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"The pain is unbearable": Nick Campo's family speaks out

<p>The parents of a Perth teenager who tragically died in a car crash have started an emotional campaign for road safety in the name of their late son. </p> <p>Budding footballer Nick Campo, who had just turned 18, was the rear passenger in a Toyota HiLux that rolled and collided with a Jeep Patriot in Perth’s southern suburbs on Saturday night and was pronounced <a href="https://www.oversixty.com.au/health/caring/rising-star-footy-player-dies-at-just-18" target="_blank" rel="noopener">dead</a> at the scene. </p> <p>Campo's parents Daniel and Bianca told <a href="https://www.9news.com.au/national/nick-campo-parents-speak-of-unbearable-pain-after-losing-son-to-horror-crash/a5ab695f-d536-4fbb-9a95-088e155e3cba" target="_blank" rel="noopener"><em>9News</em></a> of their "unbearable pain" since the sudden and tragic loss of their son. </p> <p>"My Nick, he was definitely one of a kind," his mum Bianca said. "I knew he was special, but he was really special to a lot of people."</p> <p>"And he was a beautiful boy, and he's going to be missed by so many, so many people."</p> <p>His father Daniel said his son was "the complete package" but was best known for his quick wit cheekiness.</p> <p>"If you had to sum Nick up in one word, 'cheeky'," he said. "From day dot .... Cheeky, cheeky."</p> <p>Sitting in the ute alongside Nick at the time of the crash were two of his teammates from the South Fremantle Football club, as well as the 17-year-old driver and one other young man.</p> <p>"He loved footy, he loved cricket, he just was so committed," his mum said.</p> <p>"He loved getting around all the boys, you know all the teammates. He loved being in the clubs."</p> <p>The 17-year-old boy accused of being behind the wheel, who was also injured in the crash alongside one of the other passengers,  is facing serious charges.</p> <p>Another boy is fighting for his life in Royal Perth Hospital.</p> <p>Nick's parents are praying their son's friend pulls through and don't want other families to go through what they have gone through.</p> <p>"(Because) It is, it is the worst nightmare that you can imagine and the pain is unbearable," his mum said.</p> <p>The family is now channelling their grief towards a road safety campaign called "Call Out for Nick".</p> <p>"If it doesn't look right, that person doesn't look right to drive, the habits - it's got to be called out," his father said.</p> <p>"We see it every day - young kids they think they're bulletproof, they're not."</p> <p><em>Image credits: Nine</em></p>

Caring

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Tastes from our past can spark memories, trigger pain or boost wellbeing. Here’s how to embrace food nostalgia

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/megan-lee-490875">Megan Lee</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>; <a href="https://theconversation.com/profiles/doug-angus-1542552">Doug Angus</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>, and <a href="https://theconversation.com/profiles/kate-simpson-1542551">Kate Simpson</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Have you ever tried to bring back fond memories by eating or drinking something unique to that time and place?</p> <p>It could be a Pina Colada that recalls an island holiday? Or a steaming bowl of pho just like the one you had in Vietnam? Perhaps eating a favourite dish reminds you of a lost loved one – like the sticky date pudding Nanna used to make?</p> <p>If you have, you have tapped into <a href="https://www.tandfonline.com/doi/full/10.1080/02699931.2022.2142525">food-evoked nostalgia</a>.</p> <p>As researchers, we are exploring how eating and drinking certain things from your past may be important for your mood and mental health.</p> <h2>Bittersweet longing</h2> <p>First named in 1688 by Swiss medical student, <a href="https://www.jstor.org/stable/44437799">Johannes Hoffer</a>, <a href="https://compass.onlinelibrary.wiley.com/doi/10.1111/spc3.12070">nostalgia</a> is that bittersweet, sentimental longing for the past. It is experienced <a href="https://journals.sagepub.com/doi/10.1111/j.1467-8721.2008.00595.x">universally</a> across different cultures and lifespans from childhood into older age.</p> <p>But nostalgia does not just involve positive or happy memories – we can also experience nostalgia for <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-3514.91.5.975">sad and unhappy moments</a> in our lives.</p> <p>In the <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000817">short and long term</a>, nostalgia can positively impact our health by improving <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0025167">mood</a> and <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000817">wellbeing</a>, fostering <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0017597">social connection</a> and increasing quality of life. It can also trigger feelings of <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000817">loneliness or meaninglessness</a>.</p> <p>We can use nostalgia to <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0025167">turn around a negative mood</a> or enhance our sense of <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0000817">self, meaning and positivity</a>.</p> <p>Research suggests nostalgia alters activity in the <a href="https://academic.oup.com/scan/article/17/12/1131/6585517">brain regions associated with reward processing</a> – the same areas involved when we seek and receive things we like. This could explain the <a href="https://www.sciencedirect.com/science/article/abs/pii/S2352250X22002445?via%3Dihub">positive feelings</a> it can bring.</p> <p>Nostalgia can also increase feelings of loneliness and sadness, particularly if the memories highlight dissatisfaction, grieving, loss, or wistful feelings for the past. This is likely due to activation of <a href="https://www.sciencedirect.com/science/article/pii/S2352250X22002445?casa_token=V31ORDWcsx4AAAAA:Vef9hiwUz9506f5PYGsXH-JxCcnsptQnVPNaAGares2xTU5JbKSHakwGpLxSRO2dNckrdFGubA">brain areas</a> such as the amygdala, responsible for processing emotions and the prefrontal cortex that helps us integrate feelings and memories and regulate emotion.</p> <h2>How to get back there</h2> <p>There are several ways we can <a href="https://psycnet.apa.org/fulltext/2006-20034-013.html">trigger</a> or tap into nostalgia.</p> <p>Conversations with family and friends who have shared experiences, unique objects like photos, and smells can <a href="https://www.sciencedirect.com/science/article/abs/pii/S2352250X23000076">transport us back</a> to old times or places. So can a favourite song or old TV show, reunions with former classmates, even social media <a href="https://www.theverge.com/2015/3/24/8284703/facebook-on-this-day-nostalgia-recap">posts and anniversaries</a>.</p> <p>What we eat and drink can trigger <a href="https://www.emerald.com/insight/content/doi/10.1108/QMR-06-2012-0027/full/html">food-evoked nostalgia</a>. For instance, when we think of something as “<a href="https://theconversation.com/health-check-why-do-we-crave-comfort-food-in-winter-118776">comfort food</a>”, there are likely elements of nostalgia at play.</p> <p>Foods you found comforting as a child can evoke memories of being cared for and nurtured by loved ones. The form of these foods and the stories we tell about them may have been handed down through generations.</p> <p>Food-evoked nostalgia can be very powerful because it engages multiple senses: taste, smell, texture, sight and sound. The sense of <a href="https://www.tandfonline.com/doi/full/10.1080/09658211.2013.876048?casa_token=wqShWbRXJaYAAAAA%3AqJabgHtEbPtEQp7qHnl7wOb527bpGxzIJ_JwQX8eAyq1IrM_HQFIng8ELAMyuoFoeZyiX1zeJTPf">smell</a> is closely linked to the limbic system in the brain responsible for emotion and memory making food-related memories particularly vivid and emotionally charged.</p> <p>But, food-evoked nostalgia can also give rise to <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.873">negative memories</a>, such as of being forced to eat a certain vegetable you disliked as a child, or a food eaten during a sad moment like a loved ones funeral. Understanding why these foods <a href="https://www.tandfonline.com/doi/full/10.1080/02699931.2022.2142525?casa_token=16kAPHUQTukAAAAA%3A9IDvre8yUT8UsuiR_ltsG-3qgE2sdkIFgcrdH3T5EYbVEP9JZwPcsbmsPLT6Kch5EFFs9RPsMTNn">evoke negative memories</a> could help us process and overcome some of our adult food aversions. Encountering these foods in a positive light may help us reframe the memory associated with them.</p> <h2>What people told us about food and nostalgia</h2> <p>Recently <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.873">we interviewed eight Australians</a> and asked them about their experiences with food-evoked nostalgia and the influence on their mood. We wanted to find out whether they experienced food-evoked nostalgia and if so, what foods triggered pleasant and unpleasant memories and feelings for them.</p> <p>They reported they could use foods that were linked to times in their past to manipulate and influence their mood. Common foods they described as particularly nostalgia triggering were homemade meals, foods from school camp, cultural and ethnic foods, childhood favourites, comfort foods, special treats and snacks they were allowed as children, and holiday or celebration foods. One participant commented:</p> <blockquote> <p>I guess part of this nostalgia is maybe […] The healing qualities that food has in mental wellbeing. I think food heals for us.</p> </blockquote> <p>Another explained</p> <blockquote> <p>I feel really happy, and I guess fortunate to have these kinds of foods that I can turn to, and they have these memories, and I love the feeling of nostalgia and reminiscing and things that remind me of good times.</p> </blockquote> <p>Understanding food-evoked nostalgia is valuable because it provides us with an insight into how our sensory experiences and emotions intertwine with our memories and identity. While we know a lot about how food triggers nostalgic memories, there is still much to learn about the specific brain areas involved and the differences in food-evoked nostalgia in different cultures.</p> <p>In the future we may be able to use the science behind food-evoked nostalgia to help people experiencing dementia to tap into lost memories or in psychological therapy to help people reframe negative experiences.</p> <p>So, if you are ever feeling a little down and want to improve your mood, consider turning to one of your favourite comfort foods that remind you of home, your loved ones or a holiday long ago. Transporting yourself back to those times could help turn things around.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232826/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/megan-lee-490875">Megan Lee</a>, Senior Teaching Fellow, Psychology, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>; <a href="https://theconversation.com/profiles/doug-angus-1542552">Doug Angus</a>, Assistant Professor of Psychology, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>, and <a href="https://theconversation.com/profiles/kate-simpson-1542551">Kate Simpson</a>, Sessional academic, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/tastes-from-our-past-can-spark-memories-trigger-pain-or-boost-wellbeing-heres-how-to-embrace-food-nostalgia-232826">original article</a>.</em></p> </div>

