Painfree International Charitable Foundation

02/17/2025

Pain Management
Through a pain management plan, healthcare providers help you manage all kinds and causes of pain. Pain management approaches include medications, medical procedures, therapy and complementary medicine techniques. These plans help people with chronic (long-lasting) pain feel better and improve their quality of life.

Overview
What is pain management?
Pain management helps you regulate pain with medications, procedures, exercises and therapy. Pain management specialists may recommend one approach or a combination of several to prevent, reduce or relieve pain. You may receive care in a pain clinic, your healthcare provider’s office or a hospital.
Pain is the most common symptom of thousands of injuries and conditions you can experience in your lifetime. It can also result from treatments for conditions and injuries or be the main feature of a condition (a pain disorder). Pain can last a short time and go away when you heal (acute pain). Or it can last for months or years (chronic pain).
Pain is very complex, and everyone experiences it differently. It’s also not something we can see — and a lot of people have “invisible” conditions that cause pain. These factors — and several others — can make it difficult to seek help for pain. You may be worried that others won’t take you seriously or that the pain will never go away. Know that it’s important to get medical help. No one should struggle through pain every day.
Depending on the cause and type of pain, it may not be possible to find total relief. And the pain may not get better right away. The goal of pain management is to improve your quality of life and functioning, like doing daily tasks, enjoying your usual activities, working and/or attending school. Your provider or healthcare team will work with you to adjust your pain management plan so you can feel better.
Who needs pain management?
Anyone with pain — either acute or chronic pain — can benefit from a pain management plan. A comprehensive plan can help you manage pain that lasts a few days (such as after an injury or surgery). It can also help if you have long-term pain from health conditions.
Pain is the main symptom of a wide range of injuries, infections and diseases. Some of the most common conditions that cause pain include:
• Arthritis and muscle and joint injuries.
• Autoimmune conditions, like Crohn’s disease, lupus and fibromyalgia.
• Burns.
• Cancer.
• Causes of neuropathic pain, like pinched nerves, peripheral neuropathy and trigeminal neuralgia.
• Chronic pain disorders, like complex regional pain syndrome (CRPS) and central pain syndrome.
• Circulatory disorders, like peripheral artery disease.
• Endometriosis.
• Headaches and migraines.
• Spine- or spinal cord-related conditions or injuries.
Who do I see for pain management?
If you don’t know the cause of your pain, you may want to start with your primary care provider. They can start the diagnostic process and refer you to a pain management team or clinic. If you have a diagnosis, talk to your provider who manages the condition about starting a more involved pain management plan.
You may have a team of pain management specialists who work together to help you manage long-term or severe pain. These specialists work in a field of medicine called algiatry. Your team may include:
• Pain management specialists.
• Anesthesiologists.
• Specialists on any other medical conditions you may have, like oncologists or neurologists.
• Nurses.
• Mental health providers, like psychologists and psychiatrists.
• Physical and/or occupational therapists.
• Complementary or integrative health providers.
• Social workers.
To further evaluate your pain and the cause of it, your team may recommend certain tests and assessments, like:
• Physical exam.
• Neurological exam.
• Laboratory tests (blood, urine and cerebrospinal fluid tests).
• Imaging tests, like MRI (magnetic resonance imaging) and CT scans (computed tomography scans).
• Electrodiagnostic studies, like nerve conduction studies and EMG (electromyography).
• How pain affects various aspects of your life, like your mood, ability to do everyday tasks, relationships and work.
What are different types of pain management?
Your healthcare provider or pain management team may recommend one approach or a combination of several pain management techniques. It may involve treating the underlying cause of pain and/or managing pain as a symptom.
How well a particular treatment works varies from person to person — even for the same cause of pain. Providers typically start with minimally invasive or conservative pain management therapies before trying riskier ones. But there’s no single “right” approach for pain management for all people.
At-home remedies for pain management
You may be able to relieve pain from injuries to muscles and soft tissues at home. Ask your provider about the RICE method (rest, ice, compression and elevation) and heat and cold therapy.
Certain lifestyle changes can relieve pain. If you have overweight or obesity, your provider may recommend reaching and maintaining a weight that’s healthy for you. Eating nutritious foods, drinking plenty of water, getting quality sleep and managing stress may help reduce pain.
Physical activity (like walking or swimming) and strength training may also reduce pain. These exercises can improve posture and help your body work better overall. They also benefit your mental health and help with balance. Talk to your healthcare provider before starting an exercise routine.
Physical and occupational therapy for pain management
Physical therapy is a treatment that helps you improve how your body performs physical movements. It can be part of a generalized pain management plan or a specific treatment for an injury or health condition.
Occupational therapy is a treatment that helps you improve your ability to do daily tasks. It can help you learn how to move through your environment or use different tools to participate in your activities in a way that minimizes pain.
