Test 1 - Section 4

SECTION 4

You’re going to hear a radio talk on back pain given by doctor Paula Clayburgh of Liverpool’s Wilton clinic. first you have some time to look at questions 31 to 40. now listen carefully to the talk and answer questions 31 to 40.

ANNOUNCER: Today’s Health Counsel is presented by Paula Clayburg, who is the chief Counsellor at Liverpool’s famous pain clinic: The Wilton Clinic, in Paula…

PAULA CLAYBURG: Do you know what Prince Charles, Seve Ballesteros and Elizabeth Taylor have in common? They all suffer from chronic back pain. In fact, bad backs are one of the most common health problems today, affecting people in all walks of life. The most recent available figures show that about a quarter of a million people are incapacitated with back pain every day.

And many sufferers don’t know the cause or the solution to their problem.

The majority of our patients at the clinic tend to be women. They are especially vulnerable because of pregnancy but also because of osteoporosis, which I personally believe to be the major cause of problems for women. I have many women patients who say they have completely given up exercise because the pain makes them so miserable. But of course that starts up a vicious circle. Bed rest, giving up exercise and pain killers are traditional responses to back pain but, although there are many excellent drugs on the market, at our clinic we are beginning to realise the unique benefits of relaxation therapy. Other specialists in the field make a strong case for certain types of exercise, but in our experience they are easily mishandled and can lead to more harm than good.

Now, let’s look at some of the reasons why back pain is developing into such a unique menace. In general, the body is pretty good at self repair. A strain or a blow to a limb, though painful at the time, generally resolves itself. But the body’s response to back injury can be very counterproductive. When pain strikes, we attempt to keep the back as immobile as possible, which makes the muscles tense up. Research shows that they often go into spasm, which causes further twisting of the spine. A vicious circle is underway.

The second mistake we often make when stricken with extreme back pain is to go to bed and stay there. Although at the clinic we recognise that a short rest in bed can be helpful… up to two days… any longer makes our back muscles become weaker and unable to hold up our spine. The pain therefore becomes worse.

Another problem is being overweight. Anyone a stone or more overweight who already has back pain is not doing himself any favours: though it won’t actually set it off in the first place, the weight will increase the strain and make things worse. The British diet could be partially to blame for the increase in back pain: over the last ten years the average weight of men has risen by 11 lbs and of women by 9 lbs. So much for the causes and aggravations of pain. But what can WE do to help? There are many ways in which simple day-to-day care can make all the difference. The first point to watch of course is weight. If you are overweight, a diet will make all the difference.

Also, studies have shown that just one hour sitting in a slouched position can strain ligaments in the back which can take months to heal. At the clinic we have come to the conclusion that the major cause of the problem is not with the design of chairs, as some have suggested, but in the way WE sit in them. It can be useful to get special orthopaedic chairs, but remember the most important improvement should be in OUR posture.

Another enemy of your back is, of course, your beds. If your bed doesn’t give enough support, back muscles and ligaments work all night trying to correct spinal alignment, so you wake up with a tired aching back. Try out an orthopaedic mattress or a spring slatted bed. Research shows that both can be beneficial for certain types of back pain.

Another hazard for your back are the shock waves which travel up your spine when you walk, known as heel strike. A real find for our patients has been the shock-absorbing shoe insert. A cheap but very effective solution. And you might be better off avoiding shoes with heels higher than 1 inches. Though absolutely flat shoes can be a solution for some, others find their posture suffers.

Finally a word about the state-of-the-art relief - the TENS machine a small battery-powered gadget which delivers subliminal electrical pulses to the skin. Our experience indicates that your money is better spent on the more old-fashioned remedies.

That is the end of section 4. you will now have half a minute to check your answers.