This was the message from CSP fellow Dr Mick Thacker, director of the 'Pain: Science and Society' MSc course at King’s College London.
Giving a keynote lecture, Dr Thacker advised delegates to move away from purely mechanical-based therapies for back pain patients, and become more aware of the role of neuro-immnunology in relation to pain.
"Traditional physiotherapy has based its management of back pain on anatomical, tissue-based principles and biomechanics", said Dr Thacker.
THERE'S a fuzz in my brain and an ache in my gut. My legs are leaden and my eyesight is blurry. But I have only myself to blame. Besides, I have been assured that these symptoms will pass. Between 10 days and three weeks from now, my body will adjust to the new regime, which entails fasting for two days each week.
Drawing can cause a repetitive strain injury (RSI), but with a few precautions and the right equipment, this risk can be minimized.
by Edith Zimmerman
Drawing is not usually thought of as a high-risk occupation. Calluses, dirty fingernails, stained clothes, and the occasional paper cut are usually the worst that can happen. But for many artists, particularly those who have been drawing for years, the simple act of making a pencil line drawing can yield painful and devastating results over time.
by Leslie Arwin, 2006,
colored pencil, 10 x 8.
Collection the artist.
Blame it on devotion, but many artists—chiefly those for whom pencils are the instruments of choice—experience a repetitive strain injury (RSI) at some point in their careers. Repetitive strain injuries, as the name suggests, come from repeated stressing and flexing of certain muscles and joints. For most, pain associated with RSI is located in the hand, wrist, elbow, shoulders, neck, or even the lower back. The bad news: for many, the pain is chronic and often interferes severely with their passion for drawing. The good news: everyone can benefit easily from learning how to draw with a few preventative and restorative measures. We consider working this way one of the drawing basics.
Tennis Elbow & Ergonomics
Tennis elbow—or, as Allison Fagan, a signature member of the Colored Pencil Society of America (CPSA), calls it, “pencil elbow”—is a common complaint among those who spend long hours drawing. Says colored pencil artist Helen Passey, “My tennis elbow is definitely a direct result of colored pencil work on a show deadline.” Leslie Arwin, a doctor who practices occupational medicine and a member of the CPSA, says her struggle with both tennis and golfer’s elbow (lateral and medial epicondylitis, respectively) has been frustrating and has also forced her to re-evaluate the way she draws. “It is important to have an ergonomic evaluation of your work space,” says Arwin. “For artists, that isn’t always easy.” If you don’t have an ergonomic evaluator at your disposal, here are some basic improvements you can make on your own.
|Wrist Flexors With
by Leslie Arwin, 2006,
colored pencil 8 x 10.
Collection the artist.
Setting Up Your Workspace
Make sure your chair is giving you the best support possible. Deborah Quilter, the author of The Repetitive Strain Injury Recovery Book (Walker & Company, New York, New York) and creator of an RSI website (www.rsihelp.com), recommends that artists “adjust the height of the chair so that your feet are resting flat on the floor. If your feet don’t reach the floor, use a footrest.” Moreover, “You need a chair with pelvic tilt. That means it allows you to have your hips higher than your knees,” she advises. “That’s really important, because otherwise you lose the natural curve in the spine, which leads to back pain and other problems.” Several such chairs are on the market, including the Martin Universal Vesuvio Series drafting stool, which is available through vendors such as Blick Art Materials. But Quilter asserts, “You can get a wonderful chair, but you should really spend as little time as possible sitting in it.”
Make sure there is ample support for your drawing arm. “Setting up your work space so that your forearm is supported is the most important thing,” Arwin explains. Linda Wesner, a signature member of the CPSA, agrees. “If my forearm is supported by the desktop while I’m drawing it really helps,” she says. “Whenever I let my elbow hang over the edge of the desk for extended periods of time, I feel pain.” Quilter concurs, “You don’t want the arm to be pressing into the hard edge of the table. You don’t want to lean on your elbow—both these things can give you nerve damage. Make sure you have an elevated, slanted surface so you’re not craning your neck to see your work and so your arm can move freely without being pinched by the edge of your desk.”
|Wrist Extensor With
by Leslie Arwin, 2006,
colored pencil, 8 x 10.
Collection the artist.
Changing the angle of the drawing board can also make a workstation more ergonomically sound. “I had an ergonomic assessment of my work space shortly after the problem arose,” says Fagan, “and as a result changed the angle of my drafting table so that it is almost perpendicular to the floor.” CPSA member Linda Koffenberger adds, “I don’t have any discomfort when drawing because I use a drafting board set at a 20- to 30-degree angle.” Fagan also recommends using “a small footrest so that my legs are bent at a 90-degree angle, and I’m not tempted to lean forward when I draw.”
