Talkback Autumn 2012

TalkBack Quarterly magazine of BackCare, the UK’s National Back Pain Association

£2.95 • FREE TO MEMBERS

Builder’s back pain Campaign launch Chronic pain recovery Adaptogenic nutrition New challenge events

■ NEWS

■ EVENTS ■ COMMUNITY autumn 2012

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Talkback l autumn 2012

Talkback news 3

Welcome

Contents

Hello and welcome to this special autumnal edition of TalkBack. The days have certainly grown shorter and the festive period is but weeks away, but things certainly haven’t slowed down at BackCare head office.

It’s been a busy few months for the charity with BackCare Awareness Week and the launch of the Builder’s Back Pain campaign so we’ve got lots to report on. We undertook several campaign activities, including the launch of a dedicated website, creating an e-petition on the Government petition website and doing live interviews. You can read a full report on the campaign activities in this issue.

Our campaign against excessively heavy school bags is ongoing. Alice Walsh, who appeared in the last issue, went on to volunteer as roving reporter to help produce a news video about the schoolbag health crisis, which will be released on the internet.

We’ve also had interest from some prominent UK journalists and look set for a new international collaboration – watch this space!

There’s a packed events calendar for you in this issue, including all-new fundraising challenge events. Our major fundraising event is, of course, the Virgin London Marathon and we’re now recruiting runners to join the 2013 BackCare team. Check the events page for more information. We also have a truly inspirational reader’s story detailing the dramatic recovery of Marie from East Durham. If you have an uplifting story to share, please email it in to yourstory@backcare.org.uk or pop it in an envelope and post to the usual address.

I’m excited to be launching a new educational series in this issue, entitled “Prevention is better than cure”. The first instalment, on p18/19, introduces an upgrade to the way we conceptualise nutrition illustrated by a medicinal vegetable, the Asiatic pennywort.

This will be the last issue of 2012, so let me take this opportunity on behalf of everyone at BackCare to wish you all a very merry Christmas as well as a happy, healthy and productive New Year. Without further ado, I’ll leave you to enjoy the magazine.

Queen suffers, too

4

MBE honour

4

Is back pain genetic?

5

On media duty

6

Initiatives in Europe

7

Back from despair

8/9

BackCycler review

10/11

Awareness Week

12/13

Marathon 2013

14

The right Pilates

16/17

Asiatic pennywort

18/19

Corporate partner

20/21

Dr Adam Al-Kashi Head of Research & Editor of TalkBack We welcome articles from readers, but reserve the right to edit submissions.

Paid advertisements do not necessarily reflect the views of BackCare. Products and services advertised in TalkBack may not be recommended by BackCare. Please make your own judgement about whether a product or service can help you.

Where appropriate, consult your doctor. Any complaints about advertisements should be sent to the Head of Information and Research.

All information in the magazine was believed to be correct at the time of going to press. BackCare cannot be responsible for errors or omissions. No part of this printed publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without permission of the copyright holder, BackCare. ©BackCare

BackCare 16 Elmtree Road, Teddington, Middlesex TW11 8ST Tel: +44 (0)20 8977 5474 Fax: +44 (0)20 8943 53318 Helpline: +44 (0)845 130 2704 Email: info@backcare.org.uk Website: www.BackCare.org.uk Twitter: @TherealBackCare Registered as the National Back Pain Association charity number 256751.

Talkback is designed by Pages Creative www.pagescreative.co.uk and printed by Severnprint, Gloucester.

Fundraising

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Android app

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Legacy donation

Cost of pain

patronage renewed

With great sadness, we report the passing away of BackCare member Mrs Barbara Bourne. We would additionally like to acknowledge Barbara for a generous donation of £5,000. This is a significant sum and will help us to continue in our mission of lessening the burden of back pain on society.

Back in 2007, a doctor in Denmark calculated the cost to society when a worker, aged 35, damaged their back and could not work until retirement age. We’ve added five years of inflation to update the figure, where it stands at a staggering £2.2 million just for that one worker.

We are pleased to announce that The Prince of Wales has renewed his patronage of BackCare. A representative from Clarence House confirmed by letter that the Prince was “delighted” to accept the invitation and will remain the charity’s patron for a further five years to November 2017.

Queen pulls out of honours ceremony Pain gives grounds for caution The Queen had to forgo an investiture ceremony at Windsor Castle in October on account of her chronic pain.

She had been due to present nearly 100 honours at the ceremony, but the rare decision was made to cancel her appearance – the physical demands of standing for over an hour and leaning repeatedly to pin the medals were feared too great by aides.

The 86-year-old monarch has missed very few of her engagements over the past 60 years. Nonetheless, she has suffered excruciating back pain for a number of years and in 2006 was out of action for

several weeks with chronic sciatica.

Last month’s events have refuelled concerns that too much is being asked of her as she still conducts more than 300 engagements a year.

Immediately after the event, BackCare was contacted to appear on BBC Breakfast News to discuss the Queen’s back health. Unfortunately, no sooner had we made arrangements to attend the BBC studio in Manchester, the story was postponed pending clarification of the medical details. In the meantime, we send our best wishes for a swift recovery.

backcare member awarded mbe One of our long-standing members Jan Sadler was recently awarded an MBE. Jan founded and runs the help group Pain Support, with a large online forum for pain sufferers and lots of information for dealing with chronic pain.

The MBE recognises her outstanding service to the community. Jan has also authored books, including Pain Relief without Drugs: A Self-Help Guide for Chronic Pain and Trauma, which comes with a relaxation

Talkback l autumn 2012

CD. She uses the proceeds from these to fund the Pain Support community website (www.painsupport.co.uk).

Despite being a chronic pain sufferer herself, Jan’s hard work has delivered a real and sustained impact, and she stands as an example to others – congratulations Jan! Her disability means she was unable to go to Buckingham Palace to collect her award, but instead was awarded it by a local dignitary in Cornwall where she is from.

comedian reveals how back pain has affected his life Television comedian and writer for The Guardian and The Observer newspapers, David Mitchell, reveals how his own chronic back pain has affected his life in the cleverly titled memoir, Back Story.

