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.

Would it hurt to try and do light exercise? Is it better to wait until the inflammation and pain go away? With proper treatment, how long do you think it will take to heal?

Would an MRI test on both shoulders help to determine how much inflammation is present and whether there are any muscle tears in the shoulder joints? I would appreciate any insight and information you can provide.

DEAR READER: Bursitis and tendinitis are common conditions that cause inflammation of the soft tissue around muscles and bones of the shoulders, elbows, hips, knees, ankles or wrists.

A bursa is a cushioning, fluid-filled sac located between bones, muscles, tendons or skin. Bursitis occurs when a bursa becomes inflamed. Bursitis is often caused by trauma or overuse.

A tendon is a flexible band of fibrous tissue that connects muscle to bone. Tendinitis is inflammation of a tendon that commonly occurs with the repetition of an act such as weightlifting, swinging a hammer, golfing, playing tennis or a musical instrument or other activities that place stress on joints.

There are two types of tendinitis that can affect the shoulder. Biceps tendinitis results in pain in the front or side of the shoulder. That pain may radiate to the elbow or forearm. Rotator-cuff tendinitis may result in shoulder pain at the upper outer arm and tip of the shoulder. Pain can be worsened by raising the arm above shoulder level or by lying on the affected side. Activity such as weightlifting can cause irritation to the bursa or rotator cuff and could lead to inflammation and impingement.

Diagnosis can be made through medical history and examination. Physicians and/or therapists might use manual testing known as selective tissue tension to determine which tendon is involved. X-rays might be helpful in ruling out problems with arthritis or bone but will not reveal tendons and bursae. Magnetic resonance imaging (MRI) should confirm or deny any tear and its extent. An anesthetic-injection test could also confirm the diagnosis of tendinitis. During this test, lidocaine hydrochloride is injected into the painful area. If the pain is relieved temporarily, the diagnosis is confirmed.

Treatment is directed toward healing the injured bursa or tendon.

Mild symptoms are commonly relieved with rest, elevation of the affected joint and over-the-counter medications such as ibuprofen or naproxen. Ice is often used following an initial injury for up to five days but isn’t generally helpful for chronic cases of either disorder. Corticosteroid injections may be given for control but should be used with caution because they can lead to weakening or rupture of tendons, primarily those that bear weight, such as the knees and ankles. In cases where bursitis is caused by infection, antibiotics will likely be ordered. Controlled, limited exercise or physical therapy can be performed prior to complete healing. When all else fails, surgery may be necessary.

To provide 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 No. 10 envelope and a $2 check or money order made 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.

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.

My ANA test for three years has come back normal, but I continue to get lesions, my hair falls out, and I get sick easily. I have been to two rheumatologists. Both say I do not have SLE, but my family doctor feels I do. What do you think?

I was also told that because I only have discoid lupus, this would not cause any health problems other than with my skin and hair. So why do I have it in my nose and inside both ears? I’m now 33, my bones are brittle, and I have osteoarthritis in my hands and fingers. Help!

DEAR READER: Whew, where to start? Some children have impaired immune systems, making them subject to numerous disorders. My guess is that you were unfortunate enough to fall into that category.

There are a number of forms of lupus, which is an autoimmune disease. Lupus can affect joints, skin, kidneys, brain, heart, lungs and other parts of the body. Common symptoms include skin rash, kidney problems, arthritis and unexplained fever.

Discoid lupus is a chronic skin disorder that shows as a raised red rash that ordinarily appears on the face and scalp but can appear in other areas of the body, including the nose and ears. The lesions may last for days or years and can recur. Some people diagnosed with discoid lupus may develop systemic lupus erythematosus (SLE) at a later date.

Because arthritis is a common complaint, it’s not at all surprising that you have been diagnosed with fibromyalgia, chronic pain in muscles and ligaments.

Pleurisy is swelling of the lung linings that causes pain and breathlessness during inhalation and exhalation. Causes include acute viral infections, such as influenza, and can be the result of autoimmune disorders, such as lupus.

Kidney stones and related infections have numerous causes, including dehydration, obesity, genetic factors and a diet high in protein/sugar/sodium.

Vertigo can be caused by an inner-ear disorder, migraine headache, acoustic neuroma and other causes.
Depression and anxiety can be caused by lupus, fibromyalgia, kidney stones and vertigo. You have a lot on your plate, and it has obviously resulted in a lot of stress. Osteoarthritis, a breakdown of cartilage, causes pain and stiffness of affected joints. The condition is commonly associated with the aging process, but at 33, you are far from old. Treatment is geared toward controlling pain through medication, rest, exercise and protection of the affected joint(s).

Because so many of your symptoms involve pain, I’m inclined to suggest that you be referred to a pain clinic for control or request a referral to a larger diagnostic center, such as the Mayo Clinic. You will learn methods for reducing the level of pain you presently experience that may include water aerobics and yoga. Appropriate medication might be ordered. Once you get that aspect under control, the anxiety and stress levels you are under may be reduced.

To provide related information, I am sending you a copy of my Health Report “Fibromyalgia.” 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.

I am most uncomfortable when I stand still, sit or lie down for any length of time. Using a heating pad several times during the night helps alleviate the muscle cramping, though. I have more pain in my lower back/sacral area, knees and thigh muscles than in the hips themselves. Who is right? Would the cortisone injections really help?

DEAR READER: I must side with the out-of-state specialist. Cortisone injections are often beneficial as one of the initial steps toward relieving the pain of arthritis. A randomized placebo-controlled trial of glucocorticoid injections for osteoarthritis of the hip demonstrated benefits lasting up to three months. Over-the-counter medications such as acetaminophen, ibuprofen or naproxen, topical capsaicin or menthol ointments (especially those made with castor oil), and ice packs or heat may also provide relief. If these options fail to provide satisfactory results, consider physical therapy, low-impact exercise programs or enter a chronic-pain class to learn other ways to manage the pain. A final option for those with severe joint deformity, pain and dysfunction is surgery, such as joint realignment or replacement.
Seek out another local specialist or return to the out-of-state physician for further advice and treatment.

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.

I, too, have had 3 cortisone shots in my hip (no recommendation from my doctor for hip surgery) and so far they only offer temporary relief.

Inasmuch as I did not read your original article about the castor oil rubs and grape juice with pectin, I am very interested in knowing your instructions for such. I realize there is no guarantee that this treatment will help me but I would like to give it a try.

DEAR READER: Castor oil is simply rubbed onto the affected joint or joints twice a day.

To eight ounces of purple grape juice, add 1-2 tablespoons liquid pectin. This mixture can be taken up to 3 times a day until pain is decreased and then reduced to 1 glass per day as a maintenance.

Because of the high reader interest, I have recently written a health report that contains the most popular and effective home remedies.

To give you related information, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.