Myths and Facts about Shingles

 

What Is Shingles?

When you have chickenpox, the virus that caused it sticks around, even after you get better. Later on, that virus can trigger another infection called shingles, which is known for a painful rash with blisters.

Myth: Only Older People Get Shingles

While the infection is more common in people over 50, anyone who’s had chickenpox can get it, even children. Younger people are more likely to have it if their immune systems are weak because of certain medicines or illnesses like cancer or HIV.

Myth: Shingles Is Rare

About a third of all Americans will get it in their lifetimes. That’s 1 million per year. Half of people who reach age 85 will have had shingles at some point

Myth: It’s Not Contagious

The open blisters of the rash can’t pass on shingles, but they can spread the chickenpox virus to someone who’s never had it. And that can lead to a later shingles outbreak.

Myth: Chickenpox Is the Same Thing

They’re caused by the same virus, but shingles and chickenpox are not the same illness. Chickenpox brings on hundreds of itchy blisters that heal in 5 to 7 days, usually in children. A shingles rash can last about a month.

Myth: It’s Gone in a Few Days

About 40% of people who get shingles feel a burning, shooting pain for months or years after the rash is gone. It’s called postherpetic neuralgia, or PHN. Your doctor can help you manage it with medication and other treatment.

Myth: You Can’t Treat It

If you take an antiviral medicine (acyclovir, famciclovir, valacyclovir) in the first 3 days after the rash  appears, that may ease the pain and help you get rid of it sooner. The earlier you start, the better it works. Prescription and over-the-counter pain relievers, corticosteroids, and nerve block treatments might also help.

Myth: You Can’t Get It More Than Once

It doesn’t happen often, but it’s possible. New bouts usually show up on different parts of your body. A shingles vaccine could lower your chances of a second infection, even if you get the shot after you’ve already had shingles.

Myth: The Rash Is the Biggest Problem

Aside from nerve pain caused by PHN, your skin can get infected, and you might have scarring, headache, fever, stomachache, or muscle weakness. Talk to your doctor as soon as you notice symptoms  so you can get treatment.

Fact: A Vaccine Can Help Prevent It

It doesn’t guarantee you won’t get shingles, but a vaccine can lower your chances by more than 90%. And if you do get the condition, it might not affect you as much. The CDC recommends that healthy adults 50 or older get two doses of the vaccine Shingrix, 2 to 6 months apart, unless they currently have shingles, are pregnant, or a test shows they have immunity. You likely have been exposed to chickenpox even if you didn’t develop blisters, so you should get the vaccine even if you don't remember being ill.

Fact: Stress Can Trigger Shingles

Stress can weaken your immune system and make you more likely to have an outbreak. Or it may simply run you down until you get a cold or some other illness that triggers one. And once you have shingles, stress can make the pain worse.

Fact: It Can Cause Vision Loss

If shingles makes your eye or eyelid red, swollen, or painful -- sometimes called ocular shingles -- it can be serious. Get medical help as soon as possible because it could lead to glaucoma, scarring, or even blindness. Blisters on the tip of your nose can be an early warning sign.

Fact: The Rash Can Get Infected

If blister pain and redness don’t get better -- or get worse -- over a couple of weeks, you could have a bacterial skin infection. See your doctor right away. It can make you heal more slowly and scar your skin.

Fact: Shingles Can Hurt Your Brain

It doesn’t happen often, but shingles around your eyes, ears, forehead, or nose can sometimes lead to brain swelling, paralyze part of your face, or affect your hearing and balance. In rare cases, an infection in these areas can lead to a stroke or meningitis (when tissues around your brain and spinal cord get infected and inflamed).

How to Listen to Your Body

 

Red Flags?

Your body will often let you know if something suddenly goes drastically wrong. If something feels really off -- like changes in being able to see, talk, walk, think clearly, or communicate, or having chest pain or shortness of breath -- call 911. Don’t wait to see if you feel better. If it’s a stroke or heart attack, you need medical care right away.

Do You Need A Rest Day?

You don’t feel up to your regular workout. Should you pass? Tune in. Do you feel sore and worn out? Then you may need a lighter day. Or are you feeling tempted by your favorite show and your couch? How often you need rest depends on how hard you work out and what you do, and how you feel. If you’re not in pain, some movement is usually a good idea. A certified personal trainer can give you a training schedule that builds in recovery.