David, 38, a selfconfessed worrier who finds himself constantly “checking and rechecking things”, walks for an hour every day to ease his back pain.

The memoir uses one such walk to prompt a montage of anecdotes that make up this story of his life. BackCare have contacted David’s agent to see if he’d like to collaborate – watch this space!

Talkback news 5

Is back pain in our genes?

Researchers at King’s College London have discovered a novel gene variant that is highly associated with lumbar disc degeneration (LDD).

Doctor Frances Williams and colleagues analysed the entire genome of 4,600 individuals to find associations. They found a very strong association between LDD and a variant of a gene called PARK2.

“The impact of hereditary factors on LDD is remarkably high. In the 70s and 80s the Scandinavians spent millions looking for all the occupations which caused back pain, but they couldn’t find them. Studies of identical twins who went into different professions – such as truck driving and being a PE teacher – showed both ended up with similarly bad lumbar disk degeneration in later life”, said Dr Williams.

However, the practical application of gene associations to medicine has been notoriously unfruitful, and we already have ample evidence to demonstrate that LDD is a normal age-related process which occurs in people both with and without back pain. Dr Williams agreed: “Everybody gets LDD at some point, it’s like going grey. But not everybody gets back pain.”

We would point out that care must be taken when interpreting data from genetic studies, as the modern focus which often paints genetics as the final frontier of medicine can be very misleading. It’s important to understand that the observable characteristics of any living organism – including everything from instincts and personality to symptoms and diseases – are the consequence of a dynamic interaction between its genes and its environment. This means that our psychology, behaviours, nutrition as well as all of the influences of our chemical, biological and social environments impact upon whether we will turn out happy and healthy or not. Most dangerous of all, reducing diseases to genes can lead people to believe that they have no control over their own health simply because they can’t change their genes.

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6 talkback news

Have we got news for you…

Employee Health at Work Day – Guardian News and Media BackCare was invited to attend the Employee Health at Work Day at the Guardian News and Media offices in London on October 18.

There was a good crosssection of contributors and some very useful promotions and activities focusing on the importance of good health to staff. This is the third year they have run this event as part of the Health, Safety and Wellbeing policy and management. BackCare was there to offer professional advice and information to staff who suffer with back and neck

problems; as well as guidance to employers.

One of our corporate supporters, Sheila Wellstead from Safe4work – it has more than 20 years’ experience in health and safety consultancy, auditing, training and associated services – along with one of our professionals Maria from The Chiltern Health Clinic, Sutton, meant that BackCare made a good contribution to the aims of the day, as well as highlighting the valuable services we have to offer to individuals, employers and health care professionals.

BackCare’s Helen Horton, centre, pictured with Professional Member, Maria Schlott, left, and Corporate Partner, Sheila Wellstead at the Guardian News and Media Offices in London

PREVIEW AND ORDER NOW ONLINE AT WWW.HOP6.ORG

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societies 7

SIP: taking the initiative to Europe

Delegates at the 2012 meeting in Copenhagen

BackCare working on three submissions of its own

S

ocietal Impact of Pain (SIP) is an EU organisation that brings together pain charities from across Europe to work together towards a common goal.

We are working towards submitting three of our own initiatives to the EU platform.

In the meantime, here are some of the national initiatives submitted so far.

sweden:

Pain Quality Registry for Pain Rehabilitation Pain accounts for half of all GP

appointments in Sweden, but there is still no uniform strategy to identify patients requiring a multimodal rehabilitation.

The Pain Quality Registry is a regional collaborative project being piloted by the Swedish regions, Östergötland and Västerbotten, with the aim to improve pain rehabilitation within the primary sector.

The pilot project will involve 400 patients to help develop a nationwide strategy ensuring future patients are given access to the appropriate types of rehabilitation.

Bosnia and Herzegovina:

Nationwide Pain Course

One hundred and twenty doctors from five hospitals in Bosnia and Herzegovina are taking part in a continuous education scheme focusing on chronic pain therapies.

It covers several topics, including the pathophysiological mechanism of chronic pain, its assessment and estimation, and interdisciplinary approaches to chronic pain management with multimodal therapy. It is expected to improve the recognition and standards of chronic pain treatment.

Pain uk: strength in numbers Pain UK is an umbrella organisation which aims to unite and represent the UK’s pain charities. It was founded in November 2011 by former BackCare Chief Executive, Sean McDougall, and registered as a charity in January 2012.

The first AGM was held in October 2012 and BackCare’s Head of Research, Dr Adam Al-Kashi, was there to represent the interests of BackCare’s members.

Central objectives During the course of the half-day AGM, Sean McDougall outlined the central objectives of the Pain UK alliance.

■ First, he stressed the importance of making UK pain charities more effective at helping people in pain. This included refining the vision they seek to create as well as developing the strategy and putting in place the skills to ensure it happens.

■ Second, to secure general acceptance that pain is an issue in its own right, just as significant as the disease or injury that may be causing it.

■ Third, to provide a signposting service, allowing people in pain to find the right help easily, by referral to the appropriate organisation for their type of pain.

■ Lastly, to monitor the needs of their member organisations, such as BackCare, and campaign for support where needed.

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‘

8 your stories

This was the first time I had slept for more than about 20 minutes in a couple of months. I couldn’t stand up straight at all… I pretty much struggled to walk from one end of the house to the other.

’

How I overcame

debilitating

Marie in hospital

A

fter about 10 years of mild intermittent back pain, I had built up a fear of it becoming worse. At the start, my GP had told me: “What can you expect when you weigh as much as you do? And now you have a bad back it will probably only get worse.”

In December 2009, it got worse and then much worse in March 2010. During that time I was prescribed more and more painkillers until by May I was taking high doses of four different drugs, including a nerve blocker.

I cried each day, sometimes every hour. I was waking up 20 times a night in extreme pain. I didn’t sleep for more than about 20 minutes at a stretch. I could sometimes get into a position in a chair or kneeling where the pain dissipated, but I knew it would be agony when I had to move. I felt my life was over and in truth I reached the point where I hoped it would be, as I literally could not stand the pain anymore.

