An inquiry from a physiotherapist working in an orthopaedics institute.
"Dear Gary
I have been learning a lot about rehab in orthopaedis and then I got to know your website research about hallux rigidus. Here they do a lot of surgery for Valgus also and it results in a hallux rigidus.
I would like to know if you could help me on finding some criteria to identify the pain of a patient.
Female, 63y.o. felt on september 2009, sitting position, where she injured the coccix, no fracture. 8 months later had herpes zoster in right toracic region. At the first signs, she went to a neuro, took the meds and was ok.
After 3 months the pain came back very strong.
She took a 3D MRI from lumbo-sacro column. It was shows a little bone (like a sesamoid bone) between L4-L5-S1, considering no damage on affecting nerves. MRI normal.
Rehab, massage, capsicine creme on the area. Muscular relax pills. More than a year and not getting better.A lot of pain. She has some depression, mild.
Takng anti-depression medication because of the neuro doc prescription.
She can't relieve the pain on any position. The cycle is like 2-4 day with no pain than 2 with terrible pain.
Healthly, used to do yoga, walking 4 times a week for an hours - arround 5miles- 4km, used to be very active. She can do NO physical activities now cause of the pain.
Arthritis Deformatis on the hands and some on cervical spine.
I would appreciate your help and-or suggestions at this case.
Thank you very much."
C""
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Gary:
Please bear in mind that the following is partly speculative and can only be confirmed, one way or another, the completion of a hair tissue mineral analysis. The set of conditions you are describing often are associated with a period of unrelenting or severe stress within the previous 2-5 years. Severe stress may shut down the adrenal and thyroid glands. This is the root cause of most of these types of chronic health problems and no amount of drugs therapy or physical therapy is going to make any difference. In fact, as I explain later, most of the drugs treatments employed, such as anti depressants and anti inflammatories, will make matters even worse.
Rheumatoid arthritis and copper retention
I assume she may have some degree of rheumatoid arthritis? People with rheumatoid arthritis frequently show low tissue copper. Chronic cases may show a high iron to copper ratio. If your patient was to complete an ICL Hair Tissue Mineral Analysis, we may see something along these lines going on with her.
However; she may have the opposite going on - Elevated copper levels are more the possibility as I will explain in the rest of this article.
Under active thyroid
We may see evidence of an underactive thyroid, even if blood tests do not indicate this. An underactive thyroid results in parathyroid gland dominance and this hormone imbalance drives calcium out of the bones and into the soft tissues resulting in joint and muscle pain, including joint degeneration and osteophytes. An excess of calcium in the soft tissues is associated with fatigue and depression. Elevated tissue copper is often seen with low thyroid and this will have an antagonistic effect on iron. If an iron deficiency develops, the thyroid will not function well. Copper also affects insulin through its antagonism of zinc, causing insulin to flood the blood.
These actions cause arthritis, chronic fatigue and chronic pain conditions like fibromyalgia.
Copper and the adrenal glands
Most individuals with weak adrenals have high copper levels. Hormones from the adrenals normally stimulate the liver to remove copper from the body. Poor liver function is often seen in people with high copper levels.
Herpes Zoster (Shingles)
Elevated copper levels typically accompany viral infections. Elevated copper levels predispose the person to recurrent viral infections, such as shingles.
Medications
The main excretion of copper is through the intestinal tract via the liver and gall bladder. Medications can cause copper retention. The hormone estrogen, some psychotropic drugs, tranquilisers, and pain killers will interrupt this process of copper elimination. Several of your patient's drugs will be contributing to copper retention and may thus be contributing to her chronic health problems.
What to do next
The first thing your patient needs to do is have a hair tissue mineral analysis completed.
Here is the test she needs to do. You can arrange this through me, no problem at all. It will just take longer, since you are in another country and we can review the report via a medium such as Skype.
Aim to have her progressively go off all medications. This is best done under medical supervision, especially due to the addictive powers of anti depressants. If this is not practical, or realistic right now, then I would wait for the hair analysis results to come in and then go from there using the report to guide the process.
If you feel she has elevated copper levels, then she can increase her intake of nutrients that antagonise copper such as zinc, vitamin C and vitamin A. As an aside, these three nutrients are renowned for their ability to reduce viral infections! If her symptoms improve with these nutrients, then you know you are on the right track. But please bear in mind that the medications she is taking may negate any benefit.
With regards to diet, have her avoid all foods that contain moderate to high levels of calcium and definitely no calcium supplements! Have a diet that is low in refined carbohydrates and no sugar. Eat vegetables and fresh fruit, nuts and dark berries. Have five small meals a day. Ensure there is quality protein in every meal, especially breakfast. Avoid all margarines, and foods with preservatives, colouring and flavouring (tough on the liver).
Get rid of stress from her life.
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