Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.
Since prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips.
Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.
Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.
Lift objects correctly and maintain proper posture:While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed.
While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.
Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.
Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pinpoint the diagnosis and appropriate management.

3 Essential Tips to Prevent Back Pain

A bladder infection is a bacterial infection within the bladder. Some people call a bladder infection a urinary tract infection (UTI). This refers to a bacterial infection anywhere in the urinary tract, such as the bladder, kidneys, ureters, or the urethra. While most cases of bladder infection occur suddenly (acute), others may recur over the long term (chronic). Early treatment is key to preventing the spread of the infection.

What causes Bladder Infection?
Bacteria that enter through the urethra and travel into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination. Men have added protection with the prostate gland, which secretes protective hormones as a safeguard against bacteria. Still, sometimes bacteria can attach to the walls of the bladder and multiply quickly. This overwhelms the body s ability to destroy them, resulting in a bladder infection.
Bacteria that enter through the urethra and travel into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination. Men have added protection with the prostate gland, which secretes protective hormones as a safeguard against bacteria. Still, sometimes bacteria can attach to the walls of the bladder and multiply quickly.

Other factors can increase the risk of bladder infections for both men and women. These include:

Advanced age
Insufficient fluid intake
Surgical procedure within the urinary tract
A urinary catheter
Urinary obstruction, which is a blockage in the bladder or urethra
Urinary tract abnormality, which is caused by birth defects or injuries
Urinary retention, which means difficulty emptying the bladder
Narrowed urethra
Bowel incontinence
Pregnancy
Diabetes
Symptoms for Bladder Infections

Cloudy or bloody urine
Urinating more often than usual
Foul-smelling urine
Pain or burning when urinating
A frequent sensation of having to urinate, which is called urgency
Cramping or pressure in the lower abdomen or lower back
Bladder infections can also cause back pain. This pain is associated with pain in the kidneys. Unlike muscular back pain, you might experience pain on both sides of your back or the middle of your back. Such symptoms mean the bladder infection has likely spread to the kidneys. A kidney infection can also cause a low fever.

Bladder Infections - Decoding one of the Most Common Gynae Problem in Women

Most women get accustomed to and know the pattern of their menstrual cramps. So, when something out of this pattern happens, they know it is not normal. There are various reasons for pelvic pains not associated with menses. The following are some common causes and it is always advisable to seek medical help, which will help in right diagnosis, early intervention and reduced complications.

1. Ectopic pregnancy: If a fertilized egg has planted itself outside of the uterus or the womb, it is referred to as ectopic pregnancy. The fallopian tube is the most common place for ectopic pregnancies. There is associated pelvic pain, which is unilateral, sharp, and gradually worsens. There would also be associated bleeding which is darker than the regular bleeding. This again should be confirmed on an ultrasound and then the ectopic pregnancy removed.

2. Endometriosis: The inner thick layer of the uterus could be infected leading to severe pelvic pain, especially in women who are in their 30s, who are not able to conceive. This is often ignored, considering it as normal and it continues to progress and could even result in infertility.

3. Pelvic inflammatory disease (PID): Infections like gonorrhea or chlamydia travel up from the genital tract and reach the uterus. Infection along the entire reproductive tract can lead to severe pain. In most cases, if identified early, a course of antibiotics is all that is required to control this infection. Left untreated, it can even cause infertility.

4. Ovarian cysts: Another common cause of pelvic pain, they are quite often asymptomatic, except for occasional pelvic pain. They also disappear with no medical intervention. Sometimes, however, it may get infected or rupture and can cause severe pain. This can is an indication for medical intervention. Ultrasound may be required for diagnosis and treatment may include surgical removal.

5. Uterine fibroids: The fibroids are noncancerous growths, which can grow to a considerable size and fall short of blood supply. This may cause them to burst, which can be very painful.

6. Miscarriage: Most miscarriages occur before 13 weeks of pregnancy and the usual accompanying symptoms of bleeding are severe pelvic cramps. If you are pregnant and notice bleeding with pelvic pain, it is advisable to immediately visit a doctor. Diagnosis may require an ultrasound to confirm the miscarriage. If medications are not sufficient to remove the remnants, then a dilation and curettage may be required.

7. Non-gynecological causes: Appendicitis, urinary tract infections, hernia, lower spinal problems, irritable bowel syndrome can also cause pelvic pain. The cause should be identified and managed accordingly.

Unfortunately, most women continue to experience and suffer with chronic pelvic pain without a cause identified. A thorough internal examination can help identify the problem and treat the issue.

How to Deal with Pelvic Pain other than Menstrual Cramps

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.

Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. There are 2 types of arthritis the knee joint in the human body can get afflicted with. They are:

Osteoarthritis 

The form of arthritis which, with increasing pain, slowly wears down the joint cartilages is called osteoarthritis. This form of arthritis usually affects people after the age 40. The symptoms of osteoarthritis include:

Severe pain in the knee joints
Pain after walking up the stairs and it subsiding once you are on rest
Severe pain after the movement of joints for a long time
Pain that becomes worse in rainy days
Joints becoming stiff after waking up in the morning but they improve in the latter part of the day
Pain which also occurs in the thighs and the genital regions coupled with joints swelling and joints getting stiff after rest.
Rheumatoid arthritis

Rheumatoid arthritis is a chronic form of arthritis caused because of the knee joint inflammations. This form of arthritis can occur at any age. Being an auto-immune disease, its symptoms include, but are not limited to:

Severe pain in the morning
Mild fever accompanying the pain
Joints suddenly becoming swollen, red and warm causing, immense pain
Sudden stiffness of the joints
Pain that increases in cold weather
Mild fever, extreme tiredness and weakening of the muscles
Doctors are still doubtful about what exactly causes the disease; but the deformation of the immune system might cause the damage of the joints, causing people who are already suffering from obesity, smokers, and women, in general, more prone to this disease.

When the knee pain is diagnosed as a form of arthritis, the following treatments are suggested:

If you are overweight or obese, losing some of those extra pounds can go a long way in reducing the pain.
Muscle-stretching exercises are effective in keeping the knee joints flexible.
Dry needling, cupping, taping can help to control the pain and keep the joint supported.
Prescribed dosage of anti-inflammatory drugs such as Tylenol, Motrin, and Advil or injections of hyaluronic acid might relieve your pain.
If regular treatments do not work, you might opt for knee-replacement surgery and osteotomy (the process of cutting a bone with the help of surgery) which might better the alignment of the knee by transforming the bone shapes.

Physiotherapy for knee arthritis

Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions. The main goals of physiotherapy for your knee arthritis are:

Reduce your knee pain and inflammation.
Normalise your knee joint range of motion.
Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
Strengthen your lower limb: calves, hip and pelvis muscles.
Improve your patellofemoral (knee cap) alignment and function.
Normalise your muscle lengths.
Improve your proprioception, agility and balance.
Improve your technique and function eg walking, squatting.

How Physiotherapy Helps To Manage Arthritis?

Importance of avoiding carbs in dinner for weight loss

Ideal dinner should not be rich in carbs but fibers. If you intend to lose weight, avoid carbs in dinner. 

There are many reasons of avoiding carbs in dinner.

1. Gets Converted to Fat: Carbohydrates should only be taken during daytime as muscles require fuel to do different activities and utilize carbs to convert in energy. During night we don’t do as intense workouts as the daytime like in office or household work. If carbohydrates are taken in dinner, muscles absorb carbohydrates and store them in form of fat tissues due to lack of any activities except sleep and inner organs’ functioning.

2. Increases Your Sugar Levels: Including carbohydrates in your dinner also increases blood sugar level which is harmful for diabetes patients.

3. Makes Your Digestion Difficult: Avoiding carbs also improves your digestion. Replace it with more fiber foods instead.

If you would like to consult with me privately, please click on 'Consult'.

Why It’s an Absolute Sin To Have Carbs in Dinner if You Want to Lose Weight 

The lungs are made of tubes through, which air passes in and out for exchange of gases, taking in alveoli. It is a disease of alveoli to which finer air conducting tubes are attached. Over a period of time, with age and exposure to various agents, these tubules get obstructed. The amount of air that can pass through these is reduced, leading to reduced oxygen supply to the lungs and thereby the various body organs.

Symptoms
The symptoms of copd can be easily understood if we realize how copd is caused. The progressive blockage of the air tubes causes less oxygen to reach the tissues, which is the most essential agent for all tissues and organs to function. Reduced supply produces a generalized limitation in physical activity. There are two main components to copd - chronic bronchitis and emphysema. The symptoms indicative of copd are as follows:
1. Chronic cough - also referred to as smoker's cough, the cough is relentless and does not subside with regular cough treatment. This is one of the first indications of copd.
2. Mucus buildup - there is constant buildup of mucus which gets expelled during coughing. The person never feels completely clear of mucus, and the regular cough expectorants do not help relieve the symptoms.
3. Fatigue associated with limited activity - as noted earlier, the reduced capacity of the organs limits their activities. Therefore, regular activities like walking short distances or climbing stairs can induce fatigue.
4. Shortness of breath - the above fatigue is associated with shortness of breath, even with small physical exertion. A person with copd will see marked tiredness and reduced ability to perform routine chores and feel a tightness in the chest.
5. Wheezing - passage of air through the obstructed air tubes produces a whistling sound or wheezing. It is more pronounced when there is mucus accumulation in the airways.
Rarely, frequent respiratory infections, more frequent flu attacks, swelling of the feet and ankles, cardiovascular disease, weight loss, and morning headaches.

Treatment
While there is no cure for copd, once it sets, the following are some ways to slow its progression and reduce severity of the symptoms:
1. Bronchodilators - dilate the air tubes and ease flow of air
2. Corticosteroids - help reduce inflammation and thereby improve airflow through the tubes
3. Flu vaccination - helps curb the frequent flu attacks
4. Antibiotics - to contain infections
5. Pulmonary rehabilitation - a combination of breathing exercise and patient education to improve lung function.
6. Oxygen therapy - in very severe cases, oxygen may be required.
7. Lifestyle changes - eating healthy foods, preventing exposure to dust and smoke, quitting smoking, breathing exercises, bi-annual medical check-ups to monitor lung functions are essential.

Knowing that you have copd is the first step towards managing copd, which can be managed effectively.

Chronic Obstructive Pulmonary Disease - Symptoms and Treatment

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