Everything you need to know about osteoarthritis

Osteoarthritis (OA) causes inflammation in the joints and the breakdown and gradual loss of joint cartilage. As the cartilage wears down, a person experiences pain and difficulty with movement.

OA is a common joint disorder. It develops in the hand, for example, in 1 in 12 people over the age of 60, according to the Arthritis Foundation.

OA is a progressive disease, which means that symptoms worsen over time.

There is no cure, but treatment can help manage pain and swelling and keep a person mobile and active.

Symptoms

OA leads to pain and stiffness in the joints.

In the early stages, a person may have no symptoms. Symptoms may occur in one or more joints, and they tend to appear gradually.

When symptoms develop, they can include:

  • pain and stiffness that worsen after not moving the joint for a while
  • swelling
  • difficulty moving the affected joint
  • warmth and tenderness in the joints
  • a loss of muscle bulk
  • a grating or crackling sound in the joint, known as crepitus

The progression of OA involves:

  • synovitis — mild inflammation of the tissues around the joints
  • damage and loss of cartilage
  • bony growths that form around the edges of joints

Effects

Cartilage is a protective substance that cushions the ends of the bones in the joints and allows the joints to move smoothly and easily.

In people with OA, the smooth surface of the cartilage becomes rough and starts to wear away. As a result, the unprotected bones start to rub together, causing damage and pain.

Eventually, bony lumps form on the joint. The medical names for these are bone spurs or osteophytes, and they can lend a knobbly appearance to the joint.

As the bones change shape, the joints become stiffer, less mobile, and painful. Fluid may also accumulate in the joint, resulting in swelling. While OA can develop in any joint, it commonly affects the knees, hips, hands, lower back, and neck.

The knees

OA usually occurs in both knees, unless it results from an injury or another condition.

A person with the condition may notice that:

  • There is pain when walking, especially uphill or upstairs.
  • The knees lock into position, making it harder to straighten the leg.
  • There is a soft, grating sound when they bend or flex the knee.

The hips

A person with OA in the hips may find that any movement of the hip joint, such as standing up or sitting down, can cause difficulty or discomfort.

Pain in the hips is a common feature of the condition. OA in the hips can also cause pain in the knee or in the thighs and buttocks.

A person may experience this pain while resting as well as while walking, for example.

The hands

In the hands, OA can develop in:

  • the base of the thumb
  • the top joint of the other fingers, closest to the nail
  • the middle joint of the other fingers

A person with the condition may notice:

  • pain, stiffness, and swelling in the fingers
  • bumps that develop on the finger joints
  • a slight bend sideways at the affected joints
  • fluid-filled lumps or cysts on the backs of the fingers, which may be painful
  • a bump that develops where the thumb joins the wrist, which can make it difficult to write or turn a key

For some people, the finger pain decreases and eventually goes away, though the swelling and bumps remain.

Anyone who experiences joint stiffness and swelling for more than 2 weeks should see a doctor.

Causes

Doctors do not know the exact cause of OA, but it seems to develop when the body is unable to repair joint tissue in the usual way.

It often affects older people, but it can occur at any age.

Genetic factors

Some genetic features increase the risk of developing OA. When these features are present, the condition can occur in people as young as 20 years old.

Trauma and overuse

A traumatic injury, surgery, or overuse of a joint can undermine the body’s ability to carry out routine repairs and may trigger OA, eventually leading to symptoms.

It can take several years for OA symptoms to appear after an injury.

Reasons for overuse or repeated injury include jobs and sports that involve repetitive movement.

Risk factors

A number of risk factors increase the chances of developing OA.

  • Sex: OA is more common among females than males, especially after the age of 50.
  • Age: Symptoms are more likely to appear after the age of 40, though OA can develop in younger people after an injury — especially to the knee — or as a result of another joint condition.
  • Obesity: Excess weight can put strain on weight-bearing joints, increasing the risk of damage.
  • Occupation: Jobs that involve repetitive movements in a particular joint increase the risk.
  • Genetic and hereditary factors: These can increase the risk in some people.

Other conditions

Some diseases and conditions make it more likely that a person will develop OA.

  • inflammatory arthritis, such as gout or rheumatoid arthritis
  • Paget’s disease of the bone
  • septic arthritis
  • poor alignment of the knee, hip, and ankle
  • having legs of different lengths
  • some joint and cartilage abnormalities that are present from birth

Diagnosis

A doctor will ask about symptoms and perform a physical examination.

No definitive test can diagnose OA, but tests can show whether damage has occurred and help rule out other causes.

Tests may include:

X-rays and MRI: These can reveal bone spurs around a joint or a narrowing within a joint, suggesting that cartilage is breaking down.

Joint fluid analysis: A doctor will use a sterile needle to withdraw fluid from an inflamed joint for analysis. This can rule out gout or an infection.

Blood tests: These can help rule out other conditions, such as rheumatoid arthritis.

Treatment

While no treatment can reverse the damage of OA, some can help relieve symptoms and maintain mobility in the affected joints.

Interventions include exercise, manual therapy, lifestyle modification, and medication.

Medication

Medication can help reduce pain.

Acetaminophen (Tylenol)

This can relieve pain in people with mild to moderate symptoms. Follow the doctor’s instructions, as overuse can lead to side effects and cause interactions with other medications.

Nonsteroidal anti-inflammatory drugs

If acetaminophen does not help, the doctor may recommend a stronger pain reliever, which may include ibuprofen, aspirin, or diclofenac.

A person can take these orally or topically, applying the medication directly to the skin.

Capsaicin cream

This is a topical medication that contains the active compound in chilies. It creates a sensation of heat that can reduce levels of substance P, a chemical that acts as a pain messenger.

Pain relief can take 2 weeks to a month to fully take effect.

Do not use the cream on broken or inflamed skin, and avoid touching the eyes, face, and genitals after using it.

Intra-articular cortisone injections

Corticosteroid injections in the joint can help manage severe pain, swelling, and inflammation. These are effective, but frequent use can lead to adverse effects, including joint damage and a higher risk of osteoporosis.

Duloxetine (Cymbalta) is an oral drug that can help treat chronic musculoskeletal pain.

Physical therapy

Various types of physical therapy may help, including:

Transcutaneous electrical nerve stimulation (TENS): A TENS unit attaches to the skin with electrodes. Electrical currents then pass from the unit through the skin and overwhelm the nervous system, reducing its ability to transmit pain signals.

Thermotherapy: Heat and cold may help reduce pain and stiffness in the joints. A person could try wrapping a hot water bottle or an ice pack in a towel and placing it on the affected joint.

Manual therapy: This involves a physical therapist using hands-on techniques to help keep the joints flexible and supple.

Assistive devices

Various tools can provide physical support for a person with OA.

Special footwear or insoles can help, if OA affects the knees, hips, or feet, by distributing body weight more evenly. Some shock-absorbing insoles can also reduce the pressure on the joints.

A stick or cane can help take the weight off of the affected joints and may reduce the risk of a fall. A person should use it on side of the body opposite to the areas with OA.

Splints, leg braces, and supportive dressings can help with resting a painful joint. A splint is a piece of rigid material that provides joint or bone support.

Do not use a splint all the time, however, as the muscles can weaken without use.

Surgery

Some people may need surgery if OA severely affects the hips, knees, joints, or the base of the thumbs.

A doctor will usually only recommend surgery if other therapies have not helped or if there is severe damage in a joint.

Some helpful procedures include:

Arthroplasty

This involves a surgeon removing the damaged areas and inserting an artificial joint, made of metal and plastic. Some refer to this procedure as a total joint replacement.

The joints that most often require replacing are the hip and knee joints, but implants can also replace the joints in the shoulder, finger, ankle, and elbow.

Most people can use their new joint actively and painlessly. However, there is a small risk of infection and bleeding. An artificial joint may also come loose or wear down and eventually need replacing.

Arthrodesis

This involves a surgeon realigning, stabilizing, or surgically fixing the joint to encourage the bones to fuse. Increased stability can reduce pain.

A person with a fused ankle joint will be able to put their weight on it painlessly, but they will not be able to flex it.

Osteotomy

This involves a surgeon removing a small section of bone, either above or below the knee joint. It can realign the leg so that the person’s weight no longer bears down as heavily on the damaged part of the joint.