Family breadwinner

I cried over everything that I felt I had lost – all the things I would never be able to do and for my poor children whom I felt had lost their mother.

Wherever I looked I would see an image or a reminder – for big things like cycling or dancing, simple things like cuddling up to my kids on the sofa and mundane things like cooking, washing my own feet or helping my Dad – and would tell myself, “I’ll never do that again”. As for work, I assumed that I would have to give up, which was especially worrying as I am the main family breadwinner.

In May 2010, I ended up in A&E in Durham after five months of visiting doctors and physiotherapists. After that, I had an MRI scan done which showed a massive prolapsed disc compressing the nerves on both sides, even though I mainly had pain down one leg. It was suggested I be referred for surgery, but in the meantime

Talkback l autumn 2012

pain and the depths of

despair

Back pain sufferer Marie tells how TMS and exercise gave her back her life…

I heard about something called Tension Myoneural Syndrome (TMS) and joined a Stress Illness Recovery Programme, and started to see some symptoms lessening.

When the physiotherapist called me to tell me the results of the MRI scan, she couldn’t believe that I was feeling a little better, so held off on the surgical referral and gave me some exercises instead.

When this picture was taken (top of the page), I had paracetamol going into my veins, followed by morphine, with more morphine by mouth, a good few breaths of entonox, and diclofenac suppositories. All of that just so that they could examine me.

This was the first time I slept for more than about 20 minutes in a couple of months.

I couldn’t stand up straight at all. I was in pain all the time from December 2009 until the middle of the TMS support group at the end of May. I pretty much struggled to walk from one end of the house to the other.

Turning point

I followed the TMS programme and did the exercises – but frankly I don’t think even the physiotherapist expected the exercises to work… I remember the day when she asked if I thought a session in their hydrotherapy pool would help and I had to tell her that I had been swimming. She was pleased and encouraging and didn’t dismiss the TMS approach, although she did tell me to keep all the painkillers handy,

READ UP ON TMS – YOU’VE NOTHING TO LOSE I would urge everyone to read about the TMS and Stress Illness Recovery Programme approach, which you can do for free by getting the books from the library, researching online or chatting with Georgie [BackCare Professional member, Georgie Oldfield; Ed]. There’s no commitment and no money needed unless you feel that the full programme will help. If it feels like it doesn’t fit your situation then you have lost nothing, but if it sounds like it might be for you then what have you got to lose?

your stories 9

Happier times… Marie and

her son Tristan

not to push myself and to have a plan ready for flare-ups.

It certainly wasn’t a magic wand; some of the techniques on the programme did not work for me and some (the ones I was most sceptical about) I think were the most helpful. But generally believing that things could get better was the turning point.

In July 2010, me and my youngest, Tristan, went out with his friends on a bike ride. They were very impressed I went over the jumps!

I still obviously have the prolapsed disc and for a while I couldn’t walk too fast, due to some leftover muscle weakness in my leg, but I could go anywhere I wanted virtually pain free by bike... or could swim there!

Thank you for saving my wife’s life Marie’s husband, Tony I had just played a small (sedentary) part in my theatre group’s summer show (another thing I had given up and thought was gone forever) and that night I went out and boogied like it was July 2010 – doing something else that just a few months before I thought I would never do again (a friend’s birthday disco where I dressed as the London tube map!).

By January 2011, I was virtually pain free. I could do everything that I used to do. I had achieved most of the goals that I set during the programme. I remember my

disbelief when I looked back at my notes at the time; one reads “a good night’s sleep; only woke up five times”! When I was in pain it seemed as though it had lasted forever and would never end.

A year later, January 2012, I still had a little numbness in my right foot but I mostly didn’t even notice it. I have had no back pain or sciatica for a year!

In the past year I have taken up Zumba and open water swimming – swimming a mile in Loch Ness in September. I have realised how often over the years I said to myself and family ‘be careful’ when they had to lift or bend. Last winter I shovelled snow without worry and with just a few twinges – all the time saying “this will make my back stronger” – and it did!

Marie, East Durham

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10 product review

In the last issue, we put the spotlight on Professor Hazard, a doctor, researcher and innovator in the field of back care. After his work on “continuous passive lumbar spinal motion” proved successful, he developed the concept into a product called the BackCycler for the home, office or car user.

The product has been a great success and has already been installed into 10,000 first and business class seats aboard the United Airlines fleet. In light of this, we decided to put it to the test ourselves with the kind help of our local member Ben John, pictured right, who was suffering from intense back pain associated with driving.

The BackCycler put to the test Ben’s history of back pain The start of my back pain began late in 2009 when I experienced a cramping pain in my left lower back and side. The pain was intense, at a level of 9/10, and had me on the floor on at least three occasions.

Over time, these episodes subsided, to be overtaken by a gradual but dull ache in my lower central spine area.

I visited a sports injury physiotherapist who manipulated and massaged the area and for a day or so the pain was relieved, only to resurface. Co-incidentally, in March 2010, I changed my car as the work that I was doing involved a lot of mileage and I needed to economise. I bought a Honda Jazz and soon began to feel an increase in pain in my back to a level of 7-8/10.

From a dull ache the pain turned sharper and more insistent, particularly in the lumbar region and especially noticeable during long periods of sitting in traffic jams.

I began to make frequent visits to my doctor and went for a number of tests, including three MRI scans throughout 2011. The final MRI scan taken in

Talkback l autumn 2012

December 2011 focused on the lumbar area of my spine and the conclusions were that I had “multi-factorial degenerative changes which were most pronounced at the L4-L5 level with some likely impingement of the right L5 root in the tight lateral recess”.

I didn’t receive the results of the scan until late in February 2012, by which time I was in considerable pain, which I put down to lack of exercise. I joined a gym but was unable to attend regularly because of a family crisis that intervened. The pain in my back was particularly prevalent in the mornings when getting out of bed at a level of 8/10.

At the end of March 2012 the pain rose to a new level of intensity (9-10/10) with very pronounced symptoms of numbness in my right leg and right foot and backside.

