FAQ Category: General

Finding effective ways to treat fibromyalgia hasn’t been easy. For any disease, illness, or condition it’s always best to treat the underlying process causing the symptoms. It isn’t clear what causes fibromyalgia so the best treatment to get at the cause is still unknown.

Massage may be a good tool for fibromyalgia. It isn’t invasive, meaning no needles are used and no surgery is done. No drugs are required so there are no side effects. Massage of any kind usually increases the blood flow to an area. The muscles relax. This type of treatment may be able to break the cycle of pain – anxiety – sleep problems – and muscle fatigue that comes with fibromyalgia.

A recent study from Ohio State University used a new device to do whole body massage. The skin and tissue under the skin is sucked up between two rollers and kneaded. Patients report decreased pain and increased function after 15 sessions.

Long-term results aren’t ready yet. This could be a soft-tissue “feel good” response but with no change in the underlying condition. Many patients with fibromyalgia are glad to feel better for a while, even if it doesn’t last.

This is a question many athletes, coaches, and trainers would like to have the answer to. We simply don’t know. Some studies have shown that type and number of muscle fibers may have something to do with it. If you take a muscle and cut across it, you’ll have what’s called a cross-section. Special X-ray tests can do this with a computer that then counts the muscle fibers and measures their size.

But even this doesn’t seem to be the entire answer. Some individuals with the same number and size of muscle fibers are still more powerful than others. There must be other issues at hand. Perhaps body metabolism or lung capacity makes a difference. Some men may produce more lactic acid in the muscles taking more time to repair and recover between events.

Researchers have questioned the role of nutrition and diet on muscle performance. Fluid content and hydration have also been studied as a source of greater muscle power. As testing technology improves we may have better ways to examine this question in the future.

From a physiologic point-of-view you have already peaked by age 30 but many athletes have proven it’s possible to keep going and do quite well. Your age may not be as much of a factor as your gender. Women are known to have increased or decreased peak power output based on their menstrual cycles.

Researchers have shown that maximum sprint performance varies throughout the month. During the luteal phase (after ovulation) peak muscle power may be lower than the follicular phase (before ovulation). These results are based on women with normal, regular menstrual cycles.

Many female athletes are amenorrhea. This means they stop having a menstrual period. High, intensity training that burns body fat often triggers this protective response in females. If you are still having regular periods, chart your training response for the next three months along with your menstrual cycle. See if there are any links between the two.

Patients and physicians are both noticing the same thing. There isn’t a lack of information. There’s an overload. Most of the search engines list 1000s of web sites. Sorting through all that information can be very time consuming.

Knowing what’s valid and accurate is a separate problem. Commercially sponsored sites can be misleading in an effort to sell their product. Patients can easily misunderstand information offered.

We suggest looking for academic sites posted by universities or large, reputable clinics like Mayo, Johns Hopkins, or Kaiser Permanente. Secondly, look for information written by physicians. Check the date on the web page. Look for information that is reviewed and/or updated regularly.

Be a good health consumer. Gather whatever good information you can find. Always check all information with your own doctor. This is especially important if and when you are making a decision about your health care or treatment. Don’t leave it up to the World Wide Web to decide your life for you.

Most doctors have their patients’ best interests at heart. This means giving them accurate and reliable information about diseases, illnesses, and other conditions that might concern them.

The Internet is an unregulated source of information. There are no laws to govern who writes what about anything. Web sites offering advice may be nothing more than a chat room or message board.

Studies have been done on the quality of information posted on the Internet for a variety of health topics. In most cases the web-based data is not high quality or accurate. Doctors are wary that patients might make important decisions based on faulty information.

There’s also some concern when commercial organizations trying to sell or promote their products sponsor a website with information. Two reliable sources have warned consumers that much of the information on the Web is misleading and can hurt the consumer. The two groups are the Federal Trade Commission and the U.S. Science Panel on Interactive Health Communication.

Don’t take offense by your doctor’s attitude. Gather as much information as you need and check it out with him or her for accuracy.

There are exercise restrictions for athletes who have any one of a wide range of heart problems. A heart murmur suggests one of the heart valves isn’t closing tightly. A small amount of blood leaks back into the heart instead of moving forward into the next chamber.

Most people don’t outgrow valve problems. The only way to really know is to have your son evaluated by a medical doctor. He would need a preparticipation physical exam anyway. Be sure and mention your concern to the physician so it’s not easily overlooked.

There may be some physical restrictions that would keep him from training for football. It’s possible your son’s condition only requires careful following.

