How long does back pain last? And how can learning about pain increase the chance of recovery?
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Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will have it this year.
Chronic pain, of which back pain is the most common, is the world’s most disabling health problem. Its economic impact dwarfs other health conditions.
If you get back pain, how long will it take to go away? We scoured the scientific literature to find out. We found data on almost 20,000 people, from 95 different studies and split them into three groups:
- acute – those with back pain that started less than six weeks ago
- subacute – where it started between six and 12 weeks ago
- chronic – where it started between three months and one year ago.
We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.
Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.
More pain doesn’t mean a more serious injury
Most acute back pain episodes are not caused by serious injury or disease.
There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.
DG fotostock/Shutterstock
Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.
The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.
The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.
Reduce your chance of lasting pain
Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:
- understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain
- reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.
How to reduce your pain sensitivity and learn about pain
Learning about “how pain works” provides the most sustainable improvements in chronic back pain. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.
Halfpoint/Shutterstock
These programs have been in development for years, but high-quality clinical trials are now emerging and it’s good news: they show most people with chronic back pain improve and many completely recover.
But most clinicians aren’t equipped to deliver these effective programs – good pain education is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.
When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just been told it’s all in their head.
Community-driven not-for-profit organisations such as Pain Revolution are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than 80 local pain educators and supported them to bring greater understanding and improved care to their colleagues and community.
But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.
Sarah Wallwork, Post-doctoral Researcher, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Leek vs Scallions – Which is Healthier?
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Our Verdict
When comparing leek to scallions, we picked the leek.
Why?
In terms of macros, scallions might have a point: scallions have the lower glycemic index, thanks to leek having more carbs for the same amount of fiber. That said, leek already has a low glycemic index, so this is not a big deal.
When it comes to vitamins, leek has more of vitamins B1, B2, B3, B5, B6, B9, E, and choline, while scallions have more of vitamins A, C, and K. Noteworthily, a cup of chopped leek already provides the daily dose of vitamins A and K, and the difference in levels of vitamin C is minimal. All in all, an easy 8:3 win for leeks here, even without taking that into account.
In the category of minerals, leek has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and selenium, while scallions have a little more zinc.
Both of these allium-family plants (i.e., related to garlic) have an abundance of polyphenols, especially kaempferol.
Of course, enjoy whatever goes best with your meal, but if you’re looking for nutritional density, then leek is where it’s at.
Want to learn more?
You might like to read:
The Many Health Benefits Of Garlic
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Why are people on TikTok talking about going for a ‘fart walk’? A gastroenterologist weighs in
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“Fart walks” have become a cultural phenomenon, after a woman named Mairlyn Smith posted online a now-viral video about how she and her husband go on walks about 60 minutes after dinner and release their gas.
Smith, known on TikTok as @mairlynthequeenoffibre and @mairlynsmith on Instagram, has since appeared on myriad TV and press interviews extolling the benefits of a fart walk. Countless TikTok and Instagram users and have now shared their own experiences of feeling better after taking up the #fartwalk habit.
So what’s the evidence behind the fart walk? And what’s the best way to do it?
CandyBox Images/Shutterstock Exercise can help get the gas out
We know exercise can help relieve bloating by getting gas moving and out of our bodies.
Researchers from Barcelona, Spain in 2006 asked eight patients complaining of bloating, seven of whom had irritable bowel syndrome, to avoid “gassy” foods such as beans for two days and to fast for eight hours before their study.
Each patient was asked to sit in an armchair, in order to avoid any effects of body position on the movement of gas. Gas was pumped directly into their small bowel via a thin plastic tube that went down their mouth, and the gas expelled from the body was collected into a bag via a tube placed in the rectum. This way, the researchers could determine how much gas was retained in the gut.
The patients were then asked to pedal on a modified exercise bike while remaining seated in their armchairs.
The researchers found that much less gas was retained in the patients’ gut when they exercised. They determined exercise probably helped the movement and release of intestinal gas.
Walking may have another bonus; it may trigger a nerve reflex that helps propel foods and gas contents through the gut.
Walking can also increase internal abdominal pressure as you use your abdominal muscles to stay upright and balance as you walk. This pressure on the colon helps to push intestinal gas out.
Proper fart walk technique
One study from Iran studied the effects of walking in 94 individuals with bloating.
