Well, I’m back in my study this morning, after being at a business/marketing meeting this weekend in Tampa. Since I live in the Orlando area, it’s a straight shot for me, driving along I-4 West. Takes about an hour and forty minutes to two hours, depending on traffic, especially through the city of Tampa. Compared to my recent drive to Southampton, New York, this is a snap! 
 
Given my personal history of knee pain and arthroscopic surgery, this would be a real trial causing nagging aching and swelling of the knees.  But I actually practice what I preach– I use all the tips I’ve passed along to you to reduce your knee pain, while driving. You can see all of these in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, and you can get your own copy at
 http://drbillsclinic.com/eliminate_knee_pain.html   These tips were a life saver during the long haul to New York, but they’re pretty useful for shorter drives, too. Try them yourself and see.
 
Anyway, I was catching up on my email and other correspondance when I came across an advertisement that promised to END ARTHRITIS PAIN FOREVER. Hmmmm… It sounds like they’re promising a CURE. But what do they really mean?
 
Here’s the thing: I spent a quarter century treating people with various forms of arthritis. And as a surgeon, I’ve actually SEEN the damage that arthritis does, first hand. That’s intimate knowledge of the destruction that these diseases (note, it’s NOT just one disease, but MANY) can wreak on joints. This is direct experience of seeing and feeling those destroyed joint surfaces, with my own hands, that even rheumatologists don’t have, unless they’ve personally scrubbed in on open joint surgeries.
 
Based on that experience, I can tell you this–there is NO CURE for the most serious forms of arthritis, osteoarthritis and rheumatoid arthritis (and other inflammatory forms), at this time.
 
But the ad says they cured “rheumatoid arthritis SYMPTOMS.” That implies that they cured rheumatoid arthritis, doesn’t it? But, I assure you, no one to date has done so.
 
So again, what do they REALLY mean? Is is just false advertising? No, not really. But it IS deliberately misleading. 
 
You see, when most people think of arthritis, they think of the “wear and tear” arthritis you get as you get older, in other words, osteoarthritis. When you talk about rheumatoid arthritis symptoms, you suggest (without quite saying so) that you are talking about rheumatoid arthritis. But when you read the ad copy, you find out that what they’re really describing is the arthritis of LYME DISEASE, which is due to a bacterium and therefore CAN be cured. 
 
Are the SYMPTOMS the same as rheumatoid arthritis? In the short term, yup. But will the same treatment, antibiotics, actually cure rheumatoid arthritis or osteoarthritis? Nope.
 
This is just a classic case of advertising leading you to draw inaccurate conclusions, based on false assumptions. They are NOT lying. But they ARE trying to fool you. And if you don’t know any better, you’re going to fall for it. These guys are GOOD at this.
 
To help you sift the truth from all the B.S. out there, you need someone who KNOWS on your side. If you had read my newest healing program, HOW TO AVOID KNEE SURGERY, which you CAN, if you go to  http://drbillsclinic.com/avoid_knee_surgery.html you would know better. 
 
With treatments drawn from across the entire medical spectrum, conventional, alternative and complimentary, you can finally understand WHAT TO DO, and HOW TO DO IT to relieve your pain and restore your function. And WHY, as well. So don’t be fooled. Arm yourself with the best health resource you can get to get rid of your knee pain, FAST, with easy, proven methods that WORK. Go to  http://drbillsclinic.com/eliminate_knee_pain.html
 
That’s all for today, my friend. I’m going out for a walk in this beautiful weather. There ARE advantages to being in Florida, at least at this time of year   Til next time, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill 
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

So this morning in my study, I was going over a number of health related blogs, reviewing them for any potential for commentary and teaching points. A number were pretty good, most often involving the back injuries one sees in sports or exercises or stretches for general fitness or specific injuries. A few had to do with joint replacements of the hip and knee, which happened to be my specialty in practice. 
 
But then, I read one that was incredible. Not good incredible, as in ‘Wow! How amazing!” but incredible as in, “I can’t believe they have this thing out there on the web!” It concerned ACL injuries and rehabilitation and it was so full of factual errors and frank mythology that I couldn’t believe it.
 
I wanted to tactfully reply, correct the most obvious misconceptions, hopefully without insulting the author, or hurting his feelings. It wasn’t a scam, or a deliberate attempt to misrepresent facts for some nefarious purpose. It was obvious that the author was sincere. He was just wrong.
 
