How to lower high blood pressure

Many people continue to suffer from high blood pressure, even though their lifestyle is healthy (low salt intake, low fat diet with lots of fruit and veg, regular exercise, not too much alcohol, losing weight if necessary, reducing caffeine, no smoking), and they are taking all the prescribed medications. This prolonged hypertension can lead to problems such as TIAs (transient ischaemic attacks) with increased risk of a full-scale stroke. When patients have gone through all this and consulted their GP, who may refer them to a stroke centre for comprehensive tests on head and neck blood vessels, the response may be that there is nothing else that can be done, until a more serious episode occurs. 30% of people suffer from arterial hypertension, and of these, 30% cannot be treated sufficiently and so cannot reach a target blood pressure of below 140 mm Hg.

This can lead to problems in lifestyle. Headaches may become more frequent and can be so-called “sentinel headaches” that precede a TIA. Living with this is hard and can lead to a notable reduction in activity. Are there any other ways of reducing blood pressure?

The vagus nerve and blood pressure

Professor Alexander Gourine (University College, London) has developed an instrument that stimulates the vagus nerve by means of a clip on the tragus, the small cartilaginous skin flap on the outer ear, just in front of the ear hole. He says that using this tool for half an hour every evening can reduce blood pressure by 10-15 mm Hg, with effects that last for longer than just the treatment period. The National Institute for Health and Care Research is currently performing clinical research on people, and Professor Gourine hopes that the machines will be commercially available from 2024-2025. Read more about Professor Gourine’s machine here.

But what can sufferers do up until then? Are there other ways of stimulating the vagus nerve? And how does this system work?

Transcutaneous nerve stimulation – using small electric currents applied to the skin – has been used for other conditions as well. One research study was dedicated to fibromyalgia, with an electrostimulation machine “AS Super 4 Digital“, applied to specific points in the outer ear (parameters 25 Hz, 250 microsecs, 20 mA).

The vagus nerve and its functions

The vagus nerve plays an important part in the autonomic nervous system, which controls involuntary body activities such as heart rate, blood pressure, breathing, immune system, saliva production and other processes. This nervous system has two parts, sympathetic (the so-called fight or flight response, which gets your body ready for physical and mental action) and parasympathetic, known as the “rest and digest” system. One of the changes that happens to people’s bodies as they age is that the parasympathetic system’s effect on the heart declines, while sympathetic functions intensify. This causes the autonomic system to get out of balance, and one result is increased blood pressure. A branch of the vagus nerve innervates part of the outer ear. Electrical treatment of the tragus and other parts of the ear is a way of stimulating the parasympathetic nervous system.

In another study, a range of parameters were used with the electrostimulation machine: pulse width 100, 200, 500 microseconds, frequency 1, 10, 25 Hz. The 500 microsecond, 10 Hz settings had the strongest effect on heart rate reduction. Participants in this test also reported better mood, better sleep and better quality of life.

I have purchased an instrument of this type – the German-made TENS ECO 2 (TENS stands for transcutaneous electrical nerve stimulation) with two clips for the tragus. I will start testing it on myself. My hope is that I can reproduce the effects reported by Prof. Gourine.

Isometric resistance training

There are other ways of stimulating the vagus nerve that don’t need electrical devices. In one study, Dr. Matthew Jones (University of New South Wales, Australia) says that isometric resistance training for 12 minutes a day, two or three time a week, can help reduce blood pressure. Isometric resistance training means using a muscle without moving the surrounding joints. Dr. Jones used a handgrip device, but it could even be making a fist and holding it tight for 12 minutes, or holding a squeezed soft rubber ball. The important thing is maintaining the muscular effort without movement. Results are positive but require constancy. At least three weeks is needed before reductions in blood pressure can be seen.

Vagus breathing – a technique that reduces blood pressure

The same sort of pressure-reducing effect can be achieved by a special breathing technique which stimulates the vagus nerve. You breathe more slowly, making sure that you use the diaphragm (the belly) as well as just the chest. To do this, while sitting or lying down, breathe in slowly and gently through your nose, mouth closed, first using your ribcage as in normal breathing, and then completing the inspiration by pushing down your diaphragm. Ideally this inbreath should last four or five seconds. Then hold your breath for two seconds. Then open your mouth and breathe out slowly, for at least five seconds or longer. Say “aaah” or another gentle sound as you breathe out. Try to be conscious of the diaphragm that lifts up again, pulling in your tummy again. Repeat and continue for at least five minutes. It’s a good idea to have a watch with a seconds hand, because it is important to breathe slowly. I have tried this, taking my blood pressure before and after, and saw a reduction from 111 systolic to 93. To reduce blood pressure, one study recommends 25 minutes of vagal breathing per day.

What is the mechanism of vagus breathing? Slow, deep breathing is a cue of safety that the vagus nerve recognizes and transmits to other parts of the body, telling them to turn off their defences activated by anxiety or threat. Soothing sounds also activate the vagus nerve, for example when a mother calms a child.