Mind

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I’ve been given opioids after surgery to take at home. What do I need to know?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p>Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.</p> <p>These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.</p> <p>However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.</p> <h2>Which types of opioids are most common?</h2> <p>The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).</p> <p>In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit.</p> <p><a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.</p> <p>Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.</p> <p>Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.</p> <p>Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.</p> <p>Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.</p> <p>Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.</p> <h2>But there are also risks</h2> <p>As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.</p> <p>Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.</p> <p>But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids.</p> <p>Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.</p> <p>Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer.</p> <p>Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed.</p> <p>This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.</p> <h2>How to mimimise the risks</h2> <p>Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).</p> <p>These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.</p> <p>Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.</p> <p>However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>:</p> <ul> <li> <p>ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects</p> </li> <li> <p>do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing</p> </li> <li> <p>as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen</p> </li> <li> <p>before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.</p> </li> </ul> <h2>If you’re concerned about side effects</h2> <p>If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:</p> <ul> <li> <p><a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives</p> </li> <li> <p>drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor</p> </li> <li> <p>weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.</p> </li> </ul> <h2>If you’re having trouble stopping opioids</h2> <p>Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.</p> <p>You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.</p> <h2>How about leftover opioids?</h2> <p>After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge.</p> <p>Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.</p> <hr /> <p><em>For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>.</em></p> </div>

Body

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Walking can prevent low back pain, a new study shows

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year.</p> <p>The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system.</p> <p>In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.</p> <h2>The WalkBack trial</h2> <p>We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).</p> <p>Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.</p> <p>The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.</p> <p>The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.</p> <p>Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.</p> <p>People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care.</p> <h2>What the results showed</h2> <p>We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.</p> <p>The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.</p> <p>Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.</p> <p>Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.</p> <p>This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.</p> <p>Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.</p> <h2>Walking has multiple benefits</h2> <p>We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain.</p> <p>A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.</p> <p>On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.</p> <p>Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.</p> <p>While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.</p> <h2>Why is walking helpful for low back pain?</h2> <p>We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain.</p> <p>It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this.</p> <p>Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>.</em></p> </div>

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Longer appointments are just the start of tackling the gender pain gap. Here are 4 more things we can do

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>Ahead of the federal budget, health minister Mark Butler <a href="https://www.abc.net.au/news/2024-05-10/endometriosis-australia-welcomes-govt-funding-for-endometriosis/103830392">last week announced</a> an investment of A$49.1 million to help women with endometriosis and complex gynaecological conditions such as chronic pelvic pain and polycystic ovary syndrome (PCOS).</p> <p>From July 1 2025 <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/historic-medicare-changes-for-women-battling-endometriosis">two new items</a> will be added to the Medicare Benefits Schedule providing extended consultation times and higher rebates for specialist gynaecological care.</p> <p>The Medicare changes <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">will subsidise</a> $168.60 for a minimum of 45 minutes during a longer initial gynaecologist consultation, compared to the standard rate of $95.60. For follow-up consultations, Medicare will cover $84.35 for a minimum of 45 minutes, compared to the standard rate of $48.05.</p> <p>Currently, there’s <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&amp;q=104&amp;qt=item&amp;criteria=104">no specified time</a> for these initial or subsequent consultations.</p> <p>But while reductions to out-of-pocket medical expenses and extended specialist consultation times are welcome news, they’re only a first step in closing the gender pain gap.</p> <h2>Chronic pain affects more women</h2> <p>Globally, research has shown chronic pain (generally defined as pain that persists for <a href="https://www.healthdirect.gov.au/chronic-pain">more than three months</a>) disproportionately affects <a href="https://academic.oup.com/bja/article/111/1/52/331232?login=false">women</a>. Multiple biological and psychosocial processes likely contribute to this disparity, often called the gender pain gap.</p> <p>For example, chronic pain is frequently associated with conditions influenced by <a href="https://www.sciencedirect.com/science/article/abs/pii/S0304395914003868">hormones</a>, among other factors, such as endometriosis and <a href="https://theconversation.com/adenomyosis-causes-pain-heavy-periods-and-infertility-but-youve-probably-never-heard-of-it-104412">adenomyosis</a>. Chronic pelvic pain in women, regardless of the cause, can be debilitating and <a href="https://www.nature.com/articles/s41598-020-73389-2">negatively affect</a> every facet of life from social activities, to work and finances, to mental health and relationships.</p> <p>The gender pain gap is both rooted in and compounded by gender bias in medical research, treatment and social norms.</p> <p>The science that informs medicine – including the prevention, diagnosis, and treatment of disease – has traditionally focused on men, thereby <a href="https://www.theguardian.com/lifeandstyle/2015/apr/30/fda-clinical-trials-gender-gap-epa-nih-institute-of-medicine-cardiovascular-disease">failing to consider</a> the crucial impact of sex (biological) and gender (social) factors.</p> <p>When medical research adopts a “male as default” approach, this limits our understanding of pain conditions that predominantly affect women or how certain conditions affect men and women <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921746/">differently</a>. It also means intersex, trans and gender-diverse people are <a href="https://www.deakin.edu.au/about-deakin/news-and-media-releases/articles/world-class-centre-tackles-sex-and-gender-inequities-in-health-and-medicine">commonly excluded</a> from medical research and health care.</p> <p>Minimisation or dismissal of pain along with the <a href="https://www.hindawi.com/journals/ecam/2016/3467067/">normalisation of menstrual pain</a> as just “part of being a woman” contribute to significant delays and misdiagnosis of women’s gynaecological and other health issues. Feeling dismissed, along with perceptions of stigma, can make women less likely <a href="https://link.springer.com/article/10.1186/s12905-024-03063-6">to seek help</a> in the future.</p> <h2>Inadequate medical care</h2> <p>Unfortunately, even when women with endometriosis do seek care, many <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.15494?saml_referrer">aren’t satisfied</a>. This is understandable when medical advice includes being told to become pregnant to treat their <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02794-2">endometriosis</a>, despite <a href="https://academic.oup.com/humupd/article/24/3/290/4859612?login=false">no evidence</a> pregnancy reduces symptoms. Pregnancy should be an autonomous choice, not a treatment option.</p> <p>It’s unsurprising people look for information from other, often <a href="https://www.mdpi.com/2227-9032/12/1/121">uncredentialed</a>, sources. While online platforms including patient-led groups have provided women with new avenues of support, these forums should complement, rather than replace, <a href="https://journals.sagepub.com/doi/full/10.1177/1460458215602939">information from a doctor</a>.</p> <p>Longer Medicare-subsidised appointments are an important acknowledgement of women and their individual health needs. At present, many women feel their consultations with a gynaecologist are <a href="https://www1.racgp.org.au/newsgp/clinical/longer-consults-for-endometriosis-sufferers-on-the">rushed</a>. These conversations, which often include coming to terms with a diagnosis and management plan, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/">take time</a>.</p> <h2>A path toward less pain</h2> <p>While extended consultation time and reduced out-of-pocket costs are a step in the right direction, they are only one part of a complex pain puzzle.</p> <p>If women are not listened to, their symptoms not recognised, and effective treatment options not adequately discussed and provided, longer gynaecological consultations may not help patients. So what else do we need to do?</p> <p><strong>1. Physician knowledge</strong></p> <p>Doctors’ knowledge of women’s pain requires development through both practitioner <a href="https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00815-4/tables/2">education and guidelines</a>. This knowledge should also include dedicated efforts toward understanding the <a href="https://www.newyorker.com/magazine/2018/07/02/the-neuroscience-of-pain">neuroscience of pain</a>.</p> <p>Diagnostic processes should be tailored to consider gender-specific symptoms and responses to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00137-8/fulltext">pain</a>.</p> <p><strong>2. Research and collaboration</strong></p> <p>Medical decisions should be based on the best and most inclusive evidence. Understanding the complexities of pain in women is essential for managing their pain. Collaboration between health-care experts from different disciplines can facilitate comprehensive and holistic pain research and management strategies.</p> <p><strong>3. Further care and service improvements</strong></p> <p>Women’s health requires multidisciplinary treatment and care which extends beyond their GP or specialist. For example, conditions like endometriosis often see people presenting to emergency departments in <a href="https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia/contents/treatment-management/ed-presentations">acute pain</a>, so practitioners in these settings need to have the right knowledge and be able to provide support.</p> <p>Meanwhile, pelvic ultrasounds, especially the kind that have the potential to visualise endometriosis, take longer to perform and require a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0015028223020757/">specialist sonographer</a>. Current rebates do not reflect the time and expertise needed for these imaging procedures.</p> <p><strong>4. Adjusting the parameters of ‘women’s pain’</strong></p> <p>Conditions like PCOS and endometriosis don’t just affect women – they also impact people who are gender-diverse. Improving how people in this group are treated is just as salient as addressing how we treat women.</p> <p>Similarly, the gynaecological health-care needs of culturally and linguistically diverse and Aboriginal and Torres Strait islander women may be even <a href="https://www.mdpi.com/1660-4601/20/13/6321">less likely to be met</a> than those of women in the general population.</p> <h2>Challenging gender norms</h2> <p>Research suggests one of the keys to reducing the gender pain gap is challenging deeply embedded <a href="https://pubmed.ncbi.nlm.nih.gov/29682130/">gendered norms</a> in clinical practice and research.</p> <p>We are hearing women’s suffering. Let’s make sure we are also listening and responding in ways that close the gender pain gap.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229802/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/michelle-oshea-457947">Michelle O'Shea</a>, Senior Lecturer, School of Business, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/hannah-adler-1533549">Hannah Adler</a>, PhD candidate, health communication and health sociology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/marilla-l-druitt-1533572">Marilla L. Druitt</a>, Affiliate Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/mike-armour-391382">Mike Armour</a>, Associate Professor at NICM Health Research Institute, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/longer-appointments-are-just-the-start-of-tackling-the-gender-pain-gap-here-are-4-more-things-we-can-do-229802">original article</a>.</em></p> </div>