For example, one guy said that an ACL rupture wasn’t painful. In fact, it’s one of the most painful and disabling injuries you can suffer. What he meant was that a CHRONIC ACL disruption is painless–the damage has already been done. But the resulting instability, the “wobbly knee” that results from absence of the ACL, CAN indeed cause pain, from secondary tears of the menisci, synovitis, and arthritis.
 
Further, there ARE some people with an ACL injury who DON’T require surgery. This fact is almost entirely ignored in these articles. Specific exercises, especially leg curls and calf exercises, can often compensate for people who make low demands on their injuredknee. The point is, there are options that can be offered.
 
Unfortunately, it was a major pain to reply. First, you have to register in order to reply. Then, the registry doesn’t accept the information and erased all the info I had just input. Finally, I just gave up in disgust. Too bad. Some people are going to read that blog and accept what it says uncritically. As a result, they’ll absorb information that’s just incorrect. And who knows what the consequences will be?
 
Funny thing is, people will believe almost anything they read on the net, even though it’s well known that there’s no filter. That’s one of the internet’s chief charms. But it’s also one of its chief problems, when you really have a need to know the facts about a topic. Without a bit of comparative research on your own, there’s often no way to tell what’s fact and what’s fiction.
 
You may read it on a website, but “it ain’t necessarily so.” But the written word has power to persuade, whether it’s accurate or not. So, especially in seeking medical information, it’s best to go with a trusted source. Hey, that’s one of the major reasons for the existence of Dr. Bill’s Clinic. I’m here to try to provide some guidance and practical advice, based on my nearly quarter century in clinical practice in orthopaedic surgery. That’s why I wrote my healing programs: to help those of you with knee pain, grinding, instability, arthritis, water on the knee, deformities, and any other problems with a variety of treatments, conventional, alternative, and complimentary, from across the entire medical spectrum.
 
DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN is a concise, but complete guide to all the root causes of knee pain and the treatments that I know from experience, professional and personal, do work. You can get your own copy, including an audio CD, at  http://drbillsclinic.com/eliminate_knee_pain.html
 
But, just so you know, the LGB does NOT include the recommended knee exercises. Those are given in a separate companion manual: DR. BILL’S PAIN-FREE PROGRAM, a selection of exercises and stretches that helps to prevent or eliminate knee pain–once & for all! You can get it here, at this link:   http://drbillsclinic.com/exercise_eliminate.html
 
Most recently, based on what people seemed to want, I created my newest healing program, HOW TO AVOID KNEE SURGERY, in both written and audio CD formats. This is a blend of the former two programs, and in addition, adds a great deal of new material, especially on herbs and nutriceuticals and other alternative treatments to help you avoid the unnecessary knee surgery, or at least delay the most invasive procedures, like total knee replacement, in the case of end stage disease, like arthritis. 
 
If you’ve been thinking about having surgery, but would like to delay or avoid it, you can get it here: http://drbillsclinic.com/avoid_knee_surgery.html
 
So, above all, don’t believe everything you read. DO your due dilligence before you accept whatever is out there on the net. The right advice can make a big difference in your life, but you need to be sure of the facts, before you act.
 
Well, that’s it for today. Til next time, my friend, be well. And have a great weekend!
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

I was in my study this morning, reviewing some of the articles in my inbox on orthopaedic problems and knee pain, when I came across an article in the October 14th Wall Street Journal by Thomas H. Burton. He was writing about one of the latest trends in arthritis surgery of the joints, called minimally invasive surgery, often referred to as an acronym — MIS.
 
Like the name suggests, this is a technique in which prosthetic joint replacement, mainly of the hip and the knee, is performed through a smaller (shorter) incision than normal. This means that sometimes the incision is much shorter, like only 3 to 4 inches, when the normal length may be as much as 8-12 inches, usually depending on the weight of the patient–fatter people need longer incisions (a hole has to be bigger at the top than the bottom and the fatter a person is, the deeper the hole is going to be).
 
The theory is that a smaller incision maintains the integrity of the big muscles around the joint and allows for less pain, faster healing and quicker return to full function. But here’s the problem. Because of the more limited vision into the joints allowed by the smaller incisions, the chance of complications is higher, sometimes much higher, than with more traditional approaches. It makes sense if you think about it.
 
In this respect, a MIS is as good as a mile;-) While it is true that a perfectly done MIS can heal faster, with less tissue damage, the poor visualization it affords the surgeon makes its risks much higher. So, is it worth it? Well, yes and no.
 
