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If you've ever groaned, "Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.

Most back pain goes away on its own, though it may take awhile. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.

If your back pain is severe or doesn't improve after three days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.

Treatment for back pain depends on what kind of pain you have, and what is causing it. It may include hot or cold packs, exercise, medicines, injections, complementary treatments, and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Your back is made of bones, muscles, and other tissues extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, or a sudden jolt such as a car accident. The lower back is the most common site of back injuries and back pain. Common back injuries include :

• Sprains and strains
• Herniated disks
• Fractured (broken) vertebrae

These injuries can cause pain and limit your movement. Treatments vary but might include medicines, icing, bed rest, physical therapy, or surgery. You might be able to prevent some back injuries by maintaining a healthy weight, lifting objects with your legs, and using lower-back support when you sit.

Good posture is about more than standing up straight so you can look your best. It is an important part of your long-term health. Making sure that you hold your body the right way, whether you are moving or still, can prevent pain, injuries, and other health problems.

Posture is how you hold your body. There are two types:

• Dynamic posture is how you hold yourself when you are moving, like when you are walking, running, or bending over to pick up something.
• Static posture is how you hold yourself when you are not moving, like when you are sitting, standing, or sleeping.

It is important to make sure that you have good dynamic and static posture.

The key to good posture is the position of your spine. Your spine has three natural curves - at your neck, mid back, and low back. Correct posture should maintain these curves, but not increase them. Your head should be above your shoulders, and the top of your shoulder should be over the hips.

Poor posture can be bad for your health. Slouching or slumping over can:

• Misalign your musculoskeletal system
• Wear away at your spine, making it more fragile and prone to injury
• Cause neck, shoulder, and back pain
• Decrease your flexibility
• Affect how well your joints move
• Affect your balance and increase your risk of falling
• Make it harder to digest your food
• Make it harder to breathe

• Be mindful of your posture during everyday activities, like watching television, washing dishes, or walking
• Stay active. Any kind of exercise may help improve your posture, but certain types of exercises can be especially helpful. They include yoga, tai chi, and other classes that focus on body awareness. It is also a good idea to do exercises that strengthen your core (muscles around your back, abdomen, and pelvis).
• Maintain a healthy weight. Extra weight can weaken your abdominal muscles, cause problems for your pelvis and spine, and contribute to low back pain. All of these can hurt your posture.
• Wear comfortable, low-heeled shoes. High heels, for example, can throw off your balance and force you to walk differently. This puts more stress on your muscles and harms your posture.
• Make sure work surfaces are at a comfortable height for you, whether you're sitting in front of a computer, making dinner, or eating a meal.

Many Americans spend a lot of their time sitting - either at work, at school, or at home. It is important to sit properly, and to take frequent breaks:

• Switch sitting positions often
• Take brief walks around your office or home
• Gently stretch your muscles every so often to help relieve muscle tension
• Don't cross your legs; keep your feet on the floor, with your ankles in front of your knees
• Make sure that your feet touch the floor, or if that's not possible, use a footrest
• Relax your shoulders; they should not be rounded or pulled backwards
• Keep your elbows in close to your body. They should be bent between 90 and 120 degrees.
• Make sure that your back is fully supported. Use a back pillow or other back support if your chair does not have a backrest that can support your lower back's curve.
• Make sure that your thighs and hips are supported. You should have a well-padded seat, and your thighs and hips should be parallel to the floor.

• Stand up straight and tall
• Keep your shoulders back
• Pull your stomach in
• Put your weight mostly on the balls of your feet
• Keep your head level
• Let your arms hang down naturally at your sides
• Keep your feet about shoulder-width apart

With practice, you can improve your posture; you will look and feel better.

Esophagus disorders are problems with how your esophagus works. The esophagus is the tube that carries food from your mouth to your stomach. You usually don't notice it unless you swallow something too big, hot, or cold. You might also notice it if something is wrong. When that happens, you might feel pain or have trouble swallowing (dysphagia).

The cause depends on the type of disorder. Some run in families. Others are linked to allergic reactions to food or substances in your environment. Sometimes, the cause is unknown.

You may be more likely to develop an esophagus disorder if you:

• Are overweight or have obesity
• Are pregnant
• Take certain medicines
• Have had radiation treatmentt to your neck or chest
• Smoke or are around secondhand smoke

The most common esophagus problem is gastroesophageal reflux disease (GERD). This happens when the muscle at the bottom of your esophagus doesn't close properly. Stomach acid can move back up and irritate the esophagus.