Is It Aging?

Some pain from wear and tear on your body is natural as you get older. Or you may notice that you’re not as flexible or strong as you used to be. The cushion at your joints and between the bones of your spine can start to break down. That could hurt and limit your movement. It helps to stay active, but when the pain doesn’t go away, your doctor might suggest a specialized “rehab” exercise routine to manage it.

Your Heart Rate Feels Off

You may feel lightheaded or dizzy with a racing, fluttering, or slowed pulse. If it lasts more than a few minutes or happens often, it might be from an illness or heart rhythm problem. Serious chest pain or trouble walking or speaking could mean a heart attack or stroke: Get to a hospital. An easy workout that suddenly seems hard and raises your pulse longer than usual may mean you’re overdoing it. Talk to a doctor about your symptoms.

Burned Out?

If you’re under stress that doesn’t let up, it can really get to you. You might notice that you’ve got less energy, headaches, an upset stomach, or other symptoms. Little things that you used to be able to shake off now bother you. These may be signs that you need to step up your stress management. What helps: exercise, positive relationships, meditation, smiling and laughing, and taking breaks from whatever causes you stress.

Mood Matters

Everyone has times when they feel down or anxious. But if you have depression or anxiety, those conditions can affect you physically as well as emotionally. You might notice that you cry a lot, isolate yourself, avoid doing things you normally love, have tense muscles, find it hard to concentrate, and sleep or eat more (or less) than normal. These are cues to talk to your doctor or a therapist to get help.

Appetite Changes

If you find that you eat a lot more, or a lot less, than usual, your body may be telling you that something isn’t quite right. It might be that you’re stressed out and are eating for emotional reasons. Or you might be depressed, and that’s dimmed your appetite. Some conditions, and even getting older, can also affect your appetite. It helps to be active and to favor flavorful, healthy food. If that doesn’t help, let your doctor know.

Injured or Just Sore?

A good gym session might make you mildly sore. But muscle pain that lasts several days could mean you overdid it -- too much, too soon, or too hard -- and have an injury. It’s best to wait until you’re back to normal to exercise again. So to stay healthy and keep to your routine, keep your intensity low and ramp up slowly.

Put on the Brakes

When you’re working out and your body screams “Stop!” listen. You may have broken a bone or torn a muscle or ligament. Try RICE:

• Rest: Lie down and keep your weight off

• Ice: 20 minutes at a time

• Compression: Use a bandage for support

• Elevation: Raise the hurt area (above your nose if you can)

Go to an ER or clinic if the pain is intense, it worsens, or you also have fever and chills. Call your doctor if it still hurts after 2 weeks.

Sleep Problems

Do you often toss and turn at night? Your body may be saying you need more sleep. First, try simple things, like going to bed and getting up at the same time every day, sleeping at least 7 hours a night. Keep your bedroom cool, and don't watch TV or check your phone after bedtime. Being active during the day also helps. Avoid big meals and caffeine too close to bedtime. If that’s not enough, ask your doctor what the problem might be.

Pain That Doesn’t Quit

Are you noticing twinges and aches that happen over and over again? Don’t try to cover them up with medication or just “work through” them. You want to stop a minor ache from turning into a major problem that won’t go away. A doctor can help you pinpoint the source of the problem and treat it. You might need physical therapy so you start to feel it better.

A New Lump

Whether you’re a woman with a lump in their breast or a young man with a testicular lump, these are good things to get a doctor to check. You really can’t tell what they are, just based on how they feel. They aren’t always cancer, but it’s important to find out about new lumps for sure, and as soon as possible, in case you need treatment.

A Bad Reaction

Maybe you think you’re starting to get allergies to pollen, or that your gut can’t handle lactose or gluten. Or you notice that your skin is itchy and dry all of a sudden. These are things that are easy to jump to conclusions about. But it’s a good idea to see a doctor to find out if you really do have an allergy or if something else is causing your symptoms. That way, you’ll know what you need to avoid and how to treat your triggers.

Trust Yourself

You know yourself inside and out: how you feel on a good day, what feels “off,” when you’re sick, when you’re rested. It can all show up in your body, from a clenched jaw from stress, to a sore calf muscle after hiking all weekend, to something serious. Sometimes it’s hard to tell on your own, so never hesitate to ask your doctor, who’s there to help.