Psychotherapy for pain management
Psychotherapy (talk therapy) is a term for a variety of treatment techniques that aim to help you identify and change unhealthy emotions, thoughts and behaviors. It can help you manage or change how you experience pain.
Because chronic pain can also lead to depression and anxiety, your provider may recommend psychotherapy and/or medications for your mental health, too.
Cognitive behavioral therapy (CBT), in particular, can help you build skills to cope with the emotional load of experiencing chronic pain and any associated mental health conditions. These skills may include addressing thoughts and emotions that can increase pain, relaxation strategies and mindfulness techniques. Some people keep a pain diary to keep track of what makes pain better or worse. These details can help your provider plan treatment.
Complementary medicine therapies for pain management
Complementary medicine is a term that describes the types of treatments you may receive along with traditional Western medicine. Types of complementary medicine therapies that may help with pain include:
• Massage therapy.
• Chiropractic adjustments or osteopathic manipulative treatment (OMT).
• Acupuncture.
• Biofeedback.
• Meditation.
• Breathwork.
• Yoga.
• Reflexology.
• Aromatherapy.
• Dietary supplements and herbal remedies
Medical procedures and devices for pain management
A variety of medical procedures may help manage pain. Certain procedures use electrical stimulation of nerves or soft tissue to help manage pain. They include:
• Transcutaneous electrical nerve stimulation (TENS).
• Peripheral nerve stimulation.
• Spinal cord stimulation.
Other procedures and devices for pain management include:
• Radiofrequency ablation.
• Basivertebral nerve ablation (Intracept® procedure).
• Steroid injections.
• Nerve blocks.
• Botulinum toxin (Botox®) injections.
• Patient-controlled analgesia (PCA) pump or baclofen pump.
• Surgery to address the underlying cause of pain, like spine surgery, for example.
Most of these options fall under the approach of interventional pain management. It aims to help manage pain with minimally invasive medical procedures to help you get back to everyday activities quickly. Interventional pain management tries to avoid heavy reliance on medications.
Medications for pain management
Depending on the type of pain, your provider may recommend prescription or over-the-counter (OTC) medications to relieve pain (analgesics). Several types of medications may help, including:
• Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen.
• Acetaminophen.
• Topical analgesics, like lidocaine or capsaicin cream.
• Antiseizure medications, like gabapentin and pregabalin.
• Antidepressants, like tricyclic antidepressants and SNRIs.
• Muscle relaxers.
• Corticosteroids.
• Opioids.
Healthcare providers typically aim to avoid the use of opioids when possible due to their high addiction potential.
Clinical trials for pain management
Researchers are actively studying countless new pain management treatments for various causes of pain. Ask your provider if participating in a clinical trial is an option for you.
Risks / Benefits
What are the advantages of pain management?
Chronic pain is very complex. It can change the way your brain and nervous system work and evolve over time. So, a comprehensive pain management approach led by experts is likely the best way to tackle it. It isn’t always possible to find total relief from pain. But you may be able to reduce pain or learn to respond to it differently.
Many people with chronic pain have a better quality of life with a pain management program and feel better physically and mentally. Studies show that current chronic pain treatments can result in about a 30% decrease in pain scores.
What are the risks or complications of pain management?
Different pain management approaches have their own risks, side effects and complications. And these may vary from person to person based on other conditions you have or medications you take.
For example, overuse of acetaminophen — an over-the-counter medication — is the most common cause of acute liver failure in the U.S. And prescription opioids put you at risk for opioid use disorder. Surgeries or more invasive procedures have specific risks, too, like infection and permanent nerve damage.
Talk to your healthcare provider about the risks and benefits of each pain management therapy before starting it. Don’t hesitate to ask questions. Your provider is there to help you, not judge you.
Recovery and Outlook
How effective are pain management plans?
Depending on the cause of pain and your unique characteristics, it may take time — and several different therapies — before you find the right approach that works for you. For example, less than 50% of people with neuropathic pain experience adequate pain relief with a single therapy.
Your pain might not go away completely. Your pain management plan is more likely to be effective if you work closely with your provider or team and adjust the plan as your needs change.
When To Call the Doctor
When should I see my healthcare provider about pain management?
See your provider if:
• Discomfort and pain are keeping you from enjoying your usual activities.
• Pain doesn’t get better, worsens or comes back after treatment.
• You feel anxious or depressed.
• You’re having trouble sleeping because of pain.
A note from Cleveland Clinic
Living with pain can be extremely challenging, affecting nearly all aspects of your life — it may feel more like existing with pain than living. Most of us would try nearly anything to escape the nagging, relentless nature of chronic pain. But it can be overwhelming to know where to start, who to trust and what will work for you.
If you’re in pain, talk to your healthcare provider about a personalized pain management plan. Pain specialists are experts in their field and know various approaches to managing pain. It’ll likely take more than one therapy to find some relief. But committing to the process may help you get back to enjoying life.

