How Nature Provides Us With A Surprisingly Powerful Painkiller
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It’s well-known (at least to regular 10almonds-readers) that seeing nature, ideally green leaves and blue sky, improves our mood by stimulating production of serotonin.
See also: Neurotransmitter Cheatsheet
But it does a lot more.
Reducing the actual signals of pain
Researchers at the University of Vienna have discovered that viewing nature scenes (even if just on video) alleviates physical pain—not just in self-reported subjective assessments, but also by a reduction of the neural activity that signals pain:
❝Pain is like a puzzle, made up of different pieces that are processed differently in the brain. Some pieces of the puzzle relate to our emotional response to pain, such as how unpleasant we find it. Other pieces correspond to the physical signals underlying the painful experience, such as its location in the body and its intensity.
Unlike placebos, which usually change our emotional response to pain, viewing nature changed how the brain processed early, raw sensory signals of pain.
Thus, the effect appears to be less influenced by participants’ expectations, and more by changes in the underlying pain signals❞
This was tested against, varyingly, viewing an urban environment or viewing an indoor environment, neither of which gave the same benefits.
The setup of the experiment is relevant, so…
Matching soundscape accompanied each visual stimulus. The three pain runs had a total duration of 9 min each, during which one environment was accompanied by 16 painful and 16 non-painful shocks. Neuroimaging was used for all parts, and participants were exposed to all environments:
- First, a cue indicating the intensity of the next shock (red = painful, yellow = not painful) was presented for 2000 milliseconds (ms).
- Second, a variable interval of 3500 ± 1500 ms was shown.
- Third, a cue indicating the intensity of the shock was presented for 1000 ms, accompanied by an electrical shock with a duration of 500 ms.
- Fourth, a variable interval of 3500 ± 1500 ms followed.
- Fifth, after each third trial, participants rated the shock’s intensity and unpleasantness at 6000 ms each.
- Sixth, each trial ended with an intertrial interval (ITI) presented for 2000 ms.
They found that as well as the self-assessment reports being as expected (nature scenes reduced subjective experience of pain),
❝In summary, the multivoxel and region of interest analyses converged in showing that pain responses when exposed to nature as compared to urban or indoor stimuli were associated with a decrease in neural processes related to lower-level nociception-related features (NPS, thalamus), as well as in regions of descending modulatory circuitry associated with attentional alterations of pain that also encode sensory-discriminative aspects (S2, pINS).❞
In other words—to the extent that pain can be quantified objectively by neural imaging—the pain was also objectively reduced, much like with a chemical painkiller.
You can read the paper in full, here:
Nature exposure induces analgesic effects by acting on nociception-related neural processing
How to benefit from this
Well, first there is the obvious, “view nature“.
However, note the timescales involved in the testing periods: 2000 milliseconds is two seconds, and that was the intertrial interval used—the equivalent of a washout phase in an interventional trial (but a drug/supplement/diet washout is usually a number of weeks).
The fact that the test periods were a matter of seconds, and the intertrial period was also literally two seconds, this means:
It works quickly, and the effect disappears quickly, too.
In other words: if you want pain relief from nature, the good news is you can get it immediately while viewing nature, and the bad news is that you have to keep viewing nature to continue enjoying the painkilling effect.
So that’s a limitation, but it’s still clearly a very worthy option for a little respite from chronic pain now and again, for example.
Want to learn more?
We’ve written quite a bit about pain management, including:
- Before You Reach For That Tylenol…
- How To Stop Pain Spreading
- How To Dial Down Your Pain
- Managing Chronic Pain (Realistically!)
- Get The Right Help For Your Pain
- The 7 Approaches To Pain Management
- Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)
Take care!
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A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
Women seem to feel pain more acutely and often feel ignored by doctors.
ShutterstockMedical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Everything you need to know about cervical cancer
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Every year, around 11,500 new cases of cervical cancer are diagnosed in the U.S. While cervical cancer used to be one of the most common causes of cancer death for U.S. women, the vaccine against the human papillomavirus (HPV), and increased early screening and detection have resulted in a decrease in rates.
“Cervical cancer is almost always preventable and typically diagnosed in patients who have either never had a screening test or have gone many years without one,” says Fred Wyand, director of communications at the American Sexual Health Association, which includes the National Cervical Cancer Coalition.
January is Cervical Cancer Awareness Month, so we spoke to experts to learn more about what it is, its symptoms, and what you can do to prevent it.
What is cervical cancer?
Cervical cancer is a type of cancer that starts in the cervix—the lower part of the uterus that connects the vagina to the uterus. Cervical cancer can affect anyone with a cervix but is most frequently diagnosed in women ages 35 to 44, according to the American Cancer Society.
There are two types:
- Squamous cell carcinoma: Cervical cancer that starts in the thin squamous cells on the outside of the cervix. This is the most common type of cervical cancer.