Yes, but only if you can find a very experienced surgeon in the technique. Total hip and knee replacements are highly technique-dependent surgeries. That means that the best results tend to come from the best trained, most experienced surgeons. This is even more true for the MIS.

No, because if you don’t get one of those best trained, most experienced surgeons, then your risks of complications is greatly increased. These would include soft tissue injuries, from stretching the smaller incision so the surgeon can see; incorrect bone cuts with incorrect angles, simply because the surgeon just can’t see enough of the bones to make accurate cuts; debris left in the joint, because the small incision obscures the joint so the surgeon can’t see to remove it. Also included are fractures of the bones, when attempting to impact the implants into place, malposition of the implants, often leading to dislocations, or joint instablity; and nerve injuries from traction, again in an attempt to see better through the small incision.
 
As you can see, the trade off is a chance for faster healing versus higher risks for multiple complications. All of these, the good and the bad, are a consequence of the smaller incision.
 
Funny thing is, my teachers always said to make a larger incision, because 1. you can see what you’re doing and all the anatomy and 2. there is less tension and therefore less trauma to the tissues, less edema (swelling) and 3. you can see and stop any bleeding blood vessels (“It heals from side to side, not end to end...”). 
 
But the MIS is in vogue right now–despite NO long term evidence that its results are as good as standard surgical approaches. You didn’t know that there are actual fashions in surgery? Oh, yes. Very much so. 
 
I’ve seen this before. At first, there’s a rush of enthusiasm and the public (who only know about the supposed benefits) DEMAND the new, in vogue procedure. Then, as its indications are expanded and surgeons, who are NOT as experienced, feel pressured to do the new procedure (or risk losing patients), the complications begin to emerge. As the problems begin to mount, and some true disasters are reported, the enthusiasm wanes and finally everyone goes back to the traditional approaches, or at least modifies the indications for the “new” technique.
 
As if you needed another reason to stay OUT of the operating room…. Or, you can try one of a number of proven, reliable, simple, non-surgical treatments that can help you AVOID SURGERY. It’s your choice. There are lots of cases in which surgery is UNNECESSARY. You lose nothing by trying one of the conservative, non-operative treatments I teach in HOW TO AVOID KNEE SURGERY. See it here at http://drbillsclinic.com/avoid_knee_surgery.html
 
If you want to see treatments to relieve knee pain and specially modified exercises to restore function, using conventional, alternative and complimentary methods from across the entire medical spectrum, go NOW to http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill 
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Eeeeeeeeeeeeeeee! The electronic tone went off as our front door opened this morning at 8 AM, and Joe, our contractor, came in to continue the renovation job in our basement. Woke me up instantly, though the bride remained asleep. Hey, after lots of years of having to get up at the very crack of dawn, I like to sleep in, now that I’m retired. Just before awakening, I had been dreaming about Jonathan Swift’s iconic character Gulliver, standing in the sea, on a shore, bound with a host of Lilliputian lines. 
 
“Why in the world was I dreaming about that?” I wondered. 
 
Then it dawned on me, that an article in the Oct. 14th Wall Street Journal by Bret Stephens, “America Will Remain The Superpower,” referenced that character, as a metaphor for the international ramifications and implications of the recent market meltdown: “When the tide laps at Gulliver’s waistline, it usually means the Lilliputians are already ten feet under.”
 
The author’s point was that the decline in value of our stock market by 25% in three months (before the surge back of yesterday)meant that the Dow had “outperformed nearly every single major foreign stock exchange (which all had losses substantially in excess of our own)” and that “America’s financial woes are nobody elses gain.” Or put another way, the news of America’s demise as a superpower is greatly exaggerated. And whatever affects us is that much worse for pretty much everyone else.
 
It was only a single line in a long article, but I guess that image made an impression on my subconscious, that showed up in the dream.

Well, as you may or may not recall, Jonathan Swift was a satirist, responsible for some pretty biting criticisms of his society at that time (my favorite was “A Modest Proposal,” which suggested that a way to deal with famine was cannibalism). And Gulliver met people both much smaller (Lilliputians) and much larger (Brobdingnagians) than himself. But I think my subconscious took the image more literally, perhaps portraying various problems and concerns I might be thinking about as those pesky lines, binding my “big self.” And in taking this form, the dream itself suggested the solutions. 
 
What’s interesting about this metaphor is that in order to break free of those entangling lines, ACTION is required. Passive acceptance of his situation will only result in further loss of freedom. It’s only Gulliver’s travails that will ultimately set him free.
 
