Monthly Archives: August 2010

Integrating mind and body into medicine

It is exciting to see the medical community steadily moving towards a well-rounded, holistic approach to health care.

Dr. Herbert Benson is a great example. He heads the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. Benson and his institute are working to integrate mind/body medicine into all areas of health care.

Benson sees health care as a “three-legged stool”:  one leg is drugs, another being surgical procedures, and the third as self-care or mind/body medicine which he classifies as the following:

The relaxation response (ways to de-stress, such as meditation)

Positive coping (cognitive behavioral therapy)

Physical activity

Nutrition

Social support

What’s great about the Benson Institute is not only are they promoting stress management for patients, but are educating doctors and health care professionals on how to integrate mind/body medicine into their practices, rather than just offering the text-book drugs and surgical procedures.

A quote from their own site states:

Primary care physicians often are taxed by patient complaints that do not seem to have a clear etiology, nor do the patients improve despite good medications and expensive procedures. Current studies show that stress or distress may have a significant effect on the onset, the course, and the management of many, if not all, diseases. Understanding a patient’s underlying stress physiology and coping mechanisms may enable physicians to better understand various clinical disorders and treat their manifested symptoms. -Benson-Henry Institute

Dr. Benson’s most recent book: Relaxation Revolution: Enhancing Your Personal Health Through the Science and Genetics of Mind Body Healing is now available.

You can hear an interview with Dr. Benson on the Diane Rhames Show, broadcast earlier today.

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The changing shape of the ideal body

A 1935 ad reminds us it wasn’t so long ago that “skinny” was undesirable.

Our first reaction to the above ad is shock and horror.

How could anyone fall for this ?

But then, it is only fair to question…how could anyone fall for this?

Same worries, different times. The ideal feminine physique is ultimately defined by what we eat as a society at large. Let’s go on a time traveling adventure to witness the ongoing evolution of the beautiful body.

Start your flex capacitors…

It’s 1935.  The country is in the grip of the great depression. Meat is expensive, and produce, if it isn’t canned from the year before, comes from whatever is in season. Starchy, high fiber foods are added to every meal enhancing the feeling of fullness and staving off hunger. Sugar is a rare extravagance. Some are lucky enough to afford an annual sweet for Christmas, although many look forward to receiving the exotic gift of an orange on their pillow Christmas eve.

A curvy figure is the epitome of health. It equates to vitality, wealth, sexuality, and the ability to bear healthy children. Aphrodite incarnate.

Now time travel to 2010. Oh. Hold up. We are already there. In the past 100 years we have seen farm subsidies on corn and soy commodities, WWII, the boon of the 1950s, and better living through chemistry – which introduced chemically enhanced flavor to food while keeping it fresh longer, like high fructose corn syrup, partially hydrogenated things and msg…just to name the greatest hits.

Currently we are in the midst of another depression. Fresh fruits and vegetables, and local, organically raised meats are expensive. Wild fish prices continue to rise. Chemicals, new technologies, and processes make packaged food readily available and inexpensive.  So many chemicals are found in these inexpensive packaged foods, that often there is no “food” left at all.  As a nation, most of what we eat contains sugar. All things considered, it’s a rather bizarre obesity epidemic created in the US where often citizens are simultaneously overweight and malnourished.

Now, in 2010, aphrodite looks something like this:

Being skinny now embodies a certain attitude towards health. Skinny now equates to health, energy, financial success,  happiness, sexuality, and youth. It says, “I have time to exercise and take care of myself.”

This is not to be a comment on whether it is right or wrong, just that it is. Standards of beauty have been alive and well in humanity since the dawn of time. We are instinctively hardwired to aspire to a certain ideal, whatever it may be at that time.

Societal ideals will continue to exist. Seeing beyond the cultural ideal takes strength and vision, but it also coincides with our favorite approach to health  – the moderate one.


You are really getting on my Sciatic Nerve.

Does your back make you feel like this?

Back pain universally blows. It destroys postures, mental states, and days all around the world without visible wounds displaying the immense internal pain…except for the furrowed brow. Pure torture.

