A few years ago, I suddenly got severe muscle pains in my shoulders and arms. My doctor could only advise cortisone shots which I declined. Shortly after, I went to visit a relative who lives in Germany who has suffered from terrible rheumatism all his life. I had visited because he was about to be released from the hospital after a heart problem. While helping him get ready to leave, I noticed his discharge instructions at the foot of his bed. His doctor had written that he needed to avoid peas, beans and lentils.

I remembered that, in months before, I had really indulged in these legumes which I love and are supposed to be very healthful. After that I stayed away from them and within a few weeks all the pain in my arms and shoulders disappeared. I have not had a problem in years.

Now to the best part: proof that these edibles caused my problem! A short while ago I thought it would have some lentil soup. Two days later I had pain in my shoulders! I have not had peas, beans or lentils again and the pain went away again.

I hope this may benefit some of your readers.

DEAR READER:
I am unaware of any information about peas, beans and lentils causing joint and muscle pain. However, you appear to have found the source of your pain in these healthful legumes. I suggest you speak to your physician about this potential link.

That being said, most authorities encourage diets that contain peas, beans and lentils. They play an important role in achieving adequate protein consumption in vegetarian and vegan diets.

To the best of my knowledge, the worst that these legumes can cause is abdominal pain due to increased gas pressure. That is why most people find it easier to handle small quantities at a time which can then be slowly increased. Beano is also helpful in preventing painful gas due to increased legume and fiber intake.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Sadly, you are probably a pro when it comes to recognizing the symptoms of a trigger finger. However, I will bring my reading audience up to speed before I answer your question.

Trigger finger is a condition in which any finger joint catches in a bent position (partial dislocation). An individual might be able to straighten the finger with a gun’s trigger-like motion and snap it back into proper position; thus the name. More severe cases might lock the bent finger and an individual will be unable to straighten it. More than one finger can be affected at the same time and both hands can become involved.

Common causes are repetitive motion of the fingers of the dominant hand that occur at work, during sports, or with some hobbies.

While I cannot state you won’t have additional symptoms, there are several steps you can take toward that hopeful goal. Soak your hand or hands in warm water. Stretch the fingers of one hand and massage the palm and each digit with your opposite hand. Repeat the same process with the opposite hand. While you sit in front of the television in the evening, apply gentle massage to each hand for several minutes.

Avoid repetitive gripping whenever possible. If necessary, break up the routine with different hand exercises between the repetitions and take periodic rest periods.

Use over-the-counter drugs such as Advil, Aleve, or Motrin for minor pain symptoms.

If more severe problems occur, seek the services of your physician. You are no stranger to steroids such as cortisone injections, but apparently they don’t provide relief, so let’s bypass that option.

Trigger finger release can be performed under local anesthesia. I don’t know if you have had this performed, but you might choose to speak with your physician about the possibility.

A final resort is surgery under anesthesia for tendon release, a procedure you have apparently already undergone.

I urge you to get into a stretching exercise routine as a preventive measure. Start gently and work slowly.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Over the next few months, they would come back occasionally in my face and head for up to a week, only to disappear again. I would describe the feeling as electrical currents running though my face and head and numbness in my nose and lips.

I went to see my primary care physician who sent me to a neurologist. He checked my reflexes, examined my gait and sent me home. Several weeks later, I went to a different neurologist who ordered X-rays and an MRI of my head and neck. Because of some disc misalignment I was given exercises to do. This helped but I continued to have problems, now in my lower back, down into my buttocks and legs.

My sleep is affected because I have muscle spasms that run from my back, around to my stomach, and down both legs into my feet. When I wake up I feel as though I have run a marathon. It used to only be occasionally but now it seems like it happens every night and has progressed to the point where I requested a prescription sleep aid because I couldn’t sleep at all. I don’t like taking medication but not sleeping is worse than taking too many pills.

I was referred for physical therapy but quit after three weeks because there was no significant change in my situation. Now I am frustrated and depressed because no one can tell me what is causing these symptoms and how to make them stop.

