DEAR READER: In answer to your question, I am unaware of any scientific studies to support its use; however, I’d defy anyone to go up against what the Roman Empire began using almost 2,000 years ago as a healing herb for countless maladies. Scientific studies aside, what is valid is what works. Ginger has been used with success to treat nausea during pregnancy, to prevent car or motion sickness, as an anti-inflammatory for arthritis and joint pain and post imbibing too much alcohol. Even as a tea, its soothing qualities are well known. Give it a try. It won’t do you any harm, and, if you fail to improve, you can speak with your physician regarding what he or she might recommend instead.

DEAR READER: Polymyalgia rheumatica (PMR) is an inflammatory disorder that results in widespread muscle aches, pains and stiffness of the hips, shoulders, thighs, upper arms and neck, fatigue, anemia, malaise and unintentional weight loss. Symptoms experienced are the result of mild inflammation of the joints and surrounding tissue. Stiffness can worsen following periods of inactivity, such as after a night’s sleep or sitting for too long.

The condition is thought to be related to an immune-system arthritic disorder that customarily goes away on its own in a year or two. Initially, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) might control the side effects. Long-term use of NSAIDs can include intestinal bleeding, hypertension, renal insufficiency, fluid retention and more. Beyond that, medication such as corticosteroids and self-help measures can go a long way toward dealing with the discomfort. The downside to long-term steroid use is possible hypertension, osteoporosis, diabetes, weight gain and cataracts.

Self-help includes a nutritious diet rich in fresh fruits and vegetables, lean meats, whole grains, calcium and vitamin D. The latter two recommendations can be satisfied through supplements. The daily recommendation for calcium in people over 50 is 1,200 milligrams per day with 600 to 800 international units (IU) of vitamin D. Exercise, primarily low-impact movement such as swimming, riding a stationary bicycle or walking, will go a long way toward reducing the pain.

Risk factors include age, race, gender and those diagnosed with giant cell arteritis. Older adults, primarily those 70 and older, are affected, and women are twice as likely as men to develop the disorder. No one is immune; however, Caucasians, Scandinavians and people from Northern Europe are most at risk. Finally, giant cell arteritis is a condition in which the temporal arteries and other areas of the body become swollen and inflamed. Almost 50 percent of all people diagnosed with giant cell arteritis are found to have polymyalgia, and up to 20 percent of those with polymyalgia develop giant cell arteritis.

Diagnosis can be made through laboratory testing that may include a rheumatoid factor, sedimentation rate, C-reactive protein, platelet and red-blood-cell counts. The only way to rule out giant cell arteritis is through biopsy from the scalp artery at the temple.

To provide related information, I am sending you copies of my Health Reports “Fibromyalgia” (a related topic) and “Managing Chronic Pain.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Osteoarthritis is a chronic condition that results from a breakdown of joint cartilage. Healthy cartilage allows our joints to move easily and without pain. When osteoarthritis is present, a degeneration of the cartilage that cushions bone ends occurs. Over time, some areas of cartilage may wear away completely, resulting in damage to the bone and extreme pain on movement. The ends of the bone may form spurs, and the ligaments may thicken. This common disorder affects about one in three people and, while most common in older adults, it can affect people of any age.

All of our joints are susceptible to osteoarthritis, but those most commonly affected are ones that bear weight — knees, hips, spine, feet, neck, lower back and hands. When the knees or hips are involved, pain may be experienced with motion but may disappear when at rest. When the spine is involved, stiffness and discomfort can be felt and can generate to the lower back. There may be pain generating to the head or down the arms.

I cannot determine from your brief note why you have the condition. It may be related to a sports injury when you were younger, or you may have a family history of OA. There is also a consideration of a chemical change that has occurred in your cartilage, causing it to break down faster than it can be produced. You also may be carrying more weight than is healthy for your frame, or you may be relatively inactive. As you can see, there are a number of causes for a woman at the early age of 54 to develop this condition.