Yes — there are several groups dedicated to keeping track of catastrophic injuries and changing this problem. As you noticed brain and spinal cord injuries are common in sports. Football tops the list for the most dangerous in terms of major injuries for men. Cheerleading and gymnastics account for the highest number among women.

The National Center for Catastrophic Sports Injury Research works together with the United States Consumer Product Safety Commission to collect information about injuries. The Centers for Disease Control and Prevention (CDC) also has a National Center for Injury Prevention and Control.

In addition the National Collegiate Athletic Association and the National Federation of State High School Associations review stats about injuries every year. They publish the rule books for each sport. The goal is to promote safe play.

On the other side of things, groups like the National Operating Committee on Standards for Athletic Equipment are working to develop safer equipment. Helmets have been greatly improved over the past 40 years. The number of fatal head injuries has declined as a result. Riddell, Inc. continues to test new helmet designs. They are currently working to make a helmet with better protection for the side of the face.

Other steps have been taken over the years, too. For example, spear tackling (using the crown of the head to tackle a player) has been banned since 1976. That decision reduced the number of very serious neck injuries from 34 in 1976 to three in 1992.

The area of greatest concern and focus now is deaths from heat exhaustion and overexertion during training camps. We should see some guidelines for this if they aren’t already published.

If you are newly diagnosed the doctor may want to rule out the presence of osteoarthritis (OA) since the treatment of OA is different from rheumatoid arthritis (RA).

On the other hand, X-rays are often advised to give a baseline idea of the condition of the joints. X-rays can show the joint space and any erosions into the joint cartilage and/or bone. Later the doctor will want to take follow-up X-rays.

Any future X-rays will be compared to past X-rays to look for changes (better or worse). This information helps the doctor plan the best treatment or perhaps change a treatment approach that isn’t working.

MRIs aren’t used for every patient. They cost more, take more time to get, and don’t always show the joint changes as well as an X-ray.

There may be a connection between the two conditions but what the link is remains unknown. HCV may heighten the body’s immune response. Since rheumatoid arthritis is an autoimmune disease (the body attacking itself), it’s possible the immune system is TOO stimulated to fight the HCV and ends up fighting itself.

A second theory is related to the drug treatment for HCV with interferon. The hepatitis C virus (HCV) often causes chronic liver disease. Since the liver metabolizes drugs taken, a damaged liver may result in improper drug use and elimination by the body. This may be why interferon triggers RA in some people.

The main problem in having both diseases is the impact on the liver. Patients with HCV aren’t always able to take advantage of the newer drugs for RA. Some of the medications used to treat the rheumatoid arthritis (RA) are known to damage the liver even more. Drugs to help manage the hepatitis can make the RA worse. Lab tests for liver function are needed more often to watch for developing problems.

Simply put the gel phenomenon is stiffness after inactivity. Inflammatory disorders such as rheumatoid arthritis (RA) often start out as stiffness in the morning lasting more than 1 hour.

This stiffness is relieved with activity. It comes back when the person tries to do something after sitting down or resting. After a short period of activity the stiffness gets better.

Not everyone agrees on the answer to this question. By definition remission means “a decrease or disappearance of symptoms.” That covers a lot of territory.

Some doctors say remission from RA occurs when the patient can say ‘Yes’ to five or more of the following for at least two months in a row:

In the last 10 years new medical therapies have come onto the market to not only treat rheumatoid arthritis but also actually stop the disease from its destructive course.

Patients with mild, even tolerable symptoms are often encouraged to take these medications. There are two reasons for this. First even people with no symptoms or mild symptoms can have ongoing joint changes that can lead to permanent damage.

Second, RA isn’t a disease of the joints. It’s a systemic disease that affects the joints as well as other parts of the body. The skin, eyes, lungs, heart, blood vessels, and nervous system can all be affected. Keeping this disease process in check is a good idea. Once it becomes more symptomatic it may be too late.

If you still decide to go without drug treatment, make regular visits to the doctor. Lab tests and imaging studies can help track the course of your disease. This information may help you in your future decision-making.

There’s no cure yet but some major advances in the treatment and remission of this disease have taken place in the last decade. Disease modifying antirheumatic drugs (DMARDs) can stop the symptoms and slow the disease down. Some studies even report reversal of joint damage in some cases.

Other biologic agents such as anti-tumor necrosis factor (TNF) or TNF blockers are also available for those patients who don’t respond well to the DMARDs.

Scientists are really looking more toward prevention as the “cure.” If patients with risk factors can be identified before the start of the disease, then maybe preventive drugs or diet could work.