Walking and blood pressure

A final consideration is related to taking a walk. When my fiancée was having an arterial hypertension episode, we were taking her blood pressure quite regularly, and one morning we went for a half-hour walk. When we returned, her blood pressure had dropped considerably, down to normal levels. Walking is always good, but for some reason, it seems to be better to walk in the morning.

Daily techniques for reducing blood pressure

So my recommendations would be as follows (in addition to the lifestyle factors mentioned above, and taking the prescribed medications):

– when you wake up, in bed, 5 minutes vagus breathing
– before or after breakfast, a walk, half an hour if you can manage that
– mid-morning and mid-afternoon: two more 5-minute sessions of vagus breathing
– evening while watching TV: isometric resistance training, such as squeezing and holding squeezed a tennis ball, or a resistance training handgrip
– transcutaneous nerve stimulation could also be a treatment option. Prof. Gourine recommends half an hour in the evening, perhaps while watching the TV. I will update this section after performing tests.

Please note that I am not a doctor, I have no medical training. This article was written for a family member with high blood pressure.


10 buoni motivi per mangiare tanta frutta e verdura fresca

photo 3-2000Non c’è più tempo. E’ ora che tutti sappiano che mangiare tanti prodotti animali fa male alla salute e al mondo, mentre il consumo di frutta e verdura fresca e cruda fa bene. C’è anche la questione etica, ma in questo articolo voglio parlare soprattutto della questione della salute.

1. Si può sopravvivere senza la carne
L’idea che la carne e il pesce siano necessari per una dieta equilibrata è una bugia ancora oggi perpetrata da alcuni nutrizionisti e scienziati. Si trova tutto di quello che serve al corpo umano nei prodotti derivati dalle piante, tante delle quali contengono alcuni aminoacidi (le molecole che servono per costruire le proteine), mentre la soia contiene addirittura tutti. Milioni di persone sopravvivono benissimo come vegetariani o vegani. Alcuni sono sportivi olimpionici.

2. Un armamento di composti organici
La frutta e le verdure fresche contengono tantissime sostanze interessanti quali vitamine, provitamine, enzimi, catalizzatori e altri, molte delle quali dedicate pochissima attenzione da parte dei ricercatori. Queste molecole sono utilissime al corpo umano che ogni giorno è impegnato nella costruzione e ricostruzione di tessuti e nella lotta contro i patogeni, le malattie e le cellule mutanti. A volte il corpo possiede già le risorse che servono per combattere la malattia, a volte invece gli mancano alcuni microelementi e minerali. Sono proprio questi che vengono forniti dalla frutta e verdura al naturale – la cottura snatura le macromolecole e limita, o addirittura cancella, le loro proprietà funzionali.

3. Il corpo ha dimenticato come sintetizzare alcune sostanze
Uno dei grandi misteri della biologia è perché le piante abbiano un numero di geni nella loro DNA molto maggiore rispetto agli animali (tra i quali gli uomini) che sono organismi molto più complessi. Noi abbiamo circa 20.000 geni, mentre le piante ne hanno almeno 50.000. Una spiegazione possibile è che le piante devono poter risolvere certe situazioni negative utilizzando le loro proprie risorse, mentre un organismo mobile come un uomo può gestirlo in modo diverso. Per esempio, se un uomo ha sete, può camminare finché non trova dell”acqua, mentre se una pianta va a corto dell’acqua deve adattare il suo metabolismo per sopravvivere fino a quando arrivano le piogge. E’ probabile che una pianta, in una situazione di stress, attivi alcune sezioni della sua DNA per sintetizzare nuove molecole che aiutano nelle circostanze del momento. Sembra che durante l’evoluzione, noi animali abbiamo perduto le attrezzature geniche per sintetizzare alcune sostanze, forse per poter privilegiare altre funzioni legate alla mobilità e all’intelligenza, una “dimenticanza” resa possibile dal fatto che queste sostanze si trovano proprio nelle piante. Basta non cucinarli, e mangiarli.

4. Un esempio dagli alberi
Il concetto che gli animali si siano dimenticati come produrre certe sostanze utili perché si sono abituati a trovarli nei cibi potrebbe sembrare azzardato, ma riceve conferma da alcune osservazioni legate al mondo vegetale. Gli alberi di frutta sono soggetti a un’infezione che si chiama ‘cancro rameale,’ che, diversamente al cancro negli animali, è causato dall’attacco di un fungo. La malattia, che può essere mortale, viene frenata dall’albero con l’apporto fondamentale di certi composti chimici prodotti dallo strato di alghe verdi che ricoprono il tronco e i rami. Le alghe sono organismi monocellulari molto semplici, e non fanno altro che appoggiarsi su una superficie, utilizzando l’aria, l’acqua e la luce per sintetizzare tutto che li serve alla sopravvivenza. Molto spesso non hanno neanche bisogno delle molecole che producono e li eliminano secernendoli all’esterno della cellula. L’albero si è abituato ad assorbire queste sostanze attraverso la corteccia e a utilizzarli a combattere l’infezione. Se le alghe dovessero essere rimosse, l’albero rischia la morte.

