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Wondering if you need an alcohol detox? Learn how to detox your liver from alcohol use, and how long it could take. Christina Lindenmeyer, MD.

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Cleveland Clinic

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How Long Does It Take to Detox From Alcohol?

Wondering if you need an alcohol detox? Learn how to detox your liver from alcohol use, and how long it could take.

Of all your body’s organs, your liver takes the biggest hit when it comes to alcohol. Even if your relationship with drinking consists of occasional social drinking with friends or occasionally over-indulging in wine and cocktails during the holiday season, alcohol can still leave its mark. And it’s a mark that can be hard to reverse.

That’s why many of us wonder if a month of avoiding drinking is enough to “reset” your liver back to normal. It’s true that taking a break from alcohol for any amount of time will be beneficial overall, with some research showing that liver function begins to improve in as little as two to three weeks. But a full detox is needed for the most benefit, and how much time that takes depends on a variety of personal factors.

“It depends on how much damage has already been done,” explains liver specialist Christina Lindenmeyer, MD. “And if there are any complications related to the damage.”

Dr. Lindenmeyer explains what happens to your liver from prolonged and moderate alcohol use, and what a detox process would look like.

How alcohol impacts your liver

Your liver has enzymes that work like special tools to help metabolize (break down) different toxins that enter your body, such as alcohol.

In the short term, alcohol is processed through your liver in about an hour. Essentially, feeling “drunk” is when your liver becomes too overwhelmed to properly process alcohol, so it overflows temporarily into your bloodstream. This is what causes you to feel light-headed or tipsy after multiple alcoholic drinks.

In the long term, prolonged alcohol use can cause severe damage to your liver. Your liver has a specific pathway that the toxins follow to be broken down, so if over time, this pathway becomes overwhelmed by too many toxins, it can affect the efficiency of your liver’s work. In other words: It can’t keep up.

Certain health concerns and diseases can arise in your liver due to long-term alcohol use, including:

How do you detox your liver?

If your liver has taken a hit from prolonged alcohol use, there are ways to give it — and the rest of your body — a break.

You can make the move toward detoxing your liver through these steps:

Stop drinking

The first and most important line of defense? You guessed it: Abstain from drinking. “Abstinence is the most critical intervention and treatment,” notes Dr. Lindenmeyer.

This is sometimes easier said than done, of course. If you’re a heavy drinker, you may need to wean off alcohol to let your body adjust. If you’re experiencing severe symptoms of alcohol withdrawal, be sure to talk to a healthcare provider.

If you’re more of a moderate to occasional drinker, you may find the hardest part of stopping drinking to be the social pressures. Try replacing your usual cocktail or beer with a nonalcoholic option, including many of the now popular mocktails available so you can still enjoy social time with friends without having alcohol in the mix.

Maintain a healthy diet

Another thing that will help your liver’s journey in recovery is good nutrition. There’s no miracle diet by any means, but the Mediterranean diet, for example, can help fill some of the nutritional gaps you may have due to alcohol use.

“Nutrition optimization is actually the most evidence-based and most important intervention aside from stopping drinking,” points out Dr. Lindenmeyer. This is because, for a lot of people who experience some kind of liver dysfunction, it makes them at risk of not getting enough proteins, calories or vitamins.

There are also certain foods like tea, fish and nuts that can benefit the liver’s function in many ways. Think of it as giving your liver a little boost in the right direction. “Nutrition therapy is very important in terms of feeding the liver and giving it the building blocks it needs to restore itself,” says Dr. Lindenmeyer.

How long until your liver detoxes from alcohol?

Of course, we all want a simple, achievable number for how long we should abstain from alcohol in order for our bodies to fully heal from its effects.

But the truth is,the timeline of your liver detoxing is going to depend on different factors like:

  • The amount of alcohol you consume.
  • The frequency of your drinking.
  • Any other health conditions you may have.
  • Your age.
  • Your weight.

“There is no ‘one size fits all’ answer,” states Dr. Lindenmeyer. “It depends on how much damage has already been done and any possible complications.”

There has been some research conducted on how abstaining from alcohol detoxifies your liver over time. A 2021 review of research notes that several studies determined that two to four weeks of abstinence from alcohol by heavy-alcohol users helped reduce inflammation and bring down elevated serum levels in the liver.

In short: A few weeks off will help. But the longer you can abstain from alcohol, the better. And if your liver has experienced long-term effects, your healthcare provider would probably recommend lifelong abstinence from alcohol to allow it to fully detox and recover.

“For patients who are left with cirrhosis after severe injury to the liver from alcohol, even one drink of alcohol is toxic to the liver,” cautions Dr. Lindenmeyer.

Should you take a break?

For many of us, alcohol becomes a casual routine associated with going out and spending time with loved ones. But if you’re drinking alcohol in excess of the recommended guidelines, you may be doing damage to your liver. It can be hard to notice at first if your body is sending you any warning signs that it’s overwhelmed.

Here are some common signs that your liver is taking a serious hit from alcohol:

What to know if you’re a casual drinker

It can be hard to find (or even know) the balance of how much alcohol your body is able to handle. If you’re not sure if your drinking crosses a certain line or not, try measuring your alcohol intake.

According to the U.S. Centers for Disease Control and Prevention (CDC), alcohol should be consumed in moderation, which means one drink a day for women and people assigned female at birth (AFAB), and two for men and people assigned male at birth (AMAB) — unless your doctor says otherwise. If you’re keeping up with this average (or less), the damage from alcohol is most likely minimal.

On the other hand, binge drinking is generally defined as four drinks for women and five drinks for men within a two-hour period. And even occasional binge drinking episodes can have profound effects on your liver’s health over time.

Overall, a small break from drinking like a Dry January won’t necessarily fully “detox” your liver, but if you’re prone to overindulging in alcohol, you can see small health boosts such as decreasing inflammation of the liver and increasing your energy levels with such a break.

The bottom line

Just like a broken bone or infection needs time to heal, so does an overworked liver. While this depends on the amount of alcohol you have had over the years, your liver can see partial healing within two to three weeks, but this will depend on your health history.

Depending on the extent of liver damage you have, you may need to completely abstain from alcohol in order to give your liver the best chance for recovery. Talk to a doctor about your personal history and what’s right for you.

