Back Pain

• Can affect anyone at any age, but it's most common in people between the ages of 35 and 55.
• Acute back pain lasts for less than 6 weeks.
• Sub-acute back pain lasts between 6 weeks to 3 months.
• Chronic back pain lasts longer than 3 months.

How the Back Works

The spine is made up of many small, inter-connected bones called vertebrae. These are separated by strong connectors called discs, which act as shock absorbers and allow the spine to bend. It is supported along its length by muscles and ligaments. The spinal cord threads down through the centre of each vertebra, carrying nerves from the brain to the rest of the body.

Causes of Back Pain

The main reasons for developing simple back pain are:

• Standing, sitting or bending down for long periods of time.
• Lifting, carrying, pushing or pulling loads that are too heavy, or carrying out these tasks in the wrong way.
• Having a trip or a fall.
• Being stressed or anxious.
• Being overweight.

Occasionally, there may be a more serious underlying cause for the back pain, but this is rare. These causes include osteoporosis, a prolapsed (slipped) disc, spinal stenosis, malformation of the spine, infection or collapse of the vertebrae, tuberculosis or cancer.

Symptoms of Back Pain

Simple back pain, usually lasting a few days (gets better on its own), is often in your lower back (lumbar region), and may also spread to the buttocks and thighs. It's often described as a dull pain and can come and go at different times, depending on the level of activity. The pain can begin suddenly or come on gradually if the back is strained over time.

However, you should see your Doctor as soon as possible if, as well as back pain, you have:

• Fever (high temperature).
• Redness or swelling on your back.
• Pain down your legs and below your knees.
• Numbness or weakness in one or both legs or around your buttocks.
• Loss of bladder or bowel control (incontinence).

Some symptoms are called "red flags" and may indicate that you require treatment for an underlying condition. You should see your Doctor if:

• Your pain is the result of an injury.
• You are under 20 or over 55 and the pain lasts for more than a few days.
• You have had or currently have cancer in any part of your body.
• You have HIV/AIDS.
• You have been taking steroid medicines for more than a few months.

Diagnosis of Back Pain

If your pain lasts longer than 6 weeks, or if your Doctor suspects there are some underlying cause of your pain, he/she may recommend more tests such as:

• X-rays.
• CT scan (uses x-rays to make a 3-dimensional image of your body/part of your body).
• MRI scan (uses magnets and radio waves to produce images of the inside of your body).
• Blood tests.

Treatment of Back Pain

Self-help

• Stay active – return to your usual level of physical activity as soon as possible. It may hurt at first but it will help you get better and reduce the risk of getting simple back pain again..
• Bed rest – if the pain is so bad that you can't get moving, keep the time you stay in bed as short as possible as lying in bed can do more harm than good.
• Stay positive and set yourself goals.
• Heat therapy – apply a hot water bottle/heat pack directly to the affected area or take a hot bath.
• Ice therapy – apply a cold compress (ice or bag of frozen peas wrapped in a towel). Don't apply ice directly to your skin as this could damage it.
• Pace yourself – be careful not to overdo it when your pain lessons.

Medicines

Taking painkillers or anti-inflammatory medicine (such as aspirin, Voltaren paracetamol or ibuprofen) and/or using creams/lotions/gels that contain painkillers or anti-inflammatory ingredients that can be applied directly onto the painful area. If your pain continues, your Doctor may prescribe stronger medicines (such as diazepam, morphine or tramadol). However, these aren't suitable for everyone because they can be addictive and cause side-effects.
Your Doctor/Pharmacist will advise you which treatment is the most appropriate for you. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your Doctor/Pharmacist for advice.

Transcutaneous Electrical Nerve Stimulation (TENS)

This relieves back pain by delivering mild electric pulses to the painful area through electrodes on your skin. These stimulate your nerve fibres and block the pain signals to your brain. TENS isn't suitable for everybody and isn't always effective. You should check with your Doctor before you use TENS and make sure you know how to use it properly.

Physiotherapy

Physiotherapists can assess and treat your back pain, and teach you exercises to do at home that will increase your mobility and help you manage your pain.

Manipulation

Osteopathy and chiropractic are treatments involving manipulation of the body, mainly focusing on the spine. They are most useful if you have had back pain for less than 3 months and can provide short-term (most often) or long-term pain relief. These treatments aren't suitable for everybody and aren't always effective, so it's important to speak to your Doctor first.

Pain Clinics

Offer a range of treatments that are known to be effective and can also help you deal with your pain by changing the way you think about it. Treatments at pain clinics are often combined and tailored to suit your needs.

Injections

Painkillers and anti-inflammatory medicines (usually steroids) can be injected directly into the epidural space (the space around your spinal cord) or around the joints of your spine to ease pain and decrease inflammation. These injections are only given by Specialist Doctors in hospitals. Epidural injections are usually only done if other treatments don't work.