This can help relieve symptoms, but the person may need knee replacement surgery later on.

Complications

Septic arthritis is joint inflammation caused by bacteria. Joint replacement surgery slightly increases the risk of this infection.

This is a medical emergency, and hospitalization is necessary. Treatment involves antibiotic medication and drainage of the infected fluid from the joint.

Lifestyle tips

A range of strategies can help ease the symptoms of OA. Ask the doctor for advice about suitable lifestyle adjustments. They may recommend:

Exercise and weight control

Exercise is crucial for:

  • maintaining mobility and range of movement
  • improving strength and muscle tone
  • preventing weight gain
  • building up muscles
  • reducing stress
  • lowering the risk of other conditions, such as cardiovascular disease

Current guidelines recommend that everyone should do at least 150 minutes of moderate-intensity exercise each week.

A doctor or physical therapist can help develop an exercise program, and it is important to follow their instructions carefully to prevent further damage.

Choose activities that will not put additional strain on the joints. Swimming and other types of water-based exercise are a good way to keep fit without putting additional pressure on the joints.

Assistive devices and adjustments

A loss of mobility due to OA can lead to further problems, such as:

  • an increased risk of falls
  • difficulty carrying out daily tasks
  • stress
  • isolation and depression
  • difficulty working

A physical or occupational therapist can help with these issues. They may recommend:

Assistive devices: Using a walker or cane can help prevent falls.

Adjustments to furniture and home fittings: Higher chairs and devices such as levers that make it easier to turn faucet knobs, for example, can help.

Talking to an employer: It may be possible to make adjustments to the workplace or arrange for more flexible hours.

Supplements

Some research has suggested that people with low vitamin D levels have a higher risk of OA. Also, in people with a low vitamin C intake, the disease may progress more rapidly.

Low levels of vitamin K and selenium may also contribute, but confirming these findings will require further research.

Some people use supplements for OA, including:

  • omega-3 fatty acids
  • calcium
  • vitamin D

The American College of Rheumatology note that there is not enough evidence to support the safety and effectiveness of these supplements for OA. They recommend asking a doctor before using them.

Outlook

OA is a common disease that causes joints to deteriorate, leading to pain and stiffness. It tends to appear during middle age or later.

There is currently no cure, but researchers are looking for ways to slow or reverse the damage. Lifestyle remedies and pain relief medications can help manage it.

15 natural ways to lower your blood pressure

High blood pressure is a dangerous condition that can damage your heart. It affects one in three people in the US and 1 billion people worldwide.

If left uncontrolled, high blood pressure raises your risk of heart disease and stroke.

But there’s good news. There are a number of things you can do to lower your blood pressure naturally, even without medication.

Here are 15 natural ways to combat high blood pressure.

1. Walk and exercise regularly

Exercise is one of the best things you can do to lower high blood pressure. Regular exercise helps make your heart stronger and more efficient at pumping blood, which lowers the pressure in your arteries. In fact, 150 minutes of moderate exercise, such as walking, or 75 minutes of vigorous exercise, such as running, per week, can help lower blood pressure and improve your heart health.

What’s more, doing even more exercise than this reduces your blood pressure even further, according to the National Walkers’ Health Study.

Bottom line: Walking just 30 minutes a day can help lower your blood pressure. More exercise helps reduce it even further.

2. Reduce your sodium intake

Salt intake is high around the world. In large part, this is due to processed and prepared foods.

For this reason, many public health efforts are aimed at lowering salt in the food industry.

Many studies have linked high salt intake with high blood pressure and heart events, including stroke.

However, more recent research indicates that the relationship between sodium and high blood pressure is less clear.

One reason for this may be genetic differences in how people process sodium. About half of people with high blood pressure and a quarter of people with normal levels seem to have a sensitivity to salt.

If you already have high blood pressure, it’s worth cutting back your sodium intake to see if it makes a difference. Swap out processed foods with fresh ones and try seasoning with herbs and spices rather than salt.

Bottom line: Most guidelines for lowering blood pressure recommend reducing sodium intake. However, that recommendation might make the most sense for people who are salt-sensitive.

3. Drink less alcohol

Drinking alcohol can raise blood pressure. In fact, alcohol is linked to 16% of high blood pressure cases around the world.

While some research has suggested that low-to-moderate amounts of alcohol may protect the heart, those benefits may be offset by adverse effects.

In the U.S., moderate alcohol consumption is defined as no more than one drink a day for women and two for men. If you drink more than that, cut back.

Bottom line: Drinking alcohol in any quantity may raise your blood pressure. Limit your drinking in line with the recommendations.

4. Eat more potassium-rich foods

Potassium is an important mineral.

It helps your body get rid of sodium and eases pressure on your blood vessels.

Modern diets have increased most people’s sodium intake while decreasing potassium intake.

To get a better balance of potassium to sodium in your diet, focus on eating fewer processed foods and more fresh, whole foods.

Foods that are particularly high in potassium include:

  • vegetables, especially leafy greens, tomatoes, potatoes, and sweet potatoes
  • fruit, including melons, bananas, avocados, oranges, and apricots
  • dairy, such as milk and yogurt
  • tuna and salmon
  • nuts and seeds
  • beans

Bottom line: Eating fresh fruits and vegetables, which are rich in potassium, can help lower blood pressure.

5. Cut back on caffeine

If you’ve ever downed a cup of coffee before you’ve had your blood pressure taken, you’ll know that caffeine causes an instant boost.

However, there’s not a lot of evidence to suggest that drinking caffeine regularly can cause a lasting increase.

In fact, people who drink caffeinated coffee and tea tend to have a lower risk of heart disease, including high blood pressure, than those who don’t drink it.

Caffeine may have a stronger effect on people who don’t consume it regularly.

If you suspect you’re caffeine-sensitive, cut back to see if it lowers your blood pressure.

Bottom line: Caffeine can cause a short-term spike in blood pressure, although for many people, it does not cause a lasting increase.

6. Learn to manage stress

Stress is a key driver of high blood pressure.

When you’re chronically stressed, your body is in a constant fight-or-flight mode. On a physical level, that means a faster heart rate and constricted blood vessels.

When you experience stress, you might also be more likely to engage in other behaviors, such as drinking alcohol or eating unhealthful food that can adversely affect blood pressure.

Several studies have explored how reducing stress can help lower blood pressure. Here are two evidence-based tips to try:

  • Listen to soothing music: Calming music can help relax your nervous system. Research has shown it’s an effective complement to other blood pressure therapies.
  • Work less: Working a lot, and stressful work situations, in general, are linked to high blood pressure.

Bottom line: Chronic stress can contribute to high blood pressure. Finding ways to manage stress can help.

7. Eat dark chocolate or cocoa

Here’s a piece of advice you can really get behind.

While eating massive amounts of dark chocolate probably won’t help your heart, small amounts may.

That’s because dark chocolate and cocoa powder are rich in flavonoids, which are plant compounds that cause blood vessels to dilate.

A review of studies found that flavonoid-rich cocoa improved several markers of heart health over the short term, including lowering blood pressure.

For the strongest effects, use non-alkalized cocoa powder, which is especially high in flavonoids and has no added sugars.

Bottom line: Dark chocolate and cocoa powder contain plant compounds that help relax blood vessels, lowering blood pressure.

8. Lose weight

In people with overweight, losing weight can make a big difference to heart health.

According to a 2016 study, losing 5% of your body mass could significantly lower high blood pressure .

In previous studies, losing 17.64 pounds (8 kilograms) was linked to lowering systolic blood pressure by 8.5 mm Hg and diastolic blood pressure by 6.5 mm Hg.

To put that in perspective, a healthy reading should be less than 120/80 mm Hg.

The effect is even greater when weight loss is paired with exercise.

Losing weight can help your blood vessels do a better job of expanding and contracting, making it easier for the left ventricle of the heart to pump blood.

Bottom line: Losing weight can significantly lower high blood pressure. This effect is even more significant when you exercise.

9. Quit smoking

Among the many reasons to quit smoking is that the habit is a strong risk factor for heart disease.

Every puff of cigarette smoke causes a slight, temporary increase in blood pressure. The chemicals in tobacco are also known to damage blood vessels.

