2011年9月13日星期二

Are our towering heels to blame for back troubles?

Known for tottering around in sky-high heels while heavily pregnant, it came as no surprise to some that Victoria Beckham developed a bad back.

The 37-year-old Spice Girl-turned-fashion designer wore gravity-defying Christian Louboutin heels to the wedding of Prince William and Catherine Middleton when she was six months pregnant.

So when her subsequent slipped disc was announced, which reportedly prevented her from picking up new babe Harper Seven, there was predictable speculation over whether this was caused by such inappropriate footwear.

Stiletto aficionados need not fear, however. This common problem, affecting an enormous one in five people in the UK over the duration of their lives, is unlikely to have been caused by wearing heels.

Her condition, instead, could have been linked to her pregnancy, or a number of other factors.

Brian Hammond, chairman of the charity BackCare, says: ‘There's evidence to show that wearing high shoes can give you backache, but not a slipped disc.

‘Heels can aggravate some back problems, but not always, and in some cases, wearing them actually relieves pain.'

He points out the hormone relaxin is released during pregnancy, and this can make women more prone to back problems, because as well as relaxing the joints in the pelvis, it can lead to abnormal motion in other joints, causing inflammation and pain.

The discs of the spine lie between the vertebrae and have a tough, fibrous case containing a softer, gel-like substance. A slipped disc (also called a herniated or prolapsed disc) occurs when a disc is ruptured and the gel inside leaks out.

The bulging gel can put pressure on the whole spinal cord and connected nerves, thus causing pain both in the back and throughout the body. Such problems include sciatica and brachialgia, which cause pain in the legs and arms respectively.

‘People generally get slipped discs when the spine has been abused or over-used,' says Hammond, who points out that around half of 50-year-olds have slipped discs, although some may have no symptoms.

Anything from heavy lifting and twisting, to sitting for long periods without getting up can trigger the problem. Poor seating positions can also predispose people to becoming susceptible.

Hammond, who is a chiropractor and osteopath, says slipped discs can develop suddenly or over a long period.

‘A lot of people ignore their symptoms until they interfere with their life, meaning they can't go to work or play sport.

‘The quicker you deal with it, the better the outcome,' he stresses.

Sciatica is one of the common results of a slipped disc, occurring when the disc protrudes and aggravates the sciatic nerve which runs down the leg. Symptoms include pain in the leg, buttock and foot, and pins and needles.

If the protruding disc is in the neck, patients can suffer from brachialgia, where there's pain and numbness in the arms.

Another rarer possibility is cauda equina syndrome (CES), which causes numbness around the anus and occurs when the protruding disc presses on all the nerves at the bottom of the spine. This condition is a medical emergency that can lead to permanent bowel and bladder problems, and even paralysis from the waist down.

There are a number of ways to treat a slipped disc, depending on its position and severity. They include physical therapies, anti-inflammatory drugs, muscle relaxants and even surgery - although this is only used for around one in every 200 cases.

While bed rest used to be advised for people with slipped discs, these days it's not recommended.

‘The long-term consequences of bed rest actually leave you worse off in the end,” explains Hammond. “The best thing to do is to potter around within the realms of the pain.'

People who've had a slipped disc should do specific exercises to increase core stability, and will benefit from general exercise such as swimming and pilates.

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