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4 ways to avoid foot pain when travelling

<p>Whether it’s caused by a hectic day of sightseeing or a mad rush through the airports, there’s nothing quite as annoying as foot pain when you’re on holidays. And when you consider how easy it is to avoid (so long as you take the correct preventative measures) you’ll feeling like kicking yourself for putting up with it for all these years.</p> <p>Here are four ways to avoid foot pain when travelling.</p> <p><strong>1. Choosing the right pair of shoes  </strong></p> <p>Out of all the fashion statements, shoes are probably responsible for more chronic foot pain than anything else. So make sure you choose the right pair of shoes for your trip. For example, if you’re going to be walking around all day sightseeing it might be an idea to ditch the stiletto heels for a pair of joggers (even if they’re not quite so aesthetically pleasing).</p> <p>Dr Robert Mathews from Cremorne Medical in NSW says, “I recommend wearing supportive shoe such as running shoes. If you want to wear something more stylish then consider buying some gel insoles to slip in your shoes, you can get a wide variety of these from your local chemist.“</p> <p><strong>2. Manage your feet on flights</strong></p> <p>Foot swelling can become quite a big problem on long haul flight, so managing your feet becomes crucial. Simple, preventative measures anyone can take, like wearing support stocks, standing up every so often to move around or even just flexing your feet and wriggling your toes, can make a big difference and greatly reduce the chance of swelling.</p> <p><strong>3. Slip, slop and slap</strong></p> <p>So many island holidays have been soured by the blistering pain of sunburnt feet. If you’re staying at a resort or near a beach and your feet are exposed, don’t forget to apply sunscreen everywhere. Otherwise you’re going to want to have some aloe vera gel handy!</p> <p><strong>4. Take time to rest</strong></p> <p>While you’re probably in a mad rush to see everything, fear of missing out can put significant strain on your feet. So make sure you set aside plenty of time every day to put your feet up and rest. It also might be worth considering some extra pampering, like a foot bath or even a half hour massage. You are on holidays after all, so why not treat yourself!</p> <p>Dr Matthews adds, “It may also be worth taking with you some thick band aids in case you develop any blisters from long walks.”</p> <p><em>Image credits: Shutterstock</em></p>

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How niggling hip pain led a squash coach to life-saving cancer diagnosis

<p>Melbourne squash coach and player Malcolm McClarty had been experiencing frequent pain in his right hip area for about 12 months before he mentioned it to one of his clients, a top medical oncologist, in October last year.</p> <p>The 63-year-old father-of-three coaches Professor Niall Tebbutt at the Kooyong Lawn and Tennis Club in Melbourne. </p> <p>Despite having lost his younger sister to pancreatic cancer just months earlier, Malcolm had been brushing off the pain, thinking it was a niggling sporting injury. </p> <p>Now Malcolm credits Niall, who ordered a prostate-specific antigen test (PSA), with saving his life. </p> <p>Malcolm also coaches Weranja Ranasinghe, a urologist with the Urological Society of Australia and New Zealand (USANZ), who has been his ‘unofficial second opinion’ throughout the journey. </p> <p>Associate Professor Ranasinghe says Malcolm’s diagnosis comes as the newly-released Lancet Commission on Prostate Cancer predicts cases worldwide will double from 1.4 million to 2.9 million by 2040. </p> <p>The USANZ says although the findings are alarming, Australia is well-placed to manage the spike thanks to availability of advanced diagnostic tools, improvements in treatments and quality control registries, but it needs to be coupled with more awareness. </p> <p>“Australia is better placed than many other nations to deal with a sharp spike in prostate cancer cases, but the urgent review of guidelines can’t come soon enough,” says Associate Professor Ranasinghe.</p> <p>“Prostate cancer is not commonly understood or spoken about, particularly amongst high-risk younger men, leaving too many in the dark about their cancer risk and that can be deadly,” he added. </p> <p>“Prostate cancer is already a major cause of death and disability, and the most common form of male cancer in more than 100 countries,” says Associate Professor Ranasinghe. “It’s the most commonly diagnosed cancer in Australia with over 25,000 new cases every year, and more than 11 deaths a day.”</p> <p>Malcolm was devastated to learn his cancer was aggressive Stage Four and had spread to three spots in the pelvic bone. He also experienced other symptoms including frequent and weak-flow urinating at night. </p> <p>He will begin radiotherapy, with chemotherapy on the cards as well. But his attitude is positive; he’s hoping to live for another six to 10 years. </p> <p>Malcolm’s message for other men is simple: if you’re 50 or older, get tested for prostate cancer now. He warns waiting can lead to complex and limited treatment options. </p> <p><strong>Five Risk Factors For Prostate Cancer</strong></p> <p><strong>1.<span style="white-space: pre;"> </span>Age</strong> - the chance of developing prostate cancer increases with age.</p> <p><strong>2.<span style="white-space: pre;"> </span>Family history</strong> - if you have a first-degree male relative who developed prostate cancer, like a brother or father, your risk is higher than someone without such family history.</p> <p><strong>3.<span style="white-space: pre;"> </span>Genetics</strong> - while prostate cancer can’t be inherited, a man can inherit certain genes that increase the risk.</p> <p><strong>4.<span style="white-space: pre;"> </span>Diet</strong> - some evidence suggests that a diet high in processed meat, or foods high in fat can increase the risk of developing prostate cancer.</p> <p><strong>5.<span style="white-space: pre;"> </span>Lifestyle</strong> - environment and lifestyle can also impact your risk, e.g. a sedentary lifestyle or being exposed to chemicals. </p> <p>For more information, visit <a href="https://www.usanz.org.au/" target="_blank" rel="noopener">https://www.usanz.org.au/</a></p>

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Australian Idol host opens up on painful health battle

<p>Australian Idol host and singer Ricki-Lee Coulter has revealed that she has been battling endometriosis for over a decade. </p> <p>The 38-year-old took to Instagram to share the process that led her diagnosis, straight from the hospital bed, following her laparoscopy and excision surgery. </p> <p>"For over a decade I’ve been dealing with chronic pain that has progressively gotten worse,” she began the post. </p> <p>“Anyone with endometriosis knows it takes a long time to get to the point where you have surgery and can get any kind of diagnosis — and that you have to advocate for yourself and keep pushing for answers.</p> <p>“Over the years I have seen so many doctors and specialists, and have been down so many different paths to try to figure out what was going on — and for so long I thought the pain was just something I had to deal with.</p> <p>“But the past couple of years, it has become almost unbearable and is something I’ve been dealing with every single day.</p> <p>“I met with a new GP at the start of the year, who referred me to a new specialist, and we went through all the measures that have been taken to try to get to the bottom of this pain — and the only option left was surgery.</p> <p>“So this week I had a laparoscopy and excision surgery — and they removed all the endometriosis they found, and I can only hope that is the end of the pain.</p> <p>“I’m now at home recovering and feeling good. Rich is taking very good care of me xxx," she ended the post.</p> <p>She also shared a few photos after her surgery, and of her recovering at home. </p> <p>One in nine women suffer from endometriosis, a condition where the  tissue similar to the lining of the uterus grows outside the womb, which sometimes moves to other areas of the body. </p> <p>Friends and followers shared their support in the comments, with reality TV star and fellow endo-warrior Angie Kent saying: “Sending you lots of love! You’re not alone in this — it’s a marathon not a sprint, unfortunately.</p> <p>“But there’s an amazing chronic invisible illness sista-hood out here! I hope you have a good support system with the recovery including an amazing women’s health practitioner.”</p> <p>“Sending lots of love,” Sunrise host Natalie Barr added. </p> <p>“Sending you so much love. Been where you are now and it gets so much better honey,” wrote Jackie O. </p> <p><em>Images: Instagram</em></p> <p> </p>

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Surgery won’t fix my chronic back pain, so what will?

