Posted on Musculoskeletal health

SIX IN TEN YOUNG ADULTS NOW HAVE ‘COVID BACK’ – SO WHAT SHOULD YOU BE DOING?

Mind Your Back I
Mind Your Back

Longer working hours coupled with poor hybrid  working posture have led to an explosion in back problems amongst younger working adults

 The ‘Covid stone’ – the average weight gain during pandemic has been an issue for many Brits, but hybrid working is now taking a toll on our backs. A new national survey[1] and report commissioned by www.mindyourbackuk.com – backed by Mentholatum[2] — makers of a range of evidence-backed topical muscle and joint products and the brains behind a public health initiative – reveals that 64 per cent of 18–29-year-olds have back problems.

 With back pain already costing the UK £10 billion per year and accounting for four in ten sick days,[3] it’s clear we need to take action to stop back issues spiralling out of control.

 GP and advisor to www.mindyourbackuk.com, Dr Gill Jenkins, says: “For the six in ten Brits who have been mostly or always working from home during the pandemic and are now hybrid working, almost half don’t have constant access to a table and supportive chair during their working day. And unfortunately, 20 per cent have to work while sitting on a sofa or bed. This plays absolute havoc with posture and spine health”.

 The www.mindyourbackuk.com survey also found that some workers working from home or hybrid working have been forced to buy their own specialist chairs (17%) as only 11% received work station equipment from their employers.

While the average working day has increased by 48 minutes worldwide[4], many Brits are doing less exercise to compensate for this. A fifth of those polled admitted to doing no exercise at all in a typical working week and just 7 per cent got up to walk around and stretch every hour – which is recommended for desk work.

The reasons for this include a lack of motivation – cited by 46 per cent – and being pushed for time (37 per cent) or lacking energy (26 per cent) – all very bad news for our backs.

Of the people who had experienced new back pain, more than half (56 per cent) said they have lower back pain compared with 23 per cent who have pain in the neck or shoulder blades. Lower back and neck pain are common complaints when screens are not at eye level, or chairs fail to support the back, allowing desk workers to slump.

Dr Jenkins comments: “Caring for our backs can reduce stress and boost energy so we can live our lives to the full, without pains and aches holding us back. We can’t hurry the lockdown easing but we can do things at home to care for our backs. The Mind Your Back 5 S.T.E.P.S. programme[5] keeps your back mobile, flexible and active, and is easy to incorporate into daily life”.

Mind Your Back 5 S.T.E.P.S. programme

Five simple S.T.E.P.S. for home working back care:

  • STRETCH – Gentle stretching, even for a few minutes a day, increases mobility and helps loosen tight muscles. Check out 5 stretches at https://www.mindyourbackuk.com/stretch 
  • THERAPY – hot, cold (or preferably both, alternated) or anti-inflammatory topical therapies (rubs, sprays, patches), such as Deep Heat, Deep Freeze and Deep Relief which help kick-start the healing process.
  • EXERCISE – walking, cycling and swimming are all gentle, low impact, exercises that help to mobilise your muscles and joints.
  • POSTURE – check your posture, especially while doing desk work or watching TV, to ease non-specific lower back pain and enhance healing
  • STRENGTHEN – core and back exercises strengthen back muscles and prevent localised stiffness and pain. See 5 examples at https://www.mindyourbackuk.com/strengthen

 What kind of home worker are you?

#1. Sofa Slumper

You are comfier on the sofa than sat at a table and often find yourself craning over a small screen. Hours can pass as you slide further down the sofa and although you might feel zen, your back is crying out for a posture reset. What’s more, after taking a break to go and eat, you’re back on the sofa to watch TV. Will your spine ever be upright?

Dr Jenkins tip: Place a cushion under your bottom and behind your back to correct your posture.

#2. Desk Roller

You are replicating the office environment: a desk, a chair and you’re (hopefully) sat upright. However, it can be tricky to avoid hunching over a laptop screen unless you’re set up with a big at-eye-level monitor. Tense shoulders and posture that slumps as the day goes on can wreak havoc with your poor back.

Dr Jenkins tip: Make sure your screen is at eye level by placing your laptop on a stack of books.

#3. Kitchen Cruncher

A lack of space means standing at your kitchen worktop squeezed in between the blender and kettle. Naturally, a worktop doesn’t offer the comfiest work stations and your spine soon finds itself curled over a keyboard for hours on end. You might even start placing all your weight on one leg, causing an imbalance in your spine.

Dr Jenkins tip: Ensure that both feet are flat on the floor at any given time and that you focus on standing up straight.

#4. The Pacer

Whether through choice, or lack of space, classic traits of a Pacer involve wandering from room to room, carrying the laptop in one arm and often, a phone in the other. It’s a case of working wherever there’s space, even if it’s crossed legged on the floor which has a tendency to put your back into a slumped position.

Dr Jenkins tip: Walking around is better than sitting but make sure you use a couple of cushions when you sit on the floor and try to keep your screen as close as possible to eye level.

Check out www.mindyourbackuk.com for more tips on caring for your back.