For now we may be able to “cure” patients with drugs to put them into remission. Patients with RA hope for a cure that won’t require them to take drugs every day of their lives.

For your grandmother, if a rheumatologist hasn’t seen her in the last few years, a visit might be helpful. One of the new medications may be able to help relieve some or even all of her symptoms.

Injuries are counted the same for women as they are for men. The definitions are set by the National Athletic Injury Registration System of the United States. Any physical complaint that limits play time for at least one day after the problem first started is an injury. This includes injuries that occur during training or during games.

A player is considered “injured” until he or she is able to play again. Injuries are placed in one of three groups. A minor injury is the absence from training and/or a match for one to six days. A moderate injury means the player is off for one week up to 30 days. A major injury extends beyond one month.

It’s true that game dynamics have changed over the past 10 years. It’s also true the athleticism of players has increased tremendously during the same time period. There are more fouls and more tackles causing contact injuries.

Many studies are being done to sort out the cause of injuries among high-level female athletes. Injuries to the anterior cruciate ligament have been one area of major focus. There are many reasons offered for this: poor technique, lower skill level, lack of physical fitness, and hormone changes to name just a few.

With increased competition comes increased hours of training. Done properly with the right amount of warm-up, physical conditioning, and cool-down the athlete can enhance her performance. But more injuries are bound to occur when these elements are missing.

If injured players are forced to a faster return to play, their risk of re-injury goes up. All of these factors probably contribute to why there are so many injuries in this increasingly popular sport.

Drug users get skin infections from poor hygiene and poking holes in the skin with many needles each day. These types of infections can spread to the muscles and flesh causing a condition that eats away at the tissue.

Hepatitis is also common among drug users who inject drugs daily. Often they use the same needle as someone who has hepatitis. In this way, the disease is transmitted. Abscess of the spine, lungs, and brain can occur when infection is introduced into the blood stream. Infection of the discs and joints is also possible from Staph infection carried via the blood stream to these areas.

A recent study from Denmark did show that strength and overall physical capacity does make a difference in lifting. They measured pressure in the abdomen and on the spine in
judo and jujitsu fighters while lifting patients. The fighters are used to throwing their opponents down while putting their own bodies in a twisted and bent position. Yet they
rarely hurt their backs.

So there’s something to be said for being in good shape and strong before lifting patients. An overall physical conditioning program may be best (for you and your patients). Whenever possible, use a lifting device. Otherwise, try and team up with a co-worker to maximize your safety. Proper lifting is also important. Make sure you are fully trained before starting work. Let your supervisor know you’d like training in this area.

Canada has a national health care system funded by the government. This makes it possible to start a national health survey. In the United States, there isn’t national health
insurance or a system of national health care. This means everyone has their own
insurance, no insurance, or they pay expenses out of pocket.

Americans are also quite serious about privacy. By and large, they don’t want information about them collected or stored in a database. At the same time, they have what’s called state’s rights. The Civil War resulted in each state making laws to govern the
people of that state. Under our present system, it would take agreement and legislation in all 50 states before a national health database could be started.

It may only be a matter of time before the United States Federal government steps in. A more efficient health care system is needed. There is a general trend toward automated
identification and data collection at each individual health care facility. Without funding and universal permission, it’s not likely we’ll have such a system linked together throughout the United States.

As you may remember, former First Lady Hillary Clinton tried to revamp the United States’ Health Care System. It was too complicated for one person or department to take on. Some
people think it’s only a matter of time before we have a national health service. Others don’t think it will ever happen.

Actually, yes, but not all cells are affected. Lipofuscin is an “age pigment” that accumulates in certain parts of the body. The nervous system is affected the most, especially the cells of the brain, spinal column, and nerve tissue. The nondividing cells
of muscle fibers (including the heart) are also affected. In fact, the age of the heart can be determined by how much lipofuscin is present.

It is a yellowish-brown pigment and does collect as we age. Lipofuscin is left over from the breakdown and absorption of damaged blood cells. It is also found as a fatty byproduct of cell metabolism. It’s what gives earwax its distinctive color.

Many studies have shown the importance of stretching. Improving muscle flexibility is thought to decrease muscle and tendon injuries. It also improves muscle function and,
therefore, athletic performance.

There are some muscles at greater risk for injury without stretching. The hamstrings on the back of the thigh is one. Studies show a lack of hamstring length is the most common cause of leg injury in athletes.

It’s best to take the time to begin a workout with some stretching exercises. The three to five minutes it takes to stretch your muscles is a good investment of time. It’s like
money in the back when it comes to preventing problems later.