In the same way, if you have any problem, physical, mental or spiritual, the worst thing you can do is nothing. Passive acceptance guarantees no change. You have to analyze your situation, determine what’s necssary to change it, and then you must take the necessary action to effect that change.
 
For example, if you’re crippled with arthritis, or suffering from knee pain of any cause, just sitting around won’t change your condition. You have to TAKE ACTION, like the simple, non-surgical treatments and the specialized modified exercises I teach in my newest healing program, HOW TO AVOID KNEE SURGERY, which you can see at this link:  http://drbillsclinic.com/avoid_knee_surgery.html
 
If you want to relieve your knee pain, FAST, and restore your joint stability and full function, then you need this program! Click on the link and see how:  http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

A good friend of mine emailed me today for advice.  He’s a doctor of chiropractic who’s developed severe pain in his hip joint. He saw an orthopaedist, who got an MRI, but it was inconclusive–could be edema, or it could be a more serious disease that could result in surgery. 
 
Trouble is, the picture doesn’t look like what you’d expect if he had the more serious disease. Typical of the problems one sees in clinical practice–cases often don’t follow the textbook presentation. So it makes it tough to know exactly what to do.
 
Seems the guy has asthma and he’s been taking steroids (prednisone) for some time to try to control the symptoms. But one of the potential and most dreaded side effects of longer term systemic steroid use, typically seen in asthmatics, rheumatics, or people with chronic allergies or skin diseases, is a bone disease called avascular necrosis.
 
Avascular necrosis is a kind of weird disease that no one’s ever heard of, until they get it, or know someone who did. It refers to the death of bone cells inside a bone. It’s variously called aseptic necrosis (meaning it is NOT caused by an infection), ischemic (meaning it’s due to oxygen deprivation) necrosis, or avascular (lack of blood supply) necrosis, or just plain old osteonecrosis (or “dead bone”) where “necrosis” means cell death. It commonly affects the hip, knee, shoulder, or ankle, in roughly that order.
 
For any number of reasons, this happens because there is a blockage of the blood supply to the bone of the affected joint. Think of it like a dam in a river. So everything “downstream” that is normally fed by the blood supply is suddenly cut off. The cells, deprived of oxygen, begin to die. The surrounding bone then begins to deteriorate. In the case of the hip, this area is recognized as “dead” by the body and special cells go to the site and begin eating away the dead bone area, so that new healing bone can be laid down.
 
The problem is that as that dead bone is removed, support for the overlying joint surface is is removed, too. The pressure across the joint surface causes the joint surface to collapse under the pressure. Think of a house that has its foundation eroded by an underground river, or a sink hole. What happens to the roof? Caves in, right? 
 
Same thing.
 
When the “roof” caves in, that segment collapses, the hip suddenly hurts like Hell and the resulting irregularity rapidly chews up the rest of the joint, causing rapid onset of arthritis. Very bad news, indeed.  Once that happens, nothing short of a hip replacement can relieve pain and restore function.
 
If you recognize the disease early enough, you can do a small surgery that can often save the joint from collapse. Through a tiny stab wound incision and under fluoroscopic control, a surgeon can drill a hole from the side of the hip bone into the femoral head, just like coring an apple. This relieves pressure inside the femoral head, which is believed to be responsible for cutting off the blood supply to the femoral head. Not as big a deal as total hip replacement, but, hey, it’s still surgery, right? You want to avoid it, if you can.
 
So the doctor’s dilemma is to get an accurate diagnosis quickly enough to do a lesser surgery and head off joint collapse, but not to do an unnecessary surgery, if it isn’t needed. And he has to try to relieve the hip pain, while all this is going on. Not always an easy thing to do. And made much more difficult when the picture isn’t typical. Tough to know what the right thing is to do…
 
Same thing occurs in the knee, but there, because the knee is a larger joint (in fact, the largest joint), it’s a lot more forgiving and less likely to collapse than the hip. So there, conservative non-surgical treatments make the most sense, like those I teach in my newest healing program, HOW TO AVOID KNEE SURGERY, which you can get at  http://drbillsclinic.com/avoid_knee_surgery.html
 
Meanwhile, I recommended my friend reduce the forces across his hip joint by using a cane. Same thing for a painful knee. Sometimes, the simplest things are the most effective. That, combined with a number of the alternative and conventional non-surgical treatments  to relieve pain, that I describe in detail at http://drbillsclinic.com/avoid_knee_surgery.html  may be very helpful to him. Even though the program was written for the knee, the methods I use are systemic, that is, they work for the whole body, hip included. And that program comes with a FREE Special Report on HOW TO RELIEVE HIP PAIN, too.
 