Posted on Pain Management

Psychological treatment shown to yield strong, lasting pain relief, alter brain networks

Brain scan


Technicians observe an fMRI brain scan in progress at the Intermountain Neuroimaging Consortium facility on the CU Boulder campus. CREDIT Glenn Asakawa/CU Boulder

Rethinking what causes pain and how great of a threat it is can provide chronic pain patients with lasting relief and alter brain networks associated with pain processing, according to new University of Colorado Boulder-led research.

The study, published Sept. 29 in JAMA Psychiatry, found that two-thirds of chronic back pain patients who underwent a four-week psychological treatment called Pain Reprocessing Therapy (PRT) were pain-free or nearly pain-free post-treatment. And most maintained relief for one year.

The findings provide some of the strongest evidence yet that a psychological treatment can provide potent and durable relief for chronic pain, which afflicts one in five Americans.

“For a long time we have thought that chronic pain is due primarily to problems in the body, and most treatments to date have targeted that,” said lead author Yoni Ashar, who conducted the study while earning his PhD in the Department of Psychology and Neuroscience at CU Boulder. “This treatment is based on the premise that the brain can generate pain in the absence of injury or after an injury has healed, and that people can unlearn that pain. Our study shows it works.”

Misfiring neural pathways

Approximately 85% of people with chronic back pain have what is known as “primary pain,” meaning tests are unable to identify a clear bodily source, such as tissue damage.

Misfiring neural pathways are at least partially to blame: Different brain regions—including those associated with reward and fear—activate more during episodes of chronic pain than acute pain, studies show. And among chronic pain patients, certain neural networks are sensitized to overreact to even mild stimuli.

If pain is a warning signal that something is wrong with the body, primary chronic pain, Ashar said, is “like a false alarm stuck in the ‘on’ position.”

PRT seeks to turn off the alarm.

“The idea is that by thinking about the pain as safe rather than threatening, patients can alter the brain networks reinforcing the pain, and neutralize it,” said Ashar, now a postdoctoral researcher at Weill Cornell Medicine.

For the randomized controlled trial, Ashar and senior author Tor Wager, now the Diana L. Taylor Distinguished Professor in Neuroscience at Dartmouth College, recruited 151 men and women who had back pain for at least six months at an intensity of at least four on a scale of zero to 10.

Those in the treatment group completed an assessment followed by eight one-hour sessions of PRT, a technique developed by Los Angeles-based pain psychologist Alan Gordon. The goal: To educate the patient about the role of the brain in generating chronic pain; to help them reappraise their pain as they engage in movements they’d been afraid to do; and to help them address emotions that may exacerbate their pain. 

Pain is not ‘all in your head’

“This isn’t suggesting that your pain is not real or that it’s ‘all in your head’,” stressed Wager, noting that changes to neural pathways in the brain can linger long after an injury is gone, reinforced by such associations. “What it means is that if the causes are in the brain, the solutions may be there, too.”

Before and after treatment, participants also underwent functional magnetic resonance imaging (fMRI) scans to measure how their brains reacted to a mild pain stimulus.

After treatment, 66% of patients in the treatment group were pain-free or nearly pain-free compared to 20% of the placebo group and 10% of the no-treatment group.

“The magnitude and durability of pain reductions we saw are very rarely observed in chronic pain treatment trials,” Ashar said, noting that opioids have yielded only moderate and short-term relief in many trials.

And when people in the PRT group were exposed to pain in the scanner post-treatment, brain regions associated with pain processing – including the anterior insula and anterior midcingulate —had quieted significantly.

The authors stress that the treatment is not intended for “secondary pain” – that rooted in acute injury or disease.

The study focused specifically on PRT for chronic back pain, so future, larger studies are needed to determine if it would yeild similar results for other types of chronic pain. 

Meanwhile, other similar brain-centered techniques are already ememrging among physical therapists and other clinicians who treat pain.

“This study suggests a fundamentally new way to think about both the causes of chronic back pain for many people and the tools that are available to treat that pain,” said co-author Sona Dimidjian, professor of psychology and neuroscience and director of the Renee Crown Wellness Institute at CU Boulder. “ It provides a potentially powerful option for people who want to live free or nearly free of pain.”

Posted on Diabetes

COVID-19 lockdowns have major impact on diabetes control, international study finds

COVID-19 lockdowns have major impact on diabetes control, international study finds
COVID-19 lockdowns have major impact on diabetes control, international study finds

The effects of the COVID-19 pandemic on type 1 diabetes (T1D) and type 2 diabetes (T2D) were very different, according to a systematic review and meta-analysis of 33 studies looking at how diabetes control changed with the onset of lockdowns in over 4,700 patients from 10 countries.

The findings, being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), held online this year (27 Sept-1 Oct), suggest that glycaemic (blood sugar) control substantially improved in individuals with T1D. In contrast, lockdown contributed to a short-term worsening in blood sugar control and weight gain in many with T2D.