You might be helped by over-the-counter or prescription NSAIDS (nonsteroidal anti-inflammatory medication). There are also glucosamine/chondroitin combinations available at your local pharmacy that may help to build cartilage and improve your joint mobility. If appropriate, consider weight reduction. Above all, stay as active as possible. Keeping your joints as mobile and flexible as possible can help reduce your pain and stiffness. Consider yoga, tai chi or water aerobics. On the home front, consider rubbing castor oil on your painful joints. Some of my readers have found success by using purple grape juice and liquid pectin commonly used to make jam. Simply mix 1 to 2 tablespoons of pectin in 8 ounces of grape juice, and drink it once a day.

When all else fails and the pain becomes unbearable, speak with your physician regarding heavy-duty pain medication or surgery. Your personal physician knows your complete medical history and can help you make the determination as to whether you are well enough to consider such a step. Many hospitals also have occupational therapists, who can evaluate the situation and offer suggestions.

To provide related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

For some dumb reason, I stopped taking it, and last year I had another strange episode: This time, it was strong pains in my breasts. It felt as though I was lactating, but I knew I could not be. Again, I had many doctor visits and also underwent a sophisticated mammogram. I was told I had fibromyalgia, because I also had aches and muscle pains. I disagreed with the diagnosis and began researching on my own.

We had gotten a new dog four months earlier, and, after talking to friends, I decided to stay away from the dog. Sure enough, I began feeling better. Then I told my boss at work, a female, about the strange breast pain, and she immediately told me that I must be allergic to the dog because her little boy had similar reactions to his new dog. His underarms swelled up painfully. I was elated to solve this!

We returned the dog to the shelter, and I was immediately tested for allergies. I was allergic to cats and dogs, not to mention many grasses, molds, trees and house dust. I will never stop taking my daily antihistamine, and I have been feeling great ever since restarting it.

DEAR READER: I have printed your letter because I find it interesting that you say you have joint, muscle and breast pain due to allergies.

Most allergies cause itchy, watery, red eyes; a runny nose and/or congestion; coughing, wheezing or other asthma-like symptoms; skin rashes, hives or swelling. The type of symptoms experienced depends on the allergen and how you came into contact with it. Pet dander, for example, is typically inhaled, so skin manifestations, while possible, are not generally seen.

I am unable to find any reliable scientific evidence that shows that any allergen, let alone pet dander, can cause joint, muscle or breast pain. I was able to find personal testimonies that claimed these symptoms due to allergies, but there is nothing to substantiate the claims. Perhaps this is something that should be further investigated by the medical and scientific communities.

I am not in any way dismissing your claims. I am simply stating that at this point there is no hard evidence to back up the claims. The fact that you have experienced relief by taking a daily antihistamine is compelling nonetheless.

To provide related information, I am sending you a copy of my Health Report “Allergies.” Other readers who would like a copy should send a self-addressed stamped envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

When I ask him if he warmed up before playing, he demonstrates his stretching routine by whipping his upper body back and forth. Clearly, this routine isn’t working.

Golfers exert a huge amount of effort, repetitively pounding on specific joints (usually on one side of the body). Among other ailments, this can lead to “golfer’s elbow.”

Warming up your joints is essential. Slow stretching lubricates the joints and warms the muscles surrounding them, to prevent tearing of ligaments, tendons, and other soft tissues.

To prevent injury, golfers should do exercises to strengthen the muscles supporting the joints used in golfing. That means they should do exercises to strengthen their shoulders, arms, wrists, legs, knees, ankles, abdominals and low back.

Many of our clients are golfers who compete in weekend tournaments without any preparation — and then wonder why, at the end of two grueling days, they are so sore they can barely move.

Golfers should straighten up, too. Good posture is key to achieving a great golf swing, and it is important to spinal health.

Golf also requires spinal flexibility, so try some yoga. You might be surprised at the improvements they bring to your game.