5. Le piante e l’industria dei cosmetici
Aziende come la Lancôme, impegnate nella ricerca per trovare sostanze che mantengono la pelle giovane, hanno scoperto che la pelle contiene delle cellule staminali specializzate per la manutenzione dell’epidermide, capaci di rigenerare i tessuti. La pelle invecchia perché mentre il numero di cellule staminali cutanee non cambia con l’età, la loro funzione invece sì, dovuto a modifiche dell’ambiente microscopica delle cellule. I ricercatori hanno cercato delle sostanze che potessero creare l’ambiente ottimale per le cellule staminali cutanee, dedicando particolare attenzione alle piante, che contengono anche loro delle cellule con funzioni analoghe. E’ possibile isolare queste fitocellule staminali e coltivarli in un bioreattore in modo che producono una serie di macromolecole che, applicate alla pelle, stimolano la produzione di fattori di crescita che a loro volta incoraggiano la rigenerazione della pelle da parte delle cellule staminali cutanee. Il risultato: pelle più giovane anche in età più avanzata. Le aziende dei cosmetici fanno tutto questo per fare soldi sulla nostra pelle, per così dire, però ci danno un indizio: prova a immaginare l”effetto di inondare tutti i tessuti con sostanze organiche che aiutano il corpo intero a restare giovanile!


6. Radicali liberi e anti-ossidanti
Un’altra area alla quale è dedicata molto ricerca riguarda i radicali liberi, molecole dannose che vengono prodotte nel corpo umano un po’ in seguito ai processi metabolici normali ma soprattutto come risultato da situazioni negativi quali il fumo di sigarette, gli inquinanti nell’aria, e i prodotti chimici industriali. I radicali liberi creano danni che si accumulano con l’età in tutto il corpo. Si pensa quindi che sono strettamente legati all’invecchiamento, ed anche a malattie gravi quali il cancro – è possibile che i radicali liberi provochino direttamente l’insorgenza di un tumore – e l’arteriosclerosi. Il meccanismo è comunque uguale, connesso ai danni al DNA che porta sia all’invecchiamento che alla proliferazione cellulare incontrollata che causa il cancro. Il corpo combatte i radicali liberi utilizzando gli anti-ossidanti, alcuni dei quali prodotti dall’organismo stesso e alcuni ingeriti con il cibo. Un’insufficienza di anti-ossidanti porta allo stress ossidativo, possibilmente legato a malattie infiammatorie quali l’artrite, malattie cardiovascolari e ictus, disturbi neurologici come l’Alzheimer e il morbo di Parkinson, e altri ancora. Gli anti-ossidanti comprendono sostanze conosciute come il B-carotene che protegge la pelle dal cancro e riduce gli effetti delle sostanze cancerogene sul fegato. La vitamina C forse protegge contro il cancro tramite la sua azione anti-ossidante, e la vitamina E è un altro anti-ossidante che rinforza il sistema immunitario e ostacola la proliferazione delle cellule cancerose. In sostanza, si può aumentare la qualità della vita e anche il numero di anni di vita tramite il consumo di cibi che contengono anti-ossidanti. Dove si trovano? Nela frutta e le verdure consumate crude. Aglio, alghe, arance, bacche tipo mirtilli, ribes, lamponi e more, barbabietole rosse crude, le brassicacee (cavolo, cavolfiore, broccoli, cavolini di Bruxelles, cavolo nero ecc.), canella, carote, ciliege, cipolle, curcuma, legumi, limoni, mango, mele, olive, patate, peperoni, pomodori, spinaci, susine, te verde, zenzero fresco e altri ancora. Tutti questi cibi offrono una selezione di sostanze che possono essere considerate dei farmaci naturali. I loro componenti attivi comprendono il zolforafane, B-carotene, licopene e i flavonoidi.

7. Protezione quotidiana
photo 1-2000Se stai bene, un ottimo modo per aiutare il corpo a rimanere sano, giovane e attivo è di assicurare che abbia a disposizione tutti i microelementi e anti-ossidanti di cui abbia bisogno per annullare gli effetti avversi della vita quotidiana. Si può iniziare bene la giornata con un succo fresco preparato con una carota, mezza barbabietola rossa, un arancio, un kiwi, mezza banana, un pezzo di peperone rosso, e un po’ di altre frutte e verdure fresche, che sia lo zenzero o i broccoli. Basta mettere tutto dentro il frullatore. Il succo è molto denso perché contiene tutte le sostanze e le fibre, ed è gradevole di sapore. Io ho notato un aumento generale di energia e un senso di benessere da quando ho iniziato a cominciare la giornata così. Poi insalata mista e frutta fresca a pranzo e a cena per rifare il pieno di minerali, micro-elementi e anti-ossidanti.

