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Once you have had low back pain, you are likely to have it again. To help keep your back healthy and avoid further pain:

• Practice good posture when you sit, stand, and walk.
• Get regular, low-impact exercise. Walk, swim, or ride a stationary bike. Stretch before you exercise.
• Wear low-heeled shoes with good support.
• Sleep on your side. A medium-firm mattress may be easiest on your back.
• Watch your weight. Being too heavy, especially around your waist, puts extra stress on your back.
• Don’t try to lift things that are too heavy for you. When you must lift, bend your knees and keep your back straight, keep the object you are lifting close to your belly button, and avoid lifting and twisting at the same time.

If you sit or stand for long periods at work:

• Pay attention to your posture. Sit or stand up straight, with your shoulders back.
• Make sure your chair has good back support.

ders back.

• Take regular breaks to walk around.

If your work involves a lot of bending, reaching, or lifting:

• Talk to your human resources department to see if there are other ways you can do your work.
• Don’t depend on a “back belt” to protect your back. Studies have not shown these belts to be effective in reducing back injuries. The most they can do is to help remind you to use good techniques for lifting.

Most low back pain will improve with the following treatment:

• Apply ice for the first 2 or 3 days after you hurt your back, then switch to heat. Use an ice pack for 5 to 15 minutes every 2 or 3 hours. After a couple of days, use a heating pad or take a hot shower for 15 to 20 minutes every 2 or 3 hours.
• Take over-the-counter pain medicine, such as acetaminophen or an anti-inflammatory drug such as aspirin or ibuprofen. These medicines usually work best if you take them on a regular schedule instead of waiting until the pain is severe.
• For the first day or two, rest in a comfortable position . Try lying on your side with a pillow between your knees. Or lie on your back on the floor with a pillow under your knees.
• As soon as possible, get back to your normal activities. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse.

Walking is the simplest and maybe the best exercise for the lower back. It gets your blood moving and helps your muscles stay strong. Start with easy walks of 5 to 10 minutes a day, and gradually increase your time. Walking in water up to your waist or chest is also good exercise.

Some people get relief from pain by using treatments such as massage, chiropractic, or acupuncture. Certain treatments work for some people but not for others. You may need to try different things to see which work best for you.

Only a few people with low back pain need surgery. Surgery may help if you have a herniated disc or back pain along with symptoms of nerve damage, such as numbness in your legs. Even in these cases, most people will improve without surgery. Having surgery does not guarantee that all your pain will go away. Before you have surgery, it is a good idea to get a second opinion.

In 2004, the most recent year statistics are available, almost 15,000 people 65 and older died from falls and about 1.9 million were treated for injuries in emergency rooms, said Judy Stevens, an epidemiologist with the Centers for Disease Control and Prevention.

“I think the magnitude of the problem is something that people don’t recognize,” Stevens said. “It really is a serious issue for older adults.”

Making sure that people over the age of 65 know how to avoid falling or being injured by a fall is the goal of a campaign launched this month by the National Athletic Trainers’ Association and American Academy of Orthopaedic Surgeons.

The organizations say in addition to exercise, older people can make their homes safer by installing night lights, bathroom grab bars and slip- resistant floors.

“If we continue to exercise, especially strength training, we decrease the loss of bone density. Just by working on strength training, you’re working your muscles to keep strong,” said Joe Scott, a NATA member who is outpatient orthopedic team leader for Southcoast Hospitals Group in New Bedford, Mass.
Scott said that as people get older, they’re less active so they lose strength. Also, sight and balance problems can creep in.

Stevens also said it’s a good idea for older people to have a doctor review their medicines each year to look for things like drug interactions that could lead to dizziness.

Experts say certain exercises — yoga, tai chi, and trying to balance on one leg with your eyes closed — can help improve balance.

If a younger person slips, they’ll usually catch themselves, but older people often have less strength and slower reaction times, experts say.

Injuries from falls in the elderly can include broken wrists, elbows, arms and hips, said Dr. Jay Mabrey, chief of orthopedics at Baylor University Medical Center in Dallas.

Low back pain can affect the back anywhere below the ribs and above the legs. The lower back is the connection between the upper and lower body, and it bears most of the body’s weight. Because of these roles, it is easily injured when you lift, reach, or twist.

Almost everyone has low back pain at one time or another. The good news is that most low back pain will go away in a few weeks with some basic self-care. But if your pain is severe or lasts more than a couple of weeks, see your doctor.

Low back pain is often caused by overuse, strain, or injury. For instance, people often hurt their backs playing sports or working in the yard, being jolted in a car accident, or lifting something too heavy. It is more likely to become long-lasting (chronic) if you are under stress or depressed.