And if you still have pain after you play, visit a chiropractor. Chiropractors have extensive training in the biomechanics of human movement, so if after playing you feel pain in specific joints or muscles, you probably need those joints adjusted.

People don’t normally think of chiropractic for elbows and knees, but chiropractic is very effective in mobilizing smaller joints and relieving pain.

Your chiropractor can not only treat those repetitive stress injuries but can possibly redirect your swing pattern, improving your game while getting you out of pain.

Monica S. Nowak, DC
The Chiropractic Center of Canaan
Monica Nowak, DC and Peter Markowicz, DC
176 Ashley Falls Road
Canaan, CT 06018
860-824-0748

Last year I went to a different rheumatologist in a different state because of knee pain no one could explain. Again, the doctor did the same thing. I was so shocked I could barely talk. I walked out of his office after he left me feeling angry.

I live in a rural area where doctors are limited. How do I talk to doctors that put me down like that? Both were average looking and not anything special. So where do they get off putting a patient down? I see other people on the street who can barely walk that are far worse off than me in that department.

Thank you for your time on this matter.

DEAR READER: Bow legs were not your choice. They either developed physiologically or pathologically. Generally speaking, physiologic bowing improves without treatment as a child grows. Unless treatment is given, pathologic bowing, which is due to a disease process, tends to worsen as a child grows.

Most babies are born with bowed legs because of the way an infant is curled up during the nine months a woman carries it. By about 18 months of age, the bowing self-corrects. By the age of 3 or 4, a knock-kneed alignment occurs. This, in most instances, corrects to some degree by the age of 5 or 6. There are occasions, however, when the bowing never fully corrects, and this is the reason some adults have bowed legs.

A number of diseases can cause pathologic bowing, with two of the more common ones being rickets and Blount’s disease.

Rickets results from a dietary deficiency of vitamin D, calcium and phosphorus. This is relatively uncommon in the United States because of vitamin supplements and diet but is still seen in less developed countries. It should be noted that even with a normal intake of vitamin D, a breakdown in the mechanism that uses vitamin D in the body can cause a rickets syndrome. The disorder causes cupping and widening of the growth plates that can be identified on a simple X-ray. Symptoms include bow legs and knock knees, swelling at the ends and sides of the bones, muscle pain, curvature of the spine, enlarged liver and spleen and a host of other conditions.

Blount’s affects the inner edge of the upper shin bone at the knee growth plate. It runs across the knee, causing a decrease in the growth plate closest to the leg’s inner side or inseam. The outside portion of the growth plate grows normally, which leads to bowing. The disease affects infants and teens. Both groups have a similarity in that the children are overweight for their age. The deformity is always tied with an inward direction of the foot and ankle. If detected early enough, braces can help. Diagnosis, as with rickets, can be made by X-ray, but simple positioning of the foot, not the knee, is critical for proper diagnosis.

Now, on to your less-than-professional medical contacts. I have no idea how bowed your legs are, but there is simply no excuse for such shenanigans by a physician, whether at Mayo Clinic or the walk-in clinic on the corner in a small town. You were treated poorly. You cannot do anything about the inadequacies of such uncaring, bumbling individuals. If it ever happens again, simply inform him or her that you did not leave a side show to provide entertainment for the viewer: You expected to be treated with dignity. No matter how hard this might be, toughen up and don’t let another person get the upper hand. Were it me, I certainly would never expect to see a bill for services rendered. Laughter should be free and enjoyed by everyone involved.

Request a referral to an orthopedic specialist and get the answers you should have received 10 years ago. Good luck, and remember — hang tough! You can do this.

To provide related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

In 1955, at the age of 2, I contracted polio. I was immediately put in isolation in a children’s hospital, where I remained for several weeks in casts and braces. My left leg was drastically crooked and atrophied in a short amount of time.

I have since overcome most of the setbacks, but in 1985, I was diagnosed with post-polio syndrome. It was like a recrippling and decay of all my energy. Since then, I have gotten progressively worse. I have educated myself by reading much material, visiting polio clinics and attending support groups, so I feel quite knowledgeable on the subject.

