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Massage Message, Issue 14c: massage and lower back pain, first 1000 days, stress & fertility and ,
October 13, 2011
The first 1000 days
I have been riveted by the BBC series: The First 1000 Days: A Legacy for Life . It looks at how our health is influenced not only during the first two years of life, but also during our time in the womb, and our mother's time in the womb (when the egg we came from was made).
Imagine if your health as an adult is partly determined by the nutrition and environment you were exposed to in the first 1000days of life. Or even further back; that the lifestyle of your grandparents during their children's first 1000 days, has programmed your adult health. A strong body of scientific evidence supports this explosive idea, and is gradually turning medical thinking on its head. To understand the cause of chronic adult disease, including ageing, heart disease, diabetes, osteoporosis, obesity and lung problems we need to look much further back than adult lifestyle - but to the first 1000 days. In this groundbreaking three part series Dr Mark Porter talks to the scientists who now believe that this 'lifecourse' approach, will find the cause of many adult diseases. "Chronic disease is going up in leaps and bounds, this is not a genetic change" says Kent Thornburg, Professor of Cardiovascular Medicine in Oregon, America "it's because the environment in the womb is getting worse. We know now that the first 1000 days of life is the most sensitive period for determining lifelong health'.
But it's not just down to mothers or grandmothers, there is growing evidence that diet and lifestyle along the paternal line matters too. 'You are what your dad ate,' argues Professor Anne Ferguson-Smith of Cambridge University.
"Growth has a pattern," continues Alan Jackson, Professor of Nutrition at Southampton University "everything has a time and a place and if that gets interrupted then you can catch up, but there are consequences".
So where does that leave us as adults? Good diet and lifestyle is very important, but scientists know that some individuals are more vulnerable to disease than others, and that's not just down to genetics. "All diseases may be expressions of key developments in the womb" explains Professor David Barker, "That does not mean you are doomed, it means you are vulnerable. Understanding that challenges the way medicine is structured".
The First 1000 Days: A Legacy for Life
Massage for low back pain
Massage helps to ease chronic low back pain and improve function. This was confirmed by a randomised controlled trial published in July this year. It compares two types of massage, structural and relaxation massage with a control. Both types of massage worked well, there is not much difference in terms of outcomes between the massage groups.
The trial involved 400 patients with chronic low back pain (for at least three months). Their pain was “nonspecific”, meaning that it had no identified cause. They were randomly assigned to structural massage, relaxation massage or usual care (control group). Usual care is what would have happened anyway, often medications. The massage groups received 10 one hour long weekly massages. At the end of the trial (after 10 weeks) more than half of the massage patients said that their back pain was much better or gone, compared to one in 25 patients in the usual care group. A questionnaire showed that nearly twice as many massage patients (about two thirds) than the usual care patients (just over a third) functioned significantly better than at the outset of the trial. Patients in the massage groups spent fewer days in bed, were more active and used less anti-inflammatory medication than the controls. Even six months after the trial people in the massage groups showed better function, but a year after the trial the difference in function was minimal. ( Ann Intern Med. 2011 Jul 5;155(1):1-9 )
This confirms my approach to the treatment of back pain – first weekly massages for a while (hence the special offer – 4 weekly sessions for £130 instead of £152), then going onto monthly sessions to keep the benefits.
I have been at the BLS (British Lymphology Society) conference to hear what is new in “Lymphoedema”. In a way there were lots of new things, but it was also lots of the same, if you know what I mean. There was a good choice of compression hosiery – different materials, strengths, designs, colours, patterns – with zip or velcro, on prescription or not. It is pleasing to see how much you can get on prescription – whether it will be prescribed when you need it is a different matter. In my enthusiasm I have written a webpage with all the links to suppliers of compression garments.
Acupuncture and lymphoedema
There were many talks and presentations, the most interesting one looked at improving quality of life for breast cancer patients with lymphoedema using acupuncture. Acupuncture did indeed improve the quality of life by helping general and oedema related problems after cancer treatment, such as a shoulder pain or lack of confidence. It was shown that it was safe to use acupuncture for people with lymphoedema, and the therapist had a challenge of not using the quarter of the body with the oedema. (). It was good to see a “alternative” treatment presented to a mainly NHS audience. People in Nottingham: If you have chronic pain, you can get a referral from your GP to the community acupuncture service. ( Eur J Oncol Nurs. 2011 Sep 12 ). It was good to see a “alternative” treatment presented to a mainly NHS audience. People in Nottingham: If you have chronic pain, you can get a referral from your GP to the community acupuncture service.
Stress and fertility
There is no doubt that undergoing infertility treatment is stressful, with high rates of anxiety and depression reported by many women. What is the effect of mind/body therapy on women undergoing in vitro fertilization (IVF)? They are more likely to get pregnant! Women who undergo a mind/body programme for stress reduction have a significantly higher pregnancy rate (52%) than women on the control group (20%). This study was carried out by the by Alice Domar , who devised this particular programme. ( Fertil Steril. 2011 Jun;95(7):2269-73 ) There is no reason why reducing stress before and during IVF treatments should not have a similar, positive effect, for example with yoga, meditation or massage.
Issue 14c of the Massage Message: 13 October 2011.
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