he creates a sex phone operator to work her master's thesis on the potato. not to turn on well it gets more ridiculous from a. list. straight. welcome to in good shape here's what's coming up. veganism is going without cook food healthy. spider veins how to get rid of the unsightly blood vessels. also back pain and how best to treat it. and here's your host dr constantly but many of my patients don't feel well and they come to

see me in my practice that i treat them and then they're in good shape but it's not always so simple sometimes it's really difficult like in chronic boggo which is lower back pain and this is why i'm getting some help today from a specialist from dr fernando de meo here in berlin welcome good shape. for many years doctors kept saying that if you have back pain you have to rest and avoid exercise but right now we know that that is wrong and if you want to know why we are telling you right now. in different parts of the world doctors treat back pain differently take south africa for instance doctors in just prescribe pain

killers in india they suggest better rest and then there is something like rise gains. pills and physiotherapy but what does really help. chris stop maia has always stayed active going jogging playing tennis going to the gym but right now he's limited to swimming and stand up paddle boarding due to back problems. by looking back there were personal issues that threw me off track i always tended to compensate for that with lots of exercise and work. the combination of stress and pushing himself too hard to gets told on his back. i'm just not worth the pain is like sticking your finger in a power socket it's a pulsating pain that always shoots down my left side right down to my toes.

he was unable to work for eight weeks his orthopedist prescribed painkillers injections and physiotherapy but nothing helped. eventually he was referred to use of a neurosurgeon he's been in treatment here for several weeks now. the mail. comes about because. they're getting a he's doing better but he still has some pain together they look at a scan of his spine so you. see if there's. some minor slip disc you can see this is where the disc begins to bulge and presses on the nerve these and they have a good one that's interfering with the function of the nerve and as a result the muscles here are growing weaker too. normally that would mean surgery . by a large of this base case the position of this little disc makes surgery tricky.

and from the. it would mean damaging structures that are important for the long term stability of the spine and perhaps result in instability eventually for it to prevent that and we'll try a more conservative approach in that as well but also consider truth from one option that doesn't involve surgery is perry ridiculous therapy or p.r.t. this is chris talk meyer's fifth session p.r.t. involves an injection with a combination of different drugs. guided by x. rays they will be administered directly to the root of the compressed nerve the goal is to support its regeneration. and. ridiculous therapy help support the natural healing process nature's response to a slipped disc is to try to dry it out. the question is how long can the nerve tolerate the compression. what the p.r.t.

does is accelerate that drying out process so that the nerves can recover more quickly and doesn't suffer any permanent damage. both up to eighty five percent of patients are p.t. obtain some benefit from p.r.t. so did christophe meyer even though he was skeptical at first. but it have my doubts i'd already been through a lot and you reach a point where you basically give up hope. along with the medical help dr remsburg provided me with a lot of emotional support and all those factors combined to help. with. the p.r.t. therapy helped but christoph meyer is also doing his bit going to physiotherapy and getting plenty of exercise. and give dr to me he's a doctor for sports medicine and the head of the department for health and fitness at the sports medical center in berlin thanks for having me today when i see patients with lower back pain they often ask me think head and get some x.

ray or an m.r.i. scan but and when do i have to do an m.r.i. scan as a doctor in most of the cases it's not necessarily cause lower back pain is limited and last for only a couple of days it can be severe but in most of the cases it's less just for a short time but if it does not receipt afterwards some days or eat repeated after a certain time or if the doctor suspects change in this case is indicated to carry on for their examinations for example with. x. rays why do you have so many patients problems in the lower back is a problem that mother nature just messed up. really not but right now we are observing that about eighty percent of the patients reporting back pain have some kind of mental or social stress and that means that this the sort of this excess of tension is reparable on the back but most of the patients also present

