A severe hunch from curled-up sitting or standing for long periods leads in time to a deformation in the thoracic vertebrae. If that affects nerves in the area, the affected person may feel tingling or numbness in their extremities, says the German Spinal League.

In such cases, the doctor will not send you home to rest on the couch to cure the numbness. Instead, patients will be prescribed physiotherapy or urged to do healthy core-strength sports, like swimming, Nordic walking or pilates.

Skin care reduces pregnancy stretch marks; fading later is slow

JANA ILLHARDT

DEUTSCHE PRESSE-AGENTUR

Stretch marks annoy many pregnant women: they are often hard to avoid, even if you moisturise the skin every day, and whether or not a particular woman gets them will depend on her individual body.

“They appear on about 70 per cent of all pregnant women,” says Stefanie Montag, a member of the Association of German Dermatologists.

“Stretch marks happen when the deep layer of skin, the so-called dermis, tears,” says Sven von Saldern, a doctor who specialises in cosmetic and plastic surgery.

“They are a sign that the skin’s connective tissue is under too much stress and superficial skin cells can no longer keep up,” adds gynaecologist Christian Albring. Stretch marks are most frequent in the lower abdomen and the breasts.

“We also often see them on the hips, the backside and the thighs,” Montag says. The larger the woman’s belly, the more likely it is that she will get stretch marks.

“Cosmetic care can counter their effects, but they can still emerge,” von Saldern says. Still, you should apply oil to moisturise the skin and keep it elastic.

Albring recommends doing that before the stretching gets so bad that the skin cannot keep up.

You do not need special oils, but Montag suggests properly moisturising the skin once or twice a day.

The best preventive care is gaining weight at a gentle pace.

“Pregnant women who were very thin at the beginning of their pregnancy may put on 10 to 15 kilograms,” Albring says. Women who already had more rounded figures when they started the process should not gain more than 6 to 10 kilograms, the expert says.

Albring also recommends moving.

“Taking a half-an-hour walk every day is the minimum. Doing a little bit of sport besides that would be advisable,” he says. Having a healthy diet that is rich in vitamins and drinking lots of water and no coffee should also help prevent stretch marks.

“These are all just assumptions, however,” Albring stresses. “Although all these tips make sense and are healthy, there is no proof of their effects on the firmness or the elasticity of connective tissue,” he admits.

So what can you do about stretch marks once you get them?

“At first, the layer of fat below the dermis, which has a good supply of blood, appears reddish under the skin,” says Montag. Those are the marks, but they fade over time. “The body’s repair mechanisms make stretch marks turn white.” However, that process can last a year.

Stretch marks will not go away completely, but with the right care you can make them less evident, says von |Saldern.

“With laser treatment, you can punch many little holes in the tissue, which will heal and tighten the skin so the stretch marks are less visible.” Such procedures are expensive, however.

So-called micro-needling is based on the same principle. “It employs a device that contains little needles. These are used to cause tiny injuries in the skin, which causes regeneration,” Montag explains.

For others, however, the culprit could be a herniated disc and if this is the case, patients will finally seek the help of a doctor, as the pain is generally very intense and causes other painful symptoms. These include pain that extends down through either one or both legs, with muscle weakness to the point of being unable to walk properly, inevitably disrupting lifestyle, activities and routines.

The intervertebral discs in the spine are a type of cartilaginous joint, the nucleus of which is made up of a highly flexible, jelly-like substance called mucoprotein gel. The discs are like pads that serve as cushions between the individual vertebrae of the spine.

They serve two primary purposes; they allow spinal movement, and they also act as shock absorbers bearing the impact of weight travelling down through the spine. If a disc is impacted to the point of damage or rupture, the injury can cause some of the inner gel-like substance to bulge or protrude out through the tougher outer ring of the disc, compressing the surrounding nerves and causing pain and discomfort.

A herniated disc is caused by deterioration of the intervertebral disc, most often the result of gradual age-related wear and tear. As you age, the internal gel-like substance of your spinal discs begin to lose their flexibility, causing them to slip out of place more easily and press on the surrounding nerves. An important factor in accelerated disc degeneration is a person’s lifestyle and daily habits. Some people do a lot of heavy lifting in their work and do so using the wrong positions, thus causing the discs to bear the strain of too much weight.

