Lymph drains from the body very slowly; much slower than blood movement. Lymph movement is measured in pints while blood movement is measured in gallons. In addition, damaged lymph nodes can retard lymph movement to the point where it causes lymphedema or swelling in the arms or legs. Manual lymphatic drainage (MLD) is a technique to help move the lymph up to 40 times faster than normal.
Breast cancer patients often have lymph nodes removed. Remaining lymph nodes are susceptible to damage either in treatment or by heavy pressure. When this happens it can result in severe lymphedema. The best treatment for this is MLD by especially trained therapists.
However, swelling does not have to progress to the point of lymphedema to be uncomfortable and even painful. In this case, MLD is a most excellent treatment. I had very good success in this type of treatment in cases of swelling due to bone breaks and surgery.
Watch and listen to this post on xtranormal.com
A patient states that he has been diagnosed with right sided Arthritis of the Hip. This diagnosis is complete with X-Rays and report which states there is mild osteoarthritis in the hip. He is being medically treated for this and is also self treating himself with expensive supplements. Yet the patient’s pain is still there after four months, he walks with difficulty and has a hard time climbing stairs.
As I look at the patient, I notice that his standing posture is not exactly consistent with hip pain yet he favors his right side while walking. He also states that he was also recently diagnosed with a pinched nerve in his lower back. Upon examining the patient in the prone position, I observe that his lower back muscles are very contracted. As I palpate his back and hip area he states that most of his pain is in the front, not at the side or the back.
I then tested the patient in the supine position. These tests reveal that the right psoas muscle is severely contracted. I then recall that the patient’s standing posture is consistent with unilateral psoas contraction and the whole symptomology is consistent with unilateral psoas contraction. I start the process to release the psoas and ask the patient to walk. The patient reports that while there is still pain, it is much less severe. As Willie Nelson puts it, we are “On the Road Again”.
I guess that the patient originally went straight to X-Ray without meaningful observation or examination. While there certainly is arthritis in the hip (X-rays cannot lie), it is most likely not the cause of pain.
My doctor friend’s son was a medical student at the University of Chicago and interned at a large Manhattan hospital. I first heard this from him. “Physical Examination is dead.” I think this case proves that. It is up to the “Alternative” medicine crowd to keep it alive.
“Round up the Usual Suspects” is a line made famous by Claude Rains in the 1942 movie Casablanca. This is also true in medicine where we look for usual suspects in order to diagnose a disorder.
In my practice, however, the usual suspects should have been “rounded up” before the patient sees me. Most of my patients have already seen their doctors, specialists, physical therapists, and chiropractors. They have had X-Rays, MRI’s, CAT scans and other procedures and still no help. I am sure that most people find relief with this course of action. However, a small number don’t get help and are in pain for years. In these cases, I suspect, the problem continues because “usual suspects” have hid themselves either in misdiagnosis, or excess pain. In some cases the pain is something else altogether and the usual suspects are in the clear.
Misdiagnosis. The “usual” case of misdiagnosis comes from “chasing the pain”. Those following my blog know that the upper back is often treated in upper back pain. Unfortunately, this treatment does not address the source of the pain and is often unsuccessful. The usual suspect is left untreated. When the correct suspect is rounded up, treatment dramatically reduces the pain.
Excess Pain. Sometimes the usual suspect is so stressed that treating it does not elicit the desired relief. The practitioner then looks elsewhere. However, other signs do point to the usual suspect. When a patient who complained of pain for 10 years came to me in desperation I was greatly puzzled by her situation. After application of a general treatment the area of pain calmed down enough so that I could determine that the usual suspect was indeed involved. This usual suspect did not respond to initial treatment because the pain level was too high. Once the pain was somewhat reduced a treatment plan could be developed.
Unusual Suspect. A patient complained of sciatica and was diagnosed with piriformis syndrome. As the patient was not responding to treatment, her MD suggested removing the piriformis altogether. She was assured she could live without it. When I treated the patient, I too thought that the piriformis was involved since that was the usual suspect. Again the patient did not respond my treatment. That is, the relief experienced was temporary where I usually got a better response to this type of treatment. The patient’s other complaints were caused by damp heat aggravated at the time of ovulation. I then suspected that in addition to her main complaint, she also suffered from endometriosis and that this actually was involved in her sciatica. She was eventually told that she had severe endometriosis which has spread to the posterior pelvis and was pressing on her spine and causing the pain. A true unusual suspect.