with pain because they do not exercise have a trolley they do not use their muscles so what kind of behavior or absence of behavior cause no big pain. it is important to understand one principle or three indeed if you use it it grows if you don't use it you waste it and if you all or use it you can break it and it doesn't apply to every function and every organ in your body if you use your muscles they are going to develop and to be stronger and larger if you do not use them you are going to waste than and if you all are used then you can develop pain due to an injury or two broken many of my patients who have to sit because they are working in a sitting position are they doing something wrong they do not have to see they decide to see it for example you can stand up every five or ten minutes and just

walk around the table you are not forced to see it the whole time and meanwhile there are other means to see it for example you can use a ball a huge ball and sit on it and your stenton is continuously trying to compounds the movement and to find your center since it is aggressively that you are extremely active you can also be tired after one hour because you are moving so much if you don't if you are always in this position your muscles are we sure are going to be shorter this group of muscles and the muscles on your back are going to be weaker that means that you walk around and everyone is going to observe that you have this position but some of my patients even have an active lifestyle in the physical work and they still do have back pain. they can be forgetting the thought principle if you over use it or if you use it in a wrong way you're going to break it and people understand that it can apply to

your credit card by they do not understand that it can apply to your body so spartan exercise is good for our back it's very important for back but some of my patients who are very active and really exercising a lot still have problems in their lower back if you exercise too much you can do there are problems because the body is not prepared to that you have to build up and you need a certain time if you exaggerate the movement that intensity the frequency the weight that you are working with you are going to develop problems so sports is good exercise is good and it's really not it is in the spells of all it's indispensable and that really helps if you do have lower back pain and that at how effective is it compared to painkillers and to massages. cut think licia is thirty seven and has always been plenty of exercise a year and a half ago she was struck with pain since then she's been through various treatments to no avail. and says wouldn't it i had

an m.r.i. done amende physical therapy which included much sargeant acupuncture i also saw an osteopath i did everything i could but in the end i was prescribed a painkiller ibuprofen. phenols. ibuprofen is generally safe but can have side effects some of them serious like kidney damage painkillers are not a good permanent solution something had to change cut think they should began a four week outpatient therapy. none of the therapies i tried worked so this really was my last hope. that elects to him. first her doctors wanted to make sure no. more serious had been overlooked a slipped disc for example or an irritation at the root of the nerve. and inflammation in the vertebral joint or even a tumor the size of the m.r.i.

scan was inconclusive it did something but nothing that could explain the severe pain she was feeling. it's not serious your spine looks fine for your age there's a bright spot inside one of the bones is called an. can sometimes cause pain. and working with physiotherapists. that also included lifting heavy objects something that most back patients prefer to avoid. but cutting has to learn how to undo the pain response instead of squatting to protect her back she's supposed to bend over to put the crate down. no way too much. the patients take part in a comprehensive workout program five hours a day preferably without painkillers. the exercises include threading

a rope through the strings while bending forward two weeks into the program cutting the pain is becoming unbearable. physiotherapists don't provide standard treatments where they manipulate the patient. patients have already tried that and it didn't help instead we give them tasks they carry out on their own the four week program involves more than just strength training and exercise. in many cases chronic back pain is accompanied by depression and anxiety disorders the program also includes regular sessions with a psychologist to address mental issues and how to cope with the pain. along with strengthening her back has also learned a lot about herself in these four weeks. i've learned that changing my behavior can make a difference things like exercise but also cultural activities and other distractions

they can also help bring me some relief from the pain i've also learned to take more time for myself wow that's really important that is cancer. today katlin creation no longer has back pain she's even started jogging again which does wonders for both body and soul. so let's summarize what we just learned of this report no physiotherapy no massages and no rest and this is why i'm sitting on this ball and it's even fun it is fun what we try to do is to integrate is a collectivity in your daily routine because if you decide to exercise and do workout in the gym two or three times a week for thirty or forty five minutes with different machines but easier is if you decide to exercise they for example in doing the walk you are sitting on a chair on your moving not at all the whole walk is done by the chair but if you're