8. Malattie gravi
Se qualcosa va storto e si sviluppa una malattia come il cancro, una dieta modifcata con un consumo prevalente di verdure crude può aiutare a combattere il male. Anche se le statistiche a riguardo siano contrastanti, un dato fa pensare: considerando tutti i casi di remissione spontanea del cancro, circa due terzi avvengono in soggetti che hanno cambiato radicalmente dieta, sostituendo in parte o in tutto le proteine e i carboidrati con verdure. Una dieta come quella di Gerson si basa sul fatto che le cellule cancerose hanno un metabolismo che è quattro volte più veloce delle cellule sane, e quindi hanno bisogno di livelli di glucosio più alte. Allo stesso tempo, le cellule cattive soffrono un ambiente ricco di anti-ossidanti. Una dieta di verdure tiene più bassi i livelli di glucosio, affamando le cellule cancerose, mentre gli anti-ossidanti contenuti nelle verdure le combattano direttamente.

9. Il codice dei colori della natura
Le frutte e le verdure veramente utili per la salute e per combattere le malattie sono spesso contraddistinte da colori forti, perché le molecole attive sono pigmenti. Si può quindi pensare a una dieta equilibrata nei colori, per esempio rosso (barbabietola cruda, pomodoro, peperone rosso), arancione (carote, arance), giallo (mango, zenzero, curcuma), verde (broccoli, spinaci, cavolo nero), blu e violetto (bacche), e così via. Comunque le verdure veramente importanti sono le carote e le barbabietole.

10. Gli oceani
Noi siamo arrivati dove siamo adesso dopo milioni di anni di evoluzione, partendo da organismi monocellulari negli oceani. Da quando siamo usciti dal mare e abbiamo cominciato a vivere sulla terra, le condizioni dell’ambiente terrestre hanno continuato a cambiare, e in particolare, alcuni elementi sono stati gradualmente risciacquati dalla terra per finire negli oceani. Un esempio è l’iodio, presente a livelli molto bassi nella frutta e verdura terrestri, e a livelli molto più alti nelle alghe marine. Ed è probabile che ci siano altre sostanze che hanno seguito un andamento simile. Per questo motivo, le piante aquatiche come le alghe e il kelp sono una delle ultime frontiere della ricerca su cure per le malattie oncologiche.

La questione degli animali
Più si scopre come vivono gli animali dell’industria alimentare, più si capisce che vivono male e muoiono male. E’ un’industria che genera sofferenze infinite ad animali che vedono, sentono, pensano e amano praticamente come noi. E’ strano pensare alle cure che dedichiamo ai nostri cani e gatti senza sprecare neanche un pensiero a come hanno vissuto i polli o i manzi che troviamo poi sui nostri piatti. Leonardo da Vinci era vegetariano perché non poteva contemplare l’idea di distruggere un essere così perfetto solo per mangiarlo, e lui viveva mezzo millennio fa. Oggi le fabbriche di animali per la nutrizione umana sono diventati mille volte più terribili. La sostituzione totale o parziale dei cibi di origine animale fa bene alla nostra coscienza, oltre che alla nostra salute e a quella della pianeta intera.



Top ten reasons for eating lots of raw fruit and vegetables


It’s about time. More information in the media should be dedicated to the fact that eating lots of animal products – meat, above all red meat – is bad. Eating raw fruit and veg is good. Good for you, good for the world. But in this top ten it’s not about the ethical question. It’s about our health as people.

1. You can survive without meat
One of the great lies of many nutritionists is that meat and/or fish is essential for a healthy diet. Not true. There is everything you need in plant-based products. Many plant products contain some amino acids (the building blocks of proteins), soya contains all eight of them. Millions of people survive on vegetarian and vegan diets. Even some sportsmen and women.

2. An armoury of organic chemicals
Fresh fruit and vegetables contain all sorts of different substances, complex vitamins, pro-vitamins, enzymes, catalysts and more, often dedicated little attention and little research. They are very useful to the human body, which every day has to construct and reconstruct tissues, and fight pathogens, disease and mutant cells. Often the body already has the resources it needs to combat disease, but sometimes, there are micro-elements and minerals in short supply. Fruit and vegetables can supply these and give the body the weapons it needs.

3. The body has forgotten how to make some substances
One of the great mysteries of biology is why plants have far more genes than humans who would seem to be far more complex. We have around 20,000 genes, plants have at least 50,000. Why? One theory is that plants have to have their own resources for many situations which a mobile animal such as a man can solve in different ways. For example, if a man is thirsty, he can wander around until he finds some water. If a plant gets into a drought situation, it has to adapt its metabolism. It does this by switching on some different genes and manufacturing new proteins that help it to survive. Over the course of evolution, the development of animals and humans has been accompanied by a reduction in the number of genes, presumably something that is beneficial to an animal’s way of life, and made possible by the variety of organic materials that an animal can take in as part of the diet to make up for those missing substances. These substances are in raw fruit and vegetables.

