The patient: Karthik Mariswamy, 34, lies on a mat, lifts his left leg, then his right. Every morning, he spends 10 minutes strengthening his leg, abdomen and back muscles. For six months, he had pain in his left leg. Two months ago, it was diagnosed as sciatica, pain in the sciatic nerve, which runs from the lower back to the leg.
The problem: Driving. Mariswamy drives 30km a day from his home (Banashankari, south Bangalore) to work (Bagmane Tech Park, east Bangalore), slouched over the steering wheel of his sporty Maruti Swift hatchback. This strains his back and left leg, which applies the clutch.
Also See Correct Postures (PDF)
The (partial) solution: Mariswamy does his daily exercises and uses a lumbar support cushion to buttress his lower back while driving. However, this senior manager with a multinational networking company has developed a distaste for driving, “I don’t feel like going out because going out involves driving.”
Illustration: Jayachandran / Mint
Driving is responsible for a substantial proportion of back pain and repetitive stress injury (RSI) cases. The Bangalore-based Recoup Neuromusculoskeletal Rehabilitation Centre treats 400 patients with musculoskeletal disorders every day; half of them have driving-related injuries. Deepak Sharan, consultant, orthopaedics, rehabilitation and ergonomics, and medical director, Recoup, lists the most common ones:
• Myofascial pain syndrome: chronic localized pain in the neck, upper and lower back.
•?Thoracic outlet syndrome: abnormal blood flow to the arms, causing tingling in the fingers.
•?Patellofemoral pain syndrome: affects the area around the kneecap.
Dr Sharan also names eye strain, myofascial pain syndrome in the thigh and ankle, and tendonitis, leading to wrist pain. The telltale sign—pain which worsens progressively with driving but subsides later.
Who gets the roughest ride?
Most of these ailments are more common in professionals who drive for a couple of hours every day and in commercial vehicle drivers, a result of prolonged sitting in a vehicle—with compression of the spine, lack of adequate support for the back and thighs, and wrong posture. Potholed and congested roads aggravate matters, as one repeatedly needs to apply the clutch and brakes.
Driving the pain away
Treatment, consisting of exercises and posture correction, lasts for months. “There is no one single solution,” says Rajat Chauhan, CEO and medical director, Back 2 Fitness, a New Delhi-based chain of injury prevention, rehabilitation and performance enhancement clinics. “It’s important to apply all suggestions as we are looking for many small changes to make a difference,” he adds.
Make it a smooth ride
Keep moving: Postural fixity, or holding the same posture, can aggravate musculoskeletal problems, says Russell Marshall, lecturer, design ergonomics group, department of design and technology, Loughborough University, the UK, in an email. Be it at your workstation or in your car, sitting can hurt.
Kindly adjust: All cars should have seat and steering height, tilt and fore-aft adjustment; only higher-end vehicles do, with little guidance from makers on how to use them. There’s also no guidance on buying the appropriate car, says Steve Summerskill, lecturer, design ergonomics group, department of design and technology, Loughborough University. In hindsight, given his 5ft 6-inch built, Mariswamy thinks a tall-boy model such as the Hyundai Santro would have suited him better than a low-lying Swift.
Request repair: Indian roads are spine-unfriendly, says Bharati Jajoo, co-founder and occupational therapist, Ergoworks, a Bangalore-based occupational health and safety company. You can only lobby for change.
Choose with care: Manufacturers bring international models to India without customizing physical dimensions, says A.K. Das, head, department of design, Indian Institute of Technology, Guwahati. “Most cars are made for European or Japanese body dimensions,” says Das. So the relative position of the pedals, seat, gearbox and steering wheel can lead to strain. Pune-based industrial research body Automotive Research Association of India has embarked on an India-specific anthropometric study. To be completed by March, it may help manufacturers suit cars to Indian body types.
Experts: Dr Bharati Jajoo, Ergoworks; Dr Deepak Sharan, Recoup; Dr Rajat Chauhan, Back 2 Fitness
Arnica montana-The herbal treatment
‘Arnica montana’ is a herb that has been used for centuries in a salve for muscle aches, bruises, sprains, insect bites and even open wounds in Europe, where pharmacies sell it over the counter and readily recommend it. Endorsed widely by homoeopaths, this perennial is surprisingly effective in reducing swelling, making bruises disappear and relieving exercise-induced muscle soreness. However, arnica can have serious side effects (such as dizziness, tremors and irregular heartbeat) if taken internally, unless it is extremely diluted. Also, use caution when applying to an open wound. Allergic reactions can occur. Overuse may cause skin irritation.
©2009/THE NEW YORK TIMES
Between 12-17 years of age? Beware of H1N1
The median age of those infected with the H1N1 virus (or swine flu) is 12-17, WHO says, citing data from Canada, Chile, Japan, the UK and US. Those needing hospitalization and those who don’t survive the flu may be slightly older. As the disease spreads in a community, the average age seems to go up slightly, maybe because early cases often occur as school outbreaks. WHO says the pandemic may mean two billion infections. Cardiovascular or respiratory disease, diabetes and cancer imply greater risk of complications. Obesity has been reported as a risk factor. There is mounting evidence that pregnant women are at higher risk of severe symptoms. Human trials of a vaccine began in Australia last week.
Doctor? Where’s the coat?
Picture a doctor. What do you see? Stethoscope. Black bag. Lab coat. Yet the American Medical Association is studying a proposal made at its annual meeting in June for doctors to hang up their coats. The group’s Council on Science and Public Health is looking at the role clothing plays in transmitting microbes. Peter Ragusa, author of the survey and a student at Yale School of Public Health, says little data definitively ties lab coats to infections that kill nearly 100,000 hospital patients in the US a year, but believes the “potential for transmission is significant”. A 2004 study found 48% of neckties worn by New York doctors and clinical workers surveyed carried at least one species of infectious microbe. In 2007, the UK National Health System adopted a “bare below the elbow” hospital dress policy that bans long nails, ties, jewellery…and lab coats.
©2009/THE NEW YORK TIMES
Contact lenses: not for you but your pet
Lions, giraffes, tigers, rabbits, bears, rhinoceroses, even owls can go blind from cataract. But a German firm has the answer: custom-made “contact lenses”. The delicate procedure requires special training for vets but it has propelled S&V Technologies to global leadership in a highly specialized field. Acrylic intraocular lenses are implanted in the eyes of animals when their vision gets fully impaired. They range from cat-eye-sized lenses to fist-width for rhinos. “Cataracts generally mean blindness for animals, unlike for humans,” says Ingeborg Fromberg, S&V’s veterinary division head.
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