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>This week’s ABC Four Corners episode <a href="https://www.abc.net.au/news/2024-04-08/pain-factory/103683180">Pain Factory</a> highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.</p> <p>The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.</p> <p><a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">One in five</a> Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">A$139 billion a year</a>, including $12 billion in direct health-care costs.</p> <p>The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?</p> <h2>Opioids and invasive procedures</h2> <p>Treatments offered to people with chronic pain include strong pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/30561481/">opioids</a> and invasive procedures such as <a href="https://pubmed.ncbi.nlm.nih.gov/36878313/">spinal cord stimulators</a> or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120">spinal fusion surgery</a>. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.</p> <p><a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8">Spinal fusion surgery</a> and <a href="https://privatehealthcareaustralia.org.au/consumers-urged-to-be-cautious-about-spinal-cord-stimulators-for-pain/#:%7E:text=Australian%20health%20insurance%20data%20shows,of%20the%20procedure%20is%20%2458%2C377.">spinal cord stimulators</a> are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.</p> <h2>Addressing the contributors to pain</h2> <p>Recommendations from the latest <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard">Australian</a> and <a href="https://www.who.int/publications/i/item/9789240081789">World Health Organization</a> clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:</p> <ul> <li>education</li> <li>advice</li> <li>structured exercise programs</li> <li>physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.</li> </ul> <p>Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.</p> <p>The interventions have minimal side effects and are cost-effective.</p> <p>In the <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">RESOLVE</a> trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.</p> <p>In the <a href="https://pubmed.ncbi.nlm.nih.gov/37146623/">RESTORE</a> trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.</p> <h2>Why isn’t everyone with chronic pain getting this care?</h2> <p>While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session <a href="https://www.sira.nsw.gov.au/__data/assets/pdf_file/0005/1122674/Physiotherapy-chiropractic-and-osteopathy-fees-practice-requirements-effective-1-February-2023.pdf">can cost</a> $90–$150.</p> <p>In contrast, <a href="https://www.servicesaustralia.gov.au/chronic-disease-individual-allied-health-services-medicare-items">Medicare</a> provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.</p> <p>Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.</p> <p>Access to trained clinicians is another barrier. This problem is particularly evident in <a href="https://www.ruralhealth.org.au/15nrhc/sites/default/files/B2-1_Bennett.pdf">regional and rural Australia</a>, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.</p> <p>Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/data-file-57-opioid-medicines-dispensing-2016-17-third-atlas-healthcare-variation-2018">rate of opioid use</a>, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.</p> <h2>So what can we do about it?</h2> <p>We need to reform Australia’s health system, private and <a href="https://www.health.gov.au/sites/default/files/documents/2020/12/taskforce-final-report-pain-management-mbs-items-final-report-on-the-review-of-pain-management-mbs-items.docx">public</a>, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.</p> <p>Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian <a href="https://pubmed.ncbi.nlm.nih.gov/38461844/">trial</a>, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.</p> <p>Advocacy and <a href="https://pubmed.ncbi.nlm.nih.gov/37918470/">improving the public’s understanding</a> of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/christine-lin-346821"><em>Christine Lin</em></a><em>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/surgery-wont-fix-my-chronic-back-pain-so-what-will-227450">original article</a>.</em></p>

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Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<p><em><a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial.</p> <p>UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom.</p> <p>Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year.</p> <p>They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area.</p> <p>Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments.</p> <h2>Why are chronic UTIs so hard to treat?</h2> <p>Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach.</p> <p>The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments.</p> <p>This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective.</p> <p>Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted.</p> <p>But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead.</p> <p>Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria.</p> <p>Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions.</p> <p>The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence.</p> <p>For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur.</p> <p>Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role.</p> <p>Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>.</p> <h2>What treatments might we see in the future?</h2> <p>Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu.</p> <p>Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus.</p> <p>Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves.</p> <p>Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response.</p> <p>Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/iris-lim-1204657">I<em>ris Lim</em></a><em>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.</em></p>

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How long does back pain last? And how can learning about pain increase the chance of recovery?

<p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>.</p> <p>Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>.</p> <p>If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups:</p> <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> <p>We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.</p> <p>Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.</p> <h2>More pain doesn’t mean a more serious injury</h2> <p>Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease.</p> <p>There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.</p> <p>Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.</p> <p>The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.</p> <p>The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.</p> <h2>Reduce your chance of lasting pain</h2> <p>Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:</p> <ul> <li> <p>understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain</p> </li> <li> <p>reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.</p> </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> <p>Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.</p> <p>These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover.</p> <p>But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.</p> <p>When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>.</p> <p>Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community.</p> <p>But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.</em></p>

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Socceroos great hospitalised following chest pains

<p>Mark Bosnich had a health scare this week that landed him in hospital. </p> <p>The former Socceroos and Manchester United goalkeeper was exercising at work when he began to experience chest pains. </p> <p>Not wanting to risk it, the  52-year-old made the quick decision to get himself checked out at a hospital in Sydney. </p> <p>The Aussie football great took to X, formerly known as Twitter, to update fans on his condition, straight from his hospital bed on Wednesday night. </p> <p>“Will not be able to see you all tomorrow morning,” he wrote, along with the schedule of matches for the Champions League airing on the streaming platform Stan. </p> <p>“But will be fine by Friday … but join us here in Oz from 6.35am (aedt).”</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Will not be able to see you all tomorrow morning,but will be fine by Friday…but join us here in Oz from 6.35am(aedt) <a href="https://twitter.com/ChampionsLeague?ref_src=twsrc%5Etfw">@ChampionsLeague</a> Rd 16 <a href="https://twitter.com/PSG_English?ref_src=twsrc%5Etfw">@PSG_English</a> VS <a href="https://twitter.com/RealSociedadEN?ref_src=twsrc%5Etfw">@RealSociedadEN</a> & <a href="https://twitter.com/OfficialSSLazio?ref_src=twsrc%5Etfw">@OfficialSSLazio</a> vs <a href="https://twitter.com/FCBayernEN?ref_src=twsrc%5Etfw">@FCBayernEN</a> <a href="https://twitter.com/StanSportAU?ref_src=twsrc%5Etfw">@StanSportAU</a> <a href="https://twitter.com/UEFA?ref_src=twsrc%5Etfw">@UEFA</a> .xmb <a href="https://t.co/LRL5D9YtOu">pic.twitter.com/LRL5D9YtOu</a></p> <p>— Mark Bosnich (@TheRealBozza) <a href="https://twitter.com/TheRealBozza/status/1757715714583191600?ref_src=twsrc%5Etfw">February 14, 2024</a></p></blockquote> <p>Bosnich was missing from Stan Sport’s Champions League coverage on Thursday and his on-air colleagues, Max Rushden and Craig Foster, explained what had happened. </p> <p>“For those of you who don’t know, he (Bosnich) had chest pains, he’s had a stent put in,” Rushden said during coverage of one of the matches. </p> <p>He was making a lot of noise … and he said ‘I’m going to get it checked out’.</p> <p>“He did, he’s OK. He’s back tomorrow but we are sending you our love Boz, it is very quiet without you.”</p> <p>Fellow Socceroo Foster added: “We miss you buddy. I hope you’re well and feeling OK.”</p> <p>Bosnich's hospital admission didn't stop him from keeping up with the matches as he shared a photo of himself tuning in to Champions League on a tablet, and thanked everyone for their well-wishes. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Thank you all for your wonderful messages….will be back 2morrow on <a href="https://twitter.com/StanSportAU?ref_src=twsrc%5Etfw">@StanSportAU</a> for <a href="https://twitter.com/EuropaLeague?ref_src=twsrc%5Etfw">@EuropaLeague</a> Knockout <a href="https://twitter.com/acmilan?ref_src=twsrc%5Etfw">@acmilan</a> vs <a href="https://twitter.com/staderennais_en?ref_src=twsrc%5Etfw">@staderennais_en</a> on air from 6.35am(aedt)…xmb <a href="https://t.co/bVxj93CCWv">pic.twitter.com/bVxj93CCWv</a></p> <p>— Mark Bosnich (@TheRealBozza) <a href="https://twitter.com/TheRealBozza/status/1757893486920302943?ref_src=twsrc%5Etfw">February 14, 2024</a></p></blockquote> <p>During Thursday's game, Rushden was keen for anyone watching to heed the warning from Bosnich.</p> <p>“If you’re not sure about anything, health-wise, get checked,” Rushden said.</p> <p>“Men are useless at talking about it and doing anything about it.</p> <p>“The sooner you find anything is wrong, the better it is. That is our message and that is Bozza’s message too.”</p> <p><em>Images: X</em></p>

Caring

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Mortgage and inflation pain to ease, but only slowly: how 31 top economists see 2024

