How to Beat Pain

I'm Dr Jack Kreindler. And I'm Professor Greg Whyte. We've spent

more than ten years helping celebrities and athletes get the

best out of their bodies. Awesome. And now we want to help you. We're

going to be tackling the nation's biggest health problems. Things

like pain. Bad days are really crippling. It is upsetting seeing

Andrew play with the kids more than me. I can't take one step in front

of me without pain. To get to the bottom of pain... And to find out

what we can do about it... We're going to put our own bodies on the

line in a series of, well, painful experiments. Ow! Argh! Come on, my

son! We're not sure our bodies... Or our friendship... Is going to

survive the next 30 minutes. this is How To Beat Pain. Pain

affects us all. But pain is invisible, so it is difficult to

understand. By inflicting pain on each other in a controlled way,

we're going to show you what causes pain and how to beat it. 10 million

of us suffer from severe pain every day and we spend over �1 billion a

year on painkillers. In today's programme, we'll be focusing on

three of the most common problems. Back pain, sports injury and

osteoarthritis. Our first pain to beat is back pain. It's a problem

that 80% of us will have at some point in our lives. And this

epidemic is being fuelled by our sedentary lifestyles. Oo, perfect,

mate. # You're singing with a broken string. Tell me what you

really mean... # Are you ready?

# Do you know what you want? # My name is Holly Minto. I'm 31

and I've been suffering with lower chronic back pain for nearly nine

years. Bad days are really bad, it's really crippling. 'I find it

hard' not to be able to do certain activities with the children. Good

girl, well done. They're going to grow up quite quickly. It is

upsetting seeing Andrew play with 'Poor Holly - time to get her back

'to our Harley Street clinic to find out what's causing her pain.

'First we'll give her a full health check.' Looking at the blood, we

can see a lot of things systemically around the whole body.

But it's red, so that's a good start. SHE GIGGLES. Not green! 'And

we're not stopping there. 'We want to take a look at what's going on

under the bonnet, too.' Just getting you in the right position

to start. 'So she's having an MRI scan. And the results are very

interesting.' We've got a disc that's kind of flattened and is

bulging there. 'Holly's MRI scan shows a classic back problem - 'she

has two bulging discs in her lower back. 'Discs are jelly-like

material that cushion each bone in the spine. 'If a disc bulges, it

can put pressure on a nearby nerve, and that's what causes the pain.

'But why are Holly's discs bulging in the first place? 'Well, the

Can you see how these muscles here have got so much fatty infiltration

in them? 'It turns out Holly's back muscles are turning into fat,

'which means her discs are taking on more weight than they should.'

Almost a third of that supportive muscle has been replaced by fat.

'But how can your muscles just turn into fat? 'Time to put our own

bodies on the line in the name of science.' I'm going to be

immobilising Jack's arm for six days in plaster and measuring what

happens to his muscle strength. It may seem ridiculous to be talking

about my arms when Holly's got a back problem, but the principle is

the same for every muscle of the body. And that principle is use it

or lose it. Right, Jack, before we immobilise this arm, the one thing

we want to do is take a look at the size of this forearm. There we can

see 27 centimetres on that right arm and on the left arm 27

That's our starting point, because we are now going to immobilise one

of those arms by plastering it. this is something you haven't done

before. Never done it. 'The truth is, we usually rely on a practice

nurse for this bit.' You take the compression bandage, do a little

snip there, that's enough. You'll have to get the fluffy stuff, the

cotton wool. 'The plan is that I'm going to get Dr Jack plastered -

well, from the elbow down anyway - 'so he can't move his forearm

muscles for a week.' There you go. Which end are we going to start at?