A burning sensation accompanied the pain. I returned to my doctor who diagnosed sciatica and signed me off work, prescribing a variety of painkillers including Co-Codamol, Naproxen and Amitriptyline.

I was off work for over two months and

began to exercise under the care of the physiotherapy department of Teddington Memorial Hospital. As I didn’t drive while off work, together with the right exercises and medication, I started to look more closely at finding a better driving position in the Honda as by this time the penny was beginning to drop that my driving position was inappropriate. I have had custom cushions made cut from foam and have used a BackFriend which gives stiffer support to the whole body. Though they do help, I still feel stiff and in pain (56/10) getting out of the car even on short journeys. None of these products address the fact that sitting still is not a natural position for the human frame.

I had never taken an extended period of sick leave in my life up to this point and my morale has been at an all-time low, not helped by a trial separation from my partner which I have no doubt exacerbated and extended what amounted to severe inflammation of the sciatic nerve brought on by driving in a small gear shift car for long periods of time.

product review 11

Reader discount After only one week of using the BackCycler The BackCycler provides excellent relief from lower back pain – I’m very impressed with it.

I drive a Honda Jazz with bucket seats. On long journeys, or when I’m stuck in traffic for long periods, the inactivity was causing me considerable discomfort in my lower back. Even at this early stage in the proceedings I would certainly buy the BackCycler.

It consists of a smallish cushion which inflates and deflates via a pump that can be stowed under the passenger seat. The controls are simple to operate.

The gentle forwards and backwards movement

promoted in the spine induces circulation thereby avoiding the stiffness that results from sitting for long periods in an unnatural and passive sitting position.

There are a number of cables which need to be carefully stowed with the device; with only one week of testing, the robustness of the product over a long period of time has yet to be proven.

The main drawback could be that other driving aids, such as satellite navigation systems, would have to be unplugged as both devices can’t be used at the same time, unless there are two cigarette lighter sockets available in the car.

If you think you’d benefit from the BackCycler and wish to buy one for yourself or a friend or family member, they can be purchased direct from the BackCycler website (www.backcycler.co.uk).

After such a successful review, we thought our members might be interested to get their own BackCycler, so we’ve secured an exclusive reader offer: go to www.backcycler.co.uk/ backcare-discount-offer to get a £10 discount.

After six weeks of using the BackCycler The BackCycler I am trialling continues to be a very powerful adjunct to easing my lower back pain. I would not drive without it.

It is not a cure-all for back pain, but I can confirm that without the BackCycler and the exercises given to me to do by a physiotherapist, pain levels would still be at an unacceptable level. On a scale of 0-10 my pain levels have reduced from 8-10 to

1-4 when driving; I take painkillers on the odd occasion, on average once a week.

When I’ve forgotten to turn the appliance on I have noticed the difference in a very short time.

Overall, I would say that the BackCycler so far has stood up to everyday use and I would definitely recommend it to anyone suffering from back pain.

On a practical note, there are a number of wires which can be tucked away and it is advisable to take the plug out of the socket and tuck it out of sight of curious eyes when leaving the car in an unknown location. If car manufacturers incorporated the BackCycler into their production models then presumably the security issue would not arise.

Talkback l autumn 2012

12 awareness week report 2012

Developing nicely…

October 8-12 was, of course, BackCare Awareness Week. This year, we launched a new campaign focused on back injuries in the construction industry. We undertook several campaign activities generously supported by Pfizer Limited

Dedicated campaign website We launched a dedicated website as a portal for the campaign, featuring campaign artwork and functions allowing people to get involved and use social media channels to continue spreading the word. As the campaign builds momentum, more and more content will be added to the site, including content contributed by people who have been personally affected by back pain in the construction industry and those already active in attempts to remedy it. If you haven’t visited the site yet, you can do so at www.buildersbackpain.org.uk

and pushing) is the biggest cause of injuries. People tend not to know their own safe limits and aren’t strong enough or fit enough for the tasks they put their bodies through. They also tend not to warm up or stretch as you normally would before sports or exercise. But most importantly, people tend not to know proper technique or apply it.

2. How can people prevent getting back pain themselves?

If you want to have a reasonable degree of control over your future back health and also health in general, there are three main areas that you need to get to

grips with – these are your psychology, your nutrition and your physical exercise.

People who harbour unprocessed negative emotions such as regret, remorse and resentment are more likely to succumb to ill health and less likely to recover. Obesity and malnutrition is extremely common in our society and again predisposes you to ill health and the inability to recover fully. When it comes to physical exercise, everyone seems to know that cardiovascular fitness is important. However, more recent research has established that our muscles do not simply move our arms and legs; they also

Campaign radio day At the start of the week, we conducted a day of live radio interviews, appearing on 20 local and regional stations across the UK. The total weekly reach figure for these stations adds up to 1.8 million people.

We also recorded an audio feature which went out to a further several dozen radio stations, boosting the impact of this campaign activity and bringing the total weekly reach figure to more than 8 million – this indicates that we successfully harnessed major media to get the BackCare message across. The interviews and audio feature were based on a preconceived cue sheet of five questions that was sent out to the radio presenters.

Here are the questions along with an outline of our responses.

1. What are the main causes of back injuries in the construction industry and at home doing DIY? Manual handling (lifting, carrying, pulling

Talkback l autumn 2012

Station Weekly reach

Time

Wythenshawe FM, Greater Manchester ALL FM 96.9, Manchester Colourful Radio, London BBC Radio Kent Q101.2, County Tyrone Q102.9, Londonderry Q97.2, Causeway Coast

Q100.5, County Down Q106, County Armagh Q107, County Antrim Swansea Sound 96.5 Bolton FM, Greater Manchester Swindon 105.5, Wiltshire BBC Radio Nottingham BBC Radio Coventry and Warwickshire BBC Radio Derby BBC Radio Hereford and Worcester BBC Radio Leicester BBC Radio Shropshire BBC Radio Stoke

14,000 15,000 103,000 258,000

09:30 – Simultaneous broadcast 10:40 10:50

90,000 86,000 86,000 17,000 11,000 14,000 62,000 50,000 15,000 185,000 88,000 154,000 99,000 180,000 102,000 156,000

11:10 – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast 11:30 12:15 13:05 19.35 – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast – Simultaneous broadcast

awareness week report 2012 13

release hormones into the blood stream affecting the brain and every other organ of the body. Gaining some muscle mass and training to increase your physical strength has enormously positive health implications.