My mother and sister now claim they too suffered from polio and have PPS. They were never hospitalized, never had any visible signs, and had no lingering fevers from initial exposure. They have gone for almost 50 years not claiming this. Now, as they age, they want sympathy for their “supposed” polio devastation, and I am furious. They’re claiming I’m not compassionate and think I want the “glory” all to myself.

My dad and older sister never claimed the illness, so how could anyone even want to make such an unsubstantiated claim? Is the theory possible, even without visible signs? My goodness, I would never wish this crooked body and pain-filled life on anyone. It doesn’t make sense to me. I know the entire family did have a fever in 1955, but the germ passed through everyone as diarrhea. My mother now has arthritis, and my sister has bad feet. Do they really have a claim?

DEAR READER: The polio virus can be transmitted through contaminated food or water, or through direct contact with a person infected with the virus. So anyone in close proximity to you at the time you contracted it could have also become infected. And large majorities of people are never aware they’ve become infected, because some people develop a nonparalytic form of the disease. They might experience initial symptoms of fatigue, muscle spasms, meningitis, fever, sore throat and more that can last up to 10 days.

As you are aware, PPS can develop decades after the diagnosis has been made. It can be characterized by a weakening of muscles previously affected and in muscles that were not previously affected. Some patients may develop mild symptoms; others may suffer from joint degeneration, scoliosis and more.

A diagnosis of PPS is made only if certain criteria are met. This includes documented evidence of a positive diagnosis of paralytic polio followed by an extended period (typically 15 years or more) of improvement or stability. Symptoms must begin gradually but be progressive and persistent, lasting for at least one year. Other possible causes need to be ruled out before a diagnosis of PPS can be given.

There are several risk factors for developing PPS. These include experiencing severe symptoms following the initial infection; if the initial infection were acquired as an adolescent or adult; achieving drastic recovery (especially following severe symptoms); and performing physical activities to the point of exhaustion or fatigue.

Once diagnosed with post-polio syndrome, people should be monitored for complications. Severe muscle weakness may result in increased falls. Prolonged inactivity and immobility also increase the risk of developing osteoporosis. Combined with the risk of falling, broken bones may become a major concern. People with weakness of the muscles involved in chewing, swallowing and breathing also need to be especially watchful for signs and symptoms of malnutrition, dehydration, pneumonia and acute respiratory failure. People who experienced weakness of these muscles during the initial infection are more likely to experience these symptoms than those who developed weakness of the arms and/or legs.

You appear to be in a no-win situation. Your mother and sister are convinced they suffer from PPS, and unless they are willing to undergo confirmatory testing, you will likely never convince them otherwise. I don’t know their medical histories, but based on your information, it does not seem likely that they had polio. Even if they did, it was likely so mild that it caused few or no symptoms. This drastically decreases their risks of developing PPS. I don’t understand their comments that you are seeking all the “glory” in regards to your polio status. There is nothing glorious about living with deformity and pain. Both arthritis and foot pain have other, more common causes.

I believe your efforts will be better spent continuing with the positive attitude you are exhibiting, staying abreast of new treatments, attending support groups, and visiting clinics where you can help victims of the disease learn to cope.

When I arrived in this country at the age of 28, I started taking cod-liver oil regularly with breakfast every single day. When a nephew of mine from Norway visited some time ago, I asked him what he thought of the value of cod-liver oil. Arthritis was his specialty, and he thought it was useful against rheumatoid problems. He said it works painlessly, almost like oiling a joint.

I have basically no signs of pain anyplace in my body, except I fell off a roof and broke my leg when I was 78. That hurt! I still swim one lap over one-quarter mile once a week and keep telling my relatives in Norway I think I’ll swim a kilometer some day and get my name in the paper. I could do it. I don’t remember the last time I had a cold or was ill for any reason. I never have to get up in the night.