So, I wished him luck. Hopefully, he’ll recover soon, and avoid all those problems. We’ll just have to wait and see…
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow, 
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

It’s hard to believe how fast time is flying. Here it is October 2nd, and the last quarter of 2008 has already begun. You know, it was a year ago yesterday that I sent my very first email to a small group of friends–my first subscribers. Well, everyone has to start somewhere, right? Things have changed quite a bit during this last year, too. I started with my LITTLE GREEN BOOK   http://drbillsclinic.com/eliminate_knee_pain.html
 
I have a number of products, including CD’s for the LGB and for my newest healing program, HOW TO AVOID KNEE SURGERY, which you can see at http://drbillsclinic.com/avoid_knee_surgery.html And, there’s also my magnum opus, HOW TO ELIMINATEKNEE PAIN–ONCE AND FOR ALL! THE ADVANCED MASTERS’ COURSE http://drbillsclinic.com/advanced_masters.html  for the last word in the entire spectrum of methods of treatment for knee pain of all kinds. This can be obtained in a single, BIG volume, or in 12 monthly installments, or Lessons–your choice. Or, if you’re just interested in the specially modified exercises that I used myself after my own knee surgery, and those I prescribed for my patients during my nearly quarter century of private practice in orthopaedic surgery, you could benefit from my PAIN-FREE PROGRAM  http://drbillsclinic.com/exercise_eliminate.html

These exercises can help get rid of knee pain, FAST, but can also PREVENT knee pain, when done as instructed. And, I’ve made some other great products available to you as well, like the human growth hormone releasing hormone analog, that when rubbed on the skin, helps to reduce inflammation, speed healing, and has anti-aging properties, as well. You can get it here: http://drbillsclinic.com/trans_d_tropin.html 

I’m grateful for all the subscribers who have joined our ranks and for the support of all those who have purchased one or more of my programs. I’ve gotten some great feedback from those who have followed my advice–none better than those who have come back to buy again. All in all, it’s been an exciting and pretty gratifying time. Just think–even though I can’t operate any more, I can still help people all over the world, through my programs, CD’s, tips and general advice. 

Let’s face it. The internet is a gusher of information: some good, some bad, some irrelevant. So much, in fact, that the average person is just swamped–people have NO frame of reference, no filter to determine what information is correct and what isn’t. What you really need is ADVICE, from someone who KNOWS. And that’s what I’ve tried to provide. 
 
So, what’s next for Dr. Bill’s Clinic? Well, I’m now working on a program for ARTHRITIS–what it is, and more important, what you can do about it: how to slow its effects, relieve pain and prevent joint damage, with my usual approach of giving you the latest measures from across the entire medical spectrum, conventional, alternative and complimentary. 

I’m also going to produce some DVD’s and digital videos, and I may provide some teleseminars, as well. So, it should be fun. I’m looking forward to it. And it starts right now….Talk to you soon, my friend. Til then, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html 

P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to http://drbillsclinic.com/advanced_masters.html

FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Well, as might be expected, the article in last week’s New England Journal of Medicine has spawned dozens of additional articles and blog posts across the infosphere. This, of course, was the article by Canadian researchers that found that arthroscopic surgery offered no real  benefits, when used to treat arthritis. And, as I pointed out a couple of days ago, this study reiterated the findings of earlier studies which found pretty much the same thing.
 
Dr. Robert Litchfield, the head of the Kennedy Fowler Sport Medicine Clinic and the one of the study’s co-investigators, suggested that in view of their findings, “surgeons need to think about other ways of treating patients, rather than jumping immediately to surgery.”
 
Well, DUH! I was always under the impression that that was what we were supposed to so ALL the time. Ah well, the fat’s in the fire, now. Every purveyor of alternative measures is out there, beating the drum for their own special brand of remedy. Physical therapists, in particular, are in high cotton over this report, since exercise is one of the alternatives that the study found to be just as effective as surgery in improving arthritis symptoms. And it is. And so is exercise without the benefit of a therapist, like the exercise I teach in my PAIN-FREE PROGRAM at http://drbillsclinic.com/exercise_eliminate.html
 
Now the NEJM article has led to a derivitive article in U.S. News & World Report, that promotes “six alternatives to surgery for treating arthritis.”  These not-so-secret six are well known to everyone, and in fact are included in my newest healing program,
 HOW TO AVOID KNEE SURGERY, as you can see at   http://drbillsclinic.com/avoid_knee_surgery.html
But the trick is knowing HOW and WHEN to use them, and in WHAT MANNER.
 
