Spinal Health Back Care UK

Back pain ranks second only to headaches as the most frequent pain location.
Four out of five adults will experience at least one bout of back pain at some time in their life.
Back pain can occur for no apparent reason and at any point on your spine.

The most common site for pain is your lower back because it bears the most weight and stress.
Although back pain is common, it's also quite possible for you to prevent most back problems with simple steps such as exercise and adopting new ways to sit and stand.

Even if you've injured your back before, you can learn techniques to help avoid recurrent injuries.
Limited rest combined with appropriate exercise and education is often the best course.
Acute back pain often goes away by itself in a few days or weeks.
An ice bag or hot water bottle applied to the back may also help to alleviate pain. Prolonged bed rest is not beneficial because it weakens muscles.

Exercising with Back Pain
Recommendations for preventing initial and recurring episodes of back pain include:
regular exercise stretching before participation in sporting activities
losing weight maintaining correct posture
using comfortable, supportive seats while driving
sleeping on the side with knees drawn up or on the back with a pillow under bent knees

Homeopathy

Many of the herbs used for pain relief use the same biochemical pathways as the non-opiate pain-relieving drugs, but they are not as effective. However, on the positive side, many of these herbs have multiple effects. Their antispasmodic and circulation-promoting constituents may make up for what these plants lack in prostaglandin- suppressing strength. Herbal formulas that combine prostaglandin-suppressing, antispasmodic, sedative, and antidepressant plants are commonly prescribed by professional herbalists in North America, Great Britain, and Australia

Chronic pain often creates other problems besides the pain itself. These may include: tension, spasm, insomnia, and depression. And while conventional pain medications may remedy one or two of these side effects, some formulas of herbs can address them all. A pain-reliever, an antispasrnodic, a sedative, and an antidepressant may all be in included in a typical herbal formula created by a medical herbalist. For example, one herbal combination may include equal parts of willow bark (for pain), cramp bark (for spasm), valerian (a sedative), and St. Johns wort (an antidepressant).

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Hot, moist herbal packs help relieve the pain and increase blood circulation on painful areas, while herbal teas, juices and extracts soothe muscles and nerves.

Camomile has a calming effect on smooth muscle tissue. Take it as 1-3 cups of tea, 10-20 drops of extract in a cup of liquid or 1-3 capsules daily.

Bromelain (pineapple extract) is a powerful anti-inflammatory (take 2-3 g daily at first, then 1-2 g as the pain eases). Other anti-inflammatories, effective when drunk as teas, are valerian, St. John's wort, and Jamaican dogwood.

Horsetail not only heals and builds connective tissue, but also normalizes the bowels and alleviates lower-back pain, much of which can be traced to a dysfunctional intestinal tract. Take internally as per camomile.

Burdock soothes the pain and purifies the blood. Take 1-3 capsules or 10-25 drops of extract in 1 cup liquid daily.

If the muscle tension is due to emotional stress, take borage, St. John's wort, lemon balm or valerian teas.

Fresh yarrow juice is excellent for strengthening back muscles.

Use a white or black mustard seed pack for more intense heat. A mustard pack should not be left on for more than ten minutes because it can irritate the skin.

An infusion of meadowsweet three times a day combined with a rub on the area with lobelia and cramp bark is useful for physical strain or rheumatic problems.

Here are some herbs that are useful in pain relief.

Hot Peppers
Cayenne pepper (Capsicum spp.) is used in formulas for liniments and plasters in the folk medicine. Red pepper contains a pain-relieving chemical--capsaicin--that is so potent that a tiny amount provides the active ingredient in some powerful pharmaceutical topical analgesics. One product, Zostrix, contains only 0.025 percent capsaicin.

The exact mechanism in which red pepper works is not known. But it sure does work. Red pepper's effectiveness may be due to:

Capsaicin interferes with our pain perception
Capsaicin trigger release of the body's own pain-relieving endorphins
Salicylates present in red pepper.

