Here’s what’s happening in the world of health and medical blogging…

Grand Rounds is up at Highlight Health. As usual, it contains the best in online medical writing.

Also, Change of Shift is up at Nurse Ratched’s Place featuring this week’s most outstanding posts from Nursing and other medical bloggers. MJ came up with a Curious George Christmas theme that I’m sure you’ll enjoy.

The 6th edition of the Weekly Health Tips carnival is up over at Gob’s Channel. This carnival always contains a wide variety of articles pertaining to diet, weight loss, exercise, fitness, nutrition, and general health. Be sure to check it out.

The latest edition of Take Charge of Your Health Care is up at Health Plans Plus. This month there are some interesting articles on health care and fitness.

A great line-up this week. Enjoy!

Dean

******************************

Once again, it’s time to sit back and enjoy the week’s best in health and fitness. I have to appologize in advance however, it’s been such a busy month I didn’t have time to review any blog carnivals last week, so this week you get a couple of tufers:

Grand Rounds is up this week at A Chronic Dose and last week’s edition is still available at Sharp Brains.

Change of Shift is up at Marijke: Nurse Turned Writer. As usual, it contains the very best posts from the nursing and healthcare bloggers.

The 4th edition of the Weekly Health Tips carnival is followed closely by The 5th edition over at Gob’s Channel. This carnival always contains a wide variety of articles pertaining to diet, weight loss, exercise, fitness, nutrition, and general health. Be sure to check it out.

I know it’s a sort list this week. Looks like everyone is busy this month because several scheduled carnivals have yet to post.

Maybe next week.

Enjoy!
Dean

******************************

Dec 20, 2008

Neck Pain and the Cold

*****

I received an email this week from a reader who had a very timely question to ask about neck pain and the weather. He wrote:

Dean,

I tweaked my neck yesterday while out hanging the Christmas lights. It was freezing cold and windy and I was working overhead stapling the lights around the soffet when I felt a twinge in back of my neck on the left side… [snip]

My wife insists that it was caused by the cold weather… [snip]

I realize that I just strained a muscle or something and I’m not worried about it, but I was wondering why do I always get more aches and pains when the weather turns bad?

Regards,
John

Hi John,

Does the weather affect neck strains, not to mention, other forms of joint pain? It would seem so judging from the amount of mail I receive on the subject each year.

I don’t know if anyone has come up with a real scientific explanation for why this is so, but there are several theories including such things as:

• Barometric pressure
• Temperature and/or humidity
• And even Seasonal Affective Disorder (SAD)

These have yet to be proven, but I think it’s a safe bet to assume that all of the above could play a role in one way or another. So just to be on the safe side, here’s my checklist for dealing with winter:

1. Dress warmly and keep your environment warm and humid
2. Keep active
3. Turn on more lights

Transform Your Indoor Weather

First off, while it might sound like I’m bucking the latest trend of “going green” and trying to conserve energy, I actually recommend that you turn up the thermostat in your home or office to a point that you’re reasonably comfortable.

After all, you’re not going to save much green if joint pain is sending you to the ER or the drugstore.

Secondly, get a humidifier. One characteristic of summer that is often lacking during the winter months is humidity.

Keeping the humidity levels at about 40 percent will make your home feel much more comfortable and experts agree that moist air is much easier (cheaper) to heat. Dry air just feels colder and requires a higher thermostat level to achieve the same level of comfort.

If you dress warmly enough and keep the humidity levels high, you will feel comfortable even with the thermostat set at a very green 68 degrees.

So invest in a humidifier. It’s better for you and better for your furniture and it actually saves energy.

Keep Active

During the winter months it just seems natural to want to hibernate.

Inactivity followed by sort bursts of activity seems to lead to more joint injuries than when we stay active on a regular basis. Sitting inside during inclement weather may be tempting, but it’s not good for your joints.

Also, before hanging those Christmas decorations, be sure to warm-up with some good gentle neck and shoulder exercises. And don’t try to do everything in one long marathon session. Take frequent breaks to come inside and warm up with some nice hot cocoa.

Finally, Lighten Up

Just because it’s gray and overcast outside, doesn’t mean you have to sit around in a dark gloomy room. Instead, experts recommend transforming your indoor environment into a warm, sunny day.