- Adenocarcinoma: Cervical cancer that starts in glandular cells that line the inside of the cervix. This type of cervical cancer is less common.
In some cases, cervical cancer has features of both types.
What causes cervical cancer?
Almost all cases of cervical cancer are caused by high-risk cases of HPV, a virus that is spread through sexual activity or other close skin-to-skin contact. But don’t panic: HPV is very common, and getting HPV doesn’t always mean you’ll get cervical cancer. Around 85 percent of people in the U.S. will get an HPV infection in their lifetime, but for most people, the virus clears on its own.
However, there are many strains of HPV, and some are linked to cervical cancer. In those cases, when the virus does not clear on its own and the HPV infection persists, it can cause a range of cancers in both men and women, including cancers of the cervix, anus, penis, throat, and vagina.
That’s why HPV vaccination is so important for all people: It can help prevent many types of cancer, including cervical cancer caused by those high-risk HPV infections.
What are the symptoms of cervical cancer?
Cervical cancer doesn’t usually have symptoms in its early stages, but once cancer begins to spread, the symptoms can include:
- Vaginal bleeding between periods, after sexual intercourse, or after menopause.
- Heavier and longer menstrual periods than usual.
- Vaginal discharge that has a strong odor and is watery.
- Pelvic pain or pain during sexual intercourse.
In more advanced stages, symptoms of cervical cancer can include:
- Leg swelling.
- Difficult or painful bowel movements or bleeding during a bowel movement.
- Blood in urine or difficulty urinating.
- Back pain.
“Most women present with no symptoms,” Dr. Kristina A. Butler, gynecologic oncologist at Mayo Clinic, tells PGN. “Therefore, the checkups with visualization of the cervix, speaking with your provider, and having a Pap smear are so important.”
How can you help prevent or reduce your risk for cervical cancer?
Vaccination: Cervical cancer is highly preventable. The most effective way to help protect yourself from it is by getting the HPV vaccine. The HPV vaccine is most effective before a person is first exposed to HPV, typically before becoming sexually active.
“If we are able to vaccinate children before they become adults [and] are subsequently exposed, those individuals are maximally protected against the [worst effects] of the virus, which could ultimately be cancer,” Butler adds.
You’re eligible to get the vaccine if you’re between 9 and 45 years old, but there are specific guidelines for each age group. The Centers for Disease Control and Prevention recommends HPV vaccination for children ages 11 or 12 (though it can start at 9 years).
The CDC says that you can get catch-up doses until you’re 26 if you didn’t get vaccinated earlier, but if you’re between 26 and 45 years old, you should talk to your health care provider about your individual risk for HPV and to see if you should get the vaccine.
Screenings: This is another effective way to prevent cervical cancer.
Dr. Deanna Gerber, a gynecologic oncologist at NYU Langone’s Laura and Isaac Perlmutter Cancer Center, tells PGN that regular screenings can catch HPV before it has a chance to become cancer.
“Now that we’re encouraging people to see their gynecologist and get screening more regularly, we’re catching cancer at earlier stages,” she says.
Screenings for cervical cancer include:
- Pap smear: During a Pap smear, also known as a Pap test, cells are collected from your cervix to find precancerous or cervical cancer cells. Pap smears should start at 21 years old, regardless of when you start having sex.
If you’re between 21 and 29, you should get a Pap smear every three years. If you’re 30 to 65 years old, it’s recommended you get one every three years, a Pap and HPV test together every five years, or an HPV test alone every five years.
- HPV test: During an HPV test, cells are collected from your cervix to look for infection with high-risk HPV strains that can cause cervical cancer. If you’re between 21 and 30 years old, it’s only recommended that you get an HPV test if you had an abnormal Pap smear result. After 30, an HPV test is recommended with a Pap smear every five years, as long as other results were normal.
(People over 65 years old should talk to their health care provider about whether they need screening.)
Not smoking: Avoiding smoking can reduce your risk of developing cervical cancer because “HPV and smoking tobacco work together to accelerate the negative effects of HPV,” says Gerber.
Wearing condoms: Although condoms don’t completely prevent HPV infection, they provide some protection. And according to the CDC, the use of condoms has been associated with a lower rate of cervical cancer.
There is hope with early detection
There is hope for people diagnosed with cervical cancer. “Compared to the survival [rates] 10 years ago, women survive much longer now with the great treatments we have,” adds Butler.
Some of those treatments and advances include radiation, chemotherapy, and surgical therapy.
And while there may be some stigma surrounding sexual health, it’s important to advocate for yourself, says Gerber.
“Being comfortable and bold talking to your doctor about your health or any concerns that you have, feeling comfortable with your provider by asking all these questions is really the best thing you can do.”
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Why Going Gluten-Free Could Be A Bad Idea
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Is A Gluten-Free Diet Right For You?