What you need to do is you need to put it round the wrist area, around

and over, so underneath your left hand. 'Hmm, think I've seen better

plastering from my cowboy builder.' So look, that is rock solid.

yes, it's true, I can't move a muscle. 'After some, well, armless

fun, Dr Jack's now been in plaster for a week 'unable to move his

forearm or grip anything. 'Now it's time to see what's happened to

those muscles.' I'm just desperately not trying to cut your

hand off. Oh, that's much appreciated! It's going to ruin the

experiment if we've got no fingers left, isn't it? But look at that,

though! Oh, my goodness! Instantly. It's withered. So look at that, 26,

we've lost a centimetre just in six days. That's on the widest part,

yeah it is. That's incredible. That is absolutely incredible. The thing

we want to know now is what effect does that have on strength? 'To

find out, I've devised a nice little experiment for Dr Jack.' You

are hanging from the good arm versus the plastered arm. OK? And I

want you to hang on for as long as you possibly can. And we're going

to see what the effect is of no exercise on that plastered arm for

six days. All right. Are you ready to rumble? It's sore, it's weak,

and you're a very bad man. I love it. Whoa, man. Everything all right,

Jack? It doesn't look that high, to be honest with you, mate. It's very

high. 'This may look like a circus act but it should show us 'how much

strength you can lose after just one week without exercise.' Oh, I

see...ooooh, aaaah! Right, let go when you're ready. Go! Good man.

'So first off, the arm that wasn't plastered.' So this is the good arm.

Hang on, that's it. Keep hanging, keep hanging. You don't want to

drop that far, let me tell you. it's horrid. Don't let go. Go on.

A-a-a-rgh... Keep hanging, Jack. Go on, Jack, go on. Go on, go on. Good

man, good man. That's a good effort. Fantastic work. He is strong. Oh,

he's off. 46 seconds, that's actually pretty impressive. Do you

know what? It was excruciating down here. I've been working so hard

pressing this start and stop button. I can't tell you how difficult that

is. Yes, I'm sure your thumb went through considerably more effort

than my arm(!) Keep it working. 'This time, we're going to test the

arm that I expertly plastered. 'Remember, Dr Jack's not been able

to use his left arm muscles for a week.' Right, let's go now, mate.

OK, here we go. Good man, off he goes. And now he's got to use it to

hang on to that trapeze for dear life. That's it, good man, good man.

Hang on, hang on, hang on. Good, good, good, good, good. Keep going,

keep going. As long as you can. As long as you can. Keep hanging on.

Keep going. That's it, good man, 18 seconds. That is pathetic.

Compared to 46. That is ridiculous. Not being able to use this arm in

the normal way that you would for gripping and typing and washing and

cleaning and brushing teeth and all the rest of it. Extra muscles are

being used. Those ones got fatigued very, very quickly as well. So when

we think about the spine, we mustn't just think about the

muscles in the spine, it's all the muscles everywhere that get

affected. It's the core muscles. The muscles around the buttocks and

front of the leg, back of the leg, they're very important in

supporting that. And the tummy and the sides. I just want to take you

up on one thing. You suggested there that you do washing up. I

don't believe that for a second, mate. He caught me out. 'Anyway,

enough of all this hanging around, 'I've got to get down the gym with

Holly.' On your front. Perfect. 'What happened to Jack's arm in

just one week has been happening 'to Holly's back muscles for the

past nine years.' Just lift that leg again. 'The less activity Holly

does, the weaker her muscles are becoming. 'The weaker they become,

the more her back hurts it's a vicious circle. 'To cure Holly's

back pain I need her to do the last So really what's happening here...

Actually, just drop it for me. So you're actually not using this big

muscle, this big bum muscle, the gluteus, to lift that leg. And what

you're trying to do is you're trying to lift it with much smaller

muscles in the lower back, and that's why we've got the problem

here. OK? All we need to do, if you can, just lift your upper body. How

does that feel? And then what I want you to do is just lift the

legs. 'Holly's got some hard work ahead of her, 'but if she

strengthens the muscles that she left to get flabby, 'she should

feel better in a matter of weeks.' It hurts going down. OK, let's try

that one more time for me. Now keep it really, really tight. Don't,

don't relax at any stage during this, OK? Now lift one leg off the

ground. Two, three, four, and bring it down. Hold that position. And

now the other leg. Two... We'll return to see how Holly's getting

on later in the programme. relax. OK, pop that down and relax.

That's really nice. How'd that Next up, a pain that's top of the

league - the sports injury. The most common pain we feel is one

we've all experienced. It's what happens when you play football in

the park. Strains, sprains, bruises - we call those soft tissue

injuries. Greg! That is seriously out of order! These injuries cause

acute pain, but they're simple to So we're going to show you what

these steps are. First we need a sports injury. Ah, Dr Jack. Just

the man. Now his arm's recovered, it's time to put his whole body on

the line. I've volunteered Dr Jack to take part in an up and coming

sport - mixed martial arts, otherwise known as cage-fighting.

