Ask just about anyone – friends, family, colleagues – and most of them will tell you that they've suffered from some form of back pain over the course of their lives. Ninety per cent of back pain, however, goes away after a month or so. But what about those who suffer from chronic lower backache (or lumbar pain)? A new study shows that rehabilitation may be just as good an option as surgery in the long run.
One of the reasons that back pain is so tough to treat is because of the difficulty in diagnosing its precise cause. Only about 20 per cent of lower back pain patients have an identifiable injury, caused by the likes of a car accident, disease or repetitive strain. For the remaining 80 per cent, reasons as varied as posture, lack of exercise, incorrect seating at work or the rigours of everyday life are listed as contributing factors. Even more frustrating, it is often difficult for doctors to form an accurate prognosis. So when chronic back pain persists for years, patients often opt for surgery.
Surgery vs. rehab Elective spinal fusion surgery is both costly and painful, and requires aggressive physiotherapy almost directly following the procedure. However, the British Medical Journal has recently published a study suggesting that surgery may not provide enough long-term benefit to make it a worthwhile option. The study, performed at 15 British hospitals, did show that surgery has a slight edge in helping patients. However, the data did not represent evidence that would mitigate the negative aspects of the procedure. The study suggests that 'candidates for spinal fusion surgery may obtain similar benefits from an intensive rehabilitation program as they [would] from surgery.' Additionally, the risks associated with rehab are negligible compared to those associated with the spinal fusion procedure.
The extensive study looked at 349 adults with long-term lower back pain. About half received spinal fusion surgery, while the remainder were subjected to extensive and repeated physiotherapy. Both groups were monitored for two years, and "no clear evidence emerged" that the procedure provided significant benefit over rehab alone. Although the study is not conclusive, it is already causing doctors and patients to rethink their approach to lower back pain treatment.
Preventing back pain The lower back is notoriously easy to injure, but also relatively easy to protect from harm. Correct seating at work or in front of the computer is essential to maintaining the health of your spine. Ask your doctor to examine your posture, and make sure that you stand and walk in such a way as to avoid unnecessary strain on your lumbar region. When lifting heavy objects, always bend at the knees. And working on your core strength (the abdominal muscles and the lower back muscles) through exercise can also help protect the lower back from future strain.
At the very least, doctors and patients are starting to think around spinal fusion surgery and are looking to physiotherapy with renewed interest. So, the next time you happen to see a friend, family member or colleague slouching, tell them to straighten up. It may save them a tough choice in the future.
Skywalker has depression and anxiety, and believes she should be allowed to bring her cat on board without a carrier. But some say that a mental illness doesn’t require the same considerations as blindness or epilepsy. Others say her needs shouldn’t infringe on the rights of those with allergies. Many more were in her corner, arguing that Air Canada’s refusal is discriminatory.
According to Leslie Jack, a therapy dog coordinator for St. John Ambulance in Ontario, therapy animals can make a real difference to those in distress. Jack takes specially selected and trained dogs to visit with distressed adults and children in hospitals and long-term care facilities, seniors’ residences and even university campuses. “When we visit, it’s a positive distraction,” says Jack, “and within 15 seconds of petting a dog, people’s blood pressure starts to drop, anxiety is lowered and their day is brightened.”
Jack has seen similar results in people with brain injuries, PTSD and children of deployed soldiers. “No matter why it is, it works,” she says. That’s why she’s not surprised that therapy pets are key to easing anxiety around plane travel for some people. “It really is the same type of thing,” says Jack. “If people have anxiety or fear about flying, a therapy pet would be distracting and calming.”
Airlines, too, are starting to recognize the value of therapy pets in comforting passengers. But that doesn’t mean that you can simply board a plane, expecting to keep your cat or dog in your lap. While rules and regulations around flying with service and therapy pets vary, the following guidelines are a good place to start your de-stressed travel plans.
1. Make it official
Get a letter from your care provider stating that you have a diagnosed mental health issue and that you need to travel with a support animal. Ensure the letter is on letterhead and your care provider includes his or her official credentials. The letter should also be dated less than a year from your travel dates.