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From beginner’s yoga to more advanced practices, downward dog is one of the most popular poses. Physical therapist Dawn Lorring, PT, MPT @ClevelandClinic

Take a ‘Paws’ With Downward Dog

This transitional and restorative yoga pose provides a full-body stretch

Physical therapist Dawn Lorring, PT, MPT, walks through the steps of how to do downward dog correctly and shares its many benefits.

From beginner’s yoga to more advanced practices, downward dog is one of the most popular poses…with a few common misconceptions.

Rounding your back, placing your feet too far apart or putting too much weight into your wrists can all create a deeper stretch than intended — which increases your risk of injury.

Physical therapist Dawn Lorring, PT, MPT, walks through the steps of how to do downward dog correctly and shares its many benefits.

What is downward dog?

Downward dog (also known as downward facing dog, facing dog pose or Adho Mukha Svanasana in Sanskrit) is a foundational yoga pose. It’s often used as a transition between movements, like sun salutations. It’s also a form of active resting, active stretching and strengthening. This allows you to check in with yourself and re-evaluate your intentions during your practice.

You do downward facing dog by putting your body into an inverted V-shape (or pyramid), as if there were a straight line that runs through the top of your head up your spine and out of your butt toward the ceiling.

How to properly do downward facing dog

Facing dog pose won’t usually be your first movement when doing yoga. Before trying it, it’s best to loosen up your muscles and joints and find ways to work it into your overall yoga practice.

Once you’re warmed up and ready to go, follow these steps:

  1. Start on all fours with your hands shoulder-width apart and your knees in line directly behind your hips.
  2. Spreading your fingers wide, press down into your hands and tuck your toes (almost like you’re using them to grip the floor beneath you).
  3. As you exhale, bring your hips up and back, as if there’s a string pulling your butt toward the ceiling, so your body creates an inverted V-shape (or pyramid).
  4. Focus on straightening your back, not rounding it, so your head and neck are relaxed between your upper arms. It helps to focus on pressing through your arms to “push” the ground away from you and keep your arms active.
  5. Engage your core muscles and pull your tummy in.
  6. Keep your legs straight and, if it’s comfortable for you to do so, try to drop your heels down to the floor.
  7. Adjust your posture by shifting your weight between your hands and feet until you sink comfortably into the position.
  8. Hold this pose for 10 to 15 seconds at a time, making sure to breathe throughout.
  9. For a more relaxed stretch, bend your knees a little and readjust your posture as needed.
  10. When you’re done, exhale and move into your next pose or slowly lower yourself to the floor to enter child’s pose.

“Downward facing dog isn’t about keeping your heels on the ground or holding it for long periods of time,” clarifies Lorring. “It’s really about making sure you’re going to a place that’s comfortable for you, so you can adjust your body as often as you need in this pose.”

Facing dog pose variations

If you have a hard time getting down on your hands and knees, try this wall variation:

  1. Face the wall and place both your hands out in front of you so your palms are flat and your fingers are stretched out.
  2. Keeping your head and back straight and your hands on the wall in front of you, slowly walk your legs backward.
  3. As you move, walk your hands down the wall so you hinge at your hips and look directly at the floor.
  4. Keeping your head and neck relaxed, hold this pose for 10 to 15 seconds before slowly returning to stand.
  5. If you feel stress or discomfort in your wrists, you can modify by rolling up a towel or the edge of your yoga mat and placing the roll under the heels of your hands. This will decrease some of that pressure.

For a more challenging stretch that deeply engages your hips and hamstrings:

  1. While in the downward facing dog position, lift one leg up and stretch it toward the ceiling.
  2. For a deeper stretch, bend your outstretched leg back and over your body, so your knee is facing away from you.
  3. Repeat this process with the other leg, holding the pose for as long as you feel comfortable on either side.

Downward dog benefits

Downward facing dog provides a full body stretch, while also strengthening and working your:

Adho Mukha Svanasana helps improve your flexibility and control, and provides you a moment of active rest. It also increases blood flow to your head and upper body when you’re in the inverted V position. But because of this, you should talk to your yoga instructor, athletic trainer or healthcare provider before starting this position if you have:

“Facing dog pose tries to improve flexibility but also builds the strength to control that flexibility,” says Lorring. “If you’re feeling excessive stress to a certain part of your body, then you’re probably holding the pose for too long or you’re trying to go into a range that you’re not ready for. We can help you get there.”

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Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day @ClevelandClinic

May 28, 2024/Pregnancy & Childbirth

How Long To Breastfeed: What the Guidelines Say and What To Consider

Recommendations encourage breast milk exclusively for baby’s first six months and continuing to provide human milk until age 2 and beyond

How and what you feed your baby is probably one of the most basic — and yet deeply personal — decisions you’ll face when you become a parent.

You’ll hear things like “breast is best.” As in, breastfeeding (chestfeeding) is the absolute best way to nourish your baby.

And then you’ll hear the retort, “fed is best.” Meaning breast milk (human milk) and formula are both fine. As long as your baby is getting nutrients in their belly, all is well.

Then come the opinions on how long you should breastfeed. (You’re still breastfeeding? You gave up on nursing already? You fed your baby formula?)

It can feel like there’s no right way to do it. And there’s some truth to that.

Because what works for one family may not be feasible for another. But that’s OK.

Breast milk can provide certain benefits that formula can’t mimic. But breastfeeding, especially for long periods of time, might not work for everyone. Or you may have been given the impression that you’ve continued providing human milk long after others think you “should.”

No one should feel guilt, shame or otherwise crummy about how they feed their baby. Let’s face it, mom guilt is tough enough as it is.

So, we talked with board-certified breastfeeding medicine physician Heidi Szugye, DO, about breastfeeding recommendations.

How long to breastfeed

Science shows that if you can give your baby human milk (either your own or a donor’s), it has its benefits. And the longer, the better, experts recommend.

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) share these recommendations for breastfeeding duration:

  • Newborn to 6 months: Exclusive human milk.
  • 6 months to 12 months: Mostly human milk while introducing solid foods.
  • 12 months to 24 months (and beyond): Mostly solid foods with some human milk, as mutually desired by parent and child.

