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Don’t Run if Your Back Hurts

People with back pain need to exercise as much as everyone else, but running is usually a poor choice of activity. The bones of your spine are located one on top of the other, separated by pads called discs. Bones are much harder than discs, so when spinal bones are compressed and move closer together, they can flatten the discs like pancakes. Since the discs are then shorter, they have to go somewhere else, so they widen and press on the nerves near them, causing pain. This is called a herniated disc. Anything that presses the bones closer together squashes the disc further and usually makes it hurt more. During running, the force of the foot striking the ground is transmitted up the leg to the back, which can compress the discs and cause pain.

The best sports for people with back pain are those that do not hurt when you do them. Riding a bicycle, walking slowly and swimming do not exert a jarring force on the discs to compress them, so these exercises are recommended for people with back pain as long they don’t hurt while they exercise. Doctors often recommend special exercises to flatten the lower back, strengthen the belly muscles and stretch the lower back muscles. The key to exercising when you have a compressed disc is to stop exercising when you feel pain. You may need to try several different activities to find the right one for you.

Anyone with presistent low back pain should check with his or her doctor to rule out a serious cause.

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Dear Dr. Mirkin: Why do we get fevers?

Twenty five years ago, Matthew Kluger showed that cold-blooded animals such as lizards are more likely to die when they are infected if they cannot move to a warm area to raise their body temperatures. More recent studies show that fish in interconnected tanks with different water temperatures, prefer lower water temperature when healthy, and choose a higher temperature when infected. A rise in body temperature after experimental bacterial infection helped to prevent death (Science, Volume 188, 2003).

Fever slows the growth of the bacteria and viruses in your body. Bacteria and viruses release pyrogens that enter your body and are attacked by immune cells called macrophages, which release chemicals called interleukins that raise blood levels of prostaglandins that cause fever. Aspirin inhibits prostaglandins to lower fever, and helps you feel better because it blocks pain and reduces swelling. But taking aspirin or other medications to lower a fever does not cure the disease that caused it.

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Dear Dr. Mirkin: Is there any alternative to the drugs my doctor wants me to take to lower my cholesterol?

Yes. An exciting study reported in the Journal of the American Medical Association (July 23, 2003) shows that a high-plant diet lowers blood levels of the bad LDL cholesterol as much as statin drugs do. Forty-six men and women with high blood cholesterol levels were in the study. Sixteen ate a special vegetarian diet, 16 consumed a standard low-fat diet, and 14 ate the low-fat diet and took 20 milligrams of Mevacor every day for a month. The vegetarian group showed an average drop of 28.6 percent in their LDL cholesterol. Adding the statin drug Mevacor to the high-plant diet did not lower cholesterol any more than the nearly 30 percent reduction achieved with the diet alone. The low fat diet lowered cholesterol by only eight percent. The high-plant diet included eggplant, okra, soy protein, almonds, barley, psyllium, and margarine containing plant sterols. All of these foods have individually been shown to have potentially beneficial effects on cholesterol.

Two important indicators of heart attack risk are blood levels of the bad LDL cholesterol and C-reactive protein (CRP). CRP is a blood marker of inflammation that appears to be even better as a measure of risk for a heart attack than blood cholesterol level. The high-vegetable diet lowered both of these markers as effectively as the popular statin drug, and far more than a standard low-fat diet.

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Three easy, healthful main dish recipes:

Veggie Burger Chili
Quick Moroccan Vegetable Stew
Mediterranean Clams and Beans

More main dishes, salads, soups and desserts . . .

June 27th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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