Surprisingly, studies haven’t found a conclusive link between smoking and high blood pressure. Perhaps this is because smokers develop a tolerance over time.

Still, since both smoking and high blood pressure raise the risk of heart disease, quitting smoking can help lessen that risk.

Bottom line: There’s conflicting research about smoking and high blood pressure, but what is clear is that both increase the risk of heart disease.

10. Cut added sugar and refined carbs

There’s a growing body of research showing a link between added sugar and high blood pressure.

In the Framingham Women’s Health Study, women who drank even one soda per day had higher levels than those who drank less than one soda per day.

Another study found that having one less sugar-sweetened beverage per day was linked to lower blood pressure .

And it’s not just sugar — all refined carbs, such as the kind found in white flour — convert rapidly to sugar in your bloodstream and may cause problems.

Some studies have shown that low carb diets may also help reduce blood pressure.

One study on people undergoing statin therapy found that those who went on a 6-week, carb-restricted diet saw a greater improvement in blood pressure and other heart disease markers than people who did not restrict carbs .

Bottom line: Refined carbs, especially sugar, may raise blood pressure. Some studies have shown that low carb diets may help reduce your levels.

11. Eat berries

Berries are full of more than just juicy flavor.

They’re also packed with polyphenols, natural plant compounds that are good for your heart.

Polyphenols can reduce the risk of stroke, heart conditions, and diabetes, as well as improving blood pressure, insulin resistance, and systemic inflammation.

One study assigned people with high blood pressure to a low-polyphenol diet or a high-polyphenol diet containing berries, chocolate, fruits, and vegetables.

Those consuming berries and polyphenol-rich foods experienced improved markers of heart disease risk.

Bottom line: Berries are rich in polyphenols, which can help lower blood pressure and the overall risk of heart disease.

12. Try meditation or deep breathing

While these two behaviors could also fall under “stress reduction techniques,” meditation and deep breathing deserve specific mention.

Both meditation and deep breathing may activate the parasympathetic nervous system. This system is engaged when the body relaxes, slowing the heart rate, and lowering blood pressure.

There’s quite a bit of research in this area, with studies showing that different styles of meditation appear to have benefits for lowering blood pressure.

Deep breathing techniques can also be quite effective.

In one study, participants were asked to either take six deep breaths over the course of 30 seconds or simply sit still for 30 seconds. Those who took breaths lowered their blood pressure more than those who just sat.

Try guided meditation or deep breathing. Here’s a video to get you started.

Bottom line: Both meditation and deep breathing can activate the parasympathetic nervous system, which helps slow your heart rate and lower blood pressure.

13. Eat calcium-rich foods

People with low calcium intake often have high blood pressure.

While calcium supplements haven’t been conclusively shown to lower blood pressure, calcium-rich diets do seem linked to healthful levels.

For most adults, the calcium recommendation is 1,000 milligrams (mg) per day. For women over 50 and men over 70, it’s 1,200 mg per day.

In addition to dairy, you can get calcium from collard greens and other leafy greens, beans, sardines, and tofu. Here is a list of calcium-rich plant-based foods.

Bottom line: Calcium-rich diets are linked to healthy blood pressure levels. You can get calcium through eating dark leafy greens and tofu, as well as dairy.

14. Take natural supplements

Some natural supplements may also help lower blood pressure. Here are some of the main supplements that have evidence behind them:

  • Aged garlic extract: Researchers have used aged garlic extract successfully as a stand-alone treatment and along with conventional therapies for lowering blood pressure.
  • Berberine: Traditionally used in Ayurvedic and Chinese medicine, berberine may increase nitric oxide production, which helps decrease blood pressure.
  • Whey protein: A 2016 study found that whey protein improved blood pressure and blood vessel function in 38 participants.
  • Fish oil: Long credited with improving heart health, fish oil may benefit people with high blood pressure the most.
  • Hibiscus: Hibiscus flowers make a tasty tea. They’re rich in anthocyanins and polyphenols that are good for your heart and may lower blood pressure.

Bottom line: Researchers have investigated several natural supplements for their ability to lower blood pressure.

15. Eat foods rich in magnesium

Magnesium is an important mineral that helps blood vessels relax.

While magnesium deficiency is pretty rare, many people don’t get enough.

Some studies have suggested that getting too little magnesium is linked with high blood pressure, but evidence from clinical studies has been less clear.

Still, eating a magnesium-rich diet is a recommended way to ward off high blood pressure.

You can incorporate magnesium into your diet by consuming vegetables, dairy products, legumes, chicken, meat, and whole grains.

Bottom line: Magnesium is an essential mineral that helps regulate blood pressure. Find it in whole foods, such as legumes and whole grains.

Take home message

High blood pressure affects a large proportion of the world’s population.

While drugs are one way to treat the condition, there are many other natural techniques, including eating certain foods that can help.

BACK PAIN

Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and debilitating.

It can result from injury, activity and some medical conditions. Back pain can affect people of any age, for different reasons. As people get older, the chance of developing

lower back pain increases, due to factors such as previous occupation and degenerative disk disease.

Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area.

Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

Causes

Problems with the spine such as osteoporosis can lead to back pain.

The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around.

The segments of the spine are cushioned with cartilage-like pads called disks.

Problems with any of these components can lead to back pain. In some cases of back pain, its cause remains unclear.

Damage can result from strain, medical conditions, and poor posture, among others.

Strain

Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are:

  • strained muscles or ligaments
  • a muscle spasm
  • muscle tension
  • damaged disks
  • injuries, fractures, or falls

Activities that can lead to strains or spasms include:

  • lifting something improperly
  • lifting something that is too heavy
  • making an abrupt and awkward movement

Structural problems

A number of structural problems may also result in back pain.

  • Ruptured disks: Each vertebra in the spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
  • Bulging disks: In much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
  • Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.
  • Arthritis: Osteoarthritis can cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows. This is known as spinal stenosis.
  • Abnormal curvature of the spine: If the spine curves in an unusual way, back pain can result. An example is scoliosis, in which the spine curves to the side.
  • Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
  • Kidney problems: Kidney stones or kidney infection can cause back pain.

Movement and posture

Adopting a very hunched sitting position when using computers can result in increased back and shoulder problems over time.

Back pain can also result from some everyday activities or poor posture.

Examples include:

  • twisting
  • coughing or sneezing
  • muscle tension
  • over-stretching
  • bending awkwardly or for long periods
  • pushing, pulling, lifting, or carrying something
  • standing or sitting for long periods
  • straining the neck forward, such as when driving or using a computer
  • long driving sessions without a break, even when not hunched
  • sleeping on a mattress that does not support the body and keep the spine straight

Other causes

Some medical conditions can lead to back pain.

  • Cauda equina syndrome: The cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes bowel and bladder function disturbances.
  • Cancer of the spine: A tumor on the spine may press against a nerve, resulting in back pain.
  • Infection of the spine: A fever and a tender, warm area on the back could be due to an infection of the spine.
  • Other infections: Pelvic inflammatory disease, bladder, or kidney infections may also lead to back pain.
  • Sleep disorders: Individuals with sleep disorders are more likely to experience back pain, compared with others.
  • Shingles: An infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.

Risk factors

The following factors are linked to a higher risk of developing low back pain:

  • occupational activities
  • pregnancy
  • a sedentary lifestyle
  • poor physical fitness
  • older age
  • obesity and excess weight
  • smoking
  • strenuous physical exercise or work, especially if done incorrectly
  • genetic factors
  • medical conditions, such as arthritis and cancer

Lower back pain also tends to be more common in women than in men, possibly due to hormonal factors. Stress, anxiety, and mood disorders have also been linked to back pain.

Symptoms

The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way down to the buttocks and legs.

Some back issues can cause pain in other parts of the body, depending on the nerves affected.

The pain often goes away without treatment, but if it occurs with any of the following people should see their doctor:

  • weight loss
  • fever
  • inflammation or swelling on the back
  • persistent back pain, where lying down or resting does not help
  • pain down the legs
  • pain that reaches below the knees
  • a recent injury, blow or trauma to the back
  • urinary incontinence
  • difficulty urinating
  • fecal incontinence, or loss of control over bowel movements
  • numbness around the genitals
  • numbness around the anus
  • numbness around the buttocks

When to see a doctor

You should seek medical help if you experience any numbness or tingling, or if you have back pain:

  • that does not improve with rest
  • after an injury or fall
  • with numbness in the legs
  • with weakness
  • with fever
  • with unexplained weight loss

Diagnosis

A doctor will usually be able to diagnose back pain after asking about symptoms and carrying out a physical examination.

An imaging scan and other tests may be required if:

  • back pain appears to result from an injury
  • there may be underlying cause that needs treatment
  • the pain persists over a long period

An X-ray, MRI, or CT scan can give information about the state of the soft tissues in the back.

  • X-rays can show the alignment of the bones and detect signs of arthritis or broken bones, but they may not reveal damage in the muscles, spinal cord, nerves, or disks.
  • MRI or CT scans can reveal herniated disks or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles, and bones.
  • Bone scans can detect bone tumors or compression fractures caused by osteoporosis. A radioactive substance or tracer is injected into a vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera.
  • Electromyography or EMG measures the electrical impulses produced by nerves in response to muscles. This can confirm nerve compression, which may occur with a herniated disk or spinal stenosis.

The doctor may also order a blood test if infection is suspected.

Other types of diagnosis

  • A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
  • An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
  • A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.

Chronic or acute pain?

Back pain is categorized into two types:

  • Acute pain starts suddenly and lasts for up to 6 weeks.
  • Chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.

If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.

What to know about ADHD

A person with untreated attention deficit hyperactivity disorder (ADHD) has difficulty maintaining attention, managing energy levels, and controlling impulses.

In the United States, around 8.4% of children and 2.5% of adults have ADHD. In some children, ADHD characteristics begin as early as 3 years of age.

Ways of treating ADHD include medication, behavioral management techniques, and other practical strategies.

Below, we explore what ADHD is, how it affects a person, and which treatments can help.

What is ADHD?

People with ADHD have difficulty focusing on tasks and controlling their attention, which can make completing a project, for example, challenging. ADHD can limit a person’s ability to study or work, and it can lead to stress, anxiety, and depression.

Some people with ADHD also find it hard to sit still. They may be quick to act on impulse and become easily distracted. 

While children of any age can experience distraction and impulsiveness, these traits are more noticeable in those with ADHD.

Features

ADHD may develop in one of three ways. A doctor may find that the disorder has:

  • a predominantly hyperactive and impulsive presentation
  • a predominantly inattentive presentation
  • a combined presentation

People with ADHD experience hyperactivity, impulsivity, and inattention in varying degrees.

Inattention

Below are some behaviors related to inattention that a person might notice in someone with ADHD:

  • daydreaming
  • becoming distracted and having difficulty focusing on tasks
  • making “careless” mistakes
  • appearing to not listen while others are talking
  • having difficulty with time management and organization
  • frequently losing everyday items
  • avoiding tasks that need prolonged focus and thought
  • having difficulty following instructions

Hyperactivity and impulsivity

Some or all of the following may be apparent in someone with ADHD:

  • seeming constantly “on-the-go” and unable to sit still
  • running or climbing at inappropriate times
  • having difficulty taking turns in conversations and activities
  • fidgeting or tapping the hands or feet
  • talking and making noises excessively
  • taking unnecessary risks

In adults

Adults and children tend to experience the same symptoms of ADHD, and these can create difficulties in relationships and at work.

The effects of these features vary widely from person to person, and a person may find that their experience of ADHD changes over time.

Not everyone with ADHD is noisy and disruptive. A child may be quiet in class, for example, while facing severe challenges that they do not express.

In females

Females with ADHD may be more likely to have difficulty paying attention, while males may be more likely to experience hyperactivity and impulsivity.

This may be one reason why more males than females receive diagnoses of ADHD. Hyperactivity can be easier to spot than inattention.

Diagnosis

Most children with ADHD receive a diagnosis while they are in elementary school, but some may not do so until adolescence or adulthood.

No single test can identify ADHD, and the symptoms can overlap with those of other conditions. This can make it difficult to diagnose.

A doctor will conduct examinations to rule out other potential causes, such as hearing or vision problems.

Other conditions that can lead to similar behaviors include:

  • trouble hearing or seeing
  • anxiety
  • depression
  • learning disabilities
  • sleep disorders

A doctor will often ask questions to learn more about the person’s behavioral patterns. They may speak with the individual, members of their family, and any other caregivers, such as teachers.

Many children experience hyperactivity and inattention. For a diagnosis of ADHD, the symptoms must meet specific criteria, including having a significant impact on daily life and schoolwork.

Medical myths: Vegetarian and vegan diets

Following a plant-based diet is becoming increasingly popular. While this is widely regarded as a healthful choice, many myths abound. In this edition of Medical Myths, we dig into the details.

Until fairly recently, vegetarianism was generally considered a fringe lifestyle choice in the United States, and veganism even more so. Anything on the fringes of society tends to inadvertently encourage myths and misconceptions.

Also, deciding to avoid animal products sparks rage in some people. This anger manifests for a range of reasons, which are beyond the scope of this article. Suffice it to say that if a sizable group of the population is against something, conditions are ripe for myths and half-truths.

1. Plant-based diets are always healthful

In recent decades, an increasing number of studies have demonstrated links between red meat consumption and poorer health outcomes. For instance, processed and red meat intake is associated with colon cancer, obesity, heart disease, and diabetes.

This might suggest that a diet without meat is better for the body. But, just as not all meat is red, not all vegetarian or vegan diets are healthful.

To use an extreme example, if an individual only ate potato chips, they would be vegan, but certainly not brimming with vitality, energy, and health.

As with any other diet, it depends entirely on what an individual consumes.

Additionally, lean white meat and fish are not associated with the same health issues as processed and red meats.

And certain meat substitute products can be high in salt.

2. Vegetarianism guarantees weight loss

Sadly, no. As the section above makes clear, not all vegetarian and vegan diets are equally healthful. It is incredibly easy to consume thousands of calories each day without any of them being associated with animals.

The key to weight loss is a healthful diet and regular exercise, and neither requires the avoidance of animal products.

It is still worth noting, though, the evidence that following a plant-based diet is associated with weight loss. For instance, a review published in Translational Psychiatry

explains:

“We found robust evidence for short- to moderate-term beneficial effects of plant-based diets versus conventional diets on weight status, energy metabolism, and systemic inflammation.”

This finding held true for healthy participants, people with obesity, and individuals with type 2 diabetes.

To give another example, another review, published in BMJ Open Diabetes Research and Care, looked at the impact of plant-based diets on people with diabetes. Among other benefits, the authors found that these diets were associated with a “significant improvement” in weight.

3. Vegetarians and vegans cannot get enough protein

This is perhaps the most common of all the myths that we cover today. But it is still a myth. In the world of food, protein abounds.

For people who eat them, dairy products and eggs are high in protein. Vegans also have an array of options, including seitan, tofu, lentils, chickpeas, many types of bean, spelt, spirulina, quinoa, oats, wild rice, seeds, and nuts.

Even some vegetables contain protein, including spinach, asparagus, broccoli, artichokes, potatoes, peas, brussels sprouts, and sweet potatoes.

4. You can’t build muscle without meat

This myth follows on from the protein myth above. In short, the most important nutrient for building muscle is protein, which can easily be found in abundance beyond the animal kingdom.

5. Dairy is essential for strong bones

Dairy is not essential for strong bones, but calcium is. In fact, calcium is important for a number of bodily functions, including maintaining blood pressure, muscle contraction, transmitting signals along nerves, and blood clotting.

Vegans, therefore, need to ensure that they take in enough calcium from plant-based sources. 

As with protein, there are plenty of places to pick up calcium, including soy-based foods, beans, lentils, peas, spinach, turnips, figs, flax, chia, sesame seeds, seaweed, and some nuts — almonds, in particular.

6. You cannot get B12 from a vegetarian diet

This is a myth. While vegans often take B12 supplements to ensure that they have adequate levels, vegetarians have a wealth of other options.

Vegetarians can derive B12 from eggs and milk products, including cheese.

Meanwhile, a range of vegan-friendly foods are fortified with B12, including some cereals, tofu, nondairy milks, and spreads.

