The Depths of Illness - Tailbone Pain

I can't remember when the pain started only that it was excruciating.  My tailbone felt as if a red hot clamp was slowly being tightened around it by some invisible force.  The pain fluctuated throughout the day - usually better in the morning than at night

It did not help that I had a desk job and spent eight plus hours a day sitting.  I tried sitting on a wedge pillow, to no effect.  I got rid of my usual work chair in favor of a large exercise ball, to no effect.  The pain limited my focus, caused anxiety, and by the end of the day I constantly shifted in my chair, sweaty, weary.  I talked work into buying me a stand-up desk.  Standing all day helped a little, but my knees began to ache, then my lower back.  I returned to sitting.

While the days remained difficult, the nights became restless.  As the pain got worse, I lay in bed, awake, unable to sleep due to the pain.  Shifting positions did not help.  Heat did not help.  Ice helped, numbed the nerves, but fixed nothing and did not help with sleep.  I finally figured out that if I laid on a tennis ball in exactly the right spot on my tailbone, the pain would relent to a mildly more tolerable pressure, allowing me to fall asleep before utter exhaustion was required to finish the job.    

During this time, I regularly visited an osteopath for manipulations and advice.  The manipulations did not help.  Eventually, he ordered an MRI of my back, which showed bulging discs.  Could be referred pain from the bulging disc, he said.  He ordered a second MRI of my pelvis for concurrent pain in my right hip.  That MRI was inconclusive.  He suggested stretching and jacuzzi therapy. Stretching and jacuzzi therapy didn't help. He also referred me to a back specialist.   Could be referred pain from the bulging disc, the back specialist said and offered a steroid injection.  But the injection only helps in 50% of cases and is only temporary, he added.  My take away - the pain only comes from the bulging disc in about 50% of the cases.  I refused the injection at the time, preferring to find and fix the actual cause of the pain.

            

If You Are Suffering From... Chronic Headaches

Chronic headaches...what a nightmare.  Headaches can range from low grade (buzzing in one's head) to severe (migraines) - each with different but ultimately negative impacts to daily life.

FIRST THINGS FIRST, GO SEE YOUR DOCTOR

Some very serious conditions can cause chronic headaches.  Click here to read what the Mayo Clinic has to say on chronic headaches (including some alternative medicine recommendations).  If your doctor rules out the known serious conditions that can cause chronic headaches, alternative medicine can likely help.

"UNKNOWN" CAUSES OF CHRONIC HEADACHES

The theory that I find most plausible for the causes of "unknown" chronic headaches is chronic inflammation (that either leads to or accentuates a physical imbalance - e.g. muscle tension- or chemical imbalance) due to one or more of the following: (1) dietary sources of inflammation, (2) nutrient deficiency, (3) chemical exposure.  Diet and nutrient deficiency are fairly easy to test.  Chemical exposure, however, is a much more tricky subject.  Chemical exposure can come from a variety of sources, including hygiene products, food (primarily preservatives, herbicides, and pesticides), water (municipal water is fairly well regulated by the Environmental Protection Agency- unless a company spills chemicals into your water supply as happened recently in Charleston, WV - so I would be more suspicious of well water, especially if you live near any form of industry and possibly agriculture), the environment (including materials used in your home such as lead based solder or drywall with formaldehyde), and the air (such as carbon monoxide infiltrating your home from a garage or faulty furnace, radon in your basement, and air pollution from industry). 

RECOMMENDED ALTERNATIVE THERAPIES

The following alternative therapies can likely help with chronic headaches.  My belief is that health is not sustainable without dietary change.