2. Do your research
Does your voyage include connecting flights on different airlines? Ensure both allow therapy animals. Ditto for destinations: animals are not allowed on flights to or from Bridgetown, Barbados, for example. Plus, sometimes different rules apply for domestic versus international flights.
3. Check the guidelines
Just because one airline says it’s OK for you to keep your support cat on your lap during the flight doesn’t mean that another airline will—and some airlines will only allow dogs. West Jet, for example, allows support animals but needs at least seven days’ notice on package vacations. Some airlines, meanwhile, require animals to be on harnesses at all times, while others will only allow pets in carriers.
Once you’ve done all the groundwork and have found a route that allows you to travel with your support animal, remember to feed him or her about four hours before you take off—it’s easier on travelling animals not to have a full stomach. Then sit back with your furry friend, relax and enjoy the flight.
Aside from being an easy snack for the office, yogurt is chocked full of ingredients that help your body run smoothly, no matter what age you are.
Although yogurt has been a staple in the health food world for what seems like an eternity, it has made a comeback in a big way with society's newfound love of greek yogurt. Now, people eat yogurt with a variety of tweaks and alternations to make it their own: with oats and grains sprinkled on top, honey drizzled in, and all and any fruit for added flavour and health benefits.
Whether you eat it plain, low-fat, greek, frozen, from a tube or a bottle, or in your smoothies, yogurt has health benefits beyond what you may think. Read on to find out what the good stuff is that makes up yogurt.
1. The probiotics.
You know yogurt has probiotics because every commercial for yogurt says that, but what does it actually mean? In the simplest of terms, probiotics are good-for-you bacteria. They help in regulating your digestive system and decreasing gas, diarrhea and bloating. Research has even suggested that probiotics can aid in boosting your immune system, weight management and reduce the risk of cancer.
2. The calcium.
Just like all products in the dairy family, yogurt is a great source of calcium, which plays a huge role in many health benefits. Calcium plays a primary role in the development and maintenance of healthy and strong bones and teeth. It is also important for blood clotting, healing wounds and maintaining a normal blood pressure. Some yogurts contain vitamin D, which helps the small intestine absorb calcium to its fullest potential, so finding those yogurts or pairing yogurt with foods high in vitamin D is highly beneficial.
3. The proteins.
Plain yogurt made from whole milk is a highly rich source of protein. The proteins in yogurt can increase the absorption of minerals, promote lower blood pressure and aid in weight loss.
4. The vitamins.
Yogurt made with whole milk contains every single nutrient the human body needs, although the way it is made and ingredients used can alter the levels of the vitamins and nutrients in the yogurt. Yogurt contains vitamin B12, which keeps your nerved and red blood cells healthy and can only be found in foods originating from an animal. Vitamin B2, or riboflavin, is also in yogurt. This helps the body convert carbohydrates into glucose, or 'food into fuel.'
Want to incorporate yogurt into your diet, but don't want to be stuck with buying processed, sugary yogurt cups? Check out Canadian Living's recipes:
"I've seen more changes this year than in the past three years," says Lisa Gittens, a tax expert at H&R Block.
Here are eight things families will want to be aware of when filling out their 2016 return.
1. Last chance on certain tax credits
The government is phasing out a handful of tax credits and focusing on larger benefits. The children's arts and fitness tax credits will be halved for the 2016 tax year, and cut completely next year, meaning families will no longer be able to defray costs for things like swimming lessons, ballet and tutoring. For post-secondary students, the education and textbook credits are being eliminated in 2017, although education amounts carried forward from previous years will still be claimable.
2. No more income splitting
Also gone is the Family Tax Cut, which lets the higher-earning spouse transfer up to $50,000 of income to the lower-earner. During the 2015 election, the Liberals promised to cut it, calling it a "tax break for the wealthy."
With the benefit gone, Gittens recommends a spousal RRSP, which allows the higher-earner to contribute to the lower-earning spouse's RRSP and claim the tax benefit. "You may have an RRSP set up, but you haven't thought about setting it up for your spouse. This is an ideal time to use that strategy," she says.
3. Changes to child benefits
The Canada Child Benefit was a signature feature of the 2016 budget, replacing the old Universal Child Care Benefit and the Canada Child Tax Benefit. It's non-taxable, so you don't have to claim it. However, in order to continue to receive the benefit, both parents must file a return, even if one doesn't generate any income, says Gittens.