3. What can the construction industry do to prevent workers suffering back injuries?

Prevention is the key here. It’s often said that prevention is more effective than treatment, but it’s actually much cheaper too. In 2007, a Danish doctor calculated the financial cost of a single worker permanently injuring their back aged 35 to be over £2 million. We’ve teamed up with world leaders in manual handling, Pristine Condition, whose track record has made it clear that effective training can reduce injuries by 88-100%. And if healtheffective and cost-effective training has been proven, we’d like to see it become a national standard.

4. In what ways can back pain affect people in their day-to-day lives?

Back pain doesn’t kill, but it tortures – destroying lives and livelihoods. Many people with persistent back pain find themselves literally disabled by the pain, unable to work, earn a living, function socially. It’s not surprising that clinical depression is so common in chronic pain sufferers.

5. Where can I get more information?

You can visit the dedicated campaign website at www.buildersbackpain.org.uk where you can keep updated as the campaign unfolds and sign the petition for effective and mandatory Governmentfunded manual handling training. You can also come down to meet us in person at

the Back Pain Show, London Olympia, 22-23 February 2013.

Dedicated awareness pack We created a pack of materials designed specifically to give people access to the campaign and telling them why and how to get involved. The pack contains an A5 booklet accompanied by an A3 poster featuring an x-ray of a person lifting using improper technique. The skeleton figure is wearing a brightly coloured hard hat and work boots, and the slogan reads “All The Gear, But No Idea” with the aim of being catchy and amusing to draw attention to the underlying issue. Key facts and statistics supporting the campaign are presented in a side column. The goal of the poster is to attract attention, educate the viewer and direct them to the campaign website where they are encouraged to participate. The pack also includes two designs of sticker,

again with attention-grabbing images and slogans directing people into the campaign.

The packs are still available to buy on the campaign website and are also being sent out to organisations within the industry as part of the ongoing campaign activities.

Government e-petition We submitted an application for an electronic petition on the Government’s website. The application was approved and the e-petition became available to sign online just before the awareness week.

Government e-petitions expire after 12 months so we have until 4 October 2013 to get 100,000 signatures, which could lead to it being debated in the House of Commons – so please do take the time to sign it if you agree with our proposal and share it with your friends, family and colleagues to give them an opportunity to participate.

Fund Manual Handling Training For All Construction Workers Construction has the highest rate of manual handling incidents and reports more than 25,000 back injuries every year. Nearly half of construction workers over 50 now suffer persistent back pain.

According to the Institute of Occupational Medicine, half of construction employers offer no manual handling training to their workers.

The CITB’s levy-funded ‘Health, Safety and Environment Test’ only claims to “ensure that workers have a MINIMUM level of health, safety and environmental awareness”.

Considering back pain costs us £19 BILLION every year, I think that a certification of manual handling training, employing the most efficacious methodologies evidenced, should be mandatory for all UK construction workers and should be Government funded.

Prevention is far cheaper than treatment.

Talkback l autumn 2012

14 london marathon

Run the London 2013 Marathon and support our unique charity BackCare, the charity for healthier backs, would like to offer you the chance to support its worthy cause and run in the 2013 marathon.

Limited places available Don’t miss your chance to run in the world’s greatest marathon.

Email info@backcare.org.uk or call Helen on 020 8977 5474.

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16 self help

Gentle exercise of the Pilates kind can help ease back pain.

Lynne Robinson looks at how the Back4Good programme is reaching out to back pain sufferers.

Lynne Robinson, the ‘Queen’ of Pilates

Pilates – the gentle way to ease the suffering A

lthough the Pilates Method of exercise has been taught for almost 100 years, it has only really come into the spotlight since the mid 1990s. It now enjoys huge popularity worldwide, with millions of people taking regular classes.

The method is based on the work of German-born Joseph Pilates, who developed his matwork and machine exercise regime at his New York studio in the 1920s. Since his death in 1967, the teaching of the Pilates Method has diversified in terms of style and content and you will now find many different Pilates training schools with very differing approaches.

Body Control Pilates, based in the UK, is one of these schools. Since offering its first courses in 1996, it has grown to become regarded as Europe’s foremost professional Pilates organisation, with more than 1,100 teaching members and with education bases in 15 countries in Europe, Africa and Asia.

What is it about the Body Control Pilates approach that makes it so popular and that sets it apart from other types of Pilates?

Talkback l autumn 2012

The answer lies in the standard and quality of its teaching methods and in its unique approach. Body Control Pilates has broken down Joseph Pilates’ original exercises so that they can be taught safely and effectively to everyone, regardless of their level of fitness.

Our goal is to establish good awareness and movement skills and gradually, step by step, build on these skills working progressively towards giving you the

Pilates has developed a reputation for helping people with back pain strength, flexibility and co-ordination necessary to perform Joseph Pilates’ original work. Body Control Pilates is based upon a well-constructed philosophical foundation. Central to our approach is “awareness of your own body” and each and every exercise is built around eight basic principles:

• Relaxation; • Concentration; • Co-ordination; • Centring (Core Stability); • Alignment; • Breathing; • Stamina; • Flowing Movements.

By working on the deep, architectural structure of the body, core stability is achieved, and then maintained, through increasingly complex movement sequences. Specific problem areas can be targeted by an exercise, but always in relation to the rest of one’s body. Your body awareness is heightened by bringing together mind and body – Body Control Pilates literally teaches you to be in control of your body!

Pilates has developed a reputation for helping people with back pain, and, for years, people have come to classes or private sessions for this reason – this includes many of the Body Control Pilates teachers who found that Pilates helped their own back problems and who so wanted to share this method with others that they changed careers!

