Back Pain

Howard LeWine, M.D.

Bad weather isn’t to blame for your aching back

It’s not uncommon for people to blame the weather for making their arthritis or back pain flare up. A team of Australian researchers has one word for that: bunk. They followed nearly 1,000 people who were seen for acute low back pain in several Sydney primary care clinics noted the weather conditions when the back pain started, as well one week and one month earlier. And they found … nothing. No connection between back pain and temperature, rain, humidity, or air pressure. The results were published online in the journal Arthritis Care & Research. This isn’t the first word on the pain-weather connection, and won’t be the last. If animals can sense earthquakes, then it may be possible for people with back pain, arthritis, or other types of pain to sense changes in the weather that the rest of us don’t notice. But we need good proof.

Daniel DeNoon

Back pain often overdiagnosed and overtreated

What doctors call “routine” back pain can really, really hurt. Surprisingly, the best treatment is usually quite conservative—over-the-counter pain relievers, ice and heat, and gentle exercise. Yet for decades, many doctors have been ordering more and more unnecessary tests, narcotics, and referrals to surgery. A new study of 24,000 people treated for back pain from 1999 through 2010 shows that many were not treated according to established guidelines, which promote treatment with over-the-counter pain relievers and physical therapy when appropriate, and advise against early referral for MRI or CT scans, the use of narcotics, or early referral to other physicians for injections or surgery. For a first-time bout with low back pain, or another go-round with it, try cold and heat, rest followed by gentle exercise, and over-the-counter pain relievers, such as acetaminophen or an NSAID like aspirin, ibuprofen, or naproxen.

Daniel Pendick

Acupuncture is worth a try for chronic pain

Chronic pain in the muscles and joints can make life miserable. Standard treatments like ice and heat, anti-inflammatory medications, physical therapy, and appropriate exercises can often ease the pain. But when they don’t, acupuncture is an option with a good track record that’s worth considering. Research from an international team of experts adds to the evidence that it does provide real relief from common forms of pain. The team pooled the results of 29 studies involving nearly 18,000 participants. Overall, acupuncture relieved pain by about 50%. The study isn’t the last word on the issue, but it is one of the best quality studies to date and has made an impression. For new pain, an acupuncturist should not always be the first stop. It’s important to get a clear diagnosis of what is causing the pain to rule out serious medical conditions that should be treated right away—and then seek out acupuncture if appropriate.

Edward Phillips, M.D.

Build your core muscles for a healthier, more active future

Many exercise programs these days spotlight the ever-present abs (abdominal muscles) but pay little attention to the other muscles that form the body’s core. Yet building up all of your core muscles is essential for staying strong and flexible and improving performance in almost any sport. It’s also vital for sidestepping debilitating back pain. Your core includes your back, side, pelvic, and buttock muscles, as well as the abdominal muscles. The core forms a sturdy central link between your upper and lower body. Much like the trunk of a tree, core muscles need to be strong yet flexible. A strong, flexible core underpins almost everything you do, from everyday actions like bending to put on shoes to on-the-job tasks, sports and sexual activity, and more. A strong core can also help you keep your back healthy or recover from back pain. It’s unwise to aim all your efforts at developing rippling abs. Overtraining abdominal muscles while snubbing muscles of the back and hip can set you up for injuries and cut athletic prowess.

Heidi Godman

4 tips for preventing neck strain when using a tablet computer

For all too many people, using a tablet computer is a pain in the neck, shoulders, and back. Why? Widely popular tablets like the iPad, Nook, Kindle Fire, and Xoom are so light and easy to handle that you can hold one on your lap or in your hand. That can put you in a position that’s bad for your neck, shoulders, and back. In a study of 15 experienced tablet users, Harvard School of Public Health researchers found that working with a tablet held on the lap or placed flat on a table makes the neck bend much more than does working with a desktop or notebook computer. Neck-wise, the best tablet orientation was having it propped up on a table. Next time you expect to be working with a tablet computer for more than a few minutes, place it on a table and use a case that holds it at a comfortable viewing angle. Shift your hands, your weight, or even stand up when you can. And take a break every 15 minutes.

Julie Silver, M.D.

Chicken Soup for the Soul and Harvard Health serve up inspiration, information

A new series of books is bringing readers the kind of inspirational stories that have made Chicken Soup for the Soul books international bestsellers plus with trusted health advice from Harvard Medical School. The combination of stories providing hope, inspiration, and great person-to-person advice plus straight talk and life-changing medical information from Harvard doctors will help readers live healthier, more satisfying lives. Each book focuses on a single topic. The first four will be available beginning May 22, 2012. They are Chicken Soup for the Soul: Boost Your Brain Power! by top neurologist Dr. Marie Pasinski; Chicken Soup for the Soul: Say Goodbye to Back Pain! by leading physical medicine expert Dr. Julie Silver; Chicken Soup for the Soul: Say Goodbye to Stress! by noted psychologist Dr. Jeff Brown; and Chicken Soup for the Soul: Say Hello to a Better Body! by respected internist Dr. Suzanne Koven.

Kay Cahill Allison

Treating neck pain with a dose of exercise

For neck and shoulder pain, doctors once recommended rest, maybe the use of a neck brace, and waiting until the pain had ebbed away. Today there are recommending movement instead of rest. As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publications, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain) results from controlled studies show that exercise provides some relief. Exactly how much exercise to do, what types are best, and how often it should be done have yet to be completely hashed out.

Peter Wehrwein

Yoga can help ease low back pain

Two new studies, one from the United Kingdom and one from Seattle, show that people with lower back pain may get some relief by regularly doing yoga. In the British study, yoga classes were more effective than standard care at improving “back function,” meaning it reduced back-related problems that interfered with everyday activities like walking, standing, climbing stairs, and so on. In the Seattle study, yoga was just as good as special stretching classes designed for people with low back pain. In the real world, it’s probably easier to find a yoga class than a stretching class designed specifically for low back pain. While yoga is generally safe, if you want to use it to treat something like low back pain, talk it over with your doctor first—in both studies, yoga made back pain worse for a small percentage of people.

Ann MacDonald

What to do when health problems or medical treatments thwart your love life

Health problems, or treatments for them, sometimes thwart sexual desire and sexual function. There may not be a quick fix for health-related sexual problems, but there are things you can do to enjoy your love life while taking care of the rest of your health.

Anthony Komaroff, M.D.

This week from HHP: Health apps, office noise, and hemorrhoid cream for the eyes?

As usual, Harvard Health Publications’ writers and editors have been busy covering a range of health topics. Here is a small sampling. To read more, visit us at www.health.harvard.edu. Health apps. Smart phones like the iPhone and Android aren’t just phones. They are also pocket-sized computers capable of running sophisticated applications, or apps. Hundreds of […]