Low back pain - Ask Dr. P

What is Stiff Person Syndrome?

by Pain Doc | Dec 19, 2023 | Neuromusculoskeletal Disorders

The singer Celine Dion, whose glorious singing career spanned the last four decades, was recently diagnosed with a condition called Stiff Person Syndrome. Unfortunately, the condition is prevening her from performing, due to its debilitating effect on muscle control, including the vocal cord muscles.

Stiff Person Syndrome (SPS) is a rare, progressive neurological disorder characterized by significant muscle rigidity and spasms, often leading to debilitating physical and psychological symptoms. This article provides an overview of SPS, delving into its causes, symptoms, diagnosis, and current treatment options, as informed by medical research and trusted medical resources.

What is Stiff Person Syndrome?

SPS is an autoimmune neurological disorder primarily causing muscle stiffness and painful spasms. These spasms can worsen over time and vary in symptoms, including an unsteady gait, double vision, or slurred speech, depending on the SPS type. The condition can be severely disabling, often leading to hunched over postures and frequent falls due to impaired reflexes.

Causes of Stiff Person Syndrome

While the exact cause of SPS is unknown, it is believed to be an autoimmune reaction where the immune system attacks glutamic acid decarboxylase (GAD) in the brain and spinal cord. GAD is crucial for producing gamma-aminobutyric acid (GABA), a neurotransmitter controlling muscle movement. Neurotransmitters are protein molecules released from the ends of neurons, which then attach to other neurons causing them to continue the nerve impulse until it reaches the muscle. Disruption in GABA production can lead to continuous neuron firing, contributing to muscle rigidity and spasms seen in SPS. Low GABA levels are also associated with anxiety and depression. Interestingly, SPS often occurs alongside other autoimmune diseases like type-I diabetes, thyroiditis, vitiligo, and pernicious anemia.

Symptoms of Stiff Person Syndrome

The primary symptoms of SPS include progressive muscle rigidity and painful spasms, often triggered by stimuli such as noise, touch, and emotional distress. Initial symptoms typically manifest between the ages of 30 and 60 and can vary in severity and progression. Common initial signs include muscle stiffness and pain, especially in the lower back and legs, potentially leading to difficulty in walking and performing daily activities. Severe cases may require wheelchair use, and there’s an increased risk of anxiety and depression.

Diagnosis of Stiff Person Syndrome

Diagnosing SPS is challenging due to its rarity and symptom overlap with other conditions like Parkinson’s disease, multiple sclerosis, and fibromyalgia. A definitive diagnosis is often made via a blood test measuring GAD antibodies. Most people with SPS show elevated GAD antibody levels. Electromyography (EMG) tests can also be employed to measure muscle electrical activity and assist in diagnosis and monitoring treatment response.

Treatment Options for Stiff Person Syndrome

While there is no cure for SPS, symptoms can be managed through personalized treatment plans focusing on pain management, muscle relaxation, and immune response suppression. Common medications include pain relievers, muscle relaxants, anti-seizure and anti-anxiety drugs, sedatives, and steroids. Non-medication treatments like physical therapy, heat therapy, red light therapy, and pulsed EMF are also beneficial. In cases where medications are ineffective, treatments like Botox, intravenous immunoglobulin (IVIg), and stem cell therapy have shown promise in symptom improvement.

Additionally, a narrative review of available medication treatments for SPS suggests starting with benzodiazepines as a first-line treatment, adding medications like levetiracetam or pregabalin if symptoms persist. For second-line therapy, oral baclofen is preferred over rituximab and tacrolimus. In cases of refractory symptoms, treatments like intrathecal baclofen, IVIG, or plasmapheresis can be effective, with intrathecal baclofen and IVIG being more effective than plasmapheresis.

Conclusion

Stiff Person Syndrome presents a complex clinical challenge due to its rarity, varied symptomatology, and the intricate interplay of autoimmune responses. Understanding its underlying causes, symptom patterns, and current treatment modalities is crucial for effective management. Ongoing research continues to shed light on this condition, offering hope for more effective treatments in the future. For individuals diagnosed with SPS, a collaborative approach involving neurologists, rheumatologists, and physical therapists, alongside personalized treatment strategies, is key to managing this condition and improving quality of life.