What Helps Your Doc

When you go to your doctor to find out what’s causing the problems you’ve noticed, there are a few things that will help. Bring a list of your symptoms, when they started, what seems to help, what makes them worse, and how you tried to fix the problem. Tell your doctor about all the things you take, including vitamins, herbal products, over-the-counter medicines, and prescriptions. And bring a list of questions that are on your mind.

How to Handle Pandemic Weight Gain

 

By Sally Kuzemchak, MS, RDRegistered dietitian September 13, 2021

At the doctor’s office recently, the nurse weighed me and said, “That’s 5 pounds heavier than last time you were here.”

I was taken aback -- not by the news, but that she’d actually made the comment.

“Well, the pandemic happened,” I said. “I baked a lot this past year. And I guess I ate a lot too.”

We both ended up chuckling about it. (Mine was nervous chuckling.) But I couldn’t help but wonder how many other patients were on the receiving end of that kind of comment -- and how many didn’t feel like laughing about it.

Last year, I urged you to not stress about lockdown weight gain. At the time, many of us thought we were in a short-term crisis, something that would alter our routines temporarily.

But as we head into another fall and winter that are feeling a lot like last year, you may feel like your body, habits, and physical and mental health have never fully returned to what they were before COVID. And that might feel frustrating. Here’s some advice:

Make small adjustments. Some people have used this time to start new exercise regimens or overhaul their eating. If that’s you, great. But for most of us, extreme changes will only add more stress in an already stressful time. Instead, make tinier, less painful changes that will still make a difference. For me, I scaled back my near-daily baking habit to weekends only and incorporated a couple lighter dinners each week to replace some of the heavier comfort food we were leaning on.

Find movement you enjoy. Movement is more important now than ever. I traded in boot camp workouts for Jazzercise and discovered that incorporating dance into my workouts made all the difference. Going to classes in person and virtually all through last year was vital for my physical and mental health. Walks with friends -- either in person or on video messaging apps -- were also a lifeline for me.

Plan ahead. As we’re moving into fall and winter, think back at where you struggled the most last year. Do you need to make some healthy meals for the freezer, stock up on hand weights in case your gym closes, or book a future appointment with a dietitian or therapist?

Give yourself some grace. Even though we’ve had to adjust to these circumstances as a bizarre “new normal,” there’s nothing normal about it. We’re all still living through a crisis, with stressful news that changes rapidly. Recognize this, give yourself credit for surviving this, and practice self-compassion. And if asking not to be weighed at the doctor’s office would help, you have the right to do that too!

Health Uses for Hydrogen Peroxide

 

Cleaning Cuts

Pour it on a wound and watch the serious bubble action! It kills germs, but soap and warm water do the same job much more gently. Hydrogen peroxide may irritate the delicate tissue around cuts or sores and make you take longer to heal. Still, it might be a good thing to stash it in your first aid kit in case you’re not near clean water.

Earwax

Your doctor can tell for sure if your ear’s clogged with it. They may flush it or scoop it out with a special tool. At home, you may soften the wax with a few drops of hydrogen peroxide or baby oil from an eyedropper. Rinse gently after a day or two with warm water from a rubber ball syringe. Then tilt your head until all water drains and towel dry the outside of your ear. If this doesn't work, call your doctor for advice.

Swollen Gums

This may happen if you don’t brush and floss enough or if your mouth or gums get hit. It might help to treat it with a rinse of one part hydrogen peroxide (3%) and two parts water. Swish it for 30 seconds and then spit. Saltwater is another option. Call your doctor if your sore gums stick around for more than about 7 days.

Canker Sores

Over-the-counter rinses with hydrogen peroxide (Orajel, Peroxyl) may ease pain and speed healing of these roundish, light colored sores in your mouth. They’re not contagious, but they may hurt a lot. It’s not clear what causes them. Even without treatment, they usually go away in a week or so.

Whiten Teeth

You can whiten your teeth with drugstore products that have hydrogen peroxide. Your dentist can treat you with a stronger version at the clinic. But take care: Too much could damage your teeth and the delicate surrounding gum tissue. Even normal use can turn your teeth oversensitive and cause other problems. It’s best to talk to your dentist about how to whiten your teeth safely and how often to do it.