sitting on a board you're bouncing continuously you're using your body to compensate the fine and it leaves and you can also in taste insulate it just using the floor at least let the water roll move the ball and you have to lie on your knees so on their knees or on your knees and on you have to present your answer right and at least throat your right leg and your left arm and you look down world and just stay in this position for five or six seconds and then switch to sight. ok and again in this position for five or six seconds. so i don't have any lower back pain to start with but what if my patients say that this exercise hurts this

exercise does not go into work if you do not have an injury or some kind of problem and it is the idea it is an exercise everybody can do if you have pain the one who decides which exercises to carry on which exercises to avoid what to do exactly is your doctor or your physiotherapist and you can repeat that ten fifteen twenty times thirty times with the time you are going to improve your ability and increase your strength and it is going to be easier for you i can even do this at work that is the idea you can do it at home at work everywhere and anything else like you yes please lie on the floor that is it for this time right on your elbows and just price your body you just don't like this yes that is rope planking on your toes and also

on your elbows it's quite exhausting actually stay there for fifteen or twenty seconds at the beginning shorter maybe five or ten seconds until you learn the sex of size and down relax quite exultant again it is hard if it's too hard for you what you can do is on your knees not on your hose. and legs and with your back like a cat. upwards and downwards and up and down not that fast slow or you just feel the tension and down. and even lower so how often to have to do this just start doing that many people ask how often and what should i do in

between and they are not exercising at all they are just they just want a program just stop moving move yourself more use the stairs walk a lot and you are going to improve your ability you are going to feel also much better so thanks so much for answering all markus you are very welcome start right away the exercise and if you have any questions be sure to write me an email. on an upcoming show we'll be looking at the problem of loneliness more and more people now living so how does feeling solitary impact your health and your questions to be in good shape at d w dot com just write and loneliness and the subject line we look forward to hearing from you. the problem we portrayed on next report affects family women than men i'm talking about weak veins and they are not always a medical problem like in spite of they are more like

a cosmetic problem but fortunately there is help. yanna shown how does everything she should be doing she stays active and walks are two dogs regularly but it thirty four she already has spider veins which she tends to keep hidden under long pants. as i just don't. bother me a lot in the summertime because everyone can see them and they're very dark blue or purple. they're very noticeable on my fair skin. these are the unsightly spider veins and large kopitar easy usually caused by poor circulation and muscle tone the condition may be hereditary yanna started getting them in her early twenties. yanis decided to take matters into her own hands she has an appointment with a vein specialist. an initial checkup reveals that she doesn't have varicose veins to be the muslims in

spite of ames a medically harmless but they can be an indication a virus has veins that would have to be treated. before so that's why it's important to start with a proper diagnosis. in a procedure called scleral therapy the blood vessels are closed off with the help of a special foam a solution of the active agent is mixed with air and injected into the network of enlarged to pillory so. hot the advantage of the foam is that it expels the blood from the vein much better. by foaming the agent i can empty the vein allowing the solution to work much more effectively. with the medication attacks the inner wall of the vein destroying the blood vessel and making the spider veins vanish. that's

one good thing you do you feel a brief jab but otherwise you don't notice anything i thought it would be worst. apart from square zero therapy spider veins can also be removed using laser treatment that's the option nicole schol chose she's already had varicose vein successfully treated by laser specialist. her spider veins a relatively small making her a good candidate for laser treatment. for the person he just stands vantage for the patient is that it's a good way to close up very think a pill or reason once at a so tiny that it's hard to access them with a needle. by. the laser light acts on the tiny red cap hilary's beneath the skin the spider veins fade and disappear the damaged tissue is reabsorbed within four to six weeks. laser therapy is gentle and also works for a very small spider veins square all therapy with foam usually takes somewhat

