Two studies involving postmenopausal females found that sedentary behavior increased their risk of developing heart failure and that walking lowered their risk of high blood pressure.

For people spending more time at home as a result of the COVID-19 pandemic, the new research provides an impetus to go for more walks and avoid sitting too long in front of computer or television screens.

In the two studies, which the University at Buffalo (UB), NY, led, researchers found that postmenopausal females who went for brisk walks and spent less time sitting or lying down during their waking hours had a lower risk of hypertension and heart failure, respectively.

“Walking and moving are simple activities that can be easily integrated into our daily lives,” says Jean Wactawksi-Wende, Ph.D., dean of UB’s School of Public Health and Health Professions (SPHHP) and a co-author of both studies.

LaMonte was the senior author on the paper that linked walking to a reduced risk of hypertension and first author on the paper that found an association between sedentary behavior and an increased risk of heart failure.

Walking and hypertension

The walking research followed 83,435 females who did not have a diagnosis of hypertension, heart failure, coronary heart disease, or stroke at the start of the study.

All of the participants reported that they could walk at least one block without assistance.

During the average follow-up period of 11 years, 38,230 participants received a diagnosis of hypertension.

After adjusting for other possible contributing factors, including other types of physical exercise, the participants who walked the most were 11% less likely to develop hypertension than those who walked the least.

Participants who were among the fastest walkers had a 21% lower risk of hypertension compared with those who walked the slowest.

Even after adjusting the figures to account for the overall amount of time that each participant spent walking and the distance they covered, a walking speed of at least 2 miles per hour was associated with a significant reduction in the risk of hypertension.

The study suggests that walking briskly has a more significant effect on hypertension risk than either the total distance or the duration of walks.

“To put it simply, get your steps in, and try to make them quick,” says Connor Miller, who was the lead researcher on the study, which he worked on while obtaining his master’s in epidemiology at UB. He is now an epidemiologist at Roswell Park Comprehensive Cancer Center in Buffalo.

“Our work adds to growing evidence that you don’t necessarily have to be an avid jogger or cyclist to gain health benefits from physical activity,” he adds.

Sedentary behavior and heart failure

The study of sedentary behavior followed 80,982 females who had not received a diagnosis of heart failure at the start of the study and were able to walk at least one block unassisted.

The participants regularly filled out questionnaires that included questions about the amount of time they spent sitting or lying down in their waking hours.

During the average follow-up period of 9 years, there were 1,402 cases of hospitalization for heart failure.

In their analysis, the researchers adjusted the figures to account for a wide range of other possible confounding factors, including the participants’ age, race/ethnicity, smoking status, alcohol consumption, and use of hormone replacement therapy.

Compared with the participants who reported sitting for no more than 4.5 hours a day, sitting for 4.6–8.5 hours a day was associated with a 14% increased risk of heart failure.

Sitting for more than 8.5 hours per day was associated with a 54% increased risk of heart failure.

Even among females with the highest levels of recreational physical activity, the risk of heart failure was significantly raised if they spent more than 9.5 hours per day sitting or lying down.

“This latter finding points to the need to not only promote more physical activity for heart failure prevention but to also promote interruption of sedentary time throughout the day,” says LaMonte.

In their paper, the researchers say that the risks of heart failure associated with prolonged sedentary behavior are on a par with those for obesity and diabetes.

Other studies suggest that sedentary behavior promotes the development of atherosclerosis (narrowing of the arteries supplying the heart muscle), the authors write, which, in turn, increases a person’s risk of heart failure.

Limitations of the research

Both studies had some limitations in common. The researchers could not rule out the possibility that some participants had undiagnosed underlying health conditions at the start of the study. These could have affected their walking and sedentary behavior.

Also, both studies relied upon the participants’ estimates of how far and fast they walked or the amount of time they spent sitting or lying down.

Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and debilitating.

It can result from injury, activity and some medical conditions. Back pain can affect people of any age, for different reasons. As people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease.

Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area.

Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around.

The segments of the spine are cushioned with cartilage-like pads called disks.

Problems with any of these components can lead to back pain. In some cases of back pain, its cause remains unclear.

Damage can result from strain, medical conditions, and poor posture, among others.

Strain

Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are: strained muscles or ligaments

a muscle spasm, muscle tension, damaged disks, injuries, fractures, or falls.

