February 10, 2010

You know, I just saw an ad the other day, writen by a chiropractor, who is promoting the use of a cold laser for arthritis pain relief. He cited a two year old study, published in the New England Journal of Medicine and then, MISREPRESENTED THE RESULTS, to better sell his modality.

Now, this is no slam against chiropractors. A number of them are my friends and colleagues and there’s no doubt that they help people, which is the name of the game. It IS, however, a criticism of dishonesty in advertising. Here’s what I mean.

The published study cited compared WOMAC scores (a standard statistical device for comparing clinical results of arthritis treatments) between two comparable groups. One group was treated with arthroscopic surgery (ie., debridement, or “housecleaning”), followed by medication and physical therapy.

The other group was treated only with medication and Physical Therapy. It was found after two years that there was no appreciable difference between the two groups (based on their comparative WOMAC scores). The conclusion was that there was no demonstrable clinical benefit from the arthroscopic knee surgery, when done for arthritis.

So this was the study referenced by the good doctor. But, after correctly summarizing the study’s conclusion, this doc then went further, to say this: “Once again, this study proves what conservative doctors have known all along. Non-invasive treatments are the solution to osteoarthritis knee pain.”

No. Sorry. First, that is NOT what the study proved. Second, that statement is patently absurd.

Invasive treatments, meaning ALL forms of surgery, but ALSO, strictly speaking, even injections into or around the affected arthritic joint, each have their place. You just can’t make a blanket statement that ALL non-invasive treatments alone are THE solution. It’s simply not true.

Every case is an individual situation. And no single treatment is applicable, or effective in all cases.

Look, even when I was doing joint surgery nearly every day, I encouraged people who DIDN’T need surgery to wait, try some of the many conservative treatments, from all across the medical spectrum, conventional, alternative, or some combination of the two (complementary).

Nonoperative treatments CAN be helpful and ARE effective for many cases of mild, moderate and even some severe cases of osteoarthritis.

But in other cases– where there is bone-on-bone, meaning that the underlying subchondral bone is completely exposed, by erosion of the protective cartilage layer, or even worse, cases where the bone itself has begun to wear away from friction, resulting in progressive deformities– surgery is the ONLY solution.

In these latter cases, surgery IS necessary. And frankly, treating these advanced cases with only non-invasive treatments is like pi$$ing in the wind–the results are likely to be… unfortunate. In some instances, this would be frank malpractice.

What you want is to avoid the UNNECESSARY SURGERY.

That’s why I put all the very best treatments, including the cold laser, into my newest healing program for knee pain, HOW TO AVOID KNEE SURGERY:

http://www.drbillsclinic.com/avoid_knee_surgery.html

And now, as a perfect complement to that course, I’ve released my newest healing compound, DR. BILL’S JOINT HEALTH FORMULA:

http://www.favoriteformulas.com/jointhealth

This is a wonderful amalgam of the best ingredients available for the relief of the pain of arthritis, including a secret oil from New Zealand, that dramatically reduces symptoms of pain and stiffness. Taken in conjunction with my ultra pure, enteric coated, pharmaceutical grade fish oil, POWERHOUSE OMEGA FORMULA

http://www.favoriteformulas.com

and you have a powerful combination for arthritis pain relief, that may well delay, or even eliminate any potential joint surgery. The point, though, is that you must be wary of any claims you read on the internet. Just because it’s written doesn’t mean it’s true.

Well, any time now, you’ll be getting the instructions for the big switch to another provider for this newsletter. Remember, if you want to keep receiving this daily email, you MUST re-subscribe. Otherwise, they will simply stop. I’m hoping that you find some value in this and that you’ll follow me to the new service. But, as always, the choice is yours.

Til next time, my friend, be well. Talk to you soon.

Yours for a pain-free tomorrow and optimal health,

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 conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html

P.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, 2010 by William Thomas Stillwell, MD, FACS
All rights reserved

January 12, 2010

One of the most frequent questions I get is whether or not surgery is indicated for knee pain. Usually this applies to chronic, aching, long term knee pain, typically seen with osteoarthritis. But once in a while, it applies to a sudden onset, or an acute exacerbation of low grade, pre-existing knee pain.
 