02/13/2025

Neck Pain
Neck pain, or cervicalgia, can last from days to years, depending on the cause. Common causes include physical strain, poor posture, mental stress, osteoarthritis, spinal stenosis, herniated disk, pinched nerve, tumors and other health conditions.

Overview

Dr. Andrew Bang answers common questions about neck pain.

What is neck pain (cervicalgia)?

Neck pain, sometimes called cervicalgia, is pain in or around your spine beneath your head. Your neck is also known as your cervical spine. Neck pain is a common symptom of many different injuries and medical conditions.

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You might have axial neck pain (felt mostly in your neck) or radicular neck pain (pain that shoots into other areas, such as your shoulders or arms). It can be acute (lasting from days to six weeks) or chronic (lasting longer than three months).

Neck pain can interfere with your daily activities and reduce your quality of life if it’s not treated.

Fortunately, most causes of neck pain aren’t serious and improve with conservative treatments, like pain medicine, exercise and stress management.

What does neck pain feel like?

Some people describe the pain as:

A persistent ache.
A stabbing or burning pain.
A shooting pain that travels from their neck to their shoulders or arms.
Other symptoms

Neck pain may involve other symptoms, including:

Headache.
Stiffness in your neck, shoulders and upper back.
Being unable to turn your neck or tilt your head.
Numbness or tingling (pins and needles) feeling in your shoulders or arms.
Who is affected by neck pain?

Neck pain is common, affecting 10% to 20% of adults. It’s more common in women. Your chance of developing it increases with age.

Possible Causes

Common causes of neck pain, or cervicalgia, including strain, injury and stress.Neck pain can result from physical changes related to strain, injury or aging, or it may be related to stress.

What are the possible causes of neck pain?

Neck pain has many potential causes, including:

Aging: As you age, natural wear and tear can cause parts of your cervical spine to deteriorate, or degenerate, causing pain. Degenerative conditions such as osteoarthritis (the wearing down of joint cartilage) and spinal stenosis (narrowing of the spaces in your spine) can lead to neck pain. Over time, stress and repeated movements can cause the disks in your spine to weaken, causing a herniated disk or pinched nerve.
Physical strain: Overusing your neck muscles during repetitive or strenuous activities can lead to stiffness and pain. Poor posture, weak abdominal muscles and heavier body weight can affect your spine’s alignment and contribute to neck pain. For example, straining your neck to view a computer screen for long periods is a common cause of neck pain.
Mental stress: Tightening your neck muscles because you’re stressed can lead to neck pain and stiffness. Many people who tighten these muscles when they’re stressed or agitated don’t realize they do it until their neck starts hurting.
Injury: Trauma and other injuries can damage muscles, ligaments, disks, vertebral joints and nerve roots in your spinal cord and lead to neck pain. Whiplash during automobile accidents is a common injury that causes neck pain.
Growths: Masses, including tumors, cysts and bone spurs, can put pressure on the nerves in your neck, causing pain.
Other health conditions: Neck pain is a symptom of many health conditions, including meningitis, rheumatoid arthritis and cancer.
Care and Treatment

How is neck pain diagnosed?