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However, we have recently seen the introduction of specific government accredited training programmes in the area of low back pain. These are known in the industry as Level 4 Specialist Instructor qualifications with teachers being accredited by the Register of Exercise Professionals, an independent body where a teacher’s credentials can be verified.

The new Level 4 courses tie in perfectly with guidelines published by NICE on the importance of suitable exercise in the treatment of people with chronic low back pain.

Series of exercises

In response to this, Body Control Pilates developed the Back4Good® exercise programme for the management and prevention of non-specific low back pain. So, while Pilates already has, as mentioned, a good reputation for helping with back pain, the Back4Good® programme takes this to a new level.

Working closely with medical experts in the field of back pain, we created a series of exercises designed to target many of the complex underlying causes of back pain. One example would be directionspecific back pain: that is, back pain that is aggravated by moving in a particular direction.

People have back pain for lots of different reasons. Some may find that their pain is brought on when they sit or stand for long periods. Others may find that twisting, bending forwards, or reaching up increases the pain. All these fall under the category of non-specific low back Sessions are tailored to clients’ needs

pain even though the aggravating factor is specific to the person.

A Back4Good® practitioner will help identify which are the best exercises to help someone gain control of moving in this direction, which will then give them the confidence to become more active generally. If you go to a Back4Good® session, you will be taught the ABCs of Pilates: Alignment, Breathing and Centring (core stability). Once these basics are learnt, you will be taught a series of exercises designed to help you improve your posture and control your movements, increasing the strength and flexibility of your back.

Back4Good® practitioners generally offer one-to-one or small group sessions.

They will always assess clients fully on enrolment and then tailor the sessions to a client’s particular needs, taking many factors into account, such as an individual’s attitude and perception of their pain. This is possible even in the group classes as numbers are kept to a maximum of 10 clients, allowing time for individual attention. Overall, the aim is to provide a supportive environment in which people with low back pain can exercise, safe in the knowledge that their teacher is properly qualified.

By the end of this year, there will be almost 200 Back4Good® practitioners teaching in the UK. Most offer “Healthy Back” group classes to help manage low back pain and all are able to receive referrals from medical practitioners for a more tailored approach for those with chronic low back pain.

■ Lynne Robinson is founder and director of the Body Control Pilates Group and is the world’s top-selling Pilates expert. Called “The Queen of Pilates” by The Times, Lynne has written 12 books on the Body Control Pilates Method and presented 10 DVDs. She was part of the team that developed the Back4Good® education programme.

Find a Back4Good practitioner For more information on Back4Good® and to find your nearest practitioner, please go to www.bodycontrolpilates.com You can also find Back4Good® practitioners in the BackCare Professionals listing on the BackCare website.

Practitioners tell of their experience “Qualifying as a Back4Good practitioner has really changed the way I teach Pilates. Even in my regular classes I am able to use the deeper knowledge and analytical and structured approach to help people improve their mobility and manage their back issues. But the best thing is seeing people improve on a one-to-one Back4Good programme.

I have taught people who felt their whole lives were dictated by their back pain and who have now seen their ability to live a more active life greatly enhanced by the exercises. That’s the most rewarding teaching there is!”

Clare McKenzie Back4Good Practitioner North Yorkshire “Obtaining my Back4Good® qualification completely changed the way I work with people with nonspecific low back pain.

I regularly work one-to-one with my clients and every client undergoes a movement assessment and receives a bespoke exercise plan. The results have been truly remarkable.

I also enjoy teaching Healthy Back classes where the emphasis is on prevention of back pain. It’s great to see the difference that Back4Good exercises can make in helping people control their back pain”.

Dawn Wilton Back4Good Practitioner Buckinghamshire “I became a Back4Good practitioner last year and quickly discovered a large number of people who needed guidance on how to manage their pain.

I see clients who have been suffering with back pain, sometimes for many years, and are keen to try a specifically designed backcare Pilates course. I offer one-to-one sessions and group classes.

One young mum recently told me how she can at last bath her son without pain after attending my Healthy Back classes. Brilliant!”

Jeannie Di Bon Creattiva Pilates Surrey

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18 talkback research

Prevention is better than cure Nutrition and the adaptogen concept “Prevention is better than cure”, or so the old adage goes. And it’s perhaps not surprising to find that when it comes to safeguarding our future health and preventing illness, a lot of what’s important for healthy backs is also beneficial for our overall health. If we want to have a reasonable degree of control over our future health status, there are three key areas that we have to keep in check – our psychology, nutrition and physical training. As part of a new series of articles on preventative medicine, this article will focus on nutrition, introducing the adaptogen concept with a review of the medicinal food plant, the Asiatic pennywort.

The distinction between food and medicine is open for debate. New research in the field of nutraceuticals (a contraction of nutritionals and pharmaceuticals) goes some way to bridge the gap with popular and effective products such as the margarines containing plant stanols which lower cholesterol.

But medicinal foods needn’t involve any sort of artificial manipulation; there are many foods which naturally have bona fide medicinal properties. In fact, the Ancient Greek physician, Hippocrates (460BC – 370BC), who established the Hippocratic Oath and is credited as being the father of Western medicine, was recorded as saying, “Let food be thy medicine, and medicine be thy food”.

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The Asiatic pennywort (Latin name: Centella asiatica) is a small herbaceous creeper found in many tropical and subtropical countries, including India, Sri Lanka, Thailand, South Africa and Eastern Europe. It has a long history of use in the traditional Indian, Chinese and African medical systems but is also used as a leaf vegetable – much like spinach or kale – in Thai and Sri Lankan cuisine.

In health stores, it’s often labelled as Gotu kola, meaning conical leaf in Sri Lanka’s Sinhalese language.

On the backdrop of several thousand years of ethnobotanical use, Western research efforts into the potential therapeutic uses of the plant began in the late 1940s and 50s with the corroboration

Asiatic pennywort has a long history of medicinal use in the East

It appears to exert a harmonising and restorative effect on the entire human system of its traditional use in wound healing.

Since then, the research literature has expanded to include over 300 published studies detailing the many beneficial properties of the herb.

