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Musculoskeletal Conditions and Low-Level Laser Acupuncture

Our clinicians see patients with other musculoskeletal conditions such as

Adults Still’s disease is a rare inflammatory arthritis associated with fevers, joint pain and swelling, and a salmon-pink rash appearing on your body,  especially in the evening.

The diagnosis is mainly clinical but there are tests to support the diagnosis.

Treatment involves anti-inflammatories, steroids, methotrexate, and biologics drugs.

Ankylosing spondylitis (AS) primarily involves the spine and back, with patients experiencing pain and stiffness in the back (sometimes severe).  AS can also affect peripheral joints and other organs in the body; there are streamlined approaches to clinical assessments and several forms of treatment, including physiotherapy, anti-inflammatories (a few disease-modifying drugs) and biologics drugs.

The aims of treatment are:

  • Symptom relief
  • Restore musculoskeletal function
  • Prevention of  joint damage
  • Prevent spinal fusion  and loss of function
  • reduce extraarticular manifestations
  • Prevent complications of spinal disease

Back pain is common and self-limiting.  If, however, back pain is associated with loss of function and activities impaired, weight loss, sweating, weakness or numbness, swelling, and bladder or bowel incontinence, it can require urgent medical attention.

If you are in any doubt about diagnosis or treatment, please seek the advice of your GP or contact us.

Gout is caused by the deposition of uric acid into joints.  Uric acid inflames and eventually may damage joints.  The body is unable to either rid itself or overproduce uric acid.

Symptoms
Early on, the big toe has severe pain, redness, and swelling.  It may feel like your foot is being held in a hot oven.  The onset of symptoms is typically abrupt and during the night.

If untreated over a period of years, many joints may become involved.  Chronic gouty arthritis causes swelling, pain, and deformity at the wrists, hands, elbows, knees, and ankles.   Uric acid (a chalky white substance) is deposited under the skin, most commonly on the elbows, hands, or feet.  Uric acid may accumulate in the kidney, causing kidney stones or deposits inside the kidney, damaging kidney function.

Diagnosis
The diagnosis of gout is made by removing fluid from a joint or a tophus and demonstrating the presence of uric acid crystals using a polarizing microscopic examination.

Osteoarthritis (OA) is a common form of arthritis.  Causes are age, injury, repetitive trauma, and genetics.

The basic abnormality in OA is the wearing of the articular cartilage.  The normal sponginess has amazing shock-absorbing properties.  Impaired repair and malalignment of the joints compound the problem.

Symptoms
You may experience intermittent pain, bone and soft tissue swelling, crunchy sounds and an inability to join.

Diagnosis
The diagnosis is made from the clinical symptoms and examination.  X-rays confirm this, and sometimes blood tests and other imaging investigations.

Treatment
Contrary to popular opinion, Osteoarthritis progression is slowed dramatically with proper holistic care.  The medications that increase comfort and decrease pain are useful in adjunct physical therapy and joint protection techniques.

Pain and Arthritis are important protective mechanisms the body uses to warn off possible injury/harm.  We all vary in our perception of pain, which has physical and emotional aspects.

The nerve endings sense temperature and chemical changes or mechanical changes/stresses.  The signals are relayed via the spinal cord to the brain.

Pain sensation may also be triggered by damage or altered sensitivity of nerves.  This causes the nerves to signal pain in response to something that would not normally hurt.

In some instances, it is difficult to explain the exact cause of chronic pain and impossible to make it go away completely, and this can add to the distress or anxiety.  This chronic pain can be confined to one part of the body or felt all over the body.  It could be hard to explain where the pain is coming from and may vary over time.  Often, pain is multi-faceted with physical injury, altered nerve sensitivity and individual psychological and physiological factors.

We often find patients politely putting up with symptoms for long periods of time, losing muscle function, and unable to do all their hobbies and activities with their families.  However, with safe and effective treatments, they could become symptom-free.

If your pain symptoms are interfering with your activities, then you need to see your doctor and discuss different treatment options.