That looked horrible. Welcome to the octagon of pain. This is where

I am going to put Jack tonight with Nick "The Headhunter" Chapman, a

professional fighter 30 kilos heavier than Jack. Luckily, Jack

has a black belt in martial arts so he's in no danger. But one thing

that he is going to be is in pain. I'm Nick "The Headhunter" Chapman.

It's nothing personal, Dr Jack. Enjoy the evening. # I'm gonna

knock you out # Mama said knock you out

# I'm gonna knock you out # Mama said knock you out Break

down! # Fired up? Nervous excitement now,

yeah? Unbelievable, yeah. Just keep moving, mate, keep moving. You're

going to be all right. I've briefed The Headhunter to target Jack's

legs and give him as many bruises as possible, to help me with my

experiment. In the red corner weighing in at 100 kilos, Nick "The

Headhunter" Chapman. Looks like The Headhunter's feeling nervous too -

he's roped in celebrity cage fighting champion Alex Reid for

support. And in the blue corner standing 5ft 8 inches tall, at 68

kilos, Jack Kreindler. BELL RINGS Right come on, Jack. Come on, Jack.

Looks like The Headhunter's feeling nervous too - he's roped in

celebrity cage fighting champion Alex Reid for support. And in the

blue corner standing 5ft 8 inches Right come on, Jack. Come on, Jack.

Come on. Go on. The doctor looks in trouble. Chapman deading the legs.

The crowd not best pleased. Actually this is pretty serious.

He's a big unit and he is hurting Jack. Come on, Jack, let's do it.

Dr Jack is receiving a classic sports injury - soft tissue

bruising, which will lead to swelling and plenty of pain which

is perfect for the next stage of my Straight into him, straight into

He's almost had it now. I think Raaarr! Call this match a draw. I'm

sorry, Nick, it's a draw. Amazingly the ref has called it a draw. But

what kind of injuries has Dr Jack suffered at the feet of The

Headhunter? Bet there is some acute sports injury there, no doubt about

it. How much pain? Everywhere. Serious pain, yeah? Everywhere,

head, body. 'There's no doubt Dr Jack's in pain - great! 'That's

what I need to show you how simple it is to relieve it.' Inside Jack's

body, the damaged cells and blood vessels are leaking fluid causing

swelling, which leads to pain. So what do we do about it? So the

treatment is... RICE. RICE, exactly. Rest, Ice, Compression, Elevation.

RICE is a four-step treatment which, if followed in the first three days

of a soft tissue injury, can really speed up the healing process and

ultimately stop pain. Let's pop the legs up on the chair for me. That's

lovely. The first letter in RICE, R stands for Rest. If moving his leg

causes pain, this is Jack's body's way of saying, "Stop. I need to

take it easy." Now we need that ice and our favourite icing mechanism

is... Peas. Is peas. That instantly feels better. Good. I stands for

ice. Putting ice on the injury can reduce swelling and therefore pain.

But don't put ice directly on the skin and for no longer than 20

minutes at a time. Next thing we really need to do is actually get

some compression. Lucky for you I've bought a wonderful pair of

compression tights. So they are really, really tight. C stands for

Compression. Compression brings down swelling by stopping fluid

collecting around the injury. And there's one last step. At night,

I'll elevate this on a pillow. Exactly. But this one I'll just

keep... Perfect ..as is. E means elevate the injury above the heart,

so that any fluid moves down and away from the injury. Following

RICE can reduce swelling and, therefore, reduce PAIN quickly and

It's nearly three days since Dr Jack clashed with The Headhunter.

Time to check his sports injuries. Has RICE - Rest, Ice, Compression

And look at this here. Look at that. The white shaded area on Jack's

untreated leg shows the extent of the bruising. Whereas on the other

leg, the one I treated, there's no bruising at all. It's massive.

This is classic soft tissue injury and there's a lot of damage being

done to that right leg. And that's why it's still so much more painful

and so much less mobile. Absolutely. The key thing here for me is look

at the left leg. It's gone. Absolutely nothing at all. It's

completely gone. Look at the difference between the two. Just

with Rest, Ice, Compression, Elevation. It's the gold standard.

