welcome to in good shape here's what's coming up. rob 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 long ago which is lower back pain and this is why i'm getting some help today from the specialists from doctors and i look to me you hear them welcome to in 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 jack pills and physiotherapy but what is really help. christoper meyer 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. looking back there were personal issues that 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 too gets told on his back. just enough of 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 8 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 that there's. some minor slip disc you can see this is where the disc begins to bulge and presses on the nerve of good work one that's interfering with the function of the nerve and as a result the muscles here are growing weaker. normally that would mean surgery. with this base 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. but also consider truths on the. one option that

doesn't involve surgery is perry ridiculous therapy or p.r.t. this is chris stock myers 5th 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. as a. very 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's 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 85 percent of patients appear to obtain some benefit from p.r.t. so did christophe meyer even though he was skeptical of 1st. i did

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. i'm here with dr 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 to think head and get some x. ray or an m.r.i. scan but and when do we 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 days it can be severe but in most of the cases or less just for a short time but if it does not receipt after

a some days or if it's repeated after a certain time or if the doctor suspects. age in this case is indicated to carry on for their examinations for example with. x. rays i believe so many patients problems in their lower back if there's a problem that mother nature just messed up. really not but right now we are observing that about 80 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 repetitious on the back but most of the patients also present with pain because they do not exercise have a truly they do not use their muscles so what kind of behavior or absence of behavior or cause no big pain. it is important to understand one principle or 3 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 ways them and if you all are used then you can develop pain due to an injury or 2 broken the shoe 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 5 or 10 minutes and just walk around the table you are not forced to sit the whole time and meanwhile there are other means to see it for example you can use a ball a huge wall and sit on it and your stand in continuously trying to compounds the movement and to find your center it is abusively 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 you 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 or a lot still have problems in 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 to start on 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 if this in the spends of all 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. cut is $37.00 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. as this wouldn't it i had an m.r.i. done amende physical therapy which included much sergeant 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 we should began a 4 week outpatient therapy. none of the therapies i tried worked so this really was my last hope. let's tell 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 m.r.i. scan was inconclusive it did show something but nothing that could explain the severe pain she was feeling. it's not serious your spine looks fine if you are 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. hurts too much. the patients take part in a comprehensive workout program 5 hours a day preferably without painkillers. the exercises include threading a rope through the strings while bending forward 2 weeks into the program cutting 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 4 week program involves more than just strength training and exercise . in many cases chronic back pain is accompanied by to pressure and exotic 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 4 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 this 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 2 or 3 times a week for 30 or 45 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 leave room and you can also in place in the 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 your half the person your

answers right and these stretch your right leg and your left arm and you look down the world and just stay in this position for 5 or 6 seconds and then switch the site. and again in this position for 5 or 6 seconds. so i don't if in the 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

101520 times 30 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 what anything else like you yes please lie on the floor that is it for this time right on your elbows and just rise your body you you stand like this yes this rope planking on your post and also on your elbows it's quite exhausting actually stay there for 15 or 20 seconds at the beginning shorter maybe 5 or 10 seconds until you learn the sex of size and down relax quite excellent 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 and you upwards and downwards and up and down not that fast slower you just feel the tension and down. and even lower 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 at all they are just they just want a program just stop moving move yourself more use the steer us walk a lot and you're going to improve your ability or want to feel all so much better so thanks so much for answering all my questions you are very welcome and i'll stop right away the exercise and if you have any questions be sure to write me an email

. in good shape your weekly health show on d w that covers many aspects of health care we look at what's new in medical treatment nutrition fitness and beauty we discuss these topics and depth with specialists and offer you opportunities to pose your own questions so get in touch with. the problem we portrayed on next report the facts far more 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 showing how does everything she should be doing she stays active and walks are 2 dogs regularly but it $34.00 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 capello aris 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 business on spite of ames a medically harmless but they can be an indication a virus has veins that would have to be treated. and 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. 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 0 therapy spider veins can also be removed using laser treatment that's the option to call schol chose she's already had varicose vein successfully treated by laser specialists. her spider veins are relatively small making her

a good candidate for laser treatment. for the need to stand vantage for the patient is that it's a good way to close a very thin compelling reason once that is 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 4 to 6 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. every kitchen.

could use anything especially if. they don't have the food destroys vitamins and minerals but modern scientists. and old reagan does 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. and engine for talking with 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. tools in many people also have a freak shows 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 dr 1st what's on will be going through his paces. long tests and blood samples provide information on his heart and risperidone system. dr siemionow evaluates the results so what does he think. s. my favorite all of us and if and 1st 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 to teach neither me nor dairy products. he's been on this diet since 2006 what's the secret of his success. this is from 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 3 fatty acids all of these foods are part of a typical vegetarian diet. so that means eggs and dairy products are up to leaving fruit and vegetables. role food don't cook anything so that eliminates all the foods that aren't palatable when their own cooked potatoes and old machines contain soltanieh which is difficult to digest. contain lecterns which can cause nausea and vomiting when eaten so they're no good either. just leaves nuts. and poses to 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 algae so i'm not eating that because algae contains nutrients your body needs. 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 for the dr believes there's another reason. to surprises me is that your fat metabolism is very very good and it's not just good for someone who runs 100 kilometers or does ultra triathlons it's remarkable. when you're pushing the limit in endure and sports your metabolism is still at nearly 80 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 role food. 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 0 to 100 percent raw food even specialists tend to incorporate some cooked food in their diet which is important and. there are also some tricks like pure a vegetable and fruit to make them easier to digest. after 10 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 in good shape.

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