Back Pain and Aging

Back pain is extremely common in our society. In fact, almost 80% of adults in the United States will encounter some form of back pain in their lifetimes. There are many reasons why so many people experience back pain, including poor posture, poor body mechanics, overweight, excessive strain on the spine, smoking, poor diet, as well as spinal diseases and other health conditions, but the most common cause of back pain in our country is simply aging. Read on to find out why aging can be a real pain.

The Spine

The spine is made up of individual bones called vertebrae, which provide support for the body. In between each vertebra is a disc that gives the spine flexibility and serves as a shock absorber for the body. Discs are made up of a tire‑like outer band (called the annulus fibrosus) and a gel‑like inner substance (called the nucleus pulposus). Together, the vertebrae and the discs provide a protective tunnel (called the spinal canal) through which the spinal cord and spinal nerves pass through.

What happens when we age?

For many of us, several things begin to happen to our spines as we age. Our vertebrae begin to thicken and our discs start to loose moisture and shape. As a result, the spinal canal becomes narrower putting pressure on the spinal cord and nerve endings and causing pain, numbness, or weakness in the body. This condition is called spinal stenosis. While stenosis can affect people in their 20s and 30s, it is most commonly seen in older patients. Spinal stenosis is a degenerative condition, meaning the symptoms tend to be progressive, increasing in severity as the patient ages.

Symptoms of Spinal Stenosis

Spinal stenosis can occur in all areas of the spine, but occurs most often in the lumbar (lower back) and cervical (neck) areas. Patients with lumbar spinal stenosis may feel pain, weakness, or numbness in the legs, calves or buttocks. Symptoms often increase when walking short distances and decrease when sitting, bending forward, or lying down. Cervical spinal stenosis has similar symptoms in the shoulders, arms, and legs, and may also include hand clumsiness and gait and balance disturbances.

Treatment Options for Spinal Stenosis

The good news is that nearly 90 percent of spinal stenosis cases are successfully treated without surgery. Non‑surgical treatment options most commonly used for patients with stenosis include the following:

  

  $ Medications such as non‑steroidal anti‑inflammatory drugs (NSAIDs) to reduce swelling and pain, and analgesics to relieve pain.

  $ Corticosteroid injections (epidural steroids) to reduce swelling and treat acute pain.

  $ Rest or restricted activity (this may vary depending on extent of nerve involvement).

  $ Physical therapy and stretching and strengthening exercise to help stabilize the spine, restore   mobility, and increase flexibility.

• Chiropractic care and physical therapies.

Severe cases of spinal stenosis may require surgery. However, surgery should not be considered unless several months of non‑surgical treatments have been tried. The most common surgery used to treat stenosis is called decompressive laminectomy in which the laminae (bony plates located on the back of the vertebra) are removed to create more space in the spinal canal.

Don't Ignore Back Pain

With all of the treatment options available today, it's no longer necessary to accept back pain as a normal part of the aging process. Back pain, especially if it continues to get worse, includes bowel and bladder difficulties, or prevents you from participating in your everyday activities, should not be ignored. Talk to your physician or see a spine specialist. They will help you find a treatment plan that can return you to your pain‑free life once more.

Observation by George Carlin

 
The paradox of our time in history is that we have taller buildings but shorter 
tempers, wider Freeways, but narrower viewpoints. We spend more, but have less, 
we buy more, but enjoy less. We have bigger houses and smaller families, more 
conveniences, but less time. We have more degrees but less sense, more 
knowledge, but less judgment, more experts, yet more problems, more medicine, 
but less wellness. 
 
We drink too much, smoke too much, spend too recklessly, laugh too little, drive 
too fast, get too angry, stay up too late, get up too tired, read too little, 
watch TV too much, and pray too seldom. 
 
We have multiplied our possessions, but reduced our values. We talk too much, 
love too seldom, and hate too often. 
 
We've learned how to make a living, but not a life. We've added years to life 
not life to years. We've been all the way to the moon and back, but have trouble 
crossing the street to meet a new neighbor. We conquered outer space but not 
inner space. We've done larger things, but not better things. 
 
