Proper Standing Posture for Back Pain Relief

Practicing a proper standing pose in front of a mirror each day can improve posture and back pain. Stand with your feet shoulder width apart with toes pointed straight ahead. Avoid locking your knees and imagine that the entire ball of your foot is engaged with the floor. Engage the muscles of your legs without tensing them. Imagine that the waist down is akin to the trunk of a tree. Imagine that there is a rod going from your tailbone to the top of your head along your spine. This will help straighten your back, neck and head. Look to see that your head is not tilted and your shoulders are not raised. Take 3 deep breaths in this position, visualizing the oxygen going to the places in your back that have pain. You're now in the proper position for standing stretches.

Symptoms of back pain

If you have low back pain, you may have tension, soreness or stiffness in your lower back area. This pain is often referred to as 'non-specific' back pain and usually improves on its own within a few days.

Back pain may be called either 'acute' or 'chronic' depending on how long your symptoms last. You may have:

• acute back pain - lasting less than six weeks
• sub-acute back pain - lasting six weeks to three months
• chronic back pain - lasting longer than three months

You should see your GP as soon as possible if, as well as back pain, you have:

• a fever (high temperature)
• redness or swelling on your back
• pain down your legs and below your knees
• numbness or weakness in one or both legs or around your buttocks
• loss of bladder or bowel control (incontinence)
• constant pain, particularly at night
• pain that is getting much worse and is spreading up your spine

These symptoms are known as red flags. It's important to seek medical help for these symptoms to ensure you don't have a more serious, underlying cause for your back pain

Back Pain Exercises

Exercises that specifically target your back can help to alleviate pain. This is because exercises help to strengthen your back muscles, pulling your spine back into alignment. Be careful not to overdo it with these exercises, however. Stick to five repetitions of each:

• Curl Up: This exercise strengthens the abdominals and lower back. Lie flat on the floor with your legs bent at a 45° angle. Slowly curl your chest and shoulders towards your knees, keeping your arms outstretched. Stop when your hands can touch you knees.
• Upper Body Extension: This exercise strengthens the muscles in your upper back. Lie on your stomach with a pillow placed under your hips. Clasp your hands behind your lower back and slowly lift your upper chest off the ground.
• Arm-Leg Extension: This exercise helps to realign your spine, relieving pressure on your lower back. Get on all fours. Raise one arm in front of you and raise the opposite leg behind you. Repeat with the other arm and leg.

Treating and Preventing Low Back Pain

The treatment of low back pain depends on its cause.

For low back pain involving muscle and nerves, treatment can include pain medications such as acetaminophen*, nonsteroidal anti-inflammatories (NSAIDs; e.g., ibuprofen, naproxen), or opioids (e.g., codeine, oxycodone) when pain is severe. Muscle relaxants may also be used, but their benefit in low back pain is not clear. Heat and cold (for the first few days after an injury) treatments and certain exercises as directed by a health care professional may also be used to help relieve pain. In some cases, chiropractic adjustments and physiotherapy can help with low back pain.

Bed rest is usually not recommended, but if it is needed, it should not be longer than 1 or 2 days. Avoid heavy lifting after an injury, but continue light activities. As well as losing weight, most people are advised to improve their posture or lift weights to strengthen the muscles and ligaments of the lower back. Strength training is a normal part of recovering from any muscle or ligament injury. Before starting an exercise program, discuss the activity first with your doctor and learn how to do the exercises properly.

Occasionally, slipped discs require surgery to decompress them. This may include deliberately fusing two vertebrae together. The operation shouldn't restrict back movement in any noticeable way.

Some back pain recurs over and over. Even the most thorough investigations may not find signs of injury or disease in some people. Speak to your doctor about exercises, physiotherapy, massage, or other therapies such as osteopathy, chiropractic, or manual physiotherapy.

You can help prevent low back pain by strengthening the muscles that support the back. Good posture while sitting or standing can also help prevent back pain. Proper lifting can also help prevent back injury: always keep the knees bent, do not twist the back, and use the legs to lift.

Treating Fibromyalgia Back Pain

Luckily, fibromyalgia sufferers aren’t forced to experience long-term chronic back pain. There are a number of effective back pain treatments that you can use to help alleviate your pain. Here are some of the best for back pain relief.