B12: An interesting aside

Cows need B12, too, and they rely on gut bacteria to produce it.

To produce B12, gut bacteria need cobalt, which a cow normally derives from grazing. However, many cows destined to become meat only spend the beginning of their lives in pasture before being brought inside where they are fed on grain.

Because of this unnatural diet, their gut bacteria are starved of cobalt and cannot produce B12.

But the cow still needs B12 to thrive, so farmers must provide them with either cobalt or B12 supplements.

So even a staunch, dyed-in-the-wool red meat fanatic is likely to derive their B12 from supplements — but in their case, it’s via a cow.

7. Soy increases the risk of breast cancer

As it stands, there is no convincing evidence that eating soy-based foods increases the risk of breast cancer in humans.

This misunderstanding might stem from earlier studies in rodents. Scientists showed that when these animals received large amounts of soy compounds called isoflavones, they were more likely to develop breast cancer. However, humans process soy differently from rodents.

A study published in February 2020 searched for associations between soy, dairy intake, and breast cancer risk. The scientists had followed 52,795 cancer-free women in the U.S. for an average of 7.9 years.

They found no clear association between soy intake and breast cancer, but they did identify a link between dairy milk and breast cancer.

However, the full picture is, perhaps, slightly more complex. Some women use soy-based supplements as a natural alternative to hormone therapy during menopause. One large study investigated whether these supplements might be associated with breast cancer risk.

The researchers found “no association between past use of soy supplements and breast cancer.” But, they also found that taking soy supplements, for some women, might increase the risk of breast cancer, particularly for those with a family history.

Overall, as the American Cancer Society explain:

“The evidence does not point to any dangers from eating soy in people, and the health benefits appear to outweigh any potential risk. In fact, there is growing evidence that eating traditional soy foods may lower the risk of breast cancer, especially among Asian women.”

8. Pregnant people need meat and dairy

During pregnancy, it is important to take in all the nutrients that a growing baby needs. But, as we have seen along the way, plant-based foods can provide the vast majority of them.

Someone who is vegetarian or vegan may need to do a little extra planning to be sure that have enough nutrients, especially at the beginning of pregnancy. 

As we mentioned above, it is important to ensure an adequate intake of vitamin B12, through supplements or fortified foods, and this is especially true during pregnancy and breastfeeding. The American Dietetic Association recommend vitamin B12 supplementation throughout pregnancy and breastfeeding for people with vegan or vegetarian diets.

As the authors of a review of research about plant-based diets during pregnancy explain, “The available evidence shows that well-planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients.”

Excited cheerful young couple cooking healthy salad while sitting at the kitchen

DIABETES

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed.

How can I prevent or delay getting type 2 diabetes?

If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are:

  • Losing weight and keeping it off. Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10% of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don’t gain it back.
  • Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It’s also a good idea to limit red meat, and avoid processed meats.
  • Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal.
  • Don’t smoke. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit.
  • Talk to your health care provider to see whether there is anything else you can do to delay or to prevent type 2 diabetes. If you are at high risk, your provider may suggest that you take one of a few types of diabetes medicines.

SEXUAL HEALTH BASIC

SEXUAL HEALTH

Sexuality is part of being human. Love, affection and intimacy all play a role in healthy relationships from childhood through old age.

You often hear about the importance of physical, mental and spiritual health, but feeling confident about your sexuality also is important. Achieving sexual health allows for:

  • Healthy relationships
  • Planned pregnancies
  • Disease prevention

It’s essential to be well-informed about all aspects of sexual health and what it takes to have a fulfilling sex life. Similarly, it’s important to be aware of factors that can complicate your sexual health. Don’t let embarrassment keep you from bringing up concerns or asking questions of your doctor or other health care providers.

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections usually acquired though unprotected sexual contact with someone who’s infected.

But, you can’t always tell if someone is infected, because many STIs cause no symptoms. In fact, many people who have an STI don’t know it.

That’s why you have to be vigilant about STI prevention. Barrier methods of birth control, such as condoms, also help reduce your risk of getting most STIs. If you’re sexually active, having just one partner who agrees to remain sexually exclusive with you can also help prevent STIs.

Woman’s Sexual Health

Sexual health is important for a woman’s well-being, whether you’re trying to prevent pregnancy and sexually transmitted infections or you’re worried about low sex drive, painful intercourse or other problems related to women’s sexual health.

Learn how to achieve a fulfilling sexual relationship, and know how to protect yourself from sexually transmitted infections. As you get older, understand common changes in women’s sexual health — and how to maintain a healthy and enjoyable sex life at any age.

Men’s sexual Health

Sexual health is important for a man’s well-being, whether you’re trying to prevent pregnancy and sexually transmitted infections or you’re worried about erectile dysfunction or other problems related to men’s sexual health.

For some men, worries about penis size top the list of their sexual health concerns. However, you’re probably more normal than you think — and penis-enlargement products and procedures aren’t likely to be effective and may have risks.

As you get older, understand common changes in men’s sexual health — and how to maintain a healthy and enjoyable sex life at any age.

Sex and Aging

Adults can remain sexually active regardless of their age. In fact, many older adults desire and enjoy an active sex life.

An ongoing interest in sex, as well as satisfaction with the frequency and quality of sexual activity, is positively associated with health in later life. Of course, there are some challenges when it comes to sex and aging. Physical changes, illness, disabilities and some medicines can make sex challenging or difficult to enjoy.

There are many resources available to older adults to help them achieve a satisfying sex life. Don’t be afraid to bring up concerns with your doctor or other health care provider. And remember, whatever your age, take precautions to protect yourself from sexually transmitted infections.

Talking to kids about SEX

Kids and sexuality — those words strike fear into the hearts of many parents. But talking to kids about sex is an important part of parenting. Children and teens get a lot of information from peers and media sources, so they need your guidance to help them make healthy and appropriate decisions about their sexual behavior.

When it comes to talking to kids about sex, there’s no standard script. Your decision to educate your children about sexuality will likely be based on the child’s maturity, as well as your personal goals and values.

Look for everyday opportunities and let your child set the pace with his or her questions. As your child matures, you can provide more-detailed responses.

It’s normal to feel uncomfortable when talking to kids about sex. But by providing accurate and open communication, you increase the odds that your child will understand your values and make appropriate choices about sex.

15 natural ways to lower your blood pressure

High blood pressure is a dangerous condition that can damage your heart. It affects one in three people in the US and 1 billion people worldwide 

If left uncontrolled, high blood pressure raises your risk of heart disease and stroke.

But there’s good news. There are a number of things you can do to lower your blood pressure naturally, even without medication.

Here are 15 natural ways to combat high blood pressure.

1. Walk and exercise regularly

Exercise is one of the best things you can do to lower high blood pressure.

Regular exercise helps make your heart stronger and more efficient at pumping blood, which lowers the pressure in your arteries.

In fact, 150 minutes of moderate exercise, such as walking, or 75 minutes of vigorous exercise, such as running, per week, can help lower blood pressure and improve your heart health. 

Walking just 30 minutes a day can help lower your blood pressure. More exercise helps reduce it even further.

2. Reduce your sodium intake

Salt intake is high around the world. In large part, this is due to processed and prepared foods. For this reason, many public health efforts are aimed at lowering salt in the food industry. Many studies have linked high salt intake with high blood pressure and heart events, including stroke.

However, more recent research indicates that the relationship between sodium and high blood pressure is less clear.

One reason for this may be genetic differences in how people process sodium. About half of people with high blood pressure and a quarter of people with normal levels seem to have a sensitivity to salt.

If you already have high blood pressure, it’s worth cutting back your sodium intake to see if it makes a difference. Swap out processed foods with fresh ones and try seasoning with herbs and spices rather than salt.

Most guidelines for lowering blood pressure recommend reducing sodium intake. However, that recommendation might make the most sense for people who are salt-sensitive.

3. Drink less alcohol

Drinking alcohol can raise blood pressure. In fact, alcohol is linked to 16% of high blood pressure cases around the world. While some research has suggested that low-to-moderate amounts of alcohol may protect the heart, those benefits may be offset by adverse effects. In the U.S., moderate alcohol consumption is defined as no more than one drink a day for women and two for men. If you drink more than that, cut back.

