The truth about sports, nutrition and pain!

Archive for January, 2015

The Fear of Back pain !!

I have already done quite a few blogs on back pain (Part 1, 2 , 3) but the myths surrounding it still continue, so I decided to do one more.

80% of us will probably experience an episode of back pain at one point or another in our life (some studies say that it is even more) (1-3). So, if you think about it, back pain is very common. In fact, to not experience back pain at some point in our life would be quite abnormal. And it doesn´t matter if you have strong or weak abdominals, or if you have too much flexibility or too little, or if one leg is larger than the other, or if you walk in a funny way, none of these factors will influence you experiencing an episode of back pain (4-8). To tell you the truth, the biggest factor for developing back pain is a history of back pain!!! (9). Sounds crazy but it is true.

So, instead of focusing on prevention of back pain (which we have already done for the last 20 years and nothing has changed), maybe we should focus on ¨how do I prevent my back pain from lasting so long¨. You see, when they experience back pain people get really scared, and get fearful of movement, which are two things that can actually make the back pain worse (10-11). Remember, we know the body needs movement to heal. Disk and cartilage etc. need movement to get their blood supply. So in most cases we should try and keep movement. Only when the pain is really bad should we rest but that rest should never be longer than 2 days (12). Pain does not equal tissue damage and it can be influenced by stress, beliefs, fears, anxiety and a thousand other things (as I have stated in previous blogs click here). Our body, including our back, is a wonderful strong machine. We have to start changing our beliefs around the idea that our back can get damaged easily or that our back is vulnerable.

In conclusion, we will all probably experience an episode of back pain in the coming weeks, months, years or whenever, just like we will probably experience a headache or a stomach pain. It is part of life and we shouldn´t get too worried. Studies say that 85-90% percent of the time we have back pain it is due to ¨non specific mechanical factors¨. This basically means we have no IDEA why your back hurts but it does. Only 2% of the time the pain is caused by a tumor, infection or a fracture and 8% due to a nerve compression (13-15). So next time your back hurts don´t be so afraid and keep moving. 😉

References

  1. Biering-Soeren2012 Feb 4;379(9814):482-91. doi: 10.1016/S0140-6736(11)60610-7. Epub 2011 Oct 6.se F. A prospective study of low back pain in a general population. Occurence, recurrence, and etiology. Scand S Rehabilitation Med 1983;19:71.
  2.  Balague F, Mannion AF, Pellise F, Cedraschi. Non-specific low back pain2012 Feb 4;379(9814):482-91. doi: 10.1016/S0140-67
  3. Hashemi L, Webster BS, Clancy EA, Volinn E. Length of disability and cost of workers compensation on low back pain claims. J Occup Environ Med 1998:40:261-66.
  4. Biering-Sorense F. Physical measurements as risk indicators for low-back trouble over a one-year period. Spine, 1984: 9:106-19.
  5. Battie MC, Bigos SJ, Fisher LD, Spengler DM, Hansson TH, Nachemson AL, Wortley MD. The role of spinal flexibility in back pain complaints within industry: A prospective study. Spine 1.
  6. Axler CT, Mcgill SM. Choosing the best abdominal exercises based on knowledge of tissue loads. Medicine and Science in Sports and Exercise. 1997: 29:804-11.
  7. Hellsing AL. Tightness of hamstring and psoas major muscles. Upsala Journal of Medical Science 1988. 93:267-76.
  8. Sandler R, Xuemei Su, TImothy C, Fritz S, Beattie P, Blari S. Are flexibility and muscle-strengthening activities associated with a higher risk of developing low back pain. Journal of Sciend and Medicine in Sporte. 2013.
  9. Taylor JB, Goode AP, George SZ, & Cook CE. Incidence and risk factores for first-time incident low back pain: a systematic review and meta-analysis. Spine Journal 2014
  10. Gheldof EL, Crombez G, Van den Brussche E, et al. Pain related fear predicts disability, but not pain severity: a pathway analytic approach of the fear avoidance model. Eur J Pain.2010;14:870
  11. Awinkkels-Meewisse IE, Roelofs J, Schouten EG, Verbeek AL, Oostendorp RQ, Vlaeyen JW. Fear of movemen/ re injury predicting chronic disabling low back pain: a prospective inception cohort study. Spine( Phila Pa 1976) 2006;31:658-664.
  12. Deyo RA, Diehl Ak, Rosenthal M. How many days of bed rest for acute low back pain? New England Journal of Medicine 1986;315:1064.
  13. Agency for HEalth Care Policy and Research (AHCPR). Acute low back problems in adults. Clinical Practice Guideline Number 19. Washington DC, US. Government Printing. 1994.
  14. Danish Health Technology Assessment (DIMTA). Manniche C, et al. Low back pain. Frequency Managemente and Prevention from an HAD. Perspective. 1991.
  15. Royal College of General Practioners (ACGP). Clinical Guideline for the management of Acute Low Back Pain. London Royal College of General Practicioner.1999
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What are ¨Detox Diets¨ and ¨Toxins¨ ?

I want to try to make this blog as simple as possible so that most people can understand these ¨myths¨ once and for all. Let us start by giving some definitions to these words.

Toxin-  It sounds quite scientific but nobody really knows what the hell it is. All these miracle diets will tell you that they will get rid of those nasty ¨toxins¨ but won´t give you an explanation of what they are or how they will get rid of them. If they had a name, the experts could measure these toxins to see if the miracle diets or the ¨detox diets¨ really work. In fact, in 2009 a network of scientist assembled by the UK charity SENSE about SCIENCE contacted the manufacturers of 15 products sold in pharmacies and supermarkets that claimed to ¨detoxify¨. When the scientists asked for evidence behind the claims, not one of the manufactures could define what they meant by detoxification, or toxins (1)!!

Detox- Also sounds really fancy and scientific but if we just made clear that we can´t measure these toxins or that they even exist, then how is a detox diet going to work? I mean what are they detoxifying??? In medical terminology, real detoxification refers to treatment for dangerous levels of drugs, alcohol, or poisons (to name a few examples) and the treatment usually occurs in the hospital. And guess what…. doctors can measure all these things.

But the best thing of all, and something that I have been stating all through my blogs, is that our body is the best machine we have and it is ready in case we have to ¨detoxify¨ ourselves, and for this it counts on lots of helpers like:

  • LIVER-  It is incredibly efficient at getting rid of noxious substances. It contains enzymes which convert toxic substances into less harmful ones. These are then dissolved in water and removed in the urine.
  • KIDNEYS- Are fundamental in removing acids and regulating the body pH.
  • COLON- Responsible for removing unwanted solid matter from the body.
  • LUNGS-  The respiratory system is also involved in controlling blood pH. We breathe out all that carbon dioxide we produce.
  • SKIN, DIGESTIVE TRACT, LYMPHATIC SYSTEM…….

So in other words, the body is perfectly capable of ¨detoxifying¨ itself and getting rid of all those nasty ¨toxins¨ (whatever those may be). And if it wasn´t capable of doing that you would be in lots of trouble and probably needed to go to the hospital.

But anyway, some people won´t believe this and will try different diets or different methods (colonic irragation to name one) to try to get rid of those ¨toxins¨. To those people I want to say that, before going out and wasting (I´m sorry, I wanted to say spending) your money on those treatments: try this new method, it involves exercising, eating properly and sleeping well 😉

References:

1. http://www.senseaboutscience.org/pages/debunking-detox.htm

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