Depending on the cause, low back pain can cause a range of symptoms. It may:

• Be dull, burning, or sharp.
• Be felt at a single point or over a broad area.
• Come on gradually or suddenly.
• Occur with muscle spasms or stiffness.
• Cause leg symptoms, such as pain, numbness, or tingling, often extending below the knee. These symptoms can occur on their own or along with low back pain. Leg symptoms are often caused by lower spine problems that place pressure on a nerve that leads to the leg.

A rare but serious problem called cauda equina syndrome can occur if the nerves at the end of the spinal cord are squeezed. Seek emergency treatment if you have weakness or numbness in both legs, along with loss of bladder or bowel control.

Doctors say back pain is:

• Acute if a spell (or episode) of pain lasts less than 3 months. Most back pain is acute and goes away with 4 to 6 weeks of home treatment.
• Recurrent if acute symptoms come back. Most people have at least one episode of recurrent low back pain.
• Chronic if your back bothers you most of the time for longer than 3 months.

Tai chi, an ancient Chinese martial art, may improve senior citizens’ strength and help them avoid falls, South Korean researchers find. Regular exercise is very important as we get older because when we get to 65 we start losing muscle strength at a rate of up to two percent per year. It is effective in fall prevention for older people because of improvements in strength and balance.

The researchers tested tai chi in older adults. The slow, gentle, and continuous movements help them develop stronger muscles, better balance control, concentration, and psychological well-being.

They found benefits including:

• Stronger knees and ankles
• Better balance and flexibility
• Improved walking
• More confidence in the ability to avoid falls

The tai chi students had fewer falls than others who didn’t take the class. Their study appears in the Journal of Advanced Nursing.

Tai chi uses slow, fluid body movements. It’s not a jarring form of exercise. Health experts want everyone to get enough exercise. That includes older adults.

Every year, about 30% of people aged 65 and older and living on their own fall. Some of the risk factors that lead to falls in seniors include imbalance, muscle weakness, and lack of flexibility — all of which can be modified.

Seniors who fall and are seriously injured may take a long time to recover. Meanwhile, they may be sidelined from their normal routine. That can lead to physical decline and depression.

The tai chi students had stronger knees and ankles than their peers. They also improved in flexibility and walking. The tai chi group had fewer falls during the study.

This is not to say that taking Tai Chi will definitely help you prevent falls but it may and it’s good for your body.

Getting in and out of the bathtub or shower may be a dangerous task for many older adults. A study suggests a third of adults over age 60 have difficulty climbing in and out of the bathtub or shower, and more than 70 percent of those with shower stalls use unsafe features such as the glass door or towel bar for support.

“For older adults, losing the ability to bathe is associated with having falls, fracturing bones, and even being admitted to a nursing home. It is important that we take steps to help to prevent bathing disability before it occurs,” says researcher Susan L. Murphy, ScD, OTR, an occupational therapist at the University of Michigan Medical School’s division of geriatric medicine.

In the study, published in the Journal of the American Geriatrics Society, researchers videotaped 89 independently bathing adults over 60 as they demonstrated (fully clothed) how they normally get in and out of the shower or tub. The average age was 82 years, and most of the study participants were women.

Researchers examined their movement and noted if the participants had difficulty negotiating the environment or used things like grab bars, towel bars, shower curtains, glass doors, tub seats, or other parts of the tub to assist themselves.

The results showed that a third of the older adults had difficulty getting in or out of the bath. The most common problem was falling or difficulty positioning themselves onto a tub seat or into the bathtub.

About 30 percent of the participants hit the sides of the tub or the bath seat with their legs during the transfer.

Nineteen percent of the participants using a tub used unsafe features, and 70 percent of those with shower stalls used unsafe features.

The biggest problem was using sliding glass doors in shower stalls for stability or balance. More than three-fourths of older adults who had shower stalls used the sliding glass door for assistance.

“This is extremely unsafe because shower doors were not designed to support a person’s weight,” says Murphy. “This problem could be easily remedied by educating older adults not to use the door as a support or possibly replacing it with a shower curtain, which was used only rarely by older adults in this study.”

The second most commonly used unsafe feature was the towel bar, which was used by about half of the participants.

“While bathrooms in senior housing facilities are designed to be safe, we have found that older adults often do not know the difference between a grab bar and a towel bar. They also have unsafe strategies of getting into and out of their shower or tub,” says Murphy. “We think the results from this study demonstrate the need for health care professionals to become involved in helping to prevent bathing disability, instead of just treating people in the hospital after they have had a fall in the bathroom.”

Swollen feet, sometimes called edema, is a condition where the muscles in the feet have an excessive fluid buildup. Gravity pulls the fluid to your ankles and feet.