And lastly, when your body is struggling with disease, give it assistance by providing it with nutrients, water, sunlight and mild exercise when possible. Mind-body approaches including meditation, flotation therapy, biofeedback, yoga, tai-chi, deep breathing and so on, may provide some relief as well.

Sources:

Johns Hopkins Online

https://www.hopkinsmedicine.org/

National Institute of Neuromuscular Disorders and Stroke

https://www.ninds.nih.gov/

American Brain Foundation

https://www.americanbrainfoundation.org/

How Pulsed EMF and Red Light Can Help With Low Back Pain

by Pain Doc | Nov 29, 2021 | Low Back Pain

Low back pain affects nearly everyone at some point in their lives. Medical researchers have long known that most cases of low back pain self-resolve after a couple of days with rest and palliative measures such as application of hot packs and cold packs.

But for some, low back pain returns, and eventually becomes chronic. “Chronic” means that pain has reached a level where tissue healing has for the most part completed, but there is recurring pain. Chronic pain is usually characterized as dull, persistent pain; as opposed to the sharper acute pain, which is the type of pain associated with recent injury or major aggravation of a previous injury; characterized by heat, redness and swelling. Chronic pain is believed to be central nervous system driven; meaning that some of the pain signals are emanating from brain and spinal cord neurons as opposed to nociceptors, the special pain-sensing fibers found throughout your joints, tendons and muscles.

If you have acute low back pain– again, from a recent injury, or aggravation of a previous back injury resulting in swelling and pain, the standard protocol agreed to by most orthopedic specialists is rest, ice for the first two days, followed by an optional hot pack for the next 3-4 days. “Rest” doesn’t mean bed-ridden. When used in this context, rest means no heavy lifting, bending at the waist, or activities that place undue pressure on the spine such as running or jumping. However, you should move your body in ways you can; i.e. do not mentally “catastrophize” it because studies show that this mindset can actually lead to poorer outcomes, such as taking a much longer time for the pain to resolve, and atrophy of the back muscles which reduces support to the spine and therefore predisposes it to further injury.

If you have chronic low back pain, the goal is to manage it so that it has a minimal effect on your activities of daily living– standing, sitting, walking, bending, and other activities that require similar use of the spine. If your chronic pain is mostly central nervous system in origin, it would be worthwhile to practice mind-body techniques. This includes yoga, meditation, and practices of that nature. Having control of your thoughts can be helpful in controlling chronic pain. It’s not all about ignoring your pain, but rather, not amplifying it by mentally embracing and validating it. The best approach is to continue as best as you can with your regular life activities– the things you did before the injury event. Modify them to accommodate any physical limitation, if necessary. For example, if you used to run, try speed walking. It’s less jarring to the knees and low back, and you burn the same number of calories. What’s most important is getting out there and staying active; i.e. “move through the pain.”

You can of course try to alleviate acute or chronic low back pain by using certain modalities. The ones I recommend are red light therapy and pulsed electromagnetic field therapy. Red light (emitted by a light emitting diode, or LED) has a wavelength range of around 660 nanometers. It is electromagnetic energy at a wavelength that can influence biological activity in a positive way. Studies show that light at this wavelength gets absorbed by cell mitochondria, which respond by becoming more active. Mitochondria are the parts of a cell that extract energy from ATP, the molecule synthesized from glucose (sugar) in the diet. A recent study showed that applying red light to your eyes in the morning can even improve eyesight. If you have an injury and/or inflammation, red light therapy can be helpful in accelerating the healing rate.

If the original injury event was within a year, it is possible to eliminate your chronic pain and have it never come back again. You see, in some cases of ongoing pain, it could be that your injury still has the potential to completely heal but it just needs a boost on energy. Cells are dormant or at a low energy state and there is not much activity going on; i.e. protein (collagen) synthesis and cell division/ new cell creation. Here’s where Pulsed EMF can help. Pulsed EMF, known as “energy” medicine, is the only modality that works by increasing the action potential of cells. Like voltage that drives electrical current, a strong action potential across a cell membrane will enable the cell to improve its metabolic rate. Nutrients and oxygen will move across the membrane into the cell, while waste products and CO2 will efficiently exit the cell through the membrane. When the cells are more energized, their healing capacity increases.