Other esophagus disorders include:

• Heartburn is a burning feeling in your chest or throat. It is often caused by acid reflux.
• Barrett's Esophagus happens when the lining of your esophagus changes. It is often caused by chronic (long-term) GERD.
• Achalasia is a problem where the lower muscle in your esophagus doesn't relax like it should.
• Esophageal Spasms are muscle contractions that cause chest pain or swallowing problems.
• Eosinophilic Esophagitis (EoE) is a rare condition where certain white blood cells (eosinophils) build up in the esophagus, causing swelling, pain, and trouble swallowing.
• Esophageal Cancer is a type of cancer that starts in the tissues of the esophagus.

Symptoms can be different for each condition but may include:

• Pain in your chest, abdomen (belly), or back
• A cough or sore throat that doesn't go away
• Trouble swallowing or feeling like food is stuck
• A hoarse voice or wheezing
• Heartburn or a burning feeling in your stomach
• Tasting acid or food in the back of your mouth
• Food or liquid coming back up into your mouth (regurgitation)
• Losing weight without trying

Get medical help right away if you have chest pain with shortness of breath, or pain in your jaw or arm. These could be signs of a heart problem.

Your health care provider will ask about your symptoms and medical history. They may order one or more tests, such as:

• Upper gastrointestinal (GI) endoscopy. This test uses a tiny camera to look inside your esophagus and stomach.
• Biopsy. This test takes a small tissue sample to check.
• Barium swallow. This test uses imaging to see how you swallow.
• Esophageal manometry. This test checks how well your esophagus moves food to your stomach.
• Esophageal pH test. This test measures how often acid backs up into your esophagus and how long the acid stays there.

Treatment depends on what's causing the problem and your overall health. Some esophagus disorders get better with over-the-counter medicines, diet changes, or lifestyle changes. Others may need prescription medicine or surgery.

Without treatment, some disorders may lead to other problems, such as pneumonia, from food entering the windpipe. GERD, Barrett's esophagus, and achalasia can also raise your risk for esophageal cancer.

You can help prevent or reduce symptoms by:

• Not smoking and limiting alcohol
• Eating smaller meals
• Avoiding eating close to bedtime
• Wearing loose-fitting clothes
• Sleeping on your left side or raising the head of your bed
• Maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Each person feels pain differently, even if the reason for the pain is the same. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over.

There are two types of pain:

• Acute pain usually comes on suddenly, because of a disease, injury, or inflammation (irritation, redness, and/or swelling). It usually goes away when the cause is treated or healed, though sometimes it can turn into chronic pain.
• Chronic pain lasts for longer than three months or the time in which you should have healed. It can cause severe problems.

Pain relievers are medicines that reduce or relieve pain. There are many pain medicines, each with advantages and risks. Some are over-the-counter (OTC) medicines. Others are stronger medicines, which are available by prescription. The most powerful prescription pain relievers are opioids. They are very effective, but people who take them are at risk of addiction and overdose.

Because of the side effects and risks of pain relievers, you may want to try non-drug treatments first. If you need to take medicines, doing some non-drug treatments may allow you to take a lower dose.

Many non-drug treatments can help with pain. It is important to check with your health care provider before trying any of them:

• Acupuncture involves stimulating acupuncture points. These are specific points on your body. There are different acupuncture methods. The most common one involves inserting thin needles through the skin. Others include using pressure, electrical stimulation, and heat. Acupuncture is based on the belief that qi (vital energy) flows through the body along paths, called meridians. Practitioners believe that triggering the acupuncture points can rebalance the qi. Research suggests that acupuncture can help manage certain pain conditions.
• Biofeedback techniques use electronic devices to measure body functions such as breathing and heart rate. This teaches you to be more aware of your body functions so you can learn to control them. For example, a biofeedback device may show you measurements of your muscle tension. By watching how these measurements change, you can become more aware of when your muscles are tense and learn to relax them. Biofeedback may help to control pain, including chronic headaches and back pain.
• Electrical stimulation involves using a device to send a gentle electric current to your nerves or muscles. This can help treat pain by changing or blocking pain signals. Types include:
  • Transcutaneous electrical stimulation (TENS)
  • Implanted electric nerve stimulation
  • Deep brain or spinal cord stimulation
• Massage therapy is a treatment in which the soft tissues of the body are kneaded, rubbed, tapped, and stroked. Among other benefits, it may help people relax, and relieve stress and pain.
• Meditation is a mind-body practice in which you focus your attention on something, such as an object, word, phrase, or breathing. This helps you to minimize distracting or stressful thoughts or feelings.
• Physical therapy uses techniques such as heat, cold, exercise, massage, and manipulation. It can help to control pain, condition muscles and restore strength.
• Psychotherapy (talk therapy) uses methods such as discussion, listening, and counseling to treat mental and behavioral disorders. It can also help people who have pain, especially chronic pain, by:
  • Teaching them coping skills to better deal with the stress that pain can cause
  • Addressing negative thoughts and emotions that can make pain worse
  • Providing them with support
• Relaxation therapy can help reduce muscle tension and stress, lower blood pressure, and control pain. It may involve tensing and relaxing muscles throughout the body. It may be used with guided imagery (focusing the mind on positive images) and meditation.
• Surgery can sometimes be necessary to treat severe pain, especially when back problems or serious musculoskeletal injuries cause it. There are always risks to getting surgery, and it does not always work to treat pain. It is important to go through all the risks and benefits with your provider.