1. Trigger Point Therapy - Several known trigger points cause or accentuate headaches.  Trigger Point Therapy can help eliminate any muscle tension that is causing or accentuating the headaches. 
2. Elimination Diet - Performing an elimination diet, as prescribed herein, performs two functions including eliminating all common food allergens/irritants from your diet and increasing your nutrient intake (if done properly).  These two functions help address both dietary sources of inflammation and nutrient deficiency.  Click here to find guidance on performing an elimination diet. 
3. Herbs - Herbs, specifically butterbur has been scientifically proven to be beneficial in migraines.  Click here to find additional information and guidance on the use of butterbur.
4. Vitamins, Minerals, & Other Supplements - If you have muscle tension or increased inflammation due to vitamin, mineral, or other deficiencies, identifying these deficiencies and correcting them through supplements can augment efforts to eliminate chronic headaches.
5. Acupuncture -  Acupuncture promotes blood flow, which can help reduce inflammation and may help with chronic headaches.
6. Product Elimination Trial - Modern hygiene products are full of chemicals that may promote inflammation in your body.  By identifying sources of inflammation from these products, you can reduce their contribution to any headaches.

Trigger Point Therapy - Dr. Travell, The White House Physician of JFK (Part I)

John F. Kennedy, America's 35th president, had a sordid health history.  Throughout his life, Kennedy suffered from abdominal pain, colitis (swelling of the large intestine), severe back pain, and Addison's Disease - ailments that caused severe and chronic pain throughout his life1.  While he was president, Kennedy consulted with a number of physicians and at various times was on upwards of twelve medications to deal with these ailments - all under the supervision of Janet G. Travell, MD, whom he appointed as White House physician, the first female to hold that post and the first citizen to hold the post in 40 years.

While there were a number of physician's attending to JFK during his presidency, Dr. Travell assisted JFK with his back pain, offering renewed hope for a life without crutches if not entirely without back pain2. And aside from her stint as White House physician, Dr. Travell's rofessional pursuits largely revolved around diagnosis and management of myofascial pain syndromes due to trigger points.  Travell went on to write a compendium of her life's work on trigger points and myofascial pain with Dr. David G. Simons in a two volume series titled Myofascial Pain and Dysfunction: The Trigger Point Manual. 

So what exactly are trigger points?  You may be familiar with the term "knot" as it relates to muscles.  Trigger points are nothing more than small knots, muscle tissue in constant tension. The result of a constantly tense muscle is restricted circulation, nerve impingement, and tension on adjacent connective tissue that can cause muscle weakness, muscle tightness, and pain, often "referred" pain (pain in a different location than the causal trigger point), which is why massaging the area that hurts will not relieve the pain.

Since the progressive tightening of my muscles in 2006, one of my main searches has been for a therapy to reverse the process.  Various therapies have been suggested in that cause - some that I believe are pieces of the puzzle but none that proved effective in and of themselves (at least how they were applied in my circumstance).  After reviewing the literature, Trigger Point Therapy appeared to me be sound, if little known, science.  So, I bought a book and began to experiment... 

To read more about my experiments with trigger point therapy, click the following links:

Dr. Travell, the White House Physician of JFK (Part I)
Fumbling in the Dark (Part II)
Oh the Pain (Part III)
Relief (Part IV)

To read more about JFD's chronic health troubles or Dr. Janet Travell, click the following links:

1 - The Medical Ordeals of JFK, The Atlantic, 2002. 
2 - Janet G. Travell, MD, A Daughter's Recollection, Virginia P. Wilson, 2003.

Quote of the Day - Presents

Yesterday is history, tomorrow is a mystery, but today is a gift. That is why it is called a "present" - Anonymous (though I first heard it from Oogway, in the movie Kung Fu Panda)

Allergen-Free Recipe - Slow Roasted Pork Carnitas

I started exploring Mexican cuisine through the tv shows and books of Rick Bayless (a prominent chef from Chicago) right before giving up nightshades and corn.  Needless to say, my continued exposure to Mexican cuisine is very modified, but the slow roasted pork carnitas recipe remains unmodified.  Click the following link to be taken to the original Rick Bayless recipe.  You will not be disappointed.

Slow Roasted Carnitas, courtesy of Rick Bayless

Allergen-Free Recipe - Lime and Persimmon Smoothie

Just before Adelaide turned 2, we flew to Denver for a mini vacation with a good friend, Brent.  The entire trip, I craved green smoothie but had a tough time finding a juice or smoothie bar.  Finally, while cruising around Boulder one day, Ingrid and Brent were looking for a snack and found a little shop (I think it was a yogurt shop) that also sold smoothies.  They got me one - a green-focused smoothie featuring lime, spinach, granny smith apple, and avocado.  Since then, I've been working on a recipe to recreate that smoothie and finally found the right blend of ingredients.