4. Proof from the plant world
The idea that animals have ‘forgotten’ how to make certain substances because they have become accustomed to sourcing them from the plant world is confirmed by an analogous process in the plant kingdom itself. Fruit trees can suffer from a fungal infection called canker, which would be fatal to the tree without the contribution of certain organic chemicals synthesized by the green algae that colonize the trunks and branches of trees. Algae are very simple, monocellular organisms, and they just sit on surfaces and synthesize everything that they need to survive. Most of the time, they don’t need the stuff that they are making, so they simply secrete it. The tree, far more advanced than algae, absorbs these organic macromolecules through the bark and uses then to combat infection. They have become so accustomed to getting these bonus substances from algae that without them, they are at risk of succumbing to canker.

5. Plant-derived substances that combat ageing
The objective of cosmetics companies such as Lancôme is to keep the skin youthful, and their research shows that skin has its own stem cells capable or regenerating young skin tissue. Ageing occurs because while the number of skin stem cells doesn’t change with age, their function does. This depends on the micro-environment in which they live. In the quest to find substances that can help create the right environment for skin stem cells, researchers have dedicated their attention to plants, which contain their own stem cells which can be isolated and cultivated in a bioreactor. These cells generate a range of molecules which, when applied to the skin, prompt the local production of growth factors which in turn stimulate tissue regeneration by the stem cells, ultimately keeping skin younger for longer. Cosmetics companies are doing all this to make money. But just imagine the same effect on the entire body! Imagine flooding all the tissues with substances that help the body fight disease and stay young!


6. Free radicals and anti-oxidants
Another area of research is on the effect of harmful substances called free radicals, which are produced in the human body both by normal metabolic processes or by adverse situations such as cigarette smoking, air pollutants, and industrial chemicals. Free radical reactions produce progressive adverse changes that accumulate with age throughout the body. But free radicals don’t just cause ageing. Cancer and arterioosclerosis are “free radical” diseases, and it seems that free radicals can directly cause tumour formation. The mechanism is the same for both: ageing is caused principally by accumulated damage to DNA, and cancer is also the result of uncontrollable cell proliferation caused by DNA damage. How does the body fight free radicals? Using anti-oxidants, some of which are produced by the body, and others that are taken in with food. A deficiency in anti-oxidants produces oxidative stress, which is now thought to contribute to all inflammatory diseases such as arthritis, heart diseases and stroke, neurological diseases such as Alzheimer’s and Parkinson’s disease, and many others. Familiar antioxidants include B-carotene, which helps protect the skin from cancer and also reduces the effect of carcinogens on the liver. Vitamin C also seems to help prevent cancer in part through its antioxidant effects. Vitamin E is another important antioxidant that increases immune resistance and helps fight the proliferation of cancer cells. The conclusion is that quality of life and even life span can be improved by taking in enough antioxidants in the diet. Where do you find them? Raw fruit and veg. Algae, apple, beetroot (raw), berries, brassica, broccoli, carrots, cherries, cinnamon, citrus fruits, curcuma (tumeric), garlic, ginger, green tea, legumes, mango, olives, onion, plums, potato, red peppers, spinach, tomatoes and others. All these foods are like a natural pharmacy. Their active ingredients include sulforaphane, indole-3-carbinol, B-carotene, lycopene and flavonoids.

7. Daily protection
photo 4-2000If you’re well, a great way to help the body stay well, young and active is to ensure it has the microelements and oxidants it needs to deal with the metabolic stress of everyday life. I think at a great start to the day is a fresh juice made by peeling a carrot, half a raw beetroot, an orange, a kiwi, half a banana, and whatever else I have in the fridge, whether fresh ginger, a bit of red pepper, or some broccoli, and chucking it all into the liquidizer. The resulting juice is very thick (because it has everything, fibre and all) and pretty tasty. I have noticed a positive difference in my energy levels and general well-being since I started this habit. Then top up with more minerals, micro-elements and anti-oxidants with salad and fresh fruit at lunch and dinner.

8. Help during serious disease
If things go wrong and you develop something like cancer, one thing that seems to help in the fight against the disease is by changing diet. That generally means vastly increasing the proportion of raw fruit and vegetables in the daily food intake. There are conflicting statistics here, but one piece of information I found particularly striking: if you consider all the cases of spontaneous remission of cancer, about two thirds were accompanied by a radical change in diet. Juicing regimes such as the Gerson diet are based on the idea that cancer cells have a metabolic rate that is four times higher than normal cells, and so need more glucose, and that cancer cells suffer from an antioxidant-rich environment. So a diet in which peaks in blood sugar levels are controlled by eliminating the intake of sugars and by reducing the intake of carbohydrates and fats, helps starve the cancer cells, while at the same time, the antioxidants from fruit and veg help fight cancer cell proliferation directly.


9. Nature’s colour code
The really useful fruits and vegetables useful for maintaining good health or combating disease are often strongly coloured, because the effective molecules are pigments or linked to pigment. So, all you have to do is think about a balanced colour palette: red (raw beetroot, tomato, red pepper), orange (carrot, oranges), yellow (mango, ginger, tumeric), green (brassica, broccoli, kale), blue and violet (berries), and so forth. The really important ones seem to be brassica, carrots and raw red beetroot.