In fact, the herb exhibits so many distinct and seemingly unrelated benefits that it has been given the title of adaptogen. The term adaptogen was coined in 1947 by Russian-born pharmacologist Nikolai Lazarev and is used to describe a newly realised class of botanical compounds which confer a non-specific resistance to physical, biochemical and psychosocial stressors.

In essence, adaptogens literally promote adaptation, adjustment and acclimatisation to our total environment (physical,

talkback research 19

M edicinal P roperty

R eferences

C ognitive H ealth – Enhances memory and learning in a rodent Alzheimer’s disease model and in human adults, and substantially improves child ADHD.

12859423, 20677602, 20228219

A ffective H ealth – Anti-anxiety effect in rodents and humans, and anti-depressant effect in rodents.

16488124, 20677602, 16209267, 15058206

N eurological H ealth – Anti-epileptic and anti-convulsant activity, preventing fits and seizures in

20711371, 20144879

A nti - inflammatory

20606777, 3092715

rodents.

and

A nalgesic E ffects – Demonstrated in rodents.

W ound H ealing – Promotes healing of incision and burn wounds in rodents, even reversing the suppression of healing by dexamethasone.

18484522, 22817824 16928669

U lcer H ealing – Promotes healing of physical, chemical and stress-induced gastric ulcers in rodents, and human skin ulcers.

11480209, 1293014 5153018

A ntibiotic E ffect – Natural antibiotic activity demonstrated in human leprosy and in fish columnaris

4480467, 20575361

A nti -C ancer E ffect – Kills rodent and human cancer cells.

20162036, 19865514

C irculatory H ealth – Promotes circulatory health in the context of long-distance flight-induced oedema, chronic venous insufficiency and perhaps varicose veins.

11666121, 7936334 2150405

U ltraviolet R adioprotective – Protects against UVB radiation damage in human skin cells.

22948173, 23064234

G amma R adioprotective – Protects against gamma radiation poisoning, specifically weight loss, DNA damage, and radiation-induced taste aversion in rodents.

12458490, 19589237, 11399290

H eavy M etal D etoxification – Counteracts heavy metal poisoning, specifically lead and arsenic in

21843793, 17600859

(a common fish farm infection).

rodents.

Reference numbers correspond to the PubMed archive at the US National Library of Medicine and can be accessed online by appending the number to www.pubmed.gov/

Nutritional information for the Asiatic pennywort Nutrient Beta-carotene (Vitamin A) Thiamin (Vitamin B1) Riboflavin (Vitamin B2) Ascorbic acid (Vitamin C) Calcium Chromium Iron Magnesium Manganese Phosphorus Fibre

Quantity (mg/100g)

% RDA

34 ND 0.8 70 0.7 51 21 26 880 110 1.0 2500 16 115 320 85 23 1135 155 22 11000 33

Quantity data from the US Department of Agriculture, RDA data from the UK Department of Health; ND = Not Determined

biochemical and psychosocial). This implies an interesting relationship between their usage and the philosophy of preventative medicine which is all about alleviating stresses and correcting imbalances before they generate illness.

In keeping with the concept of true adaptogens, the Asiatic pennywort is nontoxic and appears to exert a harmonising and restorative effect on the entire human system. This makes adaptogens entirely different from medicinal drugs (whether synthetic or naturally occurring, e.g. morphine) which are used to suppress biological functions, bringing an attempted

masking of symptoms but also the risk of side effects. In a sense, the adaptogen concept accommodates the highest ideals of medicine – namely to prevent and remedy illness while doing no harm.

In closing, the Asiatic pennywort is a nutritious vegetable plant with a significant volume of modern scientific research to support its long history of traditional medicinal use. But beyond this, it serves as a valuable illustration of how richly nutrition can be upgraded from the basic macronutrient (carbohydrates, proteins, and fats) and micro-nutrient (vitamins and minerals) concepts.

PERSONAL EXPERIENCE WITH THE ASIATIC PENNYWORT I started using this herb as capsules of dried extract from health food stores. More recently, I discovered that the fresh plant material is much cheaper and far more effective.

I found it available fresh in a local Sri Lankan food store as “Villarai” (its name in the Tamil language) and in a Thai food store as “Bua Bok” (the Thai name). I’ve also experimented with growing this vegetable myself and can report great success, even in our temperate climate.

I have now incorporated it into my regular diet. I eat it raw, much like a salad leaf, and have noted several interesting effects: ■ greatly enhanced sleep quality when consumed before going to bed ■ performance enhancement during cardiovascular training ■ clearly noticeable reduction in psychological stress.

Dr Adam Al-Kashi Head of Research at BackCare

Talkback l autumn 2012

20 Corporate partners

We felt it was important that our members get to know a bit more about our corporate partners and what they do. So, continuing our new series of corporate partner interviews, we bring you a conversation with Mike Dilke, the UK distributor of a rather interesting chair called the Back App that keeps the spine in constant gentle motion…

Comfort without a back rest?

It’s no illusion

The Back App looks rather unusual, can you tell us a bit about its history?

Isn’t it uncomfortable to sit without a back support?

The Back App was developed by a Norwegian scientist called Freddy Johnsen.

His field was not medical research or back pain, but he was struck down by serious back problems and had several herniated disc operations.

While recuperating, he had the revelation that it should be possible to combine the training attributes of a balance board with an office chair that allows the spine to retain its natural curvature.

His first experiment was with a kitchen stool resting on a wobble board which was on a duvet to dampen the movement. This set him off on a period of development which resulted in the Back App.

Research that has been recently published shows that 30-50 per cent less effort is required to sit on the Back App with a good neutral posture than on an ordinary chair. This means that you can sit without back support with no problem.

The research compared people with lower back pain using a Back App and a standard office chair that had a back rest and was completely adjustable. The subjects carried out a one-hour typing task and had their lower back and overall body discomfort assessed. There was significantly greater increase in lower back discomfort on the standard chair than the Back App. This research, the experience of many happy users and my own experience of using the Back App show that it is not uncomfortable to sit without a back support.

How and why did you decide to get involved with this product?