For example, if it’s nasty and depressing outside, get translucent blinds that you can keep closed so you don’t have to see how bleak the weather is. Translucent blinds will block the view, while still allowing sufficient light to pass through.

Next, turn on plenty of additional lights. Fluorescents are the most economical, but also try to include incandescent, or halogens so you can get full spectrum light. Spending a little extra for full spectrum lighting will pay off in the long run. They’re a heck of a lot cheaper than anti-depressants.

Also, paint your walls and ceilings in white or bright, sunny pastel shades such as yellow, beige or cream colors. Lighter colors make the room brighter and take less energy to illuminate.

The theory behind all of this is if you can’t see the bleak landscape, then it’s easier to ignore it and a bright, well-lit environment has been shown to have significant impact in combating Seasonal Affective Disorder (SAD).

Granted, this may not actually help prevent joint injuries, but it’s a worthwhile endeavor for its own sake.

Long story short…

Does cold weather contribute to more neck pain, joint pain and back pain? Yes, apparently it does. Why, we’re not really sure.

No doubt it’s one reason people prefer retiring to places like Florida and Arizona. The hot climate is simply kinder to poor achy joints.

So anyway, until science comes up with a cure for the weather, those of us stuck in the colder regions will just have to make the best of things.

Oh, one last thought. Did I mention snacks?

********************

Comments Disabled for this Post

It’s time for another edition of “Writer’s Block,” where blog posts from near and far are all gathered together in one place. So grab your coffee, get comfortable, and start clicking your way through these interesting health related posts…

Grand Rounds is up at Canadian Medicine. As usual, it contains the best in online medical writing.

Change of Shift is up at RehabRN featuring this week’s most outstanding posts from Nursing and other medical bloggers.

The Healthbolt Blog Carnival is up at Healthbolt with posts covering health, fitness, wellness, dieting, and everything in between.

Next, be sure to visit the new IC Disease Health Blog Carnival hosted by IC Disease. This carnival features a wide variety of articles on chronic illness, chronic pain, fitness and general health.

Also, the November edition of The Pain-Blog Carnival is up at How To Cope With Pain. Lots of great reading on the subject of health and pain management. This month the theme is thankfulness.

This week the Carnival of Healing is hosted by The Reiki Digest. Here you’ll find a wide array of health and fitness related posts focused on alternative medicine.

Next, you’ll want to visit The Aromatherapy Blog Carnival hosted by Aroma-essence. Here you’ll find numerous articles on aromatherapy, essential oils, health, fitness, healing, and alternative medicine.

Update: Dec 7th

This week the Carnival of Healing is hosted by Lessons From A Recovering Doormat. As usual it contains health and fitness related posts focused on alternative medicine.

Also you might want to take a look at The 3rd edition of the Weekly Health Tips carnival hosted by Gobs Health for some excellent tips on exercise, bodybuilding, weight loss and general health.

That should keep you busy for awhile. Enjoy!
Dean

*****************************

Nov. 26, 2008

Back Pain and Lifting Belts

Once upon a time it was commonly believed that wearing a lifting belt would prevent back injury. You couldn’t go to a gym or health club and not see dozens of weightlifters and bodybuilders wearing them. I even have one around here somewhere.

All that has changed now. The last time I was at the gym, I don’t recall seeing a single belt anywhere in sight.

So, does that mean they don’t work? Or that wearing one is a bad idea if you’re dealing with back problems?

That’s a good question. I stopped wearing mine because I had a hunch that it was more a liability than an asset — and it appears that most of the other lifters are of the same opinion.

But hunches and opinions are just hunches and opinions. Everybody has one and they aren’t worth much.

The only way to actually separate the facts from the folklore is to turn to those guys with the white lab coats (and way too much time on their hands) and see what they’ve been up to lately.

Here is a rundown of the latest findings:

First up, is a study published just this year (2008) by the Musculoskeletal Disorders Group at the Finnish Institute of Occupational Health in Helsinki, Finland. They concluded:

“There is no evidence to support use of … lifting equipment for preventing back pain or consequent disability.” [1]

Notice that they didn’t say that wearing a lifting belt was bad for you, only that there was no evidence to suggest that you need to wear one.