We've cleaned up the air, but polluted the soul. We've conquered the atom, but 
not our prejudice. We write more, but learn less. We plan more, but accomplish 
less. We've learned to rush, but not to wait. We build more computers to hold 
more information, to produce more copies than ever, but we communicate less and 
less. 
 
These are the times of fast foods and slow digestion, big men and small 
character, steep profits and shallow relationships. These are the days of two 
incomes but more divorce, fancier houses, but broken homes. These are days of 
quick trips, disposable diapers, throwaway morality, one night stands, 
overweight bodies, and pills that do everything from cheer, to quiet, to kill. 
It is a time when there is much in the showroom window and nothing in the 
stockroom. A time when technology can bring this letter to you, and a time when 
you can choose either to share this insight, or to just hit delete. 
 
Remember to spend some time with your loved ones, because they are not going to 
be around forever. 
 
Remember, say a kind word to someone who looks up to you in awe, because that 
little person soon will grow up and leave your side. 
 
Remember, to give a warm hug to the one next to you, because that is the only 
treasure you can give with your heart and it doesn't cost a cent. 
 
Remember, to say, 'I love you' to your partner and your loved ones, but most of 
all mean it. A kiss and an embrace will mend hurt when it comes from deep inside 
of you. 
 
Remember to hold hands and cherish the moment for someday that person will not 
be there again. 
 
Give time to love, give time to speak! And give time to share the precious 
thoughts in your mind. 
 
And always remember, life is not measured by the number of breaths we take, but 
by those moments that take our breath away. 
 
George Carlin 

Physiology of Sleep

The Physiology of Sleep
The 100 billion cells that make up our brain interact to become our thoughts, feelings, dreams, hopes, memories, movement and how you sleep. The master clock in the brain is called he suprachiasmatic nucleus or SCN. It regulates our circadian rhythm. Light regulates the master clock. The light passes through the pupils and ganglion cells relay the information to the SCN. When light passing through the pupils is inhibited, the SCN sends a signal to release melatonin. Levels of melatonin remain level throughout the night until interrupted by the light of the morning.

When you feel tired at night, that is determined in part when you are in the presence of sunlight in the morning. To keep the biological clock on a cycle, the brain needs input of sunlight through the eyes to reset itself each day. The tip here is to get natural light within one hour of being awake.

What happens in the brain when you are sleeping? The entire sleep cycle takes about 90 minutes and is then repeated: In stages 1 and 2, you first fall asleep, but are not in a deep-sleep state yet. During stages 3 and 4, you are in a deep, restful sleep. Your breathing and heart rate slow down, and your body remains still. In stage 5, your brain is active and you dream. Here's the entire 90-minute cycle: light sleep (lasts about 20 minutes), deep sleep, rapid eye movement (REM) sleep and repeat. It's interesting to note that your eyes move under your eyelids during REM sleep.

Deep sleep is crucial for immune system repair. Blood supply to muscles increases; tissue growth and repair occur; energy is restored; growth hormone is released, which is essential for growth and development, including muscle development; and other hormones are released, such as leptin and ghrelin, which keep your appetite in check, regulate fat storage and send signals to your brain when your stomach is full. UV damage also is repaired during deep sleep.

If you wake up during REM sleep, you might vividly remember your dreams. During REM sleep, our breathing becomes more rapid, irregular and shallow, and our eyes jerk rapidly in various directions. Our heart rate increases and our blood pressure rises.

REM sleep also allows our memory to improve. What's really important to understand here is that REM sleep promotes the consolidation of long-term memories for motor skills, facts and figures, and complex thought. If you are spending money on yourself or your child for a tutoring session (math, SAT prep, golf, tennis, soccer, swim lessons, etc.), and you / they don't get enough sleep, you are throwing money away!

One of the most important things that happens during sleep is that the brain's cells shrink. Researchers believe it's easier for brain cerebrospinal fluid (like lymphatic fluids) to flush out its many crevices. During sleep, proteins that could build up and become responsible for Alzheimer's disease and other neurological disorders are removed more efficiently from the brain than during waking hours. In this way, toxins and other waste products are washed out.