Also keep in mind that the benefit started in July, so you still have to claim the taxable UCC for the first six months of the year.
4. New tax rates
New tax rates mean you may or may not be pleasantly surprised by the size of your tax bill this year. If you're in the meaty middle that earns between $45,000 and $90,000, your rate will come down to 20.5 percent from 22 percent.
"Most Canadians will be receiving more money at the end of the day than they were under the old system," says Jamie Golombek, managing director of tax and estate planning at CIBC Wealth Strategies Group.
However, high-income earners will be paying more due to a new 33 percent bracket for people earnings more than $200,000.
5. Child care expenses
Childcare costs are usually the biggest deduction available for families, says Golombek. But what many people don't realize is that it goes beyond simply daycare. If you have a nanny, you can claim that expense, but also babysitting, if it's during the day, and summer or day camp.
6. Disability tax credit and family caregiver amount
If you have family members with a disability there are certain credits that may be available to you. The Disability Tax Credit is available to people with disabilities to reduce their taxes. For children under age 18, a parent or caregiver may be able to claim the unused amount.
If you're a caregiver to a family member with physical or mental impairments, you may also be able to claim an additional $2,121, according to the Canada Revenue Agency.
7. Selling your principal residence
Selling your home has typically not been something you've had to report on your taxes, because usually Canadians don't get taxed for capital gains on their principle residence. But starting with the 2016 tax year, individuals who sold their principal residence during the year must report the sale. The government is ostensibly doing this to crack down on people who try to pass off income-generating homes as their principal residence.
8. eFile early, get your refund early
Tax deadline is April 30, but if you want to get ahead of the game, file early, before the government is inundated with last-minute returns. You can still file the old paper return, but Gittens says you'll be looking at a turnaround time of anywhere up to eight weeks, versus 10-14 days for a return filed early and electronically.
We polled family doctors from across the country, and they laid down the law on eight things they wish we'd do—or stop doing.
According to our panel of general practitioners, Canadians aren't always doing what they should to make the most of doctor visits—and skipping out on these crucial tactics could lead to a delay in diagnosing serious conditions. Here's what our experts say you should add to your patient checklist.
1. Stop feeling shy
Many of us hesitate to talk to our physicians about sensitive issues (think substance abuse or sexual health—or even gender identity). But honesty and openness are important, both for fostering a good doctor-patient relationship and for ensuring that you get the best care, says Dr. Laura Pripstein, medical director of the Sherbourne Health Centre in Toronto and a staff physician on the family health team. That's why it's OK to try out a doc before committing. Dr. Pripstein recommends booking an initial visit to see if your potential doctor is a good fit. "You want to see if this person seems like someone you can talk to, someone you feel comfortable with," she says. And if you don't think your doctor understands or respects your concerns, don't be afraid to find someone new. "If you feel you can't ask questions that might be embarrassing, you don't have the right provider," says Dr. Pripstein.
2. Don't come to your appointments unprepared
Get the most out of your time—and your doc's—by arriving at your appointment with a clear plan for what you want to discuss, says Dr. David Ross, an associate professor of family medicine at the University of Alberta in Edmonton. "It's good to have patients think about their problems from when the issue began, then look at it chronologically to the present," says Dr. Ross. Making a prioritized point-form list in advance helps ensure that you don't forget anything or mix up the order of events, he says. Then, work with your doctor to address the most serious issues first.
3. Choose your family doc over the walk-in clinic whenever you can
Yes, a clinic is convenient, but what we gain in easy access, we lose in familiarity. "I think it's really valuable if people can connect with a family physician who they'll be able to see long term, rather than just looking for the quickest way to access care," says Dr. Maurianne Reade, a physician with the Manitoulin Central Family Health Team in Mindemoya and M'Chigeeng First Nation, Ont. A family doctor will know your medical history and will keep it in mind when suggesting treatment—so, for example, if you've recently taken several courses of antibiotics for a UTI, your physician will likely look for a different course of action if you come in with another infection. According to the most recent statistics, about 4.5 million Canadians don't have a regular family doctor. If that's you, contact your provincial College of Physicians and Surgeons, or check to see if your region has an online registry (Ontario has Health Care Connect, while Quebec launched a web-based family doctor finder last year). "It's important to know that we doctors are privileged to share in your stories and to help you through difficult times," says Dr. Reade.