Hair Dye

Hydrogen peroxide can help bleach or color your hair, too. Just be sure to follow instructions on the product for use and safety. It’s important to take care because at higher concentrations it can burn your scalp and skin. Plus overuse of dyes can turn your strands dry and brittle so that they start to look thinner.

Acne

Hydrogen peroxide is an ingredient in a number of ointments and mixtures to zap pimples. And they seem to work just as well as benzoyl peroxide, the mainstay acne treatments. But the chemical can be harsh, especially if you have scars, cuts, or sores on your face. Talk to your doctor before you use it in any form on your skin.

Disinfectant

Hospitals use it because it’s especially good at killing a parasite called cryptosporidiosis (crypto) that spreads in human poop. Even bleach can’t seem to easily get rid of these stubborn pathogens. Hydrogen peroxide may also work against the norovirus, which is both hard to kill and very contagious. More research is needed to know how well it works as a decontaminant.

Seborrheic Keratoses

These harmless skin growths tend to come on after middle age and can look like warts. These “barnacles of aging” often pop up on the chest, neck, and back. A new hydrogen peroxide-based medicine seems to get rid of them. Talk to your doctor about a prescription.

Cancer

Some people claim hydrogen peroxide helps fight cancer and other illnesses. There’s zero proof for this, but lots to suggest it can make you very sick if you drink it, inhale too much of its gases, or otherwise misuse it. Ask your doctor about any alternative treatments before you start.

Guide to Multiple Sclerosis

 

What Is Multiple Sclerosis (MS)?

MS is a chronic disease that damages the nerves in the spinal cord and brain, as well as the optic nerves. Sclerosis means scarring, and people with MS develop multiple areas of scar tissue in response to the nerve damage. Depending on where the damage occurs, symptoms may include problems with muscle control, balance, vision, or speech.

MS Symptoms: Weakness or Numbness

Nerve damage can cause: 

• Weakness in an arm or leg

• Numbness

• Loss of balance

• Muscle spasms

These symptoms may lead to frequent tripping or difficulty walking.

MS Symptoms: Vision Problems

More than half of people with MS experience a vision problem called optic neuritis. This inflammation of the optic nerve may cause blurred vision, loss of color vision, eye pain, or blindness, usually in one eye. The problem is usually temporary and tends to improve within a few weeks. In many cases, vision problems are the first sign of MS.

MS Symptoms: Speech Problems

Although less common than vision problems, some people with MS develop slurred speech. This happens when MS damages the nerves that carry speech signals from the brain. Some people also have trouble swallowing.

Other MS Symptoms

MS can take a toll on mental sharpness. Some people may find it takes longer to solve problems. Others may have mild memory loss or trouble concentrating. Most people with MS also experience some loss of bladder control, because signals between the brain and bladder are interrupted. Finally, fatigue is a common problem. You may feel tired even after a good night's sleep.

Stroke vs. MS

Confusion, slurred speech, and muscle weakness can be symptoms of MS, but they can also be signs of a stroke. Anyone who suddenly has trouble speaking or moving their limbs should be taken to the ER immediately. Treating a stroke within the first few hours provides the best odds of a successful recovery.

How MS Attacks

In people with MS, the body's own immune system attacks the tissue surrounding the nerve fibers in the brain, spinal cord, and optic nerves. This covering is made of a fatty substance called myelin. It insulates the nerves and helps them send electrical signals that control movement, speech, and other functions. When myelin is destroyed, scar tissue forms, and nerve messages are not transmitted properly.

What Causes MS?

The roots of MS remain mysterious, but doctors see some surprising trends. It's most common in regions far from the equator, including Scandinavia and other parts of Northern Europe. These areas get less sunlight, so some researchers believe that vitamin D (the "sunshine vitamin") may be involved. Research suggests a possible link between vitamin D deficiency and autoimmune disorders, but studies are ongoing. Genetics appear to play a role, as well.

Who Gets MS?

MS is at least twice as common in women as it is in men. While it can strike people of any race, Caucasians appear to be most at risk. The chances of developing the condition are highest between ages 20 and 50.

Diagnosing MS

Tests are often used, along with a medical history and neurological exam, to diagnose MS and rule out other causes of symptoms. More than 90% of people with MS have scar tissue that shows up on an MRI scan. A spinal tap can check for abnormalities in the fluid that bathes the brain and spinal cord. Tests to look at electrical activity of nerves can also help with diagnosis. Lab tests can help rule out other autoimmune conditions or infections such as HIV or Lyme disease.

