May 2005 [Volume 4, Issue 5]

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In this issue of To Your Health:

• Bed Rest: Still Unadvisable for LBP
• Want to Lost Weight? Try Catching Some Zzzzs
• Answers to Your Massage Questions: Highlights From This Month's "Ask a Massage Therapist" Online Forum

If you suffer from low back pain (LBP) you may be tempted to avoid movement by staying in bed; however, evidence in the past decade shows that bed rest has not been particularly beneficial in relieving LBP. Recently, the Cochrane Collaboration Back Review analyzed all randomized studies up to March 2003, yielding two new trials comparing advice to rest in bed with advice to stay active for patients with LBP.

Results found that advice to rest in bed was clearly less effective than advice to stay active for patients with acute simple LBP. High-quality evidence shows small but consistent differences in favor of staying active for pain and functional status at 3-4 weeks and 12 weeks follow-up, respectively. Additionally, in patients with acute simple LBP, evidence shows that bed rest will actually increase length of sick leave in the first 12 weeks, compared to advice to stay active. For patients with sciatica, evidence shows that bed rest has little or no effect on pain and functional status, compared to staying active at 3-4 weeks and 12 weeks.

All in all, it appears that LBP sufferers should not count on bedrest to help decrease their recovery time or stave off pain. If you suffer from LBP, make an appointment to see a massage therapist today. Numerous studies have shown that massage is beneficial in relieving back pain, as well as a host of other conditions. For more information on the benefits of massage therapy, visit www.massagetoday.com.

Reference: Hagen KB, Jamtvedt G, Hilde G, Winnem MF. The updated Cochrane Review of bed rest for low back pain and sciatica. Spine, March 1, 2005;30(5):542-46.

Are you struggling to shed some pounds or working hard to maintain your current weight? The answer may be as easy as making some slight adjustments to your sleep patterns. A recent study showed that sleep deprivation may be linked to the hormones responsible for controlling hunger.

Researchers studied 12 healthy men for two consecutive nights in which sleep was limited to four hours, and two consecutive nights in which participants were allowed to sleep for 10 hours. Volunteers reported feeling hungrier after sleeping for only four hours compared to sleeping for 10 hours.

Researchers believe the connection is related to leptin and ghrelin, two hormones responsible for regulating appetite. Leptin signals the brain that the body is full, while ghrelin triggers feelings of hunger. Following the four-hour nights, participants showed an 18 percent decrease in leptin and a 28 percent increase in ghrelin. Although the authors acknowledge study limitations, namely the sample size, they do note that "Additional studies should examine the possible role of chronic sleep curtailment as a previously unrecognized risk factor for obesity."

Clearly, a good night's sleep is important whether you're trying to lose weight or simply want to take better care of yourself. Experts suggest no fewer than seven hours a night. To learn more about general health and wellness, visit www.massagetoday.com.

Reference: Spiegel K, Tasali E, Penev P, Van Cauter E. Sleep duration and levels of hormones that influence hunger. Annals of Internal Medicine 2004; 141:846-50.

Question: What is the best way to treat shin splints?

Answer: "Shin Splints" is a general term for a number of conditions that cause inflammation and pain in the front or side of the shin, especially after exercising. They are caused by an increase of pressure in a muscular compartment of the lower legs, which severely decreases circulation in the soft tissues. Anterior compartment syndrome is the most common. Lymphatic drainage will help reduce the initial inflammation. If the client is having strange sensations like "pins and needles," deeper techniques may be contraindicated. In the chronic stage after inflammation has gone down try some petrissage and trigger point work. Frictions followed with ice works well on adhesions. For scarring, connective tissue techniques will help. You might want to consider some myofascial stretching to the superficial fascia and try not to elevate the leg since this will decrease the circulation even more.

Question: My son has been diagnosed with a hematoma in his calf area, the result of getting hit with a baseball. There were no symptoms for seven to eight days, but now there is swelling and bruising. We are applying heat and massage to the area. Do you recommend any other remedies?

Answer: If there is still swelling, avoid heat as this may increase the inflammation and do not massage the area over the hematoma, since that can encourage bleeding to start again. Instead, wrap ice in a towel and hold over the area for a maximum of 15 minutes, three to four times a day. After a few days when the swelling has gone down, apply heat. Localized heat promotes healing by increasing blood circulation to the injured area, which is also why it can increase swelling. A hot bath, shower, whirlpool or a heating pad will work great.

Note: Information provided in this Q&A section is drawn from the "Ask a Massage Therapist" online forum, in which massage therapists field questions relative to the massage profession. Readers are encouraged to post their questions at www.massagetoday.com/ask/. Answers should not be misconstrued as a diagnosis, prognosis or treatment recommendation and do not in any way constitute the practice of massage therapy or any other health care profession. Readers should consult their own health care providers for medical advice.

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