The six alternatives treatments that are known to be effective include 1. weight loss & exercise,  2. physical therapy (read, supervised EXERCISE),  3. medications, 4. glucosamine & chondroitin (read, NUTRICEUTICALS), 5. Viscosupplementation and 6. total knee replacement.
 
Given the message that arthroscopic surgery for arthritis was to be avoided, I was kind of amused that the sixth “alternative” to arthroscopic surgery was total knee replacement. I mean, that’s the definitive treatment for end stage arthritis, from virtually any source. But that’s pretty major–it’s as big a surgical intervention as there is, with regard to arthritis. So their recommendations range from exercises and naturopathic measures to complete joint replacement. That’s quite a jump!
 
The fact is, no one in their right mind would suggest a total knee, unless ALL other measures had been exhausted, first. It’s kind of axiomatic. It’s what I refer to as my “Ladder Principle:” you start at the bottom rung, with the least invasive, least aggressive therapy you can find. Then, you “climb the ladder” until you find that treatment that works for you.
 
The problem is that you don’t need information–there’s a world of information out there. But without a filter, without a guide to teach you what’s effective and what’s not, you’ll be spinning your wheels a long time and wasting a lot of money in the process. That’s why I wrote my healing program, HOW TO AVOID KNEE SURGERY   http://drbillsclinic.com/avoid_knee_surgery.html
 
It’s a guide to all those treatments that are out there, conventional, alternative, and complementary, that shows you, step by step, what to do, how to do it, how much of any medication or nutriceutical to take, and most important, what to AVOID. You see, you don’t need more information. You need ADVICE. And that’s what I provide. That’s what I do.
 
So, if you or someone you care about has arthritis, or some other type of joint pain, and you want to know what to do to get FAST relief of knee pain and do it WITHOUT SURGERY, click on this link for my latest and best program http://drbillsclinic.com/avoid_knee_surgery.html
 
That’s it for today. Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

The newswires were all abuzz yesterday with a study out of this week’s New England Journal of Medicine. The study was done by a group of Canadian researchers, looking at the results of treatment of arthritis pain in two groups of patients in North America, from 1999 through 2007.  One group was treated by arthroscopic surgery. The other was treated with conventional, mainstream non-surgical methods, including anti-inflammatory medications and physical therapy.
 
The headline from this study was that there was NO DIFFERENCE between those that were treated surgically and those who were NOT. This, of course, suggests that surgery done strictly for arthritis pain is not warranted. The trouble with this news flash is that it’s really not news, or at least it’s yesterday’s news.
 
In 2002, another study was done, comparing arthroscopic surgery with sham surgery (ie., a skin incision was made over the knee, that was sutured,  but instruments were not introduced into the joint, nor were any intra-articular manipulations done).  This study found similar findings among U.S. Veterans in the Veterans Administration Hospital System. Again, the use of arthroscopic surgery for the treatment of arthritis pain was discredited. Short term relief of pain in BOTH groups (ie., real surgery and sham or fake surgery) was the SAME! This was attributed to a placebo effect.
 
This prior study was so impressive that Medicare used it as a basis for determination in refusing to pay for arthroscopy for the treatment of arthritis pain. And this study was a reinforcement of an even earlier study that compared arthroscopic surgery with merely lavage (injecting and extracting saline, or salt water, into and out of the knee joint, to wash it out). Here, too, there was NO DIFFERENCE between the surgery and the wash-out groups. So here is more evidence of what you know instinctively–letting the body heal itself is the best course, except in advanced, or end-stage arthritic disease.
 
In my years of practice, it was my experience that if a patient had full-blown arthritis, there was little reason to ‘scope them, UNLESS they had a sudden increase in very specific joint line pain, or giving way (so-called mechanical symptoms) that suggested a displaced or entrapped tear of the meniscus, or a rip-roaring synovitis (as in Rheumatoid Arthritis) that would not respond to medical treatment, or needed relief but were a poor risk for major joint surgery, like a total knee replacement.
 
This is why I consider this “old news.” I used arthroscopic surgery for very specific mechanical or synovial overgrowth problems, NOT just as a “catch-all” treatment for arthritis pain. I always advocated a conservative approach first, letting the knee itself declare if and when it was ready for a major surgery.
 
