Friday, 3 April 2015

Long Term Use of Paracetamol for Low Back Pain is Ineffective and can be Harmful

In a published study in the British Medical Journal, BMJ, of 31 March 2015, 12 high quality studies of the use of paracetamol and the treatment of low back pain and osteoarthritis have shown some very interesting results in terms of its efficacy and side effects.

Low back pain is a main cause of absenteeism and according to the World Health Organisation, low back pain is responsible for more than 100 million workdays lost per year in the United Kingdom and the loss of 149 million workdays or US$200 billion a year in the United States.  We do not have the numbers for New Zealand but using per capita calculation, this should approximate 2 million workdays lost here due to low back pain.

The BMJ reported that negative side effects from the use of paracetamol included liver toxicity, kidney disease, gastrointestinal problems and in some cases may even cause premature death. These negative side effects are suffered even though paracetamol has been shown to be ineffective in the treatment of low back pain.

Most people with low back pain do not have a serious problem in the lower back like fracture or nerve issues.  Low back pain is commonly caused by muscle, ligament, disc or facet problems.  Treatment with microcurrent by increasing the energy going to the specific cells to allow cellular detoxification and healing can help alleviate low back pain.  In Traditional Chinese Medicine, low back pain is caused by low kidney energy.  Many patients with low back pain, especially the elderly will also have knee pain.  Acupuncture is proven to help.  These are more natural non-pharmacologic treatments without the side effects that pain killers like paracetamol has.  Weight loss to reduce the burden of carrying an overweight body, physiotherapy and pilates are all useful.

So, the next time you hear of a family, friend or workmate suffering from low back pain, suggest other therapies to them if they are reaching for paracetamol.

Wednesday, 1 April 2015

Sleep Hygiene to improve the Quality and Quantity of a Night’s Sleep

Sleep problems are common these days and are often worse in summer.  Whilst there can be many problems that lead to poor quality and lack of sleep, maintaining good sleep hygiene can help to alleviate some of the problems.  If pain is keeping you awake, make sure you address the problem so that you are not constantly woken up because of pain.  If frequent urination at night is a problem, investigate the possibility of benign prostate hyperplasia or chronic nocturia which should be treated.

Here are 10 tips to help you sleep better:
  1. Keep a journal of the things that need to be done the next day.  You can keep the journal beside your bed so that tasks can be dumped into the journal and you will revisit them in the morning.
  2. Do not have constant exposure to computer screens 2 hours prior to bedtime.
  3. Exercise earlier in the day, especially vigorous aerobic type exercise.  As strenuous exercise can produce lactic acid in the muscles, this can affect your sleep quality.  Gentle exercise that helps increase endorphins are helpful in aiding sleep, but should be done at least 3 hours before bed.
  4. Avoid caffeine (tea, coffee and any caffeinated beverages) after 2 p.m.
  5. Do not drink massive amount of water later in the day.  Sip your water after dinner and make yourself a chamomile tea to calm down.
  6. Make sure the temperature in the room and comfortable for sleeping.  Having too many sheets or inadequate sheets can wake you up unnecessarily.
  7. Keep the bed to relaxation, sleep and sex.  The bed should not be associated with work and stress.
  8. Obesity is a leading cause of sleep apnoea which is a common reason overweight people do not sleep well.  Reduce your weight.
  9. Actively work on reducing stress or your perception of stress in your life.  Being a perfectionist often does not help with stress management, be a realist!
  10. Have an aromatherapy bath before bed.  Drop some lavender and ylang ylang essential oil into your bath and relax!
If you constantly have sleep problems, it could be a sign of more serious medical condition and needs to be checked out by your health care professional.