Polymyalgia rheumatica (PMR) is an inflammatory condition that causes many painful muscles (poly = many, myalgia = muscle pain).  The main affected muscles ARE the shoulder and thigh.  PMR can start at any age from 50 but mainly affects people over 60.  Women are affected 2–3 times as often as men, and it affects about 1 in 2,000 people.  If you have polymyalgia rheumatica, you’ll usually have severe and painful stiffness, which is often worse in the morning, especially in your shoulders and thighs, and usually affects both sides.  PMR strikes suddenly, appearing over a week or two and sometimes just after a flu-like illness.  The symptoms are quite different from the ache you may feel after exercise.  The pain and stiffness are often widespread, are worse when resting, and improve with activity or as the day progresses.  However, it may also wake you at night.  Other symptoms include:

  • feeling unwell
  • a slight fever
  • weight loss
  • overwhelming tiredness
  • feeling low, anxious or depressed.

Rheumatoid arthritis (RA) is the most common and serious form of arthritis.  There is damage to bone and cartilage, joint deformities, loss of joint movement, and limitations of activities requiring involving joints.

The exact cause is unknown.  However, it is thought that genetic predisposition plays a role.  Elements of the immune system gather in the synovium, causing inflammation and subsequent joint damage due to excess tumour necrosis factor (TNF) and other inflammatory mediators such as IL-6.

Symptoms
RA usually begins in middle age but can start at any age, including during childhood (2-3 times more common in women). Early disease symptoms include general fatigue, soreness or aching, and stiffness, particularly in the morning.

Joint pain and swelling usually occur in the hands or feet but can affect wrists, elbows, shoulders, neck, knees, hips and ankles.  Some patients develop nodules at the back of their elbows or along the forearm.

Diagnosis
The diagnosis is based on an assessment of medical history, physical examination, x-rays, and laboratory tests.  A distinction needs to be made from more than 200 different types of arthritis and related conditions.

Common laboratory tests include rheumatoid factor, C-reactive protein and the erythrocyte sedimentation rate; x-rays are used to assess damage to cartilage and bone.

Treatments
Early rheumatology intervention and the start of proper treatment are important in preventing long-term damage to joints.  The treatment goals are to cut joint swelling, relieve stiffness, prevent damage, and maintain normal joint function.

Aspirin-like drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (prednisone) help cut joint pain, stiffness and swelling.  Drugs referred to as disease-modifying anti-rheumatic drugs (DMARDs) include methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, gold salts and a new class of drugs called biologics.

Treatment most often involves some combination of exercise, rest, joint protection, the use of heat or cold to reduce pain, and physical and occupational therapy.  Surgery is available to relieve pain and improve the function of damaged joints.

Non-Drug approaches to pain control: Low-level laser acupuncture

Dr Dhiya Houssien is a Consultant Rheumatologist at LOC and holds the American Board of Low-Level Laser certificate from the American Society for Laser Medicine and Surgery in California.

Dr Dhiya Houssien’s interest in low-level laser acupuncture was driven by the passion to offer patients new treatment options for musculoskeletal conditions – injuries or damage to the body’s joints and tissues that support the limbs, back, or neck.  The motivation came from a desire to avoid the side effects of standard therapies, using a non-invasive and non-drug-based remedy, where patients should feel a difference after the first session.

Extensive research showed that a significant degree of pain reduction could be achieved by using low-level laser acupuncture (LLLTA).  Dr Houssien developed his new method by using low-level laser LLLT on traditional acupuncture points and applying pressure during the treatment to simulate the e­ffect of acupressure.  Laser acupuncture (LLLTA) is an integral part of his strategy in his clinic at LOC.

The effectiveness of LLLT continues to be researched.  However, it has shown benefits in treating painful neurological and musculoskeletal disorders such as neck and lower back pain.  It was approved in 2002 by the U.S. Food and Drug Administration (FDA) as a non-significant risk device that may be used as an adjunctive treatment of painful conditions.

Laser acupuncture affects the function of connective tissue cells called fibroblasts.  It increases the production of natural substances such as endorphin, which decreases the pain and serotonin, which decreases the muscle spasm.

The treatment helps to accelerate connective tissue repair and acts as an anti-inflammatory agent without causing significant complications.  The primary goal is to treat patients more efficiently, reducing most treatments to one or two sessions; patients should feel a difference after the first session.

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