10. Back to the oceans
We have reached our position in the animal kingdom after millions of years of evolution that began in monocellular organisms in the oceans. From when we crawled out of the waves and onto dry land, the conditions of the ecosystem have continued to change, and some substances have gradually been leached out of the land back into the oceans. One example is iodine, which is present at very low levels in fruit and vegetables, and at far higher levels in marine algae. There are probably other substances that have suffered the same fate. This is why marine plants such as algae and kelp are one of the most promising frontiers for research on diseases such as cancer.

Animal welfare
The more you find out about animal food production, the more you realize that most farm animals – the meat we find in the supermarket – live badly and die badly. It’s an industry that creates untold suffering to animals that see, hear, think and love pretty much like us. It’s bizarre to think of the care that we lavish on our dogs and cats, and at the same time eat chicken or steak that are the end products of a horrendous story of ill-treatment. Leonardo da Vinci was a vegetarian because he couldn’t contemplate the killing of such wondrous beings just for the purpose of us eating them. That was five hundred years ago: today, the industry of animal-based food products has now become infinitely more horrifying. Reducing or eliminating the consumption of animals helps us stay healthy, helps our conscience, and helps our planet.



Causes of lower back pain after hip replacement surgery

I compiled this information from various sources, because my father had a hip replacement operation, and suffered from lower back pain during convalescence. I posted it here just in case it could be useful to someone else, and it is with great pleasure that I have been able to add some of the reader comments (scroll down to the end).

Tiredness and lower back pain after hip replacement surgery

The surgery involves the cutting and manipulation not only of bone but also of soft tissues such as muscles, tendons, nerves, and the capsule that encloses the joint. Such an invasive procedure is tough on the body, and recovering from it takes time. It is normal to be tired; your normal energy levels will return day by day. Don’t be too aggressive in exercising. Your body is working to recover and heal from the surgery even while you are resting.
Lower back pain may be caused by asymmetry in the power of thigh, abdominal and back muscles. Before surgery you were walking asymmetrically (your body was trying to reduce pain by restricting certain movements) and so you will have unconsciously decreased the power of certain muscles, because you used them less on one side. In addition, it is likely that your leg length is now slightly different. This in itself can cause lower back pain. Gradually, as you become more mobile, you will equalize muscle strength and lessen the strain on the lower back.
Something else that happens in hip replacement surgery is that the iliopsoas muscle running from your pelvis to your thigh gets traumatized. This can cause a degree of pelvic tilt for many weeks after surgery, as the iliopsoas remains in a state of contraction, causing imbalance. You may have the sensation of one leg being longer than the other, and this can be caused by this sort of contraction.
In some movements, your low back may tend to bend inwards (arching) as you perform the movement, causing lower back pain. It may help to tighten your stomach muscles during the movement; this helps keep the spine straight.

Often, even two months after surgery, people have pain when getting up out of a chair. The process of alleviating this is lengthy, because your muscles are still compensating for the pain in your hip, even though the operation has removed the source of the pain. Your muscles have been conditioned to misbehave, and many of them have atrophied and weakened in the years before your operation. Your gluteus muscles are weaker, likewise your sartorius, hip adductors and abductors. Quads and hamstrings have to be stretched and strengthened.

Convalescence timescale:

Full recovery: 3-6 months.
Total rehabilitation: muscle re-education will only be complete after a year.
In the early months, some good days and some bad days is totally normal. You should notice a gradual improvement over time.
4-6 weeks after surgery: zimmer or crutches
Next 4-6 weeks: a stick
About 10 weeks after surgery: walking without assistance, almost normally.
About 3 months after surgery: most of the soft tissue wounds have healed
3-6 months after surgery: gradual relaxation of hip and leg muscles.


You’ve been given some exercises to perform during convalescence. Remember to bear in mind all the warnings about the movements to avoid!
Don’t overdo it! Avoid high-impact exercises. Take great care whenever you are moving around to avoid tripping. Be careful going up and down stairs.
Initially you will be doing safe range-of-motion activities and muscle strengthening exercises. Exercises should be performed every day. You should allow 15 minutes, two to three times a day to begin; progress to 30 minutes, two to three times a day by the end of six weeks.
Walking is always good. Try to “walk tall,” as straight-backed as possible.

Stretching exercises:

Before you start doing these, you should talk to a physical therapist at the hospital. You have to be advised on when you can start them, and exactly how to do them. They are for hamstrings, quadriceps, hip flexors, illiotibial band, adductors. Once a day or even several times a day. There are also exercises to strengthen the core abdominal muscles.
These exercises will reduce pelvic tilt, decrease back pain, enable you to walk without a limp, equalize hip-and-abdominal strength.


Iron and vitamin supplements could be useful. Drink plenty of fluids. Try to limit your intake of coffee and alcohol.