Activities that can lead to strains or spasms include: lifting something improperly lifting something that is too heavy, making an abrupt and awkward movement

Structural problems

A number of structural problems may also result in back pain.

• Ruptured disks: Each vertebra in the spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
• Bulging disks: In much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
• Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.
• Arthritis: Osteoarthritis can cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows. This is known as spinal stenosis.
• Abnormal curvature of the spine: If the spine curves in an unusual way, back pain can result. An example is scoliosis, in which the spine curves to the side.
• Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
• Kidney problems: Kidney stones or kidney infection can cause back pain.

Movement and posture

Back pain can also result from some everyday activities or poor posture.

Examples include: twisting, coughing or sneezing, muscle tension, over-stretching, bending awkwardly or for long periods pushing, pulling, lifting, or carrying something, standing or sitting for long periods, straining the neck forward, such as when driving or using a computer, long driving sessions without a break, even when not hunched, sleeping on a mattress that does not support the body and keep the spine straight other causes may include some medical conditions such as;

Cauda equina syndrome: The cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes bowel and bladder function disturbances.

Cancer of the spine: A tumor on the spine may press against a nerve, resulting in back pain.

Infection of the spine: A fever and a tender, warm area on the back could be due to an infection of the spine.

Other infections: Pelvic inflammatory disease, bladder, or kidney infections may also lead to back pain.

Sleep disorders: Individuals with sleep disorders are more likely to experience back pain, compared with others.

Shingles: An infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.

Risk factors

The following factors are linked to a higher risk of developing low back pain:

occupational activities, pregnancy, a sedentary lifestyle, poor physical fitness, older age, obesity and excess weight, smoking, strenuous physical exercise or work especially if done incorrectly, genetic factors, medical conditions, such as arthritis and cancer.

Lower back pain also tends to be more common in women than in men, possibly due to hormonal factors. Stress, anxiety and mood disorders have also linked to back pain.

Symptoms

The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way down to the buttocks and legs. Some back issues can cause pain in other parts of the body, depending on the nerves affected. The pain often goes away without treatment, but if it occurs with any of the following, it is advise to see a doctor:

weight loss, fever, inflammation or swelling on the back, persistent back pain, where lying down or resting does not help, pain on the legs, pain that reaches below the knees, a recent injury, blow or trauma to the back, urinary incontinence, difficulty urinating, fecal incontinence, or loss of control over bowel movements, numbness around the genitals, numbness around the anus, numbness around the buttocks

When to see a doctor

You should seek medical help if you experience any numbness or tingling, or if you have back pain that does not improve with rest, after an injury or fall, with numbness in the legs, with weakness, with fever, with unexplained weight loss.

Treatment

Back pain usually resolves with rest and home remedies, but sometimes medical treatment is necessary.

Home treatments

Over-the-counter (OTC) pain relief medication, usually nonsteroidal anti-inflammatory drugs, such as ibuprofen, can relieve discomfort. Applying a hot compress or an ice pack to the painful area may also reduce pain.

Resting from strenuous activity can help, but moving around will ease stiffness, reduce pain, and prevent muscles from weakening.

Medical treatment

If home treatments do not relieve back pain, a doctor may recommend the following medication, physical therapy, or both.

Medication: Back pain that does not respond well to OTC painkillers may require a prescription NSAID. Codeine or hydrocodone, which are narcotics, may be prescribed for short periods. These require close monitoring by the doctor. In some cases, muscle relaxants may be used.

Physical therapy: Applying heat, ice, ultrasound, and electrical stimulation — as well as some muscle-release techniques to the back muscles and soft tissues — may help alleviate pain.

As the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help.

The patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence.

Cortisone injections: If other options are not effective, these may be injected into the epidural space, around the spinal cord. Cortisone is an anti-inflammatory drug. It helps reduce inflammation around the nerve roots. Injections may also be used to numb areas thought to be causing the pain.

Botox: Botox (botulism toxin), according to some early studies, are thought to reduce pain by paralyzing sprained muscles in spasm. These injections are effective for about 3 to 4 months.

Traction: Pulleys and weights are used to stretch the back. This may result in a herniated disk moving back into position. It can also relieve pain, but only while traction is applied.

Cognitive behavioral therapy (CBT): CBT can help manage chronic back pain by encouraging new ways of thinking. It may include relaxation techniques and ways of maintaining a positive attitude. Studies have found that patients with CBT tend to become more active and do exercise, resulting in a lower risk of back pain recurrence.