I am currently waiting to see the neurologist again. He ordered X-rays of my thoracic and lumbar spine which showed normal but not significant degeneration, mild to moderate spurring and mild scoliosis. I assume the next step will be to have an MRI of these areas.

I don’t know what else to do. The pain is not extreme or debilitating but when the muscle spasms start, sleeping, standing and walking become challenging, if not impossible. My coordination is also suffering because my leg muscles have become so stressed.

DEAR READER:
Your symptoms suggest to me that you have a pinched, compressed or damaged nerve somewhere in your back. Given the numbness, tingling and spasms are confined to your lower back, buttocks and legs, I would venture to guess the problem lies somewhere near your sciatic nerve.

Sciatica usually affects only one leg but on occasion can affect both. Your X-rays have shown only mild degenerative changes but this does not mean serious damage isn’t occurring because of them. If a disc slips a fraction of a millimeter in the wrong direction, it can create tremendous pain and debilitating symptoms.

I understand this is a difficult situation but I urge you to follow your neurologist’s advice. In the meantime I recommend you try low-impact exercise and stretching in an attempt to strengthen your back muscles. Stronger muscles can hold the discs and vertebrae in a better alignment. Perhaps chiropractic manipulation, acupressure or acupuncture might help.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Peripheral neuropathy causes pain, numbness, tingling, or burning of the extremities. It can result from infection, exposure to heavy metals or other toxins, infection, metabolic disorders, and more. Symptoms vary from person to person, depending on the types of nerves affected. Those with alcoholism, vitamin deficiencies, diabetes, rheumatoid arthritis, thyroid, kidney, liver or specific autoimmune disorders are at high risk for the condition. I cannot determine from your letter what caused your problem; nevertheless, the point now is to improve your quality of life.

There are a number of treatments available. For mild cases, over-the-counter pain relievers or the application of medicated chest rub to the affected areas may be all that is needed. For more severe cases, prescription antiseizure medications, such as Neurontin, or pain patches, like Lidocain, may used. If these steps fail to provide improvement, seek out a pain specialist or visit a pain clinic.

I don’t expect you to be pain-free at the age of 90, but your neurologist should be able to keep you more comfortable than you are. Pursue the issue and don’t stop until you are satisfied with the progress. Good luck.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Despite regular yoga, chiropractic care and massage, I wake up stiff and uncomfortable. It lasts all day. The left side of my back from my shoulder to the mid-back is also noticeably more developed or pronounced than the right side. A few years ago, a physician diagnosed me as having notalgia paresthetica.

What are your thoughts on this situation? Where should I go from here?

DEAR READER:
Notalgia paresthetica is defined as a chronic, localized itch that usually affects patches of skin on the upper back. It can occasionally affect the shoulders, upper chest and other portions of the back.

Symptoms include itching, tingling, prickling, and/or numbness, usually on one side of the back. The cause is unknown, but is thought to be the result of nerve damage.

Upon presentation to a physician, the affected areas are often hyper-pigmented (darkened), scratch marks are present and in some cases, scarring is also due to chronic scratching. Little treatment is available but some physicians have had success using topical capsaicin or certain types of botox.

That being said, this condition sounds nothing like what you are experiencing. I recommend you speak to your primary care physician or an orthopedic specialist. You may need imaging studies of your neck, back and hips (to get a full view of your entire spine).

Your back pain may be the result of a herniated disc, degenerative changes in the spine or more. You have taken appropriate steps by seeing a chiropractor, massage therapist and keeping physically fit and limber with stretching exercises. However, with little or no results to show, it is now time to move on to more aggressive testing and diagnosis.

In the meantime, I suggest you try using over-the-counter pain relievers such as acetaminophen or ibuprofen. Hot and cold packs may also be of benefit.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I am a cancer survivor and have suffered with this condition for more than eight years. I have severe burning, tingling and pain in my feet due to chemotherapy. Then a few years ago my sister-in-law came across an article about neuropathy in a magazine. The article talked about a new treatment called Anodyne therapy.

After doing some research, I decided I had nothing to lose and gave it a try. I had a total of 16 treatments at a local outpatient therapy center. After only six treatments, the pain in my feet was much better. The throbbing and burning were totally gone.