1 Lime
1 Persimmon
2 Dates, pitted
2 c. Coconut Water (or more for desired consistency)
1/2 c. Ice
1 c. Spinach
1/2 Granny Smith Apple, stem and seeds removed
1 Avocado, seed and skin removed





(1) Cut lime in half.  Add 1/2 lime, including the rind, to the blender.  Add the juice of the remaining lime half and the remaining ingredients.  Blend in high power blender until thoroughly incorporated.

Note that this smoothie has some bitter notes from the lime rind.  If think the bitter notes add some character to the smoothie, but if you prefer no bitterness, try using the zest and juice of the lime.  Also, a banana will work in lieu of the persimmon (we get persimmons as part of our CSA and use them frequently in place of bananas).

The Original Lime Smoothie in Boulder, CO

A Tale of Chiropractors - Misaligned Joints and Muscular Issues (Part III)

I should clarify - Dr. Berkoff did not suggest that he could fix my chronic health issues in a month,  just the back issues.  During my second appointment we got to work.  The generic diagnosis for my back troubles boiled down to four issues, three of which I'll discuss in this post: (1) certain muscle groups were too weak, (2) certain muscle groups were too tight, and (3) certain joints were subuluxated (a fancy term for misaligned).  The treatment was a variant to one I had been hearing for years over my sports and hiking careers - stretch, strengthen, and wear the right footwear. Dr. Berkoff's approach included theraband strengthening exercises, bamboo stick stretching, therapeutic ultrasound, and chiropractic adjustments as briefly discussed below.

Theraband Strengthening Exercises

A theraband is a large rubber band used in physical therapy.  It either attaches to a fixed object, like a door or a wall, or to another part of your body for use in resistance training (i.e. strength training).  As a strength training exercise, resistance training using therabands or other elastic band is a widely used and well-documented practice.

Bamboo Stick Stretching Exercises

Bamboo stick stretching is exactly what it sounds like - stretching while using the aid of a large bamboo stick.  Instead of going into exhaustive narrative on how to do bamboo stick stretching, see the below videos put together by Dr. Berkoff.





Though I was unfamiliar with bamboo stretching when I met Dr. Berkoff, I have come to see it as another useful stretching tool.

Therapeutic Ultrasound

Therapeutic Ultrasound is the application of sound waves to soft tissue (muscle, tendon, ligament) for therapeutic purposes.  The proponents of therapeutic ultrasound argue that it increases blood flow to the site, reduces pain, and massages ligaments and tendons.  And there are many proponents of therapeutic ultrasound.  However, literature posted on both the National Institutes of Health (NIH) and the American Physical Therapy Association (APTA) cast some doubt as to the effectiveness of therapeutic ultrasound.

Click here to read the article posted on the APTA website discussing the debate on Therapeutic Ultrasound

Chiropractic Adjustments

Chiropractic adjustments are  manipulations of the spine to correct subluxated joints and are sound science for fixing back-related issues.

At the end of the first month using these therapies, my original back issue was slightly but not completely better and the the pain did not go away; it seemed to transition into an adjacent area - into my tail bone.  "I don't know, doc," I said during one of our chats.  "I feel like everything is related to my tight muscles - and I don't feel like I'm getting any more limber with the stretching exercises."  After considering my feedback, Dr. Berkoff acknowledged and switched tactics, emphasized stress relief in our further sessions.


Over the year that I've been consulting with Dr. Berkoff, he has become a most trusted source for advice.  If you're looking for help with a variety of issues, I highly recommend his services.  Visit Dr. Berkoff's Website here for more information.

For more on my experiences with chiropractors click the following links:

A Tale of Chiropractors - A Mixed Beginning (Part I)
A Tale of Chiropractors - Meeting Dr. Berkoff (Part II)
A Tale of Chiropractors - Misaligned Joints (Part III)
A Tale of Chiropractors - Stress (Part IV)