They asked participants to carry out ten to 15 minutes of slow walking (about 1,000 steps) after eating lunch and dinner. They filled out gut symptom questionnaires before starting the program and again at the end of the four week program.
The researchers found walking after meals resulted in improvements to gut symptoms such as belching, farting, bloating and abdominal discomfort.
Now for the crucial part: in the Iranian study, there was a particular way in which participants were advised to walk. They were asked to clasp hands together behind their back and to flex their neck forward.
The clasped hands posture leads to more internal abdominal pressure and therefore more gentle squeezing out of gas from the colon. The flexed neck posture decreases the swallowing of air during walking.
This therefore is the proper fart walk technique, based on science.
Could walking with your hands behind your back yield better or more farts? candy candy/Shutterstock What about constipation?
A fart walk can help with constipation.
One study involved middle aged inactive patients with chronic constipation, who did a 12 week program of brisk walking at least 30 minutes a day – combined with 11 minutes of strength and flexibility exercises.
This program, the researchers found, improved constipation symptoms through reduced straining, less hard stools and more complete evacuation.
It also appears that the more you walk the better the benefits for gut symptoms.
In patients with irritable bowel syndrome, one study increasing the daily step count to 9,500 steps from 4,000 steps led to a 50% reduction in the severity of their symptoms.
And just 30 minutes of a fart walk has been shown to improve blood sugar levels after eating.
Walking after eating can help keep your blood sugar levels under control. IndianFaces/Shutterstock What if I can’t get outside the house?
If getting outside the house after dinner is impossible, could you try walking slowly on a treadmill or around the house for 1,000 steps?
If not, perhaps you could borrow an idea from the Barcelona research: sit back in an armchair and pedal using a modified exercise bike. Any type of exercise is better than none.
Whatever you do, don’t be a couch potato! Research has found more leisure screen time is linked to a greater risk of developing gut diseases.
We also know physical inactivity during leisure time and eating irregular meals are linked to a higher risk of abdominal pain, bloating and altered bowel motions.
Try the fart walk today
It may not be for everyone but this simple physical activity does have good evidence behind it. A fart walk can improve common symptoms such as bloating, abdominal discomfort and constipation.
It can even help lower blood sugar levels after eating.
Will you be trying a fart walk today?
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Walnuts vs Brazil Nuts – Which is Healthier?
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Our Verdict
When comparing walnuts to Brazil nuts, we picked the walnuts.
Why?
Talking macros first, they are about equal in protein, carbs, fats, and fiber; their composition is almost identical in this regard. However, looking a little more closely at the fats, Brazil nuts have more than 2x the saturated fat, while walnuts have nearly 2x the polyunsaturated fat. So, we’ll declare the macros category a moderate win for walnuts.
The category of vitamins is not balanced; walnuts have more of vitamins A, B2, B3, B5, B6, B9, C, and choline, while Brazil nuts have more of vitamins B1 and E. A clear and easy win for walnuts.
The category of minerals is interesting, because of one mineral in particular. First let’s mention: walnuts have more iron and manganese, while Brazil nuts have more calcium, copper, magnesium, phosphorus, potassium, and selenium. Taken at face value, this is a clear win for Brazil nuts. However…
About that selenium… Specifically, it’s more than 391x higher, and a cup of Brazil nuts would give nearly 10,000x the recommended daily amount of selenium. Now, selenium is an essential mineral (needed for thyroid hormone production, for example), and at the RDA it’s good for good health. Your hair will be luscious and shiny. However, go much above that, and selenium toxicity becomes a thing, you may get sick, and it can cause your (luscious and shiny) hair to fall out. For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
There is one last consideration, and this is oxalates; walnuts are moderately high in oxalates (>50mg/100g) while Brazil nuts are very high in oxalates (>500mg/100g). This won’t affect most people at all, but if you have pre-existing kidney problems (including a history of kidney stones), you might want to go easy on oxalate-containing foods.
For most people, however, walnuts are a very healthy choice, and outshine Brazil nuts in most ways.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
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Are Supplements Worth Taking?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝There seems to be a lot of suggestions to take supplements for every thing, from your head to your toes. I know it’s up to the individual but what are the facts or stats to support taking them versus not?❞
Short answer:
- supplementary vitamins and minerals are probably neither needed nor beneficial for most (more on this later) people, with the exception of vitamin D which most people over a certain age need unless they are white and getting a lot of sun.