How to Apply

1. You can buy a commercial cream containing capsaicin and use that.

2. Mash a red pepper and rub it directly on the painful area.

3. Take any white skin cream that you have on hand such as cold cream. Mix in enough red pepper to turn it pink.

4. Place 1 ounce of cayenne pepper in a quart of rubbing alcohol. Let the mixture stand for three weeks, shaking the bottle each day. Then, apply to the affected part during acute attacks.

5. Place 1 ounce of cayenne pepper in a pint of boiling water. Simmer for half an hour. Do not strain, but add a pint of rubbing alcohol. Let cool to room temperature. Apply as desired to the affected part.

Caution: Do not ingest any of these remedies. Wash your hands thoroughly after preparing or using red pepper. Don't get it in your eyes.

Some people are sensitive to this compound. Test it on a small area of skin to make sure that it's okay for you to use before using it on a larger area. If it seems to irritate your skin, discontinue use.

Cramp Bark and Black Haw
For the treatment of spasmodic pain, both cramp bark (Viburnum opulus) and black haw (Viburnum prunifolium) have been used in American Indian medicine. The Indians used cramp bark to treat both menstrual pain and muscle spasm. Cramp bark and black haw were also used hisatorically for arthritic or menstrual pain. The plants contain the antispasmodic and muscle-relaxing compounds esouletin and scopoletin. The antispasmodic constituents are best extracted with alcohol. So use tinctures rather than teas. Black haw also contains aspirin- like compounds.

Directions: Mix equal parts of cramp bark and black haw tinctures. Take between 1 and 4 droppers every two or three hours for up to three days.

Willow Bark
Willow bark (Salix alba) was used for treating pain by the ancient Greeks more than 2,400 years ago. American Indians throughout North America used it as a pain reliever even before the arrival of the European colonists. Investigation of salicin, a pain-relieving constituent in willow bark, led to the discovery of aspirin in 1899. The most important active constituent is salicin, but other anti-inflammatory constituents also appear in the willow bark.

Peppermint (Mentha piperita) and other mints.
The compounds menthol and camphor are found in many over-the-counter backache medications. They are chemicals that can help ease the muscle tightness that contributes to many bad backs. Menthol is a natural constituent of plants in the mint family, particularly peppermint and spearmint, although the aromatic oils of all the other mints contain it as well. Camphor occurs in spike lavender, hyssop and coriander.

Ginger
Ginger is used to treat various sorts of pain in the folk medicine of China and India. It is an important pain medication in contemporary Arabic medicine. Ginger contains 12 different aromatic anti-inflammatory compounds, including some with mild aspirin-like effects.

Directions: Cut a fresh ginger root (about the size of your thumb) into thin slices. Place the slices in a quart of water. Bring to a boil, and then simmer on the lowest possible heat for thirty minutes in a covered pot. Let cool for thirty more minutes. Strain and drink 1/2 to 1 cup, sweetened with honey, for taste if needed.

Rosemary
Drinking rosemary tea for pain is a remedy used in the contemporary Hispanic folk medicine of Mexico and the Southwest. Its leaf also contains four anti-inflammatory substances---camosol, oleanolic acid, rosmarinic acid, and ursolic acid. Carnosol acts on the same anti-inflammatory pathways as both steroids and aspirin; rosmarinic acid acts through at least two separate anti-inflammatory biochemical pathways; and ursolic acid, which makes up about 4 percent of the plant by weight, has been shown in animal trials to have anti-arthritic effects.

Directions: Put 1/2 ounce of rosemary leaves in a 1-quart canning jar and fill the jar with boiling water. Cover tightly and let it stand for thirty minutes. Drink a cup as hot as possible before going to bed, and have another cupful in the morning before breakfast.

Epsom Salt Baths
Folk traditions call for Epsom salt baths to relieve pain. Epsom salt was reputed to have magical healing properties. Epsom salt is primarily magnesium sulfate and has been used medicinally in Europe for more than three hundred years. The heat of an Epsom salt bath can increase circulation and reduce the swelling of arthritis, and the magnesium can be absorbed through the skin. Magnesium is one of the most important minerals in the body, participating in at least 300 enzyme systems. Magnesium has both anti-inflammatory and anti-arthritic properties.