If you remember only 5 things for good health…
In his last column, Dr. Tedd sums up his philosophy
Dr. Tedd Mitchell • 9/19/10
After 12 years, this will be my last column for USA WEEKEND Magazine. It has been tremendously rewarding to be able to provide helpful hints on health. I’d like to leave you with a few of my thoughts on maintaining good health. Given all the uncertainties the national health care debate has brought, it makes even more sense to make personal health maintenance a high priority. So here are some tips to remember:
Health is your responsibility. It is not the doctor’s job, the hospital’s job, your spouse’s job or the government’s job to keep you healthy — it’s up to you. We suffer from chronic diseases that are too often the result of poor habits. The choices you make today usually determine the health you have tomorrow.
Stay active. If you’re looking for the fountain of youth, look no further than that pair of sneakers in your closet. A daily “dose” of 30 minutes of moderately intense exercise will go a long way toward keeping you healthy as you age.
You are what you eat. Diets high in saturated fats and refined sugars provide lots of calories and little nutrition. Imagine your plate in four quadrants; three of them should be filled with colorful fruits and vegetables. This is a simple but very important image to maintain whether you’re at home or eating out.
Stop smoking. Smoking is the greatest modifiable health risk facing our nation. For people who want to try to kick the habit on their own, stop-smoking aids are available at the local pharmacy. For those who need an extra push, professional help can be found with the help of your local doctor. However you do it, live smoke-free.
Keep a healthy emotional outlook. Life has ups and downs for all of us, but how we react to adversity influences not only our own psychological health but also the quality of life of those who live and work with us. It’s like Grandma Moses said: “Life is what we make it — always has been, always will be.”
If you remember only 5 things for good health… | USA WEEKEND Magazine | usaweekend.com
This is my favorite time of year. Ragweed Season. Sneezing, eye itching, throat scratching, dripping. I feel like I am one big nose. A nasal irrigator twice a day brings a little relief. The irrigator removes trapped pollen in the nose and helps me fall asleep at night. I recommend the Nasaline Irrigator because it is what I wanted to design but they did it first (and better). Just be careful not to apply too much pressure and keep your mouth open. I don’t like the netti pot because if is much too messy and relies only on gravity for pressure. The best device is the Grosann Nasel Irrigator which about five times as pricy as the Nasaline and requires an electric outlet for power.
Be sure to cover your pillow with a towel during the day. Then remove the towel at night. This will remove some of the pollen which finds its way into your bedroom and which falls onto your pillow.
The bedroom air “purifier” is on 24/7 which also adds a little relief.
For total relief, schedule your vacation in upstate Vermont for this time of year. Antarctica is also starting to look good.
For more info on the Nasaline Irrigator click here.
M.S. Asks: I have a pain that starts in my right buttock and shoots down the back of my leg. I only have this pain when sitting. I don’t have it while standing.
OA: A definitive answer to your question can only be made after a thorough examination. However there are two common causes for this phenomenon which require little or no treatment.
- Fat Wallet Syndrome: A person will often carry a wallet (fat or otherwise) in the pants’ hip pocket. When sitting on this wallet it often presses on the sciatic nerve. This irritates the nerve and causes pain while sitting. Eventually, the nerve will become so irritated that the pain will become constant.
Sitting too far back while driving: A car seat is often adjusted for comfort while driving. However, while the seat may be comfortable for, let us say, highway driving, it may be too far for braking. Or the seat may be comfortable for the arms but too far away for the legs and vice versa. Seat position while driving is often a cause of Low Back Pain.
Thus, the seat may be comfortable initially but over the long term it too far away. However, as it was comfortable initially, it is not suspected as a cause for discomfort.
While these cases are common causes to the question presented they may not be relevant in any specific case. Multiple causes may be at play and an examination(s) is required to determine the true cause.
From Medscape Medical News
Tai Chi May Be Useful to Treat Fibromyalgia
Laurie Barclay, MD
August 18, 2010 — Tai chi may be a helpful intervention for patients with fibromyalgia, according to the results of a single-blind, randomized trial reported in the August 19 issue of the New England Journal of Medicine.
“Previous research has suggested that tai chi offers a therapeutic benefit in patients with fibromyalgia,” write Chenchen Wang, MD, MPH, from Tufts Medical Center, Tufts University School of Medicine in Boston, Massachusetts, and colleagues. “…[Tai chi] combines meditation with slow, gentle, graceful movements, as well as deep breathing and relaxation, to move vital energy (or qi) throughout the body. It is considered a complex, multicomponent intervention that integrates physical, psychosocial, emotional, spiritual, and behavioral elements.”