- other kinds of supplement can be very beneficial or useless, depending on what they are, of course, and also your own personal physiology.
With regard to vitamins and minerals, in most cases they should be covered by a healthy balanced diet, and the bioavailability is usually better from food anyway (bearing in mind, we say vitamin such-and-such, or name an elemental mineral, but there are usually multiple, often many, forms of each—and supplements will usually use whatever is cheapest to produce and most chemically stable).
However! It is also quite common for food to be grown in whatever way is cheapest and produces the greatest visible yield, rather than for micronutrient coverage.
This goes for most if not all plants, and it goes extra for animals (because of the greater costs and inefficiencies involved in rearing animals).
We wrote about this a while back in a mythbusting edition of 10almonds, covering:
- Food is less nutritious now than it used to be: True or False?
- Supplements aren’t absorbed properly and thus are a waste of money: True or False?
- We can get everything we need from our diet: True or False?
You can read the answers and explanations, and see the science that we presented, here:
Do We Need Supplements, And Do They Work?
You may be wondering: what was that about “most (more on this later) people”?
Sometimes someone will have a nutrient deficiency that can’t be easily remedied with diet. Often this occurs when their body:
- has trouble absorbing that nutrient, or
- does something inconvenient with it that makes a lot of it unusable when it gets it.
…which is why calcium, iron, vitamin B12, and vitamin D are quite common supplements to get prescribed by doctors after a certain age.
Still, it’s best to try getting things from one’s diet first all of all, of course.
Things we can’t (reasonably) get from food
This is another category entirely. There are many supplements that are convenient forms of things readily found in a lot of food, such as vitamins and minerals, or phytochemicals like quercetin, fisetin, and lycopene (to name just a few of very many).
Then there are things not readily found in food, or at least, not in food that’s readily available in supermarkets.
For example, if you go to your local supermarket and ask where the mimosa is, they’ll try to sell you a cocktail mix instead of the roots, bark, or leaves of a tropical tree. It is also unlikely they’ll stock lion’s mane mushroom, or reishi.
If perchance you do get the chance to acquire fresh lion’s mane mushroom, by the way, give it a try! It’s delicious shallow-fried in a little olive oil with black pepper and garlic.
In short, this last category, the things most of us can’t reasonably get from food without going far out of our way, are the kind of thing whereby supplements actually can be helpful.
And yet, still, not every supplement has evidence to support the claims made by its sellers, so it’s good to do your research beforehand. We do that on Mondays, with our “Research Review Monday” editions, of which you can find in our searchable research review archive ← we also review some drugs that can’t be classified as supplements, but mostly, it’s supplements.
Take care!
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Why You Can’t Deep Squat (And the Benefits You’re Missing)
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Matt Hsu fought his own battle with chronic pain from the age of 16 in his feet, knees, hips, back, shoulders, elbows, forearms, wrists, hands, and head. Seeking answers, he’s spent a career in corrective exercise, posture alignment, structural integration, orthopedic exercise, sports medicine, and has more certifications than we care to list. In short, he knows his stuff.
Yes you can (with some work)
The deep squat, also called Asian squat, Slav squat, sitting squat, resting squat, primal squat, and various other names, is an important way of sitting that has implications for a lot of aspects of health.
Why it’s so important: it preserves the mobility of our hips, ankles, and everything in between, and maintaining especially the hip mobility makes a big difference not only to general health, but also to reducing the risk of injury. It also maintains lower body strength, making falls in older age less likely in the first place, and if falls do happen, makes injury less likely, and if injury does happen, makes the injury likely less severe.
An important misconception: there is a popular, but unfounded, belief that the ability or inability to do this is decided by genes—or if not outright decided, that at the very least Asians and Slavs have a genetic advantage. However, this is simply not true. Westerners and others can learn to do it just fine, and on the flipside, Asians and Slavs who grew up in the West may often struggle with it. The truth is, the deciding factor is lifestyle: if your culture involves sitting this way more often, you’ll be able to do it more comfortably and easily than if you’re just now trying it for the first time.