I STILL DO.
 
Like I’ve said before, there are times when surgery is absolutely needed. To deny this, or make frankly STUPID statements that “surgery is NEVER warranted,” is to deny the facts. But surgery should be the last or the best option–not the first line of defense. In short, you want to AVOID the UNNECESSARY SURGERY. 
 
And to help you do just that, I wrote my newest healing program, HOW TO AVOID KNEE SURGERY
 http://drbillsclinic.com/avoid_knee_surgery.html   With conventional and alternative methods from across the entire medical spectrum, you have everything at your fingertips to relieve your knee pain, but stay OUT of the Operating Room.
 
If you want the very latest methods to get rid of that nagging knee pain for good, but want to do it WITHOUT SURGERY, then you need my program. Order it here:  http://drbillsclinic.com/avoid_knee_surgery.html
 
Have a great weekend, my friend, and be well. Til next time…
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
 All rights reserved

Red, burning, swollen and so stiff you don’t want to move…that’s what those who suffer from arthritis experience on a daily basis. If you know this all to well, you are probably one of the 46 million Americans (that’s 1 out of every 5 people) that are living with arthritis every day. To better understand how to get relief from this debilitating disease we need to dive deeper into its root cause.

Some of the types of arthritis, and other related conditions, which are associated with inflammation 

    * rheumatoid arthritis                                                                              

    * gout
    * tendinitis
    * bursitis
    * polymyalgia rheumatica

What is Arthritis?

Arthritis actually means joint (arthr) inflammation (itis). Arthritis can be used to define a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints or any part of your body. Additionally, it can damage the joint cartilage which can lead to joint weakness, instability and visible deformities that can interfere and, in severe cases, limit a person’s ability to perform most basic daily tasks such as walking, climbing stairs, using a computer keyboard, washing dishes or brushing your teeth. Arthritis can affect anyone regardless of age and most commonly affects joints in the knees, hips, hands and spine. If left undiagnosed and not treated properly, arthritis can cause irreversible damage to the joints, bones, organs, and skin, not to mention dramatically impair your quality of life.

Arthritis-related conditions primarily affect the muscles and the bones but are also considered to be systemic, affecting the whole body. Arthritis can cause damage to any bodily organ or system, including the lungs, kidneys, blood vessels, skin and even the heart. The Arthritis Foundation cites two independent studies (Brigham and Women’s Hospital in Boston and at the Mayo Clinic in Rochester, Minnesota) both of which prove that the widespread inflammation in rheumatoid arthritis is linked to heart disease and an increased risk of early death.

No one really knows the exact cause of arthritis but there are certain risk factors to keep in mind:

    * Genetics – likely to contribute to risk but no one knows how much.
    * Age – the older you are the more at risk you become.
    * Weight – maintaining a healthy weight will ease the load on the joints.
    * Previous Injury – major injuries are likely to contribute to risk.
    * Occupational Hazards – repetitive, high demand jobs increase risk.
    * Certain Sports – high level, high demand sports can contribute to arthritis (however, general exercise is always a plus)
    * Illness or infection – an infection in the joint or gout can lead to arthritis.

What we do know is that when you have arthritis your immune system goes into over-drive and causes the joints to swell and become inflamed. Therefore, treating the inflammation becomes key in managing the pain and discomfort associated with this condition.

Sadly enough, the Arthritis Foundation reports that half of those Americans with arthritis don’t believe anything can be done to help ease their pain. You may be in that situation yourself, having thrown your hands up in frustration and simply decided to live with your pain. The good news is that by reducing the inflammation you can significantly ease the painful symptoms associated with arthritis.

Here are a few ways to reduce your inflammation:

    * Exercise – less weight equals less stress on joints
    * Diet – Eat plenty of vegetables, fruits and whole-grain products; limit sugar, salt and fat (especially saturated fat found in animal products)
    * Rest – a good balance between rest and activity is the key to joint health
    * Over-the-counter and prescription medications – while these may provide temporary relief by masking the pain they do not always get to  the root of the problem – inflammation. They can also have serious side effects, especially with long-term use.
    * Natural anti-inflammatory supplements – probably the most promising natural approach to reducing inflammation in a long while. We recommend looking for supplements containing systemic enzymes and all-natural herbal ingredients.

By taking these simple steps to reducing inflammation you will be well on your way to managing your arthritis pain and it devastating effects on your mind and body. Everyone should strive to achieve a healthy and active lifestyle for optimal health and wellbeing.