Stretching, Posture, Breaks
Some of the simplest solutions to the pain associated with repetitive stress are based on common sense—stretch, take breaks, and maintain good posture. “Sit up straight, stretch frequently, and pace yourself,” says Quilter. Explains Fagan, “Most important to maintaining a healthy status is stretching for five to 10 minutes before I work. I extend my wrist up and down with my arm bent and my elbow straight.” Koffenberger also suggests a particular stretch that works for her: “Sit up straight in a chair next to a low table (the surface of the table flush with the seat of the chair). Place your hand, palm down, on the table. With your arm straight over your hand (your wrist forms a 90-degree angle with your palm), lean into your hand. Hold for 20 to 30 seconds and then relax. Do this five times. It helps to loosen up the tendon in your wrist and relieve pressure on the median nerve. Or at least it works for me!” Colored pencil artist Laurene Puls says that for every muscular action, she makes an equal and opposite muscular reaction to keep pain at bay. “In other words, if I’m going to make a clockwise circle a dozen times, I need to go counterclockwise a dozen times.”
Another factor that contributes to the development of an RSI is poor posture. “No ergonomics will solve poor posture,” says Quilter. Good posture—holding the spine erect, standing tall—is important to maintain not only while standing but also while sitting. “You want to sit up straight when you’re drawing,” advises Quilter, “because when you slouch, you’re compressing your diaphragm, your spine isn’t supported, and you’ll get back pain.” Working for prolonged periods in a seated position can cause people to slump, to assume the position of their chair, and to hang their heads. “I try to keep my ears aligned over my shoulders when I work, so I am not leaning forward,” says Fagan. Extending the arms for long periods of time—as one often does while drawing—can exacerbate the problems caused by poor posture. Says Quilter, “Proper posture is crucial to preventing myriad ailments, including repetitive strain injury and back pain. No state-of-the-art workstation compensates for the risks introduced by slouching.”
The importance of taking breaks can’t be overemphasized. “I take a break from drawing every 30 minutes,” Koffenberger says. “Just a short, one-minute break is enough. It keeps my mind more creative and my work more fluid.” Quilter agrees. As she states in her book, “Frequent, regular breaks are critical to preventing reinjury. Do not allow yourself to work to the point of pain. Take a break as often as you need to, but certainly well before you feel any symptoms of strain, such as fatigue, soreness, tingling, or even hyperawareness of your hands. If you wait—or work in pain—you will be causing damage to the soft tissue.” Unfortunately, as many artists know, remembering to take breaks can be challenging. “When lost in the process, our brains override pain,” Puls explains. To correct this, she developed a creative reminder: “I work for one CD’s worth of music then stop for a break to assess how my arm is feeling.”
Modifying Art Supplies/Developing Creative Solutions
Changing or modifying art supplies may also be necessary. “Making tools fatter is a key element,” says Arwin. “Wrap the pencils in foam and tape to reduce the pinch motion of the grip.” For another inexpensive fix, Quilter recommends putting hair rollers around pencils. Specially designed rubber grips—not unlike the ones popular in first grade—accomplish this as well. They make pencils easier to grip and require less clenching force. For paper, Wesner recommends a type with less tooth. “Artists should use a paper surface that has just enough tooth to accept the pencil’s wax pigment; too much texture means many more strokes are required to ‘fill in’ with pigment. Also, a softer touch, with not so much burnishing, helps.” Triangular pencils, such as those made by Staedtler or Faber-Castell, and especially the large pencils manufactured by Koh-I-Noor, are easier to grip and more ergonomically sound than their round, traditional counterparts.
Solutions can often be found by simply changing technique. If something hurts, find another way to do it. “Consider adapting your technique to your physical abilities,” recommends Passey. “There’s usually more than one way to do this, and some are easier on the body than others.” Says Arwin, “I am trying to draw more with line, less with shade, and smaller to protect my elbows and wrists.” For those whose computer work exacerbates the problem, Arwin recommends a less obvious measure to alleviate the pain: “I use Dragon voice-recognition software to reduce the amount of typing that I do at work,” she says. Quilter also recommends Dragon, as it reduces work-time muscle and joint stress.
