Benefits of Chiropractic Care After a Car Accident

First Medically Approved Back Pain App Aims to End Back Pain in UK Offices

Bad posture among UK office employees is a nationwide epidemic. Sitting at desks all day, slouching over computers and a general sedentary lifestyle has led one in five Brits to give up their job or reduce hours because of their condition. Experts behind Kaia, the first and only medically approved back pain app in the EU and UK, want to end the nationwide epidemic of back pain in UK offices, and claim that a few simple changes in the workplace can help to reduce the risk.

According to WHO, back pain is the leading global cause of disability worldwide. Meanwhile, in the UK, an estimated one-third of the adult population are affected by back issues each year And according to the Office for National Statistics, back pain accounts for almost 31 million days of work lost annually costing the UK economy £14 billion a year. In another study, 63% in higher managerial jobs attributed their back pain to bad posture, and took more days off sick for back pain than any other type of employee.

The Kaia back pain app was developed by digital therapy company Kaia Health in conjunction with physiotherapists, orthopaedic surgeons and clinical psychologists. The app offers video exercises with education, physiotherapy and psychological strategies. Users can chat online with a physiotherapist or sports scientist for motivation and exercise-related questions.

Sedentary office occupations can cause back pain as a result of inactivity between back muscles and the spine – but this is not the only factor. A combination of high workload, posture, job dissatisfaction or fear over termination can increase the occurrence of back pain at work.

In an independent clinical study published recently in NPJ Digital Medicine, patients using Kaia reported significantly lower pain levels compared to the control group treated with physiotherapy and online education.

A few simple changes can help to reduce the risk of back pain in the workplace. These include:

• • Walk and talk during phone calls
  • Take a break from the screen every 30 minutes for at least two minutes
  • Exercise regularly at your desk including arm stretches and neck rolls
  • Walk over to and talk with a colleague rather than emailing them
  • Arrange a workplace assessment to optimise the seating position and workstation
  • Meditate for 10 minutes. Be mindful of the influence workplace stress and strain has
  • Sit correctly with your thighs at right angles to your body or sloping slightly down

Stephan Huber, chief medical officer at Kaia Health, says: at Kaia says: “The core problem is our modern, sedentary working life. We’re hunched at desks all day and this puts a strain on our back. We are encouraging UK employers to adopt a holistic approach to tackling back pain in and out of the workplace – this could include increased access to exercise and relaxation like the Kaia app offers. Implementing these measures systematically for workers could lead to a more active way of dealing with the condition, and this will help to alleviate back pain and reduce the strain on the NHS [National Health Service].”

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3 Tips for Preventing Neck Pain

Without knowing it, you may be encouraging neck pain by the way you perform everyday activities. How you carry yourself can invite neck pain or help keep it at bay. In general, try to keep your head balanced directly over your spine, so it is not leaning forward or cocked to one side. That’s because your neck’s principal job is to support your head, and your head weighs a lot—about 10 to 12 pounds.

Here are some hints for achieving a healthy neck posture in common activities.

At the computer or desk

When working at your computer or at a desk, keep your head balanced directly over your spine as much as possible. That means setting your chair height so both your feet can rest on the ground, and sitting with your buttocks far back in your chair, using a small pillow to support your lower back if needed. Properly adjusting the keyboard and monitor may be difficult or impossible with a laptop, notebook, or tablet computer. You can plug in a separate, full-size keyboard to help you achieve better positioning. If that’s not an option, placing your laptop or notebook computer on a desk of standard height and propping it to about a 12% incline (a one-inch book or ring binder should do the trick) keeps your head and neck in a healthier position. The downside is that it does place slightly more stress on your wrists.

No matter how perfect your office chair posture, it’s important to get up and move around every half-hour, as prolonged sitting has been linked to worsening of neck pain and other health problems. If you tend to get lost in your work, program your computer to flash a reminder, or set an alarm on your smartphone. Stretching can help, too. Shrug your shoulders up and down or lean your head to each side while pulling the opposite shoulder down.

Telephone use

If you spend a lot of time on the phone, try to avoid leaning your head to one side. This is also important when you use a cellphone and aren’t sitting at your desk while you speak. A headset, earbuds, or speakerphone are good options to help keep your head in a neutral position for hands-free talking. Headsets are available for both your desk phone and cellphone.

Reading at home

If you are sitting in a chair, try to maintain an upright posture. Hold the book so that you don’t have to lean down or forward to see it. A pillow on your lap may help. If you must read in bed, sit up straight or use a specially designed wedge pillow. Or lie on your side with your neck straight and hold the book in front of you.

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Medical Schools Are Educating The Next Generation Of Doctors On Pain

About Twenty years ago, doctors were taught that pain was the “fifth vital sign,” and something to be taken as seriously as blood pressure, heart rate, respiratory rate and temperature. As a result, there was a new duty for doctors to prioritize treating pain and many of them were taught the solution to treating pain was more prescriptions, often for opioids. We now know that about a quarter of patients who are prescribed opioids for chronic pain will misuse them. On average, 130 Americans die every day from an opioid overdose.