This is Rachel Begun, MS, RD. She’s a nutritionist who, since her own diagnosis with Celiac disease, has shifted her career into a position of educating the public (and correcting misconceptions) about gluten sensitivity, wheat allergy, and Celiac disease. In short, the whole “gluten-free” field.
First, a quick recap
We’ve written on this topic ourselves before; here’s what we had to say:
On “Everyone should go gluten-free”
Some people who have gone gluten-free are very evangelical about the lifestyle change, and will advise everyone that it will make them lose weight, have clearer skin, more energy, and sing well, too. Ok, maybe not the last one, but you get the idea—a dietary change gets seen as a cure-all.
And for some people, it can indeed make a huge difference!
Begun urges us to have a dose of level-headedness in our approach, though.
Specifically, she advises:
- Don’t ignore symptoms, and/but…
- Don’t self-diagnose
- Don’t just quit gluten
One problem with self-diagnosis is that we can easily be wrong:
But why is that a problem? Surely there’s not a health risk in skipping the gluten just to be on the safe side? As it turns out, there actually is:
If we self-diagnose incorrectly, Begun points out, we can miss the actual cause of the symptoms, and by cheerfully proclaiming “I’m allergic to gluten” or such, a case of endometriosis, or Hashimoto’s, or something else entirely, might go undiagnosed and thus untreated.
“Oh, I feel terrible today, there must have been some cross-contamination in my food” when in fact, it’s an undiagnosed lupus flare-up, that kind of thing.
Similarly, just quitting gluten “to be on the safe side” can mask a different problem, if wheat consumption (for example) contributed to, but did not cause, some ailment.
In other words: it could reduce your undesired symptoms, but in so doing, leave a more serious problem unknown.
Instead…
If you suspect you might have a gluten sensitivity, a wheat allergy, or even Celiac disease, get yourself tested, and take professional advice on proceeding from there.
How? Your physician should be able to order the tests for you.
You can also check out resources available here:
Celiac Disease Foundation | How do I get tested?
Or for at-home gluten intolerance tests, here are some options weighed against each other:
MNT | 5 gluten intolerance tests and considerations
Want to learn more?
Begun has a blog:
Rachel Begun | More than just recipes
(it is, in fact, just recipes—but they are very simple ones!)
You also might enjoy this interview, in which she talks about gluten sensitivity, celiac disease, and bio-individuality:
Want to watch it, but not right now? Bookmark it for later
Take care!
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Managing Sibling Relationships In Adult Life
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Managing Sibling Relationships In Adult Life
After our previous main feature on estrangement, a subscriber wrote to say:
❝Parent and adult child relationships are so important to maintain as you age, but what about sibling relationships? Adult choices to accept and move on with healthier boundaries is also key for maintaining familial ties.❞
And, this is indeed critical for many of us, if we have siblings!
Writer’s note: I don’t have siblings, but I do happen to have one of Canada’s top psychologists on speed-dial, and she has more knowledge about sibling relationships than I do, not to mention a lifetime of experience both personally and professionally. So, I sought her advice, and she gave me a lot to work with.
Today I bring her ideas, distilled into my writing, for 10almonds’ signature super-digestible bitesize style.
A foundation of support
Starting at the beginning of a sibling story… Sibling relationships are generally beneficial from the get-go.
This is for reasons of mutual support, and an “always there” social presence.
Of course, how positive this experience is may depend on there being a lack of parental favoritism. And certainly, sibling rivalries and conflict can occur at any age, but the stakes are usually lower, early in life.
Growing warmer or colder
Generally speaking, as people age, sibling relationships likely get warmer and less conflictual.
Why? Simply put, we mature and (hopefully!) get more emotionally stable as we go.
However, two things can throw a wrench into the works:
- Long-term rivalries or jealousies (e.g., “who has done better in life”)
- Perceptions of unequal contribution to the family
These can take various forms, but for example if one sibling earns (or otherwise has) much more or much less than another, that can cause resentment on either or both sides:
- Resentment from the side of the sibling with less money: “I’d look after them if our situations were reversed; they can solve my problems easily; why do they resent that and/or ignore my plight?”
- Resentment from the side of the sibling with more money: “I shouldn’t be having to look after my sibling at this age”
It’s ugly and unpleasant. Same goes if the general job of caring for an elderly parent (or parents) falls mostly or entirely on one sibling. This can happen because of being geographically closer or having more time (well… having had more time. Now they don’t, it’s being used for care!).
It can also happen because of being female—daughters are more commonly expected to provide familial support than sons.
And of course, that only gets exacerbated as end-of-life decisions become relevant with regard to parents, and tough decisions may need to be made. And, that’s before looking at conflicts around inheritance.
So, all that seems quite bleak, but it doesn’t have to be like that.
Practical advice
As siblings age, working on communication about feelings is key to keeping siblings close and not devolving into conflict.