The last time I went to see my physician for a regular checkup, he had another doctor examine me. Afterward when they reviewed my lab results, my doctor said they were incredible and that he thought maybe he should eat the way I do. Part of my health is no doubt due to my genes, but I believe it is also due to the fact that I, especially during the last 20 to 25 years, have begun realizing that our bodies are made up of everything we eat. In order to stay healthy, we ought to consume a great variety of foods and include cod-liver oil.

DEAR READER: What can I say? As I have written in the past, it was common in my generation for parents to force their children to take cod-liver oil, which was thought to be healthful. Today, it is known to be. It is a good source of omega-3, vitamins A and D, and essential fatty acids EPA and DHA. These fatty acids appear to provide resistance to illnesses such as the common cold and influenza. Omega-3 fatty acids are a form of polyunsaturated fats the body derives from food. Because the body cannot produce fatty acids, they must be obtained through the foods we eat or supplements we take. Studies are limited and inconclusive but suggest this addition may be beneficial for cardiac conditions, eczema, behavioral disorders, inflammatory disorders such as arthritis and more. The jury is still out as to whether it can actually lower cholesterol levels. Cod liver acts as a natural anticoagulant, so if readers choose to add the supplement, I suggest they run it past their primary-care physician before doing so. The Food and Drug Administration has not approved it, but there is little harm (and perhaps a great deal of good) in adding cod-liver oil to the diet. Heaven knows you appear to be a walking, talking testimonial to this theory.

To provide related information, I am sending you a copy of my Health Report “Vitamins and Minerals.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: The spine is made up of bones called vertebrae. A disc that contains a soft, jelly-like inner layer cushions each vertebra. The discs in our backs can be compared with shock absorbers on a car. During activity, they absorb jarring and movements while allowing you to bend and flex in a variety of positions.

As we age, the normal wear and tear on these “shock absorbers” is known as disc degeneration. The discs may lose some of their water content, making them less capable of performing as effectively as they did before. The result is pain, numbness, weakness and the inability to function effectively. Risk factors other than age include height, excess body weight, a history of smoking and physical activity. Men taller than 5 feet 11 inches and women taller than 5 feet 7 inches have an increased risk for developing disc disease. The additional weight some people carry puts more stress on discs. A history of smoking decreases oxygen levels in the blood and deprives the body of necessary nutrients. Finally, activity such as frequent heavy lifting, sitting for hours at a time at work, or playing high-impact sports can cause problems.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or topical creams might relieve some symptoms. If you are a runner or enjoy high-impact activity, consider making a change to something less strenuous. Cold compresses should work to reduce inflammation initially. Following that, consider using heat. Conservative treatment can include water aerobics, gentle yoga, tai chi, acupuncture, massage and physical therapy. Exercise in moderation is endorsed. Bed rest may be necessary for a day or two; however, inactivity isn’t always a good thing. Too much rest will result in a loss of muscle strength, which will make symptoms worse and delay recovery.

Osteoarthritis affects almost everyone as we age. It is a joint disease caused by the breakdown of cartilage, commonly occurring in the hips, knees, feet and spine. Healthy cartilage is smooth, flexible and elastic, allowing for easy movement. With osteoarthritis, the surface of the cartilage softens, frays and cracks. With continued breakdown, the ends of bones thicken and form spurs at points where ligaments attach to bone.

Again, normal wear and tear of the joints over time is to blame. Treatment is aimed at controlling pain, preventing joint deformity and, most importantly, maintaining movement. NSAIDs might be taken for relief of symptoms. Rest, protection of the affected joint(s), yoga, water aerobics and physical therapy might be endorsed. Exercise is vital to maintain movement. Beyond that, your physician or orthopedic specialist should be consulted to determine the next step.

I don’t know what your other medical conditions are, but I suggest you speak with the prescriber(s) regarding discontinuing some of your prescription drugs. Then ask about replacing some of your supplements with a good daily vitamin supplement.

To provide related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.