Directions: Fill a bathtub with water as hot as can be tolerated. Add 2 cups of Epsom salts. Bathe for thirty minutes, adding hot water if necessary to keep the bath water warm.

Angelica
Various species of angelica have been used to quiet pain by American Indians throughout North America. The European species (Angelica archangelica) and the Chinese species (Angelica sinensis) have been used in the same way in the folk medicine of Europe and China respectively. The Chinese species is sometimes sold in North America under the names dang gui or dong quai. All species contain anti-inflammatory, antispasmodic, and anodyne (pain- relieving) properties. The European species of angelica has been used in European folk medicine since antiquity, as has the Chinese species in Chinese medicine.

Directions: Place 1 tablespoon of the cut roots of either species of angelica in a pint of water and bring to a boil for two minutes in a covered pot. Remove from heat and let stand, covered, until the tea cools to room temperature. Drink the pint in 3 doses during the day.

What ever you decide to do with regard to treating your medical condition, always consult with your GP before starting any alternative therapies or medicines.

We have known for a very long time that water exercise can benefit anyone, as water’s buoyancy accommodates both the fit and the unfit, and you’ll burn more calories with less joint wear than you would exercising on land.

So who can benefit From Water Exercise?

Age and physical condition aren't issues in the water. Seniors who rely on a walker or wheelchair on land can stand in water with the help of flotation belts and water's buoyancy.

Health benefits found in various studies include:
• Increased muscle strength
• Enhanced sense of wellbeing, mood and sleep quality
• Decreased fear of general exercise
• Improved oxygen intake
• Greater flexibility
• Loss of excess body fat
• Increased agility
• No exercise-related injuries

Why Water Exercise is Good for Arthritis

Water's buoyancy accommodates both the fit and unfit. Water cushions stiff and painful joints or fragile bones that might be injured by the impact of land exercises. When immersed to the waist, your body bears just 50% of its weight; immersed to the chest, it's 25%-35%; and to the neck, 10%. The lower gravity promotes the return of blood to the heart from the extremities.
Water provides at least 12 times greater resistance than air, and in every direction. Water cools your body and prevents overheating. But even in 80- to 85-degree water, the recommended temperature for exercise, you should warm up in the water before your workout to prevent injury. Just as with a land workout, you will sweat during water exercises, so it's important to drink water.
Also, studies of water walking have showed that the number of calories burned increases with the depth of the water. A half-hour of deep-water running burns 300 calories, compared with 200-250 for running on land, 150 for tennis, and 150-200 for aerobics. Also, a 150-pound person swimming at his or her target heart rate burns about 600 calories per hour.

Knee arthritis currently affects about 40% of people aged over 75 years, and hip OA affects about 10%. People with osteoarthritis frequently report joint pain, stiffness, loss of physical function, increasing immobility, and muscle weakness.

What Type of Water Exercise?

There are a wide range of warm water exercises to choose from, including:
• Specialised arthritis exercise programmes - check with your local fitness centres or arthritis organisations for what is available in your area.
• Hydrotherapy – a type of exercise therapy offered by physiotherapists. Classes may offer group sessions or one-on-one training. The water for hydrotherapy sessions is usually heated to around 34°C.
• Gentle water exercise – some fitness or recreation centres offer gentle water exercise programs for people who are elderly, disabled or unfit.
• Gentle aquarobics – some fitness or recreation centres offer water exercise classes that aim to improve general fitness. Because aquarobics exercises can be more vigorous than hydrotherapy, the water is usually heated to around 28°C.

Before You Join an Exercise Class

Always check with your doctor before starting any new exercise program. For example, you may need to avoid certain movements if you have had joint replacement surgery.
• Contact the various fitness and recreation centres in your local area to find out what sorts of warm water classes are on offer.
• Think carefully about the venue. Public swimming pools, for example, generally have cooler water temperatures, which means you could feel cold while exercising.
• Assess the venue. For example, is the pool easy to access? Are the change rooms accessible and comfortable?
• Before choosing a class, make sure it is appropriate to your level of fitness and ability. You may like to watch a class or two from the sidelines.