How Does MS Progress?

MS is different in every person. Doctors usually see four forms:

Relapsing-remitting: Symptoms flare during acute attacks, then improve nearly completely or "remit." This is the most common form of MS.

Primary-progressive: MS slowly but steadily worsens.

Secondary-progressive: Begins as relapsing-remitting type, then becomes progressive.

Progressive-relapsing: The underlying disease steadily worsens. The patient has acute relapses, which may or may not remit. This is the least common form of MS.

MS and Weather

Research suggests that the disease may be more active during the summer months. Heat and high humidity may also temporarily worsen symptoms. Very cold temperatures and sudden changes in temperature may aggravate symptoms, as well.

Treating MS: Medications

While there is no cure for MS, there are "disease-modifying drugs" that can reduce the frequency and severity of MS attacks. Use can result in less damage to the brain and spinal cord over time, slowing the progression of disability. When an attack does occur, high-dose corticosteroids can help cut it short. Many drugs are also available to manage troubling MS symptoms, such as muscle spasms, incontinence, and pain.

Treating MS: Pain Management

About half of people with MS develop some form of pain, either as a result of a short circuit in the nervous system or because of muscle spasms or strain. Doctors may prescribe antidepressants and anticonvulsant medications to ease nerve pain. Pain medicines and anti-spasm drugs may also be used. Muscle pain often responds well to massage and physical therapy. Be sure to discuss the options with your doctor if you find yourself in pain.

Treating MS: Physical Therapy

If MS affects balance, coordination, or muscle strength, you can learn to compensate. Physical therapy can help strengthen muscles, combat stiffness, and get around more easily. Occupational therapy can help retain coordination in your hands for dressing and writing. And if you're having trouble speaking or swallowing, a speech therapist can help.

Complementary Therapies for MS

Many nontraditional therapies for MS have not been well studied. Some people say acupuncture relieves symptoms such as muscle spasms and pain, but research to confirm its value isn't conclusive. Others have reported benefits from injections of bee venom, but a rigorous study, lasting 24 weeks, showed no improvements in disability, fatigue, or the number of MS attacks. It's important to inform your doctor about any supplements, special diets, or other therapies you want to try.

MS and Pregnancy

Doctors generally agree that it’s safe for women with MS to get pregnant. Research suggests no increased risk of complications during pregnancy. In fact, many women have fewer MS symptoms during pregnancy. High levels of hormones and proteins may suppress the immune system, reducing the odds of a new attack. It's best to talk with your doctors before pregnancy, as certain MS drugs should not be used while pregnant or nursing.  In the early months after delivery, the odds for a relapse can rise.

Staying Mobile With MS

The vast majority of people with MS are able to continue walking, though many benefit from some type of assistive device. Orthotic shoe inserts or leg braces can help increase stability. When one leg is stronger than the other, a cane can help. People with significant problems with their legs may need to use a walker. And a wheelchair or scooter may be best for those who are very unsteady or tire easily.

Adapting Your Home for MS

Making a few changes around the home can help you manage daily activities on your own. Install grab bars inside and outside the shower or tub. Use a non-slip mat. Add an elevated seat and safety rails to the toilet. Lower one of your kitchen counters so you can reach it from a sitting position. And get rid of any throw rugs, which are a tripping hazard.

MS and Exercise

Exercise can ease stiffness, fatigue, and other symptoms of MS. But overdoing it could make things worse. It's best to start slowly. Try exercising for 10 minutes at a time, then gradually working your way up to a longer session. Before you begin, check with your doctor about what type of activity and level of intensity would be most appropriate. A few possibilities include water aerobics, swimming, tai chi, and yoga.

Outlook for MS

Most people with MS live a normal or near-normal lifespan. While the condition may make it more difficult to get around or complete certain tasks, it doesn't always lead to severe disability. Thanks to effective medications, rehab therapies, and assistive devices, many people with MS remain active, stay in their jobs, and continue to enjoy their families and favorite activities.

Best Ways to Beat Belly Fat

 

Get More Fiber

You don’t have to eat a bag of Grandma’s prunes. Leafy greens, whole grains, nuts, and beans are all good for keeping away the fat that stays deep in your belly. That’s called visceral fat, and it’s the most dangerous kind because it can wrap around major organs, including your liver, pancreas, and kidneys.