A concussion is a type of brain injury. It involves a short loss of normal brain function. It happens when a hit to the head or body causes your head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in your brain. Sometimes it can also stretch and damage your brain cells.

Sometimes people call a concussion a "mild" brain injury. It is important to understand that while concussions may not be life-threatening, they can still be serious.

Concussions are a common type of sports injury. Other causes of concussions include blows to the head, bumping your head when you fall, being violently shaken, and car accidents.

Symptoms of a concussion may not start right away; they may start days or weeks after the injury. Symptoms may include a headache or neck pain. You may also have nausea, ringing in your ears, dizziness, or tiredness. You may feel dazed or not your normal self for several days or weeks after the injury. Consult your health care professional if any of your symptoms get worse, or if you have more serious symptoms such as:

• Convulsions or seizures
• Drowsiness or inability to wake up
• A headache that gets worse and does not go away
• Weakness, numbness, or decreased coordination
• Repeated vomiting or nausea
• Confusion
• Slurred speech
• Loss of consciousness

To diagnose a concussion, your health care provider will do a physical exam and will ask about your injury. You will most likely have a neurological exam, which checks your vision, balance, coordination, and reflexes. Your health care provider may also evaluate your memory and thinking. In some cases, you may also have a scan of the brain, such as a CT scan or an MRI. A scan can check for bleeding or inflammation in the brain, as well as a skull fracture (break in the skull).

Most people recover fully after a concussion, but it can take some time. Rest is very important after a concussion because it helps the brain to heal. In the very beginning, you may need to limit physical activities or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games. Doing these may cause concussion symptoms (such as headache or tiredness) to come back or get worse. Then when your health care provider says that it is ok, you can start to return to your normal activities slowly.

Centers for Disease Control and Prevention

Your backbone, or spine, is made up of 26 bones called vertebrae. In between them are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. As you age, the disks break down or degenerate. As they do, they lose their cushioning ability. This can lead to pain if the back is stressed.

A herniated disk is a disk that ruptures. This allows the jelly-like center of the disk to leak, irritating the nearby nerves. This can cause sciatica or back pain.

Your doctor will diagnose a herniated disk with a physical exam and, sometimes, imaging tests. With treatment, most people recover. Treatments include rest, pain and anti-inflammatory medicines, physical therapy, and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Gastroesophageal reflux (GER), often called reflux or spitting up, happens when food or milk comes back up from your baby's stomach into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach. Reflux is very common in healthy babies. It usually starts to get better by 6 months of age and goes away by 12 months. Reflux that continues after 18 months is unusual.

Gastroesophageal reflux disease (GERD) is a more serious and long-lasting type of reflux. It can cause feeding problems, discomfort, or other symptoms that affect your baby's growth or sleep. Babies may have GERD if symptoms prevent them from feeding well or last longer than 12 to 14 months.

There is a muscle (the lower esophageal sphincter) that acts as a valve between the esophagus and stomach. When your baby swallows, this muscle relaxes to let food pass from the esophagus to the stomach. This muscle normally stays closed, so the stomach contents don't flow back into the esophagus.

In babies who have reflux, this muscle is not fully developed and lets the stomach contents back up the esophagus. This causes your baby to spit up (regurgitate). As your baby grows and the sphincter muscle fully develops, your baby should no longer spit up.

In babies who have GERD, the sphincter muscle becomes weak or relaxes when it shouldn't. This allows stomach contents to come up more often or cause irritation.

Reflux is very common in babies and usually goes away on its own. Most babies spit up several times a day during their first 3 months. They usually stop spitting up between the ages of 12 and 14 months.

GERD is less common. Babies may show symptoms, but they decrease with growth, with only a small number of babies affected by 12 months.

Babies are more likely to have reflux or GERD if they:

• Were born too early (premature)
• Have lung problems, such as cystic fibrosis
• Have conditions that affect the nervous system, such as cerebral palsy
• Have a hiatal hernia (when part of the stomach pushes up into the chest)
• Have had surgery on the esophagus

In babies, the main symptom of reflux and GERD is spitting up. GERD may also cause symptoms such as:

• Arching of the back, often during or right after eating
• Coughing
• Gagging or trouble swallowing
• Irritability or crying, especially after eating
• Poor eating or refusing to eat
• Not gaining enough weight or losing weight
• Wheezing or trouble breathing
• Forceful or frequent vomiting

Other conditions can cause similar symptoms. Contact your baby's health care provider if your baby has symptoms, especially if your baby isn't gaining weight.