Reader comments:
Dear Henry Neuteboom, Thank you. I am recovering from a hip replacement (tripped over a rug). I live in France so the care is great. But I looked everywhere on Google for info on how to be patient with pain and what to do to get better. I only found forums where people exposed their woes. Then I stumbled (didn’t fall thank Zeus) on your blog piece about lower back pain after hip surgery and was completely satisfied by your cogent, clear explanations of what to do or not to do and how long it may take. It has inspired me. No boogie-ing till muscle and pelvis and leg length etc have been dealt with. I will share the link to your piece with my 5000 Facebook friends, many of whom have had this same surgery. Once again thanks and buona fortuna. P.S. For give my dabble into Italian. I am learning Italian with Duolingo. So far I know how to say: “The Tiger is is eating the chef.” Plan to go to Montepulciano in September for a 3 week immersion course. “Tiger eats chef” is more or less preparing me for that endeavor. Cheers, S.W.

Thank u so much for your blog on ‘lower back pain after hip replacement’ I found it very helpful since I had the op on 5/12/2016 I was progressing well with gentle exercises when all of a sudden I could not walk without great pain and my doctor prescribed ibuprofen and sent me to physio. Doctor did not explain my condition as well as your blog did. Thanks once again. C.

Hi Henry I found your article on back pain when I was searching for something to help me understand my own back pain after hip replacement surgery. Honestly, Henry, I have become so frustrated that I broke into tears thinking I may have back pain for the rest of my life. Your article helped me be hopeful that I just need to be patient and continue to strengthen my body. Then I started to look at your paintings and a wave of calm came over me and even some laughter. I like your art. Thank you. J.

I came across your article on lower back pain after THR and it helped me so much. I have made a very good recovery after my operation, but still have stiffness at the base of my spine. I was beginning to worry that all was not well,despite my three month x ray telling me otherwise, You explained very clearly the reasons for this, so thank you. J.

Thank you so very much for compiling that information into one place. Your article was well written, informative, far-reaching, and, well, quite calming. I appreciated your description of why the disruption of surgery itself, as well as years of a maladaptive gait due to hip pain, means that patience, appropriate physical therapy, exercise, and a healthy diet are keys to the fullest recovery. Best wishes, A.H.

Hello Mr. Henry, I had to write to you after reading your article on lower back pain after THR. My mum’s just undergone the surgery and we couldn’t figure out the reason for her back ache. Our doctors asked us to ignore it as being normal post surgery.
Have a few questions, if I could request your answers:
1) when can the patient start bending, for example to touch one’s toes?
2) for how long does the back pain linger?
3) does the lower back (around tail bone) also swell up at the time of pain? We thought the bed/ mattress was responsible (until we read your article)
4) by when can she start sitting in a car (with bucket seats)?
Once again, many many thanks for putting your article out there. It sure has helped open our eyes and I’m am certain it is useful to a ton of other people. Hoping your dad has recovered and is running around. Waiting to see my mom do the same. Best wishes, P.

I had both hips done 6 wks apart Apr then June 2 doing great but begin to have some back pain,but your article was very helpful.I’m athletic so want to get back on my feet time and patience.Once again thank you I will pass this on. S.

Hi I read your article about lower back pain after hip surgery. My friend is having the same problem. And i was hoping you can email me the exercises that your dad did and the frequency and duration. Hes in rehab now but still in pain. He does exercises on good days or when the pain medication starts working. It has been a month since he had the back problem. The first two weeks he did not do pt due to extreme pain. Please help. R.C.

I wanted to thank you for this information I have been searching for days on some answers and you provided me with a lot of relief on this. I had hip surgery 24 days ago and seem to be moving around good other then the lower back pain that seems to be the only thing that limits me and because of that pain I tend to get out of breath but also I’ve been sitting for 3 years too so I am a bit out of shape. I don’t take pain medicine any more but do you think taking Aleve could help? C.B.

Thanks for a great guide on recovery following hip surgery, it was great to find all my question answered on this one page. The waiting time on going back to see the Consultent these days is so long, there’s no one to ask. Great thanks! K.H.


The quest for immortality

Just a glance at a fashion magazine is enough to show that the predominant image of the human condition is that of eternal beauty. But perhaps what people are really after is something more radical: immortality.

Many writers have looked at the subject, such as Edgar Allen Poe (The Facts in the Case of M. Valdemar), Oscar Wilde (The Picture of Dorian Gray) and John Wyndham (Trouble with Lichen). More recently, Jerome Bixby wrote the film The Man from Earth on this subject.

Science has also worked on the concept. Ageing is apparently to some degree written into the human genome, just as for all species, because programmed cell death is essential in modelling the body during embryology and in keeping it in good shape during life. Unfortunately, after the body reaches physical perfection, it appears to be condemned to a downwards slope along which gravity progressively moulds its sagging forms. Is ageing actually written into the human genome? If so, what advantage can ageing bring to the species?

Perhaps the answer to this lies in the story of evolution. Man’s ascent to his position at the apex of life, starting from a unicellular organism floating in the primordial broth, necessarily required millions of successive generations. The inheritance of beneficial characteristics deriving from random genetic mutations requires reproduction, and the survival of the next generation is simpler when the previous occupants have made room by unobtrusively departing from life.