Previous recommendations called for providing breast milk until age 1. But these newer guidelines (implemented in 2022) are based on the understanding that human milk has benefits that continue long after baby’s first birthday. And they help to remove stigmas associated with people who choose to extend breastfeeding into toddlerhood.

“These recommendations are a call to action for everyone, and that includes hospitals, pediatricians and all physicians that are taking care of families,” Dr. Szugye states. “We want to make sure our practices and policies are set up to support people who choose to breastfeed beyond the first year of their child’s life.”

Think of the guidelines as the best-case scenario. If it works for you, your family, your child, your body and your life to breastfeed for two years or longer, you’re doing a great thing. And there’s no reason to stop until you and your child are ready.

If it doesn’t work for you, that’s OK, too. Your worth as a parent and your love for your child can’t be measured in ounces of milk.

Benefits of extended breastfeeding

The recommendations are based on research showing that human milk has some big benefits. And those perks continue for as long as you continue to supply it.

“Breastfeeding offers tremendous benefits — from custom-made nutrition and increased immunity to protecting you against some forms of cancer. And those benefits don’t go away as your baby ages,” Dr. Szugye shares. “We have more and more data supporting that there are benefits to breastfeeding for more than one year when possible.”

Breastfeeding can offer both you and your baby some big benefits:

Benefits for lactating parentsBenefits for baby
Lower risk of developing conditions like Type 2 diabetes, high blood pressure, cardiovascular disease, breast cancer and ovarian cancer.Decreased risk for ear infections, respiratory infections, gastrointestinal illnesses, SIDS, leukemia, diabetes, obesity, asthma and eczema.

“There are a lot of immunologic factors and components to human milk,” Dr. Szugye says. “One big advantage to human milk is that you pass antibodies to the baby. So, if you’re exposed to a respiratory illness or GI illness, those antibodies are passed on to the baby and then that makes them less likely to get sick. And if they do get sick, it’s less severe. It’s almost like a built-in immunity.”

Keeping up milk supply for the long haul

Some people can make enough milk to breastfeed for as long as they and their babies choose. But some don’t. At least not without taking some steps to keep it up.

If you suspect your supply is dwindling as your child gets older, there are ways to help promote more milk production if you want.

“Many people notice their supply drop and mistakenly assume it won’t return,” Dr. Szugye notes. “But if you want to continue to breastfeed, there are options that could help.”

If a supply boost is in order, you can try:

  • Nursing more often — Add sessions as long as your child will nurse. If you’re away from them during the day, try early evenings, mornings or weekends.
  • Pumping strategies — An extra session or several short “power pumping” sessions (think five to 10 minutes throughout the day) for several days in a row can trigger your body to make more milk.
  • Breast massage and compression — Easy-to-learn techniques can improve drainage when nursing or pumping.
  • Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day to support breastfeeding.

Not an ‘all-or-nothing’

If two or more years of breastfeeding seems daunting, remember that you have options.

For starters, giving your child human milk doesn’t always mean latching them to your breast and nursing. That’s just one way to do it. Pumping milk and putting it in a bottle, cup or spoon are also options.

And you may find that a donor bank could be a route to explore if you don’t lactate or if you have concerns about a low milk supply. Donor milk is pasteurized, screened for drugs, medications and infections, and tested for bacterial contamination before it’s stored and made available for purchase.

“Reach out to your pediatrician or women’s healthcare provider if you’re interested in obtaining donor milk. You may need a prescription from a healthcare provider,” Dr. Szugye suggests.

Remember, too, that any amount of human milk can be a benefit. If keeping up with your baby’s breastfeeding demands becomes too high a burden, there are alternatives.

Some parents may find that supplementing with formula (or other foods and milk after baby turns 1) can help give your child some human milk, while keeping up with their nutritional needs — and not burning yourself out in the process.

“It’s not an all-or-nothing thing,” Dr. Szugye reassures. “Any amount of human milk you can give is a benefit. If it doesn’t work for you to constantly supply human milk, that’s OK. We’re all just doing our best.”

If breastfeeding is going well for both you and your child, there’s no reason to give it up until you’re both ready to.

Feeding a baby is tough work, no matter how you do it. And chances are, you’re doing a fantastic job.

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5 Ways to Boost Your Child’s Immune System for Life @ClevelandClinic Adriane Lioudis, MD.

We all want to protect our kids whether it be from falls, bumps and bruises — or avoidable infections and diseases. To help your child avoid illness, it’s important to encourage good habits and take steps to boost their immune system from an early age.

“Most of what makes a child’s immune system strong is common sense,” says pediatrician Adriane Lioudis, MD. If you keep these five tips in mind, you’ll stack the deck in your child’s favor for a healthier life.

1. For newborns, consider breastfeeding

While it’s a very personal decision (that isn’t always possible), if you are able to exclusively breastfeed your child for at least six months, it may have benefits. Some research shows that breastfeeding your child might possibly reduce allergies, Dr. Lioudis says.

2. Promote regular hand washing

Eighty percent of infections are spread by touch. Teach your little one to take the time to wash their hands after sneezing, coughing and going to the bathroom. Washing hands with warm water and soap for at least 20 seconds can remove bacteria and viruses and can reduce the chance of lung infections by up to 45%.

3. Don’t skip immunizations

Follow your pediatrician’s advice when it comes to the childhood vaccination schedule. Immunizations start in infancy and continue to adulthood and prevent measles, mumps, chickenpox, rotavirus and other infections.

“Get the flu shot for your child yearly, as well,” Dr. Lioudis says. This is particularly important for children with asthma and other chronic health conditions.

Also, if your family will be traveling internationally, it’s important to seek advice from your child’s healthcare provider about any needed vaccinations.

4. Make sleep a priority

To maximize immunity, children must get enough sleep.

Sleep requirements for each night vary by age:

  • Babies between 0 and 3 months need 14 to 17 hours of sleep. Those between 4 and 12 months need 12 to 16 hours of sleep.
  • Children between the ages of 1 and 2 need between 11 and 14 hours.
  • Kids between the ages of 3 and 5 should get from10 to 13 hours.
  • Children ages 6 to 12 should get between 9 and 12 hours.
  • Teens between the ages of 13 to 18 need 8 to 10 hours.