I have closed a copy of the company’s brochure for your interest. For your readers who want to know more, I suggest they go online to www.anodynetherapy.com or call 1-800-521-6664.

Apparently the testing of this treatment was done on people with diabetes, but let me tell you it worked for me and I do not have diabetes. I guess that neuropathy is neuropathy, regardless of the cause. I have been pain free for more than a year now. Before this treatment, my neuropathy was so severe I nearly required a wheelchair.

My primary care doctor and oncologist had not heard of this treatment but after showing them some information about it, they both gave me their approvals. Medicare paid for nearly all the cost. I hope that you feel this letter is worthy to print your column as I am sure it will help many neuropathy sufferers out there.

DEAR READER:
I have not had any experience with this treatment, nor had I ever heard of it before you letter. However, your story is very compelling, as is the brochure you kindly included.

Neuropathy has many causes, the most common being diabetes and cancer treatments. Trauma, infection, exposure to toxins and metabolic conditions can also be causes.

Irreparable damage occurs to nerves which lead to burning, tingling, numbness and pain. The most common areas where this condition occurs are on the bottoms of the feet but as it progresses, the tops of the feet, ankles and lower legs may become affected. It can also affect the fingers and hands.

Most physicians refer patients to a neurologist who can perform testing to determine the extent of the damage. Once the severity is known, treatment can begin. This will also depend on the cause. Treatment must also include treatment of any possible underlying condition. Generally, this stops or slows the progression of the neuropathy. For those with no known cause (idiopathic) or those have untreatable causes, such as side effects from cancer treatment, there are several medications available.

Mild cases may be relived with the use of over-the-counter pain relievers such as ibuprofen. The most common side effects include stomach upset but most have no adverse reactions.

Moderate to severe cases may require prescription medication such as non-steroidal anti-inflammatory or narcotics. Lidocaine patches (a type of pain reliever) can be applied directly to affected areas up to three times a day. Narcotics can cause dependency and other serious side effects which limit their use. Lidocaine patches have very few side effects, the most common being rash at the site of application.

Anti-seizure medications such as Neurontin (gabapentin), Lyrica (pregnable) or Tegretol (carbamazepine) can provide relief for many sufferers. Side effects can include drowsiness and dizziness.

A final option is antidepressants. Tricyclic antidepressants can often provide relief by interrupting chemical processes in the brain and spinal cord that cause one to feel pain. Cymbalta, another type of antidepressant, has also shown positive results in treating neuropathy caused by diabetes.

Alternative treatments can include heat and/or massage therapy. Some sufferers have had success with acupuncture and still others with unconventional methods such as a thin application of medicated chest rub to the areas.

There are certain steps that individuals at risk for developing this condition can take to reduce or prevent it from occurring. Any medical condition that can cause nerve damage must be under strict control. A healthful diet rich is whole grains, lean meats, fruits and veggies can also be helpful.

As for Anodyne therapy, I can only say that it sounds intriguing. I urge interested patients to speak with their primary care physician or neurologist. If they have not heard of it, go online or call to request more information for their review.

To give you related information, I am sending you copies of my Health Reports “Managing Chronic Pain”, “Compelling Home Remedies” and “More Compelling Home Remedies”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Is there any way to treat her pain and weakness?

DEAR READER:
Your mother certain has some serious health conditions that would likely disqualify her for surgery because of the high risk of complications. That being said, there are still several treatment options she hasn’t tried.

A herniated disc is often difficult to treat and can be quite disabling for some. This is a condition in which one or more of the intervertebral discs of the spine become maligned. When this occurs, the disc often pushes on sensitive nerves in the spinal cord leading to pain, leg and lower extremity weakness, fecal and/or urinary incontinence and more. Most suffers respond well to physical therapy that increases back muscle strength which then holds the discs in proper alignment. When this fails to provide adequate relief, physicians move on to prescription pain medications, steroids (to reduce inflammation), pain clinics and even surgery to surgically replace or remove the disc(s).

Chiropractic manipulation is also a viable choice. While many physicians do not recommend this or even consider chiropractors part of the medical community, I believe chiropractors can be extremely helpful for certain conditions. These specialists can physically manipulate the muscles, discs and vertebrae of the spine which can, over time, allow a disc to return to its normal location. It may take several weeks or months before results are noticeable, but for many, relief can be experienced within just a few visits.

Exercise is important to keep the muscles strengthened and well-toned. Water aerobics and strength-building classes under the close supervision of her instructors may help because of the ease of performing in water.

Other options include acupressure or acupuncture. If pursuing this option, I recommend doing your homework. It is important to find an experienced, certified individual who uses clean, sterile instruments.

Relaxation techniques such as deep breathing exercises or yoga may help. Even simple Pilate’s exercises could improve her muscle function.

And finally, a pain clinic may be useful. In this instance, doctors, nurses, and other medical professionals work with individuals who suffer from chronic pain in order to find the best treatments. Hospital-run programs are your best bet for getting a wide variety of choices and disciplines.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

My doctor did not give me any medication except Indocin for pain. My chest and back hurt and I am extremely tired. I have not had any trauma or viral respiratory infections recently, have never smoked, nor did I go near people that smoke.

X-rays were taken and my doctor said my lungs are clear. I have had no surgeries and hope never to have any. I take vitamins, exercise and try to maintain a healthy life. The doctor said it could last as long as three weeks.

Please give me your thoughts on this illness. I had never heard of it before but it is painful and could make one think of a heart attack about to happen.

DEAR READER:
Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone, resulting in sharp pain. When accompanied by swelling, the condition is known as Tietze syndrome. One or more rib cartilages can be involved and can cause severe pain that may radiate to the neck, shoulder or arm, mimicking the pain of a heart attack. Injury, infection and fibromyalgia are common causes; however, in some instances there is no apparent cause.

Your physician obviously scheduled an X-ray to rule out other conditions, since costochondritis cannot be seen through any imaging test. In fact, it is diagnosed through history, examination and hands-on palpation over the area. It differs from a cardiac-related condition in that the pain from an attack is more widespread, while this pain is focused in a much smaller area.

I am sure you were disappointed when your physician only prescribed Indocin. In actuality, his hands were somewhat tied. Pain relief is obtained through non-steroidal anti-inflammatory drugs, muscle relaxants and, in some cases, anti-depressants. Rest, heat and moderate exercise that doesn’t aggravate the condition will also be beneficial. You do not have a contagious condition. It most often subsides in about two weeks. Obviously, you are beyond that time frame and are still experiencing pain. If your swimming involves stretching your arms out in front of you, modify your strokes to allow healing to occur.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Adhesive capsulitis is commonly known as a “frozen shoulder”. The shoulder itself is a ball and socket joint, held intact with tough connective tissue. Frozen shoulder occurs when the shoulder capsule becomes inflamed and stiff and the shoulder bones are unable to move freely within the joint. In turn, this results in limited range of motion and pain, making even simple tasks next to impossible.

There are a number of reasons for the condition to occur, such as prolonged immobilization, diabetes, hyperthyroidism, open heart surgery, and advanced age. Or, there may be a decrease in the amount of synovial fluid around the joint. This sticky fluid resembles the white of an egg and provides lubrication for joints, tendons and bursa.

Diagnosis is made primarily through a patient’s history and examination. An MRI may reveal widespread inflammation, but no specific indications of a frozen shoulder will appear.

Initial treatment is generally with over-the-counter non-steroidal anti-inflammatories (NSAIDs) such as acetaminophen or ibuprofen. This is often followed with physical therapy, hot and/or cold treatments, prescription corticosteroids, arthroscopy, shoulder manipulation, and electronic stimulation.

It appears you have run the gamut of treatment, right down to manipulation performed under anesthesia. During the process, your physician should have worked the shoulder joint through repeated movement to release any scar tissue present. The arthroscopy was performed in an effort to cut tightened ligaments and also to remove scar tissue.

There’s not much left I can recommend, but here goes. Request a second opinion from an orthopedic specialist at a teaching hospital. Bring along your reports and any relevant information for his or her review. Get an opinion on acupuncture that has helped some individuals and ask for other possible solutions. Good luck.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Everyday I run into people that notice when I limp or move slowly in pain and ask what’s wrong. I inform them I have rheumatoid arthritis and before I can finish my sentence they are telling me how they have the same thing and start telling me how bad it is in their knee, etc.

When I question them, I realize they have normal aging and osteoarthritis. People do not understand RA patients and the difference because both have arthritis in the name.

Please dedicate one column to this subject. Your column will help educate the public as it has helped educate me on so many disorders.

DEAR READER:
I will gladly take your request because you make an excellent point; many people are not aware that there are several types of arthritis. I will start with typical age-related osteoarthritis.

Osteoarthritis is the result when the lining of joints begins to wear out. The most common cause of this is the aging process but athletes, landscapers and manual laborers also are prone to developing this condition earlier in age because of the constant wear and tear on their joints.

As the lining wears away, pain and stiffness develop because there is no longer a cushion to protect the sensitive nerves, muscle and bones. Osteoarthritis commonly develops in the knees, hips, wrists and hands as these areas are the most used in everyday activities.

Treatment consists of over-the-counter medications such as, acetaminophen and ibuprofen, hot or cold packs, menthol or capsaicin rubs, and topical castor oil. Low-impact exercise such as walking, water aerobics and swimming are also beneficial. Alternative treatments include glucosamine and chondroitin supplements, MSM and others may provide relief to some sufferers.

If symptoms become severe and interfere with daily activity, joint replacement may be an option. Commonly replaced joints are knees, hips and shoulders. This drastic measure is usually reserved for individuals who are affected at a younger age or lead an active life.

Rheumatoid arthritis on the other hand is not the result of age-related deterioration, rather it is caused by the bodies’ own defenses. Mild cases can last from a few months to a year or two while severe cases can last for several years or even a lifetime and lead to serious joint damage. Others may have repeated flare ups followed by periods of remission.

The most common symptoms include joint pain, swelling and stiffness. Some may experience fatigue, fever, weight loss, firm bumps of tissue under the skin on the arms, red, puffy hands and joint tenderness. Symptoms generally appear in small joints such as the wrists, hands, ankles and feet first. Over time the knees, hips, jaw, shoulders, neck and elbows may become effected.

Rheumatoid arthritis is caused by the body’s white blood cells (infection fighters) when they move from the blood stream to the membranes that around the joints (synovium). They then appear to cause the synovium to become inflamed which releases proteins that, if untreated, leads to thickening of the membrane. Cartilage, bone, ligaments, and tendons can also become affected which, over time, leads to malignment of the joint and the bone to lose its proper shape.

Doctors do not know what causes this process to start but suspect it may be the result of a combination of factors such as lifestyle choices, genetics, and environment. Risk factors include smoking, family history, age, and gender. Rheumatoid arthritis commonly affects women between the ages of 40 and 60. It is not thought that RA is passed from one parent to the child but that a predisposition to the disorder is passed down.

There is no cure for RA but several treatments are available. Ibuprofen and naproxen sodium are helpful in reducing inflammation in mild cases and are available over-the-counter or in stronger doses as prescriptions. Some individuals may need temporary treatment with steroids. Other medications include disease-modifying antirheumatic drugs (to limit joint damage), immunosuppressants (to bring the immune system under control), TNF-alpha inhibitors (to block the inflammatory agent associated with RA) and anakinra (to stop a chemical signal from causing inflammation).

Both osteo- and rheumatoid arthritis can be diagnosed and treated by a general practitioner or internist. Rheumatoid sufferers, however, should also be seen by a rheumatologist who specializes in disorders of the joints and bones. Only severe or disabling symptoms caused by osteoarthritis may require the assistance of this type of specialist.

In summary, osteoarthritis is a common, age-related deterioration of the joints. Rheumatoid arthritis is caused by an auto-immune response and can occur in anyone at any age.

To give you related information, I am sending you copies of my Health Report “Understanding Osteoarthritis” and “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).