Heat
Heat is an excellent remedy for most muscle aches and pains, and it works particularly well for the upper and lower back. Heat works to relax the muscles and encourage circulation, allowing your body to heal itself. Popular heat therapies include:

• Heat Wraps: Heat wraps are made out of special, heat-retaining materials, and can be warmed in the microwave or in a tub of warm water. You then tie the wrap around the section of your back that hurts. Special wraps are available which are contoured to the lower back, upper back, and neck and shoulder regions. You can wear these all night long, for up to eight hours of relief.
• Heating Pad: Heating pads are inexpensive and easy to use. Simply place a heating pad on the back of your chair or in your bed, just before going to sleep. Heating pads help to target specific areas of pain.
• Warm Baths: Warm baths, spas, or hot tubs are also excellent for relieving fibromyalgia back pain. They help to encourage restful sleep, which gives your body the time it needs to heal itself.

Back Supports
Back supports have long been used by those with upper and lower back pain, and can work wonders for you, especially if you spend long hours in front of the computer at the office. Invest in a back support made out of foam or synthetic materials, as these are sturdy and breathable. Look for a support that has:

• a lumbar support (a curve that fits into the lower back region)
• a high back (as this will ensure that your neck and shoulders are properly aligned)
• an adjustable back (which will allow you to place it properly in any chair)

Additionally, you may want to invest in an ergonomic chair that offers a tilting back and adjustable seat.

Recommendations to Decrease/Limit Patient Radiation Exposure in Myocardial Perfusion and Cardiac FDG PET

 

• Follow the recommendation of the American Society of Nuclear Cardiology to decrease patient radiation exposure to < 9 mSv in 50% of patients by 2014⁶
• Follow appropriate use guidelines in selecting patients for myocardial perfusion PET^1,7
  • Do not perform cardiac imaging in patients without cardiac symptoms unless high-risk markers for coronary events are present
  • Do not perform cardiac imaging for patients who are at low risk of coronary events
  • Do not perform radionuclide cardiac imaging as part of routine follow-up of asymptomatic patients
  • Do not perform cardiac imaging as a pre-operative assessment in patients scheduled to undergo low or intermediate risk non-cardiac surgery
• Use 3D imaging mode and lower amounts of radiotracers whenever feasible to reduce radiation dose to the patient¹
• Use a single localizing scan and a single transmission scan if the patient is not moved between the rest and stress scans, whenever feasible, especially for Rubidium-82 imaging
• Minimize tube current for CT based transmission imaging
• When using gated CT imaging for calcium score, use prospective gating methods to reduce radiation dose
• Use combined perfusion imaging and CT coronary angiogram only when the second test is indicated, after review of the results of the first test

Are there steps physicians can take to reduce the risk of CIN?

Yes. SCAI's Catheterization Laboratory Standards Committee has analyzed the available data about CIN and issued recommendations for the prevention of CIN at each stage in the treatment of patients who are undergoing interventional procedures that involve the use of contrast media. 

The first step is to assess a patient's kidney function. SCAI recommends that physicians assess kidney function using estimated glomerular filtration rate, or eGFR, which takes into account the patient's age, race, and other factors. The eGFR is most accurate assessment of kidney function currently available. 

Another important precaution for preventing CIN is to ensure that the patient is adequately hydrated before, during, and after interventional procedures that involve the use of contrast dyes. Patients who are at increased risk for CIN should come into the hospital far enough in advance of the procedure so that they can be given appropriate intravenous hydration. 

Patients should consult with their physicians to determine whether to discontinue taking non-steroidal anti-inflammatory agents (NSAIDS) 24-48 hours before a procedure. These medications include ibuprofen and Naprosyn, and are commonly taken for headaches, backaches, and arthritis pain. NSAIDS may cause a decrease in blood flow to the kidneys and, when combined with contrast media, are more likely to interfere with kidney function in some patients. 

SCAI recommends that physicians use low osmolar and iso-osmolar contrast agents instead of high-osmolar agents in patients at increased risk for CIN. Osmolarity refers to the number of ion particles in the blood. A low-osmolar agent is thinner than a higher osmolar agent and is considered to be safer because it is less likely to interfere with blood flow to the kidneys. Iso-osmolar contrast agents are even thinner. 

Patients at increased risk for CIN should be monitored closely after their procedure for any signs of kidney failure. In patients at increased risk for CIN, a serum creatinine test should be done during follow-up to provide assess kidney function. This test measures the amount of creatinine, an amino acid excreted by the kidneys, in a person's blood work.