Complementary therapies

Complementary therapies may be used alongside conventional therapies or on their own. Chiropractic, osteopathy, shiatsu, and acupuncture may help relieve back pain, as well as encouraging the patient to feel relaxed.

An osteopath specializes in treating the skeleton and muscles.

A chiropractor treats joint, muscle and bone problems. The main focus is the spine.

Shiatsu, also known as finger pressure therapy, is a type of massage where pressure is applied along energy lines in the body. The shiatsu therapist applies pressure with the fingers, thumbs and elbows.

Acupuncture originates from China. It consists of inserting fine needles and specific points in the body. Acupuncture can help the body release its natural painkillers — endorphins — as well as stimulating nerve and muscle tissue.

Yoga involves specific poses, movements, and breathing exercises. Some may help strengthen the back muscles and improve posture. Care must be taken that exercises do not make back pain worse.

Studies on complementary therapies have given mixed results. Some people have experienced significant benefit, while others have not. It is important, when considering alternative therapies, to use a well qualified and registered therapist.

Transcutaneous electrical nerve stimulation (TENS) is a popular therapy for patients with chronic back pain. The TENS machine delivers small electric pulses into the body through electrodes that are placed on the skin.

Experts believe TENS encourages the body to produce endorphins and may block pain signals returning to the brain. Studies on TENS have provided mixed results. Some revealed no benefits, while others indicated that it could be helpful for some people.

A TENS machine should be used under the direction of a doctor or health professional.

It should not be used by someone who:

is pregnant, has a history of epilepsy, has a pacemaker, has a history of heart disease.

TENS is considered “safe, noninvasive, inexpensive, and patient friendly,” and it appears to reduce pain, but more evidence is needed to confirm its effectiveness in improving activity levels.

Surgery

Surgery for back pain is very rare. If a patient has a herniated disk, surgery may be an option, especially if there is persistent pain and nerve compression which can lead to muscle weakness.

Examples of surgical procedures include:

Fusion: Two vertebrae are joined together, with a bone graft inserted between them. The vertebrae are splinted together with metal plates, screws or cages. There is a significantly greater risk for arthritis to subsequently develop in the adjoining vertebrae.

Artificial disk: An artificial disk is inserted; it replaces the cushion between two vertebrae.

Diskectomy: A portion of a disk may be removed if it is irritating or pressing against a nerve.

Partially removing a vertebra: A small section of a vertebra may be removed if it is pinching the spinal cord or nerves.

Injecting cells to regenerate spine discs: Scientists from Duke University, North Carolina, developed new biomaterials that can deliver a booster shot of reparative cells to the nucleus pulposus, effectively eliminating pain caused by degenerative disc disease.

Prevention

Steps to lower the risk of developing back pain consist mainly of addressing some of the risk factors.

Exercise: Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional.

There are two main types of exercise that people can do to reduce the risk of back pain:

Core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back.

Flexibility training aims at improving core flexibility, including the spine, hips, and upper legs.

Diet: Make sure your diet includes enough calcium and vitamin D, as these are needed for bone health. A healthful diet also helps control body weight.

Smoking: A significantly higher percentage of smokers have back pain incidences compared to non-smokers of the same age, height, and weight.

Body weight: The weight people carry and where they carry it affects the risk of developing back pain. The difference in back pain risk between obese and normal-weight individuals is considerable. People who carry their weight in the abdominal area versus the buttocks and hip area are also at greater risk.

Posture when standing: Make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine.Share on Pinterest

Posture when sitting: A good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.

Lifting: When lifting things, use your legs to do the lifting, rather than your back.

Keep your back as straight as you can, keeping your feet apart with one leg slightly forward so you can maintain balance. Bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible.

Bending your back initially is unavoidable, but when you bend your back try not to stoop, and be sure to tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting, or you will be using your back for most of the work.

Do not lift and twist at the same time: If something is particularly heavy, see if you can lift it with someone else. While you are lifting keep looking straight ahead, not up or down, so that the back of your neck is like a continuous straight line from your spine.

Moving things: It is better for your back to push things across the floor, using your leg strength, rather than pulling them.

Shoes: Flat shoes place less of a strain on the back.

Driving: It is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks. Get out of the car and walk around.

Bed: You should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle.