Angina

What is Angina?

Angina pectoris is caused by an insufficient supply of oxygen to the heart muscle. Angina usually precedes a heart attack.

What are the Signs and Symptoms of Angina?

The characteristic symptoms are a squeezing or pressure-like pain in the chest occurring immediately after exertion. Angina can also be triggered by emotional tension, cold weather or large meals. Pain may radiate to the left shoulder blade, left arm or jaw. The pain typically lasts for only one to 20 minutes.

What Causes Angina?

Angina is almost always due to atherosclerosis—the build up of cholesterol-containing plaque that progressively narrows and ultimately blocks the blood vessels supplying the heart (the coronary arteries). This blockage results in a decreased supply of blood and oxygen to the heart tissue. When the flow of oxygen to the heart muscle is substantially reduced, or when there is an increased need by the heart, it results in angina.

Which Dietary Factors are Important in Angina?

I recommend the following diet to reduce the risk of angina and atherosclerosis:

• An abundance of plant food, including fruit, vegetables, breads, pasta, potatoes, beans, nuts and seeds
• Minimally processed foods, with a focus on seasonally fresh and locally grown products
• Fresh fruit as the typical daily dessert, with sweets containing concentrated sugars or honey consumed a few times per week at the most
• Daily consumption of dairy products, principally cheese and yogurt, in low to moderate amounts and in low-fat varieties
• Regular consumption of fish
• Moderate consumption of poultry and eggs—about one to four times weekly—or not at all
• Small, infrequent amounts of red meat
• Olive oil as the principal source of fat
• Wine in low to moderate amounts, normally with meals

The two components of the Mediterranean diet that have received a lot of attention are red wine and olive oil. Red wine is thought to be responsible for the “French paradox,” a term used to explain why the French consume more saturated fat than Americans, yet have a lower incidence of heart disease. This is thought to be the result of the flavonoids in red wine, which protect against oxidative damage to the arteries from LDL (bad) cholesterol.

In addition to oleic acid — a heart-protective monounsaturated fatty acid — olive oil also contains several antioxidant agents that prevent circulating LDL cholesterol from becoming damaged and then subsequently damaging the arteries. Olive oil lowers amounts of LDL cholesterol and increases the level of protective HDL cholesterol. It has also been proven to reduce elevated blood triglycerides (another risk factor for heart disease), though it is not as effective as fish oils.

Which Nutritional Supplements Should I Take for Angina?

Foundation Supplements. High potency multiple vitamin and mineral formula; Vitamin D3, Fish oil (Omega 3)

Magnesium deficiency plays a major role in many cases of angina, as it has been shown to produce spasms of the coronary arteries. Magnesium improves the delivery of oxygen to the heart muscle by relaxing the coronary artery as well as  by improving the production of energy within the heart muscle. Take 150 to 250 mg three times per day. Magnesium bound to aspartate, citrate, and malate is preferred to magnesium bound to oxide because of better absorption.

Coenzyme Q10 (CoQ10),  plays a major role in energy production within the heart. In one study, the frequency of angina attacks was reduced by 53 percent with CoQ10 supplementation.

Hawthorn (Crataegus sp.) berry and extracts of its flowering tops exhibit a combination of effects that are of great value to patients with angina and other heart problems. Studies have demonstrated that hawthorn extracts are effective in reducing angina attacks as well as in lowering blood pressure and serum cholesterol levels. For best results, use extracts containing either 10 percent procyanidins or 1.8 percent vitexin

Additional Recommendations

I want to stress that angina is a serious condition that requires careful treatment and monitoring. In severe cases, as well as in the initial stages of mild to moderate angina, prescription medications may be necessary. In my experience, in all but the most severe cases, eventually it is possible to control the condition without drugs with the help of natural measures. I would still recommend always having an emergency nitroglycerine tablet handy, just in case.

In severe cases of angina due to significant blockage of the coronary artery, angioplasty, coronary artery bypass or intravenous EDTA chelation therapy may be appropriate. EDTA is an amino acid-like molecule that, when slowly infused into the bloodstream, chelates (binds) with minerals such as calcium, iron, copper and lead and carries them to the kidneys, where they are excreted. EDTA chelation has been commonly used for lead poisoning, but in the late 1950s and early ’60s it was found to help patients with angina, peripheral vascular disease and cerebral vascular disease. For more information, contact the American College for the Advancement in Medicine (ACAM): 800-532-3688; www.acam.org.

How do I Know if the Recommendations are Working?

If you are experiencing angina, you will need to be monitored by a physician. My natural program is definitely indicated if you have angina, and will help conventional medications for angina such as nitroglycerine tablets work better. The program will help improve exercise tolerance and heart function.

CHEST PAIN

The first thing you may think of is heart attack. Certainly chest pain is not something to ignore. But you should know that it has many possible causes. Chest pain may also be caused by problems in your lungs, oesophagus, muscles, ribs, or nerves, for example. Some of these conditions are serious and life threatening. Others are not. If you have unexplained chest pain, the only way to confirm its cause is to have a doctor evaluate you.

You may feel chest pain anywhere from your neck to your upper abdomen. Depending on its cause, chest pain may be:

• Sharp
• Dull
• Burning
• Aching
• Stabbing
• A tight, squeezing, or crushing sensation. 

Here are some of the more common causes of chest pain

Chest Pain Causes: Heart Problems

Although not the only cause of chest pain, these heart problems are common causes:

Coronary Artery Disease, or CAD. A blockage in the heart blood vessels that reduces blood flow and oxygen to the heart muscle itself. This can cause pain known as angina. It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are a candidate for a heart attack at some point in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation. Angina can be triggered by exercise, excitement, or emotional distress and is relieved by rest.

Myocardial infarction (heart attack). This reduction in blood flow through heart blood vessels causes the death of heart muscle cells. Though similar to angina chest pain, a heart attack is usually a more severe, crushing pain usually in the center or left side of the chest and is not relieved by rest. Sweating, nausea, shortness of breath, or severe weakness may accompany the pain.