How Much Sleep Do We Need?

• A newborn baby might sleep 20 hours a day.
• By age 4, the average is 12 hours a day.
• By age 10, the average falls to 10 hours a day.
• Most adult people seem to need seven to nine hours of sleep a night, although after age 18, the sleep time necessary for optimal health / function becomes more individualized to the person.

Tips to Promote Healthy Sleep

When patients complain about being tired during the day, we talk about their sleeping habits. For most adults, it is essential to sleep for at least seven to eight hours every night. Some people need even more. There is evidence to suggest many people are biologically programmed to sleep not only for a long period in the middle of the night, but also for a short period in the middle of the day. Because of the sleep cycle, nap recommendations should include less than 30 minutes or a full 90 minutes (best option).

Here are some simple lifestyle changes / considerations to suggest to patients:

• Don't drink caffeine after 3 p.m.
• Keep alcohol consumption to one or two drinks with dinner, or eliminate consumption altogether.
• Turn off the TV, computer and cellphone at least an hour before bed so your brain has time to wind down, free of stimuli. Make sure all the lights are off (even cellphone screens, clock lights, etc.). If you need an eye mask, get one!
• Perform a calming activity such as reading, meditating, gentle stretching, or taking a bath an hour before bed.
• Don't eat dinner too late, especially if you're prone to digestive problems that keep you up at night.
• Go to sleep and wake up at the same time, even on weekends, so your body gets used to a regular sleeping pattern. Get early-morning light stimulation to reset your clock.
• Make sure your pillow adequately supports your neck and your mattress is comfortable.

Insomnia is often related to diet and lifestyle (too much caffeine and an overloaded calendar, which could potentially be disrupting diurnal cortisol rhythm). There are potential side effects of sleep drugs (Rufinamide, etc.), and although we cannot discourage someone from taking prescription medication, we certainly can recommend nutritional support and lifestyle approaches as first-line therapy.

Finally, a considerable number of patients seem to be taking prescription sleep aids. This seems unfortunate to me when we have many natural remedies to recommend. Prescription sleep drugs can cause severe allergic reactions and complex nighttime behavior that goes beyond sleepwalking.

Diet / Supplement Considerations

In terms of nutritional support, these are some of the common recommendations I offer to help patients maximize the quality and duration of their restorative sleep:

• Melatonin (1 mg per tablet; recommended dosage is 1-3 tablets, one hour before bedtime)
• Casein tryptic hydrolysate (enzymatically isolated decapeptide from whey milk that has natural, benzodiazepine-like properties)
• Passionflower extract (sedative and anxiolytic properties; similar mechanism of action as benzodiazepines)
• 5-HTP (the precursor for serotonin)
• Theanine and B vitamins to support balanced levels of GABA, serotonin, and dopamine, all of which are involved in regulating sleep
• DHA to support balanced levels of dopamine, GABA, and norepinephrine, which are important for cognitive function including memory formation and information consolidation during specific cycles of sleep
• Lavender scent or oils

An Aspirin A Day

America has become a "quick fix" country. We are told everyday on television to take some type of medication for "Menstrual Cramps? Take Midol! for "Backache?" Take Doan's Pills! for "Stomach Ache?" Take Pepto Bismol!"  VERY IGNORANT SUGGESTIONS!

But lately, there has been a new story in the health field, a medical "breakthrough". "An aspirin-a-day may help in reducing the risk of heart disease". Does an aspirin a day keep the doctor away? Is aspirin a safe drug?  Learn what an aspirin is and what it does and come to your own conclusion.

First, as you know, aspirin is an over the counter drug.What you may not know is that if aspirin were to be discovered today, it would likely require a prescription to get it. It's simply that strong. Aspirin has several effects on the body, but it is an ANALGESIC. That means it reduces or eliminates the body's perception of pain. It does so by releasing chemicals that "trick" the brain into believing that the cause of the pain is gone, which of course, it is NOT. So, as you can read, taking aspirin for symptom relief may keep the doctor away for a while, but your body could build up a tolerance to aspirin and you'll then need something stronger. Then you can go onto PRESCRIPTION drugs.