In most cases, your provider diagnoses reflux by reviewing your baby's symptoms and medical history. Testing is only needed if symptoms don't get better with feeding changes or medicines, or if there are other health concerns.

Several tests can help your provider diagnose GERD. Sometimes more than one test may be ordered to get a diagnosis. Common tests include:

• Upper GI series, which looks at the shape of your baby's upper GI (gastrointestinal) tract. Your baby will drink or eat a chalky-tasting liquid called barium. The barium is mixed in with a bottle or other food. Several x-rays are taken to track the barium as it goes through your baby's esophagus and stomach.
• Esophageal pH or impedance monitoring, which measures the amount of acid or liquid in your baby's esophagus. A thin flexible tube is placed through your baby's nose into the stomach. The end of the tube in the esophagus measures when and how much acid comes up into the esophagus. The other end of the tube attaches to a monitor that records the measurements. Your baby will wear this for 24 hours, most likely in the hospital.
• Upper gastrointestinal (GI) endoscopy and biopsy, which uses an endoscope, a long, flexible tube with a light and camera at the end of it. An endoscope is inserted down your baby's esophagus, stomach, and first part of the small intestine. While looking at the pictures from the endoscope, tissue samples (biopsy) may be taken.

Simple feeding changes may help reduce your baby's reflux:

• Add rice cereal to your baby's bottle of formula or breastmilk. Check with your provider about how much to add. If the mixture is too thick, you can change the nipple size or cut a little "x" in the nipple to make the opening larger.
• Burp your baby after every 1 to 2 ounces of formula. If you breastfeed, burp your baby after nursing from each breast.
• Avoid overfeeding; give your baby the amount of formula or breast milk recommended.
• Hold your baby upright for 30 minutes after feedings.
• If you use formula and your provider thinks that your baby may be sensitive to milk protein, they may suggest switching to a different type of formula. Do not change formulas without talking to your provider.

If feeding changes do not help enough, your provider may recommend medicines to reduce stomach acid. Medicines aren't usually needed, and are only suggested if your baby still has regular GERD symptoms and:

• You have already tried some feeding changes
• Your baby has problems sleeping or feeding
• Your baby does not grow or gain weight properly

Acid-blocking medicines may be given for a short time to see if they help. You shouldn't give your baby any medicines unless your provider tells you to.

If medicines don't help and your baby still has severe symptoms, your provider might talk to you about surgery. Surgery is rarely needed for babies with GERD. It may be considered only if reflux causes serious breathing problems or if your baby isn't gaining enough weight.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Sciatica is a symptom of a problem with the sciatic nerve, the largest nerve in the body. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh, part of your lower leg, and the sole of your foot. When you have sciatica, you have pain, weakness, numbness, or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It's usually on only one side of your body.

Causes of sciatica include:

• A ruptured intervertebral disk
• Narrowing of the spinal canal that puts pressure on the nerve, called spinal stenosis
• An injury such as a pelvic fracture.

In many cases no cause can be found.

Sometimes sciatica goes away on its own. Treatment, if needed, depends on the cause of the problem. It may include exercises, medicines, and surgery.

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.

Over time, high blood glucose may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetic eye problems include:

• Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
• Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (the part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
• Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
• Cataract, which is the leading cause of blindness worldwide. It happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you have diabetes and:

• Have had diabetes for a long time
• Don't have good control over your high blood glucose or high blood pressure
• Are pregnant
• Have high blood cholesterol
• Smoke tobacco

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could be signs of an emergency. Call your eye care professional right away if you notice any of these symptoms:

• Many new spots or dark wavy strings floating in your vision (floaters)
• Flashes of light
• A dark shadow over part of your vision, like a curtain
• Vision loss
• Eye pain or redness

Talk with your eye care professional if you have these symptoms, even if they come and go:

• Spots or dark wavy strings floating in your vision
• Blurry or wavy vision
• Vision that changes a lot
• Trouble seeing colors

Eye care professionals do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your eye care professional can look for signs of eye problems and treat them before they harm your vision. They will also test your vision and measure the pressure in your eyes.

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

• Lasers to stop blood vessels from leaking
• Injections (shots) in the eye to stop new, leaky blood vessels from growing
• Surgery to remove blood and scar tissue or replace a cloudy lens
• Eye drops to lower fluid pressure in the eye

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases