How to Manage Hip Stiffness and Pain

How to Manage Hip Stiffness and Pain

by | Jun 14, 2021 | Hip Pain, Pulsed EMF

The hip joints are a key component to stabilization and ambulation of the human frame, so if you are experiencing problems with one or both of your hips, it is going to cause some loss of basic movements required by common activities of daily living, which translates to a reduction in quality of life.  It is therefore imperative that you be mindful of your hip health at all times:  take care not to place excessive shock trauma and repetitive stress to your hips; engage in exercises and stretches that condition your hip stabilizers.

Hip bone, or os coxae

The hip joint, or acetabulofemoral joint is a ball and socket type joint that supports the weight of the body in a static (standing) position and ambulatory position (running, walking).  Its two articulating parts are the femoral head of the femur (upper leg bone) and the acetabulum of the pelvis (coxae), a bowl-like depression lined with cartilage.

Your hips bear quite a bit of repetitious force every day, and if you run and/or play sports that involve jumping and landing such as basketball or gymnastics, then those hip joints are really taking a pounding.

mountain bike shocks

The hip/pelvis complex, like a $10,000 mountain bike, is designed to absorb shock from multiple planes while simultaneously enabling movement.  A high-end mountain bike can be ridden over uneven ground and can withstand shock forces from bumpy terrain, drops and jumps thanks to a multiple- jointed frame outfitted with shock absorbers.  Like the mountain bike, the hip/pelvis complex enables the human body to absorb shock while ambulating.

The hip joints are balanced under the coxae, with the femoral heads partially inserted into the acetabulae and held in tightly by strong but stretchable capsular ligaments.  Smooth, nearly frictionless cartilage lines the femoral head and the acetabulum.  Comprised mainly of water molecules bound by proteins, cartilage is able to absorb shock and rebound, since water is incompressible.  In youth, cartilage is thicker, suppler and more resilient than in those past age 40 but as you age your cartilage thins and is less capable of absorbing repetitive shock; hence the difficulty of running for exercise as you age.

Major hip muscles

Deep hip rotator muscles

Rear view of the hip muscles.

The Ilia and ischia of the pelvis serve as broad attachment points for the hip stabilizer muscles:  gluteus maximus and minimus, psoas, adductor brevis and longus, and the deep hip rotator muscles (gamellus, piriformus).  These are the hip mobilizers and shock absorbers that give the hip joints their main function of propelling the body on flat and uneven ground, and stabilizing them when the upper body needs a stationary anchor such as during heavy lifting.

So what are the main types of hip problems?

The most common problem that affects the hips is osteoarthritis.  With so much pounding forces absorbed daily, the hips are prone to degenerative changes more so than other joints with the exception of the knees.  Tiny fissures appear in the cartilage and gradually expand over time, like a windshield crack that grows longer from the constant dips and bumps of driving.  The cracks turn into pits, and the hip joint starts to lose its smooth, fluid movement; giving way to clicking, stiffness, and limited range of motion.  Although osteoarthritis is often referred to as a “degenerative joint disease,” this term is not entirely accurate.  There is indeed a degenerative process involving progressive loss of articular cartilage, but there is also a reparative process in response to this degeneration that involves new bone formation, osteophyte growth, and remodelling.  The dynamic process of destruction and repair determines the final disease picture.

In advanced hip osteoarthritis, the pit erodes all the way down to the bone, and at that point you start getting pain in your hips, and where there is pain there usually is inflammation.  The hip capsule may fill up with inflammatory exudate, increasing the internal pressure of the hip joint and adding to the stiffness.

Normal hip joint vs. osteoarthritic hip

Risk factors, or things that will increase your chances of prematurely developing hip osteoarthritis are:

  • Previous injuries to one or both of your hips – a fall, sports injury, car accident, etc.
  • Participating in sports or other activities that involve high impact landings
  • Being overweight for much of your adult life
  • Smoking, as smoking restricts oxygen to tissues which is needed for maintenance and repair
  • Genetic factors – having a parent who got premature hip osteoarthritis

The genetic factors likely involve protein mutations that render the cartilage’s ability to bind water less efficient, making it extra vulnerable to shocks.  They may also involve abnormal production of synovial fluid by the cells of the synovial tissue that surrounds the joint.  Synovial fluid is analagous to motor oil in a car’s cylinder– it minimizes friction between the moving parts, so if production of synovial fluid is low, you will get erosion of the articulating surfaces; i.e. the cartilage on the femoral head and the acetabulum, accelerating the disease process.

Iliotibial band syndrome

Another form of hip pain and stiffness may be from iliotibial (IT) band syndrome.  The IT band is a broad ligament that originates on the iliac crest of the hip bone; passes over the greater trochanter of the femur (that hard bump you can feel on the sides of your hips, right underneath the skin); and then inserts into the lateral epicondyle of the proximal tibia (lower leg bone).  This is a condition that some runners get, and involves strain to the ligament and tenderness at its insertions points.  It most often causes pain on the side of the knee, but can also cause diffuse, broad pain over the entire hip.  Tenderness and pain at ligament insertion points (into the bone) typically involve micro-tears from mechanical stress, and/or inflammation to the periosteum, the thin layer of tissue where the fibers attach to the bone.

Xray of an aneurysmal bone cyst affecting proximal femur

Aneurysmal bone cysts, a benign but potentially destructive bone tumor may occur in the femur near the hip.  It involves the growth of a tumor inside the bone, filled with fluid and blood.  Normal bone is replaced by the tumor, which deforms and weakens the bone, making it prone to fracture.   ABCs typically start in the first 20 years of life and can remain into adulthood if not dealt with.  Make sure to rule this out before doing any physical therapy for hip pain; aneurysmal bone cysts are easily identified on X-ray.

There are other pathological conditions that affect the hip that can cause pain and stiffness, such as slipped capital femoral epiphysis (another pathology common to youth), fibrous dysplasia and other bone disorders but won’t be discussed in this article.  Just know that these can be a long-shot cause of hip pain, and can be usually ruled out on X-ray.

Those with hip pain or discomfort due to progressive hip osteoarthritis know the consequences:

  • Very stiff hips upon waking in the morning, that improves up to a point as the day goes on.
  • Laborious walking; takes extra effort to move your legs
  • Aggressive movements like jumping and running are out of the question
  • For some, burning pain in the hips
  • Can’t stand for very long; have to sit

For those who have medical insurance, it’s a matter of time before they elect to have an artificial hip inserted.

So what should you do if you have hip pain from osteoarthritis, and are years away from considering hip replacement?

Here’s what I recommend:

Change your Diet:  what you choose to eat day to day has the biggest influence on your health.  Make 80 percent of your diet plant-based; and of that amount, about half of it raw (uncooked).  Suggestions:  green leafy vegetables such as chard, collard greens and spinach for the cooked; red leaf and green leaf lettuce, red cabbage, and endive for the raw.  Basically, vegetables with purple and red hues are the best as they are rich in anti-oxidants.

Include protein, about 10 ounces per day.  Organic grass fed meat, deep water fish, sardines, and pastured eggs are good choices.  Whey protein and pea protein powder are also good.

Include fats high in Omega 3 fatty acids, and some saturated fat.  Fats are a component of cell membranes especially in nerves, and they are a needed energy source for your body.  Salmon, mackerel, eggs, nuts and seeds are good choices.

And of course, drink water throughout the day to stay hydrated.  We humans are almost 80% water, and you lose water from your body with every exhalation.

Reduce daily stress in your life:  if your life is stressful, make an effort to remove the stress.  Stress has an adverse effect on your health and well-being.  It can raise blood pressure, blood sugar, cholesterol and cortisol levels, which promote fat weight gain.

Get some negative ions:  negative ions are abundant in nature; i.e. the outdoors.  They can neutralize harmful positive ions that are plentiful where there is pollution and electronics; i.e. cities.  Take off your shoes and socks, and walk on grass in a nearby park.  This will “ground” your body, discharging some of your positive ions and equalizing your electrical charge with the Earth’s.

Do low-impact exercises for fitness:  you don’t have to go crazy to get a good workout.  Using your body’s own weight is sufficient. Planks, squats, pushups, crunches, and lunges are great.  For weights, use kettlebells.  Cycling can be a good exercise for those with early osteoarthritis of the hip, as the pedaling moves the hip in a non-weight bearing position.

Lastly, use a Pulsed EMF mat daily.  Pulsed EMF is considered “energy medicine.”  It is the external application of electromagnetic fields similar to those produced by your body, to augment the potential energy the body uses to help drive biological activity; i.e. molecular movement such as blood flow and nutrient transport.  This can improve blood circulation and cell membrane transport of nutrients, proteins and wastes; thus improving cell function.  In weak tissues, Pulsed EMF can stimulate healing by energizing reparative cells.  Can Pulsed EMF help cause worn cartilage to regenerate?  Several studies such as this one found that pulsed EMF can upregulate the expression of a gene that controls cartilage production in chondrocytes.  It’s definitely worth a try.

Bio Balance Pulsed EMF

Some studies show that Pulsed EMF can help cartilage regenerate.

Go here for more info on Pulsed EMF.

To recap, your hip joints are essential to a high quality of life.  They serve to ambulate you, and enable your body to perform basic movements required of daily living such as lifting, carrying, and bending.  They are also prone to degeneration, so be mindful of the health of your hip joints – avoid repetitive, high-impact activities that may accelerate degeneration.  If you like running, change your running stride to one that more resembles fast walking, where there is minimal to no change in height of your head as you run and therefore minimal impact to your knees and hips upon heel strike when running.  In fact, if you run, focus the impact of your foot on the ball of your foot as it contacts the ground, not the heel.  Running can be good for health, and your bones, when done right – not too aggressively; with moderation.

 

 

Is It Possible to Improve Long Standing, Chronic Pain?

Is It Possible to Improve Long Standing, Chronic Pain?

by | Jan 6, 2021 | 30 Day Pain Relief Challenge

In any sport that involves executing proper form such as a tennis serve, baseball pitch and boxing right cross, it is essential to follow through with the movement.  You must commit 100% to the movement the instant you initiate it.   When you do this, things go well—the movement is executed with power and precision, and you’re likely to have success.

If you are hesitant, the movement collapses or comes out wrong; it is basically doomed from the start.  This is why any pro athlete will tell you that concentration and focus are equally important to athletic ability.   The mind literally determines success and failure.  So when you throw that punch, put everything into it!

Use this sports mindset for the things you set out to do in life, especially if they involve improving yourself, and you will succeed.  Commit 100%.  Follow through.

Some examples:

  • Changing your appearance – certainly achievable. There are even “makeover” TV shows that prove it.
  • Changing your persona, attitude and outlook – certainly achievable. Not easy, but if you commit to it and follow through, you are likely to succeed.  Lots of motivational/ high performance gurus out there to help.
  • Losing fat weight is certainly achievable. Again, not easy, but achievable.  If you’re overweight, it’s like going through life with a backpack full of rocks.  It puts a burden on you and limits what you can do.  Remove that backpack you’ve been carrying around for decades, and the change will be dramatic and amazing.
  • Improving your health—quitting smoking, cutting down on alcohol and drugs, exercising more: definitely achievable.    Commit and follow through.

If your health is not where you want it to be, don’t be passive about it – be active.  Health is priceless, and the number of years you have left in this life is a finite number and decreasing each day.

Without good health, all those other plans you have in your head, short and long-term, are jeopardized.  Sure, you could do without certain things due to some physical limitation; that’s fine as long as you’re happy.   But what if you didn’t have to?  That’s something you need to find out.

This brings us to the issue I deal with – musculoskeletal health.

Musculoskeletal is exactly what it sounds like – your muscles, skeleton, and all its components:  joints, tendons, ligaments, cartilage, fascia.   This system carries your body and all its other critical systems.  It enables humans to be mobile and perform incredible, physical feats.

Basically, your ability to do things in life is largely dependent on the health of your musculoskeletal system.

The longer you’ve been alive, the more demand you’ve put on your musculoskeletal system and naturally, the more likely you’ve experienced breakdowns.  It’s just like any machine; the more usage hours the more likelihood of parts failing.

And if you participated in contact sports; a heavy labor occupation; have a history of physical trauma—accidents, falls then chances are, your musculoskeletal health is not 100%.

Conversely, if you had a sedentary job all your life and didn’t exercise, your musculoskeletal system is likely weak in strength and responsiveness, and you also have issues – back pain, neck and shoulder pain, etc.

Musculoskeletal pain is the #1 cause of disability, world-wide.  It causes billions of dollars in lost productivity and medical costs each year.  Drilling deeper, pain has other negative effects such as depression and emotional stress; pain killer addiction, and stress to the people close to the sufferer, which causes more problems and adds to the cost.  Low back pain is at the top.  Knee pain and hip pain are also high on that list.

Getting back to the original topic, is it possible to eliminate chronic, musculoskeletal pain just as you would unwanted weight?

Obviously, there is no definitive answer because of the many variables involved.  No two cases are exactly alike, because people are different.  Doctors can’t make a blanket statement that “chronic pain can be eliminated;” that would be irresponsible.  The answer depends on the case.

THE NATURE OF MUSCULOSKELETAL PAIN

So, can your situation be improved?  Let’s first discuss the nature of musculoskeletal pain so you can see what’s involved, and what needs to happen.

Acute pain from a recent injury has a very good chance of being eliminated with proper treatment/ therapy and time, as the body has amazing healing ability.  However, the more extensive the injury (such as a really bad car accident resulting in a fractured pelvis, ribs and femur) the more opportunity for chronic pain to develop.

Chronic pain is a different beast.  The body has gone through the normal stages of healing and repair, but something went wrong and pain persists.  Cases that have reached a year of daily pain likely have crossed over to the central nervous system which is a bad thing.  Generally speaking, the pain has “taken residence” in the brain and spinal cord.  In other words, it’s not only being generated by the injured tissue; there is now self-running “memory” of the pain signals.  It’s a very complex topic in neurology, and there is still a lot that is still unknown.

Chronic pain most often involves joints, and it’s no surprise.  Joints are the stress point in a muscle-lever (long bone) system.   This is where movement occurs, under a load (force).  The weight bearing joints are the most vulnerable (hips, knee, feet, and lower spine) but non-weight bearing joints (hand, elbow, shoulder) can develop chronic pain from overuse/ old injuries.

Cartilage gradually wears out, and since cartilage isn’t easy to make the damage becomes progressive.  The immune system begins to notice the damage and initiates inflammation.  This leads to swelling and a bunch of inflammatory biochemicals that generate pain.  In fact, most over-the-counter pain medications (aspirin, non-steroidal anti-inflammatory meds like Motrin and Ibuprofen) work by blocking the formation of these biochemicals.

If the pain becomes unbearable, surgery can help with artificial joints.  But the drawback is that artificial hips and knees have to be replaced every ten or so years as they get loose—not a fun experience.

In some cases the patient cannot pinpoint it because it is diffuse, and appears to be generated in a broad area of muscle such as the back muscles.

Some of the factors (variables) that play a role in chronic pain are:

  • Age, sex and general health of the individual
  • History of repetitive stress to joints, or major injuries
  • Structures involved
  • Genetics
  • Mental health

So,

  • Younger people tend to heal better and more completely.
  • Females tend to experience more pain than males, for unknown reasons. For instance, in fibromyalgia, a condition involving widespread pain throughout parts of the body, females tend to be more affected about 60% of all cases.
  • Underlying health conditions such as diabetes, blood and auto-immune disorders can result in sub-optimal healing.
  • Your diet directly impacts your health on many levels. What you put in your body influences your digestion, mood, blood pressure, heart rate, strength, endurance, immune system and more.
  • Those in heavy labor (construction workers, movers, etc.) and who have a history of major injury are more likely to develop chronic joint pain.
  • Tendons and ligament strains have a better chance of healing than cartilage.
  • Genetics can be a factor in susceptibility to degenerative changes in joints. Your genes make all kinds of proteins; many of which play a role in structural integrity.
  • The research shows that patients who are more optimistic tend to have lower pain levels and higher function, compared to those who mentally embrace the pain, called “pain catastrophizing“ and allow it to dictate their attitude and mood. It’s validation of the brain-body connection; i.e. your thoughts can affect your body.

CAN YOU GET OUT OF CHRONIC PAIN?

Ok, now that you have a better understanding of what chronic pain is and the risk factors involved, you should have a better idea of your chances of improving your pain.

Whether you have all the risk factors, or just a few, I believe you can still improve your situation.  But first we must define “improvement.”

While pain reduction is important, what’s perhaps more important is functional improvement.  They tend to go hand in hand; i.e. the more pain you have, the less you are able to do (less function), and vice versa.  The problem with this, though, is that chasing the pain with medication, chiropractic, acupuncture and other passive therapies without working around it and focusing on regaining your functional capacity (your ability to do certain tasks/movements) could be the wrong strategy.  It traps your mind into thinking that your pain determines your ability; like a gate keeper, and as long as that pain gate keeper is there, you convince yourself that you cannot move properly.  The consequences can be psychosomatic where your thoughts literally change your physiology and inhibit proper healing; and they can be limiting; causing you to avoid movement and stay bed-ridden, leading to muscle atrophy.  Remember the brain-body connection—thoughts have a powerful effect on your body.  Thoughts can imprison you, or they can liberate you.

Back to defining improvement.  In the previous post, I introduced you to the Pain and Disability Questionnaires.  This is a tool doctors use to “quasi-quantify” pain; i.e. assign a number to it.  But they are so simple to use and available for free download (the links are at the end of this post), anyone can use them.

You select the pain questionnaire that applies to your condition—low back, neck, shoulder, upper extremity, lower extremity.  Fill it out according to the directions and determine your “percent disability” or “percent functionality.”  If you’re at 40% disability for low back pain, strive for 20% in about two months; then 10% after a couple more months.  This provides something tangible to work with.

These questionnaires came about when doctors decided that improvement in common, every day movements/tasks such as walking up the stairs or raising something above your head is much more important and meaningful than improvement in pain, which is harder to measure since it is so subjective.

So, the 30 Day Challenge will focus on improving your Pain and Disability score; not so much on your pain level.  As your score improves, your pain should improve anyways, but it won’t be the focus in this challenge.

Now that you know that we will be focusing on functional capacity, you can probably guess what the strategy will be to improve your pain/ disability score.  The focus will naturally be on nutrition. 

The fastest way a person can significantly and dramatically change his/her health metrics is through diet.  The reason is simple – what you eat becomes you—the proteins, oils/fats, and fluids in your food become part of each cell in your body.  Like many things in life such as clothes, shoes, houses, cars and bridges, if high quality materials are used in construction, it lasts longer.  Use cheap materials, and the item will break down much earlier with use.  So. eat high-quality, nutrient-dense foods, and your body will be stronger and will therefore last longer without breaking down.

Food, particularly plants, have numerous phytochemical nutrients that help your body work better—vitamins, minerals, co-factors, anti-oxidants.  Eat those, and you get all these beneficial nutrients that your body needs to run its thousands of biological processes.

But as you will soon find out, it’s not just about what you eat.  What if you ate the healthiest meals, but your body couldn’t absorb the nutrients very well due to a digestive problem?

Well, those nutrients will be excreted in your waste, and your body will be deficient in them.  You can eat well but still be nutritionally starved.

So part of the strategy will focus on optimizing your body’s nutrient absorption potential.  Think of it as flushing out your plumbing and fixing any worn out parts.

How and when you eat is also important.  Should you eat three meals a day?  Is it OK to skip breakfast?  What’s the latest hour of the day that is OK to eat?  We’ll talk about this, too.

Although it’s a 30 Day Challenge, you don’t have to start all the activities in 30 days.  Try them out and implement them at your own pace.  But the most important thing is to commit.  Follow through.  How badly do you want to get out of pain?  To be able to easily do a 5-mile hike again, or go up two flights of stairs without losing your breath?  Dramatic change demands dramatic commitment—perhaps a level that is new to you.

If you truly want to reduce your pain by at least 50%, you must give it your best effort, as if your life depended on it.  Laser focus, ignore the nay-sayer thoughts that are bound to pop up (again, your mind can imprison you and it can also liberate you; you have the choice), and execute the plan faithfully and consistently.  Do this, and you will reap the many rewards in life that better health brings.

The 30 Day Pain Relief Challenge will be based on video tutorials.  Tomorrow, I will send you the first one, so keep an eye out for it in your In box.

Sincerely,

Dr. P

The 30 Day Pain Relief Challenge Kick Off

The 30 Day Pain Relief Challenge Kick Off

by | Jan 4, 2021 | Foot and Ankle Pain, Hand and Wrist Pain, Hip Pain, Knee Pain, Leg Pain, Low Back Pain, Neck Pain

It’s 2021 and time to kick off the 30 Day Pain Relief Challenge!

But first I want to acknowledge what’s on everyone’s mind.

2020 began with an unexpected crisis, the COVID-19 pandemic.  A new corona virus strain emerged; highly contagious and deadly for certain individuals, and for which there was no vaccine.  As of this writing, over 85 million people worldwide have contracted the virus, with 1.85 million dying from it.  The United States is being hit the hardest, with 20.8 million cases and 352,000 dead.   The numbers are expected to spike following the holiday season, thanks to many people choosing to get together in large groups and ignoring the risk.  So please, remain extra vigilant the next two weeks because chances are, there are more viruses around you than there were a month ago, ready to find a new host.

As we navigate through COVID-19 in 2021, life must still go on.  I know many have been hurt economically, and their number-one priority is to find a way to get back on their feet.  It is not an easy thing to do, especially if you lost your job and the life skills you possess are in an industry that has been permanently impacted by the pandemic.  If this describes your situation, I sincerely hope you find a way to re-position or re-invent yourself, to get back to earning a living. 