Mutations occur all the time during cell divisions, and some of these have an effect on cell mortality. Why, one asks, have there been no mutations in the other direction, from mortality to immortality? If the course of evolution has been so prolific as to generate so many strange and hyperspecialized creatures such as koalas, giraffes, rhinos and hippos, surely it could be conceivable that at one stage in history, a man – or an animal – was born with a genetic malformation that condemned him, her or it to immortality?

Of course, if ever a mutation gave rise to a man with the genetic apparatus enabling immortality, he could have been killed in his prime on the battlefield of the Somme, or – if he was a fly – mercilessly exterminated by a dexterous blow from a flyswat. We would never know, and the unfortunate individual would not have succeeded in passing his momentous genetic heritage on to the next generation.

Surely, bodily ageing serves no real purpose? A useless and ultimately detrimental inheritance, like the appendix? We know that nearly all human cells are constantly replenished by means of their own internally-programmed cycles of death and renewal. Our skin is constantly generated from below, while the top layer of dead cells is eliminated by daily wear and tear, or by cosmetic peels and scrubs. But, while admitting the necessity for short-cycle death and renewal of body cells, what need is there for those progressive, long term, irreversible changes that cause the skin to become less elastic and more wrinkled?

Over the last few years, some answers have been provided to these questions. Scientific research has recently made radical discoveries regarding the mechanisms of cell ageing. A fundamental role in the process is played by a section of DNA at the end of a chromosome, called a telomere, which protects the DNA sequence during cell division. The enzymes responsible for chromosome duplication cannot duplicate the entire length of DNA, and at every division, a section of DNA at the end of the chromosome is lost. Telomeres are like sacrificial sections which can get chopped off without compromising the function of the new cell, and so the number of telomeres at the end of each chromosome determine how many times a cell can divide before it becomes unviable. Another enzyme, telomerase reverse transcriptase, determines the regeneration of telomeres, therefore increasing the number of cell divisions possible.

Telomere generation is programmed during embryology and in certain parts of the body (such as the immune system) where rapid cell division is essential. This research – dating to only the last few years – caused considerable excitement in the field, because it seemed to suggest that the ageing process could be controlled or modified by telomerase. But there is a flip side to all this. The unrestricted cell division made possible by telomerase is also the cause of cancer, when a rogue cell proliferates out of control.
Some studies on human populations show that certain inherited characteristics related to telomerase increase lifespan. A study on Ashkenazi Jews published in 2009 shows that the longest-lived individuals inherit a hyper-active version of telomerase that reconstructs the telomeres at the end of chromosomes.
Another research project screened a number of traditional Chinese medicine plant extracts, and found that a natural substance named cycloastragenol is capable of enhancing telomerase activity in the human immune system. This could be used in the treatment of HIV and age-related infections by enhancing the immune system, but there is no doubt that there are hopes that this sort of substance could have an effect on the process of cellular ageing at a fundamental, age-enhancing level. The name of the pharmaceutical company that financed the research, Geron, shows exactly where their real interest lies.

While telomeres provide an inbuilt biological clock that controls development and prevents cancerous cell proliferation, cells are also subject to external influence. Another cause of cell ageing can be identified in the oxidants that are an inescapable consequence of cell metabolism. DNA damage means that eventually the cell is incapable of synthesizing the proteins that it needs to exist and perform its functions, causing its progressive deterioration and death.

This source of damage is relatively unimportant for simple organisms such as bacteria, which divide constantly in favourable conditions, remaining forever young. But in complex organisms, the programmed number of cell divisions can be relatively small – a few dozen divisions – or even nil, as in the case of brain and nerve cells. We receive our ration of neurons during embryological development, and from then on, no cell division is possible. Our nerve cells are the only ones we’re going to get, so we’d better look after them…

Research seems to suggest that the best way of reducing oxidant damage to DNA is to limit cell metabolism to what is functionally necessary. This means a low-calorie regime, or at least a food intake that does not condemn cells to working overtime.

Perhaps one day, further revelations will be provided by studies on small and primitive organisms and their interactions. Algae and lichen are organisms that spend all their time synthesizing complex molecules that they don’t seem to need at all, and simply secrete them. While a rock is incapable of doing anything with them, trees may well benefit from the substances produced by the mossy green covering on their bark, and in some cases, these chemicals seem to be capable of modifying the identity of tree cells, turning their biochemical clock back and giving them functions of youthful reproduction, stimulating growth in order to combat pathogens.

Whether or not other useful substances analogous to cycloastragenol may emerge in this field, at present we can only observe man in his incessant struggle to stave off the inevitable. The age of youth has progressively extended, and women are bearing children later and later in life. Old people are becoming more active, energetic and assertive. In Italy, there are moves to pass a law for equality in pensions, so that women will have to work until they are 65, as for men. And if an immortality drug will ever be discovered, there would doubtless be further taxation reform. The Inland Revenue would never forego the possibility of infinite income tax!