Fibromyalgia was defined by American College of Rheumatology 1990 criteria. Participants (n = 66) were randomly assigned 1:1 to receive classic Yang-style tai chi or a control intervention consisting of wellness education and stretching. In both groups, participants received 60-minute sessions twice weekly for 12 weeks.
Fibromyalgia Impact Questionnaire (FIQ) score (ranging from 0 – 100) at the end of 12 weeks was the main study outcome, with higher scores indicating more severe symptoms. Secondary outcomes were summary scores on the physical and mental components of the Medical Outcomes Study 36-Item Short-Form Health Survey. To assess durability of the response, these tests were performed again at 24 weeks.
Improvements in the FIQ total score and quality of life in the tai chi group were clinically important. For this group, mean baseline and 12-week FIQ scores were 62.9 ± 15.5 and 35.1 ± 18.8, respectively, vs 68.0 ± 11 and 58.6 ± 17.6, respectively, in the control group. The mean between-group difference from baseline in the tai chi group vs the control group was ?18.4 points (P < .001).
The tai chi group also fared better than the wellness intervention group in physical component scores of the Short-Form Health Survey (28.5 ± 8.4 and 37.0 ± 10.5 for the tai chi group vs 28.0 ± 7.8 and 29.4 ± 7.4 for the control group; between-group difference, 7.1 points; P = .001) and mental component scores (42.6 ± 12.2 and 50.3 ± 10.2 vs 37.8 ± 10.5 and 39.4 ± 11.9, respectively; between-group difference, 6.1 points; P = .03).
These improvements were still present at 24 weeks (FIQ score between-group difference, ?18.3 points; P < .001), with no reported adverse events.
Limitations of this study include lack of double blinding, lack of generalizability because treatment was delivered by a single tai chi master at a single center, and follow-up limited to 24 weeks.
“In conclusion, our preliminary findings indicate that tai chi may be a useful treatment in the multidisciplinary management of fibromyalgia,” the study authors write. “Longer-term studies involving larger clinical samples are warranted to assess the generalizability of our findings and to deepen our understanding of this promising therapeutic approach.”
The National Center for Complementary and Alternative Medicine, the American College of Rheumatology Research and Education Foundation Health Professional Investigator Award, and the Boston Claude D. Pepper Older Americans Independence Center Research Career Development Award supported this study. The contents of the journal article are solely the responsibility of the study authors and do not necessarily represent the official views of the National Center for Complementary and Alternative Medicine or the National Institutes of Health. Disclosure forms provided by the study authors are available with the full text of the original article here .
N Engl J Med. 2010;363:743-754.
Authors and Disclosures
Laurie Barclay, MD
Freelance writer and reviewer, Medscape, LLC
Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.
Thanks to Michele Candida Dobbelaere for bringing this article to my attention. Call 718 258 1829 to join a class.
Foot Rotation; Lateral Hip Rotation Causes the Foot to be Pointed Outward
Lateral hip rotation causes the foot to be pointed away from the center line. This can cause many problems in the lower back, foot and other areas of the body. Some examples of the effects of lateral hip rotation are as follows:
1. Bunions. Lateral hip rotation causes the foot to point away from the center line. The immediate effect of this posture puts pressure on the inside joint of the big toe while walking. This can cause painful bunions and worsen the pain of existing bunions.
2. Other foot pain. Longer term, the effects of the foot pointed outward can cause the ankle joint to deform, with the foot facing outward (eversion). This can also deform the arch and put additional pressure on the bones of the inner foot. The bones of the inner foot are not designed to touch the ground but are rather designed to spread the pressure over the foot, to the front and back of the foot as in an arch. Having contact with the ground can result in severe pain while walking. The deformation of the ankle joint causes it own problems as well.
3. Low Back Pain and Sciatica. Other long term effects of lateral hip rotation are the shortening of the stride. Short stride often allows the heel of the foot to hit the ground with a direct strike instead of a rolling strike. This causes shock waves to be sent up the leg where it is absorbed by the low back. Long term effects of this shock can cause severe low back pain and sciatica.
Acupuncture and massage together with exercise can help reduce lateral hip rotation and pain. Please call 718 258 1829 for an appointment to assess and treat your condition.
Muscles involved in Lateral Hip Rotation
« Newer Posts
Plumpit Qi – an unpleasant feeling of fullness in the throat with no actual physical source. This disease is recognized in TCM and dismissed in regular medicine. Denied stress and anxiety works its way to the surface disguising itself as other illness such as GERD, engendering years of useless treatments. By digging deep, asking questions and keeping an open mind the cause of plumpit qi is found.
— Older Posts »