To further enhance healing of an old injury, apply 30 minutes of Pulsed EMF twice a day, followed by ten minutes of red light therapy. What’s great is that you do not need to be a licensed doctor to acquire these modalities. They are safe enough to use at home and there are no studies that show a harmful or negative effect in the use of these machines. If you wish to get out of pain sooner and in the long run, you can’t go wrong with Pulsed EMF and Red Light therapy. When combined, they serve as a powerful treatment for injuries and pain.

Pulsed EMF and Red Light also can serve as maintenance therapy for those who have no health issues. Living in a modern society, our cells and tissues are constantly exposed to unnatural and even harmful electromagnetic fields from things like cell phone towers and powerful transformers in buildings (Pulsed EMF generates EM fields with the same frequency and wavelength profile as those naturally produced by the body itself, at higher amplitude). This saps our energy and weakens and drains cell energy. Applying pulsed EMF re-energizes the body very much like how you recharge your cell phone battery every day. Your body will feel the difference with the energy boost Pulsed EMF provides.

Two Modalities to Heal Low Back Pain in Half the Time

by Pain Doc | Oct 20, 2021 | Low Back Pain, Pulsed EMF, Red light therapy, Self Treatment

Hey, I know there are millions of pages on the internet on how to fix low back pain. It can be a dizzying experience searching through them. It’s information overload.

I began blogging on this site around 2010, but actually have been writing articles on things like exercises for low back pain, neck pain, sprains and strains and so forth, since about 1994 when the internet was in its infancy. Fast forward 28 years, and now there are tons of articles and videos online, including mine. Much of the online content for treating low back pain is good: well-written, easy to understand and follow, and backed by evidence. Others are mediocre; just a re-hash of old-school approaches to treating back pain (rest, ice, no heavy lifting, etc.).

If you know me, when it comes to teaching others how to self-treat pain, I like to write fresh, interesting and innovative content. I figure that there are more than enough good videos on stretching and exercising for low back pain. What I like to do is explain the etiology of pain and propose interventions to prevent that pain from developing or getting worse.

If you have acute (recent onset) low back pain, research shows that in most cases, it will go away on its own if you just take it easy for a couple of days. Sure, icing, applying hot packs and no heavy lifting are obviously recommended to prevent re-aggravating the condition. The problem is that most people can’t afford to wait that long, and don’t like being in pain. They have a job, they have responsibilities to other people, and, they want to have fun and do the things they want to do.

For these individuals, there are a couple of home therapies I recommend, to shorten the healing time.

When you have low back pain, muscles and ligaments in and around your spine are generating pain. Something was disrupted mechanically, and inflammation is going on – blood vessels are releasing histamine and heparin and the inflammatory cascade is active—heat, redness, swelling, pain. The inflammatory chemicals irritate sensory nerves, causing some of the pain; as well as the pressure from the swelling. The nerves themselves may be over-firing; generating a level of pain that is not really proportional to the amount of tissue injury.

So with that, my go-to home therapy is a combination of Pulsed EMF and Red Light. Pulsed EMF is an externally-applied, pulsed electromagnetic field. The field, which is similar in frequency to the body’s own natural EM fields, passes through your body and essentially energizes the membranes of cells.

Cell membranes let things in and out of the cell, especially synthesized proteins, nutrients, oxygen, and waste products. They do this via active and passive transport, which both rely on membrane potential—a weak voltage created by negatively charged ions on the outside of the cell, and positive ions on the inside. Like how a battery’s voltage can power a light bulb, a cell’s weak voltage along its membrane powers the exchange of molecules in and out of the cell.

When cells (in this case muscle, bone, nerve, blood vessel cells) are physically damaged or weakened, this exchange is hampered and the tissues are slow to recover and return to a normal, non-pain state. Pulsed EMF lends a boost to this energy, helping cells become more robust in their healing and recovery activities.

Red Light therapy also can energize weak cells, but via photobiomodulation. Cells absorb red light in the 660-720 nanometer wavelength (electromagnetic energy), due to their molecular composition. Photons strike the nucleus, mitochondria and membrane, which changes the oxidative state of the cell. When this happens, it triggers cell signaling pathways related to metabolism and energy production. The cells increase their ATP output, which gives them more energy to repair damaged sites and synthesize needed repair proteins.