Bottom line: Drinking alcohol in any quantity may raise your blood pressure. Limit your drinking in line with the recommendations.

4. Eat more potassium-rich foods

Potassium is an important mineral. It helps your body get rid of sodium and eases pressure on your blood vessels. Modern diets have increased most people’s sodium intake while decreasing potassium intake.

To get a better balance of potassium to sodium in your diet, focus on eating fewer processed foods and more fresh, whole foods.

Foods that are particularly high in potassium include:

  • vegetables, especially leafy greens, tomatoes, potatoes, and sweet potatoes
  • fruit, including melons, bananas, avocados, oranges, and apricots
  • dairy, such as milk and yogurt
  • tuna and salmon
  • nuts and seeds
  • beans

Eating fresh fruits and vegetables, which are rich in potassium, can help lower blood pressure.

5. Cut back on caffeine

If you’ve ever downed a cup of coffee before you’ve had your blood pressure taken, you’ll know that caffeine causes an instant boost.

However, there’s not a lot of evidence to suggest that drinking caffeine regularly can cause a lasting increase. In fact, people who drink caffeinated coffee and tea tend to have a lower risk of heart disease, including high blood pressure, than those who don’t drink it. Caffeine may have a stronger effect on people who don’t consume it regularly.

If you suspect you’re caffeine-sensitive, cut back to see if it lowers your blood pressure.

Caffeine can cause a short-term spike in blood pressure, although for many people, it does not cause a lasting increase.

6. Learn to manage stress

Stress is a key driver of high blood pressure.

When you’re chronically stressed, your body is in a constant fight-or-flight mode. On a physical level, that means a faster heart rate and constricted blood vessels.

When you experience stress, you might also be more likely to engage in other behaviors, such as drinking alcohol or eating unhealthful food that can adversely affect blood pressure.

Several studies have explored how reducing stress can help lower blood pressure. Here are two evidence-based tips to try:

  • Listen to soothing music: Calming music can help relax your nervous system. Research has shown it’s an effective complement to other blood pressure therapies.
  • Work less: Working a lot, and stressful work situations, in general, are linked to high blood pressure.

Chronic stress can contribute to high blood pressure. Finding ways to manage stress can help.

7. Eat dark chocolate or cocoa

Here’s a piece of advice you can really get behind.

While eating massive amounts of dark chocolate probably won’t help your heart, small amounts may. That’s because dark chocolate and cocoa powder are rich in flavonoids, which are plant compounds that cause blood vessels to dilate.

A review of studies found that flavonoid-rich cocoa improved several markers of heart health over the short term, including lowering blood pressure.

For the strongest effects, use non-alkalized cocoa powder, which is especially high in flavonoids and has no added sugars.

Dark chocolate and cocoa powder contain plant compounds that help relax blood vessels, lowering blood pressure.

8. Lose weight

In people with overweight, losing weight can make a big difference to heart health.

According to a 2016 study, losing 5% of your body mass could significantly lower high blood pressure.

In previous studies, losing 17.64 pounds (8 kilograms) was linked to lowering systolic blood pressure by 8.5 mm Hg and diastolic blood pressure by 6.5 mm Hg.

To put that in perspective, a healthy reading should be less than 120/80 mm Hg.

The effect is even greater when weight loss is paired with exercise.

Losing weight can help your blood vessels do a better job of expanding and contracting, making it easier for the left ventricle of the heart to pump blood.

Losing weight can significantly lower high blood pressure. This effect is even more significant when you exercise.

9. Quit smoking

Among the many reasons to quit smoking is that the habit is a strong risk factor for heart disease. Every puff of cigarette smoke causes a slight, temporary increase in blood pressure. The chemicals in tobacco are also known to damage blood vessels.

Surprisingly, studies haven’t found a conclusive link between smoking and high blood pressure. Perhaps this is because smokers develop a tolerance over time.

Still, since both smoking and high blood pressure raise the risk of heart disease, quitting smoking can help lessen that risk.

There’s conflicting research about smoking and high blood pressure, but what is clear is that both increase the risk of heart disease.

10. Cut added sugar and refined carbs

There’s a growing body of research showing a link between added sugar and high blood pressure. In the Framingham Women’s Health Study, women who drank even one soda per day had higher levels than those who drank less than one soda per day.

Another study found that having one less sugar-sweetened beverage per day was linked to lower blood pressure.

And it’s not just sugar — all refined carbs, such as the kind found in white flour — convert rapidly to sugar in your bloodstream and may cause problems.

Some studies have shown that low carb diets may also help reduce blood pressure.

One study on people undergoing statin therapy found that those who went on a 6-week, carb-restricted diet saw a greater improvement in blood pressure and other heart disease markers than people who did not restrict carbs.

Refined carbs, especially sugar, may raise blood pressure. Some studies have shown that low carb diets may help reduce your levels.

11. Eat berries

Berries are full of more than just juicy flavor.

They’re also packed with polyphenols, natural plant compounds that are good for your heart. Polyphenols can reduce the risk of stroke, heart conditions, and diabetes, as well as improving blood pressure, insulin resistance, and systemic inflammation.

One study assigned people with high blood pressure to a low-polyphenol diet or a high-polyphenol diet containing berries, chocolate, fruits, and vegetables.

Those consuming berries and polyphenol-rich foods experienced improved markers of heart disease risk.

Berries are rich in polyphenols, which can help lower blood pressure and the overall risk of heart disease.

12. Try meditation or deep breathing

While these two behaviors could also fall under “stress reduction techniques,” meditation and deep breathing deserve specific mention. Both meditation and deep breathing may activate the parasympathetic nervous system. This system is engaged when the body relaxes, slowing the heart rate, and lowering blood pressure. There’s quite a bit of research in this area, with studies showing that different styles of meditation appear to have benefits for lowering blood pressure.

Deep breathing techniques can also be quite effective.

In one study, participants were asked to either take six deep breaths over the course of 30 seconds or simply sit still for 30 seconds. Those who took breaths lowered their blood pressure more than those who just sat.

Try guided meditation or deep breathing. Here’s a video to get you started.

Bottom line: Both meditation and deep breathing can activate the parasympathetic nervous system, which helps slow your heart rate and lower blood pressure.

13. Eat calcium-rich foods

People with low calcium intake often have high blood pressure.

While calcium supplements haven’t been conclusively shown to lower blood pressure, calcium-rich diets do seem linked to healthful levels.

For most adults, the calcium recommendation is 1,000 milligrams (mg) per day. For women over 50 and men over 70, it’s 1,200 mg per day.

In addition to dairy, you can get calcium from collard greens and other leafy greens, beans, sardines, and tofu. 

Calcium-rich diets are linked to healthy blood pressure levels. You can get calcium through eating dark leafy greens and tofu, as well as dairy.

14. Take natural supplements

Some natural supplements may also help lower blood pressure. Here are some of the main supplements that have evidence behind them:

  • Aged garlic extract: Researchers have used aged garlic extract successfully as a stand-alone treatment and along with conventional therapies for lowering blood pressure.
  • Berberine: Traditionally used in Ayurvedic and Chinese medicine, berberine may increase nitric oxide production, which helps decrease blood pressure.
  • Whey protein: A 2016 study found that whey protein improved blood pressure and blood vessel function in 38 participants.
  • Fish oil: Long credited with improving heart health, fish oil may benefit people with high blood pressure the most.
  • Hibiscus: Hibiscus flowers make a tasty tea. They’re rich in anthocyanins and polyphenols that are good for your heart and may lower blood pressure.

Researchers have investigated several natural supplements for their ability to lower blood pressure.

15. Eat foods rich in magnesium

Magnesium is an important mineral that helps blood vessels relax.

While magnesium deficiency is pretty rare, many people don’t get enough.

Some studies have suggested that getting too little magnesium is linked with high blood pressure, but evidence from clinical studies has been less clear.

Still, eating a magnesium-rich diet is a recommended way to ward off high blood pressure.

You can incorporate magnesium into your diet by consuming vegetables, dairy products, legumes, chicken, meat, and whole grains.

Magnesium is an essential mineral that helps regulate blood pressure. Find it in whole foods, such as legumes and whole grains.