For athletes or those who play sports, a herniated disc can be the result of repetitive motion and heavy impact on the discs or a sudden twist movement. Overweight individuals are also at increased risk of herniated discs due to the additional weight that the discs must support. All of these can be contributing factors for accelerating disc degeneration or causing a tear or rupture of the disc, putting pressure on the surrounding nerves.

If you start to have back pain throughout your entire back and particularly heavy pain in the lower back and waist area that extends down to your legs, and if this is a chronic pain lasting for more than two weeks, you might well have a herniated disc.

In this case, the best course of action is to see a doctor as soon as possible in order to properly and promptly diagnose your symptoms.

A herniated disc is a treatable condition. If the patient’s symptoms are less severe, doctors will first advise medication and physical therapy. If the patient continues to experience severe or acute back pain to the point of being unable to carry out regular daily activities, the doctor may then recommend minimal access microdisectomy for treatment. This type of surgery is known as MIS (Minimally Invasive Surgery), which uses innovative surgical technology that has made ground-breaking and progressive developments in recent years.

The benefits of this type of surgery are far less pain, an incredibly small incision only the size of a fingertip, much lower risk of infection, and most importantly, a much faster recovery rate, eliminating the need for long, drawn out hospital stays. Following surgery, the patient is typically able to return home within 24 to 48 hours.

The best option is always early prevention; you can prevent the likelihood of herniated discs by simply employing proper techniques when moving or using your back.

Some important steps to take follow: avoid lifting heavy objects, if you must sit for long periods of time, try to stretch and change positions frequently, work to develop and maintain core muscle strength (this includes both the back and abdominal muscles). If you know your bones are not particularly strong, try to avoid sports that involve frequent jumping or heavy impact to the spine and take up exercises such as swimming, and other lighter forms of exercise that focus on increased flexibility. All of these changes can help to extend the lifespan of a healthy spine and intervertebral discs and prevent premature disc deterioration.

DR CHALAT WINMOON is a Spinal Surgeon at Samitivej Sukhumvit Hospital. |Call (02) 022 2494-6.

Swipe through photo after photo of legs as thin as matchsticks. Read the comments underneath: “I wish that was me” or “They’re so perfect I could cry”. Feel shock at seeing how an apparently affluent girl’s hipbones stick out from her emaciated belly.

This is one of the dark regions of Instagram, where girls and young women glorify their eating disorders, emulating one another and egging each other on with the most extreme of photos of their skinny selves.

It’s called pro-ana – short for pro-anorexia. Pro-ana is an online movement where anorexic or bulimic women encourage each other to lose more weight. The rule is that you can never be too thin. They elevate their own peculiar ideal of beauty to a commandment.

The community treats their illness not as a disorder but as a brave and enviable state, the more extreme the better.

Pro-ana sites are a space of their own for these women to interact with each other – and it’s happening on Instagram more and more. The internet and apps mean that accessing a network of like-minded women is easy.

That young women post selfies that present the best possible version of themselves has often been commented on. Andreas Schnebel, a German who works on ways to fight an epidemic of anorexia, says such selfies imply that there’s only one physical appearance that is acceptable.

Selfies create a vicious circle which makes everyone want the same body type. The “likes” and followers fuel this beauty addiction.

This internet ecosystem is especially dangerous to young women with eating disorders because the validation they get from other users spurs them on towards sickness and makes them resist pressure from parents and mentors to get back to health.

Instagram brought in new rules a few years ago to stop young women using the portal as a platform to glorify eating disorders. The search function can no longer be used to find hashtags like #probulimia or #proanorexia.

A spokesman for the company explained: “Hashtags promoting eating disorders will be deleted without warning.” For other hashtags which don’t specifically endorse anorexia, a warning is issued before the results are shown – like #ana.

Instagram defends this as useful for some: “For many Instagrammers who are struggling with eating disorders, it’s a great help to be able to talk to others while they’re in the process of getting better.”

