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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 focuses 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.

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. 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. It can often be diagnosed and treated. It usually goes away, though sometimes it can turn into chronic pain.
• Chronic pain lasts for a long time, and can cause severe problems

Pain relievers are medicines that reduce or relieve pain. There are many different pain medicines, and each one has 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. And if you do need to take medicines, also doing some non-drug treatments may allow you to take a lower dose.

There are many non-drug treatments that 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 stimulating 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 interrupting or blocking the 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, as well as 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 be able 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 it is caused by back problems or serious musculoskeletal injuries. There are always risks to getting surgery, and it does not always work to treat pain. So it is important to go through all of the risks and benefits with your health care provider.

The esophagus is the tube that carries food from your mouth to your stomach. If your child has reflux, his or her stomach contents come back up into the esophagus. Another name for reflux is gastroesophageal reflux (GER).

GERD stands for gastroesophageal reflux disease. It is a more serious and long-lasting type of reflux. If your child has reflux more than twice a week for a few weeks, it could be GERD.

There is a muscle (the lower esophageal sphincter) that acts as a valve between the esophagus and stomach. When your child 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 children who have reflux and GERD, this muscle becomes weak or relaxes when it shouldn't, and the stomach contents flow back into the esophagus. This can happen because of:

• A hiatal hernia, a condition in which the upper part of your stomach pushes upward into your chest through an opening in your diaphragm
• Increased pressure on the abdomen from being overweight or having obesity
• Medicines, such as certain asthma medicines, antihistamines (which treat allergies), pain relievers, sedatives (which help put people to sleep), and antidepressants
• Smoking or exposure to secondhand smoke
• A previous surgery on the esophagus or upper abdomen
• A severe developmental delay
• Certain neurological conditions, such as cerebral palsy

Many children have occasional reflux. GERD is not as common; up to 25% of children have symptoms of GERD.

Your child might not even notice reflux. But some children taste food or stomach acid at the back of the mouth.

In children, GERD can cause:

• Heartburn, a painful, burning feeling in the middle of the chest. It is more common in older children (12 years and up).
• Bad breath
• Nausea and vomiting
• Problems swallowing or painful swallowing
• Breathing problems
• The wearing away of teeth

In most cases, a doctor diagnoses reflux by reviewing your child's symptoms and medical history. If the symptoms do not get better with lifestyle changes and anti-reflux medicines, your child may need testing to check for GERD or other problems.

Several tests can help a doctor diagnose GERD. Sometimes doctors order more than one test to get a diagnosis. Commonly-used tests include:

• Upper GI series, which looks at the shape of your child's upper GI (gastrointestinal) tract. You child will drink a contrast liquid called barium. For young children, the barium is mixed in with a bottle or other food. The health care professional will take several x-rays of your child to track the barium as it goes through the esophagus and stomach.
• Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your child's esophagus. A doctor or nurse places a thin flexible tube through your child's nose into the stomach. The end of the tube in the esophagus measures when and how much acid comes back up into the esophagus. The other end of the tube attaches to a monitor that records the measurements. Your child will wear the tube for 24 hours. He or she may need to stay in the hospital during the test.
• Upper gastrointestinal (GI) endoscopy and biopsy, which uses an endoscope, a long, flexible tube with a light and camera at the end of it. The doctor runs the endoscope down your child's esophagus, stomach, and first part of the small intestine. While looking at the pictures from the endoscope, the doctor may also take tissue samples (biopsy).

Sometimes reflux and GERD in children can be treated with lifestyle changes:

• Losing weight, if needed
• Eating smaller meals
• Avoiding high-fat foods
• Wearing loose-fitting clothing around the abdomen
• Staying upright for 3 hours after meals and not reclining and slouching when sitting
• Sleeping at a slight angle. Raise the head of your child's bed 6 to 8 inches by safely putting blocks under the bedposts.

If changes at home do not help enough, the doctor may recommend medicines to treat GERD. The medicines work by lowering the amount of acid in your child's stomach.