While COVID-19 dominates the news and peoples’ attention, we must not lose focus on the many other challenges life presents that also need our attention.  How would you rate your health at the start of the new year?  How about your energy levels and endurance?   

Quarantining and social distancing have a way of discouraging exercising and promoting over-eating, a terrible combination to health.   When one is restricted from going outside and going to a gym (although a gym is not necessary for staying fit, but I digress…) and constantly bombarded by news of doom and gloom, the tendency is to stay home, surf the web, and eat, more than you typically do (what else is there to do in such a scenario?).  And for many, the choice is high-calorie comfort food.  This can lead to unwanted weight gain, muscle atrophy, joint pain, and so on.

If you are not feeling 100%, then I encourage you to open all the emails I’ll be sending over the next 30 days—the 30 Day Pain Relief Challenge is about to kick off, and email is how it will be executed. 

And what exactly is the challenge?  It’s about challenging yourself to get out of your comfort zone and do all the things I will suggest in the coming days so that you can get out of pain, or significantly knock it down to levels you haven’t experienced in a long time. 

The other reward may be that you will lose 10 pounds or more; will have more energy, and will notice that your mind/ thinking is clearer.  This is because the methods I’ll go over target your body and all its systems; not just the area of pain.  It is wholistic.

But first let me explain how you will be measuring your results.   After all, pain is subjective.  You need some kind of tool to quantify your improvement, so read on.

Pain, aches, discomfort or whatever you want to call it affects your health.  There is mental health and physical health; both important to happiness in different ways.  Your physical and mental health are impacted, even just a little and perhaps unnoticeable to you, if you have chronic pain/aches/discomfort.  Less-than-optimal physical and mental health impacts quality of life.  Quality of life in this sense refers to your ability to physically do what you need or want to do; whether it be your job; recreational activity such as playing golf or swimming; or activities of daily living; i.e. taking care of yourself and your personal needs.

Why You Might Have a Disability if You Have Pain

If you live with chronic pain, you likely have some degree of disability.  

“Me disabled?” you might be thinking.  “No way!”

The word “disability” is often misconstrued.   Disability doesn’t necessarily mean “disabled” and in a wheel chair.  It simply means not being able to perform a certain task without some degree of difficulty or impediment; or not being able to do it at all.  

Doctors (medical examiners) who issue disability certificates or write medical-legal reports are tasked to determine the degree to which someone is disabled.  Their findings determine the patient’s disability compensation from the insurance company or government agency.  They use observation, physical exam procedures, diagnostic tests like X-rays and nerve conduction; and instruments to measure strength, pain perception, reflexes, coordination, and range of motion.   Any deficiency is expressed as a percent disabled, and there are laws that define levels of disability. 

For example, in the insurance industry, the loss of both eyes, or the loss of two limbs equates to “100% disability.”  Not being able to maintain a tight grip could be rated as 20% disability if the person’s occupation requires power gripping machinery.

Disability can also be subjectively quantified using Disability questionnaires where the patient rates his/ her ability to perform certain tasks on a scale of zero to some number; and the level of pain.  In some questionnaires, the zero rating means you have zero difficulty doing the task (best score), while in others the zero rating means you cannot do the task at all (worst score).

For example, the following is one section of the Oswestry Low Back Pain Disability Questionnaire.  Imagine having low back pain and rating yourself (0 to 5) on your ability to lift things:

LIFTING:

 0 – I can lift heavy weights without extra pain

1 – I can lift heavy weights but it gives extra pain

2 – Pain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, i.e. on a table

3 – Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned

4 – I can lift very light weights

5 – I cannot lift or carry anything at all

 When rating yourself, you must try to be as objective as possible—don’t over rate your ability; nor under rate it.  Give each question some thought.

Then, you add up the numbers, divide it by the total number of points and multiply by 100 to get a percentage score. 

If the zero rating is assigned to “full ability to do the task” (like the Oswestry above), then the score is interpreted as “percent disabled.”  So, an individual with no low back disability whatsoever will score zero out of 50 and his rating will therefore be zero percent disabled; i.e. 100% functional.  If his score is 30, then 30/50 x (100) = 60% disabled.

Below is an example of an Oswestry Low Back Pain Disability Questionnaire completely filled out:

oswestry low back pain disability questionnaire

In the above example, the total points out of all ten questions is 19, which is considered a Moderate disability, out of No, Mild, Moderate, Severe and Total Disability.  In this case, 19/50 x 100 = 38% disabled due to low back pain.  Now this person has a baseline for his condition, and can set goals to lower it each time; perhaps to 20% after a month, then 10% after three months of therapy.

If the zero rating is instead assigned to “no ability to do the task,” the score is interpreted as “percent functional.”  This is how the Upper and Lower Extremity Disability questionnaires are designed.  So a score of zero in this case means zero percent functional (totally disabled), and 30% means you are 30% functional (you lost 70% function in that limb).

Please note that Disability questionnaires are used as tools to quantify and set baselines for pain and functional capacity; your scores do not officially establish any disability you may have, they simply provide a more tangible interpretation of pain.

Quantifying pain/disability, even if subjective, gives you a sense of how significant it is; i.e. how much it affects your life.  Secondly, it can be used as a tool to measure your improvement over time, after doing some therapy and/or rehabilitation (strength and coordination exercises).  This lets you know if what you did works for your condition, and therefore, whether to continue or discontinue it. 

For example, if your baseline Oswestry score was 60%, and you were prescribed some McKenzie exercises for one week and a follow- up score was 40%, it suggests that those exercises improved your condition and you should continue or progress to the next level.  If it was 60% or higher, you should discontinue the exercises and try another approach.

You don’t have to see a doctor to use Disability questionnaires to subjectively assess your disability.  They are fairly straightforward to use and you can download the forms from the internet (see below; I’ve done it for you). 

Determine Your Pain/Disability Baseline

If you have low back pain, neck pain, shoulder pain, or lower or upper limb pain then I suggest monitoring your condition using the appropriate disability questionnaire.   If you are getting therapy, your doctor should be having you fill these forms (or something similar) out each visit and going over the results with you.  It’s substandard care if you don’t know if the therapy you are getting or exercises you are doing is helping; these questionnaires will prompt you to think about the change or lack of change in your functional capacity, and will help you assess your care so that you can take appropriate action.

Below you will find forms to assess any musculoskeletal pain you are having.  If you wish to participate in the 30 Day Pain Relief Challenge, print out the appropriate disability questionnaire; rate your abilities as objectively as you can and calculate your score; set it aside, and be ready to fill out a new questionnaire after 30 days of diligently doing the things I will cover over the next 30 days.

My goal is for participants to experience at least a 50% improvement in their pain/ disability scores.  If you have any friends who might be interested in participating, please refer them to my site, https://PainandInjuryDoctor.com and have them enter their email in the opt in form.

Download the Low Back Pain Disability Questionnaire

Download the Neck Pain Disability Questionnaire

Download the Shoulder Pain and Disability Index Questionnaire

Download the Upper Extremity Disability Questionnaire

Download the Lower Extremity Disability Questionnaire

 

 

The Good Thing That Came Out of the COVID-19 Pandemic

The Good Thing That Came Out of the COVID-19 Pandemic

by | Oct 13, 2020 | Telemedicine

Dear Readers,

As you know, it has been a really tough 2020 so far, worldwide.

 Here in the U.S. we’re still battling COVID-19; dealing with hurricanes, social unrest from racial conflict; a very divisive political situation, and here in California where I live, forest fires (about 400 burning at the same time at one point) enough to cause air quality warnings far away from the fires.

I know some of you are in Europe, Asia, Australia and the Middle East.  I hope things aren’t so bad over there.

But enough of that.  We must focus on living and make necessary adjustments to carry on with our lives.

There is an old Chinese saying that goes something like this:   From crisis, there is opportunity (forgive me if I butchered it; no insult intended).

For the COVID pandemic, this turned out to be true:  millions, if not billions of people all over the world learned that they could do a lot of things that they normally did in person, online.  And for those who already did this well before COVID, they learned how to do it even better.

Shopping, buying groceries and sundries, attending school, working, holding meetings, attending church services, getting music lessons, and socializing are just some of the activities people learned how to effectively do online, thanks to being quarantined. 

And, in my opinion, the most significant thing people are doing more of online, thanks to COVID:  healthcare.  Telemedicine, also called telehealth involves using a telephone and/or webcam to communicate with a health professional instead of in person, face-to-face for the purpose of improving one’s health.  It also encompasses “consuming” health care content in digital format via the internet such as pre-recorded videos, slides, images, flow charts, white papers, and audio files and podcasts.  I wrote about this over five years ago when I decided to transition my practice to a telehealth model.

Telehealth was just starting to gain traction right before COVID, but the pandemic accelerated its acceptance.  The need to quarantine and social distance forced doctors and their patients to interact online, and things will never be the same (in a good way).  We were hesitating at the edge of the swimming pool and COVID pushed us into that cold water, figuratively speaking. 

Webcams, Internet, Wireless Connectivity and Mobile Devices Finally Transform Healthcare

The “planets aligned” for telemedicine, and very soon it’s going to be as common as buying groceries.  To me, it’s overdue.  I hope that telehealth not only enables healthcare for millions more lives on the planet, it will drive healthcare costs down.  The cost savings to hospitals are obvious; and those savings should be passed on to the insured and paying patients.  We’ll see if that happens.  While I know people are used to tradition, starting from the days of the old country doctor with good bedside manners I think in 2020 and beyond, people are going to be just fine seeing their doctor online for simple and routine visits. 

And the implications go beyond the actual care:  telemedicine will save time and money on a macroeconomic scale, and will be actually good for the environment in more ways than one:  less cars on the road (no need to drive to see your doctor); less electricity and other overhead expenses needed to keep a large building operable, less printed paper, etc.

Telehealth Is Ideal for your Average Doctor Visit

The vast majority of things that cause people to seek a doctor are non-emergency, and lifestyle related.  Non-emergency means not life-threatening, or risk of serious injury.  Lifestyle related means conditions that are largely borne out of lifestyle choices—high-calorie/ junk food diets; alcohol use, smoking, inadequate exercise, occupational/work-related, etc. and are usually chronic; i.e. having a long history–diabetes, high blood pressure, indigestion, arthritis, joint pain, etc.  These conditions can be self-managed with proper medical guidance provided remotely via webcam.  I believe that if lifestyle choices can cause illness, different lifestyle choices can reverse or minimize those same illnesses, which can be taught via telehealth.

Then there are the cases that are non-emergency, single incident:  fevers, rashes, stomach aches, allergies, minor cuts and scrapes, and things of that nature.  Sure, some cases of stomach aches and headaches can actually be something dire like cancer.  But doctors know that such “red flag” scenarios are comparatively rare, as in less than one percent of all cases; therefore, the vast majority of them can be handled via telehealth.  Besides, the doctor can decide at the initial telehealth session if the patient should come in the office, if he/she suspects a red flag.

