Archive | November, 2015

31. ISIS Hysteria

19 Nov

First of all, I want to make clear that ISIS is so horrendous that people inclined to hysteria can be excused for their weakness. But hysteria cannot guide our response to this serious threat.  Our leaders do best when they think clearly and consider all of the consequences of any course of action. Past cavelier and impulsive military offensives have emerged us in an expensive quagmire of problems.  Predominantly Christian troops marching into Muslim countries can sometimes be effective, but the results are usually not permanent, and can lead to conversions of peaceable citizens to terrorists. Many Middle-Eastern countries have political systems that are markedly different from ours. Trying to impose our ways on others can have serious negative consequences.

The recent attack in Paris by ISIS has provoked a lot of unwarranted criticism directed towards President Obama. He has considered all of the factors listed above, consulted with military and governmental experts, and has coolly and carefully followed a safe and effective plan.  Likely, ISIS wants us to do hysterical aggressive things that will be used justify their plan, and aid in recruitment.

Senator Dianne Feinstein just felt she had to criticize the President. She is talking more like a Republican than a Democrat, and just says non-specific and meaningless things. She says they are “growing” and we have to “take them out.” Of course, we would all like to take them out, but what is her plan. Send in the troops and face all the problems listed above?  And after defeating ISIS, how long will our troops have to remain to hold on to our gains. In Afghanistan and Iraq, after many years, when we leave, the terrorists return. Senator Feinstein has the hysterical, unclear, and wrong solution. As far as ISIS “expanding” goes, she has not provided any evidence for this. ISIS threats are not proofs of growth.

When I think about the serious problems that Obama faced when taking office, and the unrelenting, unfair criticism that he has been subjected to; and how he has been thwarted by the Republicans in almost every endeavor, I have to give him the highest rating of all our U.S. presidents. Most everything he has attempted and achieved is right on the mark, and in the worst case, defensible if not perfect.

30. Stretching Program for Back Pain

15 Nov

In a previous blog (July 17, 2015, Number 23: Treatment for Common Back-Pain), I described a treament for lower-back-pain with muscle strain as its basis. This blog, Number 30, will cover subsequent observations and information.

I suggest that the immediate cause for most lower back pain is excessive muscle tension, even if there is an ultimate, responsible, spinal defect. I have drawn this conclusion after many years of scientific research, work with patients, personal experience, and a Ph.D. program specializing in physiological psychology and neuroscience. My own severe back pain motivated me to spend hundreds of hours studying the spine, MRI scans, back muscles, and various treatments. Professionally, I was the recipient of a government research grant from NIH, and was head of a research department (Neurological and Behavioral Sciences) at Henry Ford Hospital, Detroit.

CAUTIONS
Before continuing, I want to emphasize that consultation with Medical professionals (MD or DO) is often necessary, that I am not providing “medical advice”, and that in using the procedures described below, one must avoid rapid, sudden, and angular movements that could cause additional problems. My program is most applicable to those with centered, lower back pain, as opposed to pain that is on one side, and/or radiating down one leg (often designated as Sciatica). But even if the spine has known defects, such as a herniated disc or neuroforaminal stenosis, muscle tension may be the immediate cause of pain. One must work slowly and thoughtfully, advancing the stretching little-by-little.

DIAGNOSIS
The result of my study of the medical literature and experience as a psychotherapist (specializing in stress-reduction) and as a patient, leads me to believe that the precise source and origin of the pain is often unknown. CT and MRI scans are helpful in determining spinal damage, but there can be hidden damage not detectible by scans. The bony and supportive structures (such as discs), in the spine have no pain receptors and damage to these does not directly cause pain. Pain caused by the spine comes from defective spinal structures that press or squeeze the main cord or emergent nerves. For example, squeezing of the sciatic nerve as it emerges from the spine can cause “sciatica” (pain in the back, which radiates down the leg). A final diagnosis emerges from medical history, physical examination, scans, and dialogs with the patient. “Discograms” are often needed to pin down the specific location where squeezing occurs. A discogram includes an invasive probing of the suspected spinal areas and reports of the unanesthetized patient. If probing in a certain area produces the sensation of the patients back pain, then that will be the area corrected with surgery. In the end, surgery is often performed with a less than 100% confidence in the diagnosis. It is understandably difficult to work with a complex living structure buried deeply below the surface of the skin. A more definitive procedure such as a discogram is often avoided by patients because it is painful.

Abnormal pressure on a spinal nerve may be the cause of back pain, but the cause can occur in different ways. First, there could be a direct cause: pressure causes sensory nerve impulses that are interpreted by the brain as back-pain. An indirect cause could be that certain motor output to back-muscles is greatly increased causing excessive muscle tension. It is a known fact that excessive and prolonged contraction of any muscle can cause pain and even severe cramping. The affected nerve could also interfere with reflex systems located in the spine that regulate supportive muscle tension. In my case, sleeping in bed always resulted in very tense painful back muscles. My sleeping position may have caused certain forces on the spine that affect important regulatory reflexes. For me, the biggest question is what causes the profound contraction while sleeping?

Of course back pain can occur without any defect in the spinal cord or emerging nerves. For example, a dentist needs to bend forward and perform very delicate and often difficult procedures. This situation requires back tension to support the required movements. While the dentist is operating, the back is very tense. Unfortunatly, the tension may persist after the procedures are finished. Other stresses, such as concern about cash flow, a law suit, various personal problems, etc. can make the tension worse. The work performed in many professions and in other situations can lead to back muscle tension. A computer programmer can sit for hours in front a computer trying to “de-bug” an important program. Working while sitting very still for hours can lead to severe and painful contractions (also in the legs and even fingers). Any activity that requires a considerable amount of time bending forward (or even sitting still) can tax the supportive back muscles. The fact that after the taxing activities are finished, the muscles may not resume a comfortable, fully relaxed state, is critical.