Safety suggestions

Once at the pool, safety suggestions include:
• Be guided by your instructor, but a good way to warm up is to swim gently or go for a ‘walk’ through the water.
• It will take time to build up your fitness, so aim for no more than 20 minutes of exercise at first.
• If you are exercising in a hot spa, get out after seven minutes or so.
• If you feel light-headed, sick or dizzy at any stage, get out of the water.
• Take care when moving in wet areas around the pool, including in change rooms, to avoid slipping and falls.
• Don’t try to do too much too soon. If you feel out of breath, slow down.
• Perform each movement as gracefully and smoothly as you can.
• Keep the body part you are exercising under the water. This may require you to squat or bob down at times.
• If a movement causes pain or discomfort, stop immediately.
• Drink plenty of fluids during and after exercising.
• Rest for a while once you get home.
• If you have painful joints or sore muscles for more than a few hours after your class, try to go a little slower next time.

Warm water exercise at home

You may be very lucky and have your own pool or spa at home. Suggestions include:
• Check with your doctor if you have particular medical problems – such as heart disease, low blood pressure or diabetes – before you do any exercises in hot water (such as a spa).
• Follow the routine outlined in your class or consult with a physiotherapist for an individually tailored program.
• If you are unfit, a poor swimmer or have difficulties climbing in and out of the pool or spa, only exercise when someone else is home.
• Make sure the water is comfortably warm, but not hot.
• Do not stay in a hot spa for longer than 20 minutes.
• Use the jet nozzles in your spa for massage therapy.

Water exercise is a fantastic way to both get fit and to provide much needed low impact physical therapy for a wide range of skeletomuscular medical conditions. But remember to always consult with your GP or Physical Therapist before starting any exercise programmes.

Back Trouble UK.

For at least twenty years there has been a debate about the treatment of osteoarthritis, about the use of the joint supplements glucosamine and chondroitin.

Osteoarthritis is a condition that causes problems of wearing out of the normal smooth cartilage surfaces of the joints. Often called wear-and-tear arthritis, osteoarthritis causes joint pain, swelling, and deformity. Osteoarthritis is the most common type of arthritis.

What do the supplements do?

Glucosamine and chondroitin are two molecules that make up the type of cartilage found within joints. Inside your joints, cartilage undergoes a constant process of breakdown and repair. However, to be properly repaired, the building blocks of cartilage must be present and available.

The theory behind using the glucosamine and chondroitin joint supplements is that more of the cartilage building blocks will be available for cartilage repair.
Glucosamine is a precursor to a molecule called a glycosaminoglycan-this molecule is used in the formation and repair of cartilage.

Chondroitin is the most abundant glycosaminoglycan in cartilage and is responsible for the resiliency of cartilage.

However treatment with these joint supplements is based on the theory that oral consumption of glucosamine and chondroitin may increase the rate of formation of new cartilage by providing more of the necessary building blocks.

So does glucosamine and chondroitin supplements increase cartilage formation?

While it is an interesting theory, oral consumption of glucosamine and chondroitin has not been shown to alter the availability of these cartilage building blocks inside an arthritic joint. It has not been shown that consumption of joint supplements increases the quantity of these cartilage building blocks within any joint.

Has any research been done to investigate the effectiveness of glucosamine and chondroitin?

There have been numerous studies to examine the treatment effects of glucosamine and chondroitin over short periods of time. Most of these studies last only one to two months; however, they have indicated that patients experienced more pain reduction when taking glucosamine and chondroitin than patients receiving a placebo. The improvement experienced by these patients was similar to improvements experienced by patients taking nonsteroidal anti-inflammatory medications (NSAIDs) that have been a mainstay of non-operative arthritis treatment. The difference is that NSAIDs carry an increased risk of side effects including gastrointestinal complaints and bleeding.