Not getting enough sleep limits the body’s ability to produce proteins called cytokines that help fight infection and reduce inflammation.

5. Encourage a healthy diet

A healthy diet is also important for your child’s immune system.

Dr. Lioudis recommends encouraging your child to “eat the rainbow” when it comes to fruits and vegetables. A good selection of whole grains should be part of their diet as well. Keep processed foods to a minimum. Proper food choices can help ensure that your child gets enough vitamins — such as vitamin A and E. These vitamins are needed to maintain good health and a strong immune system.

You can’t avoid all illness, but some kids need extra protection

“Even if you follow these tips, your child might still get between seven and 11 colds each year,” says Dr. Lioudis. She adds that you can expect each one to last up to two weeks.

Also, keep in mind that some things billed as common “remedies” aren’t effective in boosting immunity. For example, there’s no definitive proof that large amounts of vitamin C or echinacea help prevent colds or shorten them, she says.

However, if your child has a compromised immune system, work closely with your pediatrician to find ways to improve his or her immunity. Each child needs a personalized approach because their individual immune system varies, Dr. Lioudis says.

“There’s generally a different protocol with immunocompromised children. There are some vaccines we have to add in on top of what most children have, but it’s something that we must determine on a case-by-case basis.

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Vitamin D is one of the most powerful nutrients for supporting the immune system @ClevelandClinic  🌞

Who doesn’t want a healthy immune system? (Raise your hand. No one?) But did you know the role your diet plays in keeping it in top shape to protect you from toxins and infections?
Sadly, too many of us don’t eat enough of the fresh fruits, vegetables and other foods we need to keep ourselves healthy year-round. Healthy foods provide many substances including vitamins and minerals to keep us strong and healthy. You can’t just eat an orange or grapefruit or pop a vitamin pill and expect one quick burst of vitamin C to prevent a cold and to boost your immune system.
“A truly healthy immune system depends on a balanced healthy diet over time,” says registered dietitian Maxine Smith. “It’s like training for a battle and preparing your body ahead of time so it can through a good punch when attacked by viruses, bacteria and toxins. Other lifestyle practices such as regular exercise and good sleep will better prepare you for the battle.” 
With some exceptions, it’s best to get your vitamins and minerals from your food rather than in pill form. Smith shares some tips for some of the top vitamins and minerals your immune system needs to perform:

1. Vitamin C
Vitamin C may help prevent infections or shorten their stay. Citrus fruits are a standout, but did you know there are other good sources? It’s true! Smith recommends the following:
Spinach.
Kale.
Bell peppers.
Brussels sprouts.
Strawberries.
Papaya. 
Fun fact: vitamin C is in so many foods that most people may not need to take supplements unless a doctor advises it. Consult with your doctor before taking any vitamin C supplements

2. Vitamin E
Like vitamin C, vitamin E can be a powerful antioxidant that helps your body fight off infection. This important vitamin — part of nearly 200 biochemical reactions in your body — is critical in how your immune system functions. To get your vitamin E, think high-fat plant foods such as:
Almonds.
Peanuts/peanut butter.
Sunflower seeds. 
Oils such as sunflower, safflower, and soybean oil.
Hazelnuts.

3. Vitamin A#

Vitamin A is an infection-fighter and comes in two forms: preformed such as in animal foods such as fish, meat and dairy or from plant carotenoids. Tuna is a great source of preformed vitamin A. When it comes to carotenoids, go colorful: 
Carrots.
Sweet potatoes.
Pumpkin.
Butternut squash.
Cantaloupe.
Dark green leafy vegetables.

4. Vitamin D
Known as the sunshine vitamin, it’s one of the most important and powerful nutrients for supporting the immune system. Food sources are limited but include:  
Salmon. 
Mackerel.
Tuna.
Sardines.
Vitamin D fortified like milk, orange juice and cereals. 
In general, it’s best to get most of your vitamins from food, but vitamin D may be the exception to that rule. Talk with your doctor to find out if you need a supplement. 

5. Folate/folic acid
Folate is the natural form and folic acid is the synthetic form, often added to foods because of its health benefits. To get more folate, add more beans and lentils to your plate on a regular basis, as well as leafy green vegetables. Avocado is another tasty source. You can also get folic acid in fortified foods (check the label first).
Enriched pasta.
Enriched bread.
Enriched rice.

6. Iron
Iron, which helps your body carry oxygen to cells, plays a part in many of the immune system processes. It comes in different forms. Your body can more easily absorb heme iron (aka iron from animal products), which is abundant in:
Red meat (limit to smaller amounts and less often).
Chicken.
Turkey.
Canned sardines.
Oysters.
Clams.
Mussels.
Canned light tuna.
If you’re a vegetarian, have no fear. You can still find iron in:
Beans.
Broccoli.
Kale.
Iron-fortified cereals.

7. Selenium
Selenium seems to have a powerful effect on the immune system being important for preventing infections. Animal foods are the best sources, with the exception of Brazil nuts, that offer a whopping greater than 100% daily value in one nut. However, too much can be a problem, so keep to no more than one to two of these in a day. Look for selenium in: 
Seafood (tuna, halibut, sardines).
Meat and liver.
Poultry.
Cottage cheese.

8. Zinc
Zinc is needed for the production of new immune system cells. It’s found primarily in animal foods but can be also found in some vegetarian food like.  
Oysters.
Crab.
Lean meats and poultry.
Baked beans.
Yogurt.
Chickpeas.
Choose frozen when you can’t get fresh
Depending on where you live and what time of year it is, you can’t always get your hands on high-quality fresh produce. Keep in mind that buying frozen is a good option and can be quite convenient in our time-crunched world. Frozen food can still boost your immune system. 
“Manufacturers freeze frozen fruits and veggies at ‘peak’ ripeness, which means they’ll pack a similar nutritional value as their fresh counterparts,” she says. “Just choose plain frozen foods rather than those with added sugars or sodium.”​


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Morning back pain waking you up? Try these simple fixes. @ClevelandClinic. Pain relief from experienced Physical Therapists

Why Your Lower Back Pain Is Worse in the Morning (and What To Do About It)

Your sleep position, immobility, mattress and underlying conditions can all cause morning back pain

There’s nothing worse than waking up on the wrong side of the bed. But it can be hard to avoid when you wake with lower back pain in the morning. A back that throbs, aches or sends shooting pain down your legs can quickly set the tone for your day.