<p><em><a href="https://theconversation.com/profiles/peter-martin-682709">Peter Martin</a>, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a></em></p> <p>A panel of 31 leading economists assembled by The Conversation sees no cut in interest rates before the middle of this year, and only a slight cut by December, enough to trim just $55 per month off the cost of servicing a $600,000 variable-rate mortgage.</p> <p>The <a href="https://theconversation.com/au/topics/conversation-economic-survey-81354">panel</a> draws on the expertise of leading forecasters at 28 Australian universities, think tanks and financial institutions – among them economic modellers, former Treasury, International Monetary Fund and Reserve Bank officials, and a former member of the Reserve Bank board.</p> <p>Its forecasts paint a picture of weak economic growth, stagnant consumer spending, and a continuing per-capita recession.</p> <p>The average forecast is for the Reserve Bank to delay cutting its cash rate, keeping it near its present 4.35% until at least the middle of the year, and then cutting it to <a href="https://cdn.theconversation.com/static_files/files/3028/The_Conversation_AU_February_2024_Economic_Survey.pdf">4.2%</a> by December 2024, 3.6% by December 2025 and 3.4% by December 2026.</p> <hr /> <p><iframe id="xV821" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/xV821/4/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>The gentle descent would deliver only three interest rate cuts by the end of next year, cutting $274 from the monthly cost of servicing a $600,000 mortgage and leaving the cost around $1,100 higher than it was before rates began climbing.</p> <p>Six of the experts surveyed expect the Reserve Bank to increase rates further in the first half of the year, while 20 expect no change and three expect a cut.</p> <p>Former head of the NSW treasury Percy Allan said while the Reserve Bank would push up rates in the first half of the year to make sure inflation comes down, it would be forced to relent in the second half of the year as unemployment grows and the economy heads towards recession.</p> <p>Warwick McKibbin, a former member of the Reserve Bank board, said the board would push up rates once more in the first half of the year as insurance against inflation before leaving them on hold.</p> <p>Former Reserve Bank of Australia chief economist Luci Ellis, who is now chief economist at Westpac, expects the first cut no sooner than September, believing the board will wait to see clear evidence of further falls in inflation and economic weakening before it moves.</p> <hr /> <p><iframe id="ZQgno" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/ZQgno/7/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <h2>Inflation to keep falling, but more gradually</h2> <p>Today’s <a href="https://www.rba.gov.au/">Reserve Bank board meeting</a> will consider an inflation rate that has come down <a href="https://theconversation.com/the-7-new-graphs-that-show-inflation-falling-back-to-earth-220670">faster than it expected</a>, diving from 7.8% to 4.1% in the space of a year.</p> <p>The newer more experimental monthly measure of inflation was just <a href="https://theconversation.com/the-7-new-graphs-that-show-inflation-falling-back-to-earth-220670">3.4%</a> in the year to December, only points away from the Reserve Bank’s target of 2–3%.</p> <p>But the panel expects the descent to slow from here on, with the standard measure taking the rest of the year to fall from 4.1% to 3.5% and not getting below 3% until <a href="https://cdn.theconversation.com/static_files/files/3027/The_Conversation_AU_2024_economic_survey.pdf">late 2025</a>.</p> <p>Economists Chris Richardson and Saul Eslake say while inflation will keep heading down, the decline might be slowed by supply chain pressures from the conflict in the Middle East and the boost to incomes from the <a href="https://theconversation.com/albanese-tax-plan-will-give-average-earner-1500-tax-cut-more-than-double-morrisons-stage-3-221875">tax cuts</a> due in July.</p> <hr /> <p><iframe id="buC9f" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/buC9f/6/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <h2>Slower wage growth, higher unemployment</h2> <p>While the panel expects wages to grow faster than the consumer price index, it expects wages growth to slip from around <a href="https://www.abs.gov.au/statistics/economy/price-indexes-and-inflation/wage-price-index-australia/latest-release">4%</a> in 2023 to 3.8% in 2004 and 3.4% in 2025 as higher unemployment blunts workers’ bargaining power.</p> <p>But the panel doesn’t expect much of an increase in unemployment. It expects the unemployment rate to climb from its present <a href="https://www.datawrapper.de/_/w9h9f/">3.9%</a> (which is almost a long-term low) to 4.3% throughout 2024, and then to stay at about that level through 2025.</p> <p>All but two of the panel expect the unemployment rate to remain below the range of 5–6% that was typical in the decade before COVID.</p> <p>Economic modeller Janine Dixon said the “new normal” between 4% and 5% was likely to become permanent as workers embraced flexible arrangements that allow them to stay in jobs in a way they couldn’t before.</p> <p>Cassandra Winzar, chief economist at the Committee for the Economic Development of Australia, said the government’s commitment to full employment was one of the things likely to keep unemployment low, along with Australia’s demographic transition as older workers leave the workforce.</p> <hr /> <p><iframe id="pAioo" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/pAioo/2/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <h2>Slower economic growth, per-capita recession</h2> <p>The panel expects very low economic growth of just 1.7% in 2024, climbing to 2.3% in 2025. Both are well below the 2.75% the treasury believes the economy is <a href="https://treasury.gov.au/speech/the-economic-and-fiscal-context-and-the-role-of-longitudinal-data-in-policy-advice">capable of</a>.</p> <p>All but one of the forecasts are for economic growth below the present population growth rate of 2.4%, suggesting that the panel expects population growth to exceed economic growth for the second year running, extending Australia’s so-called <a href="https://theconversation.com/were-in-a-per-capita-recession-as-chalmers-says-gdp-steady-in-the-face-of-pressure-212642">per capita recession</a>.</p> <hr /> <p><iframe id="TO8bP" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/TO8bP/4/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>The lacklustre forecasts raise the possibility of what is commonly defined as a “technical recession”, which is two consecutive quarters of negative economic somewhere within a year of mediocre growth.</p> <p>Taken together, the forecasters assign a 20% probability to such a recession in the next two years, which is lower than in <a href="https://theconversation.com/two-more-rba-rate-hikes-tumbling-inflation-and-a-high-chance-of-recession-how-our-forecasting-panel-sees-2023-24-208477">previous surveys</a>.</p> <p>But some of the individual estimates are high. Percy Allen and Stephen Anthony assign a 75% and 70% chance to such a recession, and Warren Hogan a 50% chance.</p> <p>Hogan said when the economic growth figures for the present quarter get released, they are likely to show Australia is in such a recession at the moment.</p> <p>The economy barely grew at all in the September quarter, expanding just <a href="https://www.abs.gov.au/statistics/economy/national-accounts/australian-national-accounts-national-income-expenditure-and-product/latest-release">0.2%</a> and was likely to have shrunk in the December quarter and to shrink further in this quarter.</p> <p>The panel expects the US economy to grow by 2.1% in the year ahead in line with the <a href="https://www.imf.org/en/Publications/WEO/Issues/2024/01/30/world-economic-outlook-update-january-2024">International Monetary Fund</a> forecast, and China’s economy to grow 5.4%, which is lower than the International Monetary Fund’s forecast.</p> <h2>Weaker spending, weak investment</h2> <p>The panel expects weak real household spending growth of just 1.2% in 2014, supported by an ultra-low household saving ratio of close to zero, down from a recent peak of 19% in September 2021.</p> <p>Mala Raghavan of The University of Tasmania said previous gains in income, rising asset prices and accumulated savings were being overwhelmed by high inflation and rising interest rates.</p> <p>Luci Ellis expected the squeeze to continue until tax and interest rate cuts in the second half of the year, accompanied by declining inflation.</p> <p>The panel expects non-mining investment to grow by only 5.1% in the year ahead, down from 15%, and mining investment to grow by 10.2%, down from 22%.</p> <p>Johnathan McMenamin from Barrenjoey said private and public investment had been responsible for the lion’s share of economic growth over the past year and was set to plateau and fade as a driver of growth.</p> <h2>Home prices to climb, but more slowly</h2> <p>The panel expects home price growth of 4.6% in Sydney during 2024 (down from 11.4% in 2024) and 3.1% in Melbourne, down from 3.9% in 2024.</p> <p>ANZ economist Adam Boyton said decade-low building approvals and very strong population growth should keep demand for housing high, outweighing a drag on prices from high interest rates. While high interest rates have been restraining demand, they are likely to ease later in the year.</p> <hr /> <p><iframe id="syk8x" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/syk8x/6/" width="100%" height="400px" frameborder="0"></iframe></p> <hr /> <p>In other forecasts, the panel expects the Australian dollar to stay below US$0.70, closing the year at US$0.69, it expects the ASX 200 share market index to climb just 3% in 2024 after climbing 7.8% in 2023, and it expects a small budget surplus of A$3.8 billion in 2023-24, followed by a deficit of A$13 billion in 2024-25.</p> <p>The budget surplus should be supported by a forecast iron ore price of US$114 per tonne in December 2024, down from the present US$130, but well up on the <a href="https://budget.gov.au/content/myefo/index.htm">US$105</a> assumed in the government’s December budget update.</p> <p><a href="https://theconversation.com/profiles/peter-martin-682709"><em>Peter Martin</em></a><em>, Visiting Fellow, <a href="https://theconversation.com/institutions/crawford-school-of-public-policy-australian-national-university-3292">Crawford School of Public Policy, Australian National University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/mortgage-and-inflation-pain-to-ease-but-only-slowly-how-31-top-economists-see-2024-218927">original article</a>.</em></p>

Money & Banking

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"One step forward, two steps back": Joh Griggs reveals debilitating health battle

<p>Johanna Griggs has revealed how she overcame a debilitating health struggle that threatened to derail her career as a teenager. </p> <p>The former swimming champion won her first medal at the Commonwealth Games in 1990 at 16 years of age, but just one year later, her world changed forever. </p> <p>In a new interview with <em>Prevention magazine</em>, the <em>Better Homes & Gardens</em> host admitted that being diagnosed with chronic fatigue syndrome at the young age of 17 was a blow, but one she ultimately felt “thankful” for.</p> <p>“You learn more about yourself during a tough period than you do during a great one,” she said.</p> <p>“One of the most important things that it taught me was to be able to be by myself and to be comfortable in my own skin.”</p> <p>With her swimming career on pause, Joh shared that the next few years were “one step forward, two steps back”.</p> <p>As a teenager, she learned the power of positive self-belief while learning what was best for her body as she worked her way back to physical and emotional strength.</p> <p>“It’s asking yourself, ‘Can you put your head on the pillow and know in your heart of hearts you’ve done everything within your power that day to get better?’,” she said of that time in her life.</p> <p>“But also, not beating yourself up on it, just working out what was working (and) what wasn’t working.”</p> <p>Over the next two and a half years, Johanna was on a highly restricted diet to combat her health issues, one that was “wheat-free, yeast-free, egg-free, malt-free, sugar-free, dairy-free, herb-free, spice-free, caffeine-free”.</p> <p>Eventually she was able to return to the pool, although she faced further setbacks, including a bout of pleurisy that landed her in hospital.</p> <p>By 1993, she was back at the top of her game, taking out the win for the 50m backstroke at the Australian Swimming Championships.</p> <p>Riding this high, Johanna decided her swimming career was over.</p> <p>“For me, it was a massive milestone to get to say I could be the best, but I also knew when I hit that (pool) wall, I did not want to keep living like that,” she said.</p> <p>“I told my mum I was retiring that night and remember her voice going up a couple of octaves higher than normal.”</p> <p><em>Image credits: Getty Images / Instagram </em></p>