This epidemic has made many realize that addiction can begin in the doctor’s office so many med schools are rethinking the way they train the next generation of doctors. Four medical schools are taking on this new approach: The University of Massachusetts Medical School, the Warren Alpert School of Medicine at Brown University, the University of Michigan School of Medicine and the Uniformed Services University of the Health Sciences.

Training around use and misuse of opioids begins in the first year of med school, and students spend 30 hours of the curriculum learning about topics related to opioids and substance use. In addition to taking part in workshops, every med student receives training to prescribe buprenorphine. The medication, when combined with the opioid-reversal drug naloxone, is branded as Suboxone. It reduces the craving for opioids, as well as the chance of a fatal overdose. But federal regulations prevent clinicians from prescribing Suboxone without a waiver. Rules for obtaining the waivers vary from state to state.

“After graduating from medical school, a doctor could now prescribe pain medication,” said Dr. Sarita Warrier, an associate dean of medical education at the school. “They can prescribe Oxycodone, they can prescribe morphine. It seems almost unfair that they can’t prescribe a medication that’s used to treat some of the consequences of prescribing opioids. So being able to include buprenorphine training within our medical school curriculum became very important to us.”

Paul Wallace, a recent graduate of the medical school, is now going to focus on addiction psychiatry during his residency at University of California, San Francisco. Even though he’s pursuing a specialization in addiction medicine, he told On Point he thinks the certification is valuable for every student. “Unfortunately, my generation of physicians who are now close to midcareer are the ones who are on the frontlines with patients who are suffering from opioid use disorder, so we’re playing the catch-up game.” Dr. Paul George, Brown University “It helps dispel the notion that treating opioid use disorder is purely the domain of addiction specialists or primary care doctors when truly all different types of physicians are going to encounter patients with opioid use disorder, whether it be an emergency physician who seeing a patient after an overdose or an obstetrician who’s working with a pregnant patient with opioid use disorder,” he said.

All medical students, and all graduate nursing students, take part in what the school calls its “OSTI” program, which stands for Opioid Safe Prescribing Training Immersion. This education begins in the first year for medical students, and includes work with standardized patients, and panels where students can hear from patients and their family members, to name a few.
When Dr. Michael Englesbe was a surgery resident about three decades ago, he said he received no specific education about prescribing opioids.

“So the way surgeons learn [is], your first day as a resident, you ask the person sitting next to you how many pills do you get for this procedure,” he said. “That number continued to get more and more over the past decade or two, and surgeons were kind of running for more and more opioids.” “What we learned is, we as nurses and doctors do a poor job of talking to patients about their pain and how we can best care for it,” said Dr. Englesbe, professor of surgery at the University of Michigan Medical School. “This has expanded to a point where this small template of trying to align the pills to their pain has been exported across every procedure in the state of Michigan.”

The university estimates that the introduction of the new curriculum has prevented more than 40,000 excess pills from entering the community. Senior medical students at the university learn a technique that’s called “battlefield acupuncture.” Needles are put in up to five different points in a patient’s outer ears and fall out on their own after a few days. Dr. Arnyce Pock, associate dean for curriculum at the university, said patients have seen results in as little as a few minutes.

“In our clinic we’ll have patients coming in with say eight or nine out of 10 severe back pain,” she said. “We’ll put these needles in their ears, one at a time. And it’s not uncommon that five or 10 minutes later the patient walks out of the clinic either completely pain free or with her pain dramatically reduced from where they came in just with this alone.””Pain has an emotional quality to it. People will feel pain and it will manifest in other ways. So I think having this broader picture is important.” Jason Tsichlis, Brown University medical student

The technique was named “battlefield acupuncture” because, even in a disaster zone, the ears are accessible. But Pock says the technique isn’t limited to people who have been in combat. Between 2014 and 2016, 2,700 physicians, nurses and physical therapists were trained in the technique as part of a collaboration between the Department of Defense and the Department of Veterans Affairs. Now, she says the technique is being used extensively throughout the Washington, D.C., area.

“The beauty is even if the technique doesn’t work 100 percent, [meaning] it doesn’t bring someone’s pain all the way down to a zero, and even if they need some additional medication, chances are they’ll need far less medicine than they might have had they not had this technique,” Pock said. All of this training is just the beginning. But it’s making a difference for students. And, while that broader picture is critical to informing how practitioners approach treatment, the rest of the health care system needs to catch up, said Dr. Kelly Clark, the immediate past president of the American Society of Addiction Medicine.

“The structure that we have now of having treated addiction like a social or a moral problem with social approaches only versus where we need to be with a whole continuum of care, is really the same issue we have with pain management,” she said. “We have not built it in, [and in] some cases have dismantled a multidisciplinary infrastructure that is so needed.”

Dr. Englesbe, from Michigan, said that there’s always room to grow the curriculum. The changes put in place are a good start, ones he hopes will inform students for years to come. “Now, what we give students in the curriculum is more than just knowledge,” he said, “it’s agency to create change.”

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