They say it is part of a holistic approach to be able to find these hashtags using the search function.

But a lot of the time, those who are looking for pro-ana sites won’t be deterred by warnings or blocks.

The hashtags are often slightly altered to get around this problem – so #bulimia becomes #bulima or #thin is changed to #thynn. And using these hashtags you can find extreme, sometimes disturbing, pictures of emaciated bodies.

There’s one Instagram account taking on the pro-anas.

Amalie Lees was 17 when she developed an eating disorder.

The 21-year-old Briton is thin – but she used to be much thinner. In old photos you can see the matchstick legs she used to have, skinny and frail. Amalie uses Instagram to document her body, her food and her return to health.

“It feels good to find a place online where you can be open about your fight against your eating disorder,” she says. Through Instagram she was connected with people who were going through the same thing.

But this is also where the danger lies – it’s a double-edged sword, says Amalie.

“People with eating disorders can be competitive,” she explains. “They feel like they aren’t sick enough to earn their recovery, if others are sicker than they are.”

And there are some accounts which start off being about recovery – but end up promoting an unrealistic body image after all.

Today Lee says she now doesn’t count calories, weigh herself or go on any diets.

Because defining yourself in numbers is a waste of time.

Friederike Kolb is 100 years old and never thought she’d be able to dance again.

“When I was a young girl I used to love dancing and I still really love it,” she says.

Every Wednesday morning social worker Gerburg Cartus gives quite a special dance lesson at the Frankenhoehe senior citizens home in Mainz, western Germany.

The youngest participant is 80 and all have the same dance partner – their rollators.

The German Dance Teachers Association (ADTV) is taking elderly dancers seriously and recently launched its Elderly and Agile: the Rollator Dance Handbook in the city of Mainz.

In the book, employees at care homes are advised on how to give dance lessons.

It’s an idea that Cornelia Willius-Senzer, president of the ADTV and director of a dance school in Mainz, has copied from the Netherlands.

“It was so beautiful, the dancers had tears in their eyes,” she says.

The ADTV has been giving rollator dance classes in senior citizens homes and dance schools for two years, with health insurance firm AOK providing 20,000 euros (Bt800,000) in funding.

“It’s been very well received,” says Willius-Senzer. “Lots of people were a bit sceptical at first but as soon as the music started playing their eyes lit up.”

The residents of the Frankenhoehe home have a lot of fun in their class; three steps into the centre, rock step, and back again.

Other dances include clapping and arm movements.

Willius-Senzer was already campaigning for the rollator dance classes in care homes back in 2011 and inspired Cartus, who believes they have lots of benefits for older people.

“It does them so much good to show themselves off,” she says. “It’s great for their confidence and their enjoyment of life.”

Her group does performances at Carnival time, at summer, Christmas and other celebrations. The dancers dress up and decorate their rollators, even using fairy lights at Christmas.

“It takes me out of myself and gives me a bit of a boost,” says 80-year-old Marie-Luise Dreyer, who swears by her rollator.

“I use it to move my washing basket and it also doubles up as a tea trolley, a shopping aid and a dance partner!” she says.

Cartus begins her classes with slow dances, and then moves on to the faster ones.

“Dancing’s also very good training for the memory,” says Cartus. And it encourages socialising. After every dance there’s a short pause for conversation.

“The residents are really happy because they connect the songs with happy memories,” says Cartus.

Else Bouche, 89, says her youth was overshadowed by World War II, and she was often afraid.

“Everything was destroyed – but we still danced and had fun,” she says.

That’s why music and dancing still have a special meaning to her.

The federal Health Ministry spent 35,000 euros funding the new ADTV rollator dance handbook, which sets out beginner exercises on rhythm and keeping time and gives practical tips on lessons.

There are instructions on dance standards such as the foxtrot and the waltz with a rollator, as well Latin American classics such as the rumba and the samba, and there are three different levels of difficulty.

The dance steps are set out, often with arm and hip movements and one chapter even gives instructions on how to dance while sitting.