Most people experience lower back pain at some point, and more than 20% have chronic lower back discomfort. It’s the second most common reason people in the U.S. visit their primary care provider — behind colds and flu.

Whether you experience lower back pain all day or only in the morning, understanding what’s contributing to the pain may help you fix it. Pain management specialist Tara-Lin Hollins, MD, shares what might be behind your morning back pain and offers tips to help you wake up pain-free.

4 causes of lower back pain in the morning

Back pain and sleep have a complicated relationship. Pain can disrupt your sleep, and poor sleep can make you more likely to have higher pain. Getting to the bottom of your pain may help end the cycle.

Dr. Hollins says several factors can contribute to morning back pain.

1. The wrong sleep position

You spend a third of your life sleeping or resting, so if your spine is out of alignment while you sleep, it can have a significant impact on your body. Your sleep position affects your alignment and may (or may not) support the natural curvature of your spine.

“It’s common to be so tired at bedtime that you fall into bed and sleep however you hit the bed,” Dr. Hollins says. “But you may not be sleeping in the best position for your spine.”

The most beneficial sleep positions for your back are on your:

  • Side, with your knees partially bent
  • Back, as long as you don’t have sleep apnea (which worsens when sleeping on your back)

Sleeping on your stomach makes you more likely to twist your neck to the side — a quick way to throw your neck and spine out of alignment.

2. Lying down for hours

When you sit all day at your desk without moving, it can make you stiff. Similarly, when you sleep, you’re not moving much for seven to eight hours. Lying immobile for a long period could cause you to wake up with back or hip pain.

“Our bodies are not supposed to be stagnant for multiple hours,” Dr. Hollins explains. “Stiffness can settle in, and inflammation can build up. Then, when you try to move in the morning, releasing the inflammation can be painful.”

Tricky, right? After all, you want a good night’s sleep, and lying immobile while you doze is often a sign that you got all of your ZZZs. But to avoid lower back pain, Dr. Hollins advises taking some time to stretch before you jump out of bed.

3. An unsupportive mattress or pillow

Your mattress is your main source of back support while you sleep. And your pillow ensures proper neck alignment. A mattress that’s damaged, too soft or sagging can cause your lower abdomen to sink deeper than the rest of the spine, pulling your back out of alignment.

“All too often, people opt for a soft mattress, thinking it will be more comfortable,” Dr. Hollins notes. “You don’t want a hard mattress, but it should feel firm and supportive. You shouldn’t sink into it.”

Need tips for choosing the best mattress for your back? We can help.

4. An underlying condition or pregnancy

Some conditions or chronic diseases may put you at higher risk for morning back pain. Chronic conditions that affect both sleep and morning back pain include:

Pregnancy can also bring back pain in the morning due to:

  • Additional strain on your lower back muscles
  • Shifting center of gravity
  • Increased weight

How to stop waking up with lower back pain

Lifestyle changes, like achieving a healthy weight and exercising every day, are always helpful for back pain. But Dr. Hollins also recommends actions related to sleeping that may additionally help reduce or eliminate your morning back pain.

Add supportive pillows

Pillows are a great way to support your back’s alignment. Your typical sleep position should guide the pillows you use:

  • Back sleepers. Choose a head pillow that supports your neck and lets your head sink in. Place a pillow under your knees to support your spine’s natural curvature.
  • Side sleepers. For your head, choose a thick pillow that keeps the top portion of your spine straight and parallel to the mattress. Place a small pillow between your knees to help even out your hips.
  • Stomach sleepers. Don’t use a pillow for your head, or choose a very thin one. Put a thin pillow under your lower abdomen to keep your spine aligned.

“Look for pillows that are specific to your sleep position,” Dr. Hollins advises. “But no matter which position you use, adding pillows strategically around your body can support your spine and reduce morning pain.”

Adjust your sleep position

If you’re used to sleeping in the same position every night, it can be challenging to change it. But small adjustments may help:

  • Place both arms in the same position if you sleep on your back — instead of flinging one arm over your head — to keep your spine aligned.
  • Bend your knees when sleeping on your side to help balance your body and reduce any pressure on your lower spine.
  • Put pillows in front of you if you sleep on your side so you don’t roll onto your stomach.
  • Sleep on your left side whenever possible to take pressure off your internal organs.

“You want to be as comfortable as possible when you go to sleep,” Dr. Hollins says. “That way, you’ll be more likely to stay in a supportive sleep position.”

Replace your mattress regularly

According to the Sleep Foundation, the general guideline is to replace your mattress every six to eight years. But you may need a new mattress sooner if yours is:

  • Making noise (if it’s an innerspring mattress)
  • Noticeably sagging or damaged
  • Causing muscle or joint stiffness, especially if you don’t have the same stiffness when you sleep at hotels or other homes

When choosing a new mattress, choose a “medium firm” mattress — level 6 out of 10 on the mattress firmness scale. It may reduce your back pain symptoms by nearly half.

Pause before you get up

Most people get out of bed as soon as they wake up, Dr. Hollins points out. But taking a few minutes to prepare your back for transitioning to sitting, standing and walking can help with morning back pain.

  • Stretch while you’re still in bed. While on your back, bring one knee to your chest. Hold it for three seconds, let it go and then, switch to the other leg.
  • Warm your muscles. Slide a heating pad under your back to warm your muscles. Use one that’s designated as safe for use in the bed and has an auto shut-off. Keep the sheet or your shirt between the pad and your skin.
  • Take your time getting up. First, sit on the edge of the bed and let your back adjust. Then, use your legs — not your back — to stand up.

See your healthcare provider if your back pain worsens or occurs most mornings for two or three months. They can check for underlying back issues and may prescribe physical therapy.

“Don’t wait six or eight months to see your provider,” Dr. Hollins urges. “They can provide guidance about the best stretches to do, and your back will thank you.”