Usually, a medical history and a physical exam are enough for a healthcare provider to diagnose the cause of neck pain. A healthcare provider will first eliminate serious causes of neck pain, like pressure on your spinal cord, myelopathy, an infection or cancer.

Medical history: Your provider will ask about previous neck injuries that may have caused whiplash or a herniated disk. They may ask about work or other activities that could strain your neck. They’ll ask about your pain, including when it started, where it’s located, how long it lasts and how intense it is.
Physical exam: Your provider will check your head and neck alignment and observe your range of motion when you move your neck. They’ll feel your neck and supporting muscles to check for tenderness and signs of strain.
Imaging tests usually aren’t necessary to identify what’s causing neck pain. Still, a provider may take images of the inside of your neck if they suspect a serious injury or if you’re experiencing severe pain that doesn’t improve.
X-rays: X-rays can show problems with your bones or soft tissues that may be causing neck pain. An X-ray can show issues with cervical alignment, fractures and slipped disks, and they can detect arthritis.
Magnetic resonance imaging (MRI): An MRI can show problems with your spinal cord, nerves, bone marrow and soft tissue. It can show if a disk has slipped out of place, signs of infection and masses that may be causing neck pain, like a cyst or tumor.
Computed tomography (CT) scan: A CT scan may be used if an MRI isn’t available. It can show bone spurs and signs of bone deterioration.
In rare instances, your provider may order additional tests, including:

Electrodiagnostic tests: These tests check the function of nerves and your muscle response. Tests include nerve conduction studies and, rarely, a myelogram if an MRI is contraindicated.
Lab tests: These tests can help your provider identify causes of neck pain other than musculoskeletal injuries, like infections, rheumatological conditions or cancers. Tests include a complete blood count (CBC), urinalysis and markers of inflammation, among others.
How is neck pain managed or treated?

Treatment aims to relieve your pain and improve movement in your neck. Most causes of neck pain eventually improve and can be managed at home. Your provider will suggest treatments to manage your symptoms, including:

Pain medications and muscle relaxers: Medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs) to ease neck pain and inflammation, and muscle relaxants to help your neck muscles heal, are common first-line treatments for neck pain.
Physical therapy: You may work with a physical therapist or a fitness trainer to learn exercises and movements that strengthen the muscles and tendons in your neck and improve flexibility.
Transcutaneous electrical nerve stimulation (TENS) unit: A TENS unit applies a low-level electrical current to your skin near your nerves to disrupt the pain signal causing discomfort. Always check with a healthcare provider before using a TENS unit.
Steroid injections: A shot near the nerve roots can reduce inflammation and relieve pain.
Alternative therapies: Your provider may recommend acupuncture to relieve pain, or massage to help loosen tightened muscles contributing to your discomfort. You may see an osteopath or chiropractor to align your spine.
Surgery: Most causes of neck pain don’t require surgery. Still, you may need surgery if one or more of the vertebrae in your spine has shifted out of place or is putting pressure on your nerves.
If your pain is severe, you may need to work with a spine or pain specialist.

What can I do to relieve neck pain at home?

In addition to taking pain relief medications, you can take steps at home to relieve neck pain, including:

Hot therapy: Take a hot shower or place a hot towel or heating pad (on the lowest setting) on the site of your pain for 15 minutes every few hours. The heat loosens your muscles and promotes blood flow.
Cold therapy: Place a cold pack or a bag of frozen vegetables (wrapped in a thin towel to protect your skin) for 15 minutes every few hours. The cold narrows your blood vessels, reducing inflammation and swelling. Use cold instead of heat immediately after an injury.
Exercise: Follow your healthcare provider’s guidance on neck exercises you can try to relieve neck pain and improve your range of motion. Don’t attempt exercises if you have a serious neck injury or a pinched nerve.
Stress reduction techniques: Mindfulness, meditation, breathing exercises and yoga can help relieve tension in your body that may contribute to neck pain.
Quit smoking: Smoking damages bone structure, accelerates degenerative disk disease and slows healing.
How long does neck pain (cervicalgia) take to heal?