Pulsed EMF devices for home use are very easy to operate. Usually, it’s a matter of just pressing the power button, and sometimes a Mode button and Timer button. One of the better models is the BioBalance. You can order it with a full body mat, or a pad. Simply find a comfortable place in your home such as your sofa; place the mat on it, and lie down so that your low back is directly over the mat. No need to remove clothing; the pulsed EMF field passes right through. Do it 3x day for 20-30 minutes/ day to help your body heal and recover.

Another option is the OMI full body PEMF mat. It is lower power than the BioWave, but sometimes that works just as well, as the EM fields are very subtle. You don’t want fields that are too strong. Remember, your body already produces weak magnetic fields; you just want to complement them with a boost of comparable energy.

Red Light therapy is also a great investment in your health. I recommend getting a red light LED wrap, or LED panel. The wrap is a flexible pad embedded with red light LEDs emitting red light and infrared light (660, 820 nm). The red light diodes create photobiomodulation while the infrared diodes provide deep penetrating heat to dilate blood vessels and increase oxygen delivery to cells.

Red Light panels come in different sizes. The small ones are popular for treating facial skin conditions and beautification. The larger panels are better for treating pain. You can mount or hang the panel on the wall, and position yourself so that you are exposed to the red light (usually requires standing up).

In summary, if you are prone to getting lower back pain or have chronic pain issues, Pulsed EMF and Red Light Therapy are two, powerful and safe modalities that can be used at home for self-treatment and are easy to operate. Best of all, they have a long history of medical research to support their use in treating pain and healing injury. It does require a modest investment, but what is more important to your health and well-being? Without this, nothing else matters.

What Causes Low Back Pain?

by Pain Doc | May 29, 2020 | Low Back Pain

Low back pain continues to be a problem for many people. If not you, then most likely several people you know: neighbors, co-workers, friends and relatives. That’s what the statistics tell us.

Since it is so prevalent throughout the world, “what causes low back pain?” is a question millions of people want answered. Is it normal and expected as we age? Is it genetic? Will you need to get surgery? As you can expect, the answer is different for different people. First of all, the pain is not identical from person to person. Some people get low back pain on the right side; some get it on the left side. Some get low back pain into the hip.

In this post, I will do my best to help you understand what causes low back pain and at the end of the article provide you a tool to pinpoint what is causing your particular low pain.

The Lumbar Spine and Its Significance

Your low back or lumbar spine engineering-wise is your body’s lynch-pin– along with your pelvis, it connects your upper body to your lower body and is tasked with balancing and moving your torso. If you injure your low back it can put you out of commission: any attempt at moving places a load on your low back and makes pain worse. In extreme cases it is even painful to take in a deep breath! Acute low back pain can instantly stop a 250 pound football player in his tracks; that’s the power it has.

While most cases of low back pain self-resolve over a few days, about 20% of them become chronic, or recurring. For some, it strikes every couple of months; for others, it’s enough to impede their daily activities and quality of life. In fact, low back pain is said to be the number one reason for lost work days (disability) in industrialized nations, and therefore lost productivity.

The reason why low back pain is so prevalent is a societal phenomenon, made possible by evolution. You see, humans are the only bi-pedal animal on the planet. Dancing bears and meerkats don’t count because although they can walk a few steps their pelvic design is still quadri-pedal (walking on four limbs). When nature selected homo sapiens to be bi-pedal, it freed up his arms to carry things–heavy things. Carrying and lifting things and bending the low back places a tremendous load on the lumbar spine, and like any machine, the components bearing the most stress will be the first to break down.

Secondly, the invention of the chair and desk. When our ancient ancestors roamed the plains and forests 30,000 years ago there weren’t any chairs around to sit in for hours, placing pressure on the low back and weakening the postural muscles of the spine. Today, many jobs require sitting at a desk in front of a computer, doing just that. Also, food these days is abundant and much less nutritious causing humans to gain excess weight, placing constant stress on the low back throughout the day.

