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Re: naming the syndrome?
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Re: naming the syndrome? - October 9, 2005 2:48:00 AM
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Jon Newman
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5 more abstracts to help inform the topic. Hopefully, I haven't repeated any already posted.
[URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10522634&query_hl=23]link 1[/URL]
[URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8803506&query_hl=23]link 2[/URL]
[URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9338948&query_hl=21]link 3[/URL]
[URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7935121&query_hl=19]link 4[/URL]
[URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1395219&query_hl=17]link 5[/URL]
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: naming the syndrome? - October 9, 2005 3:03:00 PM
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ginger
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From: Melbourne Victoria
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do we really need a better way of describing stiff neck?. How about stiffimus neckadonia, or canturnum syndrome, or maybe buggermenecksoremum osteitis. Could we do a "ten best ways "shtick, I'll start you off.
Tenth best ways to describe a stiff neck,
da da da daaaa,
gregory peckadonia.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: naming the syndrome? - October 9, 2005 6:10:00 PM
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FLAOrthoPT
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I am talking way more than a stiff neck, but I think you just wanted to hear yourself make a funny joke. So congrats.
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Re: naming the syndrome? - October 9, 2005 7:09:00 PM
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nari
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ginger
I will bite this time. Are you seriously saying that with the symptoms that FLAOrtho described, you would just passively mobilise? I'm making assumptions here of course and would love to be shown as wrong........but won't hold my breath.
Nari
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Re: naming the syndrome? - October 10, 2005 3:33:00 AM
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Shill
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heres one correlation, perhaps someone else beat me to it:
Clinical Rheumatology
Publisher: Springer-Verlag London Ltd
ISSN: 0770-3198 (Paper) 1434-9949 (Online)
DOI: 10.1007/s100670070040
Issue: Volume 19, Number 4
Date: July 2000
Pages: 253 - 257
Patients with Fibromyalgia Benefit from Aerobic Endurance Exercise
L. Meiworm A1, E. Jakob A2, U. A. Walker A1, H. H. Peter A1, J. Keul A2
A1 Division of Rheumatology and Clinical Immunology
A2 Division of Rehabilitative and Preventive Sports Medicine, Department of Medicine, University Hospitals, Freiburg, Germany
Abstract:
Abstract: Fibromyalgia (FM) is a disorder characterised by diffuse widespread musculoskeletal aching and stiffness and multiple tender points [1]. Its pathophysiology is poorly understood. The influence of aerobic endurance exercise on pain in patients with FM was investigated. Twenty-seven patients (25 female, 2 male) participated in a controlled clinical study and performed 12 weeks of jogging, walking, cycling or swimming following a given schedule. Twelve sedentary FM patients (11 female, 1 male) served as controls. Before and after training both the study and the control groups were evaluated spiroergometrically. Tender point pain was quantified by dolorimetry. The painful body surface was estimated by a pain body diagram, and its intensity by a visual analogue scale and a ranking scale. Patients trained for an average of 25 min two to three times a week, with an average intensity of 50% of maximal oxygen uptake (VO2max). Unlike the control group, the training group exhibited a decrease in heart rate and VO2 and an increase in respiratory quotient during submaximal workload. Maximal performance capacity and VO2max remained unchanged, whereas the wattpulse (watt/heart rate) improved at maximal workload. Pain parameters remained unchanged in the control group, but in the training group the mean number of positive tender points (15.4/12.7), the mean pain threshold of the gluteal tender point (2.89 kp/3.50 kp) and the painful body surface (18%/15% body surface) decreased significantly.
Subjective general pain condition deteriorated in two patients **but improved in 17***. Our results suggest a positive effect of aerobic endurance exercise on fitness and well-being in patients with FM.
_____________________________
Steve Hill PT
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Re: naming the syndrome? - October 10, 2005 4:52:00 PM
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Jon Newman
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Hi Shill,
I think the fitness/pain link is complicated. We have examples of decreased pain with fitness and increased pain with fitness. To me, this suggests that there are interaction effects that are perhaps non-linear or that there are other variables that are perhaps more important. In the study you posted for example, one group got treatment, the other group didn't. We know from other studies that control groups tend to fare more poorly than treatment and placebo groups. That is, some treatment is better than none.
Fitness is worth pursuing. It has been demonstrated to decrease 'disability' whether it helps pain or not and that is one of our main tasks (preventing disability). And, in my practice, that is how I sell fitness training. I don't suggest, "jog, it will make you hurt less" or "if your BMI was better you won't hurt so much" because I can't back that up very well. But I can back up that those types of things will improve their function and help other measures of "health" and that is worth it to many patients. I also address their pain but with a different tact.