A Typical In-Office Doctor Visit

Typically when you go to a doctor/ primary care physician, you are given a list of disorders and told to check off any that apply to you recently—stomach pain, headaches, vomiting, fever, etc.

Then, you are asked a bunch of questions related to your complaint.  This is called taking your history (of your condition).  The nurse practitioner or doctor may do this.

The doctor may or may not examine you, such as checking your eyes, ears, nose, and mouth; temperature, blood pressure, heart rate, lungs and so on depending on your history and complaint.

The doctor then takes this information and comes up with a diagnosis or two.  You may be referred for diagnostic testing, again depending on what you came in for, such as an X-ray, MRI, ultrasound or blood test.

You may get a prescription for medications or medical device, and a printout of home care instructions, and then you’re done with your office visit.

With the exception of a physical examination involving touching and diagnostic tests, everything I just explained can be done via a telehealth visit on your computer.  But as technology advances, more and more medical procedures will be performed remotely via a secure internet connection.

I believe that in the very near future, there will be apps and computer peripherals capable of doing diagnostic tests which will allow your doctor to get real-time diagnostic data during your telehealth visit.  It’s already possible for blood sugar, body temperature, heart and lung auscultation and blood pressure.

Imagine wearing gloves with special, embedded sensors in the fingertips that transfer sensory information via the internet to “receiver” gloves that your doctor wears, 20 miles away.  During a telehealth visit, you can palpate (feel) your glands, abdomen, lymph nodes, etc. and this sensory information is immediately felt by your doctor, as though he was right there palpating and examining you.

Or, imagine an ultrasound device that plugs into your HD port that transfers images of your thyroid to your doctor via the internet.

The possibilities are endless, and it bodes well for global health.  Imagine all the people who can be helped, all over the world, via telehealth.  It’s truly an exciting time in healthcare.

Telemedicine for Muscle and Joint Pain and Injuries

Every day, millions of people worldwide sustain or develop some sort of musculoskeletal (affecting muscles, joints, tendons, ligaments, bone) pain, whether it’s their low back, neck, shoulder, hip, knee, hand or other body part. If not treated right, it can become permanent or chronic.

Chronic pain, and even acute (recent onset) musculoskeletal pain can effectively be addressed via telehealth (this is the domain of my platform, Pain and Injury Doctor, and it’s my goal to help a million people worldwide eliminate their pain).

Available medical procedures for musculoskeletal conditions requiring an in-office visit such as surgery and cortisone injection are usually not the first intervention choice for such pain.  Conservative care is the standard of care for the vast majority of non-emergency musculoskeletal pain and injury–an ideal application for telehealth.

For example, if you were to go to your doctor for sudden onset low back pain, you would most likely be given a prescription for anti-inflammatory medications, if not advised to just take over-the-counter NSAIDs such as Motrin, and rest.  You would also be given a printout of home care instructions, such as applying ice every two hours; avoiding heavy lifting and certain body positions; and doing certain stretches and exercises.  As you can imagine, such an office visit could easily be accomplished via a telehealth session.  No need to drive yourself to the doctor’s office for this.

But what about chiropractic or physical therapy?  You can’t get these physical treatments through your webcam.  Yes, chiropractic has been shown to be effective for acute and chronic low back pain, but available studies typically don’t conclude that chiropractic for low back pain is superior or more economical than exercise instruction or traditional medical care.  Same with physical therapy.  However, as a “biased” chiropractor myself, I believe the benefit of spinal adjustments is not just pain relief, but improved soft tissue healing and structural alignment; two things that I believe can help reduce the chance of flare ups/ chronicity. 

So get a couple of chiropractic adjustments if you can, but know that you can overcome typical back pain through self-rehabilitation as well (see my video on how to treat low back pain).

Yes, Many Types of Pain Can Be Self-Cured

logoTake a second to look at my logo.  It looks like a red cross, but it’s actually four converging red arrows that form a figure of a person showing vitality, with arms and legs apart.  The four arrows represent four pillars of self-care that my platform, The Pain and Injury Doctor, centers on:

  1. Lifestyle modification (nutrition, mindset, healthy habits)
  2. Using select home therapy equipment
  3. Rehabilitative exercises
  4. Manual therapy

These are four things that people suffering from pain are capable of doing by themselves, and sometimes with the help of a partner (manual therapy).  All of the Self Treatment Videos on Pain and Injury Doctor incorporate these four elements of self-care (some are still being produced as of this writing).  Isn’t this more interesting than a bottle of Motrin?

Conclusion

I will close with this:  research shows that when patients are actively engaged in their healthcare, they tend to experience better health outcomes and it’s not hard to figure out why.  By participating in your own health, you have “skin in the game;” i.e. you are invested in your health rather than being passive and wanting health to be “given” to you by a doctor through medicine or treatments.  Mindset is what drives behavior, and those who are passive about their health are the ones who pay no attention until it’s too late—they don’t eat healthy; they don’t exercise enough; they voluntarily ingest toxins (junk food, alcohol, and smoking) and engage in health-risky behaviors.  For many health conditions, by the time the primary symptom is noticeable, the disease has already set in; for example, onset of bone pain from metastasized cancer; or the first sign of pain and stiffness from knee osteoarthritis.

Being actively engaged and invested in one’s health will pay huge dividends in one’s quality of life, and longevity.  So, in order for telemedicine/ telehealth to work for you, you need to have this mindset.  You have to “do the work.”  I can show you clinically proven self-treatment techniques to treat common neck pain, but they obviously won’t work if you don’t do them, and do them diligently.

Self-care for managing musculoskeletal pain is a natural fit for the telemedicine model of health care, which made its world debut this year.  I’m excited to produce content that can help you defeat pain, without visiting a doctor’s office.  I’m especially excited if your are one of the millions of people who don’t have health insurance or access to a health professional, and I am able to help improve your quality of life by showing you how to self-manage your pain.

If there is anyone you know who can benefit from this site, please share.  Take care.

Dr. P

 

How I Got Trigger Finger and What I Did to Treat It

How I Got Trigger Finger and What I Did to Treat It

by | Oct 2, 2020 | Hand and Wrist Pain

It’s been a while since my last article.  Between the weekly-changing COVID restrictions in my area and major house renovations, I have been delinquent with my life mission of helping others manage and heal their pain and injuries, on their own.  But today, I’m back on track.  Today, I’ll talk about a peculiar condition known as Trigger Finger. 

But first, a little background:

For those who ever engaged in do-it-yourself home renovations such as landscaping, fence building, paver-laying and bathroom and kitchen remodeling you know how much stress it can put on your body.  This is my story of how I developed trigger finger for the first time in my life, and serves as a “lessons learned” opportunity for others so that they can be spared the inconveniences of this condition..

For the last 10 years, I would categorize my daily physical activity as “moderate.”  I would go the gym and lift free weights (reps over max); do various cardio fitness classes such as the Les Mills classes and Bootcamp; and run 3 miles about 3x/week.  My average time in the gym I would say was 60-90 minutes, with about half of that actual exercising.  At home, I would be working on my website and producing videos.  This did require prolonged sitting, but I would get up every 30 minutes or so to walk around to relieve pressure to my lumbar spine.

Starting the second week of this past July, I started the aforementioned home renovation projects.  I basically went straight from moderate activity to short bursts of sustained intense activity, daily for over four weeks.  Since I didn’t have any major musculoskeletal impediments other than a chronic right AC (acromioclavicular) joint sprain, I moved freely as though I was in my 20s, which wasn’t such a good idea.  The combination of the intense movement patterns my body wasn’t used to, plus my age, took a significant toll after four weeks.

Here are some of the heavy labor activities that I engaged in:

 

  • Carrying heavy lumber from Home Depot and loading into a pickup truck, about 10 trips
  • Carrying 50 and 80 pound bags of concrete mix and sand, for my paver project, about 5 trips.
  • Used a 2-person auger (about 120 pounds; gasoline powered) to drill several 3’ deep post holes
  • Shoveled piles and piles of dirt (pickup truck loads—about 10x)
  • Hauled away bulk trash to the dumpster
  • Carried 100 clay 12”x12” paver squares (bricks) from a truck to my yard and positioned them carefully
  • Used hand tools that required hard gripping and/or twisting including various types of saws, wrenches and screwdrivers
  • Used vibrational tools including a miter saw, reciprocating saw, drill, and nail gun
risks for getting trigger finger

By the third week, I was starting to feel pain at my right AC joint, my left wrist, and both hands especially my right, dominant hand. Thankfully, despite frequent bending at the waist my lower back wasn’t affected.  I attributed the AC join pain to aggravation of the old strain (I rate it a Grade 2 or 3 sprain – partial tearing, but intact). What happened is the heavy lifting placed a repetitious load on that unstable joint, causing the acromion and distal clavicle to aggravate surrounding soft tissues, particularly the supraspinatous tendon, and the insertion points of the ligament.  My doctor suggested my pain was impingement syndrome—compression of the supraspinatous tendon where it passes below the acromion– which could be occurring, but I’m certain most of the pain is emanating from the joint itself because I can reproduce the pain simply by pressing it with my fingertip.  I’ll tell you how I’m treating this in the next article.

I believe my left wrist pain is a Grade 2 strain of the flexor ulnaris tendon where it inserts into the distal ulnar’s styloid process; caused when I lost control of the auger.  The auger is a very powerful machine that requires two people to operate (see picture above).  Not being familiar with using one, I wasn’t prepared for the powerful torque it generated, and lost control of it, hurting my wrist.

The third problem that I’m dealing with is trigger finger.  This is the first time I’ve had it and let me tell you, it’s not very pleasant.

Trigger finger is so named because as you attempt to straighten out your finger after closing your hand, the finger “catches” mid-way, and pain is felt in one or several joint capsules usually on the palmar side.  Then, as you power through the restriction the pain increases and a popping/snapping sensation occurs right before it straightens out, just like how a gun trigger offers gradual resistance then suddenly releases at a point.  See the short video below of my actual trigger finger taken this morning that explains this.

Trigger finger is a stenosing tenosynovitis disorder.  Stenosing means narrowing of a passageway in the body; tenosynovitis refers to inflammation of the tendon and synovium.  The synovium is a specialized layer of tissue surrounding the tendon in areas where it rubs against other structures in the body.  Synovium secretes synovial fluid, a biological lubricant that helps reduce friction where the tendon moves.  Synovium also lines the synovial joints of the body which include the hips, knees, shoulders, elbows, spine and joints of the hands and feet.

 

diagram of flexor tendons of the hand

There are three, main populations of trigger finger sufferers:  young children (up to 8 years old); trigger finger as a comorbidity to a primary disease; and adults experiencing trauma/ stress to the hands, typically in the 40s-50s.  It tends to affect women more, and the most common finger is the thumb although it can occur in any finger, and in multiple fingers at the same time.

In children, trigger finger is believed to be due to uneven growth rates of the hand flexor tendons and the ligaments, where the tendon growth outpaces the growth of the ligaments that hold them against the finger bones.

Trigger finger is observed to often occur alongside certain other diseases such as carpal tunnel syndrome, diabetes, hypothyroidism, gout, rheumatoid arthritis, and amyloidosis; each probably having different etiologies involving the dysfunction causing the primary disease.  Diabetics seem to be affected by trigger finger at a higher rate than the regular population, and it is uncertain why.  With diabetes mellitus, there are high levels of glucose in the blood, and usually high insulin levels.  Insulin is considered an anabolic hormone associated with tissue growth, so this may be a possible explanation for the increased incidence of trigger finger in diabetics, if the growth leads to tendon hypertrophy (enlargement).

For the third group, which the rest of this article will address, trigger finger is caused by hypertrophy and inflammation of the finger flexor tendons at the synovial sheath, typically from repetitious hand movements, especially those involving power gripping and vibration, making them chafe against the ligaments that hold them down to the finger bones (phalanges).  (Remember, ligaments connect two bones, while tendons connect a muscle to a bone; both are components of all moveable joints).  Imagine these ligaments as slips of Scotch tape forming a tunnel over the bone.  As the hypertrophied (enlarged) section of the tendon enters the narrow tunnel during extension (straightening out of the finger), it gets stuck in that tunnel momentarily; much like how a big person trying to climb out of a small bathroom window can get stuck before being able to make it through.  Then, as the tendon makes it past that entrance, it causes the popping sensation.

illustration of trigger finger locking

Orthopedic specialists identify the tendon-ligament structures involved in hand movement as pulleys.  Remember from basic physics, a pulley is one of the simple machines (the others being a lever, plane and gear).  This is an appropriate name because the tendons and ligaments accomplish work just like the cables and pulleys used in cranes.

pulley systems of the finger
Image courtesy of OrthoBullets.com

The A1 pulley is at the metacarpo-phalangeal joint, commonly called the knuckles.  It’s where the proximal phalanx connects to the respective metacarpal bone.  This is where trigger finger usually occurs.  Those who have it here feel the pain and popping/snapping on the palmar side of the knuckle.

The A2 pulley encircles the proximal phalanx, or first finger bone, from the knuckle.

The A3 pulley is at the PIP, or proximal interphalangeal joint—the first joint from the knuckle connecting the proximal and intermediate phalanges (first and second bones of the finger).  This is also a common area of trigger finger.

The A4 pulley encircles the intermediate phalanx (second bone of the finger from the knuckle).

The A5 pulley is at the DIP, or distal interphalangeal joint, the furthest joint of the finger connecting the intermediate and distal phalanges (second and third bones of the finger, from the knuckle).  Although triggering can happen here, it is less common.

Since the thumb is comprised of only two phalanges, it has an A1 and A2 pulley only.  Trigger finger affecting the thumb almost always occurs at the A1 pulley.  Unlike the other fingers, your thumb can move in multiple planes, much like the shoulder joint.  It has a unique pulley called the oblique pulley that allows it to touch the pinky, a movement called thumb opposition.

pulleys of the thumb
Image courtesy of OrthoBullets.com

In my case, I have trigger finger in the middle and ring fingers of my right hand, mostly in the A1 and A2 pulley, and less in the A3, with the middle finger being more problematic. Pain is most pronounced in the middle of the night and upon waking, then gets better rather quickly in my case, in the first waking hour of the day.  This is because as you sleep, there is less movement of the joints and less synovium produced, causing them to be stiffer.

trigger finger at a1, a2 and a3 pulleys

I have the classic symptom where there is locking of those fingers when I move them from the natural, half-open relaxed hand to fully extending the fingers.  As I force them past the locked angle, they snap at the A1 and A2 pulleys, then straighten out.  It’s momentarily painful, but tolerable.  But for some people, it’s a lot worse.  All those weeks of sustained power gripping and twisting caused the flexor tendons and synovium to rub excessively against the ligaments holding them in place, causing microtears and initiating the inflammatory response.

TREATMENT FOR TRIGGER FINGER

The medical standard of care for trigger finger is corticosteroid injection below the affected ligament.  This quickly knocks down the inflammation, and in some cases, symptomatic improvement happens within seconds.  However, some patients report pain following the injection, and slower or no results.

Splinting is sometimes attempted.  The idea is that if you immobilize the tendon, inflammation will stop and the tendon will shrink and heal, bringing things back to normal.  However, this is not always the case.  Sometimes inflammation takes a life of its own, and prolongs long after the injurious event ceases.

If neither corticosteroid injection nor finger splinting fail to correct the problem, surgery is an option.  Direct, open surgery and percutaneous (minimal incision, special surgical tools) surgery are the two options, with direct surgery usually having better results.  This is where the ligament is cut to provide more room for the tendon to move.  This is possible because the adjacent ligament serves as a backup; for example, the A2 can back up A1 if A1 needs to be cut/ split apart.  However, as you can imagine such destruction of a functional component means some strength and stability are sacrificed.  I’m sure those having this kind of surgery lose some power in their grip.

MY TREATMENT STRATEGY

As I write this article, my trigger fingers have improved about 75%, from their worst presentation.  It could be that my connective tissues are in pretty good shape; my healing capacity is strong; my injury was not very severe; or my treatment regimen is helping accelerate healing.  Some sufferers don’t see such a quick pace of resolution.

Here is what I’m doing:  as I mentioned, the symptoms are most pronounced in the middle of the night (when I get up to use the bathroom) and upon waking.  In the middle of the night, I simply don’t move my fingers, and go back to sleep.

In the morning, I run cold water over my hand for 2 minutes, and gently move my fingers.  I get the snapping, but it dissipates shortly after.  I still feel some stiffness and soreness in my knuckles throughout the day, but no snapping.

I get localized cryotherapy done on my fingers.  Cryotherapy is extremely cold air, as in sub-zero, for 3 minutes.  The cold not only slows inflammation, it is said to cause a shock to the sensory nerves, which causes the central nervous system to respond by increasing blood flow, fibroblast activity, and nutrients to the area.

cryotherapy for hand
Note:  the image above is a localized cryotherapy session on my hand, for a previous complaint.  The red dot is not red light therapy; it is a laser thermometer the technician uses to measure my skin temperature so that it doesn’t too low (his hand is visible in the picture). Localized cryotherapy can reach temperatures of -30 degrees F.

Lastly, I apply red light therapy.  I’m an advocate of this therapeutic technology and have written articles about it.  Red light therapy is actually an electromagnetic waveform (600-880 nanometer wavelengths) that appears red to the human eye.  It’s not the red you get from shining a light through a red lens; it’s a specific waveform in the electromagnetic spectrum generated from an LED (light-emitting diode).  The device I use uses three LEDs, one of which emits a waveform closer to infrared and therefore does not appear to be red as it is invisible.  The electromagnetic energy is at a frequency that gets absorbed by cell mitochondria and other structures, which can result in changed oxidative states that lead to cell signaling that initiates reparative processes, such as increased ATP production and increased membrane permeability.  This lessens inflammation and stimulates healing.

red light therapy device

I anticipate my trigger fingers to fully recover, to pre-injury status.  I will continue to do these therapies, as I feel they are partly responsible for my good results.

BOTTOM LINE

Prevention is the best cure:  if you know you are going to be using your hands a lot, such as starting on a do-it-yourself project involving power tools and hard gripping, know that this can cause trigger finger.  Do what you can to minimize the stress to your hands—take frequent breaks; don’t overdo it/ don’t hold a power grip for more than a few seconds; and rest and stretch your hands often.  Don’t rush it.  Trigger finger creeps up on you, and by the time you notice it, it is too late.  The presentations are different from person to person, depending on age, health, fitness and so on.  I am lucky as my condition is resolving; others are not so lucky and wind up getting surgery and permanent percent loss of hand function.  So make sure you keep prevention in mind.  If you do get it, try the treatment methods for trigger finger described here that have worked for me.

How Pulsed Electromagnetic Field Therapy (PEMF) Can Improve Your Health

How Pulsed Electromagnetic Field Therapy (PEMF) Can Improve Your Health

by | Jun 29, 2020 | Pulsed EMF

Pulsed electromagnetic field therapy, or PEMF is a safe, effective treatment for many types of health conditions.  Some people use it for arthritic pain, while others use it for fibromyalgia, insomnia, and even chronic lung and cardiovascular illnesses.  Unlike medicine and surgery, PEMF therapy doesn’t have dangerous or serious side effects. 

There are many types of PEMF machines on the market, direct to consumer so it doesn’t require multiple trips to the doctor for treatment.   The beauty of this is that PEMF can be used on-demand: whenever you have an acute flare-up or especially bad day; or, for daily maintenance of health.

And, since it is safe and doesn’t involve drugs, PEMF therapy can be used with other interventions that you may be currently using to reduce pain and inflammation, which leads to faster healing and recovery.

You may be wondering at this point, “how does Pulsed EMF work?”

PEMF – The Basics

As the name implies, PEMF therapy uses magnetic pulses that it sends into the body to speed up healing of weak cells, and therefore recovery.  The human body emanates electric charges (think brain and nerve impulses and charged molecules and ions like Ca+, Mg+, H+ and OH-) and just like inanimate things that require electricity or batteries to keep them going, your body needs “recharging” once in a while.  Several trillions of cells comprise your body, depending on how big you are, so it’s not surprising that many of them can break down at any time.

Healthy, normally-functioning cells have a balance between positive and negative charges (see image below).  As these charges flow inside and between adjacent cells, electrical currents are produced.  This electrical flow is the means by which nutrients and waste products enter and exit through cells, via special structures called ion channels.   For example, when nerves are stimulated, they “depolarize,” where the negative and positive charges rapidly exchange position (inside vs. outside the membrane) and move down the nerve.  This is called an “action potential” and is the actual means by which our nerves are able to contract our muscles, control our organs and send sensory signals to our brain.

cell membrane potential

When this critical flow of electrical currents through cells is disrupted, cells don’t carry out their functions as well as they need to.  This leads to illness and symptoms.  Things like trauma, disease processes, and exposure to toxins can alter these electrical signals.  Pulsed electromagnetic therapy uses the same, natural frequencies produced in the body to give these cells a boost in energy. This restores the positive and negative charges in the weakened cells to their ideal state so they can once again function normally.

You may have heard of the dangers of electromagnetic fields (EMF) or electromagnetic radiation, especially if you follow alternative health websites. The frequencies used for PEMF therapy is nowhere near that of harmful EMF such as X-rays, gamma rays and microwaves.  PEMF generates non-ionizing radiation, identical in frequencies already emitted by your body and therefore generally accepted as harmless to humans.

Health Benefits of PEMF therapy

There are many research studies that support the use of PEMF therapy for a wide range of disorders, from acute (recent; active) injury or health problems to chronic pain.

According to studies, PEMFs are useful in treating post-surgical pain; pain related to diabetic neuropathy, joint pain from osteoarthritis, and chronic lower back pain.  PEMF therapy has also been shown to increase the healing rate of nonunion fractures, and even increase bone density in those who have osteoporosis.  PEMFs ability to increase microcirculation to tissues is likely a factor.

Perhaps most impressively, PEMFs can help your body decrease inflammation, which is present in many chronic conditions including fibromyalgia, inflammatory arthritis, chronic fatigue syndrome, and autoimmune disorders such as Chron’s disease.

There are even studies that found PEMF therapy to have measureable, positive effects on those battling depression and anxiety, with long-term, daily treatment.

Conclusion:  Pulsed EMF is a safe alternative for healing

If you are battling disease and/or pain, consider trying Pulsed EMF.  It has scientific research going back over 40 years that support its many health benefits, and it is comparatively safe/ low risk to most individuals (those with heart conditions and implants should check with their doctor first).  PEMF machines produce electromagnetic fields at the same frequency as the human body’s, so cells respond to them in a positive way.

PEMF machines available for home use are low intensity, so there is no danger of excessive exposure that could lead to significant adverse side effects.  Treatment time can vary from just a few minutes to continuous, overnight use, depending on the problem being treated.  The machines offered on our site are established leaders in PEMF technology, from the Russian-manufactured Almagia line to the HTC products—FlexPulse, BioBalance and TeslaFit lines.

Bio Balance Pulsed EMF

There are some higher intensity machines (TeslaFit) meant for use in clinics that are more effective for long-standing, chronic conditions rooted deep inside the body; but most conditions can benefit from the lower intensity units.

The FlexPulse is a low intensity, portable PEMF unit available direct to consumer.  It was developed based on NASA stem cell research done over 15 years ago, and decades of research on brain entrainment (synchronizing biological frequencies) and neurofeedback.  By increasing stem cell (cells that can turn into any type of cell) production, the FlexPulse promotes safe, natural regeneration with no side effects.  Specific, pre-programmed frequencies mimic brain patterns to promote relaxation or alertness, enhance sleep, and relieve pain depending on your treatment goals.

The FlexPulse is a compact, wearable system that comes with two small pad applicators making it easy to use anytime, anywhere.   The system comes with a 30 -day satisfaction guarantee and a 2-year International warranty, making it a no-risk healing alternative.

Check out our full line of Pulsed EMF machines here.

Watch the video below where I explain how Pulsed EMF can re-energize weak cells and help restore health.

A Look into George Floyd’s Cause of Death, From an Anatomical Perspective

A Look into George Floyd’s Cause of Death, From an Anatomical Perspective

by | Jun 4, 2020 | Anatomy and Dysfunction

On May 25, 2020 an African-American man named George Floyd was apprehended by four police officers in Minneapolis, Minnesota.  During the apprehension, a police officer named Derek Chauvin placed the handcuffed Floyd prone on the street, then knelt over him, placing his left knee on top of Mr. Floyd’s neck.  From the image circulated in the media, it appears that Chauvin exerted his full weight over his bent knee.  He kept his knee in position for 8 minutes and 46 seconds despite please from Floyd that he could not breathe.  Tragically, Mr. Floyd died at the scene.  Two autopsies on Mr. Floyd ruled the death a homicide.  The county version “revealed no physical findings that support a diagnosis of traumatic asphyxia or strangulation” while a private autopsy ruled he died of “asphyxiation due to neck and back compression.”  Asphyxiation is the deprivation of oxgyen to the body, resulting in death.  Chauvin was fired and arrested shortly after the incident, and charged with 3rd degree murder and second degree manslaughter.

This tragic and awful case spurred protests and civil disobedience throughout major cities in the U.S., against systemic police brutality and racism towards African-American men, which continues as I write this.  It is also a case that has drawn interest in the medical and forensics community, as to how exactly George Floyd died.  This is important to investigate, as it has consequences for the trial and also provides information to police forces to help them determine which types of restraints should and should not be used.

Before discussing the medical aspects of Mr. Floyd’s death, I want to emphasize that the most important thing about this incident is that a man unnecessarily lost his life to a trusted law enforcement officer, in a most inhumane way.  It is especially bad because of the systemic racism element to it, and the fact that Chauvin had several opportunities to get off of him in time after being warned by another officer at the scene and multiple witnesses, but failed to do so.  This was a textbook lesson on how not to subdue a person, and the price of this lesson is going to play out for weeks to months and will be costly to society in more ways than one.

That being said, I will discuss the anatomical and physiological factors involved in Mr. Floyd’s death.  There is some controversy over how he died, which will determine what sentence, if any, Derek Chauvin will receive. 

As you will see, the neck contains several structures directly tied to sustaining life, which is why the neck is a logical target when it comes to martial arts/ self-defense, and yes, murder.

Mr. Floyd was lying prone (stomach down) with his hands handcuffed behind his back and neck turned to his right.  So when Chauvin placed his knee over his neck it contacted the lateral (side) aspect of his neck and some of the anterior portion.  The critical structures found at the side of the neck include the vertebral arteries, cervical nerve roots, carotid arteries, jugular veins and lymphatic vessels.  Attached to the carotid artery is the carotid body, a cluster of special cells that detect oxygen saturation levels in the blood leaving the heart, and passes the information to the brain, which the brain uses to regulate heart and breathing rates accordingly.

Inside the cervical spine (the neck bones) there is the spinal cord which is comprised of the neuron axon bundles that control body movement and sensation; and lying just outside and against the cervical spine is the sympathetic chain ganglia, which play a role in innervating the heart, lungs, adrenal glands (adrenaline secretion) and other organs during “fight or flight” moments of stress.

The critical structures found in the anterior neck are the esophagus, trachea (wind pipe), larynx and thyroid gland.  Also present but not critical to life are the vocal cords.

The contact area on Mr, Floyd’s neck, based on the typical size of a bent knee, was about 4 square inches.  Chauvin weighs about 170 pounds, so I estimate that the force placed on Mr. Floyd’s lateral-anterior neck was (.9)(170 lbs)/4 in sq. =153 lbs/ 4 in sq. = 38.25 lbs./in sq.  So imagine four, 40 pound dumbells stacked and resting on the side of your neck for nearly 9 minutes.

What I believed happened is blood flow to the brain was cut off, making Mr. Floyd unconscious after a few minutes, as would happen in a martial arts choke hold.  We can assume the loss of consciousness due to restricted blood flow to the brain occured the moment he stopped talking.  Chauvin kept his knee in place for nearly 3 minutes after Floyd stopped moving.  If there was any chance of resuscitation, that chance ended with this additional time of compression.

The pressure also activated Mr. Floyd’s sympathetic chain ganglion, which caused a surge of adrenalin– a neurotransmitter secreted by the adrenal glands of the kidneys that prepares the body’s response to stress.  This increased his heart rate, increased blood pressure by vasoconstricting his arteries; dilated his pupils, and attempted to increase breathing rate.  However, with Chauvin’s knee on Floyd’s neck, the increased respiratory rate did not result in more oxygen getting to the body and the diaphragm, the sheet of muscle that pulls down and expands the lungs for breathing may have spasmed as it fought against the air blockage.

Most of Chauvin’s knee was over the side of the neck, but the front (anterior) was subject to some compression.  This likely partially collapsed the trachea, restricting air flow.  Mr. Floyd was initially able to express his inabilty to breathe, suggesting that his trachea was still patent, but his words became less and less as the seconds ticked.  Perhaps Chauvin’s knee shifted forward with his weight, slowly closing off the trachea.  This makes sense, as the neck has a curved contour which would promote such slipping.

As the knee hold persisted cutting blood flow to his brain, Mr. Floyd’s blood rapidly turned acidic as all oxygen was used up (the brain has a high metabolic rate and therefore a high rate of oxygen consumption) and CO2 levels were rapidly rising (CO2 is a byproduct of cell respiration).  This may have affected his speech center, which is supported by the fact he stopped talking a few minutes after the knee hold.  The apneustic (breathing) center in his brainstem was starting to break down as well from the hypoxia (insufficient oxygen), hampering his breathing further.

It’s not clear at what point Mr. Floyd expired.  Coroners define time of death at the point when brain activity ceases.  But the nature of Mr. Floyd’s death was so prolonged, it is likely he experienced irreversible brain damage and would have been in a vegetative state even if Chauvin had gotten off of him a little earlier and Mr. Floyd was given immediate medical attention.

One of the tell-tale signs of asphyxia by strangulation is ruptured blood vessels in the conjunctiva (whites of eyes) and face, called petechial hemmorhaging.  This information, as far as I know, is not available to the public.  If there was no evidence of this, I can see why the county autopsy reached the conclusion that he did not die of asphyxia.  In this case, it would suggest that Mr. Floyd’s primary cause of death was something else; perhaps sudden stoppage of the heart due to a breakdown in the cardioregulatory system.  But, it is not clear if you can die from asphyxia from “gradual” strangulation and not have petechial hemmorhaging.  It could also be that death was from a combination of both asphyxia and heart stoppage.

The autopsy did not mention fractured cervical vertebrae, which I could see happening if it were a smaller-framed person.  The force Chauvin exerted on the neck appears enough to break one or several neck bones, especially if the person had osteopenia (bone thinning).  Fractured neck vertebrae often result in spinal cord damage and paralysis.

Conclusion

George Floyd’s tragic death is a wake-up call for police forces across the country.  Knees to the neck to restrain someone must be prohibited.  There are too many ways for this to go wrong, given the high concentration of structures critical to maintaining life that reside in the neck.  I understand that safety to police officers is important and fully support it, but it must not be accomplished by jeopardizing the safety of the person being restrained.

What Causes Low Back Pain?

What Causes Low Back Pain?

by | May 29, 2020 | Low Back Pain

Low back pain continues to be a problem for many people. If not you, then most likely several people you know:  neighbors, co-workers, friends and relatives. That’s what the statistics tell us.

Since it is so prevalent throughout the world, “what causes low back pain?” is a question millions of people want answered. Is it normal and expected as we age? Is it genetic? Will you need to get surgery? As you can expect, the answer is different for different people. First of all, the pain is not identical from person to person. Some people get low back pain on the right side; some get it on the left side. Some get low back pain into the hip.

In this post, I will do my best to help you understand what causes low back pain and at the end of the article provide you a tool to pinpoint what is causing your particular low pain.

The Lumbar Spine and Its Significance

Your low back or lumbar spine engineering-wise is your body’s lynch-pin– along with your pelvis, it connects your upper body to your lower body and is tasked with balancing and moving your torso. If you injure your low back it can put you out of commission: any attempt at moving places a load on your low back and makes pain worse. In extreme cases it is even painful to take in a deep breath! Acute low back pain can instantly stop a 250 pound football player in his tracks; that’s the power it has.