Myocarditis. In addition to chest pain, this heart muscle inflammation may cause fever, fatigue, fast heart beat, and trouble breathing. Although no blockage exists, myocarditis symptoms can resemble those of a heart attack.

What's Causing My Chest Pain?

Pericarditis:

This is an inflammation or infection of the sac around the heart. It can cause pain similar to that caused by angina. However, it often causes a sharp, steady pain along the upper neck and shoulder muscle. Sometimes it gets worse when you breathe, swallow food, or lie on your back.

Hypertrophic cardiomyopathy:

This genetic disease causes the heart muscle to grow abnormally thick. Sometimes this leads to problems with blood flow out of the heart. Chest pain and shortness of breath often occur with exercise. Over time, heart failure may occur when the heart muscle becomes very thickened. This makes the heart work harder to pump blood. Along with chest pain, this type of cardiomyopathy may cause dizziness, lightheadedness, fainting, and other symptoms.

Mitral valve prolapse:

Mitral valve prolapse is a condition in which a valve in the heart fails to close properly. A variety of symptoms have been associated with mitral valve prolapse, including chest pain, palpitations, and dizziness, although it can also have no symptoms, especially if the prolapse is mild.

Coronary artery dissection:

A variety of factors can cause this rare but deadly condition, which results when a tear develops in the coronary artery. It may cause a sudden severe pain with a tearing or ripping sensation that goes up into the neck, back, or abdomen.

Lung Problems

Problems with the lungs can cause a variety of types of chest pain. These are common causes of chest pain:

Pleuritis:

Also known as pleurisy, this condition is an inflammation or irritation of the lining of the lungs and chest. You likely feel a sharp pain when you breathe, cough, or sneeze. The most common causes of pleuritic chest pain are bacterial or viral infections, pulmonary embolism, and pneumothorax. Other less common causes include rheumatoid arthritis, lupus, and cancer.

Pneumonia or lung abscess:

These lung infections can cause pleuritic and other types of chest pain, such as a deep chest ache. Pneumonia often comes on suddenly, causing fever, chills, cough, and pus coughed up from the respiratory tract.

Pulmonary embolism:

When a blood clot travels through the bloodstream and lodges in the lungs, this can cause acute pleuritis, trouble breathing, and a rapid heartbeat. It may also cause fever and shock. Pulmonary embolism is more likely following deep vein thrombosis or after being immobile for several days following surgery or as a complication of cancer.

Pneumothorax:

Often caused by an injury to the chest, pneumothorax occurs when a part of the lung collapses, releasing air into the chest cavity. This can also cause pain that gets worse when you breathe as well as other symptoms, such as low blood pressure.

Pulmonary hypertension:

With chest pain resembling that of angina, this abnormally high blood pressure in the lung arteries makes the right side of the heart work too hard.

Asthma. Causing shortness of breath, wheezing, coughing, and sometimes chest pain, asthma is an inflammatory disorder of the airways.

Gastrointestinal Problems

Gastrointestinal problems can also cause chest pain and include:

Gastroesophageal reflux disease (GERD):

Also known as acid reflux, GERD occurs when stomach contents move back into the throat. This may cause a sour taste in the mouth and a burning sensation in the chest or throat, known as heartburn. Factors that may trigger acid reflux include obesity, smoking, pregnancy, and spicy or fatty foods. Heart pain and heartburn from acid reflux feel similar partly because the heart and esophagus are located close to each other and share a nerve network.

Esophageal contraction disorders:

Uncoordinated muscle contractions (spasms) and high-pressure contractions (nutcracker esophagus) are problems in the esophagus that can cause chest pain.

Esophageal hypersensitivity:

This occurs when the esophagus becomes very painful at the smallest change in pressure or exposure to acid. The cause of this sensitivity is unknown.

Esophageal rupture or perforation:

A sudden, severe chest pain following vomiting or a procedure involving the esophagus may be the sign of a rupture in the esophagus.

Peptic ulcers:

A vague recurring discomfort may be the result of these painful sores in the lining of the stomach or first part of the small intestine. More common in people who smoke, drink a lot of alcohol, or take pain-killers such as aspirin or NSAID’s, the pain often gets better when you eat or take antacids.

Hiatal hernia:

This common problem occurs when the top of the stomach pushes into the lower chest after eating. This often causes reflux symptoms, including heartburn or chest pain. The pain tends to get worse when you lie down.

Pancreatitis:

You may have pancreatitis if you have pain in the lower chest that is often worse when you lie flat and better when you lean forward.

Gallbladder problems:

After eating a fatty meal, do you have a sensation of fullness or pain in your right lower chest area or the right upper side of your abdomen? If so, your chest pain may due to a gallbladder problem.

Bone, Muscle, or Nerve Problems

Sometimes chest pain may result from overuse or an injury to the chest area from a fall or accident. Viruses can also cause pain in the chest area. Other causes of chest pain include:

Rib problems:

Pain from a rib fracture may worsen with deep breathing or coughing. It is often confined to one area and may feel sore when you press on it. The area where the ribs join the breastbone may also become inflamed.

Muscle strain:

Even really hard coughing can injure or inflame the muscles and tendons between the ribs and cause chest pain. The pain tends to persist and it worsens with activity.

Shingles:

Caused by the varicella zoster virus, shingles may prompt a sharp, band-like pain before a telltale rash appears several days later.

Other Potential Causes of Chest Pain

Another potential cause of chest pain is anxiety and panic attacks. Some associated symptoms can include dizziness, sensation of shortness of breath, palpitations, tingling sensations, and trembling.

When to See the Doctor for Chest Pain

When in doubt, call your doctor about any chest pain you have, especially if it comes on suddenly or is not relieved by anti-inflammatory medications or other self-care steps, such as changing your diet.

Call if you have any of these symptoms along with chest pain:

A sudden feeling of pressure, squeezing, tightness, or crushing under your breastbone

Chest pain that spreads to your jaw, left arm, or back

Sudden sharp chest pain with shortness of breath, especially after a long period of inactivity

Nausea, dizziness, rapid heart rate or rapid breathing, confusion, ashen color, or excessive sweating

Very low blood pressure or very low heart rate

Call your doctor if you have any of these symptoms:

Fever, chills, or coughing up yellow-green mucus

Problems swallowing

Severe chest pain that does not go away.

Back Pain

Back pain is a common reason for absence from work and doctor visits. Although back pain may be painful and uncomfortable, it is not usually serious.

Even though back pain can affect people of any age, it is significantly more common among adults aged between 35 and 55 years. Experts say that back pain is associated with the way our bones, muscles and ligaments in our backs work together.

Pain in the lower back may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdomen and pelvic internal organs, and the skin around the lumbar area. Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

Risk factors for back pain

A risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2.

The following factors are linked to a higher risk of developing low back pain:

§ A mentally stressful job
§ Pregnancy - pregnant women are much more likely to get back pain
§ A sedentary lifestyle
§ Age - older adults are more susceptible than young adults or children
§ Anxiety
§ Depression
§ Gender - back pain is more common among females than males
§ Obesity/overweight
§ Smoking
§ Strenuous physical exercise (especially if not done properly)
§ Strenuous physical work.

Signs and symptoms of back pain

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

The main symptom of back pain is, as the name suggests, an ache or pain anywhere on the back, and sometimes all the way down to the buttocks and legs. In most cases signs and symptoms clear up on their own within a short period.

If any of the following signs or symptoms accompanies a back pain your should see your doctor:

§ Weight loss
§ Elevated body temperature (fever)
§ Inflammation (swelling) on the back
§ Persistent back pain - lying down or resting does not help
§ Pain down the legs
§ Pain reaches below the knees
§ A recent injury, blow or trauma to your back
§ Urinary incontinence - you pee unintentionally (even small amounts)
§ Difficulty urinating - passing urine is hard
§ Fecal incontinence - you lose your bowel control (you poo unintentionally)
§ Numbness around the genitals
§ Numbness around the anus
§ Numbness around the buttocks.

According to the National Health Service (NHS), UK, the following groups of people should seek medical advice if they experience back pain:

§ People aged less than 20 and more than 55 years
§ Patients who have been taking steroids for a few months
§ Drug abusers
§ Patients with cancer
§ Patients who have had cancer
§ Patients with low immune systems.

Causes of back pain

The human back is composed of a complex structure of muscles, ligaments, tendons, disks and bones - the segments of our spine are cushioned with cartilage-like pads. Problems with any of these components can lead to back pain. In some cases of back pain, its cause is never found.

Strain - the most common causes of back pain are:

Lifting something in an improper manner is a common cause of back pain.

§ Strained muscles

§ Strained ligaments

§ Lifting something improperly

§ Lifting something that is too heavy

§ The result of an abrupt and awkward movement

§ A muscle spasm.

Structural problems - the following structural problems may also result in back pain:

Ruptured disks - each vertebra in our spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.

Bulging disks - in much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.

Sciatica - a sharp and shooting pain that travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.

Arthritis - patients with osteoarthritis commonly experience problems with the joints in the hips, lower back, knees and hands. In some cases spinal stenosis can develop - the space around the spinal cord narrows.

Abnormal curvature of the spine - if the spine curves in an unusual way the patient is more likely to experience back pain. An example is scoliosis, when the spine curves to the side.

Osteoporosis - bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.

Below are some other causes of back pain:

Cauda equina syndrome - the cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. People with cauda equine syndrome feel a dull pain in the lower back and upper buttocks, as well as analgesia (lack of feeling) in the buttocks, genitalia and thigh. There are sometimes bowel and bladder function disturbances.

Cancer of the spine - a tumor located on the spine may press against a nerve, resulting in back pain.

Infection of the spine - if the patient has an elevated body temperature (fever) as well as a tender warm area on the back, it could be caused by an infection of the spine.

Other infections - pelvic inflammatory disease (females), bladder or kidney infections.

Sleep disorders - individuals with sleep disorders are more likely to experience back pain, compared to others.

Shingles - an infection that can affect the nerves.

Bad mattress - if a mattress does not support specific parts of the body and keep the spine straight, there is a greater risk of developing back pain.

Everyday activities or poor posture.

Back pain can also be the result of some everyday activity or poor posture. Examples include:

We live in a world of computers. Adopting a very hunched sitting position when using computers can result in increased back and shoulder problems over time.

§ Bending awkwardly
§ Pushing something
§ Pulling something
§ Carrying something
§ Lifting something
§ Standing for long periods
§ Bending down for long periods
§ Twisting
§ Coughing
§ Sneezing
§ Muscle tension
§ Over-stretching
§ Sitting in a hunched position for long periods (e.g. when driving)
§ Long driving sessions without a break (even when not hunched).

Back Pain: Causes, Symptoms and Treatments

Diagnosing back pain

Most GPs (general practitioners, primary care physicians) will be able to diagnose back pain after carrying out a physical examination, and interviewing the patient. In the majority of cases imaging scans are not required.

If the doctor and/or patient suspect some injury to the back, tests may be ordered. Also, if the doctor suspects the back pain might be due to an underlying cause, or if the pain persists for too long, further tests may be recommended.

Suspected disc, nerve, tendon, and other problems - X-rays or some other imaging scan, such as a CT (computerized tomography) or MRI (magnetic resonance imaging) scan may be used to get a better view of the state of the soft tissues in the patient's back.

§ X-rays can show the alignment of the bones and whether the patient has arthritis or broken bones. They are not ideal for detecting problems with muscles, the spinal cord, nerves or disks.

§ MRI or CT scans - these are good for revealing herniated disks or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles and bones.

§ Bone scan - a bone scan may be used for detecting bone tumors or compression fractures caused by brittle bones (osteoporosis). The patient receives an injection of a tracer (a radioactive substance) into a vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera.

§ Electromyography or EMG - the electrical impulses produced by nerves in response to muscles is measured. This study can confirm nerve compression which may occur with a herniated disk or spinal stenosis (narrowing of the spinal canal).

The doctor may also order a blood test if infection is suspected.

Chiropractic, Osteopathy and Physical Therapy (UK: Physiotherapy)

A chiropractor manipulates and adjusts the back of a patient.

A chiropractor - the chiropractor will diagnose by touching (palpation) and a visual inspection. Chiropractic is known as a direct approach, with a strong focus on the adjustments of the spinal joints. Most good chiropractors will also want to see imaging scan results, as well as blood and urine tests.

An osteopath - the osteopathic approach also diagnoses by touching and a visual inspection. Osteopathy involves slow and rhythmic stretching (mobilization), pressure or indirect techniques and manipulations on joints and muscles.

A physical therapist (UK: physiotherapist) - a physical therapist's training focuses on diagnosing problems in the joints and soft tissues of the body.
Treatments for back pain

In the vast majority of cases back pain resolves itself without medical help - just with careful attention and home treatment. Pain can usually be addressed with OTC (over-the-counter, no prescription required) painkillers. Resting is helpful, but should not usually last more than a couple of days - too much rest may actually be counterproductive.

Usually back pain is categorized into two types:

Acute - back pain comes on suddenly and persists for a maximum of three months.

Chronic - the pain gradually develops over a longer period, lasts for over three months, and causes long-term problems.

A considerable percentage of patients with back pain experience both occasional bouts of more intense pain as well as more-or-less continuous mild back pain, making it harder for the doctor to determine whether they have acute or chronic back pain.

Injecting cells to regenerate spine discs - scientists from Duke University, North Carolina, developed new biomaterials that can deliver a booster shot of reparative cells to the nucleus pulposus, effective eliminating pain caused by degenerative disc disease.

If home treatments do not give the desired results, a doctor may recommend the following:

Medication - back pain that does not respond well to OTC painkillers may require a prescription NSAID (nonsteroidal anti-inflammatory drug). Codeine or hydrocodone - narcotics - may also be prescribed for short periods; they require close monitoring by the doctor.

Some tricyclic antidepressants, such as amitriptyline, have been shown to alleviate the symptoms of back pain, regardless of whether or not the patient has depression.

Physical Therapy (UK: physiotherapy) - the application of heat, ice, ultrasound and electrical stimulation, as well as some muscle-release techniques to the back muscles and soft tissues may help alleviate pain. As the pain subsides the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques on improving posture may also help. The patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence.

Cortisone injections - if the above-mentioned therapies are not effective enough, or if the pain reaches down to the patient's legs, cortisone may be injected into the epidural space (space around the spinal cord). Cortisone is an anti-inflammatory drug; it helps reduce inflammation around the nerve roots. According to The Mayo Clinic, the pain-relief effect will wear off after less than six weeks.

Injections may also be used to numb areas thought to be causing the pain. Botox (botulism toxin), according to some early studies, are thought to reduce pain by paralyzing sprained muscles in spasm. These injections are effective for about three to four months.

Surgery - surgery for back pain is very rare. If a patient has a herniated disk surgery may be an option, especially if there is persistent pain and nerve compression which can lead to muscle weakness. Examples of surgical procedures include:

Fusion - two vertebrae are joined together, with a gone graft inserted between them. The vertebrae are splinted together with metal plates, screws or cages. There is a significantly greater risk for arthritis to subsequently develop in the adjoining vertebrae.

Artificial disk - an artificial disk is inserted; it replaces the cushion between two vertebrae.

Discectomy (partially removing a disk) - a portion of a disk may be removed if it is irritating or pressing against a nerve.

Partially removing a vertebra - a small section of a vertebra may be removed if it is pinching the spinal cord or nerves.

CBT (Cognitive Behavioral Therapy) - according to some studies, CBT can help patients manage chronic back pain. The therapy is based on the principle that the way a person feels is, in part, dependent on the way they think about things. People who can be taught to train themselves to react in a different way to pain may experience less perceived pain. CBT may use relaxation techniques as well as strategies to maintain a positive attitude. Studies have found that patients with CBT tend to become more active and do exercise, resulting in a lower risk of back pain recurrence.

Complementary therapies

A large number of patients opt for complementary therapies, as well as conventional treatments; some opt just for complementary therapies.

According to the National Health Service (NHS), UK, chiropractic, osteopathy, shiatsu and acupuncture may help relieve back pain, as well as encouraging the patient to feel relaxed.

§ An osteopath specializes in treating the skeleton and muscles.
§ A chiropractor treats joint, muscle and bone problems - the main focus being the spine.
§ Shiatsu, also known as finger pressure therapy, is a type of massage where pressure is applied along    energy lines in the body. The shiatsu therapist applies pressure with his/her fingers, thumbs and          elbows.
§ Acupuncture, which originates from China, consists of inserting fine needles and specific points in      the body. Acupuncture can help the body release its natural painkillers - endorphins - as well as          stimulating nerve and muscle tissue.

Studies on complementary therapies are have given mixed results. Some people have experienced significant benefit, while others have not. It is important, when considering alternative therapies, to use a well-qualified and registered therapist.

TENS (transcutaneous electrical nerve stimulation) - a popular therapy for patients with chronic (long-term) back pain. The TENS machine delivers small electric pulses into the body through electrodes that are place on the skin. Experts believe TENS encourages the body to produce endorphins, and may possibly block pain signals returning to the brain. Studies on TENS have provided mixed results; some revealed no benefits, while others indicated that it could be helpful for some patients.

A TENS machine should be used under the direction of a doctor or health care professional.

Pregnant women, people with epilepsy, people with a pacemaker, and patients with a history of heart disease should not use a TENS machine.

Recent developments on treating back pain from MNT news

Acupuncture back pain success determined by psychological factors

According to new research, people being treated for lower back pain with acupuncture are likely to gain less benefit from the treatment if they have low expectations of how effective it is.

The study, published in The Journal of Clinical Pain, also suggests that patients who are positive about their back pain and feel in control of their symptoms go on to experience less back-related disability while receiving acupuncture.

High-frequency spinal cord stimulation 'more effective for chronic pain'

According to a study published in the journal Anesthesiology, a new high-frequency form of spinal cord stimulation therapy has the capacity to deliver more effective pain relief without any unwanted side effects.

Motor control exercise may help lower back pain

Targeting exercises to muscles that support and control the spine may help to reduce pain and disability caused by lower back pain, says research published in the Cochrane Review.
Preventing back pain

Steps to lower the risk of developing back pain consist mainly of addressing some of the risk factors.

Exercise - regular exercise helps build strength as well as keeping your body weight down. Experts say that low-impact aerobic activities are best; activities that do not strain or jerk the back. Before starting any exercise program, talk to a health care professional.

§ Core-strengthening exercises; exercises that work the abdominal and back muscles, help strengthen muscles which protect your back.
§ Flexibility - exercises aimed at improving flexibility in your hips and upper legs may help too.

Smoking - a significantly higher percentage of smokers have back pain incidences compared to non-smokers of the same age, height and weight.

Body weight - the fatter you are the greater your risk of developing back pain. The difference in back pain risk between obese and normal-weight individuals is considerable.

Posture when standing - make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet - keep your legs straight.

If you regularly use a computer, it is important to ensure you have a chair with good back support and adopt a good posture and head position.

Posture when sitting - a good seat should have good back support, arm rests and a swivel base (for working). When sitting try to keep your knees and hips level and keep your feet flat on the floor - if you can't, use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.

Lifting things - the secret for protecting your back when lifting things is to think "legs not back". In other words, use your legs to do the lifting, more than your back. Keep your back as straight as you can, keep your feet apart with one leg slightly forward so you can maintain balance, bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible. Bending your back initially is unavoidable, when you bend your back try not to stoop or squat, tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting; otherwise you will be using your back for most of the work.

Do not lift and twist at the same time. If something is particularly heavy, see if you can lift it with someone else. While you are lifting keep looking straight ahead, not up nor down, so that the back of your neck is like a continuous straight line from your spine.

Moving things - remember that it is better for your back to push things across the floor, rather than pulling them.

Shoes - flat shoes place less of a strain on the back.

Driving - it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks - get out of the car and walk around.

Your bed - you should have a mattress that keeps you spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle.

Dietary Supplements for Back Pain


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Tips to Avoid Diabetes Complications

Choose Carbs Carefully

Diabetes doesn't mean you have to cut carbs completely. Choose carbohydrates that break down in the body slowly, providing steady energy. Reach for whole grains, beans, nuts, and fresh vegetables and fruits. Yes, you can eat fruit even though it's sweet. It's about eating the right amounts of carbohydrates at each meal. A registered dietitian can help you learn how much is right for you.

Lose Weight If You Need To

Start small. If you are overweight, shedding just a few pounds can improve the body's ability to use insulin. It'll help lower your blood sugar and improve your blood pressure and blood fats. You'll also have more energy. Ready? Aim to burn more calories than you eat. To start, try cutting fat and calories from your diet, such as chips or fries.

Get Enough Sleep

Getting too much or too little sleep can increase your appetite and cravings for high-carb foods. That can lead to weight gain, increasing your risk for complications such as heart disease. So shoot for seven or eight hours of sleep a night. If you have sleep apnea, treating it can improve your sleep and lower your blood sugar levels.

Be Active: Exercise and Diabetes

Pick something you like -- walking, dancing, biking, or just marching in place while you're on the phone. Do it a half-hour a day; work up to that if you need to. Exercise can help you lower your cardiovascular risks, cholesterol, and blood pressure levels, and keep your weight down. Exercise also relieves stress and may help you cut back on diabetes medication.

Monitor Your Blood Sugar Daily

You know you're supposed to check it. And actually checking your blood glucose levels can help you avoid diabetes complications, like nerve pain, or keep them from getting worse. Checking it can also help you see how foods and activities affect you, and if your treatment plan is working. Your doctor can help you set a target glucose level range. The closer you get to your target, the better you'll feel.

Manage Stress

When you have diabetes, stress can cause your blood glucose levels to rise. Get rid of whatever physical or mental stresses you can. Learn coping techniques to deal with others. Relaxation techniques such as breathing exercises, yoga, and meditation may be especially effective if you have type 2 diabetes.

Say No to Salt

Reduce the salt in your diet. It may help lower blood pressure and protect your kidneys. Not salting the food on your plate may not be enough. Most of the salt in Americans' diets comes from processed foods. Avoid convenience foods and use fresh ingredients when you can. Season with herbs and spices instead of salt when you cook.

Adults age 51 and older, and individuals with high blood pressure, diabetes, or chronic kidney disease should talk with their doctor about how much to reduce their sodium intake. In general, people with diabetes should decrease to less than 2,300 mgs per day, however your doctor may recommend lower amounts.

Heart Disease Risk and Diabetes

Heart disease can be a serious diabetes complication. Keep an eye on your risk by getting these ABCs checked:

A1C level. This is a measure of your average blood sugar control for the last 2-3 months. You may need it checked two or more times a year. Talk to your doctor about setting a goal.

Blood pressure. Goal: below 140/80 mm Hg.

Cholesterol. Goal: LDL to 100 mg/d or lessl; HDL above 40 mg/dl in men and greater than 50 in women; and triglycerides below 150 mg/dl.

Take Care of Bumps and Bruises

Diabetes raises your risk of infection and slows healing, so treat even simple cuts and scrapes quickly. Properly clean your wound and use an antibiotic cream and sterile bandage. See a doctor if it's not better in a few days. Check your feet every day for blisters, cuts, sores, redness, or swelling. Moisturize them to prevent cracks.

Break Your Smoking Habit

People with diabetes who smoke are two times more likely to die prematurely than those who don't. Quitting helps your heart and lungs. It lowers your blood pressure and risk of stroke, heart attack, nerve damage, and kidney disease. Ask your doctor about help for quitting tobacco.

Pick Super Foods, Don't Supersize

There's no single diabetes diet. But here are basics to keep in mind: Enjoy super foods like berries, sweet potatoes, fish with omega-3 fatty acids, and dark green, leafy vegetables. Look at food labels and avoid saturated fat and trans fats. Instead, opt for mono and polyunsaturated fats like olive oil. A registered dietitian can give you personalized advice.

Set Up Doctor Visits

Expect to see your doctor two to four times a year. If you take insulin or need help balancing your blood sugar levels, you may need to visit more often. Also get a yearly physical and eye exam. You should be screened for eye, nerve, and kidney damage, and other complications. See a dentist twice a year. And be sure to tell all health care providers that you have diabetes.

Brief

Under normal circumstances, the glucose (sugar) levels in your blood rise after you eat a meal or snack. In response, the body produces a hormone called insulin, which is necessary in order for the body to convert glucose in your bloodstream into usable energy. But if insulin isn’t available, or if the body isn’t using it correctly, your blood glucose will remain elevated, and that can be harmful to your body. The latter describes diabetes mellitus, a serious health condition that affects millions of people. There are actually three variations of this disease, but all characterized by abnormally high levels of glucose in the bloodstream.

Type 1 Diabetes

This form of diabetes is an autoimmune disorder, meaning your own immune system is damaging your body and causing the disease. In type 1 diabetes, the immune system attacks and destroys cells of the pancreas (called beta cells), which are the only cells in the body that manufacture insulin. Type 1 diabetes used to be called “insulin-dependent” because people with Type 1 diabetes must take insulin via pump or injection to survive. It is sometimes called “juvenile-onset” diabetes, because it usually makes its appearance during childhood or young adulthood. Between 5% and 10% of people with diabetes have type 1, which doesn't have a cure. Type 1 diabetics must work to manage the disease for the rest of their lives.

Who’s at risk? 
No one knows exactly what causes type 1 diabetes. According to the Centers for Disease Control (CDC), the risk factors for developing type 1 diabetes include autoimmune, genetic, and environmental factors (such as viruses). While it’s most often diagnosed in children, type 1 diabetes can occur at any age and is most prevalent in Caucasians.

Can it be prevented? 
Unfortunately, there is no way to prevent this form of diabetes.

What are the symptoms? 
The destruction of the body’s beta cells can begin years before a person notices symptoms, which usually appear suddenly. These include: increased thirst and urination, persistent hunger, weight loss, blurred vision, and severe fatigue.

How is it treated? 
Since they can’t make insulin on their own, people with type 1 diabetes must supply the body with insulin by using a pump or injections. Without a steady supply of insulin, type 1 diabetics can develop diabetic ketoacidosis, a life-threatening condition.

Type 2 Diabetes
In the early stages of type 2 diabetes, the pancreas is still manufacturing insulin, but for some reason the cells of the body are not using it properly—a condition known as insulin resistance. In response, the pancreas produces more and more insulin, wearing itself out and eventually losing its ability to produce insulin to keep blood glucose levels in the normal range. Similar to type 1 diabetes, high levels of blood glucose result, making it difficult for the body to use this glucose as fuel. Type 2 diabetes used to be called “non-insulin-dependent” or “adult-onset” or diabetes, but more and more cases are being diagnosed in children. Between 90% and 95% of diabetes cases are type 2. Like individuals with type 1, type 2 diabetics must also work to manage the disease for the rest of their lives.

Who’s at risk? 
The risk factors for developing type 2 diabetes include advanced age, obesity (80% of people with type 2 diabetes are overweight), a family history of diabetes, a history of gestational diabetes (see below), physical inactivity, and race/ethnicity.  African Americans, Hispanic/Latino Americans, American Indians, Native Hawaiians and Pacific Islander Americans are at particularly high risk for type 2 diabetes.

Can it be prevented? 
There are many ways to prevent this form of diabetes. Eating a healthy diet and getting sensible amounts of physical activity to achieve and maintain a healthy weight can help prevent or delay the development of type 2 diabetes.

What are the symptoms? 
The symptoms of type 2 diabetes appear gradually, but some people who have type 2 diabetes won’t have any symptoms at all. Many symptoms are similar to those of type 1 diabetes, such as increased thirst, increased urination, weight loss, blurred vision and fatigue. Other signs include frequent infections and slow-healing wounds.

How is it treated? 
People with type 2 diabetes can control their blood glucose levels by following a healthy diet and exercise program, losing excess weight and using medication prescribed by their doctors.

Gestational Diabetes
Some women develop this form of diabetes during the third trimester of pregnancy, in which the body still manufactures insulin, but pregnancy hormones prevent insulin from working properly. Treatment is necessary to prevent the abnormally high blood sugar levels from injuring the fetus.

Who’s at risk? 
Gestational diabetes is more common among certain racial/ethnic groups (African Americans, Hispanic/Latino Americans, and American Indians). It also occurs more frequently among women who are over 25 years old, are obese, have a family history of diabetes, or have previously delivered a baby that weighed over 9 pounds. Although the gestational diabetes usually resolves itself after delivery, 5% to10% of women with gestational diabetes are diagnosed with type 2 diabetes after delivery, and 20% to 50% will develop type 2 diabetes within 10 years.

Can it be prevented? 
The risk for developing gestational diabetes can be lowered by losing excess weight and staying physically active prior to conception, and then continuing to make healthy food choices and staying physically active during pregnancy. Women who have been diagnosed with gestational diabetes can lower their risk for developing type 2 diabetes by continuing these healthy habits after delivery, breastfeeding their children, and visiting their doctors regularly for checkups.

What are the symptoms? 
Usually, gestational diabetes doesn’t have any symptoms. But when symptoms occur, they are very similar to those of both type 1 and type 2 diabetes: increased thirst and urination, persistent hunger, weight loss despite increases in appetite, blurred vision, and severe fatigue. Other signs include nausea, vomiting, and frequent infections to the bladder, vagina and/or skin.

How is it treated? 
Since gestational diabetes can be problematic to your baby’s health and increase the risk of complications during delivery, treatment must begin right after diagnosis. This usually involves close monitoring and control of blood glucose levels by following a special eating plan (developed by your doctor and/or registered dietitian) and getting regular exercise. Some treatment plans may also include diabetes pills or insulin injections, if prescribed by your doctor.

If left unchecked, all forms of diabetes can cause serious health  consequences. If you exhibit any of the symptoms of diabetes, or if you are at high-risk for developing it, talk to your doctor. It’s never too early to start a diabetes prevention program.

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Diabetes Type 1

Type 1 Diabetes Symptoms, Causes and Treatment

What Is Type 1 Diabetes?

Type I diabetes usually starts in childhood, but can occur in adults (30 to 40-year-olds). The pancreas cannot make insulin to help body cells convert sugar into energy, which causes the sugar to build up in the blood that can cause life-threatening complications. Individuals with type I diabetes must take some form of insulin for the rest of their lives.

Warning Sign: Unusual Thirst

Symptoms of type I diabetes may appear suddenly and can include the following:

·        Frequent urination (polyuria)

·        Drinking more water because of excessive thirst (polydipsia)

·        Feeling excessively hungry (polyphagia)

·        Dry mouth

·        Fruity breath

·        Fatigue

·        Weight loss

Warning Sign: Weight Loss

Because the blood sugar levels remain high and the body then metabolizes fat for energy, people with type I diabetes develop unintentional weight loss, and an increase in appetite. Because glucose metabolism is disrupted, they also feel a lack of energy and may be drowsy for extended periods.

  

Warning Sign: Skin Problems

The disruption in glucose metabolism in people with type I diabetes causes other problems such as a higher risk for bacterial infections, fungal infections, and skin changes that result in itching and dry skin. Poor blood circulation in the skin also may occur. Girls with type I diabetes are at risk for vaginal yeast infections, while babies who have the disease can develop severe diaper rash due to the yeast Candida albicans. The diaper rash can spread to other areas of the body such as the stomach and legs.

More Dangerous Signs

People with untreated type 1 diabetes can experience serious symptoms such as blurry vision, numbness or tingling in the extremities (especially the feet), loss of consciousness, and diabetic coma. In contrast to high sugars in the blood, occasionally people with type I diabetes can get low blood sugars (hypoglycemia) when their blood glucose level falls suddenly.

In people with type 1 diabetes loss of consciousness, diabetic coma, and in some cases hypoglycemia are medical emergencies. Some people who are undiagnosed may have no warning signs, yet still can develop diabetic coma or hypoglycemia.

More Dangerous Signs: Ketoacidosis

The problem with type I diabetes is that the person’s cells are deprived of the sugar they need for energy. Without the insulin produced by the pancreas, sugar has difficulty entering the body’s cells. Consequently, the body cells start burning fat for energy, which causes ketones to build up in the blood. These acids can change the person’s blood pH level and can trigger a life-threatening coma. This is termed diabetic ketoacidosis. Diabetic ketoacidosis is a medical emergency that needs to be treated quickly, usually in a hospital setting.

Type 1 vs. Type 2 Diabetes

In people with type I diabetes, the body’s immune system attacks and destroys pancreatic cells (Beta cells) that produce insulin. In people with type II diabetes, the pancreas is not attacked and usually produces insulin. However, people with type II diabetes, for numerous reasons, cannot use the available insulin effectively. People with type II diabetes can have the same symptoms as people with type I diabetes, but people with type I diabetes usually have the symptoms occur more rapidly

What Causes Type I Diabetes?

Researchers are not sure why a person's immune system attacks its own insulin producing cells. However, researchers and clinicians suspect that genetic susceptibility and environmental factors raise the risk for developing type I diabetes. Scientists have identified genes and gene regions that raise the risk of developing type I diabetes, but they are not the only factors that cause the disease. Researchers suggest that environmental triggers such as a viral infection or perhaps dietary or pregnancy-related factors may also play a role in developing type I diabetes.

Who Gets Type 1 Diabetes?

Although type I diabetes can develop at any age, about two-thirds of new cases are diagnosed in individuals under the age of 19. Researchers have noted two peak times for development of type I diabetes; the first is in early childhood and the second occurs at puberty. Type I diabetes affects males and females equally, and is more common in Caucasians than in other ethnic groups.

Diagnosing Type 1 Diabetes

Simple blood tests can indicate the presence of abnormal sugar levels in the blood. If a person has any symptoms of diabetes, a fasting blood sugar test or even a random blood sugar test is usually the first step in diagnosis. A hemoglobin A1c test can reveal average blood sugar levels for the past 2 to 3 months. In most cases these tests are repeated on at least two separate days. Other tests used are the glucose tolerance test or testing for certain specific antibodies in the blood.

Long-Term Complications

Unfortunately, undiagnosed or prolonged high blood sugar levels can result in damage to organ systems in the body over time. People with type I diabetes have a high risk of vision problems, heart disease, stroke, kidney failure, gum disease, tooth loss, and nerve damage (especially in the hands and feet). Other organs may also be damaged.