Just amazing, isn't it? My name is Arnold Baker and I am in constant

pain. The next problem is one that's going to affect most of us

in later life and the pain that goes with it is chronic. This is a

typical month's worth of medication that I take. It's a disease of the

joints. I can't take one step in You've probably heard of arthritis.

Well, the most common form of arthritis is osteoarthritis. It

causes stiffness of the joints and above all, pain. I used to enjoy

fishing, very, very reluctant to do anything like that now because I

don't want the pain that comes with it. Osteoarthritis is making not

just Arnold's life a misery but eight million sufferers in the UK

Time to get to the bottom of Arnold's pain. I've got a very

special piece of kit here, which is actually going to listen to the

inside of your joints and I'm going to play that back to you so we can

actually both listen to what's going on. So what we would normally

hear is absolutely nothing. Away you go. LOW RUMBLING. Bend the leg,

that's it, and straighten. RUMBLING Very significant, isn't it? It is

indeed. But what's making that terrible noise? We need to find out

exactly what's going on inside Arnold's joints. Time for some more

state of the art kit. Well, let's not oversell it now, Jack, but this

is a pretty accurate model of the knee joint that I've knocked up in

the basement. What we've got here is the brick's the bone and then

this plastic part is the cartilage in between the joint. That is so

smooth. Beautiful and smooth, isn't it? But what often happens, what

starts off osteoarthritis is often this injury to one of these

surfaces, to the cartilage itself, so let's injure the surface. Ten

years' worth of damage. Ten years' worth of damage coming on to those

surfaces. And imagine this is what we're talking about with Arnold.

This is his knee, this is his ankles. All of a sudden we can

hardly move it, it's grating, it's grinding. Ooooh! That's it. Until

eventually, all of this surface then goes. Bone on bone. And that's

what we end up with. A joint that's not going to move and is incredibly

painful. Even sounds painful. that's osteoarthritis.

something that you want to have. it's now wonder that osteoarthritis

But there's something even worse that's causing problems for Arnold,

because pain itself has nasty hidden consequences. Pain isn't

just a feeling, it's a condition that affects your whole body and

your mind. Go on! And after suffering myself twice already in

the name of science, I'm now going to put Greg's body on the line to

prove it. Good morning, Prof. morning, Doc. You got something for

me? We have something in store for you today. Am I going to enjoy it?

Oh, you're going to, you're going to love it! What on earth is that,

mate? It looks like some sort of torture outfit. Yes, close. It's

called an osteosuit. Right. It is a specially designed simulator of

what it's like to live with osteoarthritis and you are going to

be squeezed into it. Wow. And we're going to measure just how stressful

it is through the pain and discomfort you feel. The whole day?

You're going to be in this the whole day. So what exactly will a

whole day of pain do to Professor Greg's god-like body? This is a

breathing rate monitor. Right, OK. I'm going to measure Greg's heart

rate and the stress hormone cortisol, which occurs naturally in

all our bodies. At the moment, they're both at normal levels. But

when Greg puts on this special suit, his joints will feel as if they've

aged by 20 years. Perfect. Ball bearings and straps in the suit

will rub and squeeze Greg's joints. Those are very colourful. You're

not supposed to comment on them. Thanks, mate(!) Instantly that's

not very pleasant. OK. Just make sure all the ball bearings are

all... What, dug in to the back of my neck?! Ah! Does it hurt when I

do that? Yeah! We're off. Let's go. This is going to be a long day.

I've trussed him up in his suit, I've told the Prof to drive himself

to our test location. Ooooh! Oh, just turning your neck is absolute

agony. Just those little things that you just don't expect to be a

problem. Just gripping the steering wheel, agony on the hands. MUSIC:

"Under Pressure" by Queen and David Come on, Greg, you should be taking

these two at a time. So, where have I made the Olympian professor

painfully drag himself to? This is incredible. Wembley Stadium for my

specially designed pain-testing assault course. It's not quite

football. We've got an urban obstacle course, so you can

experience as an osteoarthritis sufferer what it is like to do

simple tasks that everyday we take for granted, but you'll understand

how difficult it is and how painful So you've bought me to Wembley for

a domestic obstacle course? With a little bit of football. I'll take

it. 'The pain Greg's feeling from the suit 'is a continuous ache in

his joints, 'but I'm going to add to his pain by attaching collars

'which give electric shocks. 'No, it's not just for fun, an

intermittent jabbing pain, like this...' You ready? Yep, go on. OK.