That is a development process of my own as the first part of my career has been as a civil engineer. However, I have been keen on yoga for the last 15 years or so and recently developed a couple of yoga products.

On starting my own business, I wanted to use these and other products to help people with bad backs and during my research I came across the Back App. I could see it was something very different and worthwhile straightaway, so I approached Freddy and now I am the distributor in the UK.

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highly likely that the Back App will work for you as the shape and motion of the spine are similar to standing.

If you don’t experience pain, the Back App will help ensure you won’t in the future.

Is there anyone who wouldn’t benefit from the Back App? The motion of the Back App is so gentle it can help many people. If you have a back pain that gets worse when you stand up, then the Back App may not work for you.

Presumably, you sit on a Back App in your office. Do you ever get back pain?

How can one chair be right for everyone?

Some over-enthusiastic skipping in a bid to get fitter did lead to some back problems a few months ago.

I found the Back App the most comfortable way of sitting after this and the problem has gone away, so yes, I do sit on the Back App in my office.

If you have back pain symptoms that improve if you are standing up, then it is

What can we learn about positive/healthy lifestyles from the Back App ethic?

The human body is not designed to sit for long periods. So even when using the Back App… we should get up every so often

The human body is not designed to sit for long periods, let alone up to 10 hours or more in one day. So, even when using the Back App, which ensures constant and gentle movement, we should get up every so often.

If you sit on the Back App it feels more natural to do this as you sit higher, so getting up involves less effort and you are

Corporate partners 21

Mike Dilke using the Back App chair

likely to do it more often. The main lesson is keep moving.

Also, it’s important to keep an open mind and try something new every so often. The Back App does not have a back rest but helps thousands of people, so if that is your main concern, just try it.

I would recommend that people with back pain talk to Backcare and find out about the different help that exists, possibly by going to the Back Pain Show in London.

Most importantly, do not resign yourself to back pain.

■ You can find out more about the BackApp at www.backapp.co.uk

n Many thanks, Mike, for taking the time to talk to us. Since we recorded this interview, something very interesting has come to light. Mike told us that he noticed feeling more alert and creative when he attended meetings with his colleagues where they all sat on the Back App chairs. You may recall the feature on Professor Rowland Hazard which we ran in the last edition (TalkBack, Summer 2012). In 2000, Professor Hazard published some research showing that car drivers were more alert if their lumbar spine was in continuous passive motion, which certainly corroborates Mike’s own observations.

It would make a very interesting study to look at whether the Back App chair boosts people’s psychological functioning in a recordable manner – perhaps that’s something that the people at Back App could investigate.

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22 talkback fundraising

BackCare Events Calendar 2012/13 BackCare Christmas Carol Concert 2012 7.30pm, 19 December – The Queen’s Chapel of the Savoy, Savoy Hill, Strand, London

Join us at The Queen’s Chapel of the Savoy for a rich tapestry of choral masterpieces brought to you by the Tredici Choir, directed by one of Britain’s leading choral conductors, Richard Thomas. Tickets £20; refreshments available.

Box office: 020 7766 1100, www.smitf.org.uk. Proceeds go to the charity.

Moving & Handling Conference 31 January-1 February 2013 – Business Design Centre, Islington, London

Moving & Handling People: Future-proofing Care and Practice, with pre-conference ‘New Products Evaluation Workshops’ on 30 January. Delegate rates held at 2010 prices and 3 for 2 offer and early booking discounts available, www.movingandhandlingpeople.co.uk

Back Pain Show 2013 22-23 February 2013 – Olympia Exhibition Centre, London

Proudly sponsored by BackCare, the 2013 Back Pain Show brings together the latest in back care products, techniques and technologies in an exciting two-day event. Grab your two free tickets in the next issue. Significant exhibitor’s discounts available, info@backcare.org.uk or 020 8977 5474.

Virgin London Marathon 2013 21 April 2013

It’s officially the world’s largest marathon and our proudest annual challenge event. Join the BackCare team, info@backcare.org.uk or 020 8977 5474. We have 40 guaranteed places but they won’t last long! Minimum pledge £1,500. Deadline for applications is 25th January 2013.

London 2 Brighton Challenge 25-26 May 2013

This challenge is like no other: walk, jog or run 100km city to coast. In 2012, 1500 took the challenge, raising over £1 million for UK charities. An epic cross-country Ultra Marathon or the longest walk of your life, you choose! £85 to register + £400 fundraising pledge required. Full support checkpoints, hot meals provided en-route. Pace walkers, physiotherapists and medics on hand. Find out more at info@backcare.org.uk or 020 8977 5474.

Ride London 100 3 August 2013

Next August will see the debut of London’s newest mass-participation challenge event, Ride London 100. As many as 70,000 people are expected to participate, riding 100 miles from the Queen Elizabeth Olympic Park into central London through the scenic Surrey Hills before finishing on The Mall. BackCare has secured three guaranteed places of which one is already taken! Applicants must be confident cyclists who can ride safely in large groups.

Find out more at info@backcare.org.uk or 020 8977 5474.

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meet the professional 23 This version of the wordmark can only be used at this size. It has a larger registration mark than the other size wordmarks.

Please use one of the other sizes if you need a larger version.

Take one to relieve backache, neck pain and headaches Introducing headsets from Plantronics – taking the pain out of using the phone If you constantly have your ear glued to your phone at work, you’d be far better off with a headset. Using a wired or cordless headset means that you can work without crunching up your shoulder and tilting your head, improving your posture and your health. Tests have shown that they can reduce back pain, headaches and neck pain by as much as 31%*.

At Plantronics, we’ve spent over 50 years designing and refining headsets.

With the combination of stunning design, perfect sound quality, comfort and durability, it’s no wonder that more and more people worldwide feel happier talking with our headsets.

And right now, you can try one for free.

Call us on 01793 842 426 and quote ‘health business’ or visit www.plantronics.com/uk/product/cs500 before 31.12.2012 for your free trial. *Research from the University of Surrey.

© 2012 Plantronics Inc. All rights reserved.

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24 Talkback news

Talkback l autumn 2012