Healing time depends on what’s causing your neck pain. Neck pain caused by common issues like strains and stress usually improves within a week or two. It may take a few months before the pain disappears entirely.

How can I prevent neck pain?

You can take steps to prevent neck pain related to strains and tense muscles.

Practice good posture. Position electronic devices, like computers and phones, so you don’t have to slouch or strain your neck when using them. Keep your shoulders aligned and your back straight when seated so you’re not straining your neck. Adjust the seats in your car to maintain good posture while traveling.
Adjust your sleep position.Maintain good posture when you’re asleep. If you sleep on your back or side, use a pillow to support your head so your head and neck are aligned with the rest of your body. If you sleep on your back, place a pillow underneath your knees to take additional pressure off your low back. Avoid sleeping on your stomach with your head turned.
Stay active.You can use many of the same exercises used to relieve neck pain to prevent it. If you work a job that involves sitting for long periods, take occasional breaks to move around and stretch your entire body, including your neck muscles.
Don’t carry heavy weight on your shoulders.Avoid carrying heavy objects like book bags or suitcases over your shoulder. Instead, consider using luggage or bags with wheels.
Exercise your upper back extensor muscles. It’s normal to lose strength in your upper back as you age. As a result, your shoulders rock forward, and your head tips forward in a position in front of your spine. This positioning puts additional strain on your neck and upper back.
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Exercises that can help strengthen your upper back extensor muscles include:

Scapular squeezes: Pinch your shoulder blades together 10 times.
Standing push-ups: Do push-ups in a doorframe, allowing your shoulders to go past your hands 10 times.
Theraband rowing: Wrap the middle of a theraband around a doorknob so it’s stable. While standing, grab an end with each hand. Pull your hands toward your waist 10 times.


When To Call the Doctor

When should I call the doctor if I have neck pain?

Contact a healthcare provider if you have neck pain that interferes with work or other daily activities. In rare cases, neck pain can be a sign of a medical emergency.

Seek urgent medical care if your neck pain:

Develops after an accident.
Involves a loss of bowel or bladder control.
Persists whether you’re moving or staying still.
Involves a headache, dizziness, nausea or vomiting.
Occurs with chills, fever or unexplained weight loss.
Occurs with numbness or tingling in your arms, shoulders or legs.
Occurs with weakness in your legs or loss of coordination in your arms or legs.
Doesn’t get better with over-the-counter medications.
Doesn’t improve after one week.
It’s easy to overlook the important work your neck does — until you experience neck pain or have trouble moving your head. The average human head weighs about 10 pounds. Your neck is responsible for supporting this weight and keeping your head aligned with the rest of your body. Over time, this work can take a toll on your body, especially if you’re constantly straining your neck. Take preventive steps to avoid neck pain, like practicing good posture and taking frequent breaks to move and stretch. If you’re experiencing neck pain, see a healthcare provider. They can recommend medications and therapies that can provide relief.JAN

01/31/2025

Lifespan

The maximum human lifespan — so far — is a little over 120 years. That’s much greater than the average human life expectancy. But both of those metrics are trending upward. And the goal of modern medicine is to increase both the average and the maximum, while also narrowing the gap between the two.

What is lifespan?

Lifespan is the maximum length of time that a person can live. Right now, the maximum human lifespan is 122 years. Experts base that lifespan on the longest-lived person with a verifiable date of birth.

The person who holds that record is Jeanne Calment, a French woman who died in 1997. For people assigned male at birth (AFAB) only, lifespan is a bit shorter. The verified longest-lived man was Jiroemon Kimura of Japan, who died in 2013 at age 116.

But lifespan is just one metric for how long humans can or should live. Others include:

Life expectancy
Longevity
Healthspan
Life expectancy

Life expectancy is an average age that a group of people are likely to survive to. It’s common for people to use this term interchangeably with “lifespan.”

There’s no way to predict how long a single person is going to live with any accuracy. So, experts calculate an approximate average based on population statistics.

