The Pain-in-the-back Brigade

Oh, my aching back! That's the lament of more 50-year-old businessmen than you can shake a heating pad at. This pain-in-the-back brigade suffers an ailment that is among the most difficult to diagnose and to correct. Deskbound types are prone to the problem. London's Executive Health Examiners, for instance, reports that pearly 25% of the sedentary middle-agers it examines have some form of back trouble. It's equally certain that you, as a potential sufferer, can do much to head off this painful malaise before it gets you down.

Why is diagnosis hard? Look at the physical causes of lower back pain. Strained ligaments in the spine, made worse by weak back muscles that give poor support, can be the problem. Degeneration (wear and tear) of discs and joints in the spine, especially after age 45, can lead to osteoarthritis and much pain. The misplaced or "slipped" disc is not so frequent a cause as most people think. Finally, among older men, prostate, kidney, and bladder ailments can lie at the root of the trouble.

Your physician will try to eliminate the less apparent causes first, then get down to the prevalent ones: strained ligaments or arthritis. Note: Upper back pain - not so frequent - may have similar causes, but also may indicate heart or lung disease, or just poor posture. So, if you're a sufferer, go to the doctor with a spirit of tolerance and a hope - but no demand - for prompt action.

A typical scene: You awake in the morning and find it hard to sit up. You have severe stiffness in the lower back. This is common if you are over 40. It may mean that you sleep on too soft a mattress, have a touch of arthritis, maybe both. But see a doctor - a good rule for all back pains - if the condition lasts over two weeks. See your regular doctor first and let him screen out and treat the usual causes, or send you on to an orthopedic specialist. Note: Don't jump to conclusions if he refers you to a specialist - the general practitioner, faced with problems of diagnosis, may simply be playing it safe.

Types of therapy? It may be as simple as using a heat pad; it could also involve an operation. A firm mattress is commonly prescribed (a soft one can cause severe pain). Raising the heel of one shoe 1/4 or '/2 sometimes is helpful. Some specialists prescribe Novocaine or Xylocaine shots to kill the pain. Massage by a physiotherapist is a mainstay. Most orthopedic specialists will use surgery as a last resort, after lesser methods have failed. About 90% of back troubles remain nonsurgical. If you wind up facing an operation, realize that surgery to correct a slipped disc or defect in a spinal bone is "major". Hospitalization will run one to four weeks, followed by four to six weeks, sometimes longer, at home.

On the positive side, you can rest assured that although there aren't too many claims for 100% cures, the improvement rate is very high. Office people most always are able to resume their normal routines with reasonable if not complete comfort. The fatality rate is negligible. And contrary to a widespread fear, there is rarely any risk of lower-body paralysis.

How to avoid all these problems? Daily exercise is the answer. Stronger back and abdominal muscles that will help support your weight without strain on the spine can be developed by a simple routine of brisk walking (at least 30 minutes), plus about 15 minutes of calisthenics each day. The sitting-up exercises, however, must be planned. Simple limbering exercises are fine. So are isometrics - muscle tensing and relaxing exercises - because they develop muscle without strenuous contortions. A good one is to lie flat on your back and push your back downward against the bed or floor; or, lie flat and do 45-degree straight-leg raises. Straining to touch toes or the floor without bending the knees can be dangerous. So can sit-ups from a flat position, or pulling knees to the chest.

Golf won't cause back troubles unless you've already some underlying condition. But if you have a tendency to back pain, be moderate about tennis.

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There's disquieting news from the UK. Public Health Service: Diabetes is increasing. It's a greater health problem than is generally recognized. PHS says that well over 4 million English people are diabetics. Worse, half of them don't know they have the disease - though it's the third leading cause of blindness and a major villain in heart disease. Why the buildup in diabetes? It's because English people are eating too well. Overweight now is tagged as second only to heredity in triggering diabetes.

Diabetes can sneak up on a person. In 80% of cases, the classic symptoms - excessive thirst, frequent urination, mysterious weight loss, weakness, constant fatigue - don't appear until after age 40. Up... see: Diabetes