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: naming the syndrome? - October 10, 2005 5:50:00 PM
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ginger
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"is there an accepted term for this conglomeration of problems? "
Depends on who is listening and who's offering the term probably. In the circle of therapists that have been taught manual spinal treatments Like myself in Melbourne Australia, this group of symptoms would still be called different names by different fields. Diffuse periarticular pain syndrome, cervical periarthritis, diffuse upper limb neuralgia, whiplash etc.
Regardless of the name , what is observable about this group of signs and symptoms is a number of activites and effects .
Periarticular muscle tone changes.
Palpable facet joint tenderness.
poor AROM of spinal segments.
Strong likelihood of referred pain and altered sensations distally.
Strong likelihood of altered spinal phasic muscle recruitment patterns.
All the above I have characterised as part of a protective response. The effect of the altered recruitment patterns will be to create odd patterns of scapular movements and rhythms, Gleno humeral movements , along with neuralgia. It is little wonder then that the first choice for me in dealing with this seemingly complex array of signs and symptoms is to see them as one behaviour, protective behaviour. In the course of being effctive in reducing and normalising this behaviour, I have found very consistant value in the method I call continuous mobilisation ( of facet joints )
In this way I find a quick and long term answer to what may seem complex from any other view point.
Yes Nari, My first choice in dealing with this is as you say, passive intervertebral facet joint mobs. With appropriately modulated and sensitive movemnts designed to alter and normalise periarticular tone, I turn off these protective activities around facet joints. The altered behaviour of Phasic muscles ( scapular, gleno-humeral) quickly normalises also. Neuralgic pain dissapears as facet joint movements are improved. As a first choice it has everything going for it, safe, quick, effective .
The variable that may slow down the best hoped for effect of this method ( or any other for that matter) is irritability. By this I mean the kind of poor response that is often seen in cases of severe MVA "whiplash". In these cases it is still rare for there to be no usefull improvement with Continuous mobs, but certainly other soft tissue methods may play an equal role.
Stiff neck is what these events are , if we go with the simple language construct I'm fond of, but bowing to the endless stream of euphemisms for "I don't know " is adding to the confusion all round.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: naming the syndrome? - October 11, 2005 7:05:00 AM
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JLS_PT_OCS
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Jon-
Very nice post there, on the interaction between pain and fitness level. I completely agree, and well said.
I do think that large portions of the lay public and even members of our own profession still seem to think that improving someone's fitness level will reduce their pain. This has not been my experience, generally, though I do think that it may have a role for our chronic pain folks, ie the Fibromyalgia group Randy describes. Perhaps it may increase someone's resistance to some kinds of pain or damage, but it also may predispose one to others.
Ginger-
While you have an intriguing theory, isn't your explanation just another, how did you put it? A euphemism for "I don't know"?
Surely you are not expecting us to just take your word for...oh, what am I saying?
Never mind, back to my fish healing technique. I'm getting great results with continuous use of sardines on patients lately, by the way. They are much easier to store and use, and can be utilized right out of the can. The ones packed in oil seem to do better than the water packed ones. Go figure.
:)
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: naming the syndrome? - October 11, 2005 1:46:00 PM
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ginger
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Jason , forward thinker that you are , have you wondered if they might work while still in the can?, or even still in the shop ?, subtle effects like fish healing may even work while thinking fishy thoughts, or even remembering previous fishy thoughts. Explore, be creative, don't let what has gone before be you guide, innovate. The world needs you to shake off the boundaries others have set on you. Check the garden for other life forms with similar healing properties, we hold our collective breath for, maybe, slug healing.
Along with expectations of your dismissive attitude to anything else outside your safe little box.Go figure.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: naming the syndrome? - October 11, 2005 2:21:00 PM
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FLAOrthoPT
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such subtle hints of aggravation and biting sarcasm is typically lost in internet dialogue, but, man, this one has me coming back for more, even with popcorn in hand..
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Re: naming the syndrome? - October 11, 2005 5:44:00 PM
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Randy Dixon
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Ginger,
Are you surprised that Jason has a problem with the way you have presented your beliefs? I personally think that your approach will help SOME patients, maybe even for the reasons you believe. But your claims are extravagant and extravagant claims require extravagant evidence, and none has been forthcoming. Many therapists here have tried similar techniques to what you are suggesting, if not the exact ones without finding it to be the miracle cure you suggest, every therapist here has had some exposure to referred pain and pain patterns. Your refrain of "It must work because I have lots of patients and they all get better, just try it" is not evidence. I have a list of 58 pieces of equipment, 112 nutrient supplements and 43 techniques by others with exactly the same refrain and pages of glowing testimonials. (Ok, I just made those numbers up.)
On the plus side, I don't see that you are trying to make any money from this and are just sharing something you believe in. You would probably find a more receptive audience though if you could prevent yourself from disparaging other schools of thought and practice along with proposing your own.