Hey! Oooh! '..is what it's like when bone rubs on bone. Ouch!'

Ready? Go. Ouch! Ohhh! Do you have to keep doing that? Come on you're

a strong lad. 'When, and if, Professor Greg finishes the course,

'I'll have some actual results which will show what this pain is

doing to his body.' You're going to make me a cup of tea, a nice cup of

tea. Bit of milk in. Ooooh! Ouch! Agony! Oh, yeah, yeah. Thanks,

mate(!) Not bad. Come on, come on, come on. Some ironing. Ironing. Oh,

here we go. Right, right. Argh! You're making a real hash of this.

Look, it's even worse than it was. It's the big one. Come on. This is

it. Ahhh! My leg! This is it. YES! You beauty! 'He shoots, he scores

and now for the all-important results. 'Turns out Greg's heart

rate has doubled 'and his stress hormone, cortisol, is up by a third.

'Not good news.' In fact, pain causes stress, and suffering high

stress levels for a long time increases the risk of bigger health

problems like cardiovascular disease, liver and kidney disease

Ah, mate, if that is osteoarthritis, I never want it. Simple as that.

We've looked at what causes osteoarthritis pain and discovered

the worrying effect that it has on the body. Osteoarthritis can't yet

be cured, so what can we do to reduce the pain? Well, the first

way is probably the last thing you'd expect - moving the joints

more. Hey, Arnold, great to see you. What we're going to try and do is

cut your pain and the key is So pop yourself down there. I want

you to pop your legs, your feet up on to this plate. Not particularly

easy. 'It might seem strange to get Arnold to use his joints more 'when

it's obvious they hurt so much, 'but just like Holly, exercise is

actually going to help him.' To some extent what we're doing is

we're forcing the mobility here but at the same time, we're improving

the flexibility and now we extend, extend up and what we're doing

there is we're improving the The second thing Arnold needs to do

to beat the pain is lose weight... This is basically a treadmill in

the water. ..because the lighter he is, the less weight he'll put on

his joints, and the less pain he'll feel... There we go, that's it,

perfect. ..as this clever piece of kit shows. This piece of kit here

is actually going to reduce your weight while you're walking. Wow.

Amazing. OK. So, what's the sort of pain that you've got? Well, I would

say it's, it's moderate. Yep, so out of ten, on a ten scale? Six.

so about six out of ten just walking along, so you're obviously

in pain. That's at your full body weight. So what I am going to do

now, Arnold, is bring you down to 75% of your body weight, OK. Can

you feel it sort of lifting you up slightly? Yes, ever so slightly,

yes. Quite nice? Oh, hello! All we're doing here is we're using air

pressure to reduce the amount of force that's going through those

ankles and those knees. What's the pain like now? How are the ankles

and the knees feeling? It seems to have improved already. I would say

five, four to five now. It shows you really nicely how we can

actually just reduce your bodyweight, we can reduce the pain.

It's a great thing to feel the benefit almost immediately. I think

we're on the right direction now. I hope so. Excellent. Good man. 'As

with Holly, we've designed Arnold a six-week regime 'that we think will

Talking of Holly, remember her bad back? Well, she's been busting a

gut for nearly three weeks desperate to strengthen her core

muscles, eliminate pain and get her I've come to see how she's getting

So, importantly, Holly, how's the back doing? Back, so far, is

absolutely excellent now. That's only two and a half weeks in.

Posture as well, I notice I'm walking a lot more upright than I

Incredible progress. Two and a half weeks ago, Holly couldn't exercise.

What we've done is we've strengthened her back, almost

eliminated that pain and she's back exercising fully, and the quality

It's an amazing recovery by Holly. I am incredibly happy for you.

Impressed? Well, thank you. Look, you've got a smile on your face,

and this is you, a few weeks ago, worried about going for a stroll.

That's brilliant. You happy? Yes, I think there's been a change in mood.

I'm more confident in my joints because they seem to be getting