Take home message

High blood pressure affects a large proportion of the world’s population.

While drugs are one way to treat the condition, there are many other natural techniques, including eating certain foods that can help.

Controlling your blood pressure through the methods in this article may, ultimately, help you lower your risk of heart disease.

10 ways to prevent kidney stones

Kidney stones are deposits of minerals and salts that crystallize in the kidneys. They become solid, and passing them in the urine can be extremely painful.

Usually, the fluid in urine prevents waste products from coming into contact with each other. However, kidney stones can begin to form when there is not enough fluid or too much solid waste content in the urine.

Though most kidney stones develop in the kidneys, they can form anywhere in the urinary tract.

Prevention

Researchers are still not exactly sure how or why kidney stones develop.

Dehydration is the primary risk factor for kidney stones. However, certain foods and various lifestyle habits can also increase the risk of developing them.

People who suspect that they have kidney stones or are at high risk of developing them should consult a doctor to find out what type of kidney stone they have and determine which specific foods or activities to avoid.

There are many steps a person can take to reduce the risk of kidney stones, including:

1. Staying hydrated

When urine contains more fluid, it is less likely that minerals and salts will cluster together and form stones. Darker urine is a sign of dehydration. Ideally, urine should appear pale yellow.

Doctors tend to recommend that a person drinks between six and eight 8 ounce (oz) glasses of water per day.

2. Reducing salt intake

Sodium, or salt, can cause water retention and lead to dehydration. The Food and Drug Administration (FDA) suggest that adults aim to keep their salt intake below 2,300 milligrams(mg) daily. This is equivalent to around one teaspoon of table salt.

Some examples of high salt foods include:

  • deli or smoked meats
  • most packaged or prepared meals
  • potato chips
  • most canned soups
  • most ready-to-make noodle or side dishes
  • foods that contain other types of sodium, including sodium bicarbonate, disodium phosphate, monosodium glutamate, baking powder, nitrites, and sodium nitrate

3. Maintaining a healthy body weight

Having overweight or obesity can put stress on the kidneys. However, it is always important to lose weight gradually and safely.

Crash dieting and following a diet high in animal protein can both increase the risk of kidney stones.

4. Limiting foods with calcium oxalate

Kidney stones can consist of many different compounds, including uric acid, struvite, and cysteine. The most common type of kidney stone involves calcium oxalate.

One 2014 study examined nearly 44,000 kidney stones and found that 67% were composed predominately of calcium oxalate.

Doctors usually only recommend restricting oxalate intake to those at a high risk of kidney stones or those with high oxalate levels.

Consuming calcium alongside oxalate-rich foods may reduce the risk of kidney stones by binding the chemicals together before they reach the kidneys.

Foods that contain high levels of oxalate include:

  • grapefruit and cranberry juice
  • potatoes
  • soybeans
  • spinach
  • some nuts, including cashews and peanuts
  • chocolate
  • rhubarb
  • beets
  • asparagus
  • most berries
  • celery and parsley
  • whole grains
  • tea

5. Avoiding excessive caffeine consumption

Caffeine speeds up metabolism and can cause dehydration. The recommended upper limit for adults is 400 mg of caffeine daily, which is equivalent to about four cups of coffee. It is important to remember that certain sodas, chocolate, teas, and energy drinks can also contain caffeine.

6. Avoiding sugary drinks

Some studies have linked sweetened drinks, especially those containing high-fructose corn syrup, to the development of kidney stones.

At least half of a person’s fluid intake should be pure water. Some research suggests that caffeinated drinks can increase the risk of stones, as can sweetened drinks and sodas.

7. Getting enough dietary calcium

Although calcium oxalate is the most common compound in kidney stones, consuming some dietary calcium helps reduce the risk of stones.

Most dairy products are a good source of calcium. Manufacturers fortify many other foods with calcium, including:

  • orange juice
  • canned fish with bones, such as sardines
  • tofu
  • some cereals

8. Increasing citric acidic intake

About 60% of people with kidney stones also have low citric acid levels.

Some good sources of citric acid include:

  • one 4 oz glass of undiluted, unsweetened lemon or lime juice
  • one 8 oz glass of orange juice
  • one 8 oz glass of melon or mango juice

9. Monitoring the intake of high acid foods

Highly acidic urine can increase the risk of uric acid kidney stones and make passing them more painful. High amounts of acid in the urine also encourage the kidneys to reabsorb citrate rather than excrete it. Citrate is a compound that can help flush out calcium-based stones, as well as impair their growth.

Highly acidic foods include:

  • red meat and pork
  • poultry
  • most types of fish
  • most cheeses
  • eggs

People do not need to avoid high acid foods entirely, as they can be a good source of protein. However, a person should monitor and limit their intake of these foods if they experience frequent kidney stones.

10. Taking supplements and vitamins

A wide range of natural supplements and vitamins are available that may help reduce the risk of kidney stones in some people, including:

  • potassium citrate
  • vitamin B-6, which occurs in foods such as bananas, mangos, soybeans, avocados, and halibut
  • other B vitamins, including riboflavin, thiamin, and B-12, none of which are harmful to people with kidney stones
  • vitamin D
  • calcium
  • fish oils

However, for many of these, it is best to check with a doctor or dietitian before use. Some supplements can increase the risk for some individuals.

How common are kidney stones?

According to the National Kidney Foundation, almost 1 in 10 people in the United States develop a kidney stone during their lifetime. The risk is around 19% for men and 9% for women.

Most men experience their first kidney stone after the age of 30 years.

Symptoms

Small kidney stones may not cause any symptoms, and they sometimes pass on their own without causing much discomfort. Medium-to-large kidney stones, however, can cause intense, sharp pain.

Symptoms usually begin once the stones have started to travel through the urinary system. Stones that become stuck can cause a backup of urine. This can be extremely painful.

Common symptoms of kidney stones include:

  • constant, intense pain in the lower back
  • bloody urine
  • vomiting or nausea, often from the pain
  • fever and chills
  • very unpleasant or odd-smelling urine
  • cloudy urine
  • stomachache that does not improve with gas medication

Treatment and when to see a doctor

If a person suspects that a kidney stone is the cause of substantial pain or discomfort, it is important to see a doctor.

Although most people experience no long-term consequences from kidney stones, they can be extremely painful and require medical monitoring.

In most cases, treating kidney stones involves increasing fluid intake, taking pain medications, and using medications that make the urine less acidic.

People with smaller stones may be able to go home and wait for the stone or stones to pass. People with larger or more severe stones may need to stay in the hospital.

Stones that are too large to pass or that become stuck in the urinary tract may require surgery. Surgery to remove the stones may also be necessary if an infection has developed around it.

Types of anxiety and ways to overcome them

Anxiety is a natural response to feeling under threat. It causes people to feel worried, afraid, or stressed. It is natural for a person to feel anxious from time to time.

A person may have an anxiety disorder if they regularly feel severe levels of anxiety that impact their day-to-day life. A person’s feelings of anxiety may last for a long time or be out of proportion to their situation.

Anxiety comes in many different forms. Certain situations or tasks, such as public speaking or driving, can make a person feel anxious.

Additionally, a person may feel anxious about their health, certain body functions, or about relationships.

A person may also feel severe anxiety when faced with certain objects, places, or situations. Mental health professionals call this a phobia.

Anxiety can cause a person to feel restless, worried, tense, and unable to relax.

A person may also experience dizziness, a churning feeling in their stomach, nausea, and sweating.

Ways to overcome anxiety

There are numerous ways a person may overcome anxiety besides those listed here. What works for one person may not work for another.

A person struggling with anxiety can talk to a specialist about the best approach for them.

1. Coping strategies

The Anxiety and Depression Association of America (ADAA) recommends the following coping strategies for anxiety:

  • Relaxation: Practicing yoga, or trying meditation, breathing, massage, and relaxation techniques can help a person cope with anxiety.
  • Diet: Eating a well-balanced diet with regular meals and healthy snacks will keep the body healthy. Avoiding alcohol and caffeine can also reduce anxiety.
  • Sleep: Getting enough sleep each night can help a person feel more able to overcome anxiety.
  • Achievable goals: Instead of aiming for perfection, a person can try to do their best instead. This can help a person feel more positive about their achievements, and decrease the pressure they put on themselves.
  • Perspective: Stepping back from anxious feelings can help put a situation in perspective and make it seem less scary.
  • Support: Talking to friends and family or a health professional to get support with anxiety can help a person overcome anxiety.