Swelling can be a symptom of a serious problem, a sports injury, pregnancy, heart disease, fluid retention, kidney problems or another condition. If your feet swell chronically see your doctor.

Slight swelling of the lower legs commonly occurs in warm summer months. Slight swelling is more likely to occur if a person has been standing or walking a lot.

Traditional treatment might include any or all of these suggestions:

• Elevate your feet and legs. Place a pillow under your heels, and prop your feet on a chair or high stool. Use a leg wedge to elevate while sleeping.
• Dip your feet into a tub of cold water or sit on the side of the bath with your feet under a cold-water tap. After this put your feet up for a while.
• Reduce your salt intake. Salt causes you to retain water.
• Do not abuse laxatives.
• Take diuretics if prescribed by your doctor. Diuretics increase urination by pulling excess fluid out of your cellular tissues.
• Practice good health habits. Proper nutrition and daily exercise improve the health of your cardiovascular system and your circulation, helping to reduce the tendency of your feet to swell.
• Wear support socks or stockings and well fitting shoes.

Not everyone has all of the warning signs of heart attack. And, sometimes these signs can go away and come back.

Symptoms of a heart attack include:

• Pain or discomfort in the center of the chest
• Pain or discomfort in other areas of the upper body, including the arms, back, neck, jaw, or stomach
• Other symptoms, such as shortness of breath (feeling like you can’t get enough air), breaking out in a cold sweat, nausea (feeling sick to your stomach), or feeling faint or woozy

Some women have more vague symptoms such as:

• Unusual tiredness
• Trouble sleeping
• Problems breathing
• Indigestion (upset stomach)
• Anxiety (feeling uneasy or worried)

You can lower your cholesterol by taking these steps:

Maintain a healthy weight. If you are overweight, losing weight can help lower your total cholesterol and LDL (”bad cholesterol”) levels. Calculate your Body Mass Index (BMI) to see if you are at a healthy weight. If not, try making small changes like eating an apple instead of potato chips, taking the stairs instead of the elevator, or parking farther away from the entrance to your office, the grocery store, or the mall. (But be sure to park in a safe, well-lit spot.)

Eat better. Eat foods low in saturated fats, trans fats, and cholesterol.

Eat more:

• Fish, poultry (chicken, turkey–breast meat or drumstick is best), and lean meats (round, sirloin, loin). Broil, bake, roast, or poach foods. Remove the fat and skin before eating.
• Skim (fat-free) or low-fat (1%) milk and cheeses, and low-fat or nonfat yogurt
• Fruits and vegetables (try for 5 a day)
• Cereals, breads, rice, and pasta made from whole grains (such as “whole-wheat” or “whole-grain” bread and pasta, rye bread, brown rice, and oatmeal)

Eat less:

• Organ meats (liver, kidney, brains)
• Egg yolks
• Fats (butter, lard) and oils
• Packaged and processed foods

Get moving. Exercise can help lower LDL (”bad cholesterol”) and raise HDL (”good cholesterol”). Exercise at a moderate intensity for at least 30 minutes most days of the week. Take a brisk walk on your lunch break or take the stairs instead of the elevator.

Take your medicine. If your doctor has prescribed medicine to lower your cholesterol, take it exactly as you have been told to.

Cholesterol is a waxy substance found in all parts of the body. When there is too much cholesterol in your blood, cholesterol can build up on the walls of your arteries and cause blood clots. Cholesterol can clog your arteries and keep your heart from getting the blood it needs. This can cause a heart attack.

There are two types of cholesterol:

• Low-density lipoprotein (LDL) is often called the “bad” type of cholesterol because it can clog the arteries that carry blood to your heart. For LDL, lower numbers are better.
• High-density lipoprotein (HDL) is known as “good” cholesterol because it takes the bad cholesterol out of your blood and keeps it from building up in your arteries. For HDL, higher numbers are better.

What do my cholesterol and triglyceride numbers mean?

Total cholesterol level -

• Less than 200 mg/dL is best.
• If your total cholesterol is less than 200 mg/dL then that’s desirable
• If your total cholesterol is 200 - 239 mg/dL then it’s borderline high
• If your total cholesterol is 240 mg/dL and above then it’s high

LDL (bad) cholesterol -

• Less than 100 mg/dL is best.
• 100-129 mg/dL then it’s near optimal/above optimal
• 130-159 mg/dL then it’s borderline high
• 160-189 mg/dL then it’s high
• 190 mg/dL and above then it’s very high

• HDL (good) cholesterol - Higher is better. More than 60 mg/dL is best.
• Triglyceride levels - Lower is better. Less than 150mg/dL is best.