Those problems we talked about are far from unique to any set of siblings—they’re just more visible when it’s our own family, that’s all.
So: nothing to be ashamed of, or feel bad about. Just, something to manage—together.
Figure out what everyone involved wants/needs, put them all on the table, and figure out how to:
- Make sure outright needs are met first
- Try to address wants next, where possible
Remember, that if you feel more is being asked of you than you can give (in terms of time, energy, money, whatever), then this discussion is a time to bring that up, and ask for support, e.g.:
“In order to be able to do that, I would need… [description of support]; can you help with that?”
(it might even sometimes be necessary to simply say “No, I can’t do that. Let’s look to see how else we can deal with this” and look for other solutions, brainstorming together)
Some back-and-forth open discussion and even negotiation might be necessary, but it’s so much better than seething quietly from a distance.
The goal here is an outcome where everyone’s needs are met—thus leveraging the biggest strength of having siblings in the first place:
Mutual support, while still being one’s own person. Or, as this writer’s psychology professor friend put it:
❝Circling back to your original intention, this whole discussion adds up to: siblings can be very good or very bad for your life, depending on tons of things that we talked about, especially communication skills, emotional wellness of each person, and the complexity of challenges they face interdependently.❞
Our previous main feature about good communication can help a lot:
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Do You Know Which Supplements You Shouldn’t Take Together? (10 Pairs!)
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Dr. LeGrand Peterson wants us to get the most out of our supplements, so watch out for these…
Time to split up some pairs…
In most cases these are a matter of competing for absorption; sometimes to the detriment of both, sometimes to the detriment of one or the other, and sometimes, the problem is entirely different and they just interact in a way that could potentially cause other problems. Dr. Peterson advises as follows:
- Vitamin C and vitamin B12: taking these together can reduce the absorption of Vitamin B12, as vitamin C can overpower it.
- Vitamin C and copper: high amounts of vitamin C can decrease copper absorption, especially in those who are severely copper deficient.
- Magnesium and calcium: these two minerals compete for absorption in the intestines, potentially reducing the effectiveness of both.
- Calcium and iron: calcium can decrease iron absorption, so they should not be taken together, especially if you are iron deficient.
- Calcium and zinc: calcium also competes with zinc, reducing zinc absorption; they should be taken at different times.
- Zinc and copper: zinc and copper compete for absorption, so they should be taken at separate times.
- Iron and zinc: iron can decrease zinc absorption, and thus, they should not be taken together.
- Iron and green tea: perhaps a surprising one, but green tea can reduce iron absorption, so they should not be taken simultaneously.
- Vitamin E and vitamin K: vitamin E increases bleeding risk, while vitamin K promotes clotting, making them opposites and risky to take together.
- Fish oil and ginkgo biloba: both are anticoagulants and can increase the risk of bleeding, especially if taken with blood thinners like warfarin.
If you need to take supplements that compete (or conflict or otherwise potentially adversely interact) with each other, it’s recommended to separate them by at least 4 hours, or better yet, take one in the morning and the other at night. If in doubt, do speak with your pharmacist or doctor for personalized advice
You may be thinking: half my foods contain half of these nutrients! And yes, assuming you have a nutritionally dense diet, this is probably the case. Foods typically release nutrients more slowly than supplements, and unlike supplements, do not usually contain megadoses (although they can, such as the selenium content of Brazil nuts, or vitamin A in carrots). Basically, food is in most cases safer and gentler than supplements. If concerned, do speak with your nutritionist or doctor for personalized advice.
For more information on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Do We Need Supplements, And Do They Work?
Take care!
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Fitness Walking and Bodyweight Exercises – by Frank S. Ring
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A lot of exercise manuals assume that the reader has a “basic” body (nothing Olympian, but nothing damaged either). As we get older, increasingly few of us fall into the “but nothing damaged either” category!
Here’s where Ring brings to bear his decades of experience as a coach and educator, and also his personal recovery from a serious back injury.
The book covers direct, actionable exercise advice (with all manner of detail), and also offers mental health tips he’s learned along the way.
Ring, like us, is a big fan of keeping things simple, so he focusses on “the core four” of bodyweight exercises:
- Pushups
- Squats
- Lunges
- Planks
These four exercises get a whole chapter devoted to them, though! Because there are ways to make each exercise easier or harder, or have different benefits. For example, adjustments include:
- Body angle
- Points of contact
- Speed
- Pausing
- Range of motion
This, in effect, makes a few square meters of floor (and perhaps a chair or bench) your fully-equipped gym.
As for walking? Ring enjoys and extols the health benefits, and/but also uses his walks a lot for assorted mental exercises, and recommends we try them too.
A fine book for anyone who wants to gain and/or maintain good health, but doesn’t pressingly want to join a gym or start pumping iron!
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