Factors that you can control: you can’t change where you grew up, but you can change how you sit down now. Achieving the squat requires repeated position practice, and the more frequently you do so (even if you just start with a few seconds and work your way up to longer periods), the better you’ll get at it. And, on the contrary, sitting in chairs weakens and shortens the muscles involved, so any time you spend sitting in chairs is working against you. There are many reasons it’s advisable to avoid sitting in chairs more than necessary, and this is one of them.
10almonds tip: a limiting factor for many people initially is ankle flexibility, which may result in one’s center of gravity being a bit far back, leading to a tendency to have to change something to avoid toppling over backwards. Rather than holding onto something immobile (e.g. furniture) in front of where you are sitting, consider simply holding an object in front of you in your hands. A book is a fine example; holding that in front of you (feel free to read the book) will shift your center of gravity forwards a bit, and will thus allow you to sit there a little longer, thus improving your strength and flexibility while you do, until you can do it without holding something in front of you. If you try with a book and you’re still prone to toppling backwards, try with something heavier, but do use the minimum weight necessary, because ultimately the counterbalance is just a crutch to get you to where you need to be.
For more visual advice on how to do it, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
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You might also like to read:
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Jamaican Coconut Rice
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This is a great dish that can be enjoyed hot or cold, as a main or as a side. It has carbs, proteins, healthy fats, fiber, as well as an array of healthy phytochemicals. Not to mention, a great taste!
You will need
- 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same) (traditional recipe calls for pudding rice, but we’re going with the healthier option here)
- 2 cans (each 12 z / 400g) coconut milk
- 2 cups (or 2 cans, of which the drained weight is comparable to a cup each) cooked black beans. If you cook them yourself, this is better, as you will be able to cook them more al dente than you can get from a can, and this firmness is desirable. But canned is fine if that’s what’s available.
- 1 large red onion, finely chopped
- ½ cup low-sodium vegetable stock (ideally you made this yourself from vegetable offcuts you saved in the freezer for this purpose, but failing that, low-sodium stock cubes can be bought at any large supermarket)
- 2 serrano chilis, finely chopped
- 1 Scotch bonnet chili, without doing anything to it
- 1 tbsp black pepper, coarse ground
- 1 tbsp chia seeds
- 1 tbsp coconut oil
- Garnish: parsley, chopped
Note: we have erred on the side of low-heat when it comes to the chilis. If you know that you and (if applicable) everyone else eating would enjoy more heat, add more heat. If not, let extra heat be added at the table via your hot sauce of choice. Sounds heretical, but it ensures everyone gets the right amount! It’s easy to add heat than to take it out, after all.
However: if you do end up with too much heat in this or any other dish, adding acid will usually help to neutralize that. In the case of this dish, we’d recommend lime juice as a complementary flavor.
Method
(we suggest you read everything at least once before doing anything)
1) In a big sauté pan, add the coconut oil, melt it if not already melted, and add the chopped onion and the chopped chilis, at a temperature sufficient to sizzle. Keep them all moving. Once the coconut oil is absorbed into the onion (this will happen before the onion is fully cooked), add the vegetable stock, followed by the coconut milk; mix it all gently to create a smooth consistency.
2) Add the rice, chia seeds, and black pepper; mix it all gently but thoroughly; turn the temperature to a simmer, and add the Scotch bonnet chili, without cutting it at all.
3) Cover and keep on low for about 20–30 minutes until the rice is looking done. Check on it periodically to make sure it’s not running out of liquid, but resist the urge to stir it; it shouldn’t be burning but paradoxically, once you start stirring you can’t stop or it will definitely burn.
4) Take out the Scotch bonnet chili, and discard*. Add the black beans.
*its job was to add flavor without adding the high-level heat of that particular chili. If you’re a regular heat-fiend, feel free to experiment with using sliced Scotch bonnet chilis instead of serrano chilis; just be aware that there’s a big difference in heat. Only do this if you really like heat. Using it the way we described in the main recipe is what’s traditional in the Caribbean, by the way.
5) Now you can (and in fact must) stir, to mix in the black beans and bring them back to temperature within the dish. Be aware that once you start stirring, you need to keep stirring until you’re ready to take it off the heat.
6) Serve, adding the parsley garnish.
(this example went light on the beans; our recipe includes more for a heartier dish)
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Should You Go Light Or Heavy On Carbs?
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Burn! How To Boost Your Metabolism
- Capsaicin For Weight Loss And Against Inflammation
Take care!
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