Many artists weave RSI-preventative/protective measures into their creative routines in clever and unusual ways. “Because I am sharpening my pencils all day long,” says Fagan, “I have placed my electric sharpener behind my working chair on a box on the floor so that I am forced to stretch my arm down to reach it.” Suggests Quilter, “Put the phone across the room so you have to get up when it rings.”
Splints, Bands…and Surgery
For many sufferers of RSI, devices such as wrist braces and elbow bands are invaluable. It is important, however, to remember that splints are serious medical implements that may be harmful if used incorrectly. Quilter warns that using a splint while working can actually be counterproductive: “People can get addicted to splints,” she cautions. “By not moving, they’re not causing themselves pain. But if a resting splint is worn during activity, further injury may be produced in the injured or adjacent tissue, such as disuse atrophy or contracture of immobilized tissues.” It’s not so much that splints should be avoided, she says, as it is that splints should be worn only at the right time. Most splints are intended to stabilize the body and facilitate healing during a time of rest—not of work. The problem is, she says, that many artists do wear their splints while working, and this can potentially impede the healing process. “It feels good short-term,” she says, “like slouching feels good short-term. But long term it’s injurious.”
On the other hand, “If you have Carpal Tunnel Syndrome, wrist braces are the best investments you can make,” says Koffenberger. “It makes a big difference to put them on and rest your wrists when you finish drawing, even if you don’t think you’re having any symptoms,” says Passey. The bottom line: When considering a splint, use discretion. Wear a splint only if recommended by a doctor. Carefully follow your doctor’s instructions to ensure that wearing it yields the most beneficial results.
Braces can also be effective when worn at night. Intriguingly, sleep may be partially to blame for the pain associated with RSI. Many people flex their wrists intensely and repeatedly during sleep, and this can become a serious problem. Sleep-flexing, coupled with daytime pressure, could very well cause and exacerbate many of these disorders. People who suspect this might be a factor should consult a doctor about wearing a brace at night. Says Koffenberger, “The best thing I have found to prevent or overcome Carpal Tunnel Syndrome is to wear a wrist brace at night. The metal plate keeps me from bending my wrist while sleeping.”
For severe Carpal Tunnel Syndrome and other forms of RSI, many doctors prescribe steroids, nonsteroidal anti-inflammatory medication, or advise corrective surgery. Many chronic pain sufferers, however, are wary of these measures: “Just because steroid treatments or anti-inflammatory medications mask the pain doesn’t mean they are helping the problem. It is only through rest and appropriate exercises that the source of the pain heals,” says Puls. Surgery, steroids, and anti-inflammatory medication are options that should be carefully considered and evaluated by a trusted doctor.
Although the last thing we want to do is discourage anyone from drawing, we hope this serves as a reminder for all artists to continue paying close attention to the signs their bodies are giving them. It is far easier to prevent than to cure a repetitive strain injury, so it’s essential for artists to take care of their most vital tools: their bodies. So sit up straight, stretch out, support your arms, and keep drawing.
Edith Zimmerman is the editorial assistant for Drawing.
CHICAGO — Chronic back pain, a condition afflicting many Americans, shrinks the brain by as much as 11 percent — equivalent to the amount of gray matter lost in 10 to 20 years of normal aging, a Northwestern University research studyfound.
Loss in brain density is related to pain duration, indicating that 1.3 cubic centimeters of gray matter (the part of the brain that processes information and memory) are lost for every year ofchronic pain, said lead researcher A. Vania Apkarian, associate professor of physiology at Northwestern University Feinberg School of Medicine and a researcher at the Northwestern University Institute of Neuroscience.
The study, the first to examine brain changes in chronic painconditions, was published in the Nov. 23 issue of The Journal of Neuroscience.
At least 25 percent of Americans suffer from back pain; in one fourth of these individuals, back pain is chronic and unremitting. Although chronic pain greatly diminishes quality of life and increases anxiety and depression, it previously had been assumed that the brain reverts to its normal state afterchronic pain stops.
Apkarian and co-researchers used structural magnetic resonance imaging brain scan data and two automated analysis techniques to contrast brain images from 26 participants with chronic back pain with those from matched normal subjects.
All participants with chronic back pain had unrelenting pain for more than a year, primarily localized to the lumbosacral region, including buttocks and thighs, with or without pain radiating to the leg.
The participants were divided into neuropathic — exhibiting pain because of sciatic nerve damage — and non-neuropathic. Brain scans showing gray matter volume were compared.