While most cases of low back pain self-resolve over a few days, about 20% of them become chronic, or recurring. For some, it strikes every couple of months; for others, it’s enough to impede their daily activities and quality of life. In fact, low back pain is said to be the number one reason for lost work days (disability) in industrialized nations, and therefore lost productivity.

The reason why low back pain is so prevalent is a societal phenomenon, made possible by evolution. You see, humans are the only bi-pedal animal on the planet. Dancing bears and meerkats don’t count because although they can walk a few steps their pelvic design is still quadri-pedal (walking on four limbs). When nature selected homo sapiens to be bi-pedal, it freed up his arms to carry things–heavy things. Carrying and lifting things and bending the low back places a tremendous load on the lumbar spine, and like any machine, the components bearing the most stress will be the first to break down.

Secondly, the invention of the chair and desk. When our ancient ancestors roamed the plains and forests 30,000 years ago there weren’t any chairs around to sit in for hours, placing pressure on the low back and weakening the postural muscles of the spine. Today, many jobs require sitting at a desk in front of a computer, doing just that. Also, food these days is abundant and much less nutritious causing humans to gain excess weight, placing constant stress on the low back throughout the day.

Causes of Low Back Pain

The vast majority of low back pain cases are mechanical in nature; meaning caused by a breakdown of some physical component of the lumbar spine. These components are the muscles, fascia (muscle sheath), ligaments and tendons; vertebrae, vertebral joints, and discs (which are technically ligaments). If the dysfunction causes compression of nerve roots, then nerve pain is involved, which usually means shooting / radiating pain and/ or numbness down the buttock to lower extremity; sometimes as far down to the sole of the foot.

Here are the main categories of mechanical low back pain:

Congenital Malformations

Sometimes there are abnormalities in the development of the spinal column which interfere with proper movement and balance placing excess stress on soft tissues and sometimes nerves, generating pain or constant stiffness and aches, and loss of range of motion/flexibility. Examples include fused vertebrae (two adjacent vertebrae fused together instead of forming a joint); scoliosis; spina bifida, pars defect, hyperkyphosis (hunchback); and hyperlordosis (swayback).

Injuries

Low back pain is often due to injuries to tissues: sprains to ligaments; ruptured intervertebral discs from a herniated or prolapsed nucleus pulposus (jelly-like shock absorbing substance in all discs); strains (tears, small and large) to muscles and tendons; muscle spasms, and fractures. These can be traumatic from a specific incident such as a sports injury, or can be cumulative over time, often years, from performing a certain movement repeatedly or sitting/slouching causing gradual degenerative disc disease. With acute tissue injury, the inflammatory response is initiated, which is responsible for the pain generation.

Degenerative Changes

Joints wear out over time. Most doctors will tell patients their condition is from “normal” wear and tear. But that’s not accurate. For some people, joints deteriorate at an abnormally fast rate, mainly due to lifestyle factors under their control. I’ve seen X-rays of 60 year-olds look much better than 30 year-olds, on many occasions.

Factors that promote lumbar spine degeneration include:

  • Being overweight
  • Genetic predisposition
  • Sedentary lifestyle/ lack of physical activity
  • Sitting frequently (airline pilot, police officer, truckers, data entry)
  • Heavy labor job
  • Contact sports, especially football
  • Occupation or recreation that involve hard landings (basketball, gymnastics, parachuting, etc.)
  • Previous injuries/accidents such as falls and car accidents
  • Poor diet (your body needs proper nutrients to heal tissues)
  • Smoking (smoking reduces oxygen to cells and may trigger inflammation)

Doctors use three terms to describe spinal degeneration:

  • Spondylosis when referring to the vertebrae as a whole;
  • Degenerative joint disease or DJD if referring to the vertebral joints: facet joints and intervertebral joints; and
  • Degenerative disc disease or DDD if referring to the intervertebral discs

In all cases, the joint surfaces of the vertebrae lose their smooth borders and form jagged bone spurs called osteophytes. You can have a lot of osteophytes in your spine and not feel pain at all. In fact, if you are over age 40 you probably have them yourself. But if the osteophytes get big enough to narrow the openings where nerves pass through, called foramen, problems start. This narrowing of the foramen is called spinal stenosis and can occur with the intervertebral foramen (IVFs), the small holes formed by adjacent vertebrae which nerve roots pass through; and also the central canal where the spinal cord and cauda equina reside. This can lead to shooting pain down one or both legs; numbness and tingling in the legs, and leg muscle weakness, atrophy and loss of sensation.

Since osteophytes do not resorb (shrink) and only get bigger with time the only option is spinal decompression surgery which involves shaving off the osteophytes to make more room for the nerves.

And there is another problem:  when spinal discs degenerate, they lose height (this is part of the reason why most people get shorter as they age). A healthy L5-S1 disc can be in excess of 1 cm thick while a degenerated one can be just 2-3 mm thick. When this happens, the posterior and anterior longitudinal ligaments that run down the front and back of your vertebral column slacken, or buckle, at those levels. Like osteophytes, buckled ligaments can cause stenosis, compressing or irritating nerves and causing the same neurological symptoms.

When the degenerative changes involve deterioration of cartilage, you have bone on bone contact. The cartilage in your spine is located in the encapsulated facet joints, located behind the vertebral bodies. This triggers inflammation, which leads to osteoarthritis. It’s the same process as osteoarthritis of the knees and hips, occurring in the spine.

Like knee osteoarthritis, people with spinal OA will feel burning pain in their lumbar spine especially when standing, and stiffness which is worse upon waking in the morning. Osteoarthritis is a chronic, degenerative disease that is best managed by lifestyle modification (anti-inflammatory diet, exercises, stress reduction). Those with severe cases sometimes elect to use prescription anti-inflammatory medication.

Non-Mechanical Causes of Low Back Pain

Less than 1% of low back pain cases are due to other factors, most of which are “red flag” cases that require immediate medical attention. These include pelvic tumors, kidney stones, metastatic cancer (usually from prostate cancer), infection, and endometriosis. A brain tumor is capable of causing sciatica-like symptoms if it affects the sensory neurons that go to the leg.  While rare, if you have low back pain that does not improve with physical therapy or rest, it is a good idea to see your doctor and get some tests done to rule out these conditions. 

Summary and Main Take Aways

If you have low back pain, chances are very good it will go away with rest. Apply ice for the first 1 to 2 days. If severe, you can try taking over the counter anti-inflammatory medications (NSAIDs) such as Motrin or Ibuprofen to knock down some of the pain. And if you are lucky to have a cryotherapy center near you, you can do a couple of visits to shorten the healing time.

If the pain lasts more than 4 days, then it usually means something is perpetuating it:  perhaps you are not resting it properly; are re-aggravating it; or have some kind of contributing factor such as a rotated vertebra or disc protrusion. These issues can be dealt with by visiting a good physical therapist or chiropractor. You can even do some home exercises and home therapy for low back pain on your own and still get great results.

While most cases of low back pain go away, it doesn’t mean that it will stay away for the rest of your life: 20% of people who get low back pain will experience it again in the future; either from a new injury/event or a flare-up of a pre-existing injury.  And remember, some cases become chronic (pain decreases, but the improvement plateaus and remains, with some days worse than others).  Your prognosis will depend on what is causing your low back pain (see below for a self-diagnosis tool) and other factors related to your medical history and daily activities.

When dealing with low back pain, besides focusing on reducing the pain think of what things caused it and eliminate those causes as best you can. It may mean:

  • Getting a stand up desk (standing puts less stress on your low back than sitting)
  • Losing some weight
  • Eating a healthier diet
  • Stopping smoking
  • Exercising more often
  • Reducing emotional stress in your life
  • Improving the ergonomics of your work station
  • Learning how to lift properly
  • Getting your back adjusted by a chiropractor periodically to improve joint movement and joint health

And lastly, remember that low back pain should noticeably and progressively improve each day after initial onset. If you notice that pain does not get better with rest, express your concern to your doctor: demand an X-ray, MRI and/or a blood test. Red flag cases like cancer are often misdiagnosed by doctors (dismissed) as general back pain due to spasms because doctors know that the medical literature estimates red flag cases to be 1% or less of all low back pain cases. Remember to be persistent; it is your life you are dealing with.

Below is a low back pain algorithm I created to help you diagnose your particular low back pain so that you can take appropriate action. Use the top one if your low back pain onset was sudden; use the bottom one if the onset was gradual. This is only a guide; always check with you doctor who can examine you, to get an accurate diagnosis.

Self Rehab Videos for Pain In Production

Self Rehab Videos for Pain In Production

by | May 1, 2020 | Uncategorized

Dear Readers,

As we approach age 40, one of the subtle, inevitable changes we experience is shrinking muscles and weaker joints. Since males on average have a higher percentage of muscle mass, the changes are more noticeable: less strength in the gym; it’s harder walking up stairs and harder to run. Shrinking leg muscles and loss of speed and agility are what cause great athletes like Michael Jordan and Joe Montana to call it quits.

What should this mean to you?

It means that if you want those future plans you have in mind to become a reality, you need to take care of your body today because it is changing, which demands certain adjustments in your daily routine to compensate. I know people whose life changed dramatically after blowing out a disc in their back. While injuries like this eventually heal, they often result in a percent loss of function and chronic pain. Those who got surgery didn’t fare much better most of the time, as surgery disrupts nature’s design.

With that, allow me to be one of your resources to help you improve and maintain your musculoskeletal health. Even if you currently don’t have pain or limited mobility, I hope you stick around because: (1) prevention is the best cure for disease; (2) your situation can change any day; and (3) you might discover something from one of my videos or articles that you can share with a friend who is in pain, and possibly save him/her from unnecessary suffering.

Products. I’d like to be transparent about this, so let me explain. But first — did you notice the Pain and Injury Doctor logo?   A quick glance and it looks like the Red Cross symbol. Look closer, and the logo is actually four arrow pointing inwards. Each one represents a component of self-care for musculoskeletal health:

1 – diet and nutrition
2 – rehabilitative exercise
3 – manual therapy
4 – home modalities

(The four arrows form a small person with arms and legs extended (X) to symbolize maximum flexibility).

PainandInjuryDoctor.com falls under telemedicine; a broad term that encompasses aspects of health care delivered over the internet.  You’ve probably heard of sites like WebMD, ShareCare and Mayo Clinic.  These are more than websites; they are a form of telemedicine.   They enable individuals like you to research symptoms, drug names, diseases and medical terms used by your doctor and get fast answers.

With PID, you get guidance on how to self-manage common, non-emergency forms of musculoskeletal conditions such as low back pain, neck pain, tendonitis and shoulder stiffness.  Yes, there are tons of videos on YouTube on this; some good and some not-so-good.   My intent is to explain the cause of common musculoskeletal conditions in simple terms, and special strategies I developed to get relief, even permanent relief, that involve the four components mentioned above.