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Re: naming the syndrome? - October 11, 2005 6:17:00 PM
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ginger
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From: Melbourne Victoria
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Randy, thankyou for the concerns and your thoughts are well recieved. I trust that Jason is not offended by my/our robust jokey exchanges. I would be very surprised if he were. I mean no offence by the references to fish any more than he does. Or by my use of seemingly diparaging humour in a broad swipe at attitudes. If this has been construed as insulting I apologise most humbly, it is not intended. Jason and others are of course entirely capable of forming opinions based on their own means and experience. I seek to put my views forward in a way that gets attention for those valuable insights I maintain are worthy of consideration .
Take on what you will, reject at your own discretion, Rome wasn't built in a day. While your worthy fellowship continues to allow me to post here I'll do so with all the best intentions of comradely sharing .
Life is not dull unless we allow it to be, neither are we creatures of habit unless we allow habits to define us. It is the same with treatments , techniques and methods. I've never been a dull shadow, what you read is what I really believe( apart from obvious jest ).Thanks again for your wise words. Could you post the 43 techniques when you get a few minutes? , plenty of detail please.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: naming the syndrome? - October 11, 2005 6:22:00 PM
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nari
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Ginger, I might also add to Randy's and Jason's posts that you could do yourself a favour and look outside the box/square you feel safe in.
There are many ways to deal with heterogenous patient groups - but it seems you are stuck with only one. It may well be by choice, but it seems a pity to lock yourself into one way only.
Jason - I have to ask: do your patients eat the sardines, or are they a kind of poultice or BBQ moxibustion? :eek:
Nari
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Re: naming the syndrome? - October 12, 2005 3:41:00 AM
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JLS_PT_OCS
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Ginger and I will definitely hoist a pint and laugh one day. It seems he's as troubled by our exchanges as I am. Meaning not at all, and all in good fun.
Nari-
Actually, I was using them sort of the way the Chiros use activators, but instead of that clicking noise the activator makes, I was tapping the side of the fish.
Naturally I would never have them eat the fish!
What type of Vegan do you suppose I would be if I did that? :)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: naming the syndrome? - October 12, 2005 4:17:00 AM
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Yogi
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Dang, and I thought sure they were getting the Omega 3 fatty acids. Why don't you try phonophorfishesis to see if there are better results.
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Re: naming the syndrome? - October 12, 2005 4:38:00 AM
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Diane
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Jason, you tap the actual fish? Not just the tank?
Re: use of fish for tapping, depends on the extrent of vegan philosophy you adhere to. Some vegans would say you shouldn't "use" fish at all, for tapping, for treatment, for eating, for anything; that fish don't exist to fulfil any need for them we might have, tapping etc. :)
For creatures that have taste receptors and smell receptors all over the outside of their bodies I wonder how the inside of a t(r)ap tank must 'feel' after awhile.. I should think it would be a form of nocioception that even Ginger wouldn't be able to mobe the fish out of.
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Re: naming the syndrome? - October 12, 2005 5:29:00 AM
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JLS_PT_OCS
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Diane- You're right, I don't think fish are here for our use in any way. But I did want to continue with the previous example that Ginger started, he and I were having a bit of fun with the back and forth on it.
On this syndrome thing...I think reading and (trying) to get my mind around Shacklock's book has helped me see some of these issues better, from the neurodynamic point of view.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: naming the syndrome? - October 12, 2005 5:40:00 AM
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Diane
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"he and I were having a bit of fun with the back and forth on it"
Oh, I know, I wanted to play in the sandbox too.
"I think reading and (trying) to get my mind around Shacklock's book has helped me see some of these issues better, from the neurodynamic point of view"
Yes. His book is like a trail of candy wrappers that orthopaedic people can use to find their way out of the Cartesian forest.
Which leads me to this thought: Ginger, I dare you to read Michael Shacklock's book and still believe in your system to the extent that you do.
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Re: naming the syndrome? - October 12, 2005 9:03:00 AM
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Shill
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From: Madison WI USA
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Jon,
I agree with the complicated link between fitness and pain. I also agree that is sometimes helps, and sometimes doesnt. Thats as verbose as I need to get on this one. Im fit as a fiddle, but I still hurt in a number of places.
Does any one know why a fiddle happens to be the fittest of instruments? Seems to me that a trombone is rather fit, I mean, it slides and moves so well.......but I digress.
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Steve Hill PT
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Re: naming the syndrome? - October 12, 2005 1:05:00 PM
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nari
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From: Australia
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Jason
I totally agree that fish are not here for us to use as we wish.
But I am curious - how do you tap a live fish? Must be very compliant little critters, and of course very respectful of the fact you wouldn't feed them to patients or yourself...
Are you planning an RCT on fish tapping?
Shill-
Should do research on that one. I will look it up..perhaps it means 'fit' from the evolutionary viewpoint; that is, to 'fit' the environment. With all the leaping and jumping about the Irish do with their dancing..one wonders. The neural tension in the fiddle's strings must be awesome..
Nari
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