Where you live can heavily influence your life expectancy. Some other factors that play a role in that include (but aren’t limited to) the following:

Access to healthcare (including physical access, affordability, and availability of professionals and supplies)
Access to nutritious foods and clean water
Availability of sanitation services
Biological family history
Climate and any impacts of climate change
Environmental regulations to limit how pollution affects you
Inherited or genetic factors
Medical history
Presence of public safety services like firefighting and law enforcement agencies
War or armed conflicts
And sometimes, global concerns affect life expectancy. The worldwide COVID-19 pandemic that started in late 2019 caused global life expectancy to drop for two straight years, sinking to 71 in 2021.

Longevity

Longevity is the term for living longer than the average life expectancy. And around the world, the number of people living longer than average is going up. In 2000, the number of people over 75 was about 152 million. As of 2023, that number has almost doubled to 300.8 million.

Healthspan

Advances in modern medicine mean people are living longer. But living longer isn’t the same thing as being alive and healthy. That’s where the concept of healthspan comes in.

Healthspan is how long people can live without chronic conditions and age-related disabilities. It’s a concept that researchers may use when looking at groups of people, not individuals. A group with a longer average healthspan may have better health than other similar groups. Or it might mean that health interventions aimed at the group are working.

What’s the average human life expectancy?

As of 2022, the worldwide average life expectancy was 72 years. That’s well over double what the average life expectancy was in 1900. Back then, it was 32.

For people AMAB, the average life expectancy is about 70 years. For people assigned female at birth (AFAB), it’s about 75 years.

But 72 is just the global average. It can vary a lot from country to country. In 2022, the top five average life expectancies worldwide were in:

1. Macao: 85 years.

2. Liechtenstein: 84 years.

3. Japan: 84 years.

4. Hong Kong: 84 years.

5. French Polynesia: 84 years.

The United States ranks 64th on that list, with an average life expectancy of 77 years. The average life expectancy for people AMAB in the U.S. is 75. For people AFAB, it’s 80.

What’s the difference between life expectancy and lifespan?

Life expectancy is the average age that people live to. This average can vary depending on where you live, your personal background and more. Lifespan is the maximum age people can live to, so it’s much longer than the average.

Lifespan, life expectancy and longevity are all words you might use to refer to the length of a person’s life, but they aren’t always the same thing. You might not always need to use these terms as precisely as an expert or researcher, but it can still help to know their meanings. And while these concepts can’t predict how long you’ll live, they can help you better understand some of the context of your health. That knowledge can help you live a life that’s healthier, longer and, hopefully, happier.

12/06/2024

BALANCE PROBLEMS AND ROLE OF MAGNESIUM SULFATE IN IMPROVING HAZARDS

Chu J, Bruyninckx F, Goodman S

Chu J, Emeritus Associate Professor, Department of Physical Medicine and
Rehabilitation. University of Pennsylvania School of Medicine, Philadelphia,
Pennsylvania, USA
Bruyninckx F, Emeritus Clinical Professor, Department Of Physical Medicine and
Rehabilitation, University of Leuven Medical School, Leuven, Belgium
Goodman S, Consultant

Balance is an even distribution of weight enabling someone or something to remain upright and steady. To keep equilibrium a person has to adjust between opposing or divergent influences or elements
To be able to move, ambulate, and to be able to propel an individual forward or onward, this is done by means of a force that imparts motion. However, an individual with a locomotor disorder like e.g. Parkinson’s disease that is characterized by a tendency to retropulsion, which is to walk backwards, has difficulties to accomplish this.

Center of Gravity
The center of gravity occurs in the body at a point where weight is equally distributed on all sides. Center of gravity can also be referred to as center of mass. From this point, a body can pivot in any direction and remain balanced. When standing evenly over one’s center of gravity, one is in a state of equilibrium.
Where the center of gravity is located during locomotion is quite important so that the person in motion does not have calamities such as tripping, slipping and sliding causing them to fall which happens more often in the elderly. This can result in fractures and even spinal cord injuries.

Line of gravity
The line of gravity is an imaginary line that crosses through one’s center of gravity dividing the mass of the body into two equal halves. This line changes depending on the body's weight distribution. It is a vertical line running from the top of the head, usually around the ear, down to the ground anterior to the sacral vertebra behind the hip joint, anterior to the knee and ankle. To keep one’s body in balance, the posture must correspond with the person’s line of gravity.

