Fall 2006In This Issue:
Thumb Pain and ProlotherapyNoel Peterson, N.D. When B.B. first saw me for thumb arthritis, she had already been offered cortisone injections or surgery by her orthopedist. Her x-rays showed moderate arthritic changes to the thumb joints in both hands. She believed that taking Advil daily was too risky, and she was not willing to sacrifice her otherwise good health for pain relief. And besides, she knew drugs were not going to heal her thumb. Still, the pain was constantly present, and she had mild swelling and decreased strength and range of motion, making it difficult to do simple household tasks, such as turn doorknobs and open jars. And what was worse, the pain had forced her to give up knitting and other crafts, and now simple daily tasks at home and work were becoming painful. The good news is that after 6 prolotherapy treatments over the course of 4 ½, months, B.B. is pain free in her thumbs and has resumed all of her activities. And B.B. was not alone… M.B., a spry gardener in her 70’s, needed both hands to lift even small pans on the stove, or dishes from the cupboard, or to grasp her garden tools. Her X-rays showed advanced thumb arthritis. Yet, after just 6 treatments she has resumed all of her normal activities, including gardening, without pain, and no pain medications. M.C., a semi-retired machinist and farmer, brought his x-rays showing OA of his thumbs. He can now work on the farm free of thumb pain. H.L., a piano teacher in her 70’s, was losing the ability to reach the keys when playing difficult cords. Now she is playing Rachmananoff! Most of my other patients with thumb arthritis have done equally well with prolotherapy. What Causes Thumb Pain? The thumb is generally considered to be the most important single digit in the hand. The basal joint of the thumb, or carpometacarpal joint, is made up of a wrist bone (trapezium) and the first (metacarpal) bone of the thumb is subjected to an unusual amount of stress. The thumb must be strong enough to counteract the force of four fingers put together. It has been calculated that one pound of pinch between the thumb and index finger will produce six-to-nine pounds of pressure at the basal joint of the thumb. In a normal thumb joint, cartilage covers the ends of the bones — acting as a cushion and allowing bones to glide smoothly against each other. Conventional Treatment Options: NASIDS: All NSAIDS (Advil, Motrin, others). Side effects may include ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage. NSAIDS use causes over 20,000 deaths yearly in the US. Injections: Corticosteroid injections can offer some temporary pain relief, but they have serious drawbacks including nerve damage, accelerated joint degeneration, and decreased resistance to infection. Arthroscopic surgery: Most often performed during the early or middle stages of thumb arthritis. Joint fusion (arthrodesis): Surgeons permanently fuse bones in a joint to increase stability and reduce pain. The fused joint can then bear weight without pain, but has no flexibility. Osteotomy: In this procedure, surgeons reposition your bones to help correct deformities. Trapeziectomy: In this procedure, the surgeon removes the trapezium bone that sits adjacent to the joint. Joint replacement (arthroplasty): In this procedure, surgeons remove all or part of the joint and replace it with a graft from one of your tendons. Naturopathic Treatment: Only nutrition and prolotherapy can restore the strength and restore cartilage to the surface of the joint, without surgery. Prolotherapy: A small needle is used to inject a solution containing dextrose, glucosamine and procaine into the joint and ligaments of the thumb. This causes new tissue growth and repair. Treatments are repeated every 3-4 weeks for up to six treatments, and then repeated 1-2 times yearly to maintain the improvement. Nutritional Supplements: Supplements designed to help repair your joints are taken daily. Side benefits include improvement of all your joints. Contrast the benefits and economy of prolotherapy to the side effects and expense of conventional treatments and you will see why I am so excited to be able to offer prolotherapy to my patients, and why I intend to publish the results of treating 30 patients with thumb pain. Enroll in the CTM Thumb Study If you are having thumb pain, don’t wait until surgery is your only option. Treat this condition early with prolotherapy, while your thumbs can still be healed. Consider enrolling in our study so that the benefits of this treatment will someday be available to everyone with painful thumbs. How Can We Prevent and Treat Colds and Flu?Lori Horan Soule, N.D., L.Ac. “Do you have anything I can take to keep my immune system strong?” I often get asked this question this time of year. People are especially concerned about the possibility of an Avian flu pandemic. Let’s look at immunity broadly first, and then discuss a more specific naturopathic approach to prevention and treatment. Colds and the flu are believed to be caused by exposure to a variety of viruses. Yet not everyone “catches” a cold or flu when exposed to such viruses. For this reason, we emphasize preventing colds and flu by strengthening a person’s immune system, safeguarding it from susceptibility. Some patients can resist viral attacks while the immune systems in others are weakened and run down to such a degree that they become susceptible to a viral assault. In the case of most epidemics, those people who succumb represent only a fraction of the number of people exposed. This suggests that ebb and flow in immune levels in each individual is dependent on stress, diet, rest and other factors. Diet: Paying attention to the foods you eat can help you avoid creating the toxicity and imbalances that can suppress immunity. We should avoid foods that inhibit immune function, especially simple sugars and alcohol, which have been shown to reduce the function of white blood cells. Foods that cause difficulties in digestion and all junk foods should also be eliminated. Meats should be organic. Non-food additives such as synthetic colors, synthetic sweeteners and synthetic flavorings, preservatives and hydrogenated oils found in margarine are also toxic to the body and stress mucous membranes and the immune system. Overeating and improper food combinations can also lead to an accumulation of toxins in the body. Allergies: Cow’s milk, wheat and all their derivatives can be “mucous producing.” Increased congestion of the mucous membranes that these foods can cause correlates with more frequent respiratory infections. Most people who avoid dairy products while recovering from the cold or flu generally have less nasal congestion and throat phlegm. Over-exposure to dust and mold can also cause congestion and susceptibility. Stress: During times of stress, hormones are released in the body that cause the thymus gland to shrink, reducing immune activity. The more stress one is under, the greater the chance of viral infection. This effect was demonstrated in a study that evaluated 420 people for occurrences of stress during the previous year. Job loss, divorce, death and relocation were among the events included. Fear, sadness, anger and nervousness were among the emotions monitored. The group was then exposed to one of five cold viruses and tested for antibodies one month later. Of those under the greatest amount of stress, 90% became infected. Another study of 100 people showed that those who experienced particularly high degrees of anger and tension were four times more likely to develop a cold or bacterial infection than those who did not experience such emotions. Treating Colds And Flu: Proper diet and nutritional supplements lead to enhanced immune function. Caught early, many of the remedies described below can stop the cold or flu in its tracks. Diet Solutions: Cutting simple sugar intake, and drinking large amounts of herb tea, water, vegetable juices, and broths for a dehydrated respiratory tract will strengthen immune function and enhance detoxification. Drink plenty of green tea. Gyokuro tea contains some of the highest concentration of catechins in any tea, and has been shown to suppress the growth of viruses, including the influenza virus. Nutritional Supplements: Many nutritional supplements can be valuable aids in dealing with colds and flu due to their ability to stimulate immune functions and protect the body from the effects of stress. For your convenience, CTM has pre-packaged Cold & Flu Prevention and Treatment Kits containing the basic nutritional supplements needed to prevent and treat colds and the flu. These anti-flu kits contain the following items: Immucore: Immucore contains the most well-known nutrients for combating colds and the flu: UltraPotent C and zinc enhance natural killer cell activity and support white blood cell activity; Mushroom extracts of reishi and maitake target multiple organ systems to promote healthy immunity. Elderberry (Sambucus): The immune boosting and anti-inflammatory effects of elderberry are derived from its anthocyanidin constituents. Black elderberry has been proven to be effective against multiple strains of flu, including Type A/ Beijing, A/Shandong, and H3N2. It appears to inhibit several strains of influenza replication in vitro including some avian strains and reduces multiple symptoms of flu and upper respiratory infections. It is most effective when taken within 24 hours of symptom onset. Oscillococcinum: Proven in placebo-controlled studies, this well-known homeopathic remedy is widely used for the relief of cold and flu symptoms and the prevention of its onset. It could possibly be one of our best resources against avian flu. Super-Garlic 6000: Garlic is a strong antimicrobial and antiviral plant. Fresh and powdered garlic have been found to have efficient antibiotic effects, even controlling bacteria which are resistant to commonly used antibiotics. It has been shown to protect against flu viruses and enhance antibody production. Masks And Gloves: One of the best ways to prevent transmission of colds and flu is to prevent the transmission of the germs, be they respiratory droplets or hand-carried germs. In response to many patients’ concerns about an Avian flu pandemic, we have included in our kits 2 respiratory masks for when you are in public and the risk of germ communicability is high, such as during air travel. We also recommend that you use an antibacterial hand sanitizing lotion when in public, and gloves when sharing public facilities such as door handles. If you want to optimize your immunity this season to prevent colds and the flu, consider the dietary and lifestyle suggestions mentioned above, and visit CTM for a Cold & Flu Prevention and Treatment Kit. Knee Pain: Drugs and