Case Studies

A study done by the NIH (National Institute of Health) opens new insight in to arthritis and knee pain, government study is 3rd largest of it's kind, 1,583 patients with knee pain due to arthritis received one of the following five treatments: either Glucosamine or Chondroitin, a combination of both, the painkiller Celebrex or placebo. In a subgroup of 354 people with moderate to severe knee pain; 79 percent who took Glucosamine + Chondritin reported relief compared with 54 percent who took the placebo and 69 percent who took Celebrex.

According to the Center for Disease Control and Prevention, a large portion of U.S. adults population did not engage in the minimum recommended level of physical activity in 2003. Nationwide Behavioral Risk Factor Surveillance System shows that between 2001 and 2003 there were no significant changes in the proportion of U.S. adults who engage in the recommended amount of physical activity or in the proportion who don't exercise at all, the CDC said (MMWR 2005;54:1208~12). Responses from 214,500 participants in the 2001 Nationwide Behavioral Risk Factor Surveillance System were compared with those of 264,684 in the 2003 survey.

30 year old Texan male came in for a consultation . Patient complains of left knee pain . His past medical history is remarkable for multiple knee surgeries including an ACL (Anterior Cruciate Ligament) reconstruction, he describes about several years ago while playing soccer he twisted his knee causing a complete tear of ACL and requiring him to have ACL reconstruction. After the surgery he was doing well for 6 months until started having pain again, that was followed by arthroscopy and lateral meniscectomy (medical lingo: the outer part of meniscus was removed).

13 year old Amish male from Arkansas presented to the office today with complaint of pain and swelling in both knees for almost six months. Patient states whenever he runs or plays any sports the knees start to swell and ache. His family history is of significant of an older brother (age 17) who has been treated here for OCD (Osteochondritis Desicans) already. His very eldest brother also complains of knee pain occasionally especially when he walks long distances, which requires him to wear a knee brace (he has not been evaluated for his pain however at any facilities).

Germany - Essen Department of Integrative Medicine, Kliniken Essen-Mitte clinic: a large study targeted for Rheumatoid Arthritis patients showed significant benefits from a 7-day fasting program among patients with various chronic pain conditions including RA, Osteoarthritis, Fibromyalgia, and Migraine headaches. Patients visit the medical center for 10~14 days and undergo a program consisting of lifestyle changes and mind-body medicine. Between 2001 and 2004, there were 2,787 patients who attended the clinic for 3 days or more.

At the annual European congress of rheumatology in Vienna Karel Pavelka, M.D., reported on his last 5 year follow up research study suggesting some merits with use of glucosamine. The use of oral glucosamine by patients with knee osteoarthritis results in a marked reduction in need for knee replacement surgery for at least 5 years after the drug is stopped, He reported on a new 5-year follow-up data from his previously reported double-blind placebo-controlled trial involving 202 patients with knee osteoarthritis randomized to oral glucosamine sulfate at 1,500 mg once daily or placebo for 3 years.

San Francisco: At a recent meeting on osteoporosis, sponsored by the University of California a new study suggests giving patients who had stroke in the past supplements of folate and vitamin B12 may prevent fractures. Steven R. Cummings, M.D. professor of epidemiology and biostatistics at the university and director of clinical research at the California Pacific Medical Center Research Institute announced last month.

Doctors now are thinking twice about writing a prescription for the three cyclooxygenase-2 inhibitors (Vioxx, Celebrex and Bextra) because of concerns over their cardiovascular side effects. The COX-2 inhibitors were developed for patients at high risk for Gastrointestinal or stomach acidity and ulcers as well as other side effects associated with chronic treatment with traditional NSAIDs (Non steroid Anti inflammatory drugs such as Motrin, Naprosyn, Volteran, Lodine, Mobic, Relafen...).

A 17 year old Arkansas male presents complaining of knee pain since the age of 14. Patient states initially diagnosed with growing pains, subsequently an MRI confirmed diagnosis of OCD or Osteochondritis Dissecans. He initially had surgery on the left knee over a year ago followed by arthroscopy and surgery on right knee 2 months ago. The right knee continues to swell and ache him on day to day basis. Past Medical history is unremarkable, Patient was involved with sports activity up to his knee pain started. Patient has been told he may need surgeries and possible total knee replacement in future.

A 36 year old male came in today for evaluation of his left knee. Patient is concerned about preventive care and avoiding future arthritis. He states about 3 years ago while skiing he had a fall. At that time it was very painful and he needed emergency personnel to bring him down the slopes using stretcher. He had an MRI initially that showed partial tear of his ACL (Anterior Cruciate Ligament). Patient had some physical therapy and he was able to get some self healing subsequently.

Great news for advancement of science; California Gov. Arnold Schwarzenegger encourages passage of legislation to promote stem cell research, he is being supported by U.S. Sen. Dianne Feinstein. The event took place at UCLA Neuroscience Research center on the campus in Los Angeles Tuesday, Aug. 23, 2005. Politicians and scientists gathered to recommend the passage of legislation. The legislation would allow human stem cell research to proceed but would ban the cloning of humans.

18 year old Tennis player flew in from Guatemala today, presents with complaint of shoulder pain. Patient states that for the past year her shoulder has been aching and interfering with her game. The onset of pain has been gradual and she states she hears sounds as she raises her shoulder. She states there is no pain as long as she does not move the shoulder. Her past medical history is otherwise unremarkable, she takes no medications.

Professional Basketball player veteran presented to the office complaining of bilateral (medical lingo: both sides) shoulder pain, developing mostly after the last season. Pain and weakness is mostly when he lifts up shoulders sideways to pass the ball. His past medical history is positive for some degenerative joint disease of the knee that the patient received treatment at our center. He is otherwise healthy and takes Glucosamine and dietary supplements. As a player patient recalls falling several times on the shoulders.

PL is a 49 year old male who initially damaged his right knee playing Football in his youth. Patient initially was seen in our office on February of 2003. At that point he was told he needs a total knee replacement, but due to his age doctors advised him against it. His past medical history is otherwise unremarkable. Patient does not smoke and only drinks socially. On exam he had point tenderness to the medial side (medical lingo: inner side). An X-Ray showed severe arthritis of the knee (X-ray on the left).

21 year old professional motorcycle racer presenting to the office with complaint of pain of the right hand, patient had a bad fall while doing a motorcycle jump, falling on his right hand. His past medical history is unremarkable, he takes no medications. He works out and he has been racing since age 12. An X-ray shows Boxer's fracture.

30 year old dancer presents with complaint of not being able to flex or extend the big toe of the left foot. She also experiences pain and stiffness after walking or standing. Patient was involved in a head-on car collision about 2 years ago causing a fracture of her foot, ankle as well as her metatarsals. Her past medical history otherwise is non-contributory. She does not drink or smoke. She has tried Ayurvedic medicine with some success.

Professional basketball player complaining of ankle pain. Pain is mostly in the posterior ankle (medical lingo: back). Pain and discomfort is worse when she extends or flexes the ankle. Pain interferes with her game especially when she jumps. Patient states her problem developed after switching to a different type of sneakers, mandated by the club that she was recently traded to. Her past medical history is unremarkable and she takes no medications to cope with pain. On exam the Achilles tendon is very tender, even the slightest touch or palpation makes her uncomfortable.