Base of Support
How wide the person spread their feet determines the base of support and thus determines balance. The closer the center of gravity is to the ground, the more stability the person will have; the farther apart feet are placed, the steadier the person will feel. A good base of support is needed when climbing and going up and down staircases and especially when moving or lifting heavy objects..

Gravity and the Body
Gravity affects many parts of the body as one ages. It compresses the spine, contributes to poor blood circulation and can decrease flexibility. The gravitational pull also affects internal organs, causing them to shift downward, away from their proper position. Gravity is often held responsible for the way excess weight accumulates around the midsection of the body.
The center of gravity moves during the sit-to-stand movements making these motions hazardous. (1) Further studies need to be done carried out on patients who have structural deformities of the spine or weakness in the lower limbs as seen in various diseases of the spine including hemiplegia, especially sit-to-stand. (2) It has been shown that elderly people have difficulty standing on one leg for 10 seconds especially standing on the non-dominant side making it more dangerous. Anyone with spinal deformities and the elderly when ascending or descending steps should perform step to maneuver, that is, ascend to the step above or below only after when they have both feet implanted on the desirous step.
Stair climbing is one of the most challenging tasks that is performed frequently. It is difficult to negotiate going up or down steps and this study showed some additional spatiotemporal parameters during the stair case negotiation. (3)

Figure 1., below, shows various spinal conditions all in the lateral view, ranging from normal to abnormal conditions such as kyphosis, lordosis, flatback, and scoliosis. These disease conditions are treatable with physical therapy and there is only a very seldom need for spinal surgery. (4)


Figure 1. Different spinal abnormalities affecting the line of gravity

During the gait cycle, clinical assessment for sagittal plane knee and hip joint kinematics, as well as some spatiotemporal variables including pelvis displacement and step characteristics were tested. This showed the importance of pelvic, knee and joint movements having influence on the gait cycle which becomes amplified in the situation of spinal and limb abnormalities. (4)
In addition to fixed structural abnormalities, the size of the muscles determines their strength. There are four large and strong muscles namely trapezius, latissimus dorsi, gluteus maximus and adductor magnus. How the line of gravity passes through, makes these muscles tight or more difficult to relax well and unable to perform optimally and thus makes the joints more misaligned.
Since the line of gravity is very important, we support the muscle functions by making muscles as relaxed as feasible by using transdermal magnesium sulfate with the intention of making the especially huge muscles less shortened and tight. When muscles are relaxed, the joints can be more in alignment, improving the range of motion thus giving better function overall to perform daily activities. The usual daily activities of living (ADL) include sitting to standing, ambulation on inclines, stair climbing and social activities and ability to perform ADL leads to improvement in quality of life. When balance improves there will be less falls and less injuries and less chance of developing spinal and head injuries that can lead to dementia. (5, 6)


REFERENCES
1. Oh J, Kuenze CM, et al. Validity of the Microsoft Kinect™ in assessing spatiotemporal and lower extremity kinematics during stair ascent and descent in healthy young individuals. 2018, Oct:60:70-76. J. Medengphy, 2018.07.011. Epub 2018 Aug 8. 2019 Apr:66:91-95
2. Tanaka R , Ishii Y, Yamasaki T, et al. Measurement of the total body center of gravity during sit-to-stand motion using a markerless motion capture system. J. Medengphy, 2018.12.020. Epub 2019, Feb 21
3. https://www.mdedge.com/internalmedicine/article/271318/geriatrics/how-old-are-you-stand-one-leg-and-ill-tell-you?ecd=WNL_EVE_241026_mdedge&uac=437296MY&sso=true
4. https://wexnermedical.osu.edu/brain-spine-neuro/spine-diseases-conditions/spinal-curvatures
5. Chen Y, Tang Y , Allan V. Fall-induced spinal cord injury: External causes and implications for prevention. Spinal Cord Med 2016, Jan;39(1):24-31
6. Ordubad A, Dhanani H, Tulebaev S et al. Risk of Dementia Diagnosis After Injurious Falls in Older Adults. JAMA Netw Open. 2024;7(9)

Here’s some information about how Ohio State’s Wexner Medical Center cares for spine disorders I wanted to share with you.