Especially among those who lean toward the natural, often holistic treatments available in the realm of Alternative Medicine, the very idea of knee surgery is anathema. Even when they’ve been seen by a qualified orthopaedist, or other licensed health care practitioner, and been told that they do need surgery, suspicion remains.
 
Part of this is due to the Medical Profession itself, those practitioners who are overly aggressive in their promotion of the surgical approach. But part of it is unwarranted, based on a knee-jerk (sorry) assumption that a surgeon will always want to operate. That’s simply not true. 
 
The best surgeons DON’T operate on anyone who comes in the door. They only offer surgery when it’s appropriate, as the only, or the best alternative treatment, from the available options. I don’t even ask you to rely on the altruism of the surgeon. No. You can always depend on self-interest.
 
Just think about it. Were that NOT the case, if surgery was done frequently, without just cause, there would be a very high number of complications from unindicated procedures, poor results, very dissatisfied patients, and very, very unhappy referring physicians (because that would reflect badly on THEM). 
 
Result? The referrals would simply dry up and the surgeon would have no practice, in very short order. 
 
Surgeons survive and prosper by referrals from primary care physicians and other (HAPPY) patients. And the best way to enjoy an excellent reputation is to do the right thing, for the right patient, at the right time, consistently. That means to do surgery ONLY when it’s necessary and avoid unnecessary procedures.
 
Ironically enough, this approach is not only more honest and more in the interests of all concerned, patient, surgeon and referring doctor, but it results in the surgeon doing MORE surgery, that’s really needed.
 
Still, there is that suspicion, that little voice of doubt….
 
Let me give you a current example. One of my subscribers sent me the following email to ask for my opinion.
 
“Dear Dr. Bill,
 
I have arthroscopic surgery scheduled for tomorrow for a “potential” meniscus tear in my left knee (interior). I just stumbled onto your website and am having second thoughts about having surgery. I am 39 and in good health. 
 
The pain in my knee started after overindulging in three days of soccer, running and biking. It started about four months ago. It initially swelled and was painful to walk on, but is now just occasionally sore (mainly before storm events and after heavy use). 
 
My knee is tender on the inside, lower area. I have full range of motion and do not want to risk losing this due to surgery complications. Your insight would be greatly appreciated.”
 
I advised him to proceed with the surgery, which was arthroscopic, after all, and likely to cause little disability. He just sent me copies of his intraoperative photographs, taken by his surgeon as documentation of pathology, a standard practice today. He did indeed have a degenerative tear of his posterior horn of the medial meniscus. And the surfaces of his knee were otherwise in good shape. All this was consistent with his symptoms and his diagnosis of a torn medial meniscus.
 
That means that if surgery were NOT done, he would certainly have developed irreparable cartilage changes and ultimately, arthritis. In other words, this was a NECESSARY surgery. However, the same tear in someone who already had severe arthritis may, or may NOT be necessary, depending on his symptoms.
 
So, in this instance I was right. His surgeon was right. And, ultimately, the patient himself chose correctly.
 
So what can you do to choose correctly for your own knee pain? First, and I’ve said this over and over, get a real evaluation by an orthopaedist, or at the very least, a licensed health care practitioner. 
 
It’s what you DON’T know that can hurt you. No one can make you have surgery. But you need information to make a rational decision. And this is the best way to get complete information, so you can explore your options, based on what your problem actually IS.
 
By all means TRY conservative, non-operative measures, from the entire spectrum of treatments, alternative as well as conventional, like those I teach in my newest healing program, HOW TO AVOID KNEE SURGERY
 
  http://www.drbillsclinic.com/avoid_knee_surgery.html 
 
For example, inflammation is usually part of the reason for pain. Reducing inflammation will almost certainly reduce pain. One natural way to do that is to take a pharmaceutical grade fish oil, like my ultra pure, enteric coated, POWERHOUSE OMEGA FORMULA    http://www.favoriteformulas.com 
 
Local heat and strategic exercise also play a role, as do braces and ambulatory aids, at times. In many cases, pain can be resolved and function restored, using these nonsurgical therapies. 
 