“As the pandemic unfolded, there were concerns that an increase in remote consultations and the scale back of face-to-face appointments alongside changes in daily life and exercise, and increased feelings of stress and anxiety, would have a negative impact diabetes control”, explains lead author Professor Claudia Eberle from the University of Applied Sciences in Fulda, Germany.

“Our analysis has revealed that lockdown improved the way people with type 1 diabetes managed their condition. However, people with type 2 diabetes paid a heavy price, with many experiencing deteriorating glycaemic control and weight gain—which are associated with many of the common types of cancer, blindness, amputations as well as heart attacks and strokes.”

In 2019, over 9% of adults aged 20–79 years worldwide—over 463 million adults—were living with diabetes. T1D is the second most common chronic disease in children, accounting for 85% of diabetes in the under 20s (1.1 million cases in 2019), and it is on the rise [1]. People with T1D often experience very high blood sugar. But low insulin levels, as a result of the immune system attacking insulin-producing beta cells, mean that they cannot use much of the glucose in their blood. T2D accounts for around 90-95% of all diabetes diagnoses, and causes the level of sugar in the blood to become too high.




Poor glycaemic control can cause disabling and life-threatening complications such as heart attacks, stroke, chronic kidney disease, and retinopathy (the most common cause of irreversible blindness in adults), so it is important that diabetics keep blood sugar levels as close to the normal range as possible.

In this study, researchers searched for all studies published in English or German which reported the impact of COVID-19 lockdowns on glycaemic control in patients with either T1D or T2D. In total, 33 peer-reviewed studies up to March 2021 were included in the analyses.

Lockdown linked to improved blood sugar control in type 1 diabetes


The researchers found that in 25 studies including 2,881 individuals with T1D, 18 studies (72%) showed clear improvements in glycaemic control, 4 (16%) showed no changes, while 3 studies (12%) reported a deterioration—possibly due to an interruption in health care services, as seen in India where insulin was in short supply.

The changes in glycosylated haemoglobin (HbA1c; indicating how well the body is controlling blood glucose levels) and time spent in the target blood sugar range (TIR, between 70 and 180 mg/dL) from pooled studies were also favourable. Compared to before lockdown, HbA1c values went down significantly in 11/25 studies, with HbA1C levels declining by an average of 0.05%. The TIR also improved significantly (by an average 3.75%) in 18/25 studies. 

“Lockdown measures may have given people with type 1 diabetes more time to look after themselves, allowing them to eat more healthily and keep a close eye on their blood sugar levels. A more ordered routine, especially with respect to meal timing, may also have had health benefits”, explains Professor Eberle. “On top of that, the availability of digital management like telemedicine may have improved contact with healthcare providers, while almost all of the patients in our study had access to digital treatments—such as continuous and flash glucose monitoring that track sugar levels in real time and insulin pumps that provide a steady stream on insulin into the body. These factors may have counteracted lockdown consequences such as less physical activity and the harmful effects on mental health.”

Worsening blood sugar control and weight gain in type 2 diabetes

In contrast, the analysis found that in 8 studies including 1,823 individuals with T2D, half the publications noted short-term worsening in blood sugar control during lockdown, while a quarter (2 studies) showed some improvement. Overall, HbA1C levels increased by an average of 0.14% through the lockdowns. Moreover, 3 studies reported increases in body mass index (BMI) of between 0.3 kg and 0.95 kg, while one reported a substantial improvement in BMI.

According to Professor Eberle, “During lockdown, people with type 2 diabetes may have developed unhealthy habits, such as eating more snacks, more screen time, and less physical activity. At the same time, lack of sleep, increased stress, anxiety, and restricted access to hospitals and pharmacies, may have heightened the difficulty of achieving good blood sugar control. Larger studies in different locations will be needed to identify the actual impact of lockdown in people with diabetes on a broader scale.”

The authors note several limitations in the methodology and reporting of studies in the analysis, including the exclusion of non-English and non-German-language articles and that their findings show observational associations rather than cause and effect. They also note that many of the papers included in the analysis were based on patients from Europe, particularly Italy and Spain, where lockdowns tended to be very strict, so the findings may not be generalisable to all countries.

Posted on Autism

Family of missing Scottsdale man on the autism spectrum believe someone took him – please share so he can be found!

Family of missing Scottsdale man on the Autism spectrum believe someone took him | 12news.com

20-year-old Najib “Jubi” Monsif vanished from his father’s home nearly a week ago. Jubi is on the Autism spectrum and functions muck like a six-year-old. He was last seen on September 23, 2021, near Frank Lloyd Wright and Via Linda in Scottsdale.

Scottsdale police are teaming up with the Maricopa County Sheriff’s Office to expand search efforts.

Posted on Arthritis

Shoulder Arthritis: How I Sleep Through the Night Without Pain

How to sleep with a painful shoulder - YouTube


In this video, I share a sleep posture arthritis tip my physical therapist taught me years ago to stop shoulder pain in bed. It was a lifesaver for me when sleeping became unbearable due to shoulder pain caused by rheumatoid arthritis and bicep tendonitis.

Have you experienced shoulder pain when sleeping?