4. Share what's happening in your life
There's a reason your doctor wants to know where you're working, if you're dating and how the kids are—and it's not just because she likes you. (Though she does, we're sure.) Physicians need a picture of their patients' lives beyond their specific health symptoms and conditions, especially when they're first getting to know you, says Dr. Stephen Wetmore, the family medicine chair at the Schulich School of Medicine & Dentistry at Western University in London, Ont. "Doctors need to know these things to understand how your lifestyle and habits may be influencing your health," he says. So when you're talking about your exercise habits, your health history and whether you smoke, drink or use drugs, mention your employment status, family obligations and intimate relationships, too, says Dr. Wetmore.
5. Be a better googler
Doctors know you do it (hello, late-night web searches), but they would prefer you to ask about good sources of information, rather than going rogue online. They also want you to be honest about your fears if you've read something particularly upsetting. Physicians can't address your concerns or point you in the right direction if they don't know what your fingertips have been up to. "The thing we want our patients to do is ask us for the most reliable Canadian websites to go to as resources," says Dr. Heather Waters, an assistant professor of family medicine at McMaster University in Hamilton.
6. Don't think your symptoms are "no big deal"
If you've noticed you are having more headaches than usual or are sleeping more or are eating less, you might not think to tell your doctor—but you should. There's no set of rules for determining which symptoms are worthy of investigation or discussion, says Dr. Wetmore, but make a note to mention anything that is new or has changed since your last appointment. "You should bring up things like sudden weight loss or fatigue that seems excessive," he says. "It could be a sign of a larger problem, or the cause of a developing problem." Evenif it doesn't end up being serious, seeing your doctor will help ease any anxiety you might be feeling, and that's worth the visit, too.
7. Talk about what you're taking
Tell your physician about any herbal medications and alternative treatments you take, says Dr. Mel Borins, a University of Toronto associate professor and author of A Doctor's Guide to Alternative Medicine: What Works, What Doesn't, and Why. It's important for patients to share what's working for them and for doctors to be open-minded about therapies outside their own practice or traditions, he says. This is also a concern when it comes to conventional meds, especially if you're pregnant; there are only 23 medications specifically approved for use during pregnancy— yes, out of every available drug—which can leave women feeling anxious about taking prescription or over-the-counter drugs when they're expecting, says Dr. Robyn MacQuarrie, an obstetrician-gynecologist in Bridgewater, N.S. But don't stop taking your meds as soon as your pregnancy test comes back positive. "It's really important to talk to your doctor instead of stopping cold turkey," says Dr. MacQuarrie. Physicians can help you determine the risks and benefits of using different drugs, and they can let you know when the effects of not taking a medication while pregnant may be worse than taking it— which is the case with some antidepressants.
8. Avoid diagnosing yourself
You know doctors don't like it when you come in prepared with a diagnosis you've made thanks to the aforementioned Dr. Google. But do you know why? It's not because they think you're encroaching on their territory! Rather, they worry that a serious medical problem might get missed or you'll cause yourself unnecessary anxiety over something not serious. That's because not everyone has the most common symptoms of a particular condition. Plus, men, women and different ethnicities can have varying symptoms for the same problem. For instance, Dr. Reade's community has a large proportion of people with diabetes, which can affect the warning signs of cardiac disease, a major killer in Canada. Instead of the usual pain or pressure on the left side of the chest or arm, men and women with diabetes may instead have spells of profuse sweating with weakness. And, of course, women who don't have diabetes can have differing symptoms, too; sometimes, a heart attack can feel like acid reflux or come with sudden nausea, vomiting and lightheadedness. So always tell your physician if your symptoms are surprising or strange—like a headache that feels different than usual, for example. And if you're worried about a specific diagnosis, be sure to bring that up, too.
While every Canadian faces his or her own unique set of health hurdles, there are a number of ailments that have become pervasive in Canada. Though medicine has advanced over the years, our modern lifestyles have introduced a new set of health challenges. Here are some of the top health problems that Canadians face today.