But at other times, an operation IS the conservative thing to do. So don’t suffer needlessly, wondering should I, or shouldn’t I?
 
It’s a matter of judgment, based on the facts. So get your doctor involved early. And though you SHOULD be sure you are kept informed and fully understand ALL your options, don’t automatically assume that the doctor is there to screw you, or give you a surgery you didn’t really need. Most of us are pretty decent guys, if you give us a fair chance.
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
“The Wellness Warrior” TM
 
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 conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html 
 
P.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, 2010 by William Thomas Stillwell, MD, FACS
All rights reserved

December 9, 2009

Eary yesterday, while I was reading my email, I came across an article from News 8 Austin with the provocative title: “Doctors Eliminate Arthritis Without Surgery.” Wow. Who knew? That would be news to me and I should know. So, I clicked on the link and read the article.
 
Talk about your misleading headlines!
 
It was actually a pretty good, if superficial, review of what is known about arthritis: that the most common form is osteoarthritis, it affects more women than men, the hip and knee are the most commonly affected joints, it is made worse by increased body weight (ie., obesity) and in its advanced form, it can result in joint replacement surgery.
 
But as for eliminating arthritis, without surgery? Uhh…No.
 
They also reported that researchers at Tufts University (my old stomping grounds in Boston, where I did my fellowship in joint reconstruction, at the New England Baptist Hospital) had found that older people (above age 65) did better with Tai Chi. They described Tai Chi as a series of slow, rhythmic Chinese exercises. They also found similar benefits with walking, swimming, bike riding and other, comparable low impact exercises.
 
All this is very nice, but it’s old news. Nothing new in the whole thing. 
 
It’s been known for many years that low impact exercise is the thing to do with arthritis. The shock of impact with running, for example, will not cause arthritis. But if there is any pre-existing degenerative change in the cartilage surfaces of the joint (and who of us at, in, or past middle age doesn’t have some form of degeneration in our joints?), the impact will ACCELERATE the arthritis. This is the source of joint pain that seems to come suddenly, “out of the blue.”
 
I’ve been saying for years that low impact exercise is the way to maintain your joint motion, while improving your heart and lung reserves and lowering your blood pressure and blood lipids, like cholesterol and triglycerides. Stretching also helps to improve and maintain your joint motion, an important element in preserving joint function.
 
But, in addition, resistance exercises are needed to increase the mass and tone of the muscles around the joint. Why? Well, stronger muscles help to share the load of body weight borne by the joint surfaces. In addition, they provide increased dynamic joint stability and in the knee, alter the functional dynamics of the kneecap (the source of over 50% of all knee pain, in my experience).
 
These are the same principles I teach in my PAIN-FREE PROGRAM, which you can get here:
 http://www.drbillsclinic.com/exercise_eliminate.html
 
But if you truly want to eliminate the SYMPTOMS of arthritis (not the same thing as eliminating the disease itself, which we cannot do, at present), then you need to add other conservative measures to the exercises. 
 
There are many conventional and alternative treatments which reduce the pain of arthritic inflammation, slow the progress of the disease and help to preserve the cartilage which remains. All of these elements together may prevent, or at least delay, the need for joint replacement surgery.
 
Remember, I spent nearly a quarter century DOING such joint replacement surgeries (total hips, total knees and revisions) and arthroscopies. Who better than a surgeon to teach you how to avoid surgery?
 
That’s the idea behind my newest healing program, HOW TO AVOID KNEE SURGERY, which you can get here:
 http://www.drbillsclinic.com/avoid_knee_surgery.html
 
One such simple example is the use of fish oil, which contains omega-3 fatty acids, that have natural anti-inflammatory properties, in addition to its known and proven heart and brain healthy effects. My POWERHOUSE OMEGA FORMULA, an ultra pure, highly concentrated, pharmaceutical grade fish oil   http://www.favoriteformulas.com 
 
has even addressed the problem of the fishy aftertaste, or the dreaded “fish burps” by the use of a special enteric coating, which virtually eliminates this problem. That’s why I take it myself, twice a day, every day.
 
So while that headline was misleading, or at least premature in its optimism, there are a LOT of things than CAN be done. You can reduce pain and inflammation, slow or stop the progress of joint destruction, and preserve your function, so you can continue doing what you want to do for many years to come. And, in most cases, you can do it without surgery. Get one of my life changing products and see for yourself. 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 conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html 
 
P.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, 2009 by William Thomas Stillwell, MD, FACS
All rights reserved

So here I am, sitting in the study of the Southern Command Post, reviewing emails. And I came across one from a nice lady who is very concerned because she has knee pain, she is very heavy, given her size and worst of all, she has noises inside her joints that can actually be heard by people around her.
 
She was quite properly concerned because she’d like to get rid of her knee pain, and she wanted to get a copy of my newest healing program, HOW TO AVOID KNEE SURGERY (which you can get here at this link:  http://drbillsclinic.com/avoid_knee_surgery.html ), but she was afraid that it was already far too late for her–that the noise in her knees meant that all the cartilage had worn away completely, and that she had a “bone-on-bone” condition. This is what we in the trade call an “end stage knee.”
 
When articular cartilage, that normally coats the joint surfaces, is so diseased that it has eroded away and exposed the underlying bone, the naked bony surfaces grind upon each other with a deep, hard grinding sound and sensation that, once experienced or heard, is difficult to mistake for anything else.
 
It really is like rubbing two big rocks together, with grinding, rubbing and at times a mechanical ratcheting sensation. And, since the bone is where all the nerves reside, it hurts like hell! And that doesn’t count the extra pain from the inflamed lining membrane (synovium) that adds its own component to the pain.
 
So whether it’s osteoarthritis or rheumatoid arthritis, it’s at this end stage of disease, with exposed, bare bone, when major surgery IS truly indicated. Because at this state of the art, at this time, we cannot yet regrow new, healthy articular cartilage in a totally arthritic joint. The best we can offer is total knee replacements. And when they are indicated, they can be wonderful: pain relief, restoration of function and correction of deformity, with good to excellent results in over 95% of cases.
 
BUT…it’s major league surgery, with lots of risks and potential complications. So you don’t do it if you don’t HAVE to. 
 
However, all noise from within the joint doesn’t necessarily mean that your joints are finished and you need major surgery. Other conditions can cause noise, as well. When the lining of the joint becomes inflamed and swollen, its folds become thickened and enlarged. They rub upon each other, making a finer, more delicate crunching that we call crepitus or crepitation. 
 
If the membrane is restored to normal, the inflammation resolved, the swollen folds stop rubbing together and the noise stops. But if the condition persists for a long time, the membranous folds may become replaced with fibrous tissue (they become bands of scar tissue) and they then must be cut away surgically, to eliminate the sensation and the sound.
 
Then, there is degeneration of the articular cartilage surfaces, which may break apart into shredded beds of cartilage fronds, appearing like areas of “crab meat.” When these fragmented or fibrillated regions rub, one upon another, they too produce a crunching sensation, like walking in a gravel pit. 
 
This condition is called chondromalacia (“soft cartilage” grade III) and once this point has been reached, where there is physical disruption of the cartilage surface, it can never again return to a pristine, smooth surface. I discuss this disease and the various types of arthritis in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN (manual and CD). Get it here at: http://drbillsclinic.com/eliminate_knee_pain.html  However, even though the knee is noisy, it doesn’t mean that it will immediately go on to full end stage arthritis. The knee can stabilize in this state for a long time, sometimes pain-free (if a little noisy), if treated with the exercises I teach in my PAIN-FREE PROGRAM. See what I mean at this link:   http://drbillsclinic.com/exercise_eliminate.html
 
The point is, this lady has nothing to lose and everything to gain by at least trying all the conservative measures that are available, to relieve knee pain. One of them, or some combination of them, may give her the knee pain relief she seeks, and buy time, until she can lose weight and make an eventual surgery safer and more likely successful. 
 
