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pain and how best to treat it. and here's your host dr constantly. 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 long ago which is lower back pain and this is why i'm getting some help today from a specialist from dr phil under the meal here in berlin welcome to the good ship. 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 then just prescribe pain killers in india they suggest better rest and then there is something like a more rice skins ject pills and physiotherapy but what is really help. christophe maya 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. at night or looking back there were personal issues it threw me off track i always tended to compensate for that with lots of exercise and work with. the combination of stress and pushing himself too hard took its toll on his back. 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 physio therapy but nothing helped. eventually he was referred to. a neurosurgeon he's been in treatment here for several weeks now. the mild. promise that i. was. getting. 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 disk begins to bulge and presses on the nerve of good work. 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

. with this case the position of this little disc makes surgery tricky or. it would mean damaging structures that are important for the long term stability of the spine and perhaps result in instability eventually. to prevent we'll try a more conservative approach to fighting them for what also consider truths from. one option that doesn't involve surgery is perry ridiculous therapy or p.r.t. this is chris stock miles 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. this is with your 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 of what the p.r.t. does is accelerate that drying out process so that the nerve can recover more quickly and doesn't suffer any permanent damage. both up to eighty five percent of patients are p. to 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 provided me with a lot of emotional support and all those factors combined to help. the p.r.t. therapy helped but christophe maya is also doing his bit going to physiotherapy and getting plenty of exercise. and he would talk to me he's

a doctor for sports medicine and the head of the program for health and fitness at the sports they can center in them thanks for having me today when i see patients with no big pain they often ask me thinketh get some x. ray or an m.r.i. scan and when do i have to do an american is a doctor in most of the cases it's not necessarily cause lower back pain is limited and last for only a couple of they seek and receive ear but most of the cases are less just for a short time but if it does not receipt after a some days or 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 the wrong x. rate why do so many patients problems in the lower back if there's 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 rep of those 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 lower back 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 does 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 them 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 if they decide to see it for example you can stand up every five or ten minutes and 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 stand in continuously trying to calm pens the movement and to find your center since it is a beautiful event 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 everybody's 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 and the 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 the problems so sports is good exercise is good and it's really not it is in this pencil it's indispensable and that really helps if you do have lower back pain and that but how effective is it compared to painkillers and to massages. is thirty seven and has always

been plenty of exercise a year and a half ago she was struck with that pain since then she's been through various treatments to no avail. and says wouldn't it i had an m.r.i. done and then peace equal therapy which included moustache and acupuncture i also saw an osteopath i did everything i could but in the end i was prescribed a painkiller ibuprofen humidity will. i be profane 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 we should began a four week outpatient therapy. none of the therapies i tried worked so this really was my last hope. let's just walk home. first her doctors wanted to make sure nothing 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 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 cold and. that can sometimes cause pain. began 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. physical therapist 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. yes it's meant 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 cliche 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 physical activity 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 ball you're bouncing continuously you're using your body to compensate the fine and it leaves room and you can also in taste insulate it just using the floor please 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 your answer right and these stretch your right leg and your left arm and you look down ward and just stay in this position for five or six seconds and then switch the site. 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 exercises 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 this time right or your elbows and just rise your body you stand

like this yes that is right 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 sides and down relax quite exhausted again it is hard if it's too hard for you what you can do is on your knees not on your host. and legs and with your back like a cat. upwards and downwards and up and down not that first slower you just feel the tension and sit down. and even roll work so how often do have to

do that's just start believing that many people ask how often and what should i do in between and they are not exercising of all they are just they just want a program just stop moving move yourself more use the stairs walk a lot and you're going to improve your ability or want to feel all so much better so thanks so much for answer all my questions you're very welcome and i'll stop right away the exercise and if you have any questions be sure to cry to 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 g.w. dot com just write only notes in the subject line we look forward to hearing from you. the problem we portrayed on next report affects fama

women than men i'm talking about weak veins and they almost always a medical problem like in spite of their more like a cosmetic problem but fortunately there is help. yanna showing how does everything she should be doing she stays active and walks or two dogs regularly but it thirty four she already has spider veins which she tends to keep hidden under long pants. as a dish 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. no. an initial checkup reveals that she doesn't have varicose veins. to be spite of veins or medically harmless but they can be an indication of varicose veins that would have to be treated. and beyond being floated 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 how much does 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. 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 schall chose she's already had varicose vein successfully treated by laser specialist tuns christian benson her spider veins are relatively small making her a good candidate for laser treatment. for the person who just stands vantage for the patient is that it's a good way to close up very thin compare the recent ones that are so tiny that it's hard to access them with a needle. the laser light acts on the tiny red cup hilary's beneath the skin the spider veins trade 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 take some months 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 boy do we steam regrew food but not in every kitchen chefs that don't produce anything especially if they are roles. they believe that heating up the food destroys vitamins and minerals but more than a truce and scientists do. just going to see a doctor who specializes in sports medicine. cmon has spent years studying athletes and nutrition. patients today as a diet that consists almost exclusively of role fruit and vegetables.

mention for talking 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. many people also have 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 will be going through his paces. tests and blood samples provide information on his heart and or asperity system. dr siemionow evaluates the results what does he think. s. my face. 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 eats neither me nor dairy products. he's been on this diet since two thousand and six what's the secret of his success. this isn't the kind of thing 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. but arnold's a vegan so that means eggs and dairy products are up to sleeping fruits and vegetables. roll food cook anything so that eliminates all the foods that aren't palatable when they're on cooked potatoes and old machines contain soul which is

difficult to digest. contain lecterns which can cause nausea and vomiting. so they're no good either. just leaves nuts vegetable oils and pulses provide the body with the nutrients it needs. food and a vegan is difficult you really have to know what you're doing and then stick to a very very strict diet. you cannot say i don't like so i'm not eating that because algae contains nutrients your body needs. guns last. 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 for the dr 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 metabolism is still at nearly eighty percent takes a long time before you draw on your carbohydrate reserves. but arnold reagan. has always been unusually good even 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 and fish fish well and there are also some tricks like puree in raw vegetables 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 all try to stay in good shape.

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. this is the news live from berlin the death toll in the christ church mosque shootings rises to fifteen prime minister yes and our journey came together with residents in grief after the country's worst ever terrorist attack she said she would work to ensure freedom of religion in new zealand and police will be present at mosques while they're open also coming up the philippines turns its.