Surgery

Surgery is considered as a last resort in the treatment of back pain. The type of surgery you're offered will depend on the cause of your pain and each type has different risks and success rates. Your Surgeon will discuss the different options with you in more detail.

Complementary Therapies

The following may help with back pain in some people. You should talk to your Doctor before trying them as he/she may be able to refer you to a Specialist Practitioner experienced in treating back pain:

• Acupuncture.
• Counseling.
• The Alexander Technique – becoming more aware of your body's balance, posture and movement.
• Herbal remedies.
• Massage.

Prevention of Back Pain

• Take regular exercise – walking and swimming are particularly recommended.
• Try to reduce your stress levels – use relaxation techniques.
• Bend from your knees and hips and not your back.
• Maintain good posture – keep your shoulders back and don't slouch.
• Maintain a healthy weight.

Cancer Free at Any Age

Screening exams can diagnose cancer at the earliest stages, when treatment will be the most effective. Oncology recommends routine screening and/or self-exams for breast, prostate, colorectal, skin, testicular, and cervical cancers. The screening guidelines below offer recommended timing for specific ages, genders, and cancer types.

Adults at Every Age

• Keep an eye on your skin and check for changes in freckles, moles, and other skin markings once a month.
• Women should check their breasts for lumps every month and have a clinical breast exam every 1 – 3 years.
• Men should check both testicles for hard lumps or changes in size or shape every month.
• Individuals should be aware of their cancer risk, which may be higher for those with a personal or Family history of cancer, or people who have certain genetic profiles that have been associated with specific cancer types. Screening may need to begin at an earlier age for those with these risk factors.
• Research does not indicate the most appropriate age to begin cancer screening. Patients should consult their Physicians to make an informed decision about screening, considering the Patient's history and circumstances.

20s

• All Women should have a Pap smear test to screen for cervical cancer at least once every year beginning at age 21, or approximately 3 years after a Woman begins having sexual intercourse, whichever comes first, regardless of whether they have received the human papillomavirus (HPV) vaccine.

30s

• Women in their 30s should have annual Pap tests, but Women with 3 consecutive normal Pap tests may limit screenings to every 2 – 3 years. Women should also consider a DNA HPV test, which, given in conjunction with a routine Pap test, may identify existing HPV infections that could lead to cervical cancer.
• Women with a high risk for breast cancer (greater than 20%) associated with defined genetic profiles or Family history should discuss with their Physician the use of MRI for screening, in combination with a yearly mammogram. MRI screenings can help detect breast cancer in younger Women with dense breast tissue.

40s

• Women age 40 and older should begin having an annual mammogram, clinical breast exam, and if recommended by their Physician, an MRI screening.
• Women in their 40s should continue to have annual Pap tests, but Women with 3 consecutive normal Pap tests may limit screenings to every 2 – 3 years. Women may also consider a DNA HPV test.
• Men with a high risk of prostate cancer (African Americans and men with a Family history of prostate cancer before age 65) should discuss with their Physicians whether screenings are appropriate beginning at age 45.
• Men with a higher risk of prostate cancer (those with several immediate Family Members with prostate cancer) should discuss screenings with their Physicians beginning at age 40.
• Men and Women with increased risk factors for colorectal cancer should discuss with their Physician whether to begin screenings earlier than the normal age 50.

50s

• Women age 50 and older should continue having an annual mammogram, clinical breast exam, and if recommended by their Physician, an MRI screening.
• Women in their 50s should continue to have annual Pap tests, but Women with 3 consecutive normal Pap tests may limit screenings to every 2 – 3 years. Women may also consider a DNA HPV test.
• Beginning at age 50, Men should discuss with their Physicians the benefits and risks associated with prostate cancer screening to determine if it is right for them. Prostate cancer screening may involve a prostate-specific antigen (PSA) blood test and a digital rectal examination (DRE).
• Beginning at 50, both Men and Women should begin screening for colorectal cancer with 1of the following options:
  • Annual fecal occult blood tests (FOBT) or fecal immunochemical tests (FIT).
  • Every 5 years, a flexible sigmoidoscopy.
  • Every 5 years, a double-contrast barium enema.
  • Every 10 years, a colonoscopy.

Carpal Tunnel Syndrome

If you spend a lot of time doing activities that involve forceful or repetitive hand or wrist movement or use of vibrating equipment, you have an increased risk of developing Carpal Tunnel S Syndrome. These activities can include driving, working with small instruments, knitting, or using a sander. You can reduce your risk and any hand pain or weakness you may already have by

Studies indicate that 2 out of 3 Patients with mild to moderate Carpal Tunnel Symptoms were able to avoid surgery by using these exercises - twice the success rate of other non-surgical treatments. These exercises are more successful in Patients with mild symptoms, and are not recommended for Patients with severe symptoms. Patients who have persistent symptoms despite these exercises should discuss surgical treatment with their Physician.