So the next time someone, maybe you, says, “Hey, what’s that horrible crunching noise in my knee?” now you know what some of the reasons might be. And some may well be treatable by non-surgical measures, like those in HOW TO AVOID KNEE SURGERY: http://drbillsclinic.com/avoid_knee_surgery.html   Noise doesn’t necessarily mean it’s the end of the line, or that a total knee is the only option.
 
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

Every so often, I get emails asking for my advice or help regarding some persistent knee pain. It’s not at all uncommon for people to have no clue what’s going on in their own knees, sometimes even if they are seeing a physician. 
 
With the increased volumes of patients necessary to generate the revenue necessary to stay in business, most physicians simply don’t have the time or the inclination to answer a lot of questions. They need to get you out, so they can move on to the next patient.
 
Recently, I had an email from a person who was referred to me by a mutual friend. He had persistent knee pain, after he had undergone arthroscopic knee surgery 15 years ago. He was understandably upset and perplexed as to why he had undergone surgery, but STILL had pain. He had expected a “cure.”
 
I mean, what if you STILL have pain after knee surgery? What then? 

Well, here was my response:
 
 
“Sorry to hear of your knee pain. Perhaps I can help you.
 
“If you had arthroscopic surgery 15 years ago, but still have knee pain, it’s likely that you ARE healed, but you have residual degenerative (arthritic) changes inside the joint. Assuming no new injuries to the internal structures, that is the most likely explanation for your persistent pain. 
 
“This is a pretty broad topic, beyond the scope of a simple email. 
 
“But I have written several healing programs for just such problems. One of these may well help you, as they have helped a number of others.
 
“I would suggest you consider my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, manual & CD (get it at http://drbillsclinic.com/eliminate_knee_pain.html ), which helps you identify what’s causing your pain and offers methods from across the entire treatment spectrum (conventional, alternative and complimentary), and my PAIN-FREE PROGRAM, which you can get at http://drbillsclinic.com/exercise_eliminate.html  which demonstrates the specially modified exercises I used myself (I had arthroscopic surgery, personally, a couple of years ago) and that I used on my own patients, during my years in practice. 
 
“These products are designed to compliment each other, as a set.
 
“Most recently, I wrote a new program to help people get rid of knee pain, without surgery, called (appropriately enough) HOW TO AVOID KNEE SURGERY. This program combines the best of conventional and alternative measures for short term relief of inflammation the major cause of acute pain) and specific, modified exercises for long term pain relief and restoration of function. 
 
“You can see that new program (and get it) at http://drbillsclinic.com/avoid_knee _surgery.html 
 
“I’m sure that one of these options will help you get the relief you seek, if you apply the principles I teach. Let me know how you’re doing. Good Luck!
 
“All the best,
 
“Dr. Bill Stillwell”
 
 
Well, it’s too soon to tell if he took my advice. But degenerative changes within the knee joint (usually ostearthritis) is the most common long term cause for persistent knee pain. Especially after you’ve had surgery. You see, a recent Canadian study has confirmed what an earlier clinical study had already suggested–namely, that arthroscopic surgery is NOT an effective treatment for osteoarthritis. 
 
Two groups, one which followed knee surgery with medication, physical therapy and exercise, and one which ONLY had medication, physical therapy and exercise, but NO surgery, were compared. There was NO statistically significant difference between the two groups, regarding pain and function. 
 
If there was no difference, then WHY would you have surgery, with all its attendent risks and potential complications? Right. You wouldn’t.
 
It’s too bad this man waited 15 years before getting my advice. If he had used the combined methods I teach in my new program, HOW TO AVOID KNEE SURGERY ( Get it at http://drbillsclinic.com/avoid_knee_surgery.html ), he might well have avoided years of frustration and pain.
 
So, a word to the wise…if you have knee pain, DON’T WAIT until after you’ve had surgery, which isn’t indicated anyway. Click on this link, RIGHT NOW: http://drbillsclinic.com/avoid_knee_surgery.html   and relieve your knee pain, for good!
 
Til next time, my friend, be well. Time to get a nice fat turkey ready for the feast….
 