Some medicines for GERD in children are over-the-counter, and some are prescription medicines. They include:

• Over-the-counter antacids
• H2 blockers, which decrease acid production
• Proton pump inhibitors (PPIs), which lower the amount of acid the stomach makes
• Prokinetics, which help the stomach empty faster

If these don't help and your child still has severe symptoms, then surgery might be an option. A pediatric gastroenterologist, a doctor who treats children who have digestive diseases, would do the surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

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

The esophagus is the tube that carries food from your mouth to your stomach. If your baby has reflux, his or her stomach contents come back up into the esophagus. Another name for reflux is gastroesophageal reflux (GER).

GERD stands for gastroesophageal reflux disease. It is a more serious and long-lasting type of reflux. Babies may have GERD if their symptoms prevent them from feeding or if the reflux lasts more 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, the lower esophageal sphincter muscle is not fully developed and lets the stomach contents back up the esophagus. This causes your baby to spit up (regurgitate). Once his or her 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.

Reflux is very common in babies. About half all babies spit up many times a day in the first 3 months of their lives. They usually stop spitting up between the ages of 12 and 14 months.

GERD is also common in younger infants. Many 4-month-olds have it. But by their first birthday, only 10% of babies still have GERD.

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
• Colic - crying that lasts for more than 3 hours a day with no medical cause
• Coughing
• Gagging or trouble swallowing
• Irritability, especially after eating
• Poor eating or refusing to eat
• Poor weight gain, or weight loss
• Wheezing or trouble breathing
• Forceful or frequent vomiting

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

In most cases, a doctor diagnoses reflux by reviewing your baby's symptoms and medical history. If the symptoms do not get better with feeding changes and anti-reflux medicines, your baby may need testing.

Several tests can help a doctor diagnose GERD. Sometimes doctors order more than one test 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 contrast liquid called barium. The barium is mixed in with a bottle or other food. The health care professional will take several x-rays of your baby to track the barium as it goes through the esophagus and stomach.
• Esophageal pH and impedance monitoring, which measures the amount of acid or liquid in your baby's esophagus. A doctor or nurse places a thin flexible tube 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. The doctor runs the endoscope down your baby's esophagus, stomach, and first part of the small intestine. While looking at the pictures from the endoscope, the doctor may also take tissue samples (biopsy).

Feeding changes may help your baby's reflux and GERD:

• Add rice cereal to your baby's bottle of formula or breastmilk. Check with the doctor 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 doctor thinks that your baby may be sensitive to milk protein, your doctor may suggest switching to a different type of formula. Do not change formulas without talking to the doctor.

If feeding changes do not help enough, the doctor may recommend medicines to treat GERD. The medicines work by lowering the amount of acid in your baby's stomach. The doctor will only suggest medicine if your baby still has regular GERD symptoms and:

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

The doctor will often prescribe a medicine on a trial basis and will explain any possible complications. You shouldn't give your baby any medicines unless the doctor tells you to.

Medicines for GERD in babies include:

• H2 blockers, which decrease acid production
• Proton pump inhibitors (PPIs), which lower the amount of acid the stomach makes

If these don't help and your baby still has severe symptoms, then surgery might be an option. Pediatric gastroenterologists only use surgery to treat GERD in babies in rare cases. They may suggest surgery when babies have severe breathing problems or have a physical problem that causes GERD symptoms.

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.

Chiropractic is a health care profession. Chiropractors perform adjustments (manipulations) to the spine or other parts of the body. The goal is to correct alignment problems, ease pain, and support the body's natural ability to heal itself. They may also use other treatments including :

• Heat and ice
• Electrical stimulation
• Relaxation techniques
• Rehabilitative and general exercise
• Counseling about diet, weight loss, and other lifestyle factors
• Dietary supplements

Many people visit chiropractors for treatment of low back pain, neck pain, and headaches.

NIH: National Center for Complementary and Integrative Health

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 sugar levels.

Over time, high blood sugar 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 diabetes 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 (a 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 happen 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 had diabetes for a long time
• Don't have good control over your high blood sugar 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 mean an emergency. Call your doctor 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 doctor 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 doctors do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your doctor can look for signs of eye problems and treat them before they harm your vision. Your doctor 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