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Mother dies after ambulance fails to arrive

<p>A mother from Queensland has tragically died while waiting for an ambulance, after she called 000 complaining of chest pain. </p> <p>Cath Groom called paramedics just before 10:30pm on Friday after growing increasingly concerned about persistent chest pain, but was left waiting more than an hour and a half for the ambulance to arrive. </p> <p>Given the nature of Groom's symptoms, her case was deemed urgent, and she should've been tended to by paramedics within 15 minutes. </p> <p>It is believed that Cath was found dead by her teenage son while still waiting for the ambulance to arrive, the day before her 52nd birthday. </p> <p>Her friends and family have taken to social media to pay tribute to the “amazing mother” and to express their “deepest shock, grief and sadness” at the news of her sudden passing. </p> <p>“She was and will always be my favourite human on this earth, I loved her to bits we were like a brother and sister I’m going to be lost without her,” one person wrote. </p> <p>“What an absolute shock. Such a beautiful girl taken way too soon,” another said. </p> <p>Ms Groom had long been a single mum after she was left to raise her son on her own after her husband died when the boy was just a baby. </p> <p>“Rest In Peace Sis, may you rest easy now with Dad and your life’s love and husband Warren,” her sister wrote on social media.</p> <p>The shock death has renewed calls for the Queensland and federal government to address ambulance delays, with Australian Medical Association Queensland president Dr Maria Boulton saying the state’s healthcare system is “not good enough”. </p> <p>“This is what happens because the system is under such strain, we know that our healthcare workers do the best they can in a system that is completely broken,” she told the <em>Today Show</em>. </p> <p>“This is not on them but it also affects them because they don’t want to lose any lives.”</p> <p><em>Image credits: Facebook</em></p>

Caring

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How to get rid of sciatica pain: solutions from back experts

<p><strong>The scoop on sciatica pain</strong></p> <p>Fun fact: The sciatic nerve is the largest nerve in the human body. It runs from the lower back down each side of your body, along the back of the hips, butt cheeks, and knees, down the back of the calf, and into the foot. It provides both sensory and motor nerve function to the legs and feet.</p> <p>Not-so-fun fact: Sometimes this nerve can get compressed in the spine at one of the roots – where it branches off the spinal cord – and cause pain that radiates down the length of the nerve. This is a dreaded condition known as sciatica. It is estimated that between 10 and 40 percent of people will experience sciatica in their lifetime.</p> <p>“Sciatica is the body telling you the sciatic nerve is unhappy,” says E. Quinn Regan, MD, an orthopaedic surgeon. “When the nerve is compressed at the root, it becomes inflamed, causing symptoms,” Dr Regan says. These symptoms can range from mild to debilitating.</p> <p>While sciatica can often resolve on its own, easing symptoms and feeling better usually requires some attention and careful behaviour modifications. Rarely, you may need more medical intervention to recover fully.</p> <p>Here’s everything you need to know about sciatica, including symptoms, how it’s diagnosed, how it’s treated, and what you can do to prevent it from recurring.</p> <p><strong>Symptoms of sciatica</strong></p> <p>Sciatica is quite literally a pain in the butt. The telltale symptom of sciatica is pain that radiates along the nerve, usually on the outside of the butt cheek and down the back of the leg. It usually only happens on one side of the body at a time. Sciatica doesn’t necessarily cause lower back pain, though it can.</p> <p>Dr Regan says that people with sciatica describe the pain as electric, burning, or stabbing, and in more severe cases, it can also be associated with numbness or weakness in the leg. If sciatica causes significant muscle weakness, to the point of losing function, and/or the pain is so bad you can’t function, it’s time to get immediate help, Dr Regan says.</p> <p>Another symptom that warrants a trip to the ER and immediate medical intervention: bowel or bladder incontinence. “That means there’s a massive compression, and the pressure is so severe it’s harming the nerves that go to the bowel and bladder,” says orthopaedic surgeon Dr Brian A. Cole. This is rare, but when it happens, it’s imperative to decompress the nerve immediately, he says.</p> <p><strong>The main causes of sciatica</strong></p> <p>The most common cause of sciatica is a herniated or slipped disc. A herniated or slipped disc happens when pressure forces one of the discs that cushion each vertebra in the spine to move out of place or rupture. Usually it’s caused when you lift something heavy and hurt your back, or after repetitive bending or twisting of the lower back from a sport or a physically demanding job.</p> <p>Sciatica also can be caused by:</p> <ul> <li>a bone spur (osteophyte), which can form as a result of osteoarthritis</li> <li>narrowing of the spinal canal (spinal stenosis), which happens with normal wear-and-tear of the spine and is more common in people over 60</li> <li>spondylolisthesis, a condition where one of your vertebrae slips out of place</li> <li>a lower back or pelvic muscle spasm or any sort of inflammation that presses on the nerve root</li> </ul> <p>Some people are born with back problems that lead to spinal stenosis at an earlier age. Other potential, yet rare, causes of sciatic nerve compression include tumours and abscesses.</p> <p><strong>Could it be piriformis syndrome?</strong></p> <p>Something known as piriformis syndrome can also cause sciatica-like symptoms, though it is not considered true sciatica. The piriformis is a muscle that runs along the outside of the hip and butt and plays an important role in hip extension and leg rotation.</p> <p>Piriformis syndrome is an overuse injury that’s common in runners, who repetitively strain this muscle, leading to inflammation and irritation. Because the muscle is so close to the sciatic nerve, piriformis syndrome can compress the nerve and cause a similar tingling, radiating pain as sciatica. The difference is that this pain is not caused by compression at the nerve root, but rather, irritation or pressure at some point along the length of the nerve.</p> <p><strong>Sciatica risk factors </strong></p> <p>Anyone can end up with a herniated disc and ultimately sciatica, but some people are more at risk than others. The biggest risk factor is age. “The discs begin to age at about age 30, and when this happens they can develop defects,” Dr Regan says. These defects slowly increase the risk of a disc slipping or rupturing.</p> <p>Men are three times more likely than women to have a herniated disc, Dr Regan says. Being overweight or obese also increases your chance of injuring a disc. A physically demanding job, regular strenuous exercise, osteoarthritis in the spine, and a history of back injury can also increase your risk. Sitting all day doesn’t help either, Dr Cole says. “You put more stress on your back biomechanically sitting than anything else you do.”</p> <p>Certain muscle weaknesses and imbalances can also make you more prone to disc injury and, consequently, sciatica. “People with weak core muscles and instability around the spine might be more prone to this since the muscles need to stabilise the joints of the vertebrae in which the nerves exit,” says Theresa Marko, an orthopaedic physical therapist.</p> <p><strong>How sciatica is diagnosed</strong></p> <p>If your symptoms suggest sciatica, your doctor will do a physical exam to check your strength, reflexes and sensation. A test called a straight leg raise can also test for sciatica, Dr Regan says. How it’s done: Patients lie face up on the floor, legs extended, and the clinician slowly lifts one leg up. At a certain point, it may trigger sciatica symptoms. (The test can also be done sitting down.)</p> <p>Depending on how severe the pain is and how long you’ve had symptoms, doctors may also do some scans (MRI or CT) on your spine to figure out what’s causing the sciatica and how many nerve roots are impacted.</p> <p>Scans can also confirm there isn’t something else mimicking the symptoms of sciatica. Muscle spasms, abscesses, hematomas (a collection of blood outside a blood vessel), tumours and Potts disease (spinal tuberculosis) can all cause similar symptoms.</p> <p><strong>Managing mild to moderate sciatica </strong></p> <p>Resting, avoiding anything that strains your back, icing the area that hurts, and taking nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, are the first-line treatment options for sciatica, Dr Regan says. If you have a physically demanding job that requires you to lift heavy things, taking some time off, if at all possible, will help.</p> <p>While it’s important to avoid activities that might make things worse, you do want to keep moving, says Marko. “Research now advises against bed rest. You want to move without overdoing it.”</p> <p>A physical therapist can help you figure out what movements are safe and beneficial to do. For example, certain motions – squatting, performing a deadlift, or doing anything that involves bending forward at the waist – can be really aggravating. Light spine and hamstring stretching, low-impact activities like biking and swimming, and core work can help. “In general, we need the nerve to calm down a bit and to strengthen the muscles of your spine, pelvis and hips,” Marko says.</p> <p>“Within a week to 10 days, about 80 percent of patients with mild to moderate sciatica are going to be doing much better,” Dr Regan says. Within four to six weeks, you should be able to return to your regular activities – with the caveat that you’ll need to be careful about straining your back to avoid triggering sciatica again.</p> <p><strong>Treating severe sciatica</strong></p> <p>If you’re trying the treatment options for mild to moderate sciatica and your symptoms worsen or just don’t get better, you may need a higher level of treatment.</p> <p>If OTC pain relievers aren’t cutting it, your doctor may prescribe a muscle relaxant like cyclobenzaprine (Flexeril).</p> <p>An epidural steroid injection near the nerve root can reduce inflammation and provide a huge relief for some people with sciatica. The results are varied, and some people may need more than one injection to really feel relief.</p> <p>Surgery is usually a last resort, only considered once all of the conservative and minimally invasive options have been exhausted. Dr Regan notes that a small percentage of people with sciatica end up needing surgery – these are usually patients who have severe enough sciatica that their primary care doctors have referred them to spinal specialists. And only about a third of patients who see spinal specialists may end up having surgery, he says.</p> <p>Surgeries to relieve disc compression are typically quick and done on an outpatient basis, according to Dr Cole.</p> <p><strong>Preventing sciatica in the future</strong></p> <p>“Once you have a back issue, you have a higher chance of having a back issue in the future,” Dr Regan says. Which means that your first bout of sciatica isn’t likely to be your last. It’s important to adopt a healthy lifestyle to reduce the risk of sciatica striking again.</p> <p>Building core strength is key. “Think of your midsection as a box, and you need to target all sides,” Marko says. “By this, I mean abdominals, obliques, diaphragm, pelvic floor, glutes and lateral hip muscles.” These muscles all support the spine, so the stronger they are, the better the spine can handle whatever is thrown its way.</p> <p>If there’s an activity you enjoy that aggravates your back, ditch it for an alternative. For example, running can trigger back pain and sciatica in some people, Dr Regan says. If you’re prone to it, try a new form of cardio that’s gentler on your back, like swimming, biking, or using the elliptical. Even just logging fewer kilometres per week can help reduce your risk.</p> <p>Dr Regan also recommends making sure you learn how to weight train properly. Lifting with the best form possible, learning your limits, and reducing weight when you need to will help keep your back safe from disc injuries.</p> <p>Making small changes to your daily life and workouts can help keep your back healthy and minimise the time you have to waste dealing with sciatica in the future.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/backtips-advice/how-to-get-rid-of-sciatica-pain-solutions-from-back-experts" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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Take the pain out of toothache with these 11 home remedies