Try some today! Til next time, my friend, be well.

Yours for a pain-free tomorrow,

Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html

P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
http://drbillsclinic.com/exercise_eliminate.html

P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
http://drbillsclinic.com/advanced_masters.html

FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION

Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

For the past week or so, I’ve been trying to relieve your fears about surgery. Hey, you never know. One day you might NEED one of these procedures, and it would be a shame if you were terrified, due to misperceptions, misinformation, distortions and urban myths. It’s also a good idea to know just what your options are, so you can make an informed decision, should that day ever come.
 
So, I’ve attempted to give you the straight dope, tell you exactly what’s done, in each of the most common surgical procedures for the knee. As I’ve said before, when you KNOW the finite dimensions and the finite duration of an experience you fear, it helps a lot to put it in perspective, help you face it and help you handle it. 

Today, to round this all out, is the ultimate option: ARTHROPLASTY, more commonly called joint replacement. Though the term actually means “creation of a joint,” it’s come to be identified with joint replacment, and is now virtually synonymous. This was initially TOTAL knee replacement, but today, through many technical advancements, it encompasses PARTIAL or UNICOMPARTMENTAL joint replacement, as well. These options are explained in great detail, though in layman’s language, in my LITTLE GREEN BOOK at http://drbillsclinic.com/eliminate_knee_pain.html
 
This is really a misnomer, though. Unlike a total hip replacement, a total knee DOES NOT replace the entire joint, nor does it remove the bony segments of the joint. Instead, only the SURFACES are replaced with man-made shells of polished metal, articulating on very tough plastic. Technically, the operation is a joint resurfacing arthroplasty. If there’s severe arthritis on only one side of the joint, then only that side has its surfaces replaced. The so-called UNI (unicondylar knee replacement) can be done through a very small incision, sometimes even on an outpatient basis. The trick is for the surgeon to balance the ligaments and align the knee properly, so the kneecap tracks properly.
 
Small power saws are used, with special saw guides and alignment tools, to cut thin slivers off the ends of the bones, the femur and the tibia. This removes the arthritic surfaces and “opens up” the spongy (cancellous) bone, for acrylic cement intrusion, which holds the implants in place on the respective bones. The properly sized implants are then selected and implanted. 
 
A total knee replacement, like the name implies, resurfaces all three compartments, medial lateral and patellofemoral. It’s done for more extensive, or end stage disease, in two or all three compartments. It needs a larger incision, generally involves somewhat more pain, swelling and potential bleeding. It has a greater potential to develop adhesions, and limited motion, after surgery.
 
In both cases, weight bearing is initially limited by pain, and the use of crutches or a walker. Motion is started right away. Pain is controlled with medications, and physical therapy and rehabilitation are essential. Many of the exercises used are those I teach in my PAIN-FREE PROGRAM, at   http://drbillsclinic.com/exercise_eliminate.html
 
But here’s the thing. Although the success rate, in the right hands, is very good with joint replacement, you NEVER do this without the right indications. The truth is, nothing made by man is as good as what God gave you. Man-made parts can wear out, can get loose, even get infected…and there’s always the chance of a technical problem or human error, even in the best of hands. 
 
So you need to be SURE that if TKR or a UNI is recommended, it’s NECESSARY. And if you can get relief from ANY more conservative methods, conventional, alternative, or complementary, provided you don’t have a lot of bone loss in the joint or severe deformity, then it’s an UNNECESSARY SURGERY and should be delayed, or avoided. And it was to help you do just that, that I wrote my new healing program, HOW TO AVOID KNEE SURGERY   http://drbillsclinic.com/avoid_knee_surgery.html
 
Well, I hope that this series on knee surgeries has been informative for you and that I accomplished my goal: to tell you exactly what goes on in the O.R., give you some perspective and relieve your anxiety and fears about surgery. If you NEED surgery, by all means, accept the risks and get the benefits.  Odds are, you’ll do great. But if you’re not sure, or if all non-surgical measures have NOT been exhausted, then there’s at least the possibility that you may be headed for an UNNECESSARY SURGERY.
 
In that case, get my program and be prepared. Don’t guess, when you can KNOW. Click on the link and get HOW TO AVOID KNEE SURGERY today, right NOW, at   http://drbillsclinic.com/avoid_knee_surgery.html   to relieve your pain, restore your function and do it WITHOUT SURGERY.
 
Til next time, my friend, be well and have a great weekend.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved