Keep The Spring In Your Step--Tips For A Healthy Back and Joints
Keep The Spring In Your Step--Tips For A Healthy Back and Joints If you are one of the many who feel a back or knee twinge during your daily activities, this month’s issue is for you. To get you kicking up your heels again, the following lifestyle and nutritional changes may help.
Low Back Pain Low back pain may be a steady ache or a sharp, acute pain that is worse with movement. The low back supports most of the body’s weight and is susceptible to pain caused by injury or other problems. Over 80% of adults experience low back pain sometime during their lives, and more than half will have a repeat episode.
It is often difficult to pinpoint the root of low back pain, though poor muscle tone, joint problems, and torn muscles or ligaments are common causes. A herniated or slipped disc may also cause low back pain as well as sciatica, a condition where pain travels down one or both buttocks and/or legs. Standing or sitting for extended periods, wearing high heels, and being sedentary increase the risk of developing low back pain, as do obesity and back strain due to improper lifting. Up to half of pregnant women experience some low back pain. Long hours spent driving a car may contribute to a herniated disc.
Lifestyle changes that may be helpful Preliminary data indicate that smoking may contribute to low back pain. Smaller people (children, women, those who weigh less) are most affected. Smoking is thought to cause malnutrition of spinal discs, which in turn makes them more vulnerable to mechanical stress.
Regular exercise and proper lifting techniques help prevent low back problems from developing (See Everyday Answers on page 4). Therapeutic exercise helps people recover from low back pain and low back surgery. The best type of exercise, frequency, duration, and timing of a program still need to be determined.
While heavy lifting and other strenuous labor may contribute to low back pain, one trial found that people with sedentary jobs gained more benefit from an exercise program than those who have physically hard or moderate occupations. People with low back pain who wish to begin an exercise program should first consult with a physical therapist or other practitioner skilled in this area.
General recommendations for people recuperating from low back pain include wearing low-heeled comfortable shoes, sitting in chairs with good lower back support, using work surfaces that are a comfortable height, resting one foot on a low stool if standing for long periods, and supporting the low back during long periods of driving.
Nutritional supplements that may be helpful Three double-blind trials have investigated the effects of supplementing a combination of the enzymes trypsin and chymotrypsin for seven to ten days on severe low back pain with or without accompanying leg pain. Eight tablets per day were given initially in all trials, but in two trials the number of pills was reduced to four per day after two to three days.
Herbs that may be helpful Willow bark is traditionally used for pain and conditions of inflammation. According to one controlled clinical trial, use of high amounts of willow bark extract may help people with low back pain. One trial found 240 mg of salicin from a willow extract to be more effective than 120 mg of salicin or a placebo for treating exacerbations of low back pain.
Holistic approaches that may be helpful Acupuncture and spinal manipulation may be helpful. Practitioners who perform spinal manipulation include chiropractors, some osteopaths, and some physical therapists. Many practitioners use massage in combination with other physical therapies, such as spinal manipulation or therapeutic exercise.
Osteoarthritis Once called “wear-and-tear” arthritis, OA is a disease characterized by progressive degeneration of the cartilage that lines the joints. The loss of this cartilage may be accompanied by pain, stiffness, swelling, decreased motion of the affected joints, and creaking of the joints (crepitus). The onset of OA is gradual and most often affects the hips, knees, fingers, and spine, although other joints also may be involved. Repetitive overuse of a particular joint may lead to OA. Pain is the main symptom, which usually worsens with exercise and is relieved by rest. Morning stiffness is also common and diminishes with movement.
Lifestyle changes that may be helpful Obesity increases the risk of OA developing in weight-bearing joints, and weight loss in women is associated with reduced risk for developing OA. Weight loss is also thought to reduce the pain of existing OA.
Nutritional supplements that may be helpful Glucosamine sulfate (GS) is a building block needed for the synthesis and repair of joint cartilage. GS supplementation has significantly reduced symptoms of OA in double-blind trials. Most research trials use 500 mg GS taken three times per day. GS does not cure people with osteoarthritis, and they may need to take the supplement for the rest of their lives in order to maintain benefits. Fortunately, GS appears to be virtually free of side effects, even after three or more years of supplementation. Benefits from GS generally become evident after three to eight weeks of treatment.
Chondroitin sulfate (CS) is a major component of the lining of joints which may help restore joint function in people with OA. Strong clinical evidence supports the use of oral CS supplements for OA. Many double-blind trials have shown that CS supplementation consistently reduces pain, increases joint mobility, and/or shows evidence of healing within joints of people with OA. Most trials have used 400 mg of CS taken two to three times per day.
S-adenosyl methionine (SAMe) possesses anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints. Many double-blind trials have used 1,200 mg of SAMe per day. A two-year, uncontrolled trial also showed significant improvement of symptoms after two weeks at 600 mg SAMe daily, followed by 400 mg daily thereafter. A review of the clinical trials on SAMe concluded that its efficacy against OA was similar to that of conventional drugs but that patients tolerated it better.
In the 1990s, a double-blind trial confirmed a reduction in symptoms from niacinamide within 12 weeks of beginning supplementation. Although amounts used have varied from trial to trial, many doctors recommend 250 to 500 mg of niacinamide four or more times per day (with the higher amounts reserved for people with more advanced arthritis).
Herbs that may be helpful Several double-blind trials have shown that topical use of cayenne extract creams containing 0.025 to 0.075% capsaicin reduces pain and tenderness caused by OA. These creams are typically applied four times daily for two to four weeks, after which twice daily application may be sufficient.
Ginger has historically been used for arthritis and rheumatism. A double-blind trial found ginger extract (170 mg three times a day for three weeks) to be slightly more effective than placebo at relieving pain in people with OA of the hip or knee. In another double-blind study, a concentrated extract of ginger, taken in the amount of 255 mg twice daily for six weeks, was significantly more effective than a placebo for pain relief and overall improvement.
Cat’s claw has been used traditionally for OA. In a double-blind trial, 100 mg per day of a freeze-dried preparation of cat’s claw taken for four weeks was significantly more effective than a placebo at relieving pain and improving the overall condition.