<p><strong>Toothache remedy: clove oil</strong></p> <p>Cloves are a traditional remedy for numbing nerves; the primary chemical compound of this spice is eugenol, a natural anaesthetic. Research has shown that, used topically, clove oil can be as effective against tooth pain as benzocaine.</p> <p>Put two drops of clove oil on a cotton ball and place it against the tooth itself until the pain recedes. In a pinch, use a bit of powdered clove or place a whole clove on the tooth. Chew the whole clove a little to release its oil and keep it in place up to half an hour or until the pain subsides.</p> <p><strong>Toothache remedy: cayenne paste</strong></p> <p>The main chemical component of cayenne – capsaicin – has been found to alter some of the mechanisms involved in pain. Mix powdered cayenne with enough water to make a paste.</p> <p>Roll a small ball of cotton into enough paste to saturate it, then place it on your tooth while avoiding your gums and tongue. Leave it until the pain fades – or as long as you can stand it (the concoction is likely to burn).</p> <p><strong>Toothache remedy: swish some salt water</strong></p> <p>A teaspoon of salt dissolved in a cup of boiling water makes an effective mouthwash, which will clean away irritating debris and help reduce swelling. Swish it around for about 30 seconds before spitting it out.</p> <p>Saltwater cleanses the area around the tooth and draws out some of the fluid that causes swelling, according to Professor Thomas Salinas. Repeat this treatment as often as needed. “A hot rinse can also help consolidate the infection until you get to your dentist,” says Dr Salinas.</p> <p><strong>Toothache remedy: soothe with tea</strong></p> <p>Peppermint tea has a nice flavour and some medicinal powers as well. Put 1 teaspoon dried peppermint leaves in 1 cup boiling water and steep for 20 minutes. After the tea cools, swish it around in your mouth, then spit it out or swallow.</p> <p>Also, the astringent tannins in strong black tea may help quell pain by reducing swelling. For this folk remedy place a warm, wet tea bag against the affected tooth for temporary relief. “The fluoride in tea can help kill bacteria, which is especially helpful after a tooth extraction,” says Salinas.</p> <p><strong>Toothache remedy: rinse with hydrogen peroxide</strong></p> <p>To help kill bacteria and relieve some discomfort, swish with a mouthful of 3 per cent hydrogen peroxide solution diluted with water. This can provide temporary relief if a toothache is accompanied by fever and a foul taste in the mouth (both are signs of infection), but like other toothache remedies, it’s only a stopgap measure until you see your dentist and get the source of infection cleared up.</p> <p>A hydrogen peroxide solution is only for rinsing. Spit it out, then rinse several times with plain water.</p> <p><strong>Toothache remedy: ice it</strong></p> <p>Place a small ice cube in a plastic bag, wrap a thin cloth around the bag, and apply it to the aching tooth for about 15 minutes to numb the nerves. Alternatively, that ice pack can go on your cheek, over the painful tooth. Also, according to folklore, if you massage your hand with an ice cube, you can help relieve a toothache.</p> <p>When nerves in your fingers send ‘cold’ signals to your brain, they may distract from the pain in your tooth. Just wrap up an ice cube in a thin cloth and massage it in the fleshy area between your thumb and forefinger.</p> <p><strong>Toothache remedy: wash it with myrrh</strong></p> <p>You can also rinse with a tincture of myrrh. “Myrrh definitely has an effect on infected tissue and can sometimes also interfere with the pain generated by tooth infection,” says Salinas.</p> <p>Simmer 1 teaspoon of powdered myrrh in 2 cups water for 30 minutes. Strain and let cool. Rinse with 1 teaspoon of the solution in a half-cup water several times a day.</p> <p><strong>Toothache remedy: distract with vinegar and brown paper</strong></p> <p>Another country cure calls for soaking a small piece of brown paper (from a grocery or lunch bag) in vinegar, sprinkling one side with black pepper, and holding this to the cheek. The warm sensation on your cheek may distract you from your tooth pain.</p> <p>This technique is an example of the Gate Control theory of pain. By using a distracting stimulus, the ‘gates’ to the pain receptors in your brain close and you don’t feel the original pain as powerfully.</p> <p><strong>Toothache remedy: brush with the right tools</strong></p> <p>“Sensitive toothpaste is very helpful for people with significant gum recession,” says Salinas. When gums shrink, the dentin beneath your teeth’s enamel surface is exposed, and this material is particularly sensitive.</p> <p>Look for pastes that contain sodium fluoride, potassium nitrate or strontium nitrate – ingredients which have been shown to reduce sensitivity, according to Salinas. Switch to the softest-bristled brush you can find to help preserve gum tissue and prevent further shrinking.</p> <p><strong>Toothache remedy: cover a crack with gum</strong></p> <p>If you’ve broken a tooth or have lost a filling, you can relieve some pain by covering the exposed area with softened chewing gum. This might work with a loose filling, too, to hold it in place until you can get to the dentist.</p> <p>To avoid further discomfort, avoid chewing anything with that tooth until you can have it repaired. Just make sure you use sugarless gum, since sugar may actually exacerbate the pain (not to mention that it can cause cavities).</p> <p><strong>Toothache remedy: apply pressure</strong></p> <p>Try an acupressure technique to stop tooth pain fast. With your thumb, press the point on the back of your other hand where the base of your thumb and your index finger meet.</p> <p>Apply pressure for about two minutes. “This works in several ways,” says Salinas. “The pressure can help prevent pain signals from being sent as well as help express some of the fluid that causes swelling.”</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/11-home-remedies-for-a-toothache?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p> <div class="slide-image" style="font-family: inherit; font-size: 16px; font-style: inherit; box-sizing: border-box; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> </div> <div class="slide-image" style="font-family: inherit; font-size: 16px; font-style: inherit; box-sizing: border-box; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> </div> <div class="slide-image" style="font-family: inherit; font-size: 16px; font-style: inherit; box-sizing: border-box; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> </div>

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What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p>If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months).</p> <p>There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles.</p> <p>We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>.</p> <p>But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again.</p> <h2>People are often given the wrong advice</h2> <p>People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis.</p> <p>But these findings are very common in people <em>without</em> low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain.</p> <p>Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain.</p> <p>In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress.</p> <p>It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves.</p> <h2>So how should low back pain be treated?</h2> <p>A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety.</p> <p>Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language.</p> <p>They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities.</p> <p>An example of this type of care is cognitive functional therapy.</p> <h2>What is cognitive functional therapy?</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out.</p> <p>The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it.</p> <p>It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>.</p> <p>Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required.</p> <h2>What’s the evidence for this type of therapy?</h2> <p>Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments.</p> <p>We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”.</p> <p>We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care.</p> <p>The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>.</p> <p>People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group.</p> <p>The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work.</p> <h2>What does this mean for you?</h2> <p>This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success.</p> <p><a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up.</p> <p>The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.</em></p>

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If anxiety is in my brain, why is my heart pounding? A psychiatrist explains the neuroscience and physiology of fear

