In one of the surprising interconnections
in human physiology, a scar above the pubic bone from a hysterectomy
can be the primary cause of unremitting hip pain. Lawrence
D. Cohen, M.D., who practices in Danbury, Connecticut, explains,
through the case of Delia, 42, how this connection works.
Delia reported having problems in flexing
her left hip (although there was no pain) since earliest childhood.
The problem became worse at age 35, growing more aggravated,
and after the birth of her second child (at age 36), the sensation
in her hip progressed to steady arthritic pain.
Before seeing Dr. Cohen, Delia consulted
an orthopedic surgeon who, after x-raying her hip, concluded
it showed signs of degenerative joint disease. He gave her
cortisone injections, prescribed anti-inflammatory drugs,
and said if the pain got so bad that she couldn't stand it,
"we'll replace the hip."
Delia was not impressed with that prospect,
knowing that hip replacements usually fail after a decade,
requiring further surgeries and rehabilitation. And the drugs
she was taking weren't helping much. Her range of motion was
so constricted that after walking a short distance, she would
start limping with severe pain. She was fortunate to hear
about Dr. Cohen who offered a more effective, less invasive
Upon examining Delia, Dr. Cohen noted that
she had surgical scars in her lower abdomen from two gynecological
surgeries for ruptured ovarian cysts. Understanding scars
is at the heart of neural therapy, one aspect of Dr. Cohen's
medical approach. Most people think of a scar as a gristly
strip of essentially inert flesh. Not so, says Dr. Cohen.
According to the principles of neural therapy,
a medical system developed in Germany and now practiced in
the U.S. by a smattering of physicians, scars are electrically
active and can disrupt the bioelectrical activity of cells,
tissues, and muscles in the immediate area and even elsewhere
in the body.
"The normal voltage of tissues and organs
in the body is around -70 millivolts," explains Dr. Cohen,
"but the voltage in a scar can be as high as 1 or 2 volts.
That's 14 to 28 times stronger." Delia's two pubic-region
scars were acting as electrical irritants to her pelvis, generating
what neural therapy calls "interference fields"
throughout that body region, Dr. Cohen says.
During his first treatment with Delia, he
injected both abdominal scars with a local anesthetic (procaine,
known by its trademark name Novocain). The change was instantaneous,
he says. "Delia got up and immediately felt almost full
relief of her hip pain and was able to lift her leg above
her waistline, something she had been unable to do for years."
The local anesthetic deactivated the electrical
charge emitted by the scar; this cancelled the irritation
it was generating and the muscle triggers it was evoking;
so the hip pain disappeared. "When I 'turned off' the
scar, it allowed the hip to calm down," Dr. Cohen says.
A week later, in his second treatment, Dr.
Cohen injected procaine into Delia's pelvic floor (the area
surrounding her uterus) to "bathe" the nerves with
anesthetic. It is not that the anesthetic cures anything;
rather, it gives the charged area a respite, during which
it can rebalance itself, electrically and biochemically, and
eliminate the irritation it causes, says Dr. Cohen.
He fitted Delia with a flexible orthopedic
device (an arch support) to stabilize her arch when she walked.
Dr. Cohen also got her started on glucosamine and
chondroitin, which are supplements commonly given
for relief of arthritic pain and joint degeneration.
A few weeks later, he began the next phase
of Delia's treatment, using prolotherapy to stabilize and
tighten the ligaments in her pelvic girdle. Like neural therapy,
prolotherapy involves injections, but this time it's not with
an anesthetic but a substance (often sugar) that will produce
a localized, beneficial irritation in muscle, tendon, or joint
tissue. Inducing a controlled inflammation by reinjuring the
damaged or degenerating tendon can stimulate the body to heal
itself, even to grow new tissue, says Dr. Cohen.
As an additional measure to eliminate the
last vestiges of Delia's hip pain, Dr. Cohen injected a small
amount of bee venom with Novocain into the hip joint. Bee
venom, formerly disparaged as a "folk remedy," is
now under increasing consideration by North American physicians
for its ability to reduce pain and inflammation associated
with arthritis, multiple sclerosis, and other painful conditions.
"What little pain was left from her
remaining arthritis resolved with that treatment," says
Dr. Cohen. "Today, from this combination of therapies,
Delia is pain free, back to walking up to 11/2 miles four
times weekly, doing gym exercises three times weekly, and
Results like Delia's are common, says Dr.
Cohen, when you remove the source of the electrical imbalance
producing the pain. "I inject scars all the time and
I often get phenomenal responses." He relates the recent
case of Mira, 72, who complained of severe back pain, had
back surgery and did not get better, because the problem actually
stemmed from her right big toe. Mira would be golfing or walking
the links and the pain would start spreading up her leg and
then her back. An orthopedic surgeon said she had spinal stenosis-narrowing
of the spine from arthritic spurs on the bone compressing
the spinal cord, thereby pinching nerves. Learn to live with
the pain was his advice. A neurosurgeon's diagnosis was a
damaged vertebral disc; he recommended back surgery.
She had the surgery (called a discectomy,
the partial or complete removal of a disc), but it made no
difference and the pain came back again. Mira consulted another
specialist who gave her an epidural steroid (injected into
the dura mater, or outermost layer of the spinal cord) but
this had no pain-reducing effect either.
Dr. Cohen didn't waste Mira's time with fruitless
surgeries. He examined her feet. "I always check the
patient's feet," he says. He often finds that back problems
originate with problems in the feet. Mira had never mentioned
pain in her feet, but when Dr. Cohen probed her right big
toe, she winced. There was arthritis in that toe, he observed.
Then he watched Mira walk. He saw that with each step she
twisted her right ankle and turned her right leg out to avoid
bending, and thus hurting, her right big toe. But every time
Mira did this, her hip muscles had to contract to compensate
for the imbalance in posture, and this produced the back pain.
"In other words, the low back pain was
the result of her body's adaptation to avoid pushing off on
that big toe with every step," says Dr. Cohen. He injected
the tender foot joint with procaine and had Mira walk again.
The leg and back pain were gone and Mira could walk freely,
Back Pain Caused by Depleted Kidneys and
Adrenal Glands As with the modalities of the last two practitioners,
traditional Chinese medicine offers a view strikingly different
from the conventional explanation of back pain as a mechanical
(muscular, skeletal, and/or vertebral) problem.
According to acupuncturist and herbalist
Michael Tierra, L.Ac., O.M.D., of Santa Cruz, California,
numerous factors-fatigue, overwork, feebleness caused by prolonged
illness, aging, emotional stress-can deplete the kidneys and
adrenal glands of basic life force or vitality. Put in simplest
terms, an energy balance can upset the metabolic (energy-converting)
and hormonal activities of the body, which in turn destabilize
the physical structure and produce pain and discomfort.
In the language of acupuncture, a person's
inherited energy potential, called essence, is stored in the
kidneys, Dr. Tierra explains. This essence can be depleted
through lifestyle choices and it is hard to replenish. If
the level of energy in the kidneys or adrenal glands is low,
it can develop into a deficiency of kidney qi and/or essence.
This in turn makes them more susceptible to cold or dampness,
and this then starts to weaken the spine and bone tissue and
produce low back pain. In other words, Dr. Tierra says, the
structural misalignment and pain follow the energy deficiencies.
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