2. Exercise and fitness

A recent study suggests that regular exercise has similar effects to antidepressant medications and improves anxiety.

The article explains people with anxiety and depression have decreased levels of brain-derived neurotrophic factor (BDNF), a neurotrophin in the brain,

After exercise, BDNF in the brain increases, which may improve symptoms of anxiety.

The ADAA suggests including 2.5 hours of moderate intensity exercise or 1.25 hours of vigorous intensity exercise each week, or trying a combination of both.

The ADAA suggests jogging, walking, cycling, or dancing three to five times a week for 30 minutes.

Setting smaller exercise goals will make an exercise program feel more achievable, and a person may be more likely to keep up with it for the long term.

A 2016 study concluded that exercise was more effective when done in shorter durations.

3. Medications

The Office on Women’s Health (OASH) lists the following types of medication for anxiety:

  • Benzodiazepines: What doctors call antianxiety medication, benzodiazepines are usually prescribed for short periods of time because they can be addictive, according to a 2020 review of the medication. They affect the central nervous system and slow down the body’s functions by increasing the effect of the brain chemical gamma amino butyric acid.
  • Beta blockers: According to the National Institute of Mental Health (NIMH), beta blockers reduce the physical symptoms of anxiety, such as trembling, a fast heartbeat, and sweating. People can use them as needed. There are also some natural sources of beta blockers, such as omega-3, that help anxiety.
  • Selective serotonin reuptake inhibitors (SSRIs): SSRIs stop the serotonin transporter (SERT) from removing serotonin from the synaptic cleft in the brain. Removing serotonin from the synaptic cleft means the brain does not benefit from its effects. By blocking the action of the SERT, serotonin levels in the brain can increase, which can improve
    generalized anxiety disorder (GAD), panic disorders, and social anxiety.
  • Tricyclic antidepressants: This type of medication is similar to SSRIs. These medications affect five different neurotransmitter pathways, such as blocking the reuptake of serotonin and norepinephrine. However, they can cause more side effects than SSRIs, according to a 2020 review.
  • Monoamine oxidase inhibitors (MAOIs): MAOIs are an older type of antidepressant that work by blocking the monoamine oxidase enzyme, which breaks down serotonin, norepinephrine, dopamine, and tyramine. By stopping the breakdown of these neurotransmitters, their levels can increase in the brain and relieve symptoms of depression, panic disorders, and social phobia. According to OASH, a person should avoid eating certain cheeses and wines if they take MAOIs, and women may not be able to take birth control, some types of pain relief, or cold and allergy medication.

4. Therapy

There are many types of therapy a person can try to help overcome anxiety.

Psychotherapy, also called talk therapy, involves a person seeing a mental health professional.

A person can have psychotherapy in a group or on their own.

Types of psychotherapy include:

Acceptance and commitment therapy (ACT)

ACT uses acceptance and mindfulness strategies to help alleviate anxiety.

ACT also encourages a person to commit to behavior changes that will help them overcome anxiety.

Cognitive behavioral therapy (CBT)

CBT focuses on identifying and understanding a person’s thinking and behavioral patterns.

By doing this, a person can change these patterns to reduce their anxiety.

According to the ADAA, people can see benefits in 12 to 16 weeks.

CBT helps a person learn skills they can use throughout their life to overcome anxiety.

Sessions may provide a person with activities or homework to complete to help them progress during their course of therapy.

Exposure therapy

Exposure therapy is a type of CBT. A person is gradually exposed to the things that make their anxiety worse in a safe environment.

This can help a person feel less anxious about the situations, places, or objects that cause them stress.

According to the ADAA, exposure therapy can be very effective for phobias and obsessive compulsive disorder.

Types of anxiety

There are many different types of anxiety disorder. They include:

Generalized anxiety disorder (GAD)

Generalized anxiety disorder is a type of chronic anxiety.

A person with GAD will feel anxious or worried most days for at least 6 months.

A person may feel anxious about their health, work, social interactions, or their situation in life more generally.

Social anxiety

A person with social anxiety will feel anxious about social interactions or social performances.

A person may worry that other people will judge them negatively because of what they say or do.

A person may avoid social situations, so social anxiety can affect a person’s work and school life.

Swallowing anxiety

Swallowing anxiety is also called phagophobia.

Swallowing anxiety can cause problems with a person’s eating patterns.

According to the National Foundation of Swallowing Disorders (NFOSD), a person with swallowing anxiety may:

  • over-chew their food
  • avoid certain types of food or textures
  • feel as though food is stuck in their throat
  • find it difficult to start swallowing

A person may develop swallowing anxiety if they have experienced a traumatic event such as choking, regurgitation, or abuse.

Performance anxiety

Performance anxiety refers to anxiety a person experiences about performing specific tasks.

Studies into performance anxiety in musicians, summarized in a 2017 review, found that singers had higher amounts of the stress hormone cortisol when someone asked them to perform in front of an audience.

In some cases, even virtual audiences in a VR headset increased a person’s stress levels when performing.

According to the 2017 review, performance anxiety triggers include:

  • taking exams
  • public speaking
  • writing
  • sexual performance
  • sports
  • the performing arts

This review suggested that performance anxiety may be a type of social anxiety because it overlaps with the fear of negative evaluations and fear of extreme, negative social costs that characterize social anxiety.

However, the specific mechanisms behind performance anxiety in particular are unclear.

Health anxiety

Health anxiety is also called hypochondria.

A person with health anxiety will feel excessive anxiety about developing a health condition, and their worry may be out of proportion with the chances of them developing a particular health condition.

According to the Centre for Clinical Interventions (CCI), a person with health anxiety may still believe they are at risk of an illness despite having negative tests from health professionals. They may also check their body obsessively or take medical tests more than necessary.

Health anxiety can occur in people who are healthy and in people who have health conditions, regardless of whether they are experiencing symptoms.

Sexual anxiety

Both men and women can experience sexual anxiety.

Sexual anxiety can have a negative affect on a person’s sex life, as they may worry about their looks or that they will disappoint sexual partners.

A 2015 study found that over one-third of men in the study had a negative self image of their genitalia, which contributed to sex anxiety and erectile dysfunction.

Results from a 2014 study published in the journal Body Image suggest that body self-consciousness and body shame during sexual activity negatively correlated with sexual satisfaction, according to self-reported measures of these criteria in college women who participated in the study.

Relationship anxiety

Relationship anxiety can occur in new relationships or long-term relationships.

According to a 2015 study, a person may seek reassurance excessively from their partner or silence themselves to please their partner if their opinions or feelings differ from their partner.

Driving anxiety

According to the ADAA, a person’s driving anxiety may include the following fears:

  • driving outside their comfort zone on their own
  • getting lost
  • running out of gas
  • being unable to find a parking spot
  • going too fast and losing control
  • getting into a car accident

Driving anxiety can affect a person’s social and professional life.

Phobias

A person with a phobia will experience intense fear about specific objects or situations.

The fear they feel will often be out of proportion with the threat the object or situation presents.

A person with a phobia may take steps to avoid the object or situation, and experience excessive anxiety about encountering it.

Specific phobias can include:

  • flying
  • heights
  • certain animals
  • injections
  • blood

Support systems and resources

A person living with anxiety can use their friends and family as a support network to help them cope with and overcome anxiety.

A person can contact a doctor or mental health professional if they have concerns about their anxiety or are seeking treatment.

There are also many online resources that can help a person find information on anxiety, from mental health support provider directories to national mental health organizations such as Mental Health America (MHA) and the National Alliance on Mental Illness (NAMI).

Summary

The way a person responds to anxiety treatments is very individualized, and one treatment may work for some people but not others.

Coping strategies, lifestyle changes, therapy, or medication can all be part of a person’s anxiety treatment plan.

There are many different types of anxiety, and treatment may be different for each.

As a result, it is important for a person to get the correct diagnosis before seeking treatment in order to increase their chances of overcoming anxiety.