longer and while both treatments are effective if you're predisposed to spider veins others could appear in the future. in the kitchen we cook. we grew food in every kitchen. could use anything especially if. they believe that heating up the food destroys vitamins and minerals but more than the truth and scientists do share this opinion. on old reagan just going to see a doctor who specializes in sports medicine. cmon has spent years studying athletes and nutrition. as patients today as a diet that consists almost exclusively of role fruit and vegetables. devise an engine for talking the straight and most people find that kind of diet doesn't

agree with them. for one thing they cannot beat their energy needs and for another they get a lot of problems with bloating you mentioned that in many people also have a freak toes intolerance and start getting diarrhea when people don't get enough of important nutrients you'll eventually see that in the person's blood count it affects the formation of new blood cells leading to fatigue and a drop in performance before they get off on. the doctor first puts on we'll be going through this paces. run tests and blood samples provide information on his heart and or asperity system. dr siemionow evaluates the results so what does he think. s. my fate all of us and if and first of all it's clear he has a good body composition and doesn't look like he's suffering from any kind of deficiency. and that's despite engaging in extreme sports as well as having this extreme diet. so where does his body get the minerals and vitamins it needs given

that he eats neither me nor dairy products. he's been on this diet since two thousand and six what's the secret of his success. the kind of nothing is heated so that means the food retains all its vitamins this contains iodine and vitamin c. in the form of the lemon juice there's also linseed oil which has omega three fatty acids all of these foods are part of a typical vegetarian diet. so that means eggs and dairy products to leaving fruit and vegetables. all food don't cook anything so that eliminates all the foods that aren't palatable when their own cooked potatoes and old machines contain solon e which is difficult to digest. contain elections which can cause

nausea and vomiting. so they're no good either. just leaves nuts. and poses to provide the body with the nutrients it needs. as a. food and a vegan is difficult you really have to know what you're doing and then stick to a very very strict diet. and you cannot say i don't like algae so i'm not eating that because algae contains nutrients your body needs. guns last triathlon was a year and a half ago since then he's continued to train regularly but less intensively he puts his impressive fitness down to his diet but the doctor believes there's another reason. surprises me is that your fat metabolism is very very good and it's not just good for someone who runs one hundred kilometers or

does ultra triathlons it's remarkable. when you're pushing the limit in endure and sports your metabolism is still at nearly eighty percent takes a long time before you draw on your carbohydrate reserves. but arnold regan's fact metabolism has always been unusually good before he switched to a real food diet. the medical exam shows he has no nutritional deficiencies. so could this kind of diet be an option for everyone. you couldn't just go from zero to one hundred percent raw food even specialists tend to incorporate some cooked food in their diet which is important. there are also some tricks like puree and fruit to make them easier to digest. after ten years of eating only real fruit and vegetables on old reagan has now also added a small amount of cooked food to his diet. that's it for today next week and until

then let's try to stay.

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freedom and democracy the baltic group. looks stunning muglia management training. mission absolutely nearly thirty years ago. fifteen years ago a joint if you count that they've developed since the bad the baltic passed europe's model citizens. in seventy five minutes on d w. i'm not laughing at the germans because i'm down down but they stand up and with the tell me the german thinks deep into the german culture up here new don't seem ridiculous grama day on the east coast it's all out there enough time rachel join me for me to get on the golf course. five days in the midst of venezuela's

crisis and in a fight to get aid into the country with a convoy of fun guy don't supporters me an exclusive d.w. report alongside venezuelan journalist says our buddies. a close look now at the country's catastrophic conditions on the way to colombia a showdown or it. starts march eighteenth. the floods have taken everything they own now despair is the god of climate refugees flooding. they seek shelter of the capital kabul m. but even here the water's rising above the floods are coming. close march twenty want to double.

this is d.w. news line from berlin bonfires a violent clashes and looting in the streets of paris as the protesters and demand change in the french capital it's a crucial moment for the protests which have now taken place for eighteen consecutive weekends also coming up to new zealand in more.