When Therapy, Injections, and Surgery Don’t Help
Mrs J was in her 60s and came to see me complaining of pain in both heels. She had been an active woman, working full time, going to the gym to exercise 3-4 times per week. Prior to developing pain, she used to walk up and down from the 4th floor where she worked each day as an admininstrative assistant. Roughly 2 years prior to seeing me, she began having pain in her heels. She was seen by an orthopedic surgeon who diagnosed tendinitis in her achilles tendons. He prescribed an anti-inflammatory medication and she had physical therapy with stretching, ice, and ultrasound. She got better for awhile but the pain returned, worse than the first time. The surgeon did cortisone injections into her tendons. The pain improved for awhile and then recurred. Then the surgeon cut her achilles tendons to lengthen them, assuming (I suppose) that the problem was that they were too short! Not surprisingly, her pain didn’t really get better enough to allow her previous activity and function, despite several months of physical therapy.
Why Medicine Needs a New Perspective
I heard the history, and the surgeon’s diagnosis and treatment plan just didn’t add up.
Case Study: BURSITIS
Mr E came in with pain in his arm. He was in his 50s and his pain was preventing him from doing much of his household chores, and prevented him from riding his bicycle for exercise. He was feeling a bit depressed about the loss of function. He had been diagnosed in the past with carpal tunnel syndrome on the same arm, but he had refused surgery. He felt that shortly after the shoulder and upper arm pain started, his carpal tunnel got worse. The shoulder pain didn’t bother him at night, but now he had burning in his hand that kept him awake.
BURSITIS–understand it, treat it, feel better
What’s Bursitis?
Bursitis means ‘inflammation of a bursa’. A bursa is a fibrous sack that typically lubricates and cushions muscles and ligaments as they pass over bones. When a bursa gets inflamed, it is painful. Sometimes the bursa can fill with fluid, which makes it even more painful. Often the body develops spasm in the muscles around the area, which are also painful. Left untreated, those muscles and their associated nerves and soft tissues become dysfunctional. They can generate more pain and spasm in the soft tissues related to them. That process can radiate pain to other regions.
How to Find Your Way Home from Debilitating Back Pain? Get a Better Map.
Sometimes the Hospital is the Worst Place to Go
Sometimes a trip to the hospital for unrelenting back pain can take a person down the road road. Ineffective and dangerous treatment is the wrong treatment. Sometimes it happens because they’re looking at the wrong map! Over the years, I’ve seen dozens of people who went to the hospital with back pain, and came out without a real solution, on heavy drugs, with bad side effects.
The Wrong Map Leads Down the Wrong Road
Sometimes back pain is caused by a fracture, an infection, a tumor, an acutely herniated disc. That’s when X-rays or MRIs get right at the problem and the right treatment happens. That’s when you want to see a neurosurgeon or orthopedic spine specialist. And I refer to docs like that every week. X-rays and MRIs give us a map of the territory. But they are not the territory. They tell us specific and limited information about the person and his or her back. And sometimes they miss the issue. The trouble is when we think the map IS the territory. ‘The X-ray shows you have arthritis’. That must be the problem, because it doesn’t show anything else. If the pain is severe and unrelenting, that’s when the provider goes down a dangerous road and starts prescribing heavy meds, which don’t get at the problem.