Causes of Low Back Pain

The vast majority of low back pain cases are mechanical in nature; meaning caused by a breakdown of some physical component of the lumbar spine. These components are the muscles, fascia (muscle sheath), ligaments and tendons; vertebrae, vertebral joints, and discs (which are technically ligaments). If the dysfunction causes compression of nerve roots, then nerve pain is involved, which usually means shooting / radiating pain and/ or numbness down the buttock to lower extremity; sometimes as far down to the sole of the foot.

Here are the main categories of mechanical low back pain:

Congenital Malformations

Sometimes there are abnormalities in the development of the spinal column which interfere with proper movement and balance placing excess stress on soft tissues and sometimes nerves, generating pain or constant stiffness and aches, and loss of range of motion/flexibility. Examples include fused vertebrae (two adjacent vertebrae fused together instead of forming a joint); scoliosis; spina bifida, pars defect, hyperkyphosis (hunchback); and hyperlordosis (swayback).

Injuries

Low back pain is often due to injuries to tissues: sprains to ligaments; ruptured intervertebral discs from a herniated or prolapsed nucleus pulposus (jelly-like shock absorbing substance in all discs); strains (tears, small and large) to muscles and tendons; muscle spasms, and fractures. These can be traumatic from a specific incident such as a sports injury, or can be cumulative over time, often years, from performing a certain movement repeatedly or sitting/slouching causing gradual degenerative disc disease. With acute tissue injury, the inflammatory response is initiated, which is responsible for the pain generation.

Degenerative Changes

Joints wear out over time. Most doctors will tell patients their condition is from “normal” wear and tear. But that’s not accurate. For some people, joints deteriorate at an abnormally fast rate, mainly due to lifestyle factors under their control. I’ve seen X-rays of 60 year-olds look much better than 30 year-olds, on many occasions.

Factors that promote lumbar spine degeneration include:

Being overweight
Genetic predisposition
Sedentary lifestyle/ lack of physical activity
Sitting frequently (airline pilot, police officer, truckers, data entry)
Heavy labor job
Contact sports, especially football
Occupation or recreation that involve hard landings (basketball, gymnastics, parachuting, etc.)
Previous injuries/accidents such as falls and car accidents
Poor diet (your body needs proper nutrients to heal tissues)
Smoking (smoking reduces oxygen to cells and may trigger inflammation)

Doctors use three terms to describe spinal degeneration:

Spondylosis when referring to the vertebrae as a whole;
Degenerative joint disease or DJD if referring to the vertebral joints: facet joints and intervertebral joints; and
Degenerative disc disease or DDD if referring to the intervertebral discs

In all cases, the joint surfaces of the vertebrae lose their smooth borders and form jagged bone spurs called osteophytes. You can have a lot of osteophytes in your spine and not feel pain at all. In fact, if you are over age 40 you probably have them yourself. But if the osteophytes get big enough to narrow the openings where nerves pass through, called foramen, problems start. This narrowing of the foramen is called spinal stenosis and can occur with the intervertebral foramen (IVFs), the small holes formed by adjacent vertebrae which nerve roots pass through; and also the central canal where the spinal cord and cauda equina reside. This can lead to shooting pain down one or both legs; numbness and tingling in the legs, and leg muscle weakness, atrophy and loss of sensation.

Since osteophytes do not resorb (shrink) and only get bigger with time the only option is spinal decompression surgery which involves shaving off the osteophytes to make more room for the nerves.

And there is another problem: when spinal discs degenerate, they lose height (this is part of the reason why most people get shorter as they age). A healthy L5-S1 disc can be in excess of 1 cm thick while a degenerated one can be just 2-3 mm thick. When this happens, the posterior and anterior longitudinal ligaments that run down the front and back of your vertebral column slacken, or buckle, at those levels. Like osteophytes, buckled ligaments can cause stenosis, compressing or irritating nerves and causing the same neurological symptoms.

When the degenerative changes involve deterioration of cartilage, you have bone on bone contact. The cartilage in your spine is located in the encapsulated facet joints, located behind the vertebral bodies. This triggers inflammation, which leads to osteoarthritis. It’s the same process as osteoarthritis of the knees and hips, occurring in the spine.

Like knee osteoarthritis, people with spinal OA will feel burning pain in their lumbar spine especially when standing, and stiffness which is worse upon waking in the morning. Osteoarthritis is a chronic, degenerative disease that is best managed by lifestyle modification (anti-inflammatory diet, exercises, stress reduction). Those with severe cases sometimes elect to use prescription anti-inflammatory medication.