Here are some exercises intended to help prevent Carpal Tunnel Syndrome. Remember doing a quick 5 minute exercise warm up before starting work, just as runners stretch before a run, can help prevent work-related injuries.

Diabetes - Exercise to Help

Diabetes mellitus (sometimes called "sugar diabetes") is a condition that occurs when the body can't use glucose (a type of sugar) normally. Glucose is the main source of energy for the body's cells. The levels of glucose in the blood are controlled by a hormone called insulin, which is made by the pancreas. Insulin helps glucose enter the cells.

In diabetes, the pancreas does not make enough insulin (Type 1 Diabetes) or the body can't respond normally to the insulin that is made (Type 2 Diabetes). This causes glucose levels in the blood to rise, leading to symptoms such as increased urination, extreme thirst and unexplained weight loss.

Physical activity is an important part of the diabetes management plan. During exercise the muscles use glucose for energy. Regular exercise improves response to insulin. This will help to reduce blood sugar levels and control weight.

Exercise in diabetics helps to control their bodies, gain strength, courage and confidence. Exercise improves circulation mainly arms and legs preventing diabetic complications like neuropathy, diabetic foot. It also reduces the risk of heart diseases, stroke found in diabetics. Light activities like house work, gardening or being on the extended feet for longer periods can lower the blood sugar.

Tips before starting exercises:

• Check with your Doctor before starting exercises.
• Adjust the diabetic treatment plan as needed.
• Check blood sugar level before and after exercise to see if there is any hypoglycemia (low blood sugar).
• Warm up before exercising and cool down afterward.
• Have a snack handy in case the blood sugar level drops too low.
• Use well fitted trainers to prevent blisters or sores on feet leading to infection and other problems.
• Drink plenty of fluids during workout.
• Stop exercises if you have breathlessness, dizziness, chest pain, excessive sweating.
• It is recommended to exercise at least 3 times a week for about 30 to 45 minutes.
• See that your blood sugar is reasonably controlled before starting exercises.
• Do not use heavy weights. Straining raises the blood pressure and damages the blood vessels.

Here are some exercises for diabetics:

• Aerobic exercises like walking, jogging, aerobic dance or bicycling. If there are problems in feet or legs, you may consider exercises like swimming, bicycling, rowing or chair exercises.
• Aerobic tap backs: Start with the feet together. Tap the right foot to the back and return to center, tap the left foot back and return to the center. Alternate tapping the right and left foot back as you press the both arms to the front.
• Lateral raises: Start with arms at your sides with the feet shoulder length apart. Stand tall with the head in line with the spine. Keep the hips neutral. Raise the right arm to the side and up to the shoulder height. Pause at the top and slowly lower the arm back down to the side. Repeat with left arm. Alternate lifting and lowering the right and left arms.
• Warm-up or cool down with a back rotation stretch. Lie on the back and slowly drop both knees to the tight side. Make the arms to reach to the opposite side and then turn your head in the direction of arms. Holding the stretch, slowly bring the knees to the center and then gradually drop them to the opposite side and reach out the arms in the opposite direction.

Lung Cancer Awareness Month

Lung cancer is a malignant lung disease primarily caused by cigarette smoking. It often has no obvious symptoms until the disease is quite advanced, and has a low rate of survival. Treatment for lung cancer mainly involves surgery and chemotherapy, while radiation therapy and targeted drug therapies may also be used.

What is lung cancer?

Lung cancer results from abnormal growth of cells in the lining of the lungs, leading to the growth of a malignant tumour.
There are two different types of lung cancer – small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) – which differ in terms of how they grow and spread to other parts of the body and how they’re treated. Lung cancer is usually fatal – the overall survival rate is about 16% at five years after diagnosis.

Causes

The development of lung cancer is strongly associated with cigarette smoking – approximately 90% of lung cancers are attributable to tobacco use. Pipe and cigar smoking can also cause lung cancer, but the risk is not as high as with cigarette smoking. Tobacco smoke contains more than 4,000 chemical compounds, many of which are cancer-causing (carcinogens).

Passive smoking, i.e. the inhalation of tobacco smoke by non-smokers who live or work with smokers, is also an established risk factor for the development of lung cancer.

Signs, symptoms, and diagnosis:

• Persistent cough and hoarseness
• Shortness of breath, wheezing, and chest pain
• Blood-streaked sputum
• Chest pain
• Frequent episodes of bronchitis or pneumonia
• Weight loss, weakness, and fatigue.

Prevention

The most effective measure that can be taken to prevent the development of lung cancer is to stop smoking. Reducing exposure to passive smoking is also an effective method of prevention.

Reference:- www.iaslc.org/lcam