June 16, 2011

The Genetic Cause of Back Pain

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June 16, 2011
Bottom Line's Daily Health News
In This Issue...
  • Does Your CoQ10 Really Work? If You’re Taking the Wrong Kind You May Be Wasting Your Money!
  • The Genetic Cause of Back Pain
  • The Shocking Truth About Prescription Drugs
  • What Your Body Language Says... Decoding Subtle Body Language Cues
  • Arthritis Abolished in Minutes by Doctor's Astonishing Speed Cure

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The Genetic Cause of Back Pain

I had never had a back problem in my life... until the day we moved from one house to another and I loaded and unloaded boxes for a day, a night (the better part of it anyway) and another day. Then the phone rang, and I stretched myself across multiple rows of boxes to grab it. When I tried to straighten up, I found that I couldn’t. So there I was, bent at roughly a right angle and in considerable pain. Luckily for me the injury was fairly minor and things returned to normal in a number of days. But I have never forgotten that sharp pain and how easily it all happened.

It turns out that 20% to 30% of Americans are suffering from lower back pain at any given time. (Millions and millions of us!) Often the pain comes from disc degeneration in the lumbar (lower) spine. Doctors had long assumed that the main causes were activities such as heavy lifting and physically demanding jobs. But guess what? New research shows that people with lumbar disc disease (LDD) usually get it for the same reason that their eyes are brown or blue -- it runs in the family. The University of Utah analyzed health and genealogic data for more than one million people in the Utah Population Database and discovered that those who have a first-degree relative (parent or sibling) with LDD are four times more likely to develop it as well!

Given my very personal interest in the topic, I called Peter Moley, MD, a physiatrist (specialist trained in rehabilitation) at the Hospital for Special Surgery in New York City, to learn more. Dr. Moley told me that what at first glance may seem to explain why disc degeneration runs in families -- the fact that family members tend to be "built" the same way, having similar physical structures -- in fact may have nothing to do with LDD risk. Neither do similar posture habits, he says, because how people stand doesn’t have much effect on the lower spine. The real culprit in family-related disc degeneration lies deeper -- some people might have a protein structure that predisposes them to disc injury and eventual degeneration. To understand how that works, we’ll first look at a bit of LDD’s back story (so to speak).

A Problem of Collagen

It is connective tissue made of collagen, called the annulus, that keeps the nucleus of each disc in its proper place in the spine and protects us against injury. Should this nucleus or "center" slip out of place, or bulge forward like a partially squished jelly doughnut, one can suffer with sciatica or other "slipped" disc pain. These collagen fibers not only protect the nucleus but also allow the spine to tolerate the compression force put on it when a person lifts heavy loads... as well as the shearing force that results from making perpendicular motions that angle the spine away from its usual vertical position. (Yes, that was my big mistake!)

Some portions of the spine tolerate compression force better, while others are better able to tolerate shearing, but in either case if the collagen fibers weaken and break down, the person is at high risk for a disc injury. This is where family makeup comes in -- before the Utah study, research in Finland and elsewhere had revealed a genetic linkage in the nature of the spine’s collagen and in fact identified two versions of a gene that directly impacts how strong -- or weak -- the collagen will be. Dr. Moley adds that the Finnish research had shown a high LLD risk among twins, but the sheer size of the University of Utah research revealed a much more powerful association than previously believed. "The risk of having disc degeneration is four times more likely for a first-degree relative and 1.5 times more likely for a third-degree relative, such as a cousin, for instance. It was quite an undertaking to review three generations of medical records and produce this data. It really opened our eyes," he says.

Stronger at the Core

Dr. Moley stresses the importance of everyone strengthening the lumbar spine area because that is where discs get the greatest pressure and hence the greatest risk for injury -- and families at higher risk should, of course, be particularly aware of this need. Most important is that they strengthen the core muscles in the pelvic and abdominal areas. Hip and leg strengthening helps to provide the solid support that the back needs, and back exercises are best done while lying down at first so there is less chance of straining the back. The second critical element in self-preservation is to be sure to practice an exercise program that teaches good body mechanics.

Working with physical therapists, Dr. Moley designs programs for clients to teach them how to move properly. As patients become stronger, they graduate to exercises on their hands and knees, raising an arm and a leg at the same time, for example, and doing the plank, a yoga position similar to holding a push-up, which activates multiple muscles and builds endurance. The final stage includes various standing balance and rotation exercises that further train people to keep their spines well-positioned during movement.