The joint supplements glucosamine and chondroitin have few side effects, and thus their use would be preferred if the effects of pain reduction were indeed the same. Furthermore, there is an indication that NSAIDs may increase the progression of arthritis, whereas glucosamine and chondroitin may offer a more protective effect to the cartilage surface.

So when it comes to choosing joint supplements there are many options. Use caution when choosing both the supplement and brand. Recent studies have shown that some brands come far short of the label claims. In one study of eleven chondroitin products, tests showed four of the products contained less than half the stated amount of chondroitin. How do you choose a product? The Arthritis Foundation says to pick the most reputabile brand--don't try to save with a cheaper imitation.

Diagnosing ankylosing spondylitis can be quite difficult in the early stages or indeed in very mild cases. As back pain is very common and is usually caused by muscle strain.

An x-ray of the spine and sacroiliac joints is taken, as degenerative changes are usually first seen in the sacroiliac joints. A rheumatologist that specializes in ankylosing spondylitis can usually make an accurate diagnosis.

Ankylosing Spondylitis Symptoms

The symptoms and severity of ankylosing spondylitis vary from mild to severe back pain, from mild stiffness to loss of mobility. Symptoms may come and go. In the early stages, inflammation of the sacroiliac joints causes hip pain (deep within the buttocks) and lower back and stiffness, especially at night, in the morning, and after periods of inactivity.

Later, the inflammation may spread further up the spine and to other joints. If inflammation occurs in the joints between the ribs and spine, pain may be felt in the chest area. The hips, shoulders, heels or knees are sometimes affected. Sometimes there is inflammation of the eyes. Very rarely, the inflammation may involve the heart.

There may be fatigue, lack of appetite, weight loss, a low-grade fever. In severe cases, the spine sometimes fuses in a stooped over position. However this can be avoided.

Preventing Stooping

Inflammation damages the joints. Scarring of the tissues and extra bone overgrowth can develop as a result of chronic inflammation. Eventually, in some severe cases of ankylosing spondylitis, the ligaments of the spine become fused together by bony overgrowth of the vertebrae this is called ankylosis.

Not all cases of Ankylosing spondylitis reach this stage, but maintaining good posture is essential so that if the spine does fuse the spine will be in a fixed upright position rather than a fixed hunched over position.

Strengthening exercises for the muscles that support the spine and stretching exercises help maintain proper posture. A physical therapist can create a customised exercise program for a patient to follow. Exercise plays a vital role in managing this disease.

Medications Used to Treat Ankylosing Spondylitis

Medications for Ankylosing spondylitis are geared at reducing inflammation.

NSAIDs:

Non-steroidal Anti-Inflammatory Drugs. NSAIDs treat the pain and inflammation. Ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox, ) and indomethacin (Indocin) are NSAIDs.
When NSAIDs are not effective enough other medications are often used.

Sulfasalazine, often used for inflammatory bowel disease, also can reduce pain and inflammation in the joints and is sometimes used to treat ankylosing spondylitis.

Immunosuppressive agents:

Drugs that suppress the immune system, such as Azathiprine, or Methotrexate are sometimes used to treat Ankylosing spondylitis. Immunosuppressive agents are used to suppress the inflammatory response by suppressing the immune system.

The immune system seems to be overly sensitive in people with Ankylosing spondylitis and certain cells of the immune system that initiate inflammation may be triggered too easily.

Corticosteroids (such as prednisone) have extremely powerful anti-inflammatory properties and also suppress the immune system. The problem with corticosteroids is that the side effects are severe in long-term use and the person taking them can develop a host of other unwanted problems.

TNF Inhibitors:

One class of drugs, TNF Inhibitors (such as Remicade), has shown a lot of promise in treating ankylosing spondylitis along with other chronic inflammatory diseases. Remicade suppresses inflammation by binding to and neutralizing substances (TNFa) that act as an alarm signal that triggers inflammation. New drugs in this class are being developed.

Remicade infusion contains the active ingredient infliximab, which is a type of medicine called a monoclonal antibody. It works by suppressing part of the immune system and modifying the process of inflammation.