Monitoring Your Blood Sugar

For people with diabetes, complications that can damage organ can be prevented or reduced by regulating their blood sugar (glucose level). This is done by pricking the finger and putting a drop of blood on a test strip. The strip is in placed in a monitor that reads the glucose level. Close monitoring of glucose levels allows the individual to regulate their blood sugar by either medication if the sugar is high, or taking in sugar if the level is low. If a person with diabetes is able to keep blood sugar level in or near the normal range, they will decrease the likelihood of developing complications and have more energy and fewer problems related to diabetes.

 

Continuous Glucose Monitoring

Another device that measures glucose is termed a continuous glucose monitoring system. Although it’s not designed for day-to-day monitoring or long-term use, it is designed to discover trends in blood sugar levels. It’s a cell phone sized device that records an average glucose value every five minutes for about 72 hours.

Diabetes Treatment: Insulin Shots

Every person with type I diabetes needs to take insulin to help their body process sugar in the blood. Most people with type 1 diabetes take insulin in the injectable form and require several shots per day. You and your doctor can adjust your insulin shots based on results of blood sugar testing. As stated previously, the goal is to keep glucose levels in the blood within normal range as often as possible.

Insulin Reaction Warning Signs

Although insulin is a wonderful drug that helps people with diabetes, it needs to be used carefully. If a person takes too much insulin it is possible the blood sugar level will lower into dangerous levels. This situation is termed an insulin reaction (low blood sugar due to excessive insulin). Too much insulin can result in symptoms that may be mild, moderate, or severe, depending on how low and how long the low blood sugar levels exist in a person's blood. Some signs and symptoms of low blood sugar include fatigue, excessive yawning, mild confusion, decreased coordination, sweating, muscle twitching, and pale skin. As these symptoms get progressively worse, seizures, loss of consciousness, and even death may occur.

Neutralizing an Insulin Reaction

Although most people with diabetes who take insulin daily are careful, mistakes can result in an insulin reaction (low blood sugar). People with diabetes, especially type I diabetes, are advised to carry about 15 grams of a quick-acting carbohydrate at all times. Quick-acting carbohydrates are foods or drinks containing glucose that is rapidly absorbed into the body and the blood. Examples include a half-cup of fruit juice or a non-diet soda, five Life Savers (small hard candies), two tablespoons of raisins, one cup of milk, or three glucose tablets. These carbohydrates may resolve mild to moderate insulin reactions. For severe reactions, a drug called glucagon should be injected under the skin by a family member or friend familiar with treating severe insulin reactions and the person should be seen by a medical health care professional.

Diabetes Treatment: Insulin Pump

Although many people administer insulin through several shots per day, some people may be able to utilize an insulin pump. This pump delivers insulin round-the-clock by pushing insulin through a thin tube inserted into the person's skin. People with diabetes are encouraged to discuss the advantages and disadvantages of this insulin delivery system with their doctor.

How Well Is Your Treatment Working?

There is a test called the hemoglobin A1c blood test that is used to help determine how well a person is managing their blood glucose levels. This test measures how well the blood sugar has been controlled over about a 2 to 3 month time span. If the results show poor blood sugar control (high A1c levels), it suggests that the person's insulin therapy, dietary habits, and/or physical activity be modified to lower blood sugar levels into a more normal range.

Pancreatic Islet Cell Transplant

Some people with diabetes fail insulin therapy and may have reactions to the insulin that is injected. These people may be candidates for a procedure that some clinicians consider experimental. The procedure is a transfer of healthy insulin-producing cells from a donor into the pancreas of the patient with type I diabetes. Although there are benefits to this procedure, there are also drawbacks including medications with serious side effects that must be used to prevent rejection of the donor cells, and the probability that the transplanted cells may only function for a few years.

Type 1 Diabetes and Exercise

Most people benefit from exercise; people with type I diabetes also can benefit, but they need to take precautions to prevent sudden drops in blood glucose levels. People with type I diabetes should check their blood sugars before exercising, and may require eating a snack before or during exercise. In addition, they may need to adjust their insulin dosage before exercising to ensure they stay within normal ranges of blood glucose. People with type I diabetes also may need to check their urine for ketones – ketones suggest that your blood sugar is too high. Strenuous activity needs to be avoided if ketones are detected or if your blood sugar level is either high or low before exercise.

Type 1 Diabetes and Diet

People with type I diabetes, like everyone else, need to eat a well-balanced diet. This will help their insulin therapy and reduce the chance of diabetic complications. Even a person with type I diabetes can eat sweets as long as it is part of a well-balanced diet. That is not to say they can eat anything all the time – it means there are no foods people with diabetes should consider off-limits but they do need to consider how sweets (for example, a thin slice of pie) can fit into their well-balanced diet. Healthcare workers such as dietitians can help people with diabetes plan a well-balanced and varied diet.

Type 1 Diabetes and Pregnancy

Women with type I diabetes need to let their doctors know if they plan to become pregnant because if they are in poor control of their blood sugars, complications including birth defects may occur. Planning ahead, even before conception, to control blood sugar levels can lower the risk of miscarriage and birth defects. Good blood sugar control can reduce other complications during pregnancy such as high blood pressure or retinal damage in the mother.

Type 1 Diabetes in Children

Diagnosis of diabetes in children is a life-changing situation because it affects the whole family. Parents must help children monitor blood sugar and plan family meals that are appropriate for the child with diabetes and other family members. Insulin dosages must be monitored and blood sugar levels also need to be checked by child’s caregivers. Diabetes in children is a 24-hour-a-day problem that needs to be considered when a child is attending school and participating in extracurricular activities. Parents and their children need to make arrangements to follow through with insulin treatments even while the child is at school. These arrangements need to be planned in advance as not every state or school may participate in the child’s care the same way.

Hope for an Artificial Pancreas

Researchers are attempting to develop an artificial pancreas. This device is a combination of an insulin pump and continuous glucose monitoring system controlled by a computer program. The goal is for the system to release insulin in response to blood sugar levels and to reduce the release of insulin if blood sugar levels drop. The goal is to have a device that mimics the function of a normal pancreas. Some early trials of experimental devices suggest this device may be available in the future.

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