them understand how to perform pelvic floor exercises that strengthen the muscles that control leakage from the bladder. "These are the muscles you use when you're in a public place and need to pass gas and you draw in and lift." The muscles are also used to stop urination in midflow, she said.

Some patients tell her a doctor has recommended pelvic floor or "Kegel" exercises. "They tell me they've been doing them for years but they're not helping." The problem in that case, she said, is that patients are doing them wrong, which actually makes the problem worse rather than correcting it.

To determine how strong the muscles are, McLaughlin uses a one-finger exam to assess the strength of pelvic floor muscle contraction and to see how long patients can maintain the contraction. She then teaches them how to build muscle endurance, working two different parts of the muscle system.

She also uses a bio-feedback system, which senses the activity of the muscles so patients can see on a screen how well they are contracting and can make adjustments accordingly. "It's a good tool to help re-educate them about how to use their muscles correctly."

Patients build muscle strength and endurance at home as they do daily exercises, usually from 60 to 80 repetitions per day.

Generally patients see the therapist once a week for twoor three weeks, then the visits are spaced further apart. McLaughlin said most people require a total of six visits but must maintain their exercise schedule for several weeks or months to see real improvement, just as with any other muscle group, she said.

"It's easier to take a pill because this takes commitment, and people will only improve if they are doing the exercises." Young mothers with children sometimes opt for surgery even if they know about physical therapy, she said, because they can't find time to do the exercises.

Yet surgery "doesn't permanently repair" the problem. "The muscles and connective tissue become weak again over time, and going through menopause thins out the tissue."

McLaughlin is hopeful that patients thinking about medication or surgery will learn they have another option.

"People come in all the time and say 'I didn't know you could do physical therapy for this.' The whole pelvic area has been kind of a no-no to talk about," despite the fact that physical therapists have been treating incontinence since the 1980s, she said. "We need to do a better job of educating people."

Read more abot back pain at www.backpainloss.com

Back Pain and Gardening

An interesting article from The Cape Cod Times, as the summer keeps attempting to appear and the garden beckons.
By STEPHANIE FOSTER
CONTRIBUTING WRITER
May 07, 2009
Gardeners' minds are active most months of the year, but what about their bodies? As soon as the soil is warm, many gardeners will be digging, bending, lifting, stretching and exerting themselves in ways they haven't since fall. Even walking on a regular basis isn't enough to stay fit for gardening, according to Carol Penfield, a nurse practitioner, personal trainer and owner of the Chatham Health & Swim Club.

"People go from sloth to being highly active. Specific body positions put them at risk. When people are active in the summertime, an injury can keep them from something they enjoy. I want them to be able to enjoy their activity longer," she says, sitting in her office at the facility on Crowell Road in Chatham.

Grow your gardening fitness
Basic tips from Carol Penfield, R.N., on getting in gardening shape. If your club or group is interested in getting in shape for spring, call Penfield at 508-945-7761.

Don't set yourself for stiffness: Change your body position frequently. For example, when bent forward gardening, before rising to a standing position, place your hands on your thighs and tuck under and release the pelvis five to 10 times.



Take a break every 10 to 15 minutes. Set your watch alarm or, if listening to an iPod, rest at the end of each song.

Shrug off achy necks and shoulders: Place your hands on your hips; pull your elbows back and squeeze your shoulder blades together. Hold for 10 seconds and repeat every 10 to 15 minutes.



For shoulder pain, slowly backstroke the arms using a range of motion that is comfortable.


Grease the elbow: Maintaining a grip on a trowel, pruners or shovel can lead to elbow pain. Periodic stretching of the forearm can help relieve discomfort. Extend the arm out straight, making a fist, and push the fist down toward your torso and hold for 10 seconds.Step back from back pain: Do daily posture and back exercises. Do your work on a table or use raised beds. Lunge when raking. Stretch afterward and during the day.Keep knees happy: Keep your joints properly aligned, change positions frequently and use a kneepad or chair. Avoid doing too much, too fast for too long. Pay attention! Overuse of the body can lead to tendonitis, bursitis or back pain.For more information on gardening fitness, visit:


www.chathamhealthclub.com and click on health tips;

www.gardenfitness.com/garden_fitness_plan.htm;


www.flower-and-garden-tips.com/exercise.html; and www.allegromedical.com/blog/gardening-stretches-and-exercises-for-pain- free-gardening-787.html .
Each spring, Penfield, a vegetable gardener herself, offers free classes and advice to area garden clubs to help their members get in shape for their favorite hobby. She lectures about body mechanics and anatomy and shows gardeners ways to improve flexibility, strength and endurance. She says it's also about being mindful of the body and avoiding physical stress.

Penfield says spring can be a dangerous season for many people who are active but not athletic. Suddenly there is a surge of activity that puts bodies on overload.

Annie Maquire, a personal trainer at Gold's Gym in Mashpee, agrees. "A lot of older people haven't been exercising all winter. They'll be spending hours and hours bent over. It's tough on the lower back and legs. Pulling weeds goes straight to the back. They're at it for four or five hours. They need

to strengthen the lower back and legs..

Penfield says gardening tends to be repetitive activity, putting people at risk for tendonitis. "Gardeners get lost in a project and hold a specific position for a long time. It causes stiffness, achiness or pain. They tend to lose themselves in time," she says.

Flexibility of the knees is one problem gardeners encounter. "Getting down and up involves leg strength and knee flexibility," says Penfield. "They can walk all year round, but kneeling is different. When they walk, there is only a slight bend to the knees. When they garden, the bend is beyond a 90-degree angle. It's the same concept for the back."

Vicky Burke-Marjewski, owner of Mid-Cape Racquet and Health Club in South Yarmouth, touts the benefits of getting in shape for the gardening season and the dire consequences if gardeners don't. She notes that gardening is a double whammy involving bending and twisting, which creates additional stress. "When you add the motions together, you can run into trouble from a strained back, muscle injuries to disk issues. Most of the process is bending over. It's hard on the knees," she says.

Flexibility is important along with core strength when gardeners assume odd positions, which they tend to do when concentrating on a project.

Penfield recommends developing a healthy style of working. "There are different ways to bend forward that will not aggravate the back. You can use the support of a low stool, box or crate. The torso can rest on it while you garden. Or use your own body. Brace yourself by putting your free hand on your thigh. Also, bend with your knees, keep the weight of items close to the body. There is a danger in heavy lifting coupled with twisting. It's improper body mechanics. The biggest risk is bending and then twisting. It puts people at higher risk. Always face your project, bending from the waist."

Penfield recommends starting with 10 to 15 minutes of exercise, five days a week. "Then add 10 to 20 percent more time until the garden season arrives. That's a minimum. You have to be realistic. No one is going to spend an hour on it. We're all in training for whatever activities we want to do, gardening or whatever else. There has to be some conditioning."

"It's about consistency," Penfield adds. "You don't have to be fancy. It can be basic. It's about enjoying a hobby for a long time to come. Exercise now and it will make gardening more enjoyable later."

Take a look at www.backpainloss.com for more on this subject

Sunday, 3 May 2009

I should know better.

Hello eveyone.
The English summer keeps on appearing, then vanishing. This weekend is a Bank Holiday, plus my wife has had a cold which I finally came down with on Friday, so I stayed in bed, slept and by Satarday head pains, coughing and all the rest were gone. A sure sign of a sensible person taking their own advice, You might think that.
So why come Satardy was I cleaning our collapsable pool which I made the mistake of leaving up? On my hands a knees srubbing the plastic to get rid of dirt, leaves, dead insects. All this after spending an hour cleaning any rain water that was left in from the previous weeks rain. Great way to insure Back Pain Loss you would think. I finally cleaned the pool bottom and found some damage to the plastic. This meant I had to buy a repair kit, repair the bottom and leave for 24 hours.
How did this affect my back. Well, suprise to say, my back pain was severe for a while, some stretching and massage seems to have cleared it. I slept well, woke up and went shopping, I have yet to clean and polish the cars, but at least the sun is still shining and I can sit down comfortably.
But there is still bank Holiday Monday, will I keep doing things to encourage Back Pain, will the rest of Britain be out digging, cutting the hedge, mowing the grass, or will they take it easy, just as I will.
If you want to learn about Back Pain, have a look at www.backpainloss.com.
Bue for now

Paul

Golfers who want Back Pain Loss, read.

Here is an article from Burlington Sports Therapyhttp://www.burlingtonsportstherapy.com/blog/how-golfers-with-back-pain-use-their-muscles-differently/ if you want more info. This talks about Back Pain and Golfers
How Golfers With Back Pain Use Their Muscles Differently…
Neuromuscular control (the way that our brain and nervous system coordinate the timing and activity of our muscles) has been an area of considerable research in recent years, particularly when investigating lower back pain. Interestingly, some of this research has found that golfers with lower back pain activate their external oblique muscles in a different pattern than those players without pain. Among the various affects this will have on the player in pain, research has found that it will place an increased demand on the external obliques over the course of a round of golf.



Chiropractic treatment consisting of active release technique and adjustments can be helpful in this situation to re-establish normal biomechanics of the lumbar spine and allow the appropriate muscles to help out with the workload. Consulting with a suitable teaching professional can also be helpful in identifying altered movement patterns and correcting the problem. In the meantime, it may be advisable to improve the endurance in your external obliques to help cope with the added demand placed upon them. Below are a few exercises that are helpful in strengthening the external obliques. Keep in mind that they are dynamic exercises which are not suitable for everyone as they require movement in the spinal joints. If you have a history of lower back pain we strongly recommend that you consult with a knowledgeable doctor who can assist you in choosing a suitable strategy for your condition.



References

Cole MH, Grimshaw PN. Trunk muscle onset and cessation in golfers with and without lower back pain. Journal of Biomechanics 2008: 41; 2829-2833.

Horton JF, Lindsay DM, Macintosh BR. Abdominal muscle activation of elite male golfers with chronic low back pain. Medicine and Science in Sports and Exercise. 2001; 33: 1647-1654.

Lindsay DM, Horton JF. Trunk rotation strength and endurance in healthy normals and elite male golfers with and without lower back pain. North American Journal of Sports Physical Therapy 2006: 1; 80-89.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.


Posted in by Kevin

Hope you liked it. More info on exercise and back pain loss at www.backpainloss.com

Have fun

Paul.