In earlier research, Apkarian and colleagues found that back pain sustained for six months or longer is accompanied by abnormal brain chemistry, indicated by chemical changes in the area of the brain known to be important in making emotional assessments, including decision-making and for controlling social behavior. Based on these results, Apkarian’s laboratory group embarked on the brain atrophy study.
It is possible that some of the observed decreased gray matter shown in this study reflects tissue shrinkage without substantial neuronal loss, suggesting that proper treatment would reverse this portion of the decreased brain gray matter, Apkarian said. The atrophy also may be attributable to more irreversible processes, such as neurodegeneration. Other research has shown that spinal cord neurons undergo apoptosis — cell death — in rats with neuropathic pain.
“Given that, by definition, chronic pain is a state of continuous persistent perception with associated negative affect and stress, one mechanistic explanation for the decreased gray matter is overuse atrophy caused by excitotoxic and inflammatory mechanisms,” Apkarian said.
The researchers hypothesize that atrophy of brain circuitry involved in pain perception may dictate the properties of the pain state, such that as atrophy of elements of the circuitry progresses, the pain condition becomes more irreversible and less responsive to therapy.
Other researchers on the study were Yamaya Sosa, physiology; Sreepadma Sonty, neurology; Robert M. Levy, M.D., neurosurgery; R. Norman Harden, M.D., physical medicine and rehabilitation; Todd B. Parrish, radiology; and Darren R. Gitelman, M.D., neurology, radiology and the Cognitive Neurology and Alzheimer’s Disease Center, at Feinberg.
A new study has found that participating in an 8-week meditation training program can have measurable effects on how the brain functions even when someone is not actively meditating. In their report in the November issue of Frontiers in Human Neuroscience, investigators at Massachusetts General Hospital (MGH), Boston University (BU), and several other research centers also found differences in those effects based on the specific type of meditation practiced.
“The two different types of meditation training our study participants completed yielded some differences in the response of the amygdala – a part of the brain known for decades to be important for emotion – to images with emotional content,” says Gaëlle Desbordes, PhD, a research fellow at the Athinoula A. Martinos Center for Biomedical Imaging at MGH and at the BU Center for Computational Neuroscience and Neural Technology, corresponding author of the report. “This is the first time that meditation training has been shown to affect emotional processing in the brain outside of a meditative state.”
Several previous studies have supported the hypothesis that meditation training improves practitioners’ emotional regulation. While neuroimaging studies have found that meditation training appeared to decrease activation of the amygdala – a structure at the base of the brain that is known to have a role in processing memory and emotion – those changes were only observed while study participants were meditating. The current study was designed to test the hypothesis that meditation training could also produce a generalized reduction in amygdala response to emotional stimuli, measurable by functional magnetic resonance imaging (fMRI).
Participants had enrolled in a larger investigation into the effects of two forms of meditation, based at Emory University in Atlanta. Healthy adults with no experience meditating participated in 8-week courses in either mindful attention meditation – the most commonly studied form that focuses on developing attention and awareness of breathing, thoughts and emotions – and compassion meditation, a less-studied form that includes methods designed to develop loving kindness and compassion for oneself and for others. A control group participated in an 8-week health education course.
Within three weeks before beginning and three weeks after completing the training, 12 participants from each group traveled to Boston for fMRI brain imaging at the Martinos Center’s state-of-the-art imaging facilities. Brain scans were performed as the volunteers viewed a series of 216 different images – 108 per session – of people in situations with either positive, negative or neutral emotional content. Meditation was not mentioned in pre-imaging instructions to participants, and investigators confirmed afterwards that the volunteers had not meditated while in the scanner. Participants also completed assessments of symptoms of depression and anxiety before and after the training programs.
In the mindful attention group, the after-training brain scans showed a decrease in activation in the right amygdala in response to all images, supporting the hypothesis that meditation can improve emotional stability and response to stress. In the compassion meditation group, right amygdala activity also decreased in response to positive or neutral images. But among those who reported practicing compassion meditation most frequently outside of the training sessions, right amygdala activity tended to increase in response to negative images – all of which depicted some form of human suffering. No significant changes were seen in the control group or in the left amygdala of any study participants.
“We think these two forms of meditation cultivate different aspects of mind,” Desbordes explains. “Since compassion meditation is designed to enhance compassionate feelings, it makes sense that it could increase amygdala response to seeing people suffer. Increased amygdala activation was also correlated with decreased depression scores in the compassion meditation group, which suggests that having more compassion towards others may also be beneficial for oneself. Overall, these results are consistent with the overarching hypothesis that meditation may result in enduring, beneficial changes in brain function, especially in the area of emotional processing.”
