SECTION 4 Questions 31-40 Questions 31-36 Choose the correct letters A-C.

ANNOUNCER: Today’s Health Counsel is presented by Paula Clayburg, who is the chief
Counsellor at Liverpool’s famous pain clinic: The Wilton Clinic. Paula...
PAULA CLAYBURG: Do you know what Prince Charles, Seve Ballesteros and Elizabeth
   Taylor have in common? They all suffer from chronic back pain. In fact,
   bad backs are one of the most common health problems today,
   affecting people in all walks of life. The most recent available figures
   show that about a quarter of a million people are incapacitated with 【Q31】
   back pain every day.
    And many sufferers don’t know the cause or the solution to their
   problem.
    The majority of our patients at the clinic tend to be women. They are
   especially vulnerable because of pregnancy but also because of
   osteoporosis, which I personally believe to be the major cause of
   problems for women. I have many women patients who say they have 【Q32】
   completely given up exercise because the pain makes them so miserable.
   But of course that starts up a vicious circle. Bed rest, giving up exercise
   and pain killers are traditional responses to back pain but, although
   there are many excellent drugs on the market, at our clinic we are
   beginning to realise the unique benefits of relaxation therapy. Other 【Q33】
   specialists in the field make a strong case for certain types of exercise,
   but in our experience they are easily mishandled and can lead to more
   harm than good.
    Now, let’s look at some of the reasons why back pain is developing
   into such a unique menace. In general, the body is pretty good at self-
   repair. A strain or a blow to a limb, though painful at the time,
   generally resolves itself. But the body’s response to back injury can be
   very counter-productive. When pain strikes, we attempt to keep the 【Q34】
   back as immobile as possible, which makes the muscles tense up.
   Research shows that they often go into spasm, which causes further
   twisting of the spine. A vicious circle is underway.
    The second mistake we often make when stricken with extreme back
   pain is to go to bed and stay there. Although at the clinic we recognise
   that a short rest in bed can be helpful.., up to two days.., any longer 【Q35】
   makes our back muscles become weaker and unable to hold up our
   spine. The pain therefore becomes worse.
    Another problem is being overweight. Anyone a stone or more over- 【Q36】
   weight who already has back pain is not doing himself any favours:
   though it won’t actually set it off in the first place, the weight will
   increase the strain and make things worse. The British diet could be
   partially to blame for the increase in back pain: over the last ten years the
   average weight of men has risen by 11 lbs and of women by 9 lbs. So much
   for the causes and aggravations of pain. But what can WE do to help?
    There are many ways in which simple day-to-day care can make all
   the difference. The first point to watch of course is weight. If you are
   overweight, a diet will make all the difference.
    Also, studies have shown that just one hour sitting in a slouched
   position can strain ligaments in the back which can take months to heal.
   At the clinic we have come to the conclusion that the major cause of the
   problem is not with the design of chairs, as some have suggested, but
   in the way WE sit in them. It can be useful to get special orthopaedic 【Q37】
   chairs, but remember the most important improvement should be in
   OUR posture.
    Another enemy of your back is, of course, your beds. If your bed
   doesn’t give enough support, back muscles and ligaments work all night
   trying to correct spinal alignment, so you wake up with a tired aching
   back. Try out an orthopaedic mattress or a spring slatted bed. Research
   shows that both can be beneficial for certain types of back pain.
    Another hazard for your back are the shock waves which travel up
   your spine when you walk, known as heel strike. A real find for our
   patients has been the shock-absorbing shoe insert. A cheap but very 【Q38】
   effective solution. And you might be better off avoiding shoes with
   heels higher than 1 1/2A inches. Though absolutely flat shoes can be a
   solution for some, others find their posture suffers.    【Q39】
    Finally a word about the state-of-the-art relief - the TENS machine -
   a small battery-powered gadget which delivers subliminal electrical
   pulses to the skin. Our experience indicates that your money is better 【Q40】
   spent on the more old-fashioned remedies.