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“When you create a meal centered around vegetables, you’re taking steps to improve and maximize your health,” says Liz Moore @HarvardHealth #nutrition

Harvard Health

@HarvardHealth

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“When you create a meal centered around vegetables, you’re taking steps to improve and maximize your health,” says Liz Moore, registered dietitian at Beth Israel Deaconess Medical Center. Try these three meals today. — #HarvardHealth #Diet #Nutrition

Meatless Mondays, meet summer’s bounty: a wide variety of colorful, fresh summer vegetables now available in grocery stores, backyard gardens, and farmer’s markets. We’re talking sunshiny golden corn on the cob, deep purple eggplant, red beets, peppers of all hues, not to mention tomatoes, zucchini, green beans, cucumbers, and more. With a bit of simple prep, they’re ready to take center stage on your plate, reinforcing the joy of summer.

“Vegetables in our diet provide many benefits. And when you create a meal centered around them, you’re taking steps to improve and maximize your health,” says Liz Moore, the author of a heart-healthy cookbook and a registered dietitian at Harvard-affiliated Beth Israel Deaconess Medical Center.

Centering healthy vegetables on your plate

Making vegetables the stars of a meal is part of the “veg-centric” movement, which teaches people how to elevate even average vegetables to creative entrées and side dishes. The trend gives vegetables bold flavors by grilling, layering, caramelizing, or roasting them — steps you can take with a backyard grill or stovetop skillet.

Summer veggie meals have lots of important health perks. “Vegetables such as eggplant and beets of all colors are rich in fiber, Moore says. “Eating a high-fiber diet helps lower cholesterol and is linked to heart health, digestive health, and helping to maintain stable blood sugar levels. For those trying to lose weight, vegetables are low in calories and provide volume, which helps keep you full.”

Summer vegetables also have a wide variety of essential vitamins, minerals, and phytochemicals (beneficial plant chemicals) like flavonoids. “For example, carotenoids in cooked tomatoes are rich in lycopene, which is associated with inhibiting cancer growth and boosting the immune system. And beets are a good source of folate and potassium,” Moore says.

Three easy summer vegetable meals

Wondering what to do with the colorful harvest available to you? Moore suggests keeping it simple by making a meal of vegetables paired with whole grains or legumes (beans or lentils). Here are three meals that fill the bill.

Grilled eggplant steak with cucumber, tomato, onion, chickpea, and feta salad

  1. Slice an eggplant (from root to stem) into three-inch thick “steaks.” On each side, drizzle olive oil and a little black pepper. Grill on both sides until tender.
  2. Dice two tomatoes, one cucumber, and half a red onion. Add a can of rinsed, drained chickpeas. Toss with a dressing of olive oil, a little red wine vinegar, and oregano to taste.
  3. Serve the salad over the eggplant steak. Top with some diced feta cheese, if you like.

Veggie pita pocket with gazpacho

  1. Put a couple of tomatoes, a cucumber, a green pepper, half a red onion, some bread crusts, and a little olive oil into a blender. Blend until chunky or finer, as you prefer. Add salt, pepper, and cumin to taste, blending for a few more seconds. Chill for 30 minutes.
  2. Open a whole-wheat pita and spread a tablespoon of hummus inside. Add slices of zucchini and carrots, and some arugula, salad greens, or other vegetables that appeal to you.
  3. Serve the pita with half a cup of the gazpacho.

Quinoa-stuffed red peppers

Based on a recipe from BIDMC’s CardioVascular Institute’s Hungry Heart Cookbook by Liz Moore, RD, LDN

  1. Cut peppers in half, remove seeds, and lay them open side up on a dish.
  2. Mix cooked quinoa, diced tomatoes, and corn off the cob (you can grill the corn first and cut off the kernels for a special summer flair). Add low-fat grated cheddar cheese, canned (rinsed) black beans, one egg, and some spices to taste, such as a bit of cumin, chili powder, salt, and pepper.
  3. Use the mixture to stuff the peppers evenly, and then cook them on the grill in a grilling basket for about 30 minutes. You can also cook them in the oven at 350° F on a cookie sheet or in a roasting pan, checking at 30 minutes to see if they are done.

Other ideas include

  • grilled veggie kebabs with chunks of eggplant, zucchini, cherry tomatoes, and mushrooms. Serve on a bed of lettuce and add a little goat cheese.
  • whole-wheat pasta with a mix of sautéed vegetables that appeal to you.
  • salad with green leaf lettuce, raw green beans, cherry tomatoes, Kalamata or black olives, and half a hard-boiled egg. Top with a dressing you enjoy.

Which combinations of summer vegetables you choose can depend on cost, taste preferences, and how much time you want to spend cooking. If you’re in a hurry, go with a salad. If you have more time, try grilling or sautéing vegetables.

Finally, be open to inspiration from the bounty you see at the market. “Focus on getting a variety of colors in the vegetables you choose. The more colors there are on the plate, the more nutrients you’ll be consuming,” Moore says. “And try something new. Explore vegetables you’ve never tried before or new methods of cooking. Think of it as one of summer’s glorious adventures.”

About the Author

photo of Heidi Godman

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio

View all posts by Heidi Godman

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How Alcohol Affects Your Heart @ClevelandClinic #heartaware

You likely know that drinking alcohol too often or to excess isn’t a good idea, health-wise. But when it comes to alcohol and heart health, you may have heard different sides. Is drinking all that bad for your heart? Can a glass of wine help reduce your risk of heart disease — or make it worse? 

First things first: If you drink alcohol, you should do so in moderation to avoid alcohol-related heart issues. And you should never intentionally use alcohol to try to reduce your risk of heart disease. 

To further explore the relationship between your ticker and your favorite glass of merlot or IPA, we chatted with cardiologist Leslie Cho, MD.

Ways alcohol can impact heart health

Here are some of the effects of alcohol on your heart:

Increased heart rate

One of the most important things your heart does is keep a rhythm. On average, a regular heart rate is about 60 to 100 beats per minute when your body is at rest. But alcohol can lead to your heart rate temporarily jumping up in speed, and if it goes over 100 beats per minute, it can cause a condition called tachycardia. Too many episodes of tachycardia could lead to more serious issues like heart failure or going into irregular rhythms, which can cause heart attack and stroke.

Raises blood pressure

That fourth drink at the bar may feel like it’s relaxing you, but it’s actually affecting your body differently than you might think. Alcohol can affect your blood pressure, causing it to go up temporarily. This is especially true when you engage in binge drinking (that’s defined as four or more drinks within two hours for women and people assigned female at birth, and five or more drinks within two hours for men and people assigned male at birth).

And sure, we’ve all had a night here or there where we’ve had one too many and we know it. But it’s important to make sure those nights of overindulgence are the exception and not the rule. If you’re not sure, make a note to tune into how much you’re having over the course of the next month or so. If it’s more than recommended, try to consciously pace your drinking to help reduce the spike in your blood pressure that excessive alcohol causes. 

And if you have a history of high blood pressure, it’s best to avoid alcohol completely or drink only occasionally, and in moderation. 

Irregular heartbeat

Whether it’s a glass of red wine with your turkey or toasting champagne for the new year, alcohol definitely becomes more present during the holiday season. And while enjoying celebratory spirits in moderation is alright for most people, it’s important to be aware you can fall victim to holiday heart syndrome if you overdo it. This is when overeating and overindulging in alcohol lead to an irregular heartbeat.

Holiday heart syndrome can happen if you don’t typically drink alcohol, but then have a few at a holiday party or if you binge drink. This can cause you to develop an irregular heartbeat, called atrial fibrillation, which can increase your risk of stroke, heart attack and heart failure.

Prolonged drinking can cause alcoholic cardiomyopathy

The short-term effects of alcohol (headache, nausea, you know the rest) are easy to pinpoint. But there are ways that alcohol affects your body over time that are important to understand. One of the long-term effects of alcohol on your heart is alcoholic cardiomyopathy. This is when your heart-pumping function gets weaker and your heart gets larger due to changes from heavy alcohol use over a long period of time.

OK, don’t panic. If you’re an occasional drinker, there’s no cause for worry. But it may be worthwhile learning about what counts as binge drinking and whether or not you may be drinking too much and don’t even know it.

Is some level of alcohol safe or beneficial?

It’s true, red wine is a better choice than hard liquor. But can a trip to the wine bar boost your heart health?

You should never consider wine or any other alcohol as a way to lower your heart disease risk. And, in fact, the study also showed that drinking one or fewer drinks per day was related to the lowest likelihood of dying from a stroke. However, Dr. Cho points out that more recent data shows that there may be no amount of alcohol that is truly safe. “The myth that wine is beneficial for heart health is no longer true,” she states.

“It’s not a good idea to start drinking alcohol in an effort to lower your risk of heart disease,” Dr. Cho continues. “It’s better not to drink any alcohol at all.” 

The American Heart Association recommends the same. 

Other factors to keep in mind

It’s also important to know that the ways in which alcohol affects your heart will vary from person to person, depending on your age and other conditions you may have.

Age

Let’s face it, a hangover in your mid-40s doesn’t feel the same as one in your early 20s. This is because your age plays a factor in how well you tolerate alcohol. While some people develop a tolerance to alcohol over time, this isn’t true for everyone — and this ability doesn’t last forever, Dr. Cho notes.

“As we get older, our ability to clear alcohol definitely decreases and our sensitivity to alcohol probably increases,” she explains. “Also as we get older, we end up having more diseases, so we could be on medicines that can interfere with the way our bodies metabolize alcohol.”

Other medical conditions

In many ways, your medical history (and present) can tell you a lot about your future with alcohol. That means, if you’re living with other medical conditions and/or taking certain medications, this will all have an impact on how alcohol affects you.

“Certain health conditions can make drinking alcohol more dangerous,” Dr. Cho says.

For example, some people who are on cholesterol-lowering medicines may experience muscle aches when they drink alcohol. Because alcohol and cholesterol medicine both are processed through your liver, they are, in a sense, competing for clearance. So, it’s important to think about your overall health and talk to a healthcare provider about your personal risk factors.

“Alcohol is made out of sugar,” Dr. Cho points out. “So, if you’re predisposed to diabetes or if high triglycerides are one of your issues, it’s not a good idea to drink alcohol.”

Dr. Cho also warns that if you have liver dysfunction or take other medicines that are processed through the liver, your risks might be different. Talk to your healthcare provider about how alcohol might interact with your prescription medicines.

The last thing you want is for that casual drink after work or glass of wine at dinner to negatively impact your heart health. There’s a way to have a healthy, balanced relationship with alcohol that lets you enjoy a drink occasionally and celebrate with friends and family. But your heart is an important organ that should also be cared for, so be sure to drink in moderation, learn about binge drinking and know what your body can (and can’t) tolerate before opening that tab.FACEBOOKTWITTERLINKEDINPINTERESTEmailalcoholalcohol and healthalcoholic beveragesbinge drinkingheart health

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Recipe: Spanish Omelet With Veggies and Cheese @ClevelandClinic

Recipe: Spanish Omelet With Veggies and Cheese

Omelets are a great choice for a one-skillet meal, and our recipe delivers on nutrition and taste! This meatless dinner option provides 100% of your daily vitamin C and is a good source of calcium.

Ingredients

  • 5 small potatoes, sliced
  • Vegetable cooking spray
  • 1/2 medium onion, minced
  • 1 small zucchini, sliced
  • 1 1/2 cups green/red peppers, sliced thin
  • 5 medium mushrooms, sliced
  • 3 whole eggs, beaten
  • 5 egg whites, beaten
  • 1/4 teaspoon pepper
  • 1/2 teaspoon garlic powder
  • 1/4 teaspoon oregano
  • 3 ounces shredded part-skim low-fat mozzarella cheese
  • 1 tbsp grated Parmesan cheese

Directions

  1. Preheat oven to 375 F.
  2. Cook potatoes in boiling water until tender, about 12 minutes.
  3. In a nonstick pan, add vegetable spray and warm at medium heat.
  4. Add onion and sauté until brown. Add vegetables and sauté until tender but not brown.
  5. In a medium mixing bowl, slightly beat eggs and egg whites, pepper, garlic powder, oregano and low-fat mozzarella cheese. Stir egg-cheese mixture into the cooked vegetables.
  6. In a 10-inch pie pan or ovenproof skillet, add vegetable spray and transfer potatoes and egg mixture to pan. Sprinkle with low-fat parmesan cheese and bake until firm and brown on top, about 20 to 30 minutes.
  7. Remove omelet from oven, cool for 10 minutes, and cut into five pieces.

Ingredient health benefits

  • Potatoes: Don’t let their higher carb and caloric content scare you; in moderation, these starchy vegetables are delicious and nutritious. Potatoes are full of vitamins and minerals like vitamin C , which boosts your immune system, and vitamin B6, which suppresses inflammation and promotes brain health. To get the most out of your potatoes, cook them with the skin on.
  • Onions: This allium is more famous for its potent aroma than its health perks, but rest assured, there are plenty to go around. For instance, onions have chemicals called flavonoids that fight inflammation and help lower blood pressure. And in addition to being a good source of fiber, onions contain prebiotics, which feeds the good bacteria in your gut so they can keep your whole body healthy.
  • Zucchini: If you’re looking for foods with head-to-toe benefits, consider adding squashes like zucchini to your diet. Nutritional highlights include calcium, vitamin A and vitamin C — all of which support strong bones and healthy eyes. Squashes are also a good plant source of iron, which keeps your blood cells happy.
  • Red bell peppers: These members of the nightshade family are an excellent, nutrient-dense addition to any meal. Red bell peppers are chock full of vitamins like vitamin E and vitamin B9 (folate). They also contain anthocyanins, which are natural plant pigments that protect your heart, help lower your blood pressure and might support your brain function.
  • Mushrooms: Though these fungi may be small, they’re a mighty culinary ingredient. Mushrooms are full of antioxidants, which help protect your cells from damage by free radicals. And they have compounds that stimulate your immune system to fight invaders and, potentially, cancer. Other properties found in mushrooms also support the health of your heart, gut and brain!
  • Eggs: A perfect example of how good things come in small, oval-shaped packages. Eggs are rich in vitamins like vitamin B12, which is essential for your blood cells and nerve cells to work properly. Eggs also have lutein, a carotenoid that helps preserve your vision. Egg whites have about 60% of the protein found in an egg.

Nutrition information (per serving)

Makes 5 servings

Calories: 290
Total fat: 6 g
Saturated fat: 2.5 g
Trans fat: 0 g
Cholesterol: 120mg
Sodium: 250 mg
Total carbohydrate: 43 g
Fiber: 6 g
Sugars: 5 g
Protein: 18 g

— Recipe courtesy of Digestive Disease Health Team Dietitians.

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The Focus of our Treatment is Exercise Prescription #Physiotherapy

What is Physiotherapy?

Physiotherapy (also known as physical therapy) places full and functional movement at the heart of what it means to be healthy. It involves treating patients of all ages with a range of illnesses and conditions, including those with back and neck problems, sports injuries, arthritis, or those recovering from strokes and operations. The focus of our treatment is exercise prescription. 

Physiotherapists may be part of a multidisciplinary medical team that includes physicians, nurses, speech and language therapists, psychologists, occupational therapists and social workers among others. Alternatively, they may work from clinics or specialise in particular areas of the discipline.

Physiotherapy: The course for you?

Physiotherapy is both physically and academically demanding and an interest in working with people is an requirement, alongside strong communication skills. Visiting a local general hospital or other area where physiotherapists work will give you a good understanding of what exactly is involved.

Physiotherapy at Trinity

Physiotherapy is based in the Trinity Centre for Health Sciences in a purpose built complex at St. James’s Hospital. This complex houses other health science disciplines and allows physiotherapy students to share courses with those in the other health sciences to give a multidisciplinary approach to studying and working. The centre is about 3km from the main campus and is beside a Luas station on the line running between Tallaght and Connolly Station.

All students will have clinical placements at Trinity’s associated teaching hospitals of St. James’s and AMNCH in Tallaght, where there is an established expertise in most areas of physiotherapy. These placements allow students to gain experience in some of the specialist areas of physiotherapy including neurology, respiratory care, coronary care, orthopaedics, women’s health, care of the elderly, sports and out-patients.

Graduate skills and career opportunities

Successful completion of the course entitles you to membership of the Irish Society of Chartered Physiotherapists, the accrediting body for physiotherapy in Ireland. Physiotherapists are sought throughout the world and you will be able to work with a wide range of conditions or to specialise, as you wish. There is also great scope for you to continue to develop your skills and expertise in areas such as sports medicine, neurology, cardiology, respiratory, research, education, management or private practice. Students may also work with a professional sports team as part of multidisciplinary athlete support.

Your degree and what you’ll study

The major objective of this four-year course is to enable you to become a competent professional with the ability to work independently with patients. There are two components to Physiotherapy: theory and clinical practice. In the first year the emphasis is on laying a foundation of theoretical knowledge and the second year introduces students to the clinical skills and procedures used by physiotherapists. Clinical sciences are taught mainly in the second and third years. In the third and fourth years students spend up to fifty percent of their time on clinical placement. In the fourth-year, students have an opportunity to develop specialist knowledge in a particular area of physiotherapy and undertake a research project.

First and second years

In first and second year as you will have approximately 20 hours of teaching each week, divided between lecture and practical classes.

Courses covered in the first two years include: Physiology, Anatomy, Physics, Chemistry, Pathology, and Exercise. You will also start to study various conditions and specialities frequently seen in physiotherapy, such as respiratory conditions and musculoskeletal conditions.

At the end of second year you will start clinical placements under the supervision of skilled and experienced tutors. These may be taken in hospitals, clinics, day centres or within private and community practice.

Third and fourth years

In the third year, half of the time is spent on academic studies and the other half on clinical placements in a variety of settings both within and outside the Dublin area.

In fourth year, you will undertake an investigative project and study the following subjects: sports and exercise medicine, ergonomics, professional issues and advances in physiotherapy.

End-of-year written examinations and tests in certain subjects, such as anatomy, make up the theoretical assessment structure. There are a number of submitted assignments in third and fourth years.

In addition, you will be continuously assessed during your clinical placement and will have practical exams on the skills element of the course, including your assessment of a patient while on a clinical placement.

Click here for further information on modules/subjects.