Sciatica is a subset of back pain mostly felt in the legs. The sciatic nerve is a long cord of nervy fun that goes through the spine, separating down into the legs and ending in the feet.  Sciatica occurs when something close to the sciatic nerve impinges upon it. The muscles around the nerve, in an attempt to protect it, seize up causing sharp, shooting pain through the buttocks and the back of the leg. Muscle atrophy can result from the stress of seizing up. Big nervy fun, indeed.

The sciatic nerve

Sciatica and back pain can attack anyone at anytime. A young athletic person with muscular imbalances is as likely to feel back pain as an older person with a sedentary lifestyle.

If ignored, sciatica and back pain often gets worse. With a bulging disc at 25 and an acute onset of sciatica, I know. Without proper care, I was forced to lay on the floor for a week, unable to sit or stand for long. My leg would buckle underneath me, and even as the pain lessened, I could barely stand up for more than an hour or two at a time. It took a year of constant work to become pain free. The year was crucial for understanding proper care of my body, preventing further back problems for years to come.

Every body is different. Back problems are relative to the individual. Proper core strength, self-knowledge and self-care are golden tickets to recovery, from the first pang to post spine surgery.

Below are suggestions to help ease sciatica, but always consult your physician regarding any prolonged back pain.

#1. R-I-C-E – It’s the physical therapy stand-by for acute pain. Practiced everywhere from the school nurse’s office to NBA courts.

REST– After an acute back injury, rest is the best medicine. Allow the spine and muscles to relax and to heal on their own terms. Listen to your body.

ICE– When in doubt, go with ice to help relieve inflammation and numb the pain. My favorite ice pack is a super large bag of corn or peas from the grocer, just don’t eat it later. ewww.

COMPRESSION– Wearing a back brace or wrapping an ace bandage in a corset-like fashion can temporarily aid in supporting the spine and muscle strain.

ELEVATION – Rest flat on the back, allowing the legs to be propped up at an ELEVATED angle. Either with a pillow below the knees or lying on the floor with calves draped on the couch or a chair.

#2. Stretch out the spasm.

Stretching out cramping muscles provides temporary relief. Proper stretching is crucial. Do not stretch the leg past a 90 degree angle, causing the low back to curl forward or twist. While this might feel good at the time, it can make the pain worse later by straining the low back.  Keep the spine neutral while stretching the legs. Again, when stretching the leg do not allow the low back to round or tuck under.

hamstring stretch. turn the leg in and out

Piriformis stretch: This stretch releases the muscle spasm temporarily around part of the sciatic nerve.  Lie on your back. Cross one foot over the opposite thigh. Pull the thigh in towards your chest, but keep your backside on the floor (do not allow it to curl up off the floor).

Piriformis stretch

#3. Build a better core

Begin to work on slow, controlled movements that allow you to find your core muscles. No crunches or sit ups. Without proper awareness these movement can create further muscular imbalance and continued back pain. I recommend trying the dead bug exercise, which is explained here.

dead bug exercise

#4. McKenzie Exercises

Physical therapists either approve or condemn this method. There is no in between. After 6 months of pain, the McKenzie extension exercises helped correct my spine and strengthen my back muscles.

 

Named after a physical therapist in New Zealand, McKenzie exercises are primarily extension (arching) exercises that could help reduce the symptoms of herniated disc by reducing pressure on a nerve root. For acute pain, the McKenzie exercises should be done frequently, at least once every two hours. For more information, you can buy the book, or check out their website. Although many back and sciatica problems could be helped by these exercises, it is not for everybody. Consult a therapist or a doctor to determine if this method is for you.

#5. Get moving with strength and balance

Once back pain is under control, it’s time to consider exercises to make sure the pain stays away. Understand your body’s muscular balance and how it works: Which muscles need to be strengthened? Which are overdeveloped or strained? A strong core includes the back and side muscles too, not just the abdominal wall we berate in the front. Strengthen the entire trunk to maintain a healthy neutral spine posture. Often, the back muscles need to be exercised in order to “teach” the spine how to stay in a neutral position. The guidance of a professional Pilates instructor, physical therapist, or movement therapist is highly recommended.  Ideas for low impact exercise can include:

walking

elliptical

swimming

pilates (with a certified instructor, preferably one with a rehabilitation background)

low impact aerobics

dance

…really, just get moving! Finding an enjoyable form of exercise is key to lasting strength. Regular activity, with balanced trunk strength, prevents back pain from recurring, allowing you to stay mobile and strong for many years to come.