Forget These Two Things

There are no “super foods” that burn off visceral fat. And you can’t tone it away with specific moves like crunches. Instead, look for ways to upgrade your eating habits and add activity every day. Think about your average week. Where might you be able to make some changes?

The Best Thing You Can Do

While anyone can have too much visceral fat, it’s more likely if you’ve got a lot of weight to lose. As you start to take those pounds off, it will help your whole body, including belly fat that’s hidden out of your sight.

Be Choosy About Fat

You can still have some! But limit the “saturated” kind that’s in animal foods, coconut and palm oils, and full-fat dairy. Keep the portions of those foods smaller than you might normally do, for instance. And check nutrition labels to see how many calories and how much fat is in a serving. Look for fats that are better for you, too, like those from plant foods or fish such as salmon, tuna, and mackerel that are rich in omega-3s.

Stop Trying to Outrun It

Still trying to “burn off” that belly fat by pounding the pavement for hour upon hour? Research shows that a few quick bursts of high-intensity exercise -- such as a 30-second sprint or intense pull-up set -- may be more effective, and easier to fit into your schedule. You can add bursts of higher intensity to any workout. Just speed up or work harder for a brief time, then drop back to a more mellow pace, and repeat.

Sleep: the Goldilocks Formula

When it comes to weight gain, shut-eye is a bit like porridge: Too little -- less than 5 hours -- may mean more belly fat. But too much -- more than 8 hours -- can do that, too. “Just right” seems to be around 6-8 hours. If you don’t sleep that much now, or if you tend to toss and turn, try to go to bed a little earlier, relax before bedtime, keep your bedroom cool, and try not to text and email right before you turn in.

Forget a ‘Quick Fix’

Sorry, but cosmetic surgery isn’t the solution here. Liposuction doesn’t reach inside the abdominal wall. So it can’t get rid of visceral belly fat. Likewise, crash diets aren’t the solution, either. You’re too likely to go off them. The slower, steadier option -- lifestyle changes that you can commit to for a long time -- really is the best bet.

Keep Calm

Are you stressed out? That can make you eat more fat and sugar, and unleash the “stress hormone” cortisol, which can boost belly fat. Stress also can make you sleep less, exercise less, and drink more alcohol -- which can add belly fat, too. It’s a great reason to take up meditation, work out, listen to music you love, or find other healthy ways to unwind and relax.

Rethink Your Drink

Whether it’s a latte, a regular soda, a mug of beer, or a glass of wine, it’s got calories. And when you’re trying to unwind the numbers on the scale, water (or a smaller glass of your favorite beverage) might be a better choice. If you drink alcohol, remember that it just might make you throw your willpower out the window when you order your meal, too. 

Don’t Smoke

As if you need another reason to quit. Smoking makes you more likely to store fat in your belly, rather than your hips and thighs. And that’s bad. Oh, and it’s also a cause of diabetes. And cancer. And heart disease. And lung disease. And … you get the idea. If you’ve tried before, try again. Tell your doctor, so you can get pointers on what might help you quit for good.

Don’t Rely on Clothing Sizes

One company’s size 14 could be another’s size 12. A better method is to measure your waist. If you’re a woman, you want that number to be 35 inches or less. Men get up to 40 inches. The reason? You may lower your chance of having a heart attack, a stroke, or possibly certain types of cancer. A tape measure can’t check on visceral fat. But along with the scale, it can help you track your weight loss.

Lift Weights

Think about hitting the gym instead of the trail. In one study, healthy middle-aged men who did 20 minutes of daily weight training gained less abdominal fat than men who spent the same time doing aerobic exercises, such as biking. Strength training is also good for women -- and it won’t make you bulky. You still need to do some cardio, but make sure strength training is in the mix.

Bad Habits for Your Back

 

Sit Hunched

It goes against the natural alignment of your spine. Slumping forward also puts more pressure on your lower back. Gently stretch and move your head and neck up and down and to the right and left every half-hour. To ease any pain or spasm, apply an ice pack or heating pad to the area. Be sure to cover the skin with a light towel or cloth first. See your doctor if the pain won't go away.

Too Many “Treats”

Choosing the wrong foods too often can lead to inflammation and leave out nutrients you need to be strong. Your body needs lean protein, whole grains, fruits and veggies, and healthy fats like those from avocado and salmon to build strong muscles, bones, and soft tissue in your back. Be sure to get nutrients like calcium, phosphorus, and vitamin D, too.

Sleep on the Wrong Mattress

It should be firm enough to support your back, but soft enough to fit the shape of your body. Your ideal mattress can depend on how you sleep and whether you already have back pain. Want to see if a firmer one might help? Put yours on the floor for a couple of nights without the bed-springs. Some stores let you return a mattress, even after several weeks, if it causes back pain or other problems.

Sleep on Your Back …

This may be one of the best positions if you have back pain. But it can be hard to change how you sleep since it's a habit you've probably had for a long time. It may help to put a rolled towel or pillow under your knees to keep the natural curve of your back. You also can try different pillow heights for your neck to find what's comfortable.

… Or on Your Belly

It's better not to do it, especially if you have a back problem. You're more likely to toss and turn, which can strain both your neck and lower back. If you're a belly sleeper and don't want to switch positions, it can help to lay your head on a very soft pillow or none at all to keep your neck in the right position.

How Should You Sleep?

Side sleepers seem to have luck avoiding back pain, especially if they're not curled up too tightly. Slip a pillow between your legs to take pressure off your hips and lower back, and tuck your legs slightly toward your chest. This position can be especially comfortable for people who already have back pain and for pregnant women.

Sit Too Long

It  stresses  your back muscles, neck, and spine. Slouching makes it worse. Sit straight in a chair that supports your back, and set the height so your feet rest naturally on the floor. But no matter how comfortable you get, your back won't like sitting for long stretches. Get up and move around for a couple of minutes every half hour to give your body a break.

Skip Exercise

You're more likely to have back pain if you're not active. Your spine needs support from strong stomach and back muscles. Lifting weights can help. So can everyday activities like climbing stairs and carrying groceries. Low-impact exercises like walking, biking, or swimming can help protect the disks between the bones in your spine. Make it a habit for most days. Don't be a “weekend warrior” who overdoes it and gets injured.

Smoke

Do it, and you're 3 times more likely to get lower back pain. It can curb blood flow, including to your spine. That might also the cushioning disks between your bones break down quicker. It also can weaken bones and give you osteoporosis, and it can slow healing. Even coughs from smoking can cause back pain. If you smoke, make quitting your top health priority and ask your doctor for help.

Overeat

Extra pounds can strain the bones and muscles in your back, especially if you gain weight quickly. Eat slowly so that your body has a chance to let you know it's full. Pick nutrition-packed munchies and meals so you feel satisfied with fewer calories. So if you snack on cheese or chips, try eating some veggies and plain yogurt instead.

Overload Your Bag

Heavy weights can strain your back and tire out muscles that you need to support your spine. This can affect kids who lug many books. Your child's backpack shouldn't weigh more than 20% of their body weight. Large, padded, adjustable shoulder straps help spread the weight evenly. But only if you use both straps. Slinging your pack or heavy purse over only one shoulder can cause strain.

Ride the Wrong Bike

Or just a badly adjusted one. It's bad for your back if you have to hunch over to grab your handlebars the way pro cyclists do. (They train hard to do it safely.) You also may have back pain if you're too stretched out or cramped up on your bicycle. A physical therapist can help you find a bike that's a good fit and suggest exercises to help if you have lower back pain.

Wear High Heels

You may overuse muscles in your lower back and harm your posture and your spine, especially as you age. If you wear them at the office, you might bring a pair of walking shoes for your commute. Regular foot and leg stretches, like rolling your foot on a tennis ball, may help prevent pain and strengthen muscles.

Should You Do Yoga?

Too much of any exercise, including yoga, can cause back pain. But in some cases, yoga can help relieve low back pain. Ask your doctor if yoga will be OK for you. There are lots of online resources and videos. But start with a yoga instructor first to make sure you're using the proper form and techniques. Just 10-20 minutes a few times a week of this mind-body exercise might help you feel better. But don't overdo it, and stop if it hurts.

Do Sit-ups Incorrectly

Never let them flatten the natural curve in your spine. You don't want to let your hip flexor muscles, which connect your thighs and lower back, do the work. When those muscles are too strong or too tight, they pull the lower spine, which can cause pain. Front and side planks -- where you support your stiff body on your hands, elbows, and feet -- are easier on your back and still build core strength.