Monoclonal antibodies are manufactured antibodies that are specifically designed to recognise and bind to unique proteins in the body. Infliximab works by binding to and preventing the activity of a specific protein produced by the body, called tumour necrosis factor alpha (TNF alpha). TNF alpha is involved in producing inflammation. It controls the activity of other inflammatory chemicals.

This medicine can compromise the body's ability to fight infections, and cases of tuberculosis (T have been seen. For this reason, you should be tested for TB prior to treatment. Tell your doctor immediately if you experience persistent coughing, weight loss or fever, as these can be symptoms of TB.

It is important to try and avoid exposure to infections during your treatment. Contact your doctor as soon as possible if you get any symptoms of any infection so that it can be treated without delay. This applies for up to six months after finishing treatment, as this is how long it may take for the medicine to be removed from the body. Be aware that this medicine can mask some of the usual symptoms of infection, such as a high temperature (fever), so it is important to be extra vigilant. If you develop a serious infection, further treatment with this medicine should not be given.

Even with the many advances in medicine and in particular skeletomuscular medicine, Whiplash is still not that well understood. Severity of injury varies considerably between people in the same types of car accidents, even when circumstances are similar. Speed is a major factor, as is the weight of the vehicles. There are several other factors involved. When the person sees the accident coming, the injury is often less severe. This may be because the nervous system has time to prepare. The position of the neck at the time of impact also plays a role. Risk of injury appears to be greater when the head is turned to the side than when it is facing straight ahead - except in very low speed crashes. The position of the headrest is important - it needs to be at the proper height and distance from the head to reduce severity of injury. The strength of a person’s neck also plays a role. Females, having less strength in their necks, generally suffer more severe whiplash injuries than males.

Seatbelts with shoulder harnesses should always be used and head rests at the proper height for the person. The height of the headrest should be just above the ear. The distance between the headrest and back of the head should be two to four inches.

Symptoms may occur immediately after the injury or set in gradually over the next couple of days. It is common for a person with no immediate symptoms to wake up stiff and sore the next morning. Whiplash can vary greatly in severity and cause a wide range of symptoms. Not all people experience the same symptoms. Symptoms that develop rapidly often indicate a serious injury.

The most common symptoms of whiplash are neck pain and stiffness. The neck becomes stiff as muscles tighten up to protect the injured area from further injury by reducing motion.

Headaches are also common. Pain originating in the neck (from muscle spasms in the neck and/or irritated nerves in the back of the neck) is often referred to the head. The pain may felt be over the entire head or any area of the head - often over the forehead and behind the eyes.

There may be back pain or shoulder pain, or numbness or tingling in the arm. Other symptoms of whiplash include problems with memory and concentration, feelings of disorientation, dizziness, ringing in the ears, impaired hearing, blurred vision, sensitivity to sound and light, irritability, depression, and difficulty sleeping.
Neurological symptoms may be the result of injury to soft tissue injury to the neck or a mild brain injury or concussion. A sudden jolt to the head can jar the brain. Neurological symptoms often resolve within a week.

If symptoms occur immediately or shortly after the accident an ambulance should be called so that the neck can be immobilised during transport to a hospital emergency ward.
There may be serious injuries that may require immediate medical treatment (such as hemorrhage, fracture, dislocation, or spinal cord injury). In addition, auto accidents that result in whiplash may also result in other injuries such as chest injuries, back injuries, internal injuries, etc.

Always seek a proper diagnosis from a GP, even if the symptoms are mild. The diagnosis may be based upon symptoms alone, or an MRI or CT may be taken to see the extent of soft tissue injury. X-rays may be taken to rule out fractures or dislocation.

Treatment depends on severity of symptoms. If the injury is mild, applying ice packs at home for the first couple of days along with the short-term use of NSAIDs may be sufficient. If symptoms are moderate (especially if there is limited range of motion), physical therapy is often recommended. Massage therapy and/or spinal manipulation may also be beneficial.

Applying Ice
Applying ice every four hours for the first couple of days helps reduce inflammation (the main cause of the pain). Inflammation is greatest for the first two days. Wrap ice in a cloth and apply to area of neck pain for 20 minutes every three to four hours.