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

This past weekend, I was at a business/marketing meeting in Tampa. One of the attendees was a fellow I had advised in the past, and one who had used the recommended exercises in my PAIN-FREE PROGRAM  http://drbillsclinic.com/exercise_eliminate.html/.  He’s  a few years older than me, but in otherwise good shape.
 
Up to now, he had done pretty well. So well in fact, that he has written a testimonial for me, which I will post, once he sends me a photo of himself to run with it. But, like many of us (me too) he got a little bit complacent and slacked off the exercises. 
 
Sure enough, he started to develop recurrent symptoms. ”Hey, what’s that vague ill-defined knee pain?” he wanted to know. I shouldn’t wonder. 
 
Knee pain, especially low grade, achey pain, is often diffuse and ill-defined. That is, unless there’s a specific injury that causes a sharp, acute pain, associated with damage to specific structures. These would be things like a fall, twist or sprain of ligaments, or strain of muscles, a tear of the meniscal cartilage, a rupture of the ACL, degenerative diseases (like chondromalacia or it’s cousin, osteoarthritis), or inflammatory conditions, including rheumatoid arthritis (and its relatives, psoriatic arthritis, lupus, spondylitis, etc.)infectious arthritis (Lyme Disease, staph or strep infection).
 
Why do these conditions cause this low grade ache? In a word, SYNOVITIS. This is an inflammation of the lining membrane of the joint. Now, synovitis is a very non-specific response to ANY stimulation, regardless of what it is–IT HURTS. The membrane also becomes thicker and more swollen, actually grows in volume, becomes red (from dilated blood vessels) and produces an excessive amount of joint fluid (which it normally makes in very small amounts, to lubricate the articular cartilage and nourish the cartilage surfaces). Lay people call this “water on the knee.” 
 
Since I was there with him, I examined my friend’s knee, right there in the conference room. Very few findings, though. Some loss of the last few degrees of motion at the extremes of flexion and extension, maybe five degrees at each end, consistent with the thickening of the synovial membrane. And he had a little bit of pain under the kneecap, when pressure was applied. Pretty much, that was it. Of course, I had no x-rays or MRI images to examine.
 
My impression was that he had developed a recurrent case of chondromalacia patellae–softening of the cartilage of the patella. Either that,or it’s first cousin, osteoarthritis. So, what to do?
 
First, he needs to resume the exercises I teach at http://drbillsclinic.com/exercise_eliminate.html  Exercise is the overall best method for long term pain relief of the knee.
 
Next, he needs to get on the anti-inflammatory regimen I present in detail in my newest healing program, HOW TO AVOID KNEE SURGERY, at  http://drbillsclinic.com/avoid_knee_surgery.html
 
With luck and some work, he should get fast pain relief in as little as one week. If he does the work…
 