Aspirin is also an anti-pyretic. This means that it reduces a fever. It has chemical properties which tell the brain to decrease he body's temperature. Did you know that the body raises it's temperature for a reason? Harmful bacteria can not thrive 100 degrees, so the body raises it's temperature to kill the bacteria naturally, and without drugs. But we, in our infinite wisdom, take aspirin to kill to lower a fever (and penicillin to kill the bacteria).

What else aspirin does to the body? Aspirin is an acid. It's chemical name is acetylsalicylic acid. Because it is an acid, it often eats through the stomach's protective lining. So aspirin can, and does cause upset stomach's and if taken frequently, bleeding ulcers, No problem, you've got Tylenol, and Pepto Bismol.

Aspirin also thins the blood. That is the main reason M.D.'s say it's "good" for the heart. A thinner blood decreases the work load on the heart and lowers the chance of heart disease and it also decreases the chance of stroke by not allowing blood clots to form. Unfortunately, a thinner blood also means that the platelets, the blood clotting cells, are diminished, meaning that wounds heal slowly, and you bleed longer. Sadly, that bleeding ulcer may not heal, but they've got lots of "good" prescription drugs for ulcers.

So, what good is aspirin then. Does it cure headaches, back pain and heart disease? OF COURSE NOT! To cure something, it's cause must be eliminated. All drugs, not matter what the name, only relieve the symptoms. They seldom remove the cause of the problem. Sometimes, such as in a severe accident, or for surgical purposes, drugs are needed. But in most cases, there is a better more natural and less harmful way to obtain lasting relief. Despite the facts that aspirin is harmful, and that many medications have serious side effects, you will still go to your medicine cabinet and get temporary relief by covering up your symptoms, rather than finding the cause of your problem and getting lasting relief.

But, why take drugs when you don't have to? Drugs make unhealthy people think they are healthy because they are free of symptoms. Don't go another day before you discover the CAUSE of your symptoms and see if there is a better and safer way of eliminating them.

An aspirin a day may keep the doctor away today, but tomorrow, .... well, beware!

.

Signs of Depression

 Is your life out of control? Find yourself covering up certain aspects of your life? For some people who are depressed, it is not uncommon for compulsive buying, drinking, and internet etc. One may believe it serves as a distraction or self-esteem booster. But all excessive activities are a short-lived high because it doesn't address underlying depression. Also be aware that certain activities could also be a sign of mania, in bipolar disorder.

Drinking Heavily

Nearly a third of people with major depression abuse alcohol.  If you feel that you need to drink to cope with anxiety and depression, you may be one of them.  Although a drink may seem like it provides a lift when you're down, alcohol is a depressant, so overdoing it can make depression episodes worse and more frequent.

Forgetfulness

Depression may be one reason for feeling foggy or forgetful. Studies show that prolonged depression or stress can raise the body's levels of cortisol. This can shrink or weaken the part of the brain associated with memory and learning. Depression-linked memory loss seems to be worse for older people. The good news: Treating depression may also improve depression-related memory problems.

Excessive Internet Use

Prefer virtual social interactions to real-life ones? Spending excessive amounts of time on the Internet? It may be a sign of depression. Studies have shown a link between high levels of depression and excessive Internet use. People who overuse the Internet tend to spend their time on pornography, online community, and game sites.

Binge Eating and Obesity

A 2010 study from the University of Alabama found that young adults who report being depressed tended to gain weight more around their waist -- a risk for heart disease. Other studies have linked depression with binge eating, particularly in middle-age people. Treating depression can help treat these problems.

Shoplifting

About a third of shoplifters suffer from depression. For some people who feel powerless and insignificant from depression, shoplifting provides feelings of power and importance.  It can also provide a rush to counter depression "numbness." For people who shoplift because they are depressed, these feelings are more important than the item they are stealing.

Back Pain

Got a backache that won't quit? Studies show that depression may be a risk factor for chronic lower back pain. One study showed that up to 42% of people with chronic lower back pain experienced depression before their back pain started. Yet depression can often go ignored or undiagnosed because people don't associate it with aches and pains. By the same token, having chronic pain puts you at risk for depression.

Risky Sexual Behavior

Depression is more commonly associated with lost libido than with an increased interest in sex. But some people use sex to cope with depression or stress. Increased promiscuity, infidelity, sexual obsession, and high-risk behavior such as unsafe sex can all be signs of depression. It can also reflect problems with impulse control or be a sign of mania in bipolar disorder. And they can have serious, negative effects on health and in your personal life.

Exaggerated Emotions

Often people who are depressed show little emotional expression. Other times, they show too much. They can be suddenly irritable or explosive. They may express exaggerated feelings of sadness, hopelessness, worry, or fear. The key is a sudden change in behavior. If a person who is usually flat with their feelings becomes hyperemotional, depression may be the cause.

Problem Gambling

Gambling can make you feel excited and revved up. But if you gamble more than recreationally, you may be depressed or you may suffer from a gambling addiction disorder. Problem gamblers are much more likely than others to be depressed and abuse alcohol. Many say they were anxious and depressed before they started gambling. No matter how much of a quick rush gambling causes, it won't provide the big payoff -- relief from depression.

Smoking

Having trouble quitting smoking? Being depressed doubles your risk of smoking. Heavy smoking – more than a pack a day – and having a cigarette within 5 minutes of waking are common habits among smokers who are depressed, according to the CDC. While depressed smokers are less likely to quit, they can. Quitting programs that use techniques similar to those used to treat depression, such as cognitive-behavioral therapy or antidepressant medications, seem to help.

Not Taking Care of Yourself

What does fastening your seatbelt have to do with depression? Suddenly neglecting basic self-care can be a sign of depression and low self-esteem. The signs may be as small as not buckling up or brushing your teeth or as big as skipping physical exams or not tending to chronic conditions such as heart disease or diabetes. Get help for your depression and you'll likely begin to take care of yourself again.

Eating Turkey Will NOT Make You Sleepy

Contrary to popular belief, eating turkey isn't the main reason you feel sleepy after a Thanksgiving feast.

The oft-repeated turkey myth stems from the fact that turkey contains the amino acid tryptophan, which forms the basis of brain chemicals that make people tired. But turkey isn't any more sleep-inducing than other foods. In fact, consuming large amounts of carbohydrates and alcohol may be the real cause of a post-Thanksgiving-meal snooze,experts say.

Tryptophan is a component of the brain chemical serotonin, which gets converted into the well-known sleep-inducing hormone melatonin. Poultry and many other foods also contain tryptophan, in similar amounts to that found in turkey. Gram for gram, cheddar cheese actually contains more tryptophan than turkey does.

But tryptophan competes with all of the body's other amino acids to enter the brain, through a strict gatekeeper known as the blood-brain barrier. It's the heaps of carbohydrates, the stuffing, potatoes and yams smothered in marshmallows, that are the true problem, according to medical experts. Consuming carbs triggers the release of insulin, which removes most amino acids from the blood, but not tryptophan, that dearth of competitors allows tryptophan to enter the brain and form serotonin and, ultimately, melatonin. (Melatonin can also be produced in the intestine, and a small amount of that may ultimately leak out into the bloodstream and end up in the brain, too.)

Basically, any big meal containing tryptophan and lots of carbohydrates can trigger sleepiness — not just turkey. And on Thanksgiving, many other factors contribute to feelings of tiredness, such as drinking alcohol. The holidays are also a time when people often take a break from their hard work.

When consumed on an empty stomach, tryptophan can lead to serotonin production and more vivid dreams. Tryptophan supplements were a popular sleep aid in the 1980's, but the U.S. Food and Drug Administration banned them in 1991.

5 Ways to Feel Better in the Morning

If your typical morning starts with your alarm clock’s harsh ringing startling you out of a sound sleep, two or three slaps on the snooze button, and an exhausted drag out of bed, it’s time for something better. Starting your day feeling miserable sets the tone for your entire morning, and often, your entire day. While the key to waking up feeling good is getting enough sleep to begin with – if you routinely go to bed later than you should, your mornings are bound to be tough – there are several easy ways to improve your mood and energy level right after waking up in the morning. In fact, you can feel better before you even get out of bed.

Start the Night Before
If you want to feel your best in the morning, start getting ready the night before. You’ll wake up feeling refreshed and ready for your day if you:

Follow a relaxing nighttime routine before bed.

• Eat a small snack within an hour of sleep time – a piece of fruit with yogurt, cereal with milk or crackers with peanut butter are all good choices that are just enough to keep your stomach satisfied overnight without keeping you awake.

• Drink a small cup of water before retiring for the night.

• Set out your clothes for the next day. You’ll wake up with one less thing to worry about.

Wake Up to Pleasing Sound and Natural Light
You might need an alarm clock to wake up on time for work, but that doesn’t mean you have to start your day with a harsh buzzing, ringing or blaring sound. Instead, use an alarm clock that awakens to you to your favorite music, nature sounds or the gentle chime of bells.

The first sound you hear in the morning should be a pleasant one.

For the best sleep, your bedroom should be as dark as possible during the night, but waking up with natural light helps your body maintain the circadian rhythms that regulate your body’s functions. If possible, leave your blinds open enough to admit morning sunshine.

If that isn’t an option, try a dawn simulator alarm clock or lamp attachment. Instead of a noisy alarm, these devices wake you up with light that simulates the rising sun by gently intensifying over a period of 30 or so minutes. As the light hits your closed eyelids, it stimulates your brain to awaken you naturally. It’s a lot more pleasant waking up to a lovely spring sunrise than the electronic blare of a traditional alarm.

Don’t Touch That Snooze Button!
Though it may be tempting to hit the snooze button for a few precious minutes longer in bed, resist the temptation. The snooze button is not your friend. In fact, hitting that snooze is likely to leave you feeling even more tired and irritable once you finally get up. Those few extra minutes allow you to drift into a doze, only to be abruptly awakened right as your brain is restarting the sleep cycle. The result is even worse fatigue and difficulty in getting out of bed. If it seems impossible to resist the lure of the snooze button, try setting your alarm clock across the room so you’re forced to get up just to shut it off. If you still struggle to get up, take an honest look at how much sleep you’re getting each night, and get to bed earlier if necessary.

Stretches You Can Do In Bed
Taking a few minutes for a gentle stretch before getting out of bed is a great way to start your day. You’ll wake up your muscles, give your circulation a boost, and ease any sleep-related stiffness or soreness. Here are five easy stretches you can try:

Long stretch: Lie on your back with your arms at your sides and your legs straight. Now reach your arms up past your head and point your toes towards the foot of the bed, lengthening your spine until you feel a nice stretch.

Back rock: Still on your back, bring your knees up against your chest, and hug your legs against your body. Now gently rock from side to side.

Side stretch: Sit up with your legs crossed. Reach both arms over your head, and interlink your fingers so your palms are facing upwards. Now slowly and gently rock from side to side, just enough to feel a pleasant stretch along your sides and arms.

Seated crawl: Still sitting cross-legged, “crawl” your fingers out in front of you, until you are stretched forward as far as you can comfortably reach without your rear leaving the bed. Slowly and gently sway from side to side, keeping your arms stretched out long. Let your hands roll back and forth with your movements.

Lift off: From your cross-legged seated position, reach both hands onto the bed behind you. Lean your head back, and lift your chest and hips upwards until your rear leaves the bed. Balance your weight on your palms for several seconds before releasing the stretch.

Get In a Good Mood
Finally, take two or three minutes to prepare your mind for the day ahead; not by thinking about all you need to accomplish or the problems of the day, but with a prayer, list of three things you are grateful for or short yoga session. Opening your day with a brief interlude of positive, reflective thought puts you in a good mood as you get out of bed and start your morning preparations.