Non-Mechanical Causes of Low Back Pain

Less than 1% of low back pain cases are due to other factors, most of which are “red flag” cases that require immediate medical attention. These include pelvic tumors, kidney stones, metastatic cancer (usually from prostate cancer), infection, and endometriosis. A brain tumor is capable of causing sciatica-like symptoms if it affects the sensory neurons that go to the leg. While rare, if you have low back pain that does not improve with physical therapy or rest, it is a good idea to see your doctor and get some tests done to rule out these conditions.

Summary and Main Take Aways

If you have low back pain, chances are very good it will go away with rest. Apply ice for the first 1 to 2 days. If severe, you can try taking over the counter anti-inflammatory medications (NSAIDs) such as Motrin or Ibuprofen to knock down some of the pain. And if you are lucky to have a cryotherapy center near you, you can do a couple of visits to shorten the healing time.

If the pain lasts more than 4 days, then it usually means something is perpetuating it: perhaps you are not resting it properly; are re-aggravating it; or have some kind of contributing factor such as a rotated vertebra or disc protrusion. These issues can be dealt with by visiting a good physical therapist or chiropractor. You can even do some home exercises and home therapy for low back pain on your own and still get great results.

While most cases of low back pain go away, it doesn’t mean that it will stay away for the rest of your life: 20% of people who get low back pain will experience it again in the future; either from a new injury/event or a flare-up of a pre-existing injury. And remember, some cases become chronic (pain decreases, but the improvement plateaus and remains, with some days worse than others). Your prognosis will depend on what is causing your low back pain (see below for a self-diagnosis tool) and other factors related to your medical history and daily activities.

When dealing with low back pain, besides focusing on reducing the pain think of what things caused it and eliminate those causes as best you can. It may mean:

Getting a stand up desk (standing puts less stress on your low back than sitting)
Losing some weight
Eating a healthier diet
Stopping smoking
Exercising more often
Reducing emotional stress in your life
Improving the ergonomics of your work station
Learning how to lift properly
Getting your back adjusted by a chiropractor periodically to improve joint movement and joint health

And lastly, remember that low back pain should noticeably and progressively improve each day after initial onset. If you notice that pain does not get better with rest, express your concern to your doctor: demand an X-ray, MRI and/or a blood test. Red flag cases like cancer are often misdiagnosed by doctors (dismissed) as general back pain due to spasms because doctors know that the medical literature estimates red flag cases to be 1% or less of all low back pain cases. Remember to be persistent; it is your life you are dealing with.

Below is a low back pain algorithm I created to help you diagnose your particular low back pain so that you can take appropriate action. Use the top one if your low back pain onset was sudden; use the bottom one if the onset was gradual. This is only a guide; always check with you doctor who can examine you, to get an accurate diagnosis.

How Do You “Do” Health Care?

by Pain Doc | Feb 6, 2017 | Telemedicine

The Evolving Paradigm of Health Care

Health care. It’s one of those things that’s talked about regularly that carries sub-conscious assumptions.

I’d like to ask you today, “What does health care mean to YOU?”

You might say:

“Health care is being able to see a doctor whenever I need to, for a health-related complaint.”

Ok, fine. Let’s say you do. Now what?

You may then further elaborate, “Being able to ask the doctor what is causing the problem and what I need to do to get it fixed.”

Ok, you’re talking about getting a diagnosis and prescription. You ask the doctor about that nagging symptom, and he or she explains that it is being caused by a virus. Your doctor then writes a prescription and prints out a pre-written information sheet about your condition, which includes things you should do, and hands it to you and you are discharged.

That’s great. It’s reassuring to have access to a doctor whenever you are ill.

But, given all the tools that are available these days, was a doctor really necessary? Could a lower-cost nurse sufficed? Some RNs and Nurse Practitioners are very knowledgeable in disease signs, symptoms and treatment.

And did you know that there are some pretty accurate apps and websites (WebMD, ShareCare) that could have provided the same information to you in minutes, for FREE?

And, how much a month are you paying in health insurance to have this access? For my family, it’s $1,500/month and we’re all pretty healthy. Is it worth it?

My point here is that the old model of out patient service is getting a lot of challenges in this age of technology and big data access. It is time for people to start questioning how they wish to utilize, or “do” health care.

Another valid question is “Should this be called “sick care” instead?

After all, in this scenario the person seeks out the doctor AFTER the condition is already there; after he is ill or stricken with the malady.

So yes, a better description of this service is “sick care.” But although it’s a more accurate term, sick care sounds negative (which it is) compared to the term health care. When you hear the word health it evokes positive images like strength, energy, vitality and longevity. So don’t expect to see hospitals, doctors and insurance companies extolling their sick care services.

The Three Paradigms of Health Care Today

Returning to the questions “What is health care?” and “How should I use or do it?”, here’s another thing to consider:

Do you really need to take medicine, get a shot, see a physical therapist or get surgery?

Ok, in some cases you do; usually emergency cases like heart attacks and stroke.

The first paradigm of health care, which we’re all familiar with is having some procedure done to you by a medical professional. This is passive health care, where you receive it passively and includes taking medicine, getting surgery, and having therapy done on you.

The second paradigm of health care is the doctor or professional instructing you what to do to get well or for prevention; i.e. prescribing home care or lifestyle modification routines.

This is a big improvement from the first paradigm in the following ways:

(1) it gets you involved in your health, which trains you to be more responsible for your health and not reliant on a doctor;

(2) it is less expensive because you are in the doctor’s office less; and

(3) it is likely to be more effective and safer than visiting a hospital or taking medications.

Diet, exercise, home care strategies and other lifestyle modification interventions have a bigger, direct and longer-lasting impact on your health than medicine or passively receiving ongoing therapy (for a pain condition) such as physical therapy and chiropractic.

Medicines typically work by altering or “jury-rigging” your physiology to counter the symptoms you are experiencing, which gives the “illusion” of health. This is not natural, and there is almost always blow back by your body; i.e. side effects, some which create more problems (such as how taking Aspirin for pain can give you ulcers; or how taking too much Ibuprofen can cause renal failure).

Ongoing chiropractic or physical therapy is almost as bad, because anything passive risks your body becoming dependent or addicted to it, which again leads to blow back in the form of weakness and reduced coordination of muscle and joint systems.

Finally, the third paradigm of health care is when YOU get involved in researching your condition thoroughly, and then getting instruction on how to resolve your health condition from legitimate sources.

Now, this paradigm gives you the most freedom, but it also has some drawbacks. You need to learn how to differentiate between legitimate websites and the extreme ones. Health is an art as well as a science, so there are gray areas and some people are known to take excessive liberties in their writings about health.

Traditional medical websites obviously have an “allopathic medicine” bias. This is good in that the information is usually backed by research (evidence-based medicine), especially when on reputable, authoritative sites like Cleveland Clinic and Johns Hopkins.

(However, in recent years I have seen WebMD warm up to natural medicine; i.e. herbs and traditional natural remedies; although they are careful to use non-committal words and phrases such as “…may be helpful” and “…some anecdotal cases show that herb x reduced pain..”)

But the traditional allopathic websites are not as in-depth into alternative health favorites such as nutrition, herbs and things like electromagnetic therapy and grounding.

Then there are the alternative health websites. These sites are usually written by bloggers; some of whom have credentials (unfortunately, you will have to verify it yourself by doing internet research) and some who do not– just health enthusiasts who read other sites and report on them. Be more cautious about the information you get from these sites. That’s not to say that you can’t find useful information on some of them; some are really good despite being written by non-doctors.

Alternative health websites fit in better with this third paradigm of health care by virtue of the nature of alternative health, which essentially IS about implementing lifestyle modifications to achieve health from within. Things like diet, nutrition, herbs, exercise, breathing, meditation, massage, stretches, and using safe, energy emitting devices to enhance your body’s healing.

Fix chronic pain at home using nutrition, lifestyle modification and techniques used by physical medicine professionals.

ShareCare

Online medical consultation with real doctors.

Cleveland Clinic Online

Online medical consultations and prescriptions by real doctors.

WebMD Symptom Checker

Interactive symptoms checker and medical report and recommendations.

Mercola.com

The world’s largest natural health care website featuring articles on wellness, prevention and the dangers of common medical interventions.