Medications
Anti-inflammatory medication to relieve both pain and inflammation such as Ibuprofen or Aspirin are often helpful. Your GP may prescribe muscle relaxants or pain medication that contains codeine for temporary use.

Physical Therapy
Depending upon the severity of the whiplash injury, physical therapy may be recommended by your GP. A physical therapist can prescribe range-of-motion exercises, teach proper posture to avoid excess strain on neck, treat pain with cold and heat, etc.

Prolonged Use of Soft Collars do Delay Recovery.

Soft collars may be helpful for the first two or three days, when pain and inflammation is at its greatest. Inflammation may trigger muscle spasms - a protective mechanism to restrict movement to prevent further injury. Wearing a soft collar helps relax the muscles to relieve pain. However, prolonged use of soft collars has been shown to delay recovery from whiplash. Intermittent use may be recommended in some cases.
*If a fracture or dislocation is involved, a wearing molded collar may be necessary to stabilize the neck.
How quickly one recovers from whiplash depends largely upon the severity of the injury. How quickly the symptoms develop often correlate with the seriousness of the injury.

Mild whiplash injuries often heal completely within two to three weeks, moderate whiplash injuries within two to three months. Severe whiplash injury may take several months to heal. For some people, symptoms (such as mild neck pain and/or headaches) may linger for longer periods of time. If symptoms are still present after six months, the pain is considered to be chronic. Chronic symptoms may last for years. Whiplash injury may increase risk of degenerative changes in the discs and spinal joints.

Their have been cases were people report that new symptoms appear years after the initial whiplash injury, though it is difficult to determine whether or not symptoms that appear years later are related to the whiplash injury.

Are Computer games responsible for increased back pain cases among the nation’s teenagers?

The problem of low back and neck pain in teenagers is likely to increase significantly in years to come.

This seems on the cards considering the associated health problems of obesity, reduced levels of activity, and the popularity of passive entertainment systems such as play stations that encourage further inactivity and prolonged sitting posture in the adolescent age group.

Terry O’Brien of Back Trouble UK says “While 80 percent of the population are likely to experience low back pain at some stage in their life, there is a worrying trend in the amount of back pain experienced by teenagers.

It is well founded that having another family member with a history of back pain means you are more likely to develop back pain as an adolescent. As does poor family functioning and increased life stress.

Higher levels of stress, anxiety and depression are also associated with adolescent back pain.

Back pain is commonly provoked by sporting activity and static postures such as sitting. It is also known that specific sporting groups such as rowers are at higher risk of back pain.

Children seem to fall into two broad groups, those doing very little activity and those doing too much. Both groups are prone to back pain. However it is the worrying trend of inactivity amongst adolescents that is the greatest cause for concern. Fuelled by the dramatic increase in computer games and multi-media consoles.”

Advice:

We’ve all felt neck or back pain at one point or another, especially those of us who spend a lot of time in front of a computer. Sitting puts stress the back and neck and the longer you sit, the more strain you place on yourself. With back and neck pain it is important to know that the torso is a system of interrelated parts, and symptoms in the arms, legs, head, and chest such as tingling, sharp pains, burning, spasm, vague aches, soreness, lack of muscle strength, and stiffness are all possible indicators of back or neck problems.

Neck Pain often begins gradually as a result of fixed staring at a small area or glancing repeatedly from one to another (from the screen to a document on your desk for example). If the head is held at an angle greater than 15 degrees (for example holding the phone between your neck or shoulder, or looking down at your keyboard) will cause greater muscular fatigue and pain will become apparent more rapidly.

Prevention
Be sure you have a proper workstation set-up.
Take active breaks, move around and do a few stretches.
Shift positions every now and then. Try not to fall habitually into one computer position – even small changes help avoid overtaxing certain muscles.
Use a headset for your phone – crooking a phone between your shoulder and cheek is one of the worst things you can do to your neck.
Use a document stand so you aren’t constantly looking down while you are typing. Position it at the same height as your monitor, and close to one side.