Eric Schwartz, PhD, of the BU Department of Electrical and Computer Engineering and Center for Computational Neuroscience and Neural Technology, is senior author of the Frontiers in Human Neuroscience report. Additional co-authors are Lobsang T. Negi, PhD, and Thaddeus Pace, PhD, Emory University; Alan Wallace, PhD, Santa Barbara Institute for Consciousness Studies; and Charles Raison, MD, University of Arizona College of Medicine. The study was supported by grants from the National Center for Complementary and Alternative Medicine, including an American Recovery and Reinvestment Act grant to Boston University
Sunday, November 11th 2012 at 5:00 am
Beyond flavor and crunch, there are plenty of good reasons to throw some nuts into your brownies, banana bread, yogurt, muffins, pancakes, salads and smoothies. Antioxidants, lower oxidized cholesterol and better heart health are just a few of the benefits of indulging in nuts.
According to a study published in the Archives of Internal Medicine, eating more nuts is associated with improved blood cholesterol levels.
Researchers from Loma Linda University in California gathered data from 25 studies on eating nuts conducted in seven countries and involving 583 women and men with high or normal cholesterol levels. All the studies compared a control group to a group assigned to eat nuts.
Every day study participants ate an average of 2.4 ounces of nuts – equivalent to about 50 almonds. This was associated with an average 5.1 percent reduction in total cholesterol, a 7.4 percent reduction in low-density lipoprotein (LDL, or “bad” cholesterol) and an 8.3 percent improvement in the ratio of LDL cholesterol to high-density lipoprotein (HDL, or “good” cholesterol). In addition, triglyceride levels declined by 10.2 percent.
The authors of the study (funded by the International Tree Nut Council Nutrition Research and Education Foundation) claim their results support including nuts in therapeutic dietary interventions for improving blood cholesterol levels. In a press release they stated:
Nuts are a whole food that have been consumed by humans throughout history. Increasing the consumption of nuts as part of an otherwise prudent diet can be expected to favorably affect blood lipid levels (at least in the short term) and have the potential to lower coronary heart disease risk.
The study found benefits in all types of nuts, which are rich in healthy fats, high quality protein, dietary fiber, minerals, vitamins, antioxidants and phytosterols and have long been associated with heart health.
Of all nuts, however, walnuts warrant special attention. An analysis presented at a meeting of theAmerican Chemical Society concluded that walnuts have a combination of more healthful antioxidants and higher quality antioxidants than any other nut.
According to the author, Joe Vinson, Ph.D., of the University of Scranton, walnuts have almost twice as much antioxidants as an equivalent amount of other commonly eaten nuts. He analyzed nine different types of nuts: walnuts, almonds, peanuts, pistachios, hazelnuts, Brazil nuts, cashews, macadamias, and pecans.
Vinson also found that walnuts boast the highest quality, or potency, of antioxidants. He measured the antioxidants in walnuts as 2-15 times more potent than vitamin E.
And walnuts have another advantage because most people enjoy them raw. The heat from roasting nuts can reduce the quality of their antioxidants but raw nuts preserve more antioxidants intact.
Walnuts are also an excellent source of heart healthy omega 3 essential fatty acids with a quarter-cup providing over 90% of the recommended daily value. They are also a good source of monounsaturated fats which other studies have shown have a favorable effect on cholesterol.
Walnuts have been associated with better cognitive function, as well as anti-inflammatory effects that are beneficial in relieving asthma, rheumatoid arthritis, eczema and psoriasis. In addition, they contain an antioxidant that supports the immune system and appears to have several anticancer properties. [view additional walnut health benefit research on GreenMedInfo.com]
Years of research link regular consumption of small amounts of all sorts of nuts or peanut butter with decreased risk of heart disease, certain kinds of cancer, gallstones, Type 2 diabetes, and other health problems.
But apparently the wide-ranging health benefits of nuts are not fully appreciated since Vinson’s research shows that nuts account for barely eight percent of the daily antioxidants in the average person’s diet.
Because nuts are high in fat and calories many people try to avoid them. But eating nuts does not appear to cause weight gain and even makes people feel full and less likely to overeat. In a 2009 study from the Harvard School of Public Health, higher nut consumption was associated with a significantly lower risk of weight gain and obesity.
Vinson says that it takes only about 7 walnuts a day to get the potential health benefits, so add a handful every day in your meals or snacks.
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