A Program for Life

Dr. Moley notes that 95% of people who complete his programs avoid the need for spinal surgery. If you have lower back pain, he advises calling an orthopedic or spine center to ask specifically for a doctor who specializes in nonsurgical spine work. Be sure you locate the best doctor for you, and don’t be timid if you feel the need for a second opinion. Once the doctor has completed work on your back, you will need to practice your exercises for life. Constant maintenance, yes, but it’s a small price for a strong spine and no more aching back!

Source(s):

Peter Moley, MD, assistant attending physiatrist, Hospital for Special Surgery, an assistant professor of rehabilitation, Weill Cornell Medical College, both in New York City.


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What Your Body Language Says...

Isn’t it funny -- we all have bodies... we all look at each others’ bodies all day long... and yet most of us aren’t really very good at understanding what other people’s bodies can tell us. Oh, sure, we can spot the obvious signals such as arms folded tightly over the chest -- communicating annoyance or displeasure -- but there are many other more subtle ways that people communicate their real feelings if you know what to look for. By learning a bit more about body language, not only can you communicate more effectively and enhance the impression that you make on others, but you can also spot untruths, anxiety, boredom or genuine enthusiasm and confidence in the person you are talking to!

To learn more about decoding body language, I called Janine Driver, president of the Body Language Institute in Alexandria, Virginia. Driver worked for more than 10 years at the federal Bureau of Alcohol, Tobacco, Firearms and Explosives, where she learned from research-based techniques to decipher body language signals as part of criminal investigations before writing her book, You Say More Than You Think. She shared some of her most useful "secrets"...

"Eye" Witnesses

Research from around the world has demonstrated that no matter where or how people live, whether in primitive tribal villages or multimillion-dollar mansions, our eyes reveal our emotions the same way. Driver told me, for instance, that police detectives are trained to look for a universal "burst of fear" signal, which is a dead giveaway that a person feels guilt -- and it’s easy to spot once you know to look for it. Guilty feelings cause your eyebrows to shoot straight up while remaining horizontal, while the eyes widen so much you can see the "three whites," i.e., the white around the top of the eyeball and on both sides. This is an example of a "micro expression" -- a facial change that happens in a fraction of a second, so quickly that if you didn’t know to look for it (or blinked), you would miss it.

On a happier note, Driver shared how to identify genuine surprise -- so you can tell, for instance, whether your friend really had no clue about that surprise party you planned for her. When a person is truly surprised, the eyes widen (though not as much as for guilt -- you won’t see the three whites) and the brows go up suddenly but retain their curved shape.

And here’s another crucial clue: If the feeling is genuine, the surprise response won’t last longer than three seconds -- it then merges into another layer of emotion, such as happiness or dismay. If the guest of honor retains the "I’m so surprised" look longer than that, somebody told.

Tilt Your Head... or Not

The way a person tilts his/her head speaks volumes. Holding your head level communicates that you have authority and certainty about what you are saying -- you’re "level-headed" and trustworthy. Therefore, Driver advises against tilting your head to the left or the right when you are speaking.

But, she said, it’s another matter altogether when you are listening. Tilting your head to the right stacks the odds that a person will think you look attractive -- useful on a blind date, for instance... while tilting slightly to the left makes you look more intelligent -- helpful at a job interview. This phenomenon is independent of right- or left-handedness and, as peculiar as it sounds (which it does), you’ll see that it works by testing it yourself in a mirror or by taking tilting-head photos of yourself. Driver says there are theories about why this works having to do with the different functions of the right and left sides of the brain, but no one really knows for sure.

Rise to the Occasion

Have you noticed that some people -- probably even you, at times -- seem to spontaneously rise onto their tiptoes, and not because something is blocking their view? This might happen, for example when you receive an unexpected phone call from a new love...or get the lowball price you have been negotiating on a new car. According to Driver, this is a sign of capability and enthusiasm. She calls it "defying gravity," surmising that people do this when they feel the earth is not strong enough to hold them down. "It is great to see this," she says. "It shows this is a happy, confident person."

In contrast, when a person is trying to appear confident but isn’t really feeling that way, you often will see the person cross his/her ankles.

There are of course many more silent signals. Once you start looking, you’ll be surprised at how much people tell you without saying a word!

Source(s):

Janine Driver, president and CEO of the Body Language Institute, Alexandria, Virginia, and author of You Say More Than You Think (Three Rivers).

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Be well,


Carole Jackson
Bottom Line's Daily Health News


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