The Big Idea of PID is that yes, you can cure common presentations of musculoskeletal pain faster than waiting it out by doing home rehabilitation.  I’ll share with you videos of the techniques I prescribed to patients when I was in practice, and still personally use to get relief when needed.  Some of these techniques involve using equipment.  Yes, I do sell them on my site PulsedEMF.com.  It’s obviously up to you to purchase them, and if you decide to do so, where to buy them.  My job is to show and explain what I believe will bring the best, fastest results in relieving pain but the action is up to you.  Rest assured, the products on my site are the select few out of nearly a hundred that I have tested over my 20 years in practice that I’ve seen actually work on pain sufferers.  In fact, I have many of these products lying around my home that I use regularly to treat friends and family.  They all have scientific and/or clinical evidence to back them up.  Think of them as investments in your health and quality of life.

I truly believe this is just the tip of the telemedicine iceberg, and greater things are yet to come as technology advances.  I believe that virtual assistants like Alexa, in the near future, will be able to project a hologram demonstration of exercises to do for a bulging disc; or be able to accurately diagnose a condition by scanning your body and reading your vital signs, right in your living room.

In the meantime, I welcome you to keep visiting The Pain and Injury Doctor online.  I am in the process of producing self-rehab video guides for the 15 most common presentations of musculoskeltal pain I’ve come across.  The ones for Low Back Pain and Fibromyalgia and Insomnia are completed.  Next up is Neck Pain.  Please share on social media, as there is a good chance someone you know can benefit from these free rehab videos.  They are taking longer than anticipated to produce, partly because of the Covid pandemic, and partly because of my high quality standards.  But when they are complete, I hope for these videos to help millions of pain sufferers across the world; especially those who do not have access to a doctor.

Also in the meantime, I plan to release more articles and YouTube videos on managing pain.  Some of the topics coming up include what to do about foot weakness and pain; a great, inexpensive home recipe for joint health; and a factor that might be affecting your health that you probably don’t know about.

Till then, take care, and stay vigilant until the pandemic is declared over.

Dr. Perez

P.S. You can ask me a question any time on my FaceBook page, or you can use the form at the bottom of the PID home page.

Can Pulsed Electromagnetic Field Therapy Help With Pain?

Can Pulsed Electromagnetic Field Therapy Help With Pain?

by | Apr 1, 2020 | Pulsed EMF

As a strong advocate for the advancement of science, the human capacity for ingenuity fascinates me. Not too long ago, if you were away from your home or office and needed to make a phone call, you had to find a pay phone and come up with a quarter.   Now how ancient is that?  If you wanted to check your email, you needed to have a dial-up internet connection on a big, bulky PC with big, bulky monitor.  CDs were the data storage choice boasting 600 MB of storage, and now tiny MicroSD cards are capable of holding 32 GB of data (which will likely be exceeded by the time you read this).  It seems that when certain milestone discoveries are made in technology, the floodgates open.

What separates humans from other mammals is the thirst for knowledge.  We have to know why things are, and how to make things in our lives better.  We observe phenomena, do research to determine cause and effect, and create machines, devices and other interventions like drugs to influence cause and effect to our advantage.  It could be something to make a task or procedure easier; or a therapy to reverse disease in the body.  Usually the first attempt is totally off and we have to start over again after doing more research.  But as we experience degrees of success, we make tweaks to our invention until it works as best we can get it to work.  This is the path taken by every single thing that ever was invented by mankind.

Let’s take for instance mankind’s development of electricity. In 1831, Faraday found that electricity could be produced through magnetism by motion. He discovered that when a magnet was moved inside a coil of copper wire, a tiny electric current manifests (later called induction) and flows through the wire. In 1820 H.C. Oersted demonstrated that conversely, electric currents produce a magnetic field. Inventors Thomas Edison and Nikola Tesla, among others, furthered this research which led to the major inventions of alternating current, the electrical generator, radio, radar and Wi-Fi.

A long time ago, it was hypothesized that the human body used electrical activity to drive its many life functions such as movement, thought, growth, organ function and tissue healing, to name a few.   When instruments were invented to detect electrical charge, we found this to be true.  We know for instance that nerve impulses are the movement of positive and negative charges along a nerve; that the heart works by synchronized electrical charges that contract its four chambers to pump blood; and that there are sodium-potassium pumps (Na+/K+) that maintain proper electrical charges across the cell membrane (voltage), which drives the transport of water, proteins and nutrients into and out of the cell. 

We also know, thanks to Faraday and Oersted that electricity and magnetic fields occur together in nature.  When electricity flows it induces a magnetic field perpendicular to its direction of flow.  Likewise, moving magnetic fields cause movement of charges (electricity flow) in a conductor.

We learned way back when we were kids that magnetic fields attract metals (ever played with one of those horse shoe magnets as a kid?). When we think of metals we usually think steel and iron. But did you know that sodium (Na), potassium (K), calcium (Ca), and magnesium (Mg) are also metals? Check the Periodic Table of Elements if you don’t believe me.  As metals, they respond to magnetic fields. These of course are very important elements your body needs in order to function properly. The metals copper (Cu) and iron (Fe) are also needed by your body in trace amounts, often to catalzye numerous biochemical processes. Referred to as micronutrients, we get them from the food we eat (plants and animals), which get them from the earth’s soil. When these elements lose or gain an electron, they exist as ions and now have an electrical charge, which enables them to create voltage in your cells and drive tiny electrical currents to move things.

It is not known when humans first realized a connection between the electrical nature of the human body and health. Some say the use of magnetic therapy with natural magnets, or lodestones, goes back to 2000 BC when it was used by Aztec Indians and ancient Greeks, Egyptians and Chinese. In the late-18th century, German physician Samuel Hahnemann, widely known as the father of alternative medicine’s homeopathy, was reputed to use magnets in his treatment programs. In the mid-19th century D.D. Palmer, the father of chiropractic was a “magnetic healer” before he turned his attention to spine and nervous system.

If you’ve ever been to an acupuncturist, you probably know about ear magnets– tiny magnetic beads taped to various acupuncture points, usually in the outer ear. Acupuncture is based on the theory that disease in the body is related to blockages in the flow of energy along meridians mapped on the body’s surface, and that those blockages can be removed with needles inserted in certain acupuncture points along the affected meridian. While this might have sounded skeptical and quirky in the past, the fact that the human body relies on tiny electrical currents to function properly, and that electrical currents generate magnetic fields lends validity to acupuncture (a branch of traditional Chinese medicine). Could it be that the “energy flow” in acupuncture is actually the flow of the body’s magnetic fields, much like the magnetic fields of the Earth?

This brings us to the topic Pulsed Electromagnetic Field Therapy, or Pulsed EMF or just PEMF. This technology was first used in the 1960s (back when a visit to the doctor’s office or hospital wasn’t so money and insurance driven) to help non-union fractures heal faster, which they did with the help of PEMF. It’s making a comeback, because recent research shows multiple health benefits of pulsed EMF such as decreased pain, decreased inflammation, improved wound healing, improved sleep, and improved energy levels. We’ve identified the low magnetic frequencies naturally emanated by the body, such as by the brain, heart, muscles and skin, and how they can be helped/ augmented by PEMF which duplicates these magnetic field frequencies. 

With the surge of mobile device use, along with Wi-Fi and Bluetooth the typical person is constantly bombarded with unnatural, high frequency magnetic fields which can disrupt or weaken the body’s own magnetic fields. This puts the body at a disadvantage especially when it is trying to heal from an injury or fight a disease.

Since the thousands of biological processes that occur every second in the body involve the movement of tiny electrical charges, these processes can be positively influenced by pulsed magnetic fields of a certain frequency, generated externally:

• Proper blood circulation
• Instructions from the nervous system
• Production of energy
• Transfer of nutrients
• Elimination of waste, toxins and dead cells
• Reduction of inflammation
• Defense through the immune system
• Repair and regeneration
• Need for mobility
• Operation of the senses
• Production and use of hormones
• Protection from the environment

Pulsed EMF devices are generally safe to use as they are low frequency and relatively low energy. They are so safe that you do not have to be a doctor to acquire one for personal use.

Note: higher frequency electromagnetic energy such as those produced by cell phones and power lines are the ones that are potentially harmful.  PEMF puts out much lower frequencies (1-100 Hz) that match the human body’s and are therapeutic in nature.

When you apply PEMF, you are essentially giving your body’s cells and tissues an energy boost by providing magnetic field strength to augment the fields that drive various cell activities which are weakened or abnormally functioning during injury, pain and disease. The result is more efficient cell processes, which leads to positive biomarkers such as reduced inflammation, reduced pain signals, improved protein synthesis, improved cell waste disposal, and improved membrane transport. The noticeable signs following PEMF therapy are not due to pain blocking, but rather improved biomarkers. This is basically true healing.

Today, many people use Pulsed EMF for chronic pain from arthritis and other degenerative conditions; heart and cardiovascular disease, stress, insomnia and a host of other problems. However, it is improper to state that PEMF can be used to “cure” or even “treat” a disease; rather, PEMF is used to boost the body’s natural maintenance and reparative processes on the cellular level so that it can overcome the disease and return the body to a healthier state. It’s like how regular exercise doesn’t cure heart disease but can nevertheless improve cardiovascular health by burning excess fat, lowering cholesterol and strengthening the heart muscles.

If you are experiencing chronic pain; have low energy, get sick often and find yourself having to see the doctor often, look into getting a Pulsed EMF device. It’s a great investment in your health and may actually save you a lot in annual health expenses (doctor visits, therapy, medications, sick days and so on). More importantly, it may improve your quality of life. Stay tuned for more ways Pulsed Electromagnetic Field Therapy can be used to reduce or eliminate pain, and help with other health conditions.

In the meantime, watch this YouTube video where I explain PEMF.

Credits to:

Biography.  Nikola Tesla.  2015.

https://www.biography.com/inventor/nikola-tesla

A Brief History of Magnets and Medicine.  The Journal Times.  2002.

https://journaltimes.com/lifestyles/health-med-fit/a-brief-history-of-magnets-and-medicine/article_ab4d6c8e-095c-5620-9f15-23bf52aea767.html

Pawluk, William MD.  Power Tools for Health:  How Pulsed Magnetic Fields (PEMFs) Help You. Friesen Press, 2017.

Receive a FREE, 30-Day Plan to Boost Your Health and Eliminate Pain!

Receive a FREE, 30-Day Plan to Boost Your Health and Eliminate Pain!

As a subscriber, you'll also learn the special methods used by experts in human biomechanics to fix body aches and pain the RIGHT way, long term. 

We'll also send you a Free eBook, Concepts of Self-Healing as a way of saying thanks.

Please check your email in 5 minutes to access your Special Report. Make sure to whitelist "newsletter@painandinjurydoctor.com" in your email client (Gmail, Yahoo, Outlook, etc.) so that you don't miss this valuable information. One way is to add this email to your email Contacts.

Your email is safely kept on an encrypted server and never shared; you can unsubscribe at any time, with one click.