Chronic back pain is on the rise – in part because the way we treat it often does more harm than good. It’s time to think differently about our aches.  One in four adults are experiencing it right now, and 90 per cent of people having back pain at least once in their life. Nearly a quarter of all primary care appointments for adults are for back pain.Back pain is a leading cause of disability around the world. In the US alone it costs an eye-watering $635 billion a year in medical bills and loss of productivity.

Much of the blame has fallen on our increasingly desk-bound lifestyles and growing lifespans, which mean more years of wear and tear on our spines.   Slumping in front of computer screens puts pressure on the muscles, ligaments and discs that support the spine and can deactivate muscles that promote good posture.   Obesity (amplifies the mechanical strain on the back and decreases mobility, and increases the production of inflammatory chemicals associated with pain.) and smoking (associated with a clogging of the arteries, which can damage the blood vessels that supply the spine) , are both huge contributors to back pain.

Identifying which of these problems has led to your own back pain is incredibly difficult. According to one study in the US, Less than 1 per cent of people who seek help will have something seriously wrong,  It turns out that MRI scans simply cannot indicate to a doctor what is wrong. They are not only be a waste of time and money, but it can actually worsen your back pain. Once you start to look for abnormalities, you will find them. Once that happens, doctors are more likely to prescribe painkillers, steroid injections or surgery, which may be unnecessary, ineffective and sometimes harmful.  In fact, people  who have had an MRI are more likely to move on to surgery, exposing them to the risk of infection and other complications. “The potential for harm has been shown in many studies,” says Buchbinder.

In the UK, for instance, patients are offered anti-inflammatory steroid injections, but these have been shown to be no more effective than placebo. They can also cause increased appetite, mood changes and difficulty sleeping.  In the US doctors tend to prescribe stronger opioid painkillers than are necessary,  fuelling the opioid crisis that has decreased life expectancy in the US. Backache is the number one reason for prescribing opioids. (Part of an unusually long article. Helen Thomson in New Scientist)

Tomorrow: The probable causes of back pain and what to do about it

Apparently, an increasing number of men want joy, laughter and happiness in a girlfriend – and no drama.  They appear to be looking for a partner who never gets angry, afraid or sad, who never worries about her family, money or her job, never complains, and by extension, gives the impression she will be quite content to be messed around by thoughtless men.

This is, of course, ridiculous. These men must be very spoiled by their parents.  Presumably, everything in their lives has so far run faultlessly and smoothly.  Poor dears, they must not be bothered by real life.  It is understandable that one might avoid someone with a severe personality disorder, but “no drama” infers that the lads will only be happy with someone with no issues.   Good luck with that!

Is this a side-product of internet dating?  The internet promises an infinite number of possible matches, or at least appears to.  If one lass doesn’t work out there are hundreds more to try out.   Why choose a challenging young woman if a fun one is an easy option.  But what we think we want isn’t necessarily what’s best for us.  In the old days you might connect with a difficult partner and you had to make the best of it and learn to cope, to be patient and understanding.  The perfect partner has wings, a long dress, a golden trumpet and is depicted on church walls, a mythical angel.

We are breeding a lot of selfish people who, if things don’t go precisely their way, grab their teddy bears and go home alone, or at least opt out, stay home and watch a Netflix movie.  Dedicating your life to another human being with a few natural, human failings is a wonderful and fulfilling thing.  You are a better person for it, in sickness or in heath.

I owe the readers an apology.  I have spent far too much time alluding to politics on this blog, something Epicurus would tut-tut about were he with us and had a computer.

I live between the US and the UK, both unhappy places, and have allowed myself  ( I like to think for patriotic  reasons) to dwell too much upon the divisive politics in both countries.  I realise millions are absorbed in them as well, but that is no excuse.  This is the Epicurus.Today blog, and Epicurus not only advised us not to involve ourselves directly in (party) politics, but, if we were to achieve calm and peace of mind, to ignore the subject.  Yes, that is a bit difficult to do!

Why do I raise this now.  Because I have been attending lessons in the Alexander Technique, famous among actors and musicians.  The teacher told me that, far from reaching a state of ataraxia, I was  getting more anxious and uptight, and that this did nothing for my health and was probably making me grumpy.  He is right!  Too much time exclaiming , “Oh. no! I don’t believe it!  ( Does this ring a bell, perhaps? )

So I have made a directional decision:  I will henceforward try to choose subjects which are not directly party political, and will concentrate on subjects which you ought to know about, but which are concerned with decency, consideration, human kindness (or unkindness), selfishness (or unselfishness), greed generosity etc.  In other words subjects concerning human behaviour, and what Epicurus might say about our collective faults and foibles.

I hope I won’t lose you!  Think of it this way, I am trying to illustrate Epicurean principle with real-life examples.  There is little Epicurean about current politics, which could be causing us to age, to be bad tempered  and jump up and down.  Best keep the latter for the gym!

People with optimistic outlooks tend to live longer than their more negative peers, researchers at Boston University School of Medicine have found. The study drew on data from two long-running studies of Americans aged over 60: one of 1,500 male war veterans, and one of 70,000 female nurses. At the start of both, the participants had completed questionnaires to gauge how optimistic they were, and had also been asked about other factors likely to influence their longevity, including diet, health and exercise.

Analysis of the data revealed that most optimistic participants lived 10% to 15% longer on average than the least optimistic ones, and that they were significantly more likely to live to the age of 85. “Healthier behaviours and lower levels of depression only partially explained our findings,” said lead researcher Dr Lewina Lee. “Initial evidence from other studies suggests that more optimistic people tend to have goals and the confidence to reach them, are more effective in problem-solving, and they may be better at regulating their emotions during stressful situations.” The exciting possibility raised by the findings, she added, is that we may be able to “promote healthy and resilient ageing by cultivating psycho-social assets such as optimism” in people.  (The Week, 7 September 2019)

This is mainly common sense, and must be the very devil to quantify. However, it poses the problem “how can one be optimistic when you see your ordered world so casually disordered by people so dissatisfied with the world that they can condemn the world to potential chaos”.  I refer in particular to the climate change deniers, who might live a year or two longer owing to their optimism, but are condemning millions to chaos and early death with their stubborn denial.  These people are not admirable.

As for world politics….well…..   Last night we watched a movie on the rise of Hitler, a reminder of how human beings never seem to learn.  They say they want “strong men” who “get things done”.   But seldom are these paragons able or prepared to think things through before lurching in and causing chaos.  I am thinking of Brexit, of course. The politicians involved in it had multiple years to identify the difficulties, but were too lazy and effete to do the work. So we, the people, suffer.  Hard to be optimistic.  But then Epicurus knew this and warned against involvement in politics.