surgery can be part of the problem!Noel Peterson, N.D. Ads on TV, radio, and in magazines and newspapers all feature the sweet smiles of arthritic actors freed from the jaws of their pain by the wonders of modern drugs. Even doctors have been seduced by these multibillion-dollar advertising blitzes, and often prescribe NSAIDs (ibuprofen, naproxen, aspirin) or injected cortisone to control pain. When these are not enough, they perform arthroscopic surgery. But according to recent studies published in the New England Journal of Medicine and the British Medical Journal, none of these treatments really work! In fact, they often do more harm than good. What about NSAIDs for pain? Multiple studies have concluded that NSAIDs and COX2 drugs (like Celebrex) offer no significant pain control but do cause serious side effects. In fact, NSAIDS cause as many deaths as leukemia every year. The British Medical Journal (11/30/04) reported on an analysis of 23 randomized trials of NSAIDs, including drug company sponsored studies, in the treatment of osteoarthritis of the knee. They found only a temporary, short term 15% reduction in pain, and no improvement in function in 7,807 patients, even at the highest (and most dangerous) doses. Due to the risks and the lack of demonstrated benefit, these investigators recommend against long-term use of NSAIDs for OA. If drugs don’t help, then what about surgery? What if I told you that arthroscopic knee surgery has no measurable benefit in OA of the knee? Well, it’s true. The definitive double-blind study on surgery for OA of the knee was performed by Dr. J. Bruce Moseley and his team at Baylor College of Medicine and published July 11, 2002 in the New England Journal of Medicine. Dr. Moseley studied a total of 180 patients with osteoarthritis of the knee that were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores — three on scales for pain and two on scales for function — and one objective test of walking and stair climbing. At no time in the 2-year follow-up did either of the intervention groups report less pain or better function than the placebo group. Moseley concluded that “the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure”. What causes Osteoarthritis (OA) of the knee? OA is caused by the gradual wear and tear of joint cartilage. OA happens whenever the joint’s ability to repair itself is outpaced by the rate of joint injury. When the conditions are right, OA of the knee can happen at any age and any level of activity. I treat teenage patients with OA, and patients in their 80’s who are free of OA. The “SAD” Diet. The excess intake of sugar, saturated fats, and nutrient depleted fast foods is known as the Standard American Diet- “SAD” for short. This diet actually turns on our internal inflammatory cycle, and causes the release of pro-inflammatory compounds within our joints. Think about it: Your child just played a hard game of soccer, and now the team celebrates at McDonalds or Dairy Queen, consuming the very foods that turn on the inflammatory cycle! The “SAD” diet is deficient in nutrients and can cause the loss of the bone underlying our cartilage. When the joint’s foundation crumbles, the cartilage is weakened and wears more quickly. Weak muscles = weak joints. To be stable, a joint requires strong muscles for support. When muscles are weak the joint is lax and moves in a sloppy manner, enhancing friction and wear. When the muscles support the joint, it glides smoothly and cleanly. Even so, strong muscles are no match for the “SAD” diet. What can you do about knee pain? With prolotherapy injections, a proliferative solution of dextrose, procaine and Glucosamine sulfate can be injected directly into the knee joint. This has been shown to tighten lax ligaments, stabilize the hypermobile joint, promote the growth of new cartilage, and relieve pain. Even partial tears of the ACL and the meniscus have been shown to improve with prolotherapy injections and proper nutrition. Don’t ignore pain. If not treated properly, trauma and osteoarthritis can set in motion ever advancing degenerative changes in the knee.The sooner you get definitive help, the better. Don’t let mild degeneration get worse beyond the point of no return. No mater what your age, we can help you recover function and vanquish pain with our cost-effective osteoarthritis protocol that provides specific nutrition, focused exercises, physical therapy and joint-building Prolotherapy injections. For more articles on prolotherapy, and for more scientific references on this and other subjects, visit our web site: www.MyCTM.org, or visit www.GetProlo.com, www.aaomed.org (the American Academy of Orthopedic Medicine), www.injectiontx.org, www.prolotherapy.org
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S.H. had pain in both thumbs that made most gripping activities painful. She could not just stop doing the things she enjoyed just because of arthritis. Her thumbs had a grinding feel to them on examination. Still, after 7 prolotherapy treatments her pain was gone and she was using her hands normally.
With thumb arthritis, the ligaments and joint capsule become thin, weak, unstable and painful. Eventually the cartilage that covers the ends of the bones deteriorates and its smooth surface roughens. The bones then rub against each other, resulting in friction and joint damage. Over time, the degeneration and pain worsens. 