<p><em><a href="https://theconversation.com/profiles/arash-javanbakht-416594">Arash Javanbakht</a>, <a href="https://theconversation.com/institutions/wayne-state-university-989">Wayne State University</a></em></p> <p>Heart in your throat. Butterflies in your stomach. Bad gut feeling. These are all phrases many people use to describe fear and anxiety. You have likely felt anxiety inside your chest or stomach, and your brain usually doesn’t hurt when you’re scared. Many cultures tie cowardice and bravery more <a href="https://afosa.org/the-meaning-of-heart-qalb-in-quran/">to the heart</a> <a href="https://byustudies.byu.edu/article/bowels-of-mercy/">or the guts</a> than to the brain.</p> <p>But science has traditionally seen the brain as the birthplace and processing site of fear and anxiety. Then why and how do you feel these emotions in other parts of your body?</p> <p>I am a <a href="https://scholar.google.com/citations?user=UDytFmIAAAAJ&amp;hl=en">psychiatrist and neuroscientist</a> who researches and treats fear and anxiety. In my book “<a href="https://rowman.com/ISBN/9781538170380/Afraid-Understanding-the-Purpose-of-Fear-and-Harnessing-the-Power-of-Anxiety">Afraid,</a>” I explain how fear works in the brain and the body and what too much anxiety does to the body. Research confirms that while emotions do originate in your brain, it’s your body that carries out the orders.</p> <h2>Fear and the brain</h2> <p>While your brain evolved to save you from a falling rock or speeding predator, the anxieties of modern life are often a lot more abstract. Fifty-thousand years ago, being rejected by your tribe could mean death, but not doing a great job on a public speech at school or at work doesn’t have the same consequences. Your brain, however, <a href="https://doi.org/10.1006/nimg.2002.1179">might not know the difference</a>.</p> <p>There are a few key areas of the brain that are heavily involved in processing fear.</p> <p>When you perceive something as dangerous, whether it’s a gun pointed at you or a group of people looking unhappily at you, these sensory inputs are first relayed to <a href="https://doi.org/10.1038%2Fnpp.2009.121">the amygdala</a>. This small, almond-shaped area of the brain located near your ears detects salience, or the emotional relevance of a situation and how to react to it. When you see something, it determines whether you should eat it, attack it, run away from it or have sex with it.</p> <p><a href="https://theconversation.com/the-science-of-fright-why-we-love-to-be-scared-85885">Threat detection</a> is a vital part of this process, and it has to be fast. Early humans did not have much time to think when a lion was lunging toward them. They had to act quickly. For this reason, the amygdala evolved to bypass brain areas involved in logical thinking and can directly engage physical responses. For example, seeing an angry face on a computer screen can immediately trigger a <a href="https://doi.org/10.1006/nimg.2002.1179">detectable response from the amygdala</a> without the viewer even being aware of this reaction.</p> <figure><iframe src="https://www.youtube.com/embed/xoU9tw6Jgyw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">In response to a looming threat, mammals often fight, flee or freeze.</span></figcaption></figure> <p><a href="https://doi.org/10.1038/npp.2009.83">The hippocampus</a> is near and tightly connected to the amygdala. It’s involved in memorizing what is safe and what is dangerous, especially in relation to the environment – it puts fear in context. For example, seeing an angry lion in the zoo and in the Sahara both trigger a fear response in the amygdala. But the hippocampus steps in and blocks this response when you’re at the zoo because you aren’t in danger.</p> <p>The <a href="https://doi.org/10.1176/appi.ajp.2016.16030353">prefrontal cortex</a>, located above your eyes, is mostly involved in the cognitive and social aspects of fear processing. For example, you might be scared of a snake until you read a sign that the snake is nonpoisonous or the owner tells you it’s their friendly pet.</p> <p>Although the prefrontal cortex is usually seen as the part of the brain that regulates emotions, it can also teach you fear based on your social environment. For example, you might feel neutral about a meeting with your boss but immediately feel nervous when a colleague tells you about rumors of layoffs. Many <a href="https://theconversation.com/trump-the-politics-of-fear-and-racism-how-our-brains-can-be-manipulated-to-tribalism-139811">prejudices like racism</a> are rooted in learning fear through tribalism.</p> <h2>Fear and the rest of the body</h2> <p>If your brain decides that a fear response is justified in a particular situation, it activates a <a href="https://doi.org/10.1093/med/9780190259440.003.0019">cascade of neuronal and hormonal pathways</a> to prepare you for immediate action. Some of the fight-or-flight response – like heightened attention and threat detection – takes place in the brain. But the body is where most of the action happens.</p> <p>Several pathways prepare different body systems for intense physical action. The <a href="https://doi.org/10.3389/fnins.2014.00043">motor cortex</a> of the brain sends rapid signals to your muscles to prepare them for quick and forceful movements. These include muscles in the chest and stomach that help protect vital organs in those areas. That might contribute to a feeling of tightness in your chest and stomach in stressful conditions.</p> <figure><iframe src="https://www.youtube.com/embed/0IDgBlCHVsA?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Your sympathetic nervous system is involved in regulating stress.</span></figcaption></figure> <p>The <a href="https://www.ncbi.nlm.nih.gov/books/NBK542195/">sympathetic nervous system</a> is the gas pedal that speeds up the systems involved in fight or flight. Sympathetic neurons are spread throughout the body and are especially dense in places like the heart, lungs and intestines. These neurons trigger the adrenal gland to release hormones like adrenaline that travel through the blood to reach those organs and increase the rate at which they undergo the fear response.</p> <p>To assure sufficient blood supply to your muscles when they’re in high demand, signals from the sympathetic nervous system increase the rate your heart beats and the force with which it contracts. You feel both increased heart rate and contraction force in your chest, which is why you may connect the feeling of intense emotions to your heart.</p> <p>In your lungs, signals from the sympathetic nervous system dilate airways and often increase your breathing rate and depth. Sometimes this results in a feeling of <a href="https://theconversation.com/pain-and-anxiety-are-linked-to-breathing-in-mouse-brains-suggesting-a-potential-target-to-prevent-opioid-overdose-deaths-174187">shortness of breath</a>.</p> <p>As digestion is the last priority during a fight-or-flight situation, sympathetic activation slows down your gut and reduces blood flow to your stomach to save oxygen and nutrients for more vital organs like the heart and the brain. These changes to your gastrointestinal system can be perceived as the discomfort linked to fear and anxiety.</p> <h2>It all goes back to the brain</h2> <p>All bodily sensations, including those visceral feelings from your chest and stomach, are relayed back to the brain through the pathways <a href="https://www.ncbi.nlm.nih.gov/books/NBK555915/">via the spinal cord</a>. Your already anxious and highly alert brain then processes these signals at both conscious and unconscious levels.</p> <p><a href="https://doi.org/10.1176/appi.ajp.2016.16030353">The insula</a> is a part of the brain specifically involved in conscious awareness of your emotions, pain and bodily sensations. The <a href="https://doi.org/10.1038%2Fs41598-019-52776-4">prefrontal cortex</a> also engages in self-awareness, especially by labeling and naming these physical sensations, like feeling tightness or pain in your stomach, and attributing cognitive value to them, like “this is fine and will go away” or “this is terrible and I am dying.” These physical sensations can sometimes create a loop of increasing anxiety as they make the brain feel more scared of the situation because of the turmoil it senses in the body.</p> <p>Although the feelings of fear and anxiety start in your brain, you also feel them in your body because your brain alters your bodily functions. Emotions take place in both your body and your brain, but you become aware of their existence with your brain. As the rapper Eminem recounted in his song “Lose Yourself,” the reason his palms were sweaty, his knees weak and his arms heavy was because his brain was nervous.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210871/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/arash-javanbakht-416594"><em>Arash Javanbakht</em></a><em>, Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/wayne-state-university-989">Wayne State University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-anxiety-is-in-my-brain-why-is-my-heart-pounding-a-psychiatrist-explains-the-neuroscience-and-physiology-of-fear-210871">original article</a>.</em></p>

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"I fell asleep in the fire escape": Grant Denyer's pain meds confession

<p>Grant Denyer has opened up about the "horrific" time he was on strong pain medication, which at the peak of his reliance, led him to wander off in only his underwear and socks. </p> <p>The former<em> Sunrise</em> presenter recalled the incident on the <em>Jess Rowe Show Podcast</em> and how it left his then-girlfriend Chezzi, with "PTSD" after she spent four hours looking for him in the Sydney CBD.</p> <p>The pair were staying at a hotel in Sydney’s Chinatown when the incident occurred. </p> <p>“I wanted some scotch one night, for whatever reason, and just went wandering around town in my undies, got lost in the fire escape on the way back to the apartment,” he said in the podcast. </p> <p>“I did not know where my apartment was and fell asleep in the fire escape.</p> <p>“It took Chez three or four hours to find me.”</p> <p>In another part of the interview he opened up on the effects of the medication. </p> <p>“When you are under the influence of that kind of power of medication and in that much pain, when you close your eyes at night you go into your worst nightmares immediately and it is every night,” he explained. </p> <p>“So I would come down and think there was a home invasion, I would be crawling down with a broken back to fight off people I thought were there attacking and raping Chez.</p> <p>“This would happen daily.”</p> <p>He added that the pain meds left him in such a daze that whenever he woke up couldn't "differentiate what was real and what wasn’t.”</p> <p>At the time, Denyer had a reliance on both endone and morphine following a monster truck accident in 2008 which left him with a severe spinal injury.  </p> <p>The former <em>Sunrise </em>presenter was training for the Monster Truck Championships at Dapto Showground when the accident occurred, and had only been dating Chezzi for "a couple of weeks", which forced her "straight into carer nurse mode”.</p> <p>Denyer also opened up about the incident on the couple's podcast <em>It’s All True?</em></p> <p>“As soon as you close your eyes you go into your worst nightmares. The things that you are afraid of the most are the first things that happen the moment you fall asleep and you start dreaming.</p> <p>“It is traumatic as every time you sleep and then when you wake up you can’t tell what is real and what isn’t," he said in 2020.</p> <p>Chezzi also explained her side of the story and said that when she found him in the fire exit, he was covered in filth. </p> <p>“It was pretty gross and it broke my heart,” she said.</p> <p>Despite the challenges, the couple's love has prevailed as the pair have been married since 2009 and share three daughters, Sunday, Sailor and Scout.</p> <p><em>Images: Instagram</em></p>

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