THE STRETCHING PROGRAM
Who should try the stretching programs described here? Before continuing, I want to re-emphasize the “Cautions” listed above. If you think that stretching your back muscles could possibly produce more damage, then consult with a medical specialist before experimenting.

This program could benefit anyone with lower back pain resulting from any cause. The safest application would be after an examination by a physician who finds no specific spinal involvement. If there are spinal defects and/or pain on one side, then be more cautious. In the end, the patient must make a final decision, which is always a kind of gambling and weighing of benefits versus risks. My own inclination is towards self-help, but I definetly value the input of established experts. In most cases, I have been correct, but a couple of times I have made serious, but not lethal (as you have already guessed) errors.

My blog 23 has a good description of the stretching procedures. What I will do here is to emphasize the important points and further observations. Many years ago, the benefits of “toe touching” exercises was established. I recommend doing this many times a day, at least hourly. Also, it should be done before and after certain activities, such as sleeping, napping, sitting at a desk, doing anything stressful or requiring concentration, carrying heavy objects, many types of physical work, etc. Experimenting is key to success. A single repetition is to bend over (standing or sitting) and try to touch the toes. Use a moderate amount of effort, too little would be ineffective and too much could be harmful. After bending, resume an upright position. Do at least three bends, without pausing, or with pauses of a few seconds. It is very important that you continue until you achieve a maximum bending. Experimenting will tell you how many reps are necessary to fully stretch the back muscles. As you work with the back muscles, you may be able to alter or abidge the procedures so that less time is taken. While writing this lengthy blog I moved in various ways so as to feel if tension is building up. Twice I fully bent over from a sitting position. Finally, I want re-emphasize reaching maximum bending, because, my experience is that failure to do so will allow pain to persist.

FEEDBACK AND LEARNING
Maybe the most important contribution I can make here is to describe the feedback and tension-gauge that is very helpful. You can better achieve any goal by “seeing” the actions, developing a gauge, and understanding the process. Biofeedback instruments are often used to combat tension and stress. Biofeedback can help, but it is difficult to locate and study the many and deep supportive back muscles. Earlier in life I saw many patients for stress using biofeedback methods.

A really good way to gauge back tension is the following.
1. Establish a standard bending procedure: use a specific chair or standing posture.
2. Perform at least 4 or 5 bending repititions.
3. Your current measure of back tension is the difference between the first and last amount of bending. The “bending amount” is the distance from finger tips to floor.
4. If you can muster the motivation, record the activity and the tension gauge.

Here is an example. You are sitting on the side of your bed and a moderate effort on the first bending results in your finger tips reaching a point 3-inches above the floor. The second time you bend, you reach 1.5 inches from the floor. Third and fourth bending are one-inch and 1/2 inch. Several more bendings are 1/2 inch away.
The tension gauge is 2.5 inches (the first, 3-inches minus the last: 1/2 inch). I have already done this procedure hundreds of times. If you easily touch the floor when bending (using your standard procedure) then you can measure the distance from your wrist or knuckles (making a fist) to the floor. The gauge is always the difference (in inches-to-floor) between the first attempt and last. As you work on this, your will quickly learn what is your maximum stretch and can stop the reps at this point. Think about what you are doing and what the muscles feel like when tense and fully stretched.

Here are some details of my personal experience. I have two standard positions: one is standing-up with legs straight and feet separated by about 18-inches, the other is sitting on the side of my bed. When I wake up after several hours of sleep, my back is very tense. First bend from a sitting position is about two-inches above floor. The last (after 4 to 6 bends) and best sitting bend is to palms on floor. The difference is five-inches. Five inches represents the current tension. That is a maximum for me. A long sleep always results in a “five” even though I fully stretch before entering bed. A short sleep or just resting in bed produces a lesser amount. Working at the computer, depending on the activity and intensity can produce tensions ranging from about one-inch to four-inch toe-touching differences. Various types of movement tend to lessen the tension. Being still for a long time increases the tension. My overall max is the five-inches. For me, walking around with a five-inch tension level can produce severe stabbing pains and a feeling of collapse. Several years ago, I realized that a few stretches before standing up was helpful, but I did not realize the full picture. Unfortunatly I never saw the importance of stretching at other times, particularly before sleeping. Although I always wake-up with back tension, I suspect that stretching before getting into bed helps to produce a more relaxing painless sleep.

FINAL THOUGHTS
If you study and experiment you may be able to avoid expensive and painful medical procedures. On the other hand, there are times when good medical advice is really necessary. I wish I could define these times with 100% accuracy. If you have unusual back-pains or severe back pains consult with a well-established and credentialed orthopedic doctor. If other symptoms accompany the back pains, see the doctor. I have not yet mentioned inflamation. Any severe painful condition may be accompanied by harmful inflamation. There are numerous drugs and natural remedies for this. I take two common NSAID anti-inflamatory pills early in the morning. I experimented with tumeric, but for me this was of little effect. When I cured the severe backaches with stretching, I totally stopped taking the NSAID. But after about 10-days my knees started to hurt more, so I resumed two/day.  I suspect this also helps with any back-muscle inflammation.

Here is another factor that comes to mind. General good health achieved through diet and the right exercise can be of benefit. Fourteen years ago I developed a moderate sciatica, which disappeared after about two months. I had an MRI scan and noticed that the report mentioned dessicated (dry) spine. I discovered that Vitamins A and D were missing from my diet and I restored these factors. The pain disappeared in about two months, and the vitamins may well have been the cause.