Next, we have a study conducted by the Institute for Work and Health, Toronto, Ontario, Canada. Their findings…

“Currently, because of conflicting evidence and the absence of high-quality trials, there is no conclusive evidence to support back belt use… ” [2]

Sort of reminds me of an old Herman’s Hermits song… “Second verse, same as the first.”

Undaunted we move back over the pond to Amsterdam and the folks at the Institute for Research in Extramural Medicine who had this to say…

“There was moderate evidence that lumbar supports are not effective for primary prevention. No evidence was found on the effectiveness of lumbar supports for secondary prevention… There continues to be a need for high quality randomized trials on the effectiveness of lumbar supports.” [3]

Wait a minute…

“There continues to be a need for high quality randomized trials?”

So what exactly is it we’re paying you guys to do? Sorry, just kidding. I know you’ve been tied up lately, what with the kids and everything…

(I swear. You ever get the feeling some of these guys are just phoning it in?)

Speaking of which, here’s a summarization of the prevailing literature by the hardworking crew at the National Institute for Occupational Safety and Health (NIOSH) that further echoes the above opinions…

“They (back belts) appear to have little effect on most back injury risk factors, but may have a limited effect on improving muscle strength and supporting the back during lifting and twisting activities… Based on insufficient objective scientific data, NIOSH recommended against back belt use by healthy people.” [4]

Anyone else starting to notice a pattern here?

Anyway, moving right along, the Program in Physical Therapy at Washington University School of Medicine reports.

“The epidemiological data concerning the efficacy of back belts in the prevention of occupational low back injuries are not sufficient to warrant general use of back belts in the occupational setting for uninjured workers.” [5]

They then go on to add…

“There is actually a potential for increasing the degree of low back injury with general application of back belts in occupational settings.” [5]

Finally, we have at least some indication that wearing a back belt may actually weaken the spine and set you up for injury at a latter date. Nothing conclusive, mind you, but they seem to be thinking along the same lines as the rest of us.

“In sum, there are insufficient data in the scientific literature to indicate that general use of back belts in occupational settings is appropriate for uninjured workers.” [5]

At this point, I’m thinking Arby’s, but let’s look at one more, then we’ll wrap this up.

“In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain.” [6]

My Conclusion

While it may seem — judging from popular opinion — that the verdict is in on back belts, the truth of the matter is, it’s not. We don’t really know if back belts help or not. (Maybe if those guys in Amsterdam would get off the pot…)

Anyway, what we do know is this:

1. There is little evidence to suggest that they prevent back injuries, and
2. There is the possibility that wearing them can lead to weak core muscles.

So, should you wear one or not? I guess it comes down to personal choice.

Until there is a truly definitive study, all we can do is speculate.

If you feel that wearing a belt helps support your back when lifting heavy objects, there seems to be no harm in doing so. However, you should probably only wear it when absolutely necessary.

My personal opinion (which is worthless, by the way) is that if you have a healthy back, you shouldn’t really need one. World-class athletes are able to lift safely without them.

Addendum:

By the way, if you’ve been wearing a lifting belt at the gym or at work, you shouldn’t just quit cold turkey. Instead, gradually wean yourself off of the belt as you condition your core muscles to take over that task.

The best way to do that would be to start out performing your preliminary (lighter) lifts without the belt while still using it for the heavy stuff. Then over the next few weeks progressively increase the weight you lift au natural, until you no longer need the belt for support.

Take care,
Dean

References:

1. Martimo KP, Verbeek J, Karppinen J, Furlan AD, Takala EP, Kuijer PP, Jauhiainen M, Viikari-Juntura E. Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review. BMJ. 2008 Feb 23;336(7641):429-31.

2. Ammendolia C, Kerr MS, Bombardier C. Back belt use for prevention of occupational low back pain: a systematic review. J Manipulative Physiol Ther. 2005 Feb;28(2):128-34.

3. Jellema P, van Tulder MW, van Poppel MN, Nachemson AL, Bouter LM. Lumbar supports for prevention and treatment of low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine. 2001 Feb 15;26(4):377-86.

4. Hodgson EA. Occupational back belt use: a literature review. AAOHN J. 1996 Sep;44(9):438-43.

5. Minor SD. Use of back belts in occupational settings. Phys Ther. 1996 Apr;76(4):403-8.

6. Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM. A prospective study of back belts for prevention of back pain and injury. JAMA. 2000 Dec 6;284(21):2727-32.

********************