Back Pain
Sitting is one of the hardest positions in which to maintain proper posture, and many computer users regularly feel back pain. Spinal compression is one of the most common problems because sitting tends to tilt the pelvis backward, flattening the lumbar curve and resulting in uneven and increased pressure on spinal disks.

Prevention
Along with the same preventative measures mentioned above for neck pain you can:
Try not to round your shoulders – this puts extra pressure on your upper spine.
Stay active, get up and move around to circulate your blood. Sitting still for too long can slow blood circulation and muscle fatigue can set in.
Practice back safety everywhere – bend at the knees to pick up heavy objects, watch your posture, don’t slouch, keep your shoulders back, head high, and stomach tucked in to help the back muscles hold your own weight.
Consider pain medication such as aspirin or ibuprofin for mild or occasional back pain, but if pain persists see a doctor or a professional physical therapist.

Terry O’Brien
BackTrouble.co.uk

Piriformis Syndrome.

The Piriformis is one of the small muscles deep in the buttocks that rotates the leg outwards. It runs from the base of the spine and attaches to the thigh bone (femur) roughly where the outside crease in your bum is. The sciatic nerve runs very close to this muscle and sometimes even through it! If the muscle becomes tight it can put pressure on the sciatic nerve and cause pain which can radiate down the leg.

A common cause of Piriformis syndrome is having tight adductor muscles (inside your thigh). This means the abductors on the outside cannot work properly and so put more strain on the Piriformis.

Symptoms of piriformis syndrome:

Tenderness in the area of the muscle.
Pain in the buttocks.

Reduced range of motion of the hip joint.

What can you do to help combat piriformis syndrome?

Apply heat.
Stretch the Piriformis muscle.
Strengthen the Piriformis muscle.
See a Physical Therapist professional who can advise on treatment, rehabilitation and prevention

What can a Physical Therapist do?

Apply specific sports massage techniques.
Stretch the Piriformis muscle using Muscle Energy Techniques.
Apply ultrasound.
Advise on strengthening and rehabilitation to avoid injury recurrence.

Rehabilitation (Piriformis syndrome)

The guidelines below are for information purposes only. We recommend seeking professional advice before starting any rehabilitation.

Aims of rehabilitation of Piriformis syndrome:

Reduce pain.

Improve flexibility and condition of the surrounding muscles through deep massage and stretching and strengthening.
Return to full fitness.

Injury prevention.

Reducing pain.
Ice (apply for 20 minutes)
Heat in the form of a hot bath or hot water bottle.
Rest from activities that produce pain. This is likely to include running.
Gentle stretching if pain allows.

Flexibility and conditioning

After the first two to three days a stretching and strengthening programme can begin.
It is important to stretch in conjunction with strengthening and massage.
Deep sports massage techniques can be used to release the tension in the Piriformis muscle. Massage can be applied on alternate days. At the very least two to three sessions at the start of rehabilitation is a good idea.

Muscle energy techniques are an excellent way of improving the stretch of the muscle.

On a daily basis perform Piriformis strengthening exercises immediately followed by stretching.

Hold stretches for 30 seconds and repeat 5 times.

In addition to the specific Piriformis stretches it is important to stretch the hamstrings, hip abductors and lower back.

Return to full fitness.

In most cases a return to jogging is possible within 5 days.
But this should be a gradual process combining running and walking.
It is essential that stretching and strengthening are continued throughout the rehabilitation process and beyond.

Injury Prevention

The following steps can be taken to avoid Piriformis syndrome returning:
Stretch religiously before and after training.
If you have a break from training, keep doing the stretches as you may find things tighten up, especially if you sit for long periods.
Get a regular sports massage. A good therapist will spot potential problems before they happen.

Get a bio mechanical assessment. If you over pronate or have one leg longer than the other then this may make you more susceptible to injury.
Maintain regular hip and Piriformis strengthening exercises.

Make sure you have the right footwear for your activity and that they are not too old.
Finally when recovering from injury, do not do too much too soon.