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

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

May 8, 2008For all the many years that I served my community as The Hip & Knee Specialist of Long Island, the majority of my patients were women. Not that I didn’t see a good number of men as well, but they were outnumbered by a significant number of females. Now, I would have liked to think that this was because of my killer looks, my expertise, reputation and technical skill, or maybe my overwhelming personal charm . Yeah, I would have liked to imagine any of that. But the truth is, there were more women patients simply because, due to anatomical and physiological  factors, they have more joint problems than men do. I mean, they have a higher incidence of patellofemoral problems, like painful kneecaps, a higher incidence of idiopathic adolescent scoliosis (spinal curvature), more arthritis, both degenerative (osteoarthritis) and inflammatory (rheumatoid arthritis) and more osteoporosis. And that doesn’t even take into account the increasing numbers of young women who get involved in contact and running sports, like soccer, with itsattendant injuries. Who said, “I enjoy being a girl?” So, why is that? You would think that as the bearers of offspring, females would be better protected. Actually, a lot of knee pain is a direct result of the structural variations in female anatomy that differ from the male. Because women must deliver children, their pelvises are, in general, proportionally broader than those of men. This means their hips are wider and that results in a greater valgus (knock-kneed) angle at the knee, as the thigh bones sweep inward from the wider hips. So the knees of women tend to be more”knocked” than those of men. Since the thigh muscles follow the path of the bones, this tends to make the quadriceps pull the kneecaps more toward the outside of the knee, resulting in kneecap pain and a greater tendency to maltracking (slipping out of position). Then, there’s the tendency to get arthritic changes, both degenerative (osteoarthritis) and inflammatory (rheumatoid arthritis, lupus) that’s considerably higher in women. And, like the rest of us, women these days are getting heavier, too, which adds more stress to the knee joints. All these factors are additive, too.  I discuss all of these elements in greater detail at    http:drbillsclinic.com/eliminate_knee_pain.htmlWhen you add up all of these influences and predispositions, it’s not really too surprising that I ended up seeing more women than men in the office. Fortunately, I was able to get most of them better by conservative measures, that allowed them to heal and get pain relief, without surgery. Weight loss, activity modification, bracing and very specific, specially modified exercises, like those I teach at http://drbillsclinic.com/exercise_eliminate.html   worked most of the time, to get rid of their pain and get them back in action again.And, you know what?  They still work… really, really well. You can even apply the same principles to the rest of the body. If you are a lady, or if you know a lady, that needs a terrific overall dedicated exercise program for the fair sex, try Bodysculpting for Women    http://drbillsclinic.com/body_sculpting.html      Eddie Baran’s program is great for toning, strengthening and, yes, sculpting the female form. I’ve personally spoken to women who’ve tried it and they love it! So, whether you need your knee pain relieved, or you need an overall program for improved health, exercise is not only a great cure for a lot of what ails you,  but the closest thing we’ve found yet to the “Fountain of Youth.”  Til next time, my friend, be well. Yours for a pain-free tomorrow, Dr. BillP.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, MDAll rights reserved

April 11, 2008

One of the most striking things I noticed early on in my practice was that most of the knee problems were in women. When you think about it, that’s kind of counterintuitive. I mean, you would think that guys playing weekend warrior would be the most frequent visitors to my office, but no. Women, hands down. That’s not to say that I didn’t see a good number of men, too. Just that they were outnumbered by the ladies.
 
Turns out, there are a few good, scientific reasons for that observation. First, anatomically, you may have noticed that most women have broader pelvises than men. Not all men, just most men. And that makes sense, because they need a wider pelvis to permit childbirth. Because of that anatomical fact, their hips are also wider. So the thigh bones have to sweep inward to the knee at a more pronounced angle.
And therefore, their knees tend to have a more knock-kneed angle than men, too.

This is the source of most of the trouble. This increased knock-kneed angle (genu valgum) means that the thigh muscles that pull on the kneecap are also more angled outward. So the kneecap (patella) is more likely to be pulled outward and track laterally. This makes the possibility of the kneecap slipping out of joint more likely and also puts abnormal pressure on the kneecap, often resulting in painful
degenerative softening of the cartilage (chondromalacia patellae). You can read more about the influence of gender on knee pain in my LITTLE GREEN BOOK   http://drbillsclinic.com/eliminate_knee_pain.html

Now, in addition to the anatomical influences, women also tend to get osteoporosis, especially in middle age, after having children, or after a total  hysterectomy. And they have a greater tendency to develop osteoarthritis, and rheumatoid arthritis–no one knows why. Finally, in general, most women have less muscle mass and are not as strong as most men: their legs are simply weaker. They lack the joint stabilizing and shock absorbing effects of more muscle. This is why they can benefit from my PAIN-FREE PROGRAM of selected knee exercises
http://drbillsclinic.com/exercise_eliminate.html
 
But this is true of the rest of their bodies, as well, especially in the older women. My friend Ed Baran, “The Baron of Body Sculpting” has developed a terrific bodyweight exercise program, especially designed for women. I can’t recommend this highly enough. You don’t
need any equipment, just the desire to improve your function and your appearance. See what I mean at
http://drbillsclinic.com/body_sculpting.html
 
Whether it’s osteoporosis, knee or back pain, high blood pressure, diabetes, high cholesterol, or frank heart disease, exercise is often the very best medicine for what ails you. Try it. You’ll like it. That’s all for today my friend. Have a great weekend and, as always, 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