Posture, Pain Relief and Exercise

Posture

Posture refers to how we hold our bodies. If your body is not in correct alignment, your muscles and other body parts are subject to extra stresses for which they are not designed. The following additional factors further increase the stress on your body:

• Poor footwear
• Being physically unfit
• Fatigue
• Emotional stress
• Being overweight
• Maintaining one position for too long.

Outlined below is a guide for good posture:

Sitting:	Place your bottom back in the seat, with hips and knees bent to 90 degrees and your feet flat on the floor (use a stool or book if your feet do not reach the floor). Avoid low, saggy chairs which are hard to get out of and provide poor support. Adjust your work chair correctly, considering seat tilt and heights of the chair and back support . When in a chair at home or in the car, use a lumbar roll (or roll up a towel) to support the curve in your lower back. Ensure your desk height is at elbow level.
Standing:	Keep your chin tucked in (not poked forward), shoulders relaxed (not hunched forward or backward) and knees a little relaxed (not forced backward). Vary your position by placing one foot on a stool and keep your work height at elbow level.
Lying:	A firm mattress will provide good support. It is better to rest your joints in a flat rather than a flexed position. Do not place a pillow under your knees and only place enough under your neck so it is not bent up or down.
Lifting:	Hold object close to your body and never bend or twist your spine.

Pain Relief

Heat or cold may be used to relieve your symptoms and help you cope with pain. These can provide temporary relief but do not affect the disease process itself. It is very important that you have adequate sensation in the area to which you are applying the heat or cold. When receiving a heat/cold treatment all you should feel is a mild or comfortable warmth/cold sensation, though not so hot or cold that it is painful. If you feel more than this, or the heat/cold concentrates in any particular spot you must remove the heat/cold, otherwise you may be in danger of being burned.

You should also check with your doctor or physiotherapist first before applying heat or cold if you have any of the following conditions:

• Poor circulation
• Open wounds
• Acute areas of inflammation and infection
• Skin disorders, eg eczema, dermatitis
• Areas of increased fluid tension
• Conditions where you bleed easily
• Severe heart or kidney disease

Heat Therapy

Heat can relieve pain, stiffness and muscle spasm and should be applied for 20 to 30 minutes. Ways of applying heat include:

• Hot shower or bath
• Hot water bottle
• Heat wheat pack
• Gel pack
• Hot towel
• Electric blanket
• Lambskin

Coat hands in baby oil, apply gloves and place hands in warm water (this is also a good time to do your hand exercises) .

Cold Therapy

Cold can be effective for the relief of pain, muscle spasm and swelling and should be applied for 15 to 20 minutes. It should not be used if you have Raynaud’s Phenomenon. Could can be applied using:

• Crushed ice in a wet towel
• A packet of frozen peas
• Gel pack

Exercise

Exercise has many physical, social and psychological benefits. Regular exercise can help to improve your:

• Muscle and joint mobility and flexibility
• Muscle strength
• Heart and lung fitness

These guidelines will help to make your exercise routine effective and safe:

1. Exercise on ‘good’ days and rest on ‘bad’ days

It is important to find a good balance between exercise and rest. When you are less comfortable, it may be possible to maintain some form of exercise by modifying the position in which you exercise (eg lying or sitting rather than standing) or decreasing the number of exercises. Performing some relaxation (breathing exercises, meditation or muscle relaxation) may help to enhance periods of exercise and rest. You do not have to do all your exercises at once.

2. Respect pain

You may push into a little bit of stiffness but never force joints into pain.

3. Do not substitute activities of daily living for exercise

Vacuuming or sweeping do not have the same value as exercise.

4. Exercise at the right time

You will exercise more effectively if you are not in pain. Use heat therapy and medications prior to exercise.

5. Start exercise slowly and increase gradually

Individual joint exercises should start at 2 repetitions and increase one daily until you reach six. Start you walking program at 10 minutes and gradually increase.

6. If you have any medical problems, check with your doctor before starting a new exercise program.

7. Exercise safely and make it fun

• Make realistic goals
• Keep your fluids up
• Wear correct clothing and footwear
• Keep a diary
• Warm up and cool down
• Exercise with a friend or take your dog for a walk to the shops
• Do not hold your breath when you exercise. You should be able to carry on a normal conversation when you exercise.

The following forms of exercise may be suitable for you:

• Walking
• Badminton
• Swimming
• Line Dancing
• Aquarobics
• Ballroom Dancing
• Tennis
• Table Tennis
• Cycling
• Tai Chi
• Golf Yoga
• Bowls
• Stretch and Tone Classes
• Croquet
• Individual joint range of movement exercises at home or in a pool

If you